Project Summary and Conclusions

NASA Technical Reports Server (NTRS)

Sawin, Charles

1999-01-01

A top level summary of activities conducted throughout the course of the EDOMP in response to initial concerns at the outset of the program is provided. Significant findings from the investigations are summarized, together with resulting countermeasures that were implemented and flight rules that were developed in response to these findings. Subsequent paragraphs provide more information; details will be found in the referenced sections.

Re-Establishing Broca's Initial Findings

ERIC Educational Resources Information Center

Richardson, Jessica D.; Fillmore, Paul; Rorden, Chris; LaPointe, Leonard L.; Fridriksson, Julius

2012-01-01

The importance of the left inferior pre-frontal cortex (LIPC) for speech production was first popularized by Paul Broca, providing a cornerstone of behavioral neurology and laying the foundation for future research examining brain-behavior relationships. Although Broca's findings were rigorously challenged, comprehensive contradictory evidence was…

The Double Star Orbit Initial Value Problem

NASA Astrophysics Data System (ADS)

Hensley, Hagan

2018-04-01

Many precise algorithms exist to find a best-fit orbital solution for a double star system given a good enough initial value. Desmos is an online graphing calculator tool with extensive capabilities to support animations and defining functions. It can provide a useful visual means of analyzing double star data to arrive at a best guess approximation of the orbital solution. This is a necessary requirement before using a gradient-descent algorithm to find the best-fit orbital solution for a binary system.

Working Together, Creating Knowledge: The University-Industry Research Collaboration Initiative.

ERIC Educational Resources Information Center

Business-Higher Education Forum, Washington, DC.

This document provides a detailed assessment of the opportunities and challenges facing university-industry research collaborations. This report represents a synthesis of the work and findings of this initiative. It analyzes several of the critical issues facing research collaborations between industry and universities and offers suggestions to…

Master Logic Diagram: An Approach to Identify Initiating Events of HTGRs

NASA Astrophysics Data System (ADS)

Purba, J. H.

2018-02-01

Initiating events of a nuclear power plant being evaluated need to be firstly identified prior to applying probabilistic safety assessment on that plant. Various types of master logic diagrams (MLDs) have been proposedforsearching initiating events of the next generation of nuclear power plants, which have limited data and operating experiences. Those MLDs are different in the number of steps or levels and different in the basis for developing them. This study proposed another type of MLD approach to find high temperature gas cooled reactor (HTGR) initiating events. It consists of five functional steps starting from the top event representing the final objective of the safety functions to the basic event representing the goal of the MLD development, which is an initiating event. The application of the proposed approach to search for two HTGR initiating events, i.e. power turbine generator trip and loss of offsite power, is provided. The results confirmed that the proposed MLD is feasiblefor finding HTGR initiating events.

Formative Evaluation of the Understanding the Early Years Initiative. Final Report

ERIC Educational Resources Information Center

Human Resources and Skills Development Canada, 2009

2009-01-01

This report presents the findings of the formative evaluation of the Understanding the Early Years (UEY) Initiative. The evaluation was conducted to examine issues of implementation and design, early progress in achieving immediate objectives, and issues related to accountability. The evaluation team was also asked to provide preliminary guidance…

Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

PubMed

Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

2017-07-01

Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

Active Case Finding for Communicable Diseases in Prison Settings: Increasing Testing Coverage and Uptake Among the Prison Population in the European Union/European Economic Area

PubMed Central

Vroling, Hilde; Babudieri, Sergio; Monarca, Roberto; Vonk Noordegraaf-Schouten, Marije; Beer, Netta; Gomes Dias, Joana; O’Moore, Éamonn; Hedrich, Dagmar; Oordt-Speets, Anouk

2018-01-01

Abstract Prison populations are disproportionally affected by communicable diseases when compared with the general community because of a complex mix of socioeconomic determinants and environmental factors. Tailored and adequate health care provision in prisons has the potential to reach vulnerable and underserved groups and address their complex needs. We investigated the available evidence on modalities and effectiveness of active case-finding interventions in prisons by searching PubMed, Embase, and the Cochrane Library for records on prison and active case finding with no language limit. Conference abstracts and unpublished research reports also were retrieved. We analyzed the findings by testing modality, outcomes, and study quality. The included 90 records—63 peer-reviewed, 26 from gray literature, and 1 systematic review—reported variously on viral hepatitis, human immunodeficiency virus, sexually transmitted infections, and tuberculosis. No records were retrieved for other communicable diseases. Provider-initiated opt-in testing was the most frequently investigated modality. Testing at entry and provider-initiated testing were reported to result in comparatively higher uptake ranges. However, no comparative studies were identified that reported statistically significant differences between testing modalities. Positivity rates among tested inmates ranged broadly but were generally high for all diseases. The evidence on active case finding in correctional facilities is limited, heterogeneous, and of low quality, making it challenging to draw conclusions on the effect of different testing modalities. Scale-up of provider-initiated testing in European correctional facilities could substantially reduce the undiagnosed fraction and, hence, prevent additional disease transmission in both prison settings and the community at large. PMID:29648594

Treatment Options

MedlinePlus

American Tinnitus Association Donate Become A Member Member Login Find A Provider Support Search form Search Menu Close Understanding The Facts Managing Your Tinnitus Research Toward A Cure About Us Initiatives News & ...

Energy Reporting Practices among Top Energy Intensive Industries in Malaysia

NASA Astrophysics Data System (ADS)

Tasrip, N. E.; Mat Husin, N.; Alrazi, B.

2016-03-01

This study content analyses the energy content in the corporate report of top 30 Malaysian energy-intensive companies. Motivated by the gap among prior corporate social responsibility and environmental reporting studies in respect of energy, this study provides evidence of Malaysian companies’ initiative to reduce energy consumption. While the evidence suggests that not all 30 companies have reported energy-related information, the findings provide an overview on the response of energy intensive companies in relation to Malaysian government initiatives on energy.

Evaluating MyPlate: An Expanded Framework Using Traditional and Nontraditional Metrics for Assessing Health Communication Campaigns

ERIC Educational Resources Information Center

Levine, Elyse; Abbatangelo-Gray, Jodie; Mobley, Amy R.; McLaughlin, Grant R.; Herzog, Jill

2012-01-01

MyPlate, the icon and multimodal communication plan developed for the 2010 Dietary Guidelines for Americans (DGA), provides an opportunity to consider new approaches to evaluating the effectiveness of communication initiatives. A review of indicators used in assessments for previous DGA communication initiatives finds gaps in accounting for…

Finding Common Ground: Use of a Geographically-Framed Landscape Template as an Integrating Platform for an International Education Initiative

ERIC Educational Resources Information Center

Brierley, Gary; Li, Xilai; Qiao, Youming; Huang, He Qing; Wang, Zhaoyin

2018-01-01

This situated case study outlines how a place-based landscape template provided an integrative platform for the environmental arm of a cross-disciplinary international education initiative, the Three Brothers Project, wherein geographers at the University of Auckland worked alongside engineers at Tsinghua University in Beijing to support…

The Impact of ICT Initiatives in Scottish Schools: Cultural Issues.

ERIC Educational Resources Information Center

Condie, Rae; Simpson, Mary

2004-01-01

At the beginning of a series of ICT (information and communication technology) initiatives in Scottish schools by the Scottish Executive and again, 2 years later, a survey of teachers and pupils provided evidence of the impact that these strategic investments had made on the classroom. The findings indicate that while there are innovative and…

Using the knowledge-to-action framework to guide the timing of dialysis initiation.

PubMed

Sood, Manish M; Manns, Braden; Nesrallah, Gihad

2014-05-01

The optimal time at which to initiate chronic dialysis remains unknown. Using a contemporary knowledge translation approach (the knowledge-to-action framework), a pan-Canadian collaboration (CANN-NET) set out to study the scope of the problem, then develop and disseminate evidence-based guidelines addressing the timing of dialysis initiation. The purpose of this review is to summarize the key findings and describe the planned Canadian knowledge translation strategy for improving knowledge and practices pertaining to the timing dialysis initiation. New research has provided considerable insights regarding the initiation of dialysis. A Canadian cohort study identified significant variation in the estimated glomerular filtration rate level at dialysis initiation, and a survey of providers identified related knowledge gaps that might be amenable to knowledge translation interventions. A recent knowledge synthesis/guideline concluded that early dialysis initiation is costly, and provides no measureable clinical benefits. A systematic knowledge translation intervention including a multifaceted approach may aid in reducing variation in practice and improving the quality of care. Utilizing the knowledge-to-action framework, we identified practice variation and key barriers to the optimal timing for dialysis initiation that may be amenable to knowledge translation strategies.

Key principles of community-based natural resource management: a synthesis and interpretation of identified effective approaches for managing the commons.

PubMed

Gruber, James S

2010-01-01

This article examines recent research on approaches to community-based environmental and natural resource management and reviews the commonalities and differences between these interdisciplinary and multistakeholder initiatives. To identify the most effective characteristics of Community-based natural resource management (CBNRM), I collected a multiplicity of perspectives from research teams and then grouped findings into a matrix of organizational principles and key characteristics. The matrix was initially vetted (or "field tested") by applying numerous case studies that were previously submitted to the World Bank International Workshop on CBNRM. These practitioner case studies were then compared and contrasted with the findings of the research teams. It is hoped that the developed matrix may be useful to researchers in further focusing research, understanding core characteristics of effective and sustainable CBNRM, providing practitioners with a framework for developing new CBNRM initiatives for managing the commons, and providing a potential resource for academic institutions during their evaluation of their practitioner-focused environmental management and leadership curriculum.

Tinnitus: Understanding the Facts

MedlinePlus

American Tinnitus Association Donate Become A Member Member Login Find A Provider Support Search form Search Menu Close Understanding The Facts Managing Your Tinnitus Research Toward A Cure About Us Initiatives News & ...

Aggregating School Based Findings to Support Decision Making: Implications for Educational Leadership

ERIC Educational Resources Information Center

Kaniuka, Theodore S.; Vitale, Michael R.; Romance, Nancy R.

2013-01-01

Successful school reform is dependent on the quality of decisions made by educational leaders. In such decision making, educational leaders are charged with using sound research findings as the basis for choosing school reform initiatives. As part of the debate regarding the usability of various evaluative research designs in providing information…

Dynamics and stability of light-like tachyon condensation

NASA Astrophysics Data System (ADS)

Barnaby, Neil; Mulryne, David J.; Nunes, Nelson J.; Robinson, Patrick

2009-03-01

Recently, Hellerman and Schnabl considered the dynamics of unstable D-branes in the background of a linear dilaton. Remarkably, they were able to construct light-like tachyon solutions which interpolate smoothly between the perturbative and nonperturbative vacua, without undergoing the wild oscillations that plague time-like solutions. In their analysis, however, the full structure of the initial value problem for the nonlocal dynamical equations was not considered. In this paper, therefore, we reexamine the nonlinear dynamics of light-like tachyon condensation using a combination of numerical and analytical techniques. We find that for the p-adic string the monotonic behaviour obtained previously relied on a special choice of initial conditions near the unstable maximum. For generic initial conditions the wild oscillations come back to haunt us. Interestingly, we find an ``island of stability'' in initial condition space that leads to sensible evolution at late times. For the string field theory case, on the other hand, we find that the evolution is completely stable for generic choices of initial data. This provides an explicit example of a string theoretic system that admits infinitely many initial data but is nevertheless nonperturbatively stable. Qualitatively similar dynamics are obtained in nonlocal cosmologies where the Hubble damping plays a role very analogous to the dilaton gradient.

"AfterZone:" Outcomes for Youth Participating in Providence's Citywide After-School System. Executive Summary

ERIC Educational Resources Information Center

Kauh, Tina J.

2011-01-01

This executive summary highlights the main findings from our participation and outcomes analysis of the "AfterZone" initiative--a citywide system-building effort in Providence, Rhode Island, that aims to provide high-quality, accessible out-of-school-time services to middle school youth. The summary briefly defines the AfterZone's unique…

The (Missed) Potential of the Patient-centered Medical Home for Disparities.

PubMed

Reibling, Nadine; Rosenthal, Meredith B

2016-01-01

Disparities in health care and health outcomes are a significant problem in the United States. Delivery system reforms such as the patient-centered medical home (PCMH) could have important implications for disparities. To investigate what role disparities play in current PCMH initiatives and how their set-up might impact on disparities. We selected 4 state-based PCMH initiatives (Colorado, Massachusetts, Pennsylvania, and Rhode Island), 1 regional initiative in New Orleans, and 1 multistate initiative. We interviewed 30 key actors in these initiatives and 3 health policy experts on disparities in the context of PCMH. Interview data were coded using the constant comparative method. We find that disparities are not an explicit priority in PCMH initiatives. Nevertheless, many policymakers, providers, and initiative leaders believe that the model has the potential to reduce disparities. However, because of the funding structure of initiatives and the lack of adjustment of quality metrics, health policy experts do not share this optimism and safety-net providers report concerns and frustration. Even though disparities are currently not a priority in the PCMH community, the design of initiatives has important implications for disparities.

AQMEII Phase 3 in the context of HTAP2: Scope, Objectives and Findings

EPA Science Inventory

This presentation provides an overview of the third phase of the Air Quality Model Evaluation International Initiative (AQMEII) and its coordination with the work under the task force on Hemispheric Transport of Air Pollution (HTAP). It also provides a number of examples of analy...

Engaging with Quality Improvement Initiatives: A Descriptive Study of Learning in the Complex and Dynamic Context of Everyday Life for Family Child Care Providers

ERIC Educational Resources Information Center

Tonyan, Holli A.; Nuttall, Joce; Torres, Jeannette; Bridgewater, Jessie

2017-01-01

Research Findings: This article reports on family child care providers' views about their engagement with professional development programs, including providers who were and were not participating in Quality Rating and Improvement Systems in Los Angeles, California. Most providers participating in the study were taking active steps to improve…

Teaching Teachers for the Future (TTF) Project TPACK Survey: Summary of the Key Findings

ERIC Educational Resources Information Center

Finger, Glenn; Jamieson-Proctor, Romina; Cavanagh, Rob; Albion, Peter; Grimbeek, Peter; Bond, Trevor; Fitzgerald, Robert; Romeo, Geoff; Lloyd, Margaret

2013-01-01

This paper presents a summary of the key findings of the TTF TPACK Survey developed and administered for the Teaching the Teachers for the Future (TTF) Project implemented in 2011. The TTF Project, funded by an Australian Government ICT Innovation Fund grant, involved all 39 Australian Higher Education Institutions which provide initial teacher…

Public purchasers contracting external primary care providers in Central America for better responsiveness, efficiency of health care and public governance: issues and challenges.

PubMed

Macq, Jean; Martiny, Patrick; Villalobos, Luis Bernardo; Solis, Alejandro; Miranda, Jose; Mendez, Hilda Cecilia; Collins, Charles

2008-09-01

Several national health systems in Latin America initiated health reforms to counter widespread criticisms of low equity and efficiency. For public purchasing agencies, these reforms often consisted in contracting external providers for primary care provision. This paper intends to clarify both the complex and intertwined issues characterizing such contracting as well as health system performances within the context of four Central American countries. It results from a European Commission financed project lead between 2002 and 2005, involving participants from Costa Rica, Guatemala, Nicaragua, Salvador, United Kingdom, Netherlands and Belgium, whose aim was to promote exchanges between these participants. The findings presented in this paper are the results of a two stage process: (a) the design of an initial analytical framework, built upon findings from the literature, interlinking characteristics of contractual relation with health systems performances criteria and (b) the use of that framework in four case studies to identify cross-cutting issues. This paper reinforces two pivotal findings: (a) contracting requires not only technical, but also political choices and (b) it cannot be considered as a mechanical process. The unpredictability of its evolution requires a flexible and reactive approach. This should be better assimilated by national and international organizations involved in health services provision, so as to progressively come out of dogmatic approaches in deciding to initiate contractual relation with external providers for primary care provision.

History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA.

PubMed

Mittal, Maria Luisa; Vashishtha, Devesh; Sun, Shelly; Jain, Sonia; Cuevas-Mota, Jazmine; Garfein, Richard; Strathdee, Steffanie A; Werb, Dan

2017-10-03

Medication-assisted treatment (MAT) remains the gold standard for the treatment of opioid use disorder. MAT also reduces the frequency of injecting among people who inject drugs (PWID). Relatedly, data suggest that PWID play a key role in the initiation of others into drug injecting by exposing injecting practices to injection-naïve drug users. Our primary objective was to test whether a history of MAT enrollment is associated with a reduced odds of PWID providing injection initiation assistance. Preventing Injecting by Modifying Existing Responses (PRIMER; NIDA DP2-DA040256-01), is a multi-site cohort study assessing the impact of socio-structural factors on the risk that PWID provide injection initiation assistance. Data were drawn from a participating cohort of PWID in San Diego, CA. The primary outcome was reporting ever providing injection initiation assistance; the primary predictor was reporting ever being enrolled in MAT. Logistic regression was used to model associations between MAT enrollment and ever initiating others into injecting while adjusting for potential confounders. Participants (n = 354) were predominantly male (n = 249, 70%). Thirty-eight percent (n = 135) of participants reported ever initiating others into injection drug use. In multivariate analysis, participants who reported a history of MAT enrollment had significantly decreased odds of ever providing injection initiation assistance (Adjusted Odds Ratio [AOR]: 0.62, 95% Confidence Interval [CI]: 0.39-0.99). These preliminary findings suggest an association between MAT enrollment and a lower odds that male PWID report providing injection initiation assistance to injection-naïve drug users. Further research is needed to identify the pathways by which MAT enrollment may impact the risk that PWID initiate others into drug injecting.

The challenges facing initial teacher education: Irish prospective elementary teachers' mathematics subject matter knowledge

NASA Astrophysics Data System (ADS)

Hourigan, Mairéad; O'Donoghue, John

2013-01-01

Given the acknowledged relationship between teachers' knowledge, their teaching and pupil learning, teachers' mathematics subject matter knowledge (MSMK) has received increased attention internationally. As children's early mathematics experiences have been recognized as a critical stage, elementary teachers' MSMK has become a focal point among researchers and policy makers alike. International research findings have uncovered that in many cases, there is a mismatch between what is perceived to be an appropriate MSMK for teaching elementary mathematics and that demonstrated by many qualified and prospective elementary teachers. Following repeated incidences of weak MSMK during interactions with prospective elementary teachers in one Irish College of Education (provider of initial teacher education programme for elementary teachers), this study sought to examine and address the issue purposefully through two cycles of action research. This article focuses on the data collected prospective teachers' MSMK in the initial stage (reconnaissance) of these cycles, i.e. pre-test findings. While considerable differences were evident among the pre-test population, the findings suggest that prior to the intervention stage many participating prospective teachers; regardless of previous mathematics achievements or the level of mathematics study; demonstrate weaknesses and gaps in their 'common' MSMK. Particular difficulties were evident in relation to pre-test items requiring knowledge of rational numbers, conceptual understanding or problem solving. These findings highlight the inadequacy of previous mathematics achievements and indeed minimum entry requirements as predictors of MSMK for teaching. As well as its contribution at a local and national level, the findings provide an Irish perspective on this international issue.

School Leadership Interventions under the Every Student Succeeds Act: Volume I--A Review of the Evidence Base, Initial Findings. Research Report

ERIC Educational Resources Information Center

Herman, Rebecca; Gates, Susan M.; Chavez-Herrerias, Emilio R.; Harris, Mark

2016-01-01

The reauthorization of the U.S. Elementary and Secondary Education Act, referred to as the Every Student Succeeds Act (ESSA), emphasizes evidence-based initiatives while providing new flexibilities to states and districts with regard to the use of federal funds, including funds to promote effective school leadership. This report describes the…

A Review of Empirical Analyses of Disinvestment Initiatives.

PubMed

Chambers, James D; Salem, Mark N; D'Cruz, Brittany N; Subedi, Prasun; Kamal-Bahl, Sachin J; Neumann, Peter J

Disinvesting in low-value health care services provides opportunities for investment in higher value care and thus an increase in health care efficiency. To identify international experience with disinvestment initiatives and to review empirical analyses of disinvestment initiatives. We performed a literature search using the PubMed database to identify international experience with disinvestment initiatives. We also reviewed empirical analyses of disinvestment initiatives. We identified 26 unique disinvestment initiatives implemented across 11 countries. Nineteen addressed multiple intervention types, six addressed only drugs, and one addressed only devices. We reviewed 18 empirical analyses of disinvestment initiatives: 7 reported that the initiative was successful, 8 reported that the initiative was unsuccessful, and 3 reported that findings were mixed; that is, the study considered multiple services and reported a decrease in the use of some but not others. Thirty-seven low-value services were evaluated across the 18 empirical analyses, for 14 (38%) of which the disinvestment initiative led to a decline in use. Six of the seven studies that reported the disinvestment initiative to be successful included an attempt to promote the disinvestment initiative among participating clinicians. The success of disinvestment initiatives has been mixed, with fewer than half the identified empirical studies reporting that use of the low-value service was reduced. Our findings suggest that promotion of the disinvestment initiative among clinicians is a key component to the success of the disinvestment initiative. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Leaderless Transcripts and Small Proteins Are Common Features of the Mycobacterial Translational Landscape

PubMed Central

Lapierre, Pascal; Mir, Mushtaq; Chase, Michael R.; Pyle, Margaret M.; Gawande, Richa; Ahmad, Rushdy; Sarracino, David A.; Ioerger, Thomas R.; Fortune, Sarah M.; Derbyshire, Keith M.; Wade, Joseph T.; Gray, Todd A.

2015-01-01

RNA-seq technologies have provided significant insight into the transcription networks of mycobacteria. However, such studies provide no definitive information on the translational landscape. Here, we use a combination of high-throughput transcriptome and proteome-profiling approaches to more rigorously understand protein expression in two mycobacterial species. RNA-seq and ribosome profiling in Mycobacterium smegmatis, and transcription start site (TSS) mapping and N-terminal peptide mass spectrometry in Mycobacterium tuberculosis, provide complementary, empirical datasets to examine the congruence of transcription and translation in the Mycobacterium genus. We find that nearly one-quarter of mycobacterial transcripts are leaderless, lacking a 5’ untranslated region (UTR) and Shine-Dalgarno ribosome-binding site. Our data indicate that leaderless translation is a major feature of mycobacterial genomes and is comparably robust to leadered initiation. Using translational reporters to systematically probe the cis-sequence requirements of leaderless translation initiation in mycobacteria, we find that an ATG or GTG at the mRNA 5’ end is both necessary and sufficient. This criterion, together with our ribosome occupancy data, suggests that mycobacteria encode hundreds of small, unannotated proteins at the 5’ ends of transcripts. The conservation of small proteins in both mycobacterial species tested suggests that some play important roles in mycobacterial physiology. Our translational-reporter system further indicates that mycobacterial leadered translation initiation requires a Shine Dalgarno site in the 5’ UTR and that ATG, GTG, TTG, and ATT codons can robustly initiate translation. Our combined approaches provide the first comprehensive view of mycobacterial gene structures and their non-canonical mechanisms of protein expression. PMID:26536359

Leaderless Transcripts and Small Proteins Are Common Features of the Mycobacterial Translational Landscape.

PubMed

Shell, Scarlet S; Wang, Jing; Lapierre, Pascal; Mir, Mushtaq; Chase, Michael R; Pyle, Margaret M; Gawande, Richa; Ahmad, Rushdy; Sarracino, David A; Ioerger, Thomas R; Fortune, Sarah M; Derbyshire, Keith M; Wade, Joseph T; Gray, Todd A

2015-11-01

RNA-seq technologies have provided significant insight into the transcription networks of mycobacteria. However, such studies provide no definitive information on the translational landscape. Here, we use a combination of high-throughput transcriptome and proteome-profiling approaches to more rigorously understand protein expression in two mycobacterial species. RNA-seq and ribosome profiling in Mycobacterium smegmatis, and transcription start site (TSS) mapping and N-terminal peptide mass spectrometry in Mycobacterium tuberculosis, provide complementary, empirical datasets to examine the congruence of transcription and translation in the Mycobacterium genus. We find that nearly one-quarter of mycobacterial transcripts are leaderless, lacking a 5' untranslated region (UTR) and Shine-Dalgarno ribosome-binding site. Our data indicate that leaderless translation is a major feature of mycobacterial genomes and is comparably robust to leadered initiation. Using translational reporters to systematically probe the cis-sequence requirements of leaderless translation initiation in mycobacteria, we find that an ATG or GTG at the mRNA 5' end is both necessary and sufficient. This criterion, together with our ribosome occupancy data, suggests that mycobacteria encode hundreds of small, unannotated proteins at the 5' ends of transcripts. The conservation of small proteins in both mycobacterial species tested suggests that some play important roles in mycobacterial physiology. Our translational-reporter system further indicates that mycobacterial leadered translation initiation requires a Shine Dalgarno site in the 5' UTR and that ATG, GTG, TTG, and ATT codons can robustly initiate translation. Our combined approaches provide the first comprehensive view of mycobacterial gene structures and their non-canonical mechanisms of protein expression.

Insight and search in Katona's five-square problem.

PubMed

Ollinger, Michael; Jones, Gary; Knoblich, Günther

2014-01-01

Insights are often productive outcomes of human thinking. We provide a cognitive model that explains insight problem solving by the interplay of problem space search and representational change, whereby the problem space is constrained or relaxed based on the problem representation. By introducing different experimental conditions that either constrained the initial search space or helped solvers to initiate a representational change, we investigated the interplay of problem space search and representational change in Katona's five-square problem. Testing 168 participants, we demonstrated that independent hints relating to the initial search space and to representational change had little effect on solution rates. However, providing both hints caused a significant increase in solution rates. Our results show the interplay between problem space search and representational change in insight problem solving: The initial problem space can be so large that people fail to encounter impasse, but even when representational change is achieved the resulting problem space can still provide a major obstacle to finding the solution.

Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

PubMed

Gros, Daniel F

2014-12-15

Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. Published by Elsevier Ireland Ltd.

Potentials of Mobile Technology for K-12 Education: An Investigation of iPod Touch Use for English Language Learners in the United States

ERIC Educational Resources Information Center

Liu, Min; Navarrete, Cesar C.; Wivagg, Jennifer

2014-01-01

This case study investigated a m-learning initiative by a large school district in the United States to provide iPod touch devices 24/7 to teachers and students of English Language Learners. We described the initiative and presented the research findings of its implementation for two years at elementary and middle school levels. The results…

The social ecology of adolescent-initiated parent abuse: a review of the literature.

PubMed

Hong, Jun Sung; Kral, Michael J; Espelage, Dorothy L; Allen-Meares, Paula

2012-06-01

This article provides an ecological framework for understanding adolescent-initiated parent abuse. We review research on adolescent-initiated parent abuse, identifying sociodemographic characteristics of perpetrators and victims (e.g., gender, age, race/ethnicity, and socioeconomic status [SES]). Bronfenbrenner's [1] ecological systems theory is applied, which examines the risk and protective factors for adolescent-initiated parent abuse within micro- (maltreatment, domestic violence, parenting behavior and disciplinary strategies), meso- (peer influence), exo- (media influence), macro- (gender role socialization), and chronosystem (change in family structure) levels. Findings from our review suggest that older and White children are significantly more likely to abuse their parents. Females are selective in the target of their aggression, while males target family members in general. Mothers are significantly more likely to be abused than fathers. However, researchers also report variations in the association between SES and parent abuse. Domestic violence and child maltreatment are risk factors, while findings on parenting behavior and disciplinary strategies are mixed. Peer influence, exposure to media violence, gender role socialization, and change in family structure can potentially increase the risk of parent abuse. Practice and research implications are also discussed. An ecological systems framework allows for an examination of how various contexts interact and influence parent abuse behavior, and can provide needed directions for further research.

Understanding the Manager of the Project Front-End

NASA Technical Reports Server (NTRS)

Mulenburg, Gerald M.; Imprescia, Cliff (Technical Monitor)

2000-01-01

Historical data and new findings from interviews with managers of major National Aeronautics and Space Administration (NASA) projects confirm literature reports about the criticality of the front-end phase of project development, where systems engineering plays such a key role. Recent research into the management of ten contemporary NASA projects, combined with personal experience of the author in NASA, provide some insight into the relevance and importance of the project manager in this initial part of the project life cycle. The research findings provide evidence of similar approaches taken by the NASA project manager.

Computerization of material test data reporting system : interim report.

DOT National Transportation Integrated Search

1973-09-01

This study was initiated to provide an integrated system of reporting, storing, and retrieving of construction and material test data using computerized (storage-retrieval) and quality control techniques. The findings reported in this interim report ...

Empirical Inquiry Into Teacher Centers. Teacher Education Forum; Volume 3, Number 13.

ERIC Educational Resources Information Center

Ruchkin, Judith P.

This report represents a summary of a larger, on-going investigation in teacher education committed to providing a detailed description of the differences found in teacher center and noncenter programs. Part one describes the design, and then summarizes the findings, of the initial phase of the center study by providing the answers to the six…

NIAAA's rapid response to college drinking problems initiative: reinforcing the use of evidence-based approaches in college alcohol prevention.

PubMed

Dejong, William; Larimer, Mary E; Wood, Mark D; Hartman, Roger

2009-07-01

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) created the Rapid Response to College Drinking Problems initiative so that senior college administrators facing an alcohol-related crisis could get assistance from well-established alcohol researchers and NIAAA staff. Based on a competitive grant process, NIAAA selected five teams of research scientists with expertise in college drinking research. NIAAA then invited college administrators to propose interventions to address a recently experienced alcohol-related problem. Between September 2004 and September 2005, NIAAA selected 15 sites and paired each recipient college with a scientific team. Together, each program development/evaluation team, working closely with NIAAA scientific staff, jointly designed, implemented, and evaluated a Rapid Response project. This supplement reports the results of several Rapid Response projects, plus other findings of interest that emerged from that research. Eight articles present evaluation findings for prevention and treatment interventions, which can be grouped by the individual, group/interpersonal, institutional, and community levels of the social ecological framework. Additional studies provide further insights that can inform prevention and treatment programs designed to reduce alcohol-related problems among college students. This article provides an overview of these findings, placing them in the context of the college drinking intervention literature. College drinking remains a daunting problem on many campuses, but evidence-based strategies-such as those described in this supplement-provide hope that more effective solutions can be found. The Rapid Response initiative has helped solidify the necessary link between research and practice in college alcohol prevention and treatment.

Perceptions and Expectations of Youth with Disabilities. A Special Topic Report of Findings from the National Longitudinal Transition Study-2 (NLTS2). NCSER 2007-3006

ERIC Educational Resources Information Center

Wagner, Mary; Newman, Lynn; Cameto, Renee; Levine, Phyllis; Marder, Camille

2007-01-01

The National Longitudinal Transition Study-2 (NLTS2) was initiated to provide a national picture of the characteristics and experiences of youth with disabilities, including their self-representations, their schooling, their personal relationships, and their hopes for the future. This report presents findings drawn from the first time (2003) data…

White paper : Mn/DOT driver acceptance : IVI FOT evaluation report

DOT National Transportation Integrated Search

2003-06-30

This white paper provides findings from surveys and interviews for the evaluation of driver acceptance as a component of Battelles independent evaluation of the Mn/DOT Intelligent Vehicle Initiative (IVI) Field Operational Test (FOT), sponsored by th...

Developing and Implementing a Food Insecurity Screening Initiative for Adult Patients Living With Type 2 Diabetes.

PubMed

Thomas, Brittany; Fitzpatrick, Sandra; Sidani, Souraya; Gucciardi, Enza

2018-06-01

Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto. A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes. Interviews with 10 patients and a focus group with 15 care providers elicited feedback on the relevance and acceptance of the food insecurity screening questions and a care algorithm. Subsequently, 5 care providers at 4 sites implemented the screening initiative over 2 weeks, screening 33 patients. After implementation, 7 patients and 5 care providers were interviewed to assess the acceptability and feasibility of the screening initiative. Our findings demonstrate that patients are willing to share their experiences of food insecurity, despite the sensitivity of this topic. Screening elicited information about how patients cope with food insecurity and how this affects their ability to self-manage diabetes. Care providers found this information helpful in directing their care and support for patients. Using a standardized, respectful method of assessing food insecurity can better equip health-care providers to support food-insecure patients with diabetes self-management. Further evaluation of this initiative is needed to determine how food insecurity screening can affect patients' self-management and related health outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative.

PubMed

Myers, B; Petersen Williams, P; Johnson, K; Govender, R; Manderscheid, R; Koch, J R

2017-01-30

A performance measurement system - the Service Quality Measures (SQM) initiative - has been developed to monitor the quality of South Africa (SA)'s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63). In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df)=3.70), p=0.015), awareness (r=0.78, p<0.0001), leadership support (r=0.70, p<0.0001), resources (r=0.65, p<0.0001), openness to change (r=0.372, p=0.001), and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE) 0.08, t=4.4, p<0.0001) and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001) were significantly associated with readiness to adopt this system. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.

Wellness programs: a remedy for reducing healthcare costs.

PubMed

Kocakulah, Mehmet C; Joseforsky, Holly

2002-01-01

Offering wellness programs has become a popular method for preserving the health of employees in the hope of generating lower healthcare expenses and, in turn, higher profits. This article offers a cost/benefits analysis of providing wellness programs, to determine whether such programs could add value to a company. Recommendations follow for how to implement a successful wellness program with minimal initial costs should an analysis find that wellness initiatives would prove beneficial.

A hypothesis-driven physical examination learning and assessment procedure for medical students: initial validity evidence.

PubMed

Yudkowsky, Rachel; Otaki, Junji; Lowenstein, Tali; Riddle, Janet; Nishigori, Hiroshi; Bordage, Georges

2009-08-01

Diagnostic accuracy is maximised by having clinical signs and diagnostic hypotheses in mind during the physical examination (PE). This diagnostic reasoning approach contrasts with the rote, hypothesis-free screening PE learned by many medical students. A hypothesis-driven PE (HDPE) learning and assessment procedure was developed to provide targeted practice and assessment in anticipating, eliciting and interpreting critical aspects of the PE in the context of diagnostic challenges. This study was designed to obtain initial content validity evidence, performance and reliability estimates, and impact data for the HDPE procedure. Nineteen clinical scenarios were developed, covering 160 PE manoeuvres. A total of 66 Year 3 medical students prepared for and encountered three clinical scenarios during required formative assessments. For each case, students listed anticipated positive PE findings for two plausible diagnoses before examining the patient; examined a standardised patient (SP) simulating one of the diagnoses; received immediate feedback from the SP, and documented their findings and working diagnosis. The same students later encountered some of the scenarios during their Year 4 clinical skills examination. On average, Year 3 students anticipated 65% of the positive findings, correctly performed 88% of the PE manoeuvres and documented 61% of the findings. Year 4 students anticipated and elicited fewer findings overall, but achieved proportionally more discriminating findings, thereby more efficiently achieving a diagnostic accuracy equivalent to that of students in Year 3. Year 4 students performed better on cases on which they had received feedback as Year 3 students. Twelve cases would provide a reliability of 0.80, based on discriminating checklist items only. The HDPE provided medical students with a thoughtful, deliberate approach to learning and assessing PE skills in a valid and reliable manner.

Nuclear Reactions in the Crusts of Accreting Neutron Stars

NASA Astrophysics Data System (ADS)

Lau, R.; Beard, M.; Gupta, S. S.; Schatz, H.; Afanasjev, A. V.; Brown, E. F.; Deibel, A.; Gasques, L. R.; Hitt, G. W.; Hix, W. R.; Keek, L.; Möller, P.; Shternin, P. S.; Steiner, A. W.; Wiescher, M.; Xu, Y.

2018-05-01

X-ray observations of transiently accreting neutron stars during quiescence provide information about the structure of neutron star crusts and the properties of dense matter. Interpretation of the observational data requires an understanding of the nuclear reactions that heat and cool the crust during accretion and define its nonequilibrium composition. We identify here in detail the typical nuclear reaction sequences down to a depth in the inner crust where the mass density is ρ =2× {10}12 {{g}} {cm}}-3 using a full nuclear reaction network for a range of initial compositions. The reaction sequences differ substantially from previous work. We find a robust reduction of crust impurity at the transition to the inner crust regardless of initial composition, though shell effects can delay the formation of a pure crust somewhat to densities beyond ρ =2× {10}12 {{g}} {cm}}-3. This naturally explains the small inner crust impurity inferred from observations of a broad range of systems. The exception are initial compositions with A ≥ 102 nuclei, where the inner crust remains impure with an impurity parameter of Q imp ≈ 20 owing to the N = 82 shell closure. In agreement with previous work, we find that nuclear heating is relatively robust and independent of initial composition, while cooling via nuclear Urca cycles in the outer crust depends strongly on initial composition. This work forms a basis for future studies of the sensitivity of crust models to nuclear physics and provides profiles of composition for realistic crust models.

Seminar on the Economics of Education-Investment Decisions and Contributions to Income and Economic Growth. Final Report.

ERIC Educational Resources Information Center

Hansen, W. Lee; Weisbrod, Burton A.

A workshop on the Economics of Human Resources was initiated in 1966, at the University of Wisconsin to provide a vehicle for stimulating research by both faculty and graduate students and to provide a medium for disseminating the latest research findings of outside scholars, University of Wisconsin faculty and graduate students. This document is…

A Qualitative Study of the Lived Experiences of Disabled Post-Transition Students in Higher Education Institutions in Northern Ireland

ERIC Educational Resources Information Center

Redpath, Jennifer; Kearney, Patricia; Nicholl, Peter; Mulvenna, Maurice; Wallace, Jonathan; Martin, Suzanne

2013-01-01

This article provides a systematic analysis of 13 in-depth interviews of disabled students from universities in Northern Ireland. Undertaken as part of the Uni4U initiative, the findings presented describe barriers experienced by students with disabilities to participation in higher education. The students provided comments concerning their…

Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

PubMed

Wolcott, Vickee; Agarwal, Ritu; Nelson, D Alan

2017-04-06

Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it? We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients. The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system. We used a negative binomial regression model on over 25 million observations to determine the adjusted association between provider-initiated and provider-response messaging and subsequent messaging by their patients in this population over a 4-year period. Prior provider-initiated and response messaging levels were associated with new patient messaging when controlling for the patient's health care utilization and diagnoses, with the strongest association for high provider-response messaging level. Patients whose providers were highly responsive to the messages of other patients initiated 334% more secure messages (P<.001) than patients with providers who did not personally respond to other patients' messages. Our results indicate that provider messaging usage levels and types thereof predict their patients' subsequent communication behavior. The findings suggest the need for more study into the factors associated with provider messaging to fully understand the mechanisms of this relationship. ©Vickee Wolcott, Ritu Agarwal, D. Alan Nelson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.04.2017.

Basins of distinct asymptotic states in the cyclically competing mobile five species game

NASA Astrophysics Data System (ADS)

Kim, Beomseok; Park, Junpyo

2017-10-01

We study the dynamics of cyclic competing mobile five species on spatially extended systems originated from asymmetric initial populations and investigate the basins for the three possible asymptotic states, coexistence of all species, existences of only two independent species, and the extinction. Through extensive numerical simulations, we find a prosperous dependence on initial conditions for species biodiversity. In particular, for fixed given equal densities of two relevant species, we find that only five basins for the existence of two independent species exist and they are spirally entangled for high mobility. A basin of coexistence is outbreaking when the mobility parameter is decreased through a critical value and surrounded by the other five basins. For fixed given equal densities of two independent species, however, we find that basin structures are not spirally entangled. Further, final states of two independent species are totally different. For all possible considerations, the extinction state is not witnessed which is verified by the survival probability. To provide the validity of basin structures from lattice simulations, we analyze the system in mean-field manners. Consequently, results on macroscopic levels are matched to direct lattice simulations for high mobility regimes. These findings provide a good insight into the fundamental issue of the biodiversity among many species than previous cases.

Building organizational capacity for evidence use: the experience of two Canadian healthcare organizations.

PubMed

Humphries, Serena; Hampe, Tanis; Larsen, Derrick; Bowen, Sarah

2013-01-01

The use of evidence to inform decisions at the program level within healthcare organizations is a priority. The purpose of this article is to provide an overview of an innovative collaboration between two Canadian healthcare organizations to build organizational capacity for evidence use in program planning, implementation, and evaluation. The lessons learned from the initiative suggest that other healthcare organizations would find the capacity-building strategies identified and developed through the initiative useful.

Making sense of HUSK: practice implications for social change initiatives.

PubMed

McBeath, Bowen

2015-01-01

As an exemplar of bottom-up progressive social experimentation, HUSK provides opportunities to examine how innovative practice is supported and challenged in bureaucratic settings. In this analysis the author uses a sensemaking lens to identify critical issues and questions for those seeking to promote progressive change initiative in social welfare systems. Findings identify essential organizational and managerial supports needed to support service user voice and participation and reinforce the importance of reflexivity in practice and research.

Daughter-Initiated Cancer Screening Appeals to Mothers.

PubMed

Mosavel, M; Genderson, M W

2016-12-01

Youth-initiated health interventions may provide a much needed avenue for intergenerational dissemination of health information among families who bear the greatest burden from unequal distribution of morbidity and mortality. The findings presented in this paper are from a pilot study of the feasibility and impact of female youth-initiated messages (mostly daughters) encouraging adult female relatives (mostly mothers) to obtain cancer screening within low-income African American families living in a Southern US state. Results are compared between an intervention and control group. Intervention group youth (n = 22) were exposed to a 60-min interactive workshop where they were assisted to prepare a factual and emotional appeal to their adult relative to obtain specific screening. The face-to-face workshops were guided by the Elaboration Likelihood Model (ELM) and the Theory of Planned Behavior (TPB). Control group girls (n = 18) were only provided with a pamphlet with information about cancer screening and specific steps about how to encourage their relative to obtain screening. Intervention youth (86 %) and adults (82 %) reported that the message was shared while 71 % in the control group reported sharing or receiving the message. Importantly, more women in the intervention group reported that they obtained a screen (e.g., mammogram, Pap smear) directly based on the youth's appeal. These findings can have major implications for youth-initiated health promotion efforts, especially among hard-to-reach populations.

Daughter-Initiated Cancer Screening Appeals to Mothers

PubMed Central

Mosavel, Maghboeba; Genderson, Maureen Wilson

2015-01-01

Youth-initiated health interventions may provide a much needed avenue for intergenerational dissemination of health information among families who bear the greatest burden from unequal distribution of morbidity and mortality. The findings presented in this paper are from a pilot study of the feasibility and impact of female youth-initiated messages (mostly daughters) encouraging adult female relatives (mostly mothers) to obtain cancer screening within low income African American families living in a Southern US state. Results are compared between an intervention and control group. Intervention group youth (n=22) were exposed to a 60-minute interactive workshop where they were assisted to prepare a factual and emotional appeal to their adult relative to obtain specific screening. The face-to-face workshops were guided by the Elaboration Likelihood Model (ELM) and the Theory of Planned Behavior (TPB). Control group girls (n=18) were only provided with a pamphlet with information about cancer screening and specific steps about how to encourage their relative to obtain screening. Intervention youth (86%) and adults (82%) reported that the message was shared while 71% in the control group reported sharing or receiving the message. Importantly, more women in the intervention group reported that they obtained a screen (e.g., mammogram, Pap smear) directly based on the youth's appeal. These findings can have major implications for youth-initiated health promotion efforts, especially among hard-to-reach populations. PMID:26590969

20 CFR 652.8 - Administrative provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... determination. Such determinations shall be based on the requirements of the Act, regulations, and State plan. (i) The initial determination shall identify the audit findings, state the Secretary's proposed determination of the allowability of questioned costs and activities, and provide for informal resolution of...

Health provider responsiveness to social accountability initiatives in low- and middle-income countries: a realist review.

PubMed

Lodenstein, Elsbet; Dieleman, Marjolein; Gerretsen, Barend; Broerse, Jacqueline E W

2017-02-01

Social accountability in the health sector has been promoted as a strategy to improve the quality and performance of health providers in low- and middle-income countries. Whether improvements occur, however, depends on the willingness and ability of health providers to respond to societal pressure for better care. This article uses a realist approach to review cases of collective citizen action and advocacy with the aim to identify key mechanisms of provider responsiveness. Purposeful searches for cases were combined with a systematic search in four databases. To be included in the review, the initiatives needed to describe at least one outcome at the level of frontline service provision. Some 37 social accountability initiatives in 15 countries met these criteria. Using a realist approach, retroductive analysis and triangulation of methods and sources were performed to construct Context-Mechanism-Outcome configurations that explain potential pathways to provider responsiveness. The findings suggest that health provider receptivity to citizens' demands for better health care is mediated by health providers' perceptions of the legitimacy of citizen groups and by the extent to which citizen groups provide personal and professional support to health providers. Some citizen groups activated political or formal bureaucratic accountability channels but the effect on provider responsiveness of such strategies was more mixed. Favourable contexts for health provider responsiveness comprise socio-political contexts in which providers self-identify as activists, health system contexts in which health providers depend on citizens' expertise and capacities, and health system contexts where providers have the self-perceived ability to change the system in which they operate. Rather than providing recipes for successful social accountability initiatives, the synthesis proposes a programme theory that can support reflections on the theories of change underpinning social accountability initiatives and interventions to improve the quality of primary health care in different settings. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

ER stress inducer tunicamycin suppresses the self-renewal of glioma-initiating cell partly through inhibiting Sox2 translation.

PubMed

Xing, Yang; Ge, Yuqing; Liu, Chanjuan; Zhang, Xiaobiao; Jiang, Jianhai; Wei, Yuanyan

2016-06-14

Glioma-initiating cells possess tumor-initiating potential and are relatively resistant to conventional chemotherapy and irradiation. Therefore, their elimination is an essential factor for the development of efficient therapy. Here, we report that endoplasmic reticulum (ER) stress inducer tunicamycin inhibits glioma-initiating cell self-renewal as determined by neurosphere formation assay. Moreover, tunicamycin decreases the efficiency of glioma-initiating cell to initiate tumor formation. Although tunicamycin induces glioma-initiating cell apoptosis, apoptosis inhibitor z-VAD-fmk only partly abrogates the reduction in glioma-initiating cell self-renewal induced by tunicamycin. Indeed, tunicamycin reduces the expression of self-renewal regulator Sox2 at translation level. Overexpression of Sox2 obviously abrogates the reduction in glioma-initiating cell self-renewal induced by tunicamycin. Taken together, tunicamycin suppresses the self-renewal and tumorigenic potential of glioma-initiating cell partly through reducing Sox2 translation. This finding provides a cue to potential effective treatment of glioblastoma through controlling stem cells.

Gestational Age at First Antenatal Care Visit in Malawi.

PubMed

Mkandawire, Paul

2015-11-01

This paper examines the gestational age at first antenatal care (ANC) visit and factors associated with timely initiation of ANC in Malawi in a context where maternal and child health services are generally provided for free. Lognormal survival models are applied to Demographic and Health Survey data from a nationally representative sample of women (n = 13,588) of child-bearing age. The findings of this study show that less than 30 % of pregnant women initiate ANC within the World Health Organization recommended gestational timeframe of 16 weeks or earlier. The hazard analysis shows a gradient in the initiation of ANC by maternal education level, with least educated mothers most likely to delay their first ANC visit. However, after adjusting for variables capturing intimate partner violence in the multivariate models, the effect of maternal education attenuated and lost statistical significance. Other significant predictors of gestational age at first ANC include media exposure, perceived distance from health facility, age, and birth order. The findings of the study link domestic violence directly with the gestational age at which mothers initiate ANC, suggesting that gender-based violence may operate through delayed initiation of ANC to undermine maternal and child health outcomes.

Driven neutron star collapse: Type I critical phenomena and the initial black hole mass distribution

NASA Astrophysics Data System (ADS)

Noble, Scott C.; Choptuik, Matthew W.

2016-01-01

We study the general relativistic collapse of neutron star (NS) models in spherical symmetry. Our initially stable models are driven to collapse by the addition of one of two things: an initially ingoing velocity profile, or a shell of minimally coupled, massless scalar field that falls onto the star. Tolman-Oppenheimer-Volkoff (TOV) solutions with an initially isentropic, gamma-law equation of state serve as our NS models. The initial values of the velocity profile's amplitude and the star's central density span a parameter space which we have surveyed extensively and which we find provides a rich picture of the possible end states of NS collapse. This parameter space survey elucidates the boundary between Type I and Type II critical behavior in perfect fluids which coincides, on the subcritical side, with the boundary between dispersed and bound end states. For our particular model, initial velocity amplitudes greater than 0.3 c are needed to probe the regime where arbitrarily small black holes can form. In addition, we investigate Type I behavior in our system by varying the initial amplitude of the initially imploding scalar field. In this case we find that the Type I critical solutions resemble TOV solutions on the 1-mode unstable branch of equilibrium solutions, and that the critical solutions' frequencies agree well with the fundamental mode frequencies of the unstable equilibria. Additionally, the critical solution's scaling exponent is shown to be well approximated by a linear function of the initial star's central density.

A Survey of Levels of Supervisory Support and Maintenance of Effects Reported by Educators Involved in Direct Instruction Implementations.

ERIC Educational Resources Information Center

Blakely, Molly Riley

2001-01-01

Provides results of a survey given to 150 educators across 5 school Direct Instruction implementations. Proposes that this survey is an initial step in the direction of determining teacher preferences with regard to levels of support and coaching provided in school. Finds teachers identified the team-teach method of coaching as the most effective.…

Environmental computing compendium - background and motivation

NASA Astrophysics Data System (ADS)

Heikkurinen, Matti; Kranzlmüller, Dieter

2017-04-01

The emerging discipline of environmental computing brings together experts in applied, advanced environmental modelling. The application domains address several fundamental societal challenges, ranging from disaster risk reduction to sustainability issues (such as food security on the global scale). The community has used an Intuitive, pragmatic approach when determining which initiatives are considered to "belong to the discipline". The community's growth is based on sharing of experiences and tools provides opportunities for reusing solutions or applying knowledge in new settings. Thus, limiting possible synergies by applying an arbitrary, formal definition to exclude some of the sources of solutions and knowledge would be counterproductive. However, the number of individuals and initiatives involved has grown to the level where a survey of initiatives and sub-themes they focus on is of interest. By surveying the project landscape and identifying common themes and building a shared vocabulary to describe them we can both communicate the relevance of the new discipline to the general public more easily and make it easier for the new members of the community to find the most promising collaboration partners. This talk presents the methodology and initial findings of the initial survey of the environmental computing initiatives and organisations, as well as approaches that could lead to an environmental computing compendium that would be a collaborative maintained shared resource of the environmental computing community.

Preferences for the Return of Individual Results From Research on Pediatric Biobank Samples.

PubMed

Christensen, Kurt D; Savage, Sarah K; Huntington, Noelle L; Weitzman, Elissa R; Ziniel, Sonja I; Bacon, Phoebe L; Cacioppo, Cara N; Green, Robert C; Holm, Ingrid A

2017-04-01

Discussions about disclosing individual genetic research results include calls to consider participants' preferences. In this study, parents of Boston Children's Hospital patients set preferences for disclosure based on disease preventability and severity, and could exclude mental health, developmental, childhood degenerative, and adult-onset disorders. Participants reviewed hypothetical reports and reset preferences, if desired. Among 661 participants who initially wanted all results (64%), 1% reset preferences. Among 336 participants who initially excluded at least one category (36%), 38% reset preferences. Participants who reset preferences added 0.9 categories, on average; and their mean satisfaction on 0 to 10 scales increased from 4.7 to 7.2 ( p < .001). Only 2% reduced the number of categories they wanted disclosed. Findings demonstrate the benefits of providing examples of preference options and the tendency of participants to want results disclosed. Findings also suggest that preference-setting models that do not provide specific examples of results could underestimate participants' desires for information.

Preferences for the return of individual results from research on pediatric biobank samples

PubMed Central

Christensen, Kurt D.; Savage, Sarah K.; Huntington, Noelle L.; Weitzman, Elissa R.; Ziniel, Sonja I.; Bacon, Phoebe L.; Cacioppo, Cara N.; Green, Robert C.; Holm, Ingrid A.

2016-01-01

Discussions about disclosing individual genetic research results include calls to consider participants’ preferences. In this study, parents of Boston Children’s Hospital patients set preferences for disclosure based on disease preventability and severity, and could exclude mental health, developmental, childhood degenerative, and adult-onset disorders. Participants reviewed hypothetical reports and reset preferences, if desired. Among 661 participants who initially wanted all results (64%), 1% reset preferences. Among 336 participants who initially excluded at least one category (36%), 38% reset preferences. Participants who reset preferences added 0.9 categories, on average; and their mean satisfaction on 0–10 scales increased from 4.7 to 7.2 (p<0.001). Only 2% reduced the number of categories they wanted disclosed. Findings demonstrate the benefits of providing examples of preference options and the tendency of participants to want results disclosed. Findings also suggest that preference-setting models that do not provide specific examples of results could underestimate participants’ desires for information. PMID:28421887

Fully automatic detection of salient features in 3-d transesophageal images.

PubMed

Curiale, Ariel H; Haak, Alexander; Vegas-Sánchez-Ferrero, Gonzalo; Ren, Ben; Aja-Fernández, Santiago; Bosch, Johan G

2014-12-01

Most automated segmentation approaches to the mitral valve and left ventricle in 3-D echocardiography require a manual initialization. In this article, we propose a fully automatic scheme to initialize a multicavity segmentation approach in 3-D transesophageal echocardiography by detecting the left ventricle long axis, the mitral valve and the aortic valve location. Our approach uses a probabilistic and structural tissue classification to find structures such as the mitral and aortic valves; the Hough transform for circles to find the center of the left ventricle; and multidimensional dynamic programming to find the best position for the left ventricle long axis. For accuracy and agreement assessment, the proposed method was evaluated in 19 patients with respect to manual landmarks and as initialization of a multicavity segmentation approach for the left ventricle, the right ventricle, the left atrium, the right atrium and the aorta. The segmentation results revealed no statistically significant differences between manual and automated initialization in a paired t-test (p > 0.05). Additionally, small biases between manual and automated initialization were detected in the Bland-Altman analysis (bias, variance) for the left ventricle (-0.04, 0.10); right ventricle (-0.07, 0.18); left atrium (-0.01, 0.03); right atrium (-0.04, 0.13); and aorta (-0.05, 0.14). These results indicate that the proposed approach provides robust and accurate detection to initialize a multicavity segmentation approach without any user interaction. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Diabetes Self-management Quality Improvement Initiative for Medically Underserved Patients.

PubMed

Seol, Haesun; Thompson, Mark; Kreider, Kathryn Evans; Vorderstrasse, Allison

The burden of diabetes is greater for minorities and medically underserved populations in the United States. An evidence-based provider-delivered diabetes self-management education intervention was implemented in a federally qualified health center for medically underserved adult patients with type 2 diabetes. The findings provide support for the efficacy of the intervention on improvement in self-management behaviors and glycemic control among underserved patients with diabetes, while not substantially changing provider visit time or workload.

Strand invasion structures in the inverted repeat of Candida albicans mitochondrial DNA reveal a role for homologous recombination in replication.

PubMed

Gerhold, Joachim M; Aun, Anu; Sedman, Tiina; Jõers, Priit; Sedman, Juhan

2010-09-24

Molecular recombination and transcription are proposed mechanisms to initiate mitochondrial DNA (mtDNA) replication in yeast. We conducted a comprehensive analysis of mtDNA from the yeast Candida albicans. Two-dimensional agarose gel electrophoresis of mtDNA intermediates reveals no bubble structures diagnostic of specific replication origins, but rather supports recombination-driven replication initiation of mtDNA in yeast. Specific species of Y structures together with DNA copy number analyses of a C. albicans mutant strain provide evidence that a region in a mainly noncoding inverted repeat is predominantly involved in replication initiation via homologous recombination. Our further findings show that the C. albicans mtDNA forms a complex branched network that does not contain detectable amounts of circular molecules. We provide topological evidence for recombination-driven mtDNA replication initiation and introduce C. albicans as a suitable model organism to study wild-type mtDNA maintenance in yeast. Copyright © 2010 Elsevier Inc. All rights reserved.

Speech-language pathologists and the Common Core Standards initiative: an opportunity for leadership and organizational change.

PubMed

Dunkle, Jennifer; Flynn, Perry

2012-05-01

The Common Core State Standards initiative within public school education is designed to provide uniform guidelines for academic standards, including more explicit language targets. Speech-language pathologists (SLPs) are highly qualified language experts who may find new leadership roles within their clinical practice using the Common Core Standards. However, determining its usage by SLPs in clinical practice needs to be examined. This article seeks to discover the social context of organizations and organizational change in relation to clinical practice. Specifically, this article presents the diffusion of innovations theory to explain how initiatives move from ideas to institutionalization and the importance of social context in which these initiatives are introduced. Next, the values of both SLPs and organizations will be discussed. Finally, this article provides information on how to affect organizational change through the value of an affirmative, socially based theoretical perspective and methodology, appreciative inquiry. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nuclear Reactions in the Crusts of Accreting Neutron Stars

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

Lau, Rita; Beard, Mary; Gupta, Sanjib S.

X-ray observations of transiently accreting neutron stars during quiescence provide information about the structure of neutron star crusts and the properties of dense matter. Interpretation of the observational data requires an understanding of the nuclear reactions that heat and cool the crust during accretion and define its nonequilibrium composition. We identify here in detail the typical nuclear reaction sequences down to a depth in the inner crust where the mass density ismore » $$\\rho =2\\times {10}^{12}\\,{\\rm{g}}\\,{\\mathrm{cm}}^{-3}$$ using a full nuclear reaction network for a range of initial compositions. The reaction sequences differ substantially from previous work. We find a robust reduction of crust impurity at the transition to the inner crust regardless of initial composition, though shell effects can delay the formation of a pure crust somewhat to densities beyond $$\\rho =2\\times {10}^{12}\\,{\\rm{g}}\\,{\\mathrm{cm}}^{-3}$$. This naturally explains the small inner crust impurity inferred from observations of a broad range of systems. The exception are initial compositions with A ≥ 102 nuclei, where the inner crust remains impure with an impurity parameter of Q imp ≈ 20 owing to the N = 82 shell closure. In agreement with previous work, we find that nuclear heating is relatively robust and independent of initial composition, while cooling via nuclear Urca cycles in the outer crust depends strongly on initial composition. As a result, this work forms a basis for future studies of the sensitivity of crust models to nuclear physics and provides profiles of composition for realistic crust models.« less

Nuclear Reactions in the Crusts of Accreting Neutron Stars

DOE PAGES

Lau, Rita; Beard, Mary; Gupta, Sanjib S.; ...

2018-05-24

X-ray observations of transiently accreting neutron stars during quiescence provide information about the structure of neutron star crusts and the properties of dense matter. Interpretation of the observational data requires an understanding of the nuclear reactions that heat and cool the crust during accretion and define its nonequilibrium composition. We identify here in detail the typical nuclear reaction sequences down to a depth in the inner crust where the mass density ismore » $$\\rho =2\\times {10}^{12}\\,{\\rm{g}}\\,{\\mathrm{cm}}^{-3}$$ using a full nuclear reaction network for a range of initial compositions. The reaction sequences differ substantially from previous work. We find a robust reduction of crust impurity at the transition to the inner crust regardless of initial composition, though shell effects can delay the formation of a pure crust somewhat to densities beyond $$\\rho =2\\times {10}^{12}\\,{\\rm{g}}\\,{\\mathrm{cm}}^{-3}$$. This naturally explains the small inner crust impurity inferred from observations of a broad range of systems. The exception are initial compositions with A ≥ 102 nuclei, where the inner crust remains impure with an impurity parameter of Q imp ≈ 20 owing to the N = 82 shell closure. In agreement with previous work, we find that nuclear heating is relatively robust and independent of initial composition, while cooling via nuclear Urca cycles in the outer crust depends strongly on initial composition. As a result, this work forms a basis for future studies of the sensitivity of crust models to nuclear physics and provides profiles of composition for realistic crust models.« less

Local Gov`t assistance in commercial waste reduction & recycling

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

Hannah, C.W.

This paper outlines programs and strategies for reducing the waste stream by targeting the commercial, industrial and institutional sectors. The programs described are implemented by the Wake County Solid Waste Management Division, North Carolina. Findings and recommendations of a task force focusing on the role of the private sector in meeting state waste reduction mandates are summarized. Commercial initiatives, educational initiatives, and a grant program are described. Several case studies are provided which overview the variety of businesses and waste materials addressed.

Preparation of freezing quantum state for quantum coherence

NASA Astrophysics Data System (ADS)

Yang, Lian-Wu; Man, Zhong-Xiao; Zhang, Ying-Jie; Han, Feng; Du, Shao-jiang; Xia, Yun-Jie

2018-06-01

We provide a method to prepare the freezing quantum state for quantum coherence via unitary operations. The initial product state consists of the control qubit and target qubit; when it satisfies certain conditions, the initial product state converts into the particular Bell diagonal state under the unitary operations, which have the property of freezing of quantum coherence under quantum channels. We calculate the frozen quantum coherence and corresponding quantum correlations, and find that the quantities are determined by the control qubit only when the freezing phenomena occur.

Carcinogen-induced mutations in the mouse c-Ha-ras gene provide evidence of multiple pathways for tumor progression.

PubMed Central

Brown, K; Buchmann, A; Balmain, A

1990-01-01

A number of mouse skin tumors initiated by the carcinogens N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), methylnitrosourea (MNU), 3-methylcholanthrene (MCA), and 7,12-dimethylbenz[a]anthracene (DMBA) have been shown to contain activated Ha-ras genes. In each case, the point mutations responsible for activation have been characterized. Results presented demonstrate the carcinogen-specific nature of these ras mutations. For each initiating agent, a distinct spectrum of mutations is observed. Most importantly, the distribution of ras gene mutations is found to differ between benign papillomas and carcinomas, suggesting that molecular events occurring at the time of initiation influence the probability with which papillomas progress to malignancy. This study provides molecular evidence in support of the existence of subsets of papillomas with differing progression frequencies. Thus, the alkylating agents MNNG and MNU induced exclusively G ---- A transitions at codon 12, with this mutation being found predominantly in papillomas. MCA initiation produced both codon 13 G ---- T and codon 61 A ---- T transversions in papillomas; only the G ---- T mutation, however, was found in carcinomas. These findings provide strong evidence that the mutational activation of Ha-ras occurs as a result of the initiation process and that the nature of the initiating event can affect the probability of progression to malignancy. Images PMID:2105486

Health justice partnerships: initial insights into the delivery of an integrated health and legal service for youth in regional Victoria.

PubMed

Ollerenshaw, Alison; Camilleri, Margaret

2017-01-01

This article presents interim findings from research examining the implementation of a health justice partnership (HJP) focusing on the legal and health needs of regional young people. HJPs provide an innovative service model offering an integrated health and legal service for the community. HJPs are a relatively new service model for Australia, yet the program is well suited to meet the needs of particular population cohorts, including young people and those in regional locations experiencing complex legal issues. Funded by the Victorian Legal Services Board and Commissioner, an HJP in partnership with three organisations was established in a large regional area in Victoria, Australia. Research is being conducted alongside the program to examine its impact on young people, and the implications on practice for staff in the partner organisations. Findings provide preliminary support for the HJP model with a number of young people - from predominantly disadvantaged backgrounds and with varying legal issues - having been referred to the program in the first 6 months. Referrals were received from both partner agencies and external agencies. Initial client and staff survey responses indicate that the legal problem of the young people was affecting how they feel. While these findings provide preliminary support for the HJP further research will offer longer term insights about HJPs within the Australian context, particularly rural and regional settings.

Obesity services planning framework for interprofessional primary care organizations.

PubMed

Brauer, Paula; Royall, Dawna; Dwyer, John; Edwards, A Michelle; Hussey, Tracy; Kates, Nick; Smith, Heidi; Kirkconnell, Ross

2017-03-01

Aim We report on a formative project to develop an organization-level planning framework for obesity prevention and management services. It is common when developing new services to first develop a logic model outlining expected outcomes and key processes. This can be onerous for single primary care organizations, especially for complex conditions like obesity. The initial draft was developed by the research team, based on results from provider and patient focus groups in one large Family Health Team (FHT) in Ontario. This draft was reviewed and activities prioritized by 20 FHTs using a moderated electronic consensus process. A national panel then reviewed the draft. Findings Providers identified five main target groups: pregnancy to 2, 3-12, 13-18, 18+ years at health risk, and 18+ with complex care needs. Desired outcomes were identified and activities were prioritized under categories: raising awareness (eg, providing information and resources on weight-health), identification and initial management (eg, wellness care), follow-up management (eg, group programs), expanded services (eg, availability of team services), and practice initiatives (eg, interprofessional education). Overall, there was strong support for raising awareness by providing information on the weight-health connection and on community services. There was also strong support for growth assessment in pediatric care. In adults, there was strong support for wellness care/health check visits and episodic care to identify people for interventions, for group programs, and for additional provider education. Joint development by different teams proved useful for consensus on outcomes and for ensuring relevancy across practices. While priorities will vary depending on local context, the basic descriptions of care processes were endorsed by reviewers. Key next steps are to trial the use of the framework and for further implementation studies to find optimally effective approaches for obesity prevention and management across the lifespan.

BIOREMEDIATION FIELD EVALUATION: EIELSON AIR FORCE BASE, ALASKA (EPA/540/R-95/533)

EPA Science Inventory

This publication, one of a series presenting the findings of the Bioremediation Field Initiatives bioremediation field evaluations, provides a detailed summary of the evaluation conducted at the Eielson Air Force Base (AFB) Superfund site in Fairbanks, Alaska. At this site, the ...

Linking Outcomes to Organizational Planning.

ERIC Educational Resources Information Center

Ligon, Glynn; Jackson, Elaine

Linking Outcomes to Organizational Planning (LOOP) was initiated during the 1984-85 school year in the Austin (Texas) Independent School District. LOOP was designed to ensure that evaluation, research, and informal findings became part of the instructional planning loop; to provide information to the Superintendent on progress toward priorities…

Unintended Consequences of Evidence-Based Treatment Policy Reform: Is Implementation the Goal or the Strategy for Higher Quality Care?

PubMed

Park, Alayna L; Tsai, Katherine H; Guan, Karen; Chorpita, Bruce F

2018-02-14

This study examined patterns of evidence-based treatment (EBT) delivery following a county-wide EBT reform initiative. Data were gathered from 60 youth and their 21 providers, who were instructed to deliver therapy as they normally would under the EBT initiative. Results showed limited applicability of county-supported EBTs to this service sample, and that most youth did not receive traditional delivery of EBTs. Findings suggest that it may be unrealistic to expect providers to deliver EBTs with fidelity with all clients, and that EBT implementation may be best thought of as a strategy for improving mental health services rather than a goal.

Foudroyant Course of an Extensive Clostridium septicum Gas Gangrene in a Diabetic Patient with Occult Carcinoma of the Colon

PubMed Central

Kutup, Asad; Gehl, Axel; Zustin, Jozef; Grossterlinden, Lars G.; Rueger, Johannes M.; Lehmann, Wolfgang

2013-01-01

Background. Spontaneous gas gangrene is a rare disease in which Clostridium septicum frequently can be detected. After an incubation period of 5–48 hours, a very painful swelling is accompanied by a rapidly spreading toxic-infectious clinical picture ultimately leading to septic shock and multiple organ failure. We present a case of a completely documented rare infectious disease with triage findings including initial vital signs, initial medical findings, and the emergency lab., radiological, intraoperative, histopathological, microbiological, and postmortem results. After initial diagnosis of the underlying disease, the patient has been immediately transferred to the operating theatre. The laboratory findings reflect the devastating effect of toxin α which is a toxin typically produced by C. septicum. The patient presented both an anaemia and a manifest coagulopathy as well as an onset of multiple organ failure. Despite the aggressive medical and surgical measures that have been taken, this patient could not be saved. Discussion. The case presented vividly emphasises the difficulty to identify these cases early enough to save a patient. This documentation may help health care providers to identify this life threatening disease as early as possible in future cases. PMID:23864974

Predictors of provider- initiated HIV testing and counseling refusal by outpatient department clients in Wolaita zone, Southern Ethiopia: a case control study.

PubMed

Facha, Wolde; Kassahun, Wondewosen; Workicho, Abdulhalik

2016-08-12

Despite different strategies designed to rapidly identify HIV infected individuals, majority of HIV-infected people are unaware of their sero-status in developing countries. The objective of this study was to assess predictors of provider-initiated HIV testing and counseling (PITC) refusal by outpatient department (OPD) clients in Wolaita zone, Southern Ethiopia. Facility based unmatched case control study was conducted on outpatient department clients in randomly selected seven health facilities in Wolaita zone, Southern Ethiopia in February 2012. A total of 291 participants (97 cases and 194 controls) were included in our study. Cases were patients who refused HIV test while controls were patients who tested for HIV after provider-initiated HIV testing and counseling (PITC) recommendation by outpatient department (OPD) clinicians. We used both quantitative and qualitative methods of data collection. Pretested interviewer administered questionnaires were used to collect quantitative data by trained nurses, and in-depth interview with 14 OPD clinicians was conducted by principal investigator to supplement quantitative findings. Bivariate and multivariate analyses were done to identify independent predictors of provider-initiated HIV testing and counseling refusal by OPD clients. Study participants who had stigmatizing attitude [AOR = 6.09, (95 % CI: 1.70, 21.76)], who had perceived risk for HIV infection [AOR = 5.23, (95 % CI: 2.22, 12.32)], who did not perceive the benefits of provider-initiated HIV testing and counseling [AOR = 4.64, (95 % CI: 1.79, 12.01)], who did not get minimum recommended pretest information from their providers [AOR = 2.98, (95 % CI: 1.06, 8.35)], who ever not heard of provider-initiated HIV testing and counseling service [AOR = 2.41, (95 % CI: 1.14, 5.09)], and who were from urban area [AOR = 2.40, (95 % CI = 1.26, 4.57)] were more likely to refuse provider-initiated HIV testing and counseling service than their counterparts. Knowledge on HIV/AIDS, attitude towards people living with HIV/AIDS and perceived risk for HIV infection by clients were the major barriers for provider-initiated HIV testing and counseling acceptance. Health professionals working at outpatient department should give due attention to overcome these barriers so as to enhance HIV testing acceptance by their clients.

The Mediator Complex and Transcription Elongation

PubMed Central

Conaway, Ronald C.; Conaway, Joan Weliky

2013-01-01

Background Mediator is an evolutionarily conserved multisubunit RNA polymerase II (Pol II) coregulatory complex. Although Mediator was initially found to play a critical role in regulation of the initiation of Pol II transcription, recent studies have brought to light an expanded role for Mediator at post-initiation stages of transcription. Scope of review We provide a brief description of the structure of Mediator and its function in the regulation of Pol II transcription initiation, and we summarize recent findings implicating Mediator in the regulation of various stages of Pol II transcription elongation. Major conclusions Emerging evidence is revealing new roles for Mediator in nearly all stages of Pol II transcription, including initiation, promoter escape, elongation, pre-mRNA processing, and termination. General significance Mediator plays a central role in the regulation of gene expression by impacting nearly all stages of mRNA synthesis. PMID:22983086

Programs for School Principal Preparation in East Europe

ERIC Educational Resources Information Center

Karstanje, Peter; Webber, Charles F.

2008-01-01

Purpose: This paper is intended to provide an overview of trends in European education and to offer a framework for considering the elements of school management. Design/methodology/approach: This paper reports elements of the planning and implementation of a graduate-level leadership development initiative in Bulgaria. Findings: Several lessons…

Agenda Setting and Mass Communication Theory.

ERIC Educational Resources Information Center

Shaw, Eugene F.

The agenda-setting concept in mass communication asserts that the news media determine what people will include or exclude in their cognition of public events. Findings in uses and gratification research provide the foundation for this concept: an initial focus on people's needs, particularly the need for information. The agenda-setting concept…

"I Learned More at Lunchtime": Guideposts for Reimagining Professional Development

ERIC Educational Resources Information Center

Patton, Kevin; Parker, Melissa

2015-01-01

While professional development (PD) initiatives for practicing teachers are not new, an increasing body of research has contributed to a growing understanding of what constitutes effective practice in physical education. Findings indicate an enhanced recognition of the importance of providing teachers with PD opportunities where learning is…

Degrees of Freedom: Expanding College Opportunities for Currently and Formerly Incarcerated Californians

ERIC Educational Resources Information Center

Mukamal, Debbie; Silbert, Rebecca; Taylor, Rebecca M.

2015-01-01

"Degrees of Freedom" finds that California has not been adequately providing effective college opportunities for criminal justice-involved students, despite the fact that such access will help California build safer and more economically viable communities. This report is part of a larger initiative--Renewing Communities--to expand…

An Initial Reintegration Treatment of Children with Acute Lymphoblastic Leukemia (ALL).

ERIC Educational Resources Information Center

Lurie, Michelle; Kaufman, Nadeen

2001-01-01

Evaluated the cognitive, psychological, and social adjustment of pediatric acute lymphoblastic leukemia (ALL) patients and assessed how their needs could best be met through reintegration programs focusing on learning/ educational needs. Findings from three case studies highlight the need for ALL patients to be provided with comprehensive programs…

National STEM Consortium Evaluation. Final Report

ERIC Educational Resources Information Center

Stewart, Sarah

2015-01-01

Acting as the lead agency for the "National STEM Consortium" (NSC), Anne Arundel Community College (AACC) engaged Hezel Associates to provide an independent program and impact evaluation of the U.S. Department of Labor (USDOL)-funded STEM certificate initiative. This report is comprehensive and covers the findings from all 4 years of the…

77 FR 54917 - Findings of Research Misconduct

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... values for inter-observer reliabilities when coding was done by only one observer, in both cases leading... Research Integrity (ORI) has taken final action in the following case: Marc Hauser, Ph.D., Harvard... collaborators that he miscoded some of the trials and that the study failed to provide support for the initial...

Internationally Mobile Academics: Concept and Findings in Europe

ERIC Educational Resources Information Center

Teichler, Ulrich

2017-01-01

Information on the international mobility of persons in charge of teaching and/or research at institutions of higher education is by no means abundant. Most official statistics provide only information on their current citizenship. A closer look reveals that international mobility can be enormously varied--for example, migration initiated by their…

Students with Dual Diagnosis: Can School-Based Mental Health Services Play a Role?

ERIC Educational Resources Information Center

Lambros, Katina; Kraemer, Bonnie; Wager, James Derek; Culver, Shirley; Angulo, Aidee; Saragosa, Marie

2016-01-01

This article describes and investigates initial findings from the Esperanza Mental Health Services (EMHS) Program, which is an intensive outpatient program that provides individual and group mental health services for students with "dual diagnosis" or developmental disabilities and co-occurring mental health problems. Previous research…

Physicians' accounts of frontline tensions when implementing pilot projects to improve primary care.

PubMed

Mansfield, Elizabeth; Bhattacharyya, Onil; Christian, Jennifer; Naglie, Gary; Steriopoulos, Vicky; Webster, Fiona

2018-03-19

Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

Translating research findings into practice – the implementation of kangaroo mother care in Ghana

PubMed Central

2012-01-01

Background Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants and is promoted for its potential to improve newborn survival. Many countries find it difficult to take KMC to scale in healthcare facilities providing newborn care. KMC Ghana was an initiative to scale up KMC in four regions in Ghana. Research findings from two outreach trials in South Africa informed the design of the initiative. Two key points of departure were to equip healthcare facilities that conduct deliveries with the necessary skills for KMC practice and to single out KMC for special attention instead of embedding it in other newborn care initiatives. This paper describes the contextualisation and practical application of previous research findings and the results of monitoring the progress of the implementation of KMC in Ghana. Methods A three-phase outreach intervention was adapted from previous research findings to suit the local setting. A more structured system of KMC regional steering committees was introduced to drive the process and take the initiative forward. During Phase I, health workers in regions and districts were oriented in KMC and received basic support for the management of the outreach. Phase II entailed the strengthening of the regional steering committees. Phase III comprised a more formal assessment, utilising a previously validated KMC progress-monitoring instrument. Results Twenty-six out of 38 hospitals (68 %) scored over 10 out of 30 and had reached the level of ‘evidence of practice’ by the end of Phase III. Seven hospitals exceeded expected performance by scoring at the level of ‘evidence of routine and institutionalised practice.’ The collective mean score for all participating hospitals was 12.07. Hospitals that had attained baby-friendly status or had been re-accredited in the five years before the intervention scored significantly better than the rest, with a mean score of 14.64. Conclusion The KMC Ghana initiative demonstrated how research findings regarding successful outreach for the implementation of KMC could be transferred to a different context by making context-appropriate adaptations to the model. PMID:22889113

Translating research findings into practice--the implementation of kangaroo mother care in Ghana.

PubMed

Bergh, Anne-Marie; Manu, Rhoda; Davy, Karen; van Rooyen, Elise; Asare, Gloria Quansah; Williams, J Koku Awoonor; Dedzo, McDamien; Twumasi, Akwasi; Nang-Beifubah, Alexis

2012-08-13

Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants and is promoted for its potential to improve newborn survival. Many countries find it difficult to take KMC to scale in healthcare facilities providing newborn care. KMC Ghana was an initiative to scale up KMC in four regions in Ghana. Research findings from two outreach trials in South Africa informed the design of the initiative. Two key points of departure were to equip healthcare facilities that conduct deliveries with the necessary skills for KMC practice and to single out KMC for special attention instead of embedding it in other newborn care initiatives. This paper describes the contextualisation and practical application of previous research findings and the results of monitoring the progress of the implementation of KMC in Ghana. A three-phase outreach intervention was adapted from previous research findings to suit the local setting. A more structured system of KMC regional steering committees was introduced to drive the process and take the initiative forward. During Phase I, health workers in regions and districts were oriented in KMC and received basic support for the management of the outreach. Phase II entailed the strengthening of the regional steering committees. Phase III comprised a more formal assessment, utilising a previously validated KMC progress-monitoring instrument. Twenty-six out of 38 hospitals (68 %) scored over 10 out of 30 and had reached the level of 'evidence of practice' by the end of Phase III. Seven hospitals exceeded expected performance by scoring at the level of 'evidence of routine and institutionalised practice.' The collective mean score for all participating hospitals was 12.07. Hospitals that had attained baby-friendly status or had been re-accredited in the five years before the intervention scored significantly better than the rest, with a mean score of 14.64. The KMC Ghana initiative demonstrated how research findings regarding successful outreach for the implementation of KMC could be transferred to a different context by making context-appropriate adaptations to the model.

Evolution of the magnetorotational instability on initially tangled magnetic fields

NASA Astrophysics Data System (ADS)

Bhat, Pallavi; Ebrahimi, Fatima; Blackman, Eric G.; Subramanian, Kandaswamy

2017-12-01

The initial magnetic field of previous magnetorotational instability (MRI) simulations has always included a significant system-scale component, even if stochastic. However, it is of conceptual and practical interest to assess whether the MRI can grow when the initial field is turbulent. The ubiquitous presence of turbulent or random flows in astrophysical plasmas generically leads to a small-scale dynamo (SSD), which would provide initial seed turbulent velocity and magnetic fields in the plasma that becomes an accretion disc. Can the MRI grow from these more realistic initial conditions? To address this, we supply a standard shearing box with isotropically forced SSD generated magnetic and velocity fields as initial conditions and remove the forcing. We find that if the initially supplied fields are too weak or too incoherent, they decay from the initial turbulent cascade faster than they can grow via the MRI. When the initially supplied fields are sufficient to allow MRI growth and sustenance, the saturated stresses, large-scale fields and power spectra match those of the standard zero net flux MRI simulation with an initial large-scale vertical field.

Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

PubMed

Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

2016-10-01

To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and establishing a motivated and skilled project or program team. The lack of evaluative data made it difficult to identify the most effective interventions or models of care. The CanIMPACT Casebook documents Canadian efforts to improve or support the coordination of cancer care by PCPs and oncology specialists as a means to improve patient outcomes and cancer system performance. Copyright© the College of Family Physicians of Canada.

Using a Multisectoral Approach to Assess HIV/AIDS Services in the Western Region of Puerto Rico

PubMed Central

Asencio Toro, Gloria; Burns, Patricia; Pimentel, Daniel; Sánchez Peraza, Luis Raúl; Rivera Lugo, Carmen

2006-01-01

The Enhancing Care Initiative of Puerto Rico assessed services available to people living with HIV/AIDS in the western region of Puerto Rico. Participants were 212 people living with HIV/AIDS and 116 employees from 6 agencies providing HIV/AIDS services in the region. Two main findings were that depression symptoms were present in 98.1% of people living with HIV/AIDS, and 7 of the 15 municipalities in the region did not provide any specific services to this population. Most urgent needs identified by people living with HIV/AIDS were economic support, housing, mental and psychological services, medicines, medical treatment, and transportation. The Enhancing Care Initiative provides an example of a successful multisectoral, multidimensional volunteer team effectively overcoming challenges while translating research into interventions to enhance HIV/AIDS care. PMID:16670220

Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

USGS Publications Warehouse

Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

2016-01-01

Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

Provider-Initiated Patient Satisfaction Reporting Yields Improved Physician Ratings Relative to Online Rating Websites.

PubMed

Ricciardi, Benjamin F; Waddell, Brad S; Nodzo, Scott R; Lange, Jeffrey; Nocon, Allina A; Amundsen, Spencer; Tarity, T David; McLawhorn, Alexander S

2017-09-01

Recently, providers have begun to publicly report the results of patient satisfaction surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party surveys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics. The authors identified 12 institutions that provided publicly available patient satisfaction outcomes derived from third-party surveys for their orthopedic surgeons as of August 2016. Orthopedic surgeons at these institutions were eligible for inclusion (N=340 surgeons). Provider characteristics were recorded from publicly available data. Four high-traffic commercial online physician rating websites were identified: Healthgrades.com, UCompareHealthCare.com, Vitals.com, and RateMDs.com. For each surgeon, overall ratings (on a scale of 1-5), total number of ratings, and percentage of negative ratings were compared between provider-initiated internal ratings and each commercial online website. Associations between baseline factors and overall physician ratings and negative ratings were assessed. Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satisfaction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites. A greater number of years in practice had a weak association with lower internal ratings, and an academic practice setting and a location in the Northeast were protective factors for negative physician ratings. Compared with commercial online physician rating websites, provider-initiated patient satisfaction ratings of orthopedic surgeons appear to be more favorable, with greater numbers of responses. [Orthopedics. 2017; 40(5):304-310.]. Copyright 2017, SLACK Incorporated.

Investigating the 3-D Subduction Initiation Processes at Transform Faults and Passive Margins

NASA Astrophysics Data System (ADS)

Peng, H.; Leng, W.

2017-12-01

Studying the processes of subduction initiation is a key for understanding the Wilson cycle and improving the theory of plate tectonics. Previous studies investigated subduction initiation with geological synthesis and geodynamic modeling methods, discovering that subduction intends to initiate at the transform faults close to oceanic arcs, and that its evolutionary processes and surface volcanic expressions are controlled by plate strength. However, these studies are mainly conducted with 2-D models, which cannot deal with lateral heterogeneities of crustal thickness and strength along the plate interfaces. Here we extend the 2-D model to a 3-D parallel subduction model with high computational efficiency. With the new model, we study the dynamic controlling factors, morphology evolutionary processes and surface expressions for subduction initiation with lateral heterogeneities of material properties along transform faults and passive margins. We find that lateral lithospheric heterogeneities control the starting point of the subduction initiation along the newly formed trenches and the propagation speed for the trench formation. New subduction tends to firstly initiate at the property changing point along the transform faults or passive margins. Such finds may be applied to explain the formation process of the Izu-Bonin-Mariana (IBM) subduction zone in the western Pacific and the Scotia subduction zone at the south end of the South America. Our results enhance our understanding for the formation of new trenches and help to provide geodynamic modeling explanations for the observed remnant slabs in the upper mantle and the surface volcanic expressions.

The two faces of enhancing utilization of health-care services: determinants of patient initiation and retention in rural Burkina Faso.

PubMed Central

Mugisha, Frederick; Bocar, Kouyate; Dong, Hengjin; Chepng'eno, Gloria; Sauerborn, Rainer

2004-01-01

OBJECTIVE: To explore the factors that determine whether a patient will initiate treatment within a system of health-care services, and the factors that determine whether the patient will be retained in the chosen system, in Nouna, rural Burkina Faso. METHODS: The data used were pooled from four rounds of a household survey conducted in Nouna, rural Burkina Faso. The ongoing demographic surveillance system provided a sampling framework for this survey in which 800 households were sampled using a two-stage cluster sampling procedure. More than one treatment episode was observed for a single episode of illness per patient. The multinomial logit model was used to explore the determinants of patient initiation to systems of modern, traditional and home treatment, and a binary logit model was used to explore the determinants of patient retention within the chosen health-care provider system. FINDINGS: The results suggest that the determinants of patient initiation and their subsequent retention are different. Household income, education, urban residence and expected competency of the provider are positive predictors of initiation, but not of retention, for modern health-care services. Only perceived quality of care positively predicted retention in modern health-care services. CONCLUSION: Interventions focusing on patient initiation and patient retention are likely to be different. Policies directed at enhancing initiation for modern health-care services would primarily focus on reducing financial barriers, while those directed at increasing retention would primarily focus on attributes that improve the perceived quality of care. PMID:15375446

Incidence and predictors of onset of injection drug use in a San Francisco cohort of homeless youth.

PubMed

Parriott, Andrea M; Auerswald, Colette L

2009-01-01

Few studies document incidence of injection drug use among homeless youth. We followed a cohort of 70 street-recruited homeless youth in San Francisco, California who had never injected drugs for six months in 2004-5. We examined initiation of injection drug use and its predictors, informed by prior ethnographic findings. Data were analyzed using exact logistic regression. 11.4% of youth initiated injection drug use. Having no high school education, being over 21 years old, and being in disequilibrium predicted initiation. Limitations, implications and suggestions for future research are noted. Funding was provided by the National Institute for Child Health and Development.

Driver-initiated distractions: examining strategic adaptation for in-vehicle task initiation.

PubMed

Horrey, William J; Lesch, Mary F

2009-01-01

Today, drivers are faced with many in-vehicle activities that are potentially distracting. In many cases, they are not passive recipients of these tasks; rather, drivers decide whether or not (or how) to perform them. In this study, we examined whether drivers, given knowledge of the upcoming road demands, would strategically delay performing in-vehicle activities until demands were reduced. Twenty drivers drove an instrumented van around a closed track that was divided into sections of varying demands and difficulty. Drivers were asked to perform one of four in-vehicle tasks (e.g., phone conversation; read a text message; find an address; pick up an object on the floor); however, they were free to decide when to initiate these tasks, provided they finish them before a given deadline. Although drivers were fully aware of the relative demands of the road, they did not tend to strategically postpone tasks--a finding that was consistent across the different tasks (p >.05). Rather, drivers tended to initiate tasks regardless of the current driving conditions. This strategy frequently led to driving errors. Given the control that drivers have over many in-vehicle distractions, interventions that focus on strategic decisions and planning may have merit.

Learned recognition of maternal signature odors mediates the first suckling episode in mice

PubMed Central

Logan, Darren W.; Brunet, Lisa J.; Webb, William R.; Cutforth, Tyler; Ngai, John; Stowers, Lisa

2012-01-01

Summary Background Soon after birth all mammals must initiate milk suckling to survive. In rodents, this innate behavior is critically dependent on uncharacterized maternally-derived chemosensory ligands. Recently the first pheromone sufficient to initiate suckling was isolated from the rabbit. Identification of the olfactory cues that trigger first suckling in the mouse would provide the means to determine the neural mechanisms that generate innate behavior. Results Here we use behavioral analysis, metabolomics, and calcium imaging of primary sensory neurons and find no evidence of ligands with intrinsic bioactivity, such as pheromones, acting to promote first suckling in the mouse. Instead, we find that the initiation of suckling is dependent on variable blends of maternal ‘signature odors’ that are learned and recognized prior to first suckling. Conclusions As observed with pheromone-mediated behavior, the response to signature odors releases innate behavior. However, this mechanism tolerates variability in both the signaling ligands and sensory neurons which may maximize the probability that this first essential behavior is successfully initiated. These results suggest that mammalian species have evolved multiple strategies to ensure the onset of this critical behavior. PMID:23041191

Video self-modeling in children with autism: a pilot study validating prerequisite skills and extending the utilization of VSM across skill sets.

PubMed

Williamson, Robert L; Casey, Laura B; Robertson, Janna Siegel; Buggey, Tom

2013-01-01

Given the recent interest in the use of video self-modeling (VSM) to provide instruction within iPod apps and other pieces of handheld mobile assistive technologies, investigating appropriate prerequisite skills for effective use of this intervention is particularly timely and relevant. To provide additional information regarding the efficacy of VSM for students with autism and to provide insights into any possible prerequisite skills students may require for such efficacy, the authors investigated the use of VSM in increasing the instances of effective initiations of interpersonal greetings for three students with autism that exhibited different pre-intervention abilities. Results showed that only one of the three participants showed an increase in self-initiated greetings following the viewing of videos edited to show each participant self-modeling a greeting when entering his or her classroom. Due to the differences in initial skill sets between the three children, this finding supports anecdotally observed student prerequisite abilities mentioned in previous studies that may be required to effectively utilize video based teaching methods.

Comparative Initial and Sustained Engagement in Web-based Training by Behavioral Healthcare Providers in New York State.

PubMed

Talley, Rachel; Chiang, I-Chin; Covell, Nancy H; Dixon, Lisa

2018-06-01

Improved dissemination is critical to implementation of evidence-based practice in community behavioral healthcare settings. Web-based training modalities are a promising strategy for dissemination of evidence-based practice in community behavioral health settings. Initial and sustained engagement of these modalities in large, multidisciplinary community provider samples is not well understood. This study evaluates comparative engagement and user preferences by provider type in a web-based training platform in a large, multidisciplinary community sample of behavioral health staff in New York State. Workforce make-up among platform registrants was compared to the general NYS behavioral health workforce. Training completion by functional job type was compared to characterize user engagement and preferences. Frequently completed modules were classified by credit and requirement incentives. High initial training engagement across professional role was demonstrated, with significant differences in initial and sustained engagement by professional role. The most frequently completed modules across functional job types contained credit or requirement incentives. The analysis demonstrated that high engagement of a web-based training in a multidisciplinary provider audience can be achieved without tailoring content to specific professional roles. Overlap between frequently completed modules and incentives suggests a role for incentives in promoting engagement of web-based training. These findings further the understanding of strategies to promote large-scale dissemination of evidence-based practice in community behavioral health settings.

3 CFR 8704 - Proclamation 8704 of September 1, 2011. National Wilderness Month, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... environment and our communities. Today, wilderness areas serve as places for us to roam, hunt, fish, and find solitude. They are also strong engines of local economies, providing tourism and recreation revenue for communities. To help preserve our natural surroundings, I established the America’s Great Outdoors Initiative...

Social Information Processing in Preschool Children: Relations to Sociodemographic Risk and Problem Behavior

ERIC Educational Resources Information Center

Ziv, Yair; Sorongon, Alberto

2011-01-01

Using a multicomponent, process-oriented approach, the links between social information processing during the preschool years and (a) sociodemographic risk and (b) behavior problems in preschool were examined in a community sample of 196 children. Findings provided support for our initial hypotheses that aspects of social information processing in…

The "Good Faith" Requirement in School Desegregation Cases.

ERIC Educational Resources Information Center

Patin, Charles L., Jr.; Gordon, William M.

The good-faith requirement in school desegregation was initially discussed by the United States Supreme Court in "Brown II." However, it was not until recently, in "Freeman v. Pitts," that the Court was to provide a definitive statement as to the meaning of the requirement, indicate the need for specific findings with respect…

Hawaii Demonstration Project to Avert Unintended Teenage Pregnancy: 1978-1982. Final Report. Executive Summary.

ERIC Educational Resources Information Center

Levitt-Merin, Marta; Sutter, Sharon Kingdon

This final report provides a descriptive overview of three approaches which the Hawaii Demonstration Project initiated to reduce unintended teenage pregnancies. Project evaluation findings are summarized; both qualitative and quantitative data are presented for a comprehensive picture of the project and its input. Project limitations and successes…

RTI Success: Proven Tools and Strategies for Schools and Classrooms

ERIC Educational Resources Information Center

Whitten, Elizabeth; Esteves, Kelli J.; Woodrow, Alice

2009-01-01

What is Response to Intervention (RTI) and how can it benefit your school? Find out in "RTI Success", an all-in-one resource that provides information on this innovative model as well as step-by-step administrator guidelines and practical teacher tools for implementation. Despite ongoing federal initiatives meant to increase the profile…

10 CFR 2.334 - Implementing hearing schedule for proceeding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... proceeding shall, based on information and projections provided by the parties and the NRC staff, take... issuance of its initial decision. (b) Modification of hearing schedule. A hearing schedule may not be modified except upon a finding of good cause by the presiding officer or the Commission. In making such a...

Initial Report of the Task Force on Cultural Competence Education in the Health Sciences

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2007

2007-01-01

This report summarizes the findings and recommendations of the Task Force on Cultural Competence Education and represents the distillation of the Task Force's efforts to fulfill its legislative charge. The report is intended to facilitate a statewide conversation about the health services provided to New Mexico's multicultural citizenry. It…

Consumerization of Information Technology: An Exploratory Qualitative Inquiry of Michigan Community Colleges

ERIC Educational Resources Information Center

Skallos, Maryly K.

2014-01-01

With funding cuts, reduced enrollments, and meeting a presidential initiative, Michigan community colleges need to find ways in which they can continue to provide quality education at an affordable price. Consumerization of information technology (IT) has been proposed to meet the technological needs of the community college. There is little…

Computer-Based Intepretation of the Marital Satisfaction Inventory: Use in Treatment Planning.

ERIC Educational Resources Information Center

Snyder, Douglas K.; And Others

1988-01-01

Describes computer-based interpretive system for Marital Satisfaction Inventory (MSI) and application in initial phases of clinical assessment and treatment planning. Provides case study. Compares clinical findings at intake with MSI profiles for one couple obtained at termination and follow-up. Considers strengths and limitations of self-report…

Factors That Drive RTO Performance: An Overview. Synthesis Report

ERIC Educational Resources Information Center

Misko, Josie

2017-01-01

This paper provides an overview of recent research on the factors that drive the performance of registered training organisations (RTOs), with a view to identifying areas for future research. Initially it explores the drivers of RTO performance; then discusses findings from available literature from Australia and from overseas, and discusses some…

Sexting Behavior among College Students: Implications for College Clinicians

ERIC Educational Resources Information Center

Hertlein, Katherine M.; Twist, Markie L. C.

2017-01-01

The practice of sexting is becoming increasingly common among college students but has the potential to both initiate productive interactions with others and interfere with relationship development. The purpose of this paper is to report on the findings of a study on sexting among college students and to provide a framework through which…

What Matters, What Works: Advancing Achievement after School

ERIC Educational Resources Information Center

Public/Private Ventures, 2008

2008-01-01

This brief provides highlights from "Advancing Achievement: Findings from an Independent Evaluation of a Major After-School Initiative." The brief underscores the potential of after-school programs in the ongoing drive to advance children's academic achievement. It shines a light on some of the issues that matter most for programs striving to…

Evaluation of Learning Money Matters (LMM). Final Report

ERIC Educational Resources Information Center

Spielhofer, Thomas; Kerr, David; Gardiner, Clare

2009-01-01

This report presents the final findings of research carried out by the National Foundation for Educational Research (NFER), as part of an independent evaluation on behalf of pfeg, of the Learning Money Matters (LMM) initiative. LMM provides help, support and advice for secondary schools in delivering personal finance education (PFE) to their…

Repositioning Professionalism: Teachers, Mentors, Policy and Praxis

ERIC Educational Resources Information Center

Ingleby, Ewan; Tummons, Jonathan

2012-01-01

This article reflects on the interplay between the recommended policy of providing mentors for PCET ITT (Post-Compulsory Education and Training Initial Teacher Training) students and the praxis or application of this policy. The findings are based on questionnaire data that has been gathered from 80 PCET ITT students and their mentors alongside…

A Critical Policy Analysis of Texas' "Closing the Gaps 2015"

ERIC Educational Resources Information Center

Mansfield, Katherine Cumings; Thackik, Stefani Leigh

2016-01-01

This critical policy analysis uses critical race theory to provide a counter narrative to the P-16 initiative in Texas known as "Closing the Gaps 2015". Findings indicate that while these reforms aim to increase educational access and achievement for people of color, they fall short of addressing systemic inequities such as enduring…

The Impact of Menthol Cigarettes on Smoking Initiation among Non-Smoking Young Females in Japan

PubMed Central

Connolly, Gregory N.; Behm, Ilan; Osaki, Yoneatsu; Wayne, Geoffrey F.

2011-01-01

Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry’s actions—increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females. PMID:21318010

The impact of menthol cigarettes on smoking initiation among non-smoking young females in Japan.

PubMed

Connolly, Gregory N; Behm, Ilan; Osaki, Yoneatsu; Wayne, Geoffrey F

2011-01-01

Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry's actions-increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females.

Time dependency of the prediction skill for the North Atlantic subpolar gyre in initialized decadal hindcasts with MPI-ESM

NASA Astrophysics Data System (ADS)

Brune, Sebastian; Düsterhus, Andre; Pohlmann, Holger; Müller, Wolfgang; Baehr, Johanna

2017-04-01

We analyze the time dependency of decadal hindcast skill in the North Atlantic subpolar gyre within the time period 1961-2013. We compare anomaly correlation coefficients and interquartile ranges of total upper ocean heat content and sea surface temperature for three differently initialized sets of hindcast simulations with the global coupled model MPI-ESM. All initializations use weakly coupled assimilation with the same full-field nudging in the atmospheric component and different assimilation techniques for oceanic temperature and salinity: (1) ensemble Kalman filter assimilating EN4 and HadISST observations, (2) nudging of anomalies to ORAS4 reanalysis, (3) nudging of full values to ORAS4 reanalysis. We find that hindcast skill depends strongly on the evaluation time period, with higher hindcast skill during strong multiyear trends and lower hindcast skill in the absence of such trends. While there may only be small differences between the prediction systems in the analysis focusing on the entire hindcast period, these differences between the hindcast systems are much more pronounced when investigating any 20-year subperiod within the entire hindcast period. For the ensemble Kalman filter high skill in the assimilation experiment is generally linked to high skill in the initialized hindcasts. Such direct link does not seem to exist in the hindcasts initialized by either nudged system. In the ensemble Kalman filter initialized hindcasts, we find significant hindcast skill for up to 5 to 8 lead years, except for the 1970s. In the nudged system initialized hindcasts, hindcast skill is consistently diminished in lead years 2 and 3 with lowest skill in the 1970s as well. Overall, we find that a model-consistent assimilation technique can improve hindcast skill. Further, the evaluation of 20 year subperiods within the full hindcast period provides essential insights to judge the success of both the assimilation and the subsequent hindcast skill.

Time dependency of the prediction skill for the North Atlantic subpolar gyre in initialized decadal hindcasts

NASA Astrophysics Data System (ADS)

Brune, Sebastian; Düsterhus, André; Pohlmann, Holger; Müller, Wolfgang A.; Baehr, Johanna

2017-11-01

We analyze the time dependency of decadal hindcast skill in the North Atlantic subpolar gyre within the time period 1961-2013. We compare anomaly correlation coefficients and temporal interquartile ranges of total upper ocean heat content and sea surface temperature for three differently initialized sets of hindcast simulations with the global coupled model MPI-ESM. All initializations use weakly coupled assimilation with the same full value nudging in the atmospheric component and different assimilation techniques for oceanic temperature and salinity: (1) ensemble Kalman filter assimilating EN4 observations and HadISST data, (2) nudging of anomalies to ORAS4 reanalysis, (3) nudging of full values to ORAS4 reanalysis. We find that hindcast skill depends strongly on the evaluation time period, with higher hindcast skill during strong multiyear trends, especially during the warming in the 1990s and lower hindcast skill in the absence of such trends. Differences between the prediction systems are more pronounced when investigating any 20-year subperiod within the entire hindcast period. In the ensemble Kalman filter initialized hindcasts, we find significant correlation skill for up to 5-8 lead years, albeit along with an overestimation of the temporal interquartile range. In the hindcasts initialized by anomaly nudging, significant correlation skill for lead years greater than two is only found in the 1980s and 1990s. In the hindcasts initialized by full value nudging, correlation skill is consistently lower than in the hindcasts initialized by anomaly nudging in the first lead years with re-emerging skill thereafter. The Atlantic meridional overturning circulation reacts on the density changes introduced by oceanic nudging, this limits the predictability in the subpolar gyre in the first lead years. Overall, we find that a model-consistent assimilation technique can improve hindcast skill. Further, the evaluation of 20 year subperiods within the full hindcast period provides essential insights to judge the success of both the assimilation and the subsequent hindcast quality.

Longitudinal relations between forgiveness and conflict resolution in marriage.

PubMed

Fincham, Frank D; Beach, Steven R H; Davila, Joanne

2007-09-01

Does forgiveness predict later conflict resolution in married couples? Twelve-month follow-up data on conflict resolution were collected from the couples studied by F. D. Fincham, S. R. Beach, and J. Davila, who had provided earlier reports of forgiveness and conflict resolution. For wives, the positive dimension of forgiveness or benevolence predicted husbands' later reports of better conflict resolution controlling for initial levels of conflict resolution. This finding was independent of wives' marital satisfaction and the degree of hurt engendered by husbands' transgressions. For husbands, the only predictor of wives' reports of later conflict resolution was initial level of conflict resolution. The findings are discussed in terms of the direction of effect between forgiveness and conflict resolution and of the mechanisms that might link them. PsycINFO Database Record (c) 2007 APA, all rights reserved

Understanding the investigators: a qualitative study investigating the barriers and enablers to the implementation of local investigator-initiated clinical trials in Ethiopia

PubMed Central

Franzen, Samuel R P; Chandler, Clare; Enquselassie, Fikre; Siribaddana, Sisira; Atashili, Julius; Angus, Brian; Lang, Trudie

2013-01-01

Objectives Clinical trials provide ‘gold standard’ evidence for policy, but insufficient locally relevant trials are conducted in low-income and middle-income countries. Local investigator-initiated trials could generate highly relevant data for national governments, but information is lacking on how to facilitate them. We aimed to identify barriers and enablers to investigator-initiated trials in Ethiopia to inform and direct capacity strengthening initiatives. Design Exploratory, qualitative study comprising of in-depth interviews (n=7) and focus group discussions (n=3). Setting Fieldwork took place in Ethiopia during March 2011. Participants Local health researchers with previous experiences of clinical trials or stakeholders with an interest in trials were recruited through snowball sampling (n=20). Outcome measures Detailed discussion notes were analysed using thematic coding analysis and key themes were identified. Results All participants perceived investigator-initiated trials as important for generating local evidence. System and organisational barriers included: limited funding allocation, weak regulatory and administrative systems, few learning opportunities, limited human and material capacity and poor incentives for conducting research. Operational hurdles were symptomatic of these barriers. Lack of awareness, confidence and motivation to undertake trials were important individual barriers. Training, knowledge sharing and experience exchange were key enablers to trial conduct and collaboration was unanimously regarded as important for improving capacity. Conclusions Barriers to trial conduct were found at individual, operational, organisational and system levels. These findings indicate that to increase locally led trial conduct in Ethiopia, system wide changes are needed to create a more receptive and enabling research environment. Crucially, the creation of research networks between potential trial groups could provide much needed practical collaborative support through sharing of financial and project management burdens, knowledge and resources. These findings could have important implications for capacity-strengthening initiatives but further research is needed before the results can be generalised more widely. PMID:24285629

The Current Practices in Injury Prevention and Safety Helmet Use in an Air Force Medical Center

DTIC Science & Technology

2000-05-01

skateboarding . Findings from the DoD survey (1995) suggest that additional effort is necessary to meet Healthy People 2000 objectives in the area of...rollerblading or skateboarding . Primary care provider A family or individual goes to a primary care provider initially for medical care and the management...related head injury was considered a head injury that occurred while the subject was riding either a bicycle, motorcycle, rollerblading or skateboarding

Analysis of Shuttle Orbiter Reliability and Maintainability Data for Conceptual Studies

NASA Technical Reports Server (NTRS)

Morris, W. D.; White, N. H.; Ebeling, C. E.

1996-01-01

In order to provide a basis for estimating the expected support required of new systems during their conceptual design phase, Langley Research Center has recently collected Shuttle Orbiter reliability and maintainability data from the various data base sources at Kennedy Space Center. This information was analyzed to provide benchmarks, trends, and distributions to aid in the analysis of new designs. This paper presents a summation of those results and an initial interpretation of the findings.

Women’s perspectives on female-initiated barrier methods for the prevention of HIV in the context of methamphetamine use and partner violence

PubMed Central

Stockman, Jamila K.; Syvertsen, Jennifer L.; Robertson, Angela M.; Ludwig-Barron, Natasha T.; Bergmann, Julie N.; Palinkas, Lawrence A.

2014-01-01

BACKGROUND Female-initiated barrier methods for the prevention of HIV may be an effective alternative for drug-using women who are unable to negotiate safe sex, often as a result of physical and/or sexual partner violence. METHODS Utilizing a SAVA (substance abuse, violence, and AIDS) syndemic framework, we qualitatively examined perspectives on female condoms and vaginal microbicides among 18 women with histories of methamphetamine abuse and partner violence in San Diego, CA, USA. FINDINGS Most women were not interested in female condoms due to perceived discomfort, difficulty of insertion, time-intensive effort, and unappealing appearance. Alternatively, most women viewed vaginal microbicides as a useful method. Positive aspects included convenience, ability to disguise as a lubricant, and a sense of control and empowerment. Concerns included possible side effects, timing of application, and unfavorable characteristics of the gel. Acceptability of female-initiated barrier methods was context dependent (i.e., partner type, level of drug use and violence that characterized the sexual relationship). CONCLUSIONS Findings indicate that efforts are needed to address barriers identified for vaginal microbicides to increase its uptake in future HIV prevention trials and marketing of future FDA-approved products. Strategies should address gender-based inequalities (e.g., partner violence) experienced by drug-using women and promote female empowerment. Education on female-initiated barrier methods is also needed for women who use drugs, as well as health care providers and other professionals providing sexual health care and contraception to women with histories of drug use and partner violence. PMID:24837396

Capillary fracture of soft gels.

PubMed

Bostwick, Joshua B; Daniels, Karen E

2013-10-01

A liquid droplet resting on a soft gel substrate can deform that substrate to the point of material failure, whereby fractures develop on the gel surface that propagate outwards from the contact line in a starburst pattern. In this paper, we characterize (i) the initiation process, in which the number of arms in the starburst is controlled by the ratio of the surface tension contrast to the gel's elastic modulus, and (ii) the propagation dynamics showing that once fractures are initiated they propagate with a universal power law L[proportional]t(3/4). We develop a model for crack initiation by treating the gel as a linear elastic solid and computing the deformations within the substrate from the liquid-solid wetting forces. The elastic solution shows that both the location and the magnitude of the wetting forces are critical in providing a quantitative prediction for the number of fractures and, hence, an interpretation of the initiation of capillary fractures. This solution also reveals that the depth of the gel is an important factor in the fracture process, as it can help mitigate large surface tractions; this finding is confirmed with experiments. We then develop a model for crack propagation by considering the transport of an inviscid fluid into the fracture tip of an incompressible material and find that a simple energy-conservation argument can explain the observed material-independent power law. We compare predictions for both linear elastic and neo-Hookean solids, finding that the latter better explains the observed exponent.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

PubMed Central

Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

2011-01-01

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

Public views on a wait time management initiative: a matter of communication

PubMed Central

2010-01-01

Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management. PMID:20687952

Public views on a wait time management initiative: a matter of communication.

PubMed

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2010-08-05

Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

Culture, management and finances as key aspects for healthy workplace initiatives.

PubMed

Waterworth, Pippa; Pescud, Melanie; Chappell, Stacie; Davies, Christina; Roche, Dee; Shilton, Trevor; Ledger, Melissa; Slevin, Terry; Rosenberg, Michael

2018-02-01

The aim of this study was to qualitatively explore the barriers and enablers to implementing healthy workplace initiatives in a sample of workplaces based in Perth, Western Australia. In-depth interviews were conducted with representatives from 31 organizations representing small, medium and large businesses in the Perth metropolitan area which reported having healthy workplace initiatives. In total, 43 factors were mentioned as influencing the implementation of healthy workplace initiatives. Factors appearing to exert the most influence on the implementation of health promoting initiatives in this sample were culture; support from managers and staff; collaboration with industry providers; financial resources circumstances and the physical environment. These factors appeared to be mutually reinforcing and interconnected. Findings suggest there may be merit in applying an organizational development lens to the implementation of workplace health promotion initiatives as this could assist in leveraging enablers and minimizing barriers. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

HPV vaccination among lesbian and bisexual women: Findings from a national survey of young adults

PubMed Central

McRee, Annie-Laurie; Katz, Mira L.; Paskett, Electra D.; Reiter, Paul L.

2014-01-01

Background Human papillomavirus (HPV) infection and associated cervical disease are common among all women, regardless of sexual identity, yet limited research has examined HPV vaccination among lesbian and bisexual women. Methods A national sample of lesbian and bisexual women ages 18-26 (n=543) completed our online survey during Fall 2013. We used multivariable logistic regression to identify correlates of HPV vaccine initiation (receipt of at least 1 dose) and completion (receipt of all 3 recommended doses among initiators). Results Overall, 45% of respondents had initiated HPV vaccine, and 70% of initiators reported completing the series. HPV vaccine initiation was higher among respondents who: were students, had received a healthcare provider's recommendation, perceived greater positive social vaccination norms, or anticipated greater regret if they did not get vaccinated and later got HPV. Initiation was lower among those who perceived greater HPV vaccine harms or greater barriers to getting the vaccine (all p<.05). HPV vaccine completion was higher among initiators who had a college degree while it was lower among those who perceived a greater likelihood of acquiring HPV or who anticipated greater regret if they got the vaccine and fainted (all p<.05). Among HPV vaccine initiators who had not yet completed the series, about half (47%) intended to get the remaining doses. Conclusions Many lesbian and bisexual women are not getting vaccinated against HPV. Healthcare provider recommendations and women's health beliefs may be important leverage points for increasing vaccination among this population. PMID:25038312

Prospective versus predictive control in timing of hitting a falling ball.

PubMed

Katsumata, Hiromu; Russell, Daniel M

2012-02-01

Debate exists as to whether humans use prospective or predictive control to intercept an object falling under gravity (Baurès et al. in Vis Res 47:2982-2991, 2007; Zago et al. in Vis Res 48:1532-1538, 2008). Prospective control involves using continuous information to regulate action. τ, the ratio of the size of the gap to the rate of gap closure, has been proposed as the information used in guiding interceptive actions prospectively (Lee in Ecol Psychol 10:221-250, 1998). This form of control is expected to generate movement modulation, where variability decreases over the course of an action based upon more accurate timing information. In contrast, predictive control assumes that a pre-programmed movement is triggered at an appropriate criterion timing variable. For a falling object it is commonly argued that an internal model of gravitational acceleration is used to predict the motion of the object and determine movement initiation. This form of control predicts fixed duration movements initiated at consistent time-to-contact (TTC), either across conditions (constant criterion operational timing) or within conditions (variable criterion operational timing). The current study sought to test predictive and prospective control hypotheses by disrupting continuous visual information of a falling ball and examining consistency in movement initiation and duration, and evidence for movement modulation. Participants (n = 12) batted a ball dropped from three different heights (1, 1.3 and 1.5 m), under both full-vision and partial occlusion conditions. In the occlusion condition, only the initial ball drop and the final 200 ms of ball flight to the interception point could be observed. The initiation of the swing did not occur at a consistent TTC, τ, or any other timing variable across drop heights, in contrast with previous research. However, movement onset was not impacted by occluding the ball flight for 280-380 ms. This finding indicates that humans did not need to be continuously coupled to vision of the ball to initiate the swing accurately, but instead could use predictive control based on acceleration timing information (TTC2). However, other results provide evidence for movement modulation, a characteristic of prospective control. Strong correlations between movement initiation and duration and reduced timing variability from swing onset to arrival at the interception point, both support compensatory variability. An analysis of modulation within the swing revealed that early in the swing, the movement acceleration was strongly correlated to the required mean velocity at swing onset and that later in the swing, the movement acceleration was again strongly correlated with the current required mean velocity. Rather than a consistent movement initiated at the same time, these findings show that the swing was variable but modulated for meeting the demands of each trial. A prospective model of coupling τ (bat-ball) with τ (ball-target) was found to provide a very strong linear fit for an average of 69% of the movement duration. These findings provide evidence for predictive control based on TTC2 information in initiating the swing and prospective control based on τ in guiding the bat to intercept the ball.

The Times They Are a Changin': Neuropsychology and Integrated Care Teams.

PubMed

Kubu, Cynthia S; Ready, Rebecca E; Festa, Joanne R; Roper, Brad L; Pliskin, Neil H

2016-01-01

To gather illustrative data from clinical neuropsychologists who are working in integrated care settings in order to provide an initial blueprint for moving forward in this new era of health care. A survey was designed to illustrate the ways in which neuropsychologists are participating in integrated care teams and distributed on major neuropsychology listservs. The survey evaluated the settings, roles, services provided, practice issues, remuneration, and impact of neuropsychologists' participation in integrated care teams with respect to patient care and health outcomes. Frequencies were used to summarize the findings as well as qualitative coding of narrative responses. There were 412 respondents to the survey and 261 of those indicated that they worked in at least one integrated care setting. Neuropsychologists work in a variety of integrated care settings and provide diverse services which contribute to improved patient care and outcomes. Three primary themes emerge from the findings with regard to the engagement and teams: advocacy, collaboration, and communication. We argue for the need for more easily accessible outcome studies illustrating the clinical benefits and cost-savings associated with inclusion of neuropsychologists in integrated care teams. In addition, educational and training initiatives are needed to better equip current and future clinical neuropsychologists to function effectively in integrated care settings.

Institutional change to support regime transformation: Lessons from Australia's water sector

NASA Astrophysics Data System (ADS)

Werbeloff, Lara; Brown, Rebekah; Cocklin, Chris

2017-07-01

Institutional change is fundamental to regime transformation, and a necessary part of moving toward integrated water management. However, insight into the role of institutional change processes in such transitions is currently limited. A more nuanced understanding of institutional frameworks is necessary, both to advance understanding of institutional change in the context of transitions toward improved water management and to inform strategies for guiding such processes. To this end, we examine two contemporary cases of transformative change in Australia's urban water sector, exploring the evolution of institutional change in each city. This paper offers insights into regime transformation, providing guidance on types of institutional structures and the ways structure-change initiatives can be sequenced to support a transition. The results reveal the importance of regulation in embedding regime change and suggest that engagement with structural frameworks should begin early in transition processes to ensure the timely introduction of supporting regulation. Our findings also highlight the inextricable link between culture-based and structure-based change initiatives, and the importance of using a diverse range of institutional change mechanisms in a mutually reinforcing way to provide a strong foundation for change. These findings provide a foundation for further scholarly examination of institutional change mechanisms, while also serving to inform the strategic activities of transition-oriented organizations and actors.

Empowering potential: a theory of wellness motivation.

PubMed

Fleury, J D

1991-01-01

Data were collected from 29 individuals who were attempting to initiate and sustain programs of cardiac risk factor modification. Data were analyzed through the technique of constant comparative analysis. Empowering potential, the basic social process identified from the data, explained individual motivation to initiate and sustain cardiovascular health behavior. Empowering potential was a continuous process of individual growth and development which facilitated the emergence of new and positive health patterns. Within the process of empowering potential, individuals use a variety of strategies which guide the initiation and maintenance of health-related change. The process of empowering potential consists of three stages: appraising readiness, changing, and integrating change. Two categories occurred throughout the process of empowering potential: imaging and social support systems. These findings provide a better understanding of how motivated action is initiated and reinitiated over time.

Public acceptance of wildlife trapping in Colorado

USGS Publications Warehouse

Manfredo, M.J.; Pierce, C.L.; Fulton, D.; Pate, J.; Gill, B.R.

1999-01-01

In November 1994, the Colorado Division of Wildlife (CDOW) initiated a stakeholder process to develop trapping regulations that would seek to achieve compromise among divergent interests. A telephone survey was conducted to provide stakeholders with information about the Colorado public's acceptance of trapping. A random sample of 900 residents, stratified by geographic region, indicated that the public would vote to ban trapping and that they believed the ban would eliminate a cruel activity and help to preserve endangered wildlife. Most, however, agreed that trapping was acceptable to prevent spread of disease and to protect livestock, but unacceptable on the basis of providing recreation or making money. Beliefs about trapping were found to be rooted in a protection versus use value orientation about wildlife. The regulations subsequently adopted by the CDOW were consistent with survey findings; however, the regulatory process was bypassed by legislative action, giving trapping authority to the Colorado Department of Agriculture. In response, citizen activists succeeded in placing a ballot initiative before voters. In 1996, the ballot initiative passed, banning trapping in Colorado.

Ventures in Community Improvement (VICI): Findings from a Four-Site Replication Initiative, 1984-1987.

ERIC Educational Resources Information Center

Levin, Laurie; And Others

Ventures in Community Improvement (VICI) is a program that provides intensive training in construction skills to disadvantaged youth and at the same time allows them to produce tangible improvements in housing and public facilities in their own low-income communities. The model was tested twice previously, once in an eight-state demonstration that…

"Trying to Decide … What Sort of Teacher I Wanted to Be": Mentoring as a Dialogic Practice

ERIC Educational Resources Information Center

Talbot, Debra; Denny, Jane; Henderson, Sarah

2018-01-01

Mentoring of pre-service teachers in school contexts is acknowledged as an important part of initial teacher education. However, finding sufficient school-based professional experience placements for pre-service teachers, ensuring the quality of the learning experiences provided by such placements, and gaining a clear understanding of what…

Finding Funding: Supporting Making Connections Core Result that Children are Healthy and Prepared to Succeed in School

ERIC Educational Resources Information Center

Lind, Christianne; Crocker, Jarle; Stewart, Nichole; Torrico, Roxana; Bhat, Soumya; Schmid, William; Ennis, Melissa, Ed.

2009-01-01

The Annie E. Casey Foundation's "Making Connections" initiative provides support to communities across the country to help improve outcomes for children and families in disadvantaged neighborhoods. The sites, together with local partners, are engaged in a range of strategies and activities, reflecting local conditions and priorities, to ensure…

Community Job Initiatives: Readiness, Training, Creation and Retention.

ERIC Educational Resources Information Center

Shabecoff, Alice; And Others

1993-01-01

A community-based approach can excel at putting people back to work. The community-based strategy for helping people find and keep jobs needs to provide comprehensive and integrated services. Collaboration is likely to be the most practical means to round up those services. Community groups usually have a dual purpose in pursuing a jobs program:…

National evaluation of the SafeTrip-21 initiative I-95 corridor coalition test bed : final evaluation report, providing multi-modal travel information to airport users.

DOT National Transportation Integrated Search

2011-12-30

The purpose of this document is to present the findings of the national evaluation of the I-95 Corridor Coalitions Airport Ground Transport Travel Information project, one element of the I-95 Test Bed conducted under the USDOTs SafeTrip-21 Init...

A Preliminary Instrument for Measuring Students' Subjective Perceptions of Difficulties in Learning Recursion

ERIC Educational Resources Information Center

Lacave, Carmen; Molina, Ana I.; Redondo, Miguel A.

2018-01-01

Contribution: Findings are provided from an initial survey to evaluate the magnitude of the recursion problem from the student point of view. Background: A major difficulty that programming students must overcome--the learning of recursion--has been addressed by many authors, using various approaches, but none have considered how students perceive…

CASE Fundraising in International Schools Report 2016. Findings from Data Collected for the Academic Year 2014-15

ERIC Educational Resources Information Center

Council for Advancement and Support of Education, 2016

2016-01-01

The CASE Fundraising in International Schools Survey (FRIS) provides a set of measurement standards for advancement programmes at international schools around the world. The survey was first conducted in 2009 among practitioners to trace the expansion and innovation of development and external relations initiatives in international schools. Given…

Fisher population and landscape genetics

Treesearch

Michael Schwartz; Joel Saunder; Kristine L. Pilgrim; Ray Vinkey; Michael K. Lucid; Sean Parks; Nathan Albrecht

2013-01-01

This talk provides a population and landscape genetic overview of fishers in Idaho and Montana. We start by discussing some of our initial findings using mitochondrial DNA (Vinkey et al. 2006, Schwartz 2007, Knaus et al. 2011). On balance these results demonstrate the uniqueness of a native haplotype that persisted in the Bitterroot-Selway Ecosystem. They also show the...

Training: Who Needs It? Research Report 1995. Key Issues for Providers.

ERIC Educational Resources Information Center

Hotel and Catering Training Co., London (England).

Aimed at all those involved in the supply of training and vocational education for the hospitality industry, this report summarizes findings of the research report, "Training Who Needs It?" It draws out and explores in more detail key issues relating to the provision of training, support, and related initiatives for the industry. Section…

A Mixed Methods Investigation of Maternal Perspectives on Transition Experiences in Early Care and Education

ERIC Educational Resources Information Center

Swartz, Rebecca Anne; Speirs, Katherine Elizabeth; Encinger, Amy Johnson; McElwain, Nancy L.

2016-01-01

Research Findings: Strong relationships among children, families, and early care and education (ECE) providers are key to quality infant-toddler care. These relationships are shaped during the initial transition period to group care. We used a mixed methods approach to (a) assess maternal perspectives on the transition to group care, (b) explore…

Negative Emotions and Alcohol Use Initiation in High-Risk Boys: The Moderating Effect of Good Inhibitory Control

ERIC Educational Resources Information Center

Pardini, Dustin; Lochman, John; Wells, Karen

2004-01-01

Studies on the relation between negative affect and later alcohol use have provided mixed results. Because definitions of negative affect often include diverse emotions, researchers have begun to dismantle this higher-order construct in an attempt to explain these inconsistent findings. More recent evidence also indicates that good inhibitory…

Theatre Curriculum in the US: A Great Tasting Sandwich on Stale Bread

ERIC Educational Resources Information Center

Duffy, Peter

2016-01-01

This essay considers the role that local control, poverty, access and policy play in providing drama/theatre education opportunities to students in the US. It examines how state and federal initiatives shape and determine the curriculum. While there are studies that suggest robust theatre education in the US, these findings are complicated when…

Reliability and Validity of the Social Anxiety Scale for Children--Revised for Hispanic Children.

ERIC Educational Resources Information Center

Storch, Eric A.; Eisenberg, Philip S.; Roberti, Jonathan W.; Barlas, Mitchell E.

2003-01-01

A study examined the psychometric properties of the Social Anxiety Scale for Children--Revised (SASC-R) in a sample of 159 predominantly Dominican and Puerto Rican fifth- and sixth-grade students from New York City. Findings provided initial support for SASC-R reliability and validity in Hispanic children. Convergent validity was supported by…

Changing Times: A Survey of Registered Nurses in 1998. IES Report 351.

ERIC Educational Resources Information Center

Smith, G.; Seccombe, I.

A national survey of registered nurses and analysis of official statistics provided an overview of the dimensions and dynamics of the labor market for nurses in the United Kingdom. Findings indicated the following: enrollment in preregistration nurse training courses decreased by 27 percent over the 1990s; initial entries to the UK Central Council…

Coordination and Evaluation of Videodisc and Microcomputer Programs. Final Technical Report.

ERIC Educational Resources Information Center

McLaughlin, Donald H.; And Others

This report provides information on the background, methodology, and findings of the Videodisc-Microcomputer (ViM) Network project, which brought together over 40 schools in 15 states to explore the potential of a new technology for basic skills instruction. Initiated in 1981 and completed at the end of 1983, the project involved a wide variety of…

Perturbations in the initial soil moisture conditions: Impacts on hydrologic simulation in a large river basin

NASA Astrophysics Data System (ADS)

Niroula, Sundar; Halder, Subhadeep; Ghosh, Subimal

2018-06-01

Real time hydrologic forecasting requires near accurate initial condition of soil moisture; however, continuous monitoring of soil moisture is not operational in many regions, such as, in Ganga basin, extended in Nepal, India and Bangladesh. Here, we examine the impacts of perturbation/error in the initial soil moisture conditions on simulated soil moisture and streamflow in Ganga basin and its propagation, during the summer monsoon season (June to September). This provides information regarding the required minimum duration of model simulation for attaining the model stability. We use the Variable Infiltration Capacity model for hydrological simulations after validation. Multiple hydrologic simulations are performed, each of 21 days, initialized on every 5th day of the monsoon season for deficit, surplus and normal monsoon years. Each of these simulations is performed with the initial soil moisture condition obtained from long term runs along with positive and negative perturbations. The time required for the convergence of initial errors is obtained for all the cases. We find a quick convergence for the year with high rainfall as well as for the wet spells within a season. We further find high spatial variations in the time required for convergence; the region with high precipitation such as Lower Ganga basin attains convergence at a faster rate. Furthermore, deeper soil layers need more time for convergence. Our analysis is the first attempt on understanding the sensitivity of hydrological simulations of Ganga basin on initial soil moisture conditions. The results obtained here may be useful in understanding the spin-up requirements for operational hydrologic forecasts.

Chronic obstructive pulmonary disease case finding by community pharmacists: a potential cost-effective public health intervention.

PubMed

Wright, David; Twigg, Michael; Thornley, Tracey

2015-02-01

This study aims to pilot a community pharmacy chronic obstructive pulmonary disease (COPD) case finding service in England, estimating costs and effects. Patients potentially at risk of COPD were screened with validated tools. Smoking cessation was offered to all smokers identified as potentially having undiagnosed COPD. Cost and effects of the service were estimated. Twenty-one community pharmacies screened 238 patients over 9 months. One hundred thirty-five patients were identified with potentially undiagnosed COPD; 88 were smokers. Smoking cessation initiation provided a project gain of 38.62 life years, 19.92 quality-adjusted life years and a cost saving of £392.67 per patient screened. COPD case finding by community pharmacists potentially provides cost-savings and improves quality of life. © 2014 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

Findings from the Medicaid Competition Demonstrations: A guide for States

PubMed Central

Heinen, LuAnn; Fox, Peter D.; Anderson, Maren D.

1990-01-01

The Medicaid Competition Demonstrations were initiated in 1983-84 in six States (California, Florida, Minnesota, Missouri, New Jersey, and New York). State experiences in implementing the demonstrations are presented in this article. Although problems of enrolling Medicaid recipients in prepaid plans or with primary care case managers under these demonstrations proved challenging to States, lessons were learned in three key areas: program design and administration, health plan and provider relations, and beneficiary acceptance. Therefore, States considering similar programs in the future could benefit from these findings. PMID:10113403

77 FR 33143 - Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition To List the Southern...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

...We, the U.S. Fish and Wildlife Service (Service), announce a 90-day finding on a petition to list the southern white-tailed ptarmigan (Lagopus leucura altipetens) and the Mt. Rainier white-tailed ptarmigan (L. l. rainierensis) as threatened under the Endangered Species Act of 1973, as amended (Act), and designate critical habitat. Based on our review, we find that the petition presents substantial scientific or commercial information indicating that listing the southern white-tailed ptarmigan and the Mt. Rainier white-tailed ptarmigan may be warranted. Therefore, with the publication of this notice, we are initiating a review of the status of the two subspecies to determine if listing is warranted. To ensure that this status review is comprehensive, we are requesting scientific and commercial data and other information regarding these subspecies. Based on the status review, we will issue a 12-month finding on the petition, which will address whether the petitioned action is warranted, as provided in section 4(b)(3)(B) of the Act. We will make a determination on critical habitat for these subspecies if and when we initiate a listing action.

State-Sponsored Public Reporting Programs of Hospital Quality in the United States

PubMed Central

Ross, Joseph S.; Sheth, Sameer D.; Krumholz, Harlan M.

2011-01-01

The prevalence of state public reporting initiatives focused on hospital quality is not known. We systematically reviewed state-sponsored publicly reporting programs focused on clinical aspects of hospital quality and performance for adults, surveying the 50 U.S. states and the District of Columbia. We found that while identifying information about programs was frequently a challenge, programs were present in 25 states (49%) and provided hospital quality information that varied considerably from state to state both by condition and by process and outcome measures reported. We examine the implications of these findings for future state initiatives. PMID:21134936

Initial Results of Interdisciplinary Science Enabled by Eclipse 2017: NASA Perspective

NASA Astrophysics Data System (ADS)

Guhathakurta, M.

2017-12-01

The exceptionally long path over land of the August 21st total and partial solar eclipse provided an unprecedented opportunity for cross disciplinary studies of the sun, moon, Earth, and their interactions. NASA supported research using ground-based measurements, balloons and planes that "chased" the eclipse as well as data taken from a vast array of orbiting spacecraft, all of which helped scientists take continuous measurements of the sun and the effects of the eclipse on the ionosphere and Earth for relatively long periods of time. This talk will summarize some of the initial findings from these research.

Formative evaluation of practice changes for managing depression within a Shared Care model in primary care.

PubMed

Beaulac, Julie; Edwards, Jeanette; Steele, Angus

2017-01-01

Aim To investigate the implementation and initial impact of the Physician Integrated Network (PIN) mental health indicators, which are specific to screening and managing follow-up for depression, in three primary care practices with Shared Mental Health Care in Manitoba. Manitoba Health undertook a primary care renewal initiative in 2006 called the PIN, which included the development of mental health indicators specific to screening and managing follow-up for depression. These indicators were implemented in three PIN group practice sites in Manitoba, which are also part of Shared Mental Health Care. The design was a non-experimental longitudinal design. A formative evaluation investigated the implementation and initial impact of the mental health indicators using mixed methods (document review, survey, and interview). Quantitative data was explored using descriptive and comparative statistics and a content and theme analysis of the qualitative interviews was conducted. Survey responses were received from 32 out of 36 physicians from the three sites. Interviews were conducted with 15 providers. Findings This evaluation illustrated providers' perceived attitudes, knowledge, skills, and behaviours related to recognizing and treating depression and expanded our understanding of primary care processes related to managing depression related to the implementation of a new initiative. Depression is viewed as an important problem in primary care practice that is time consuming to diagnose, manage and treat and requires further investigation. Implementation of the PIN mental health indicators was variable across sites and providers. There was an increase in use of the indicators across time and a general sentiment that benefits of screening outweigh the costs; however, the benefit of screening for depression remains unclear. Consistent with current guidelines, a question the findings of this evaluation suggests is whether there are more effective ways of having an impact on depression within primary care than screening.

Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru.

PubMed

Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F

2017-04-01

We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

Examining Concurrent and Longitudinal Relations Between Personality Traits and Social Well-being in Adulthood

PubMed Central

Hill, Patrick L.; Turiano, Nicholas A.; Mroczek, Daniel K.; Roberts, Brent W.

2013-01-01

Past work has demonstrated that Big Five personality traits both predict relationship success and respond to changes in relationship status. The current study extends this work by examining how developments on the Big Five traits correspond to another important social outcome in adulthood, social well-being. Using the Mid-Life Development in the U.S. longitudinal data sample of adults, the authors examined traits and social well-being at two time points, roughly 9 years apart. Results find support for two primary claims. First, initial levels of social well-being correlated positively with initial standing on extraversion, agreeableness, conscientiousness, emotional stability, and openness. Second, changes in social well-being over time coincided with changes on these traits, in the same directions. Taken together, these findings provide broad support that trait development and social well-being development coincide during adulthood. PMID:23526708

Social and Contextual Constraints on Embodied Perception.

PubMed

Schnall, Simone

2017-03-01

A number of papers have challenged research on physiological and psychological influences on perception by claiming to show that such findings can be explained by nonperceptual factors such as demand characteristics. Relatedly, calls for separating perception from judgment have been issued. However, such efforts fail to consider key processes known to shape judgment processes: people's inability to report accurately on their judgments, conversational dynamics of experimental research contexts, and misattribution and discounting processes. Indeed, the fact that initially observed effects of embodied influences disappear is predicted by an extensive amount of literature on judgments studied within social psychology. Thus, findings from such studies suggest that the initially presumed underlying processes are at work-namely, functional considerations that are informative in the context of preparing the body for action. In this article, I provide suggestions on how to conduct research on perception within the social constraints of experimental contexts.

Japan's long-term care policy for older people: the emergence of innovative "mobilisation" initiatives following the 2005 reforms.

PubMed

Hayashi, Mayumi

2015-04-01

Japan leads the global race for solutions to the increasing long-term care demand from an ageing population. Initial responses in 2000 saw the launch of the public Long-Term Care Insurance (LTCI) system which witnessed an unexpectedly substantial uptake - with doubts raised about financial viability and sustainability. The post-2005 LTCI reform led to the adoption of innovations - including the "mobilisation" of active, older volunteers to support their frailer peers. This strategy, within the wider government's "2025 Vision" to provide total care for the entire older population, sought to secure financial viability and sustainability. Drawing on qualitative in-depth interviews with 21 provider organisations this study will examine three "mobilisation" schemes and identify those factors contributing to overall strengths while acknowledging complexities, diversities and challenges the schemes encountered. Initial literature written by mobilisation proponents may have been overly optimistic: this study seeks to balance such views through providing an understanding and analysis of these mobilisation schemes' realities. The findings will provide insights and suggest more caution to policy-makers intending to promote such schemes - in both Japan and in countries considering doing so. Furthermore, more evaluation is required to obtain evidence to support financial feasibility and sustainability. Copyright © 2015 Elsevier Inc. All rights reserved.

eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

PubMed

Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

2015-01-01

Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

Temporal predictive mechanisms modulate motor reaction time during initiation and inhibition of speech and hand movement.

PubMed

Johari, Karim; Behroozmand, Roozbeh

2017-08-01

Skilled movement is mediated by motor commands executed with extremely fine temporal precision. The question of how the brain incorporates temporal information to perform motor actions has remained unanswered. This study investigated the effect of stimulus temporal predictability on response timing of speech and hand movement. Subjects performed a randomized vowel vocalization or button press task in two counterbalanced blocks in response to temporally-predictable and unpredictable visual cues. Results indicated that speech and hand reaction time was decreased for predictable compared with unpredictable stimuli. This finding suggests that a temporal predictive code is established to capture temporal dynamics of sensory cues in order to produce faster movements in responses to predictable stimuli. In addition, results revealed a main effect of modality, indicating faster hand movement compared with speech. We suggest that this effect is accounted for by the inherent complexity of speech production compared with hand movement. Lastly, we found that movement inhibition was faster than initiation for both hand and speech, suggesting that movement initiation requires a longer processing time to coordinate activities across multiple regions in the brain. These findings provide new insights into the mechanisms of temporal information processing during initiation and inhibition of speech and hand movement. Copyright © 2017 Elsevier B.V. All rights reserved.

Improved prediction of severe thunderstorms over the Indian Monsoon region using high-resolution soil moisture and temperature initialization

PubMed Central

Osuri, K. K.; Nadimpalli, R.; Mohanty, U. C.; Chen, F.; Rajeevan, M.; Niyogi, D.

2017-01-01

The hypothesis that realistic land conditions such as soil moisture/soil temperature (SM/ST) can significantly improve the modeling of mesoscale deep convection is tested over the Indian monsoon region (IMR). A high resolution (3 km foot print) SM/ST dataset prepared from a land data assimilation system, as part of a national monsoon mission project, showed close agreement with observations. Experiments are conducted with (LDAS) and without (CNTL) initialization of SM/ST dataset. Results highlight the significance of realistic land surface conditions on numerical prediction of initiation, movement and timing of severe thunderstorms as compared to that currently being initialized by climatological fields in CNTL run. Realistic land conditions improved mass flux, convective updrafts and diabatic heating in the boundary layer that contributed to low level positive potential vorticity. The LDAS run reproduced reflectivity echoes and associated rainfall bands more efficiently. Improper representation of surface conditions in CNTL run limit the evolution boundary layer processes and thereby failed to simulate convection at right time and place. These findings thus provide strong support to the role land conditions play in impacting the deep convection over the IMR. These findings also have direct implications for improving heavy rain forecasting over the IMR, by developing realistic land conditions. PMID:28128293

Critical Parameters of the Initiation Zone for Spontaneous Dynamic Rupture Propagation

NASA Astrophysics Data System (ADS)

Galis, M.; Pelties, C.; Kristek, J.; Moczo, P.; Ampuero, J. P.; Mai, P. M.

2014-12-01

Numerical simulations of rupture propagation are used to study both earthquake source physics and earthquake ground motion. Under linear slip-weakening friction, artificial procedures are needed to initiate a self-sustained rupture. The concept of an overstressed asperity is often applied, in which the asperity is characterized by its size, shape and overstress. The physical properties of the initiation zone may have significant impact on the resulting dynamic rupture propagation. A trial-and-error approach is often necessary for successful initiation because 2D and 3D theoretical criteria for estimating the critical size of the initiation zone do not provide general rules for designing 3D numerical simulations. Therefore, it is desirable to define guidelines for efficient initiation with minimal artificial effects on rupture propagation. We perform an extensive parameter study using numerical simulations of 3D dynamic rupture propagation assuming a planar fault to examine the critical size of square, circular and elliptical initiation zones as a function of asperity overstress and background stress. For a fixed overstress, we discover that the area of the initiation zone is more important for the nucleation process than its shape. Comparing our numerical results with published theoretical estimates, we find that the estimates by Uenishi & Rice (2004) are applicable to configurations with low background stress and small overstress. None of the published estimates are consistent with numerical results for configurations with high background stress. We therefore derive new equations to estimate the initiation zone size in environments with high background stress. Our results provide guidelines for defining the size of the initiation zone and overstress with minimal effects on the subsequent spontaneous rupture propagation.

On crack initiation in notched, cross-plied polymer matrix composites

NASA Astrophysics Data System (ADS)

Yang, Q. D.; Schesser, D.; Niess, M.; Wright, P.; Mavrogordato, M. N.; Sinclair, I.; Spearing, S. M.; Cox, B. N.

2015-05-01

The physics of crack initiation in a polymer matrix composite are investigated by varying the modeling choices made in simulations and comparing the resulting predictions with high-resolution in situ images of cracks. Experimental data were acquired using synchrotron-radiation computed tomography (SRCT) at a resolution on the order of 1 μm, which provides detailed measurement of the location, shape, and size of small cracks, as well as the crack opening and shear displacements. These data prove sufficient to discriminate among competing physical descriptions of crack initiation. Simulations are executed with a high-fidelity formulation, the augmented finite element method (A-FEM), which permits consideration of coupled damage mechanisms, including both discrete cracks and fine-scale continuum damage. The discrete cracks are assumed to be nonlinear fracture events, governed by reasonably general mixed-mode cohesive laws. Crack initiation is described in terms of strength parameters within the cohesive laws, so that the cohesive law provides a unified model for crack initiation and growth. Whereas the cracks investigated are typically 1 mm or less in length, the fine-scale continuum damage refers to irreversible matrix deformation occurring over gauge lengths extending down to the fiber diameter (0.007 mm). We find that the location and far-field stress for crack initiation are predicted accurately only if the variations of local stress within plies and in the presence of stress concentrators (notches, etc.) are explicitly computed and used in initiation criteria; stress redistribution due to matrix nonlinearity that occurs prior to crack initiation is accounted for; and a mixed-mode criterion is used for crack initiation. If these factors are not all considered, which is the case for commonly used failure criteria, predictions of the location and far-field stress for initiation are not accurate.

Translocation of the neonicotinoid seed treatment clothianidin in maize

PubMed Central

Krupke, Christian H.

2017-01-01

Neonicotinoid seed treatments, typically clothianidin or thiamethoxam, are routinely applied to >80% of maize (corn) seed grown in North America where they are marketed as a targeted pesticide delivery system. Despite this widespread use, the amount of compound translocated into plant tissue from the initial seed treatment to provide protection has not been reported. Our two year field study compared concentrations of clothianidin seed treatments in maize to that of maize without neonicotinoid seed treatments and found neonicotinoids present in root tissues up to 34 days post planting. Plant-bound clothianidin concentrations followed an exponential decay pattern with initially high values followed by a rapid decrease within the first ~20 days post planting. A maximum of 1.34% of the initial seed treatment was successfully recovered from plant tissues in both study years and a maximum of 0.26% was recovered from root tissue. Our findings show neonicotinoid seed treatments may provide protection from some early season secondary maize pests. However, the proportion of the neonicotinoid seed treatment clothianidin translocated into plant tissues throughout the growing season is low overall and this observation may provide a mechanism to explain reports of inconsistent efficacy of this pest management approach and increasing detections of environmental neonicotinoids. PMID:28282441

A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

PubMed

Mohanraj, Rani; Kumar, Shuba; Manikandan, Sarojini; Kannaiyan, Veerapandian; Vijayakumar, Lakshmi

2014-08-01

Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

Genetic variation in adaptability and pleiotropy in budding yeast

PubMed Central

Mitchell, James Kameron; Bloom, Joshua S; Kruglyak, Leonid

2017-01-01

Evolution can favor organisms that are more adaptable, provided that genetic variation in adaptability exists. Here, we quantify this variation among 230 offspring of a cross between diverged yeast strains. We measure the adaptability of each offspring genotype, defined as its average rate of adaptation in a specific environmental condition, and analyze the heritability, predictability, and genetic basis of this trait. We find that initial genotype strongly affects adaptability and can alter the genetic basis of future evolution. Initial genotype also affects the pleiotropic consequences of adaptation for fitness in a different environment. This genetic variation in adaptability and pleiotropy is largely determined by initial fitness, according to a rule of declining adaptability with increasing initial fitness, but several individual QTLs also have a significant idiosyncratic role. Our results demonstrate that both adaptability and pleiotropy are complex traits, with extensive heritable differences arising from naturally occurring variation. PMID:28826486

Characterisation of an Exploding Foil Initiator (EFI) system

NASA Astrophysics Data System (ADS)

Davies, H. R.; Chapman, D. J.; Vine, T. A.; Proud, W. G.

2009-06-01

Exploding Foil Initiators (EFIs) provide a safe and reliable means of detonation of explosives. They are highly insensitive to mechanical shock and electrical interference, requiring a specific high current pulse for initiation. The use of only insensitive secondary explosives and not more sensitive primary explosives further improves safety. When a high current is passed through the metal bridge, a plasma is formed as the metal can not expand beyond the polymer film layer above. This causes the film to expand forming a bubble or shearing off to form a flyer. These flyers can then be used to initiate secondary explosives. Due to the very high speed at which these systems operate, high speed streak photography was used to characterise the behaviour of the polymer film flyers produced. This paper will report the preliminary findings on the mechanical, electrical and velocity changes seen in some proprietary systems.

Developmental trajectories of girls' and boys' delinquency and associated problems.

PubMed

Pepler, Debra J; Jiang, Depeng; Craig, Wendy M; Connolly, Jennifer

2010-10-01

Developmental trajectories in delinquency through adolescence were studied along with family and peer relationship problems. Drawing from eight waves of data over seven years, we conducted trajectory analyses with a sample of 746 students (402 girls; 344 boys). Analyzing girls and boys together, a five-class model emerged: 60% of the adolescents rarely reported delinquency; 27.7% reported low initial levels with moderate levels of delinquency over time; 6% in the late onset group reported initially low and rising levels of delinquency; 5% in the early onset group reported moderate initial levels which increased and then decreased in later adolescence. A small group of only boys (1.3%) labeled chronic reported high initial levels of delinquency that increased over time. Group comparisons revealed problems in internalizing, parent and peer relationship problems. The findings provide direction for early identification and interventions to curtail the development of delinquency.

Effects of an appointment reminder call on patient show rates.

PubMed

Gariti, P; Alterman, A I; Holub-Beyer, E; Volpicelli, J R; Prentice, N; O'Brien, C P

1995-01-01

A pilot study (N = 80) was conducted to determine if (1) prospective substance-dependent patients randomly selected to be reminded (TC) of their scheduled intake evaluation the day before their first appointment would have a higher show rate than those not contacted (NC); and (2) if TC subjects administered a satisfaction questionnaire 1-3 days after intake would exhibit higher treatment retention rates at one week and one month posttreatment entry than NC subjects not exposed to the questionnaire. The findings suggest that reminding prospective patients of their initial scheduled appointments and following up with phone calls to those who fail to show can improve the rate at which patients will initiate treatment, provided initial appointments are scheduled in a timely manner (7 days or less). Similarly, the combination of the reminder call and the satisfaction questionnaire were associated with higher treatment retention rates for those whose initial appointments were scheduled in a timely manner.

Genetic variation in adaptability and pleiotropy in budding yeast.

PubMed

Jerison, Elizabeth R; Kryazhimskiy, Sergey; Mitchell, James Kameron; Bloom, Joshua S; Kruglyak, Leonid; Desai, Michael M

2017-08-17

Evolution can favor organisms that are more adaptable, provided that genetic variation in adaptability exists. Here, we quantify this variation among 230 offspring of a cross between diverged yeast strains. We measure the adaptability of each offspring genotype, defined as its average rate of adaptation in a specific environmental condition, and analyze the heritability, predictability, and genetic basis of this trait. We find that initial genotype strongly affects adaptability and can alter the genetic basis of future evolution. Initial genotype also affects the pleiotropic consequences of adaptation for fitness in a different environment. This genetic variation in adaptability and pleiotropy is largely determined by initial fitness, according to a rule of declining adaptability with increasing initial fitness, but several individual QTLs also have a significant idiosyncratic role. Our results demonstrate that both adaptability and pleiotropy are complex traits, with extensive heritable differences arising from naturally occurring variation.

Rhythm Perception and Its Role in Perception and Learning of Dysrhythmic Speech.

PubMed

Borrie, Stephanie A; Lansford, Kaitlin L; Barrett, Tyson S

2017-03-01

The perception of rhythm cues plays an important role in recognizing spoken language, especially in adverse listening conditions. Indeed, this has been shown to hold true even when the rhythm cues themselves are dysrhythmic. This study investigates whether expertise in rhythm perception provides a processing advantage for perception (initial intelligibility) and learning (intelligibility improvement) of naturally dysrhythmic speech, dysarthria. Fifty young adults with typical hearing participated in 3 key tests, including a rhythm perception test, a receptive vocabulary test, and a speech perception and learning test, with standard pretest, familiarization, and posttest phases. Initial intelligibility scores were calculated as the proportion of correct pretest words, while intelligibility improvement scores were calculated by subtracting this proportion from the proportion of correct posttest words. Rhythm perception scores predicted intelligibility improvement scores but not initial intelligibility. On the other hand, receptive vocabulary scores predicted initial intelligibility scores but not intelligibility improvement. Expertise in rhythm perception appears to provide an advantage for processing dysrhythmic speech, but a familiarization experience is required for the advantage to be realized. Findings are discussed in relation to the role of rhythm in speech processing and shed light on processing models that consider the consequence of rhythm abnormalities in dysarthria.

Increasing the health promotion practices of workplaces in Australia with a proactive telephone-based intervention.

PubMed

Daly, Justine; Licata, Milly; Gillham, Karen; Wiggers, John

2005-01-01

The aim of this study was to explore the potential effectiveness of a proactive telephone-based intervention in increasing workplace adoption of health promotion initiatives. A telephone-based direct marketing strategy was used to contact a sample of Australian workplaces to encourage the adoption of health promotion initiatives. Workplaces were offered free services and resources designed to facilitate adoption of health promotion initiatives. A total of 227 (71%) workplaces provided informed consent to participate in both baseline and 4-year follow-up surveys. Significant increases were evident for seven of the eight health promotion initiatives. The findings of this study suggest that a proactive telephone-based intervention has the potential to be effective in increasing the prevalence of health promotion initiatives across a range of health topics in a large population of workplaces. Given the capacity to reach an entire population of workplaces, this approach represents a promising means of achieving the established potential of workplace health promotion.

Evaluating MyPlate: an expanded framework using traditional and nontraditional metrics for assessing health communication campaigns.

PubMed

Levine, Elyse; Abbatangelo-Gray, Jodie; Mobley, Amy R; McLaughlin, Grant R; Herzog, Jill

2012-01-01

MyPlate, the icon and multimodal communication plan developed for the 2010 Dietary Guidelines for Americans (DGA), provides an opportunity to consider new approaches to evaluating the effectiveness of communication initiatives. A review of indicators used in assessments for previous DGA communication initiatives finds gaps in accounting for important intermediate and long-term outcomes. This evaluation framework for the MyPlate Communications Initiative builds on well-known and underused models and theories to propose a wide breadth of observations, outputs, and outcomes that can contribute to a fuller assessment of effectiveness. Two areas are suggested to focus evaluation efforts in order to advance understanding of the effectiveness of the MyPlate Communications Initiative: understanding the extent to which messages and products from the initiative are associated with positive changes in social norms toward the desired behaviors, and strategies to increase the effectiveness of communications about DGA in vulnerable populations. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Enhancing reproducibility: Failures from Reproducibility Initiatives underline core challenges.

PubMed

Mullane, Kevin; Williams, Michael

2017-08-15

Efforts to address reproducibility concerns in biomedical research include: initiatives to improve journal publication standards and peer review; increased attention to publishing methodological details that enable experiments to be reconstructed; guidelines on standards for study design, implementation, analysis and execution; meta-analyses of multiple studies within a field to synthesize a common conclusion and; the formation of consortia to adopt uniform protocols and internally reproduce data. Another approach to addressing reproducibility are Reproducibility Initiatives (RIs), well-intended, high-profile, systematically peer-vetted initiatives that are intended to replace the traditional process of scientific self-correction. Outcomes from the RIs reported to date have questioned the usefulness of this approach, particularly when the RI outcome differs from other independent self-correction studies that have reproduced the original finding. As a failed RI attempt is a single outcome distinct from the original study, it cannot provide any definitive conclusions necessitating additional studies that the RI approach has neither the ability nor intent of conducting making it a questionable replacement for self-correction. A failed RI attempt also has the potential to damage the reputation of the author of the original finding. Reproduction is frequently confused with replication, an issue that is more than semantic with the former denoting "similarity" and the latter an "exact copy" - an impossible outcome in research because of known and unknown technical, environmental and motivational differences between the original and reproduction studies. To date, the RI framework has negatively impacted efforts to improve reproducibility, confounding attempts to determine whether a research finding is real. Copyright © 2017 Elsevier Inc. All rights reserved.

Variability in use of voiding cystourethrogram during initial evaluation of infants with congenital hydronephrosis.

PubMed

Vemulakonda, Vijaya M; Chiang, George; Corbett, Sean T

2014-05-01

To identify geographic variability in the imaging of infants with congenital hydronephrosis at initial pediatric urologic evaluation. We performed a retrospective review of infants aged ≤ 12 months with congenital hydronephrosis seen as new patients from October 2010 to September 2011 at 3 regionally diverse pediatric urology practices: University of Virginia Hospital, Rady Children's Hospital, and Children's Hospital Colorado. Primary outcomes measured were the type and number of tests ordered at initial evaluation. Independent variables collected included the following: patient age, location, and initial ultrasound findings. Ultrasound findings were manually extracted from the attending pediatric urologist's clinic note. All other data were automatically extracted from the electronic medical record. Proportions were analyzed using Pearson's goodness of fit and Fisher exact tests. Medians were compared using the Kruskal-Wallis test. Two hundred forty-one patients met the study criteria. Median patient age was 2 months and did not differ across sites. Most patients (64.7%) had Society for Fetal Urology grade 0-2 hydronephrosis; prevalence of high-grade hydronephrosis varied across sites (P = .002). Use of voiding cystourethrography also varied across sites (17.6%-88.9%); this difference persisted when controlling for age and hydronephrosis grade (P <.05). Use of other imaging studies did not significantly differ across sites. Use of screening voiding cystourethrography for infants with congenital hydronephrosis varies across practices. This variation persists when controlling for differences in age and ultrasound findings, suggesting that regional differences in patient demographics, provider/parental preferences, or referral patterns might contribute to practice variations in the evaluation of these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

The High Return to Private Schooling in a Low-Income Country. Africa Growth Initiative. Working Paper 5

ERIC Educational Resources Information Center

Bold, Tessa; Kimenyi, Mwangi; Mwabu, Germano; Sandefur, Justin

2013-01-01

Existing studies from the United States, Latin America and Asia provide scant evidence that private schools dramatically improve academic performance relative to public schools. Using data from Kenya--a poor country with weak public institutions--we find a large effect of private schooling on test scores, equivalent to one full standard deviation.…

Coping with pregnancy resolution among never-married women.

PubMed

Bracken, Michael B; Klerman, Lorraine V; Bracken, Maryann

1978-04-01

The Janis-Mann model of decision-making provides the theoretical orientation for empirical analyses of decisions to deliver or abort in matched samples of never-married women. Results focus on four variables: happiness about pregnancy; initial acceptance of delivery or abortion; ease of decision-making; and satisfaction with final choice. Path analyses summarize findings, which are discussed in terms of conflict resolution strategies.

Continuity, Support, Togetherness and Trust: Findings from an Evaluation of a University-Administered Early Professional Development Programme for Teachers in England

ERIC Educational Resources Information Center

McIntyre, Joanna; Hobson, Andrew J.; Mitchell, Nick

2009-01-01

This article discusses the evaluation of a unique university-based early professional development (EPD) programme in England that enabled newly and recently qualified teachers to have continued contact with their initial teacher preparation provider. The programme was designed to enhance the induction, EPD and retention of beginning teachers of…

Learning to Reason and Communicate in College: Initial Report of Findings from the CLA Longitudinal Study

ERIC Educational Resources Information Center

Arum, Richard; Roksa, Josipa

2008-01-01

This research emerged from the Social Science Research Council's collaborative partnership with the Pathways for College Network, with technical assistance in data collection provided by the Council for Aid to Education. The project has followed over 2,300 students at 24 institutions over time to examine what factors are associated with learning…

Sociometric Indicators of Leadership: An Exploratory Analysis

DTIC Science & Technology

2018-01-01

streamline existing observational protocols and assessment methods . This research provides an initial test of sociometric badges in the context of the U.S...understand, the requirements of the mission. Traditional research and assessment methods focusing on leader and follower interactions require direct...based methods of social network analysis. Novel Measures of Leadership Building on these findings and earlier research , it is apparent that

The Children's Services Delivery System in California: Preliminary Report--Phase I.

ERIC Educational Resources Information Center

Commission on California State Government Organization and Economy, Sacramento.

Concerned because California now annually administers an estimated $5.9 billion in funding for children's services programs, the Little Hoover Commission initiated a study on the state's provision for children's services. This report, on Phase I of the study, identifies the extent of the problem in 23 findings and provides a plan of action in 15…

Three Independent Evaluations of Healthy Kids Programs Find Substantial Gains in Children's Dental Health Care. In Brief, September 2008, Number 2

ERIC Educational Resources Information Center

Hughes, Dana; Howell, Embry; Trenholm, Christopher; Hill, Ian; Dubay, Lisa

2008-01-01

This brief presents highlights from rigorous, independent evaluations of the Healthy Kids programs in three California counties: Los Angeles, San Mateo, and Santa Clara. Launched by Children's Health Initiatives (CHIs) in these counties between 2001 and 2003, the three Healthy Kids programs provide children with comprehensive health insurance…

The Health of Youth: A Cross-National Survey. WHO Regional Publications, European Series No. 69.

ERIC Educational Resources Information Center

King, Alan; And Others

This report presents the preliminary findings from WHO's (World Health Organization) fourth Health Behaviour in School-Aged Children (HBSC) Study. The study has two main objectives: (1) to monitor health-risk behavior in youth over time in order to provide the necessary background and clear targets for health promotion initiatives; and (2) to…

Partners in Pittsburgh Public Schools' Excellence for All Initiative: Findings from the First Year of Implementation. Documented Briefing. DB-544-FFE

ERIC Educational Resources Information Center

Tharp-Taylor, Shannah; Nelson, Catherine Awsumb; Dembosky, Jacob W.; Gill, Brian

2007-01-01

The Pittsburgh Public School District asked the RAND Corporation to monitor the first year's implementation (2006-2007) of Excellence for All (EFA) and provide feedback to district staff, the board, and other stakeholders. The Pittsburgh Public School District leadership developed EFA with the aim of increasing student achievement by improving…

A Case Study of the County School Facility Tax Initiative in Mary County, Illinois

ERIC Educational Resources Information Center

Hughes, Vince L.; Reeves, Alison G.; Puchner, Laurel

2017-01-01

K-12 Illinois public school facilities need to be repaired and rebuilt. The County School Facility Occupation Tax (CSFT) was made law in 2007 in Illinois to help provide funding for Illinois public school facilities. This single case study, qualitative research, outlines findings from 86, face-to- face, phone and email interviews and approximately…

Understanding Parent Perceptions of a 1:1 Laptop Program in Western Australia

ERIC Educational Resources Information Center

Bate, Frank; MacNish, Jean; Males, Steven

2012-01-01

This paper provides some initial findings from a current longitudinal study that examines the implementation of a student-owned 1:1 laptop program in a school for boys in Perth, Western Australia. This research tracks 196 students, their families and associated teachers for a 3-year period (2010-2012). Underpinning this research is a mixed methods…

The Potentials of Student Initiated Netspeak in a Middle Primary Science-inspired Multiliteracies Project

NASA Astrophysics Data System (ADS)

Ridgewell, Jay; Exley, Beryl

2011-11-01

There is no denying that the information technology revolution of the late twentieth century has arrived. Whilst not equitably accessible for many, others hold high expectations for the contributions online activity will make to student learning outcomes. Concurrently, and not necessarily consequentially, the number of science and technology secondary school and university graduates throughout the world has declined substantially, as has their motivation and engagement with school science (OECD 2006). The aim of this research paper is to explore one aspect of online activity, that of forum-based netspeak (Crystal 2006), in relation to the possibilities and challenges it provides for forms of scientific learning. This paper reports findings from a study investigating student initiated netspeak in a science inspired multiliteracies (New London Group 2000) project in one middle primary (aged 7-10 years) multi-age Australian classroom. Drawing on the theoretical description of the five phases of enquiry proposed by Bybee (1997), an analytic framework is proffered that allows identification of student engagement, exploration, explanation, elaboration and evaluation of scientific enquiry. The findings provide insight into online forums for advancing learning in, and motivation for, science in the middle primary years.

Organizational Responsibility for Age-Friendly Social Participation: Views of Australian Rural Community Stakeholders.

PubMed

Winterton, Rachel

2016-01-01

This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.

Statins in Acute Ischemic Stroke: A Systematic Review

PubMed Central

Hong, Keun-Sik; Lee, Ji Sung

2015-01-01

Background and Purpose Statins have pleiotropic effects of potential neuroprotection. However, because of lack of large randomized clinical trials, current guidelines do not provide specific recommendations on statin initiation in acute ischemic stroke (AIS). The current study aims to systematically review the statin effect in AIS. Methods From literature review, we identified articles exploring prestroke and immediate post-stroke statin effect on imaging surrogate markers, initial stroke severity, functional outcome, and short-term mortality in human AIS. We summarized descriptive overview. In addition, for subjects with available data from publications, we conducted meta-analysis to provide pooled estimates. Results In total, we identified 70 relevant articles including 6 meta-analyses. Surrogate imaging marker studies suggested that statin might enhance collaterals and reperfusion. Our updated meta-analysis indicated that prestroke statin use was associated with milder initial stroke severity (odds ratio [OR] [95% confidence interval], 1.24 [1.05-1.48]; P=0.013), good functional outcome (1.50 [1.29-1.75]; P<0.001), and lower mortality (0.42 [0.21-0.82]; P=0.0108). In-hospital statin use was associated with good functional outcome (1.31 [1.12-1.53]; P=0.001), and lower mortality (0.41 [0.29-0.58]; P<0.001). In contrast, statin withdrawal was associated with poor functional outcome (1.83 [1.01-3.30]; P=0.045). In patients treated with thrombolysis, statin was associated with good functional outcome (1.44 [1.10-1.89]; P=0.001), despite an increased risk of symptomatic hemorrhagic transformation (1.63 [1.04-2.56]; P=0.035). Conclusions The current study findings support the use of statin in AIS. However, the findings were mostly driven by observational studies at risk of bias, and thereby large randomized clinical trials would provide confirmatory evidence. PMID:26437994

Selection of the initial design for the two-stage continual reassessment method.

PubMed

Jia, Xiaoyu; Ivanova, Anastasia; Lee, Shing M

2017-01-01

In the two-stage continual reassessment method (CRM), model-based dose escalation is preceded by a pre-specified escalating sequence starting from the lowest dose level. This is appealing to clinicians because it allows a sufficient number of patients to be assigned to each of the lower dose levels before escalating to higher dose levels. While a theoretical framework to build the two-stage CRM has been proposed, the selection of the initial dose-escalating sequence, generally referred to as the initial design, remains arbitrary, either by specifying cohorts of three patients or by trial and error through extensive simulations. Motivated by a currently ongoing oncology dose-finding study for which clinicians explicitly stated their desire to assign at least one patient to each of the lower dose levels, we proposed a systematic approach for selecting the initial design for the two-stage CRM. The initial design obtained using the proposed algorithm yields better operating characteristics compared to using a cohort of three initial design with a calibrated CRM. The proposed algorithm simplifies the selection of initial design for the two-stage CRM. Moreover, initial designs to be used as reference for planning a two-stage CRM are provided.

Opt-out provider-initiated HIV testing and counselling in primary care outpatient clinics in Zambia

PubMed Central

Chipukuma, Julien M; Chiko, Matimba M; Wamulume, Chibesa S; Bolton-Moore, Carolyn; Reid, Stewart E

2011-01-01

Abstract Objective To increase case-finding of infection with human immunodeficiency virus (HIV) in Zambia and their referral to HIV care and treatment by supplementing existing client-initiated voluntary counselling and testing (VCT), the dominant mode of HIV testing in the country. Methods Lay counsellors offered provider-initiated HIV testing and counselling (PITC) to all outpatients who attended primary clinics and did not know their HIV serostatus. Data on counselling and testing were collected in registers. Outcomes of interest included HIV testing coverage, the acceptability of testing, the proportion testing HIV-positive (HIV+), the proportion enrolling in HIV care and treatment and the time between testing and enrolment. Findings After the addition of PITC to VCT, the number tested for HIV infection in the nine clinics was twice the number undergoing VCT alone. Over 30 months, 44 420 patients were counselled under PITC and 31 197 patients, 44% of them men, accepted testing. Of those tested, 21% (6572) were HIV+; 38% of these HIV+ patients (2515) enrolled in HIV care and treatment. The median time between testing and enrolment was 6 days. The acceptability of testing rose over time. Conclusion The introduction of routine PITC using lay counsellors into health-care clinics in Lusaka, Zambia, dramatically increased the uptake and acceptability of HIV testing. Moreover, PITC was incorporated rapidly into primary care outpatient departments. Maximizing the number of patients who proceed to HIV care and treatment remains a challenge and warrants further research. PMID:21556300

Internet advertisements for public sexual encounters among men who have sex with men: are safe behaviors communicated?

PubMed

Downing, Martin J

2011-09-01

Public and commercial sex venues typically provide easy access to sexual encounters that are often anonymous and, therefore, may facilitate HIV/STD transmission among those men who attend. Recently, researchers have suggested that men who have sex with men may be using the Internet to search for sexual encounters to occur within sex venues. The current study explored the extent to which men who advertise for public or commercial sexual encounters initially communicate to potential partners their safe-sex intentions. Advertisements for sexual encounters (n = 99) were collected from a publicly accessible website and examined for content related to venue type, sexual behavior, and indications of sexual safety or risk. Word frequencies were calculated to provide a closer investigation of how individuals negotiate safe sex within these communications. The findings revealed that approximately half of the men who advertised for sex in a public or commercial sex venue failed to communicate to potential partners in their initial advertisement a desire to be safe during sexual encounters involving oral and anal practices. Additionally, a small percentage of men advertised specifically for risky encounters (e.g., barebacking). Together, these findings suggest that men do use the Internet to coordinate public sexual encounters, some of which may be unprotected from HIV/STD transmission. Future research should address the process of condom negotiation among men who initially meet their male sex partners on the Internet for subsequent encounters in sex venues.

Reliable transformation system for Microbotryum lychnidis-dioicae informed by genome and transcriptome project.

PubMed

Toh, Su San; Treves, David S; Barati, Michelle T; Perlin, Michael H

2016-10-01

Microbotryum lychnidis-dioicae is a member of a species complex infecting host plants in the Caryophyllaceae. It is used as a model system in many areas of research, but attempts to make this organism tractable for reverse genetic approaches have not been fruitful. Here, we exploited the recently obtained genome sequence and transcriptome analysis to inform our design of constructs for use in Agrobacterium-mediated transformation techniques currently available for other fungi. Reproducible transformation was demonstrated at the genomic, transcriptional and functional levels. Moreover, these initial proof-of-principle experiments provide evidence that supports the findings from initial global transcriptome analysis regarding expression from the respective promoters under different growth conditions of the fungus. The technique thus provides for the first time the ability to stably introduce transgenes and over-express target M. lychnidis-dioicae genes.

Degarelix: a novel gonadotropin-releasing hormone blocker for the treatment of prostate cancer.

PubMed

Anderson, John

2009-05-01

Androgen deprivation therapy with gonadotropin releasing-hormone (GnRH) receptor agonists provides the mainstay of endocrine treatment for advanced prostate cancer. Although effective, GnRH agonists induce an initial testosterone surge, which can cause painful and potentially dangerous clinical flare. Degarelix is a novel GnRH receptor blocker that provides immediate, profound and sustained testosterone reduction, without an initial surge. In a Phase III trial, degarelix and leuprolide showed similar long-term efficacy in maintaining testosterone levels of 0.5 ng/ml or less over 1 year, and induced significantly faster testosterone and prostate-specific antigen suppression. Degarelix was well tolerated; the most common side effects were mild/moderate injection-site reactions and hot flashes. Findings to date suggest that degarelix may make an important contribution to the treatment of prostate cancer.

Reshaping clinical science: Introduction to the Special Issue on Psychophysiology and the NIMH Research Domain Criteria (RDoC) initiative.

PubMed

Patrick, Christopher J; Hajcak, Greg

2016-03-01

The National Institute of Mental Health's (NIMH) Research Domain Criteria (RDoC) initiative seeks to establish new dimensional conceptions of mental health problems, through the investigation of clinically relevant "process" constructs that have neurobiological as well as psychological referents. This special issue provides a detailed overview of the RDoC framework by NIMH officials Michael Kozak and Bruce Cuthbert, and spotlights RDoC-oriented investigative efforts by leading psychophysiological research groups as examples of how clinical science might be reshaped through application of RDoC principles. Accompanying commentaries highlight key aspects of the work by each group, and discuss reported methods/findings in relation to promises and challenges of the RDoC initiative more broadly. © 2016 Society for Psychophysiological Research.

A possible reason behind the initial formation of pentagonal dodecahedron cavities in sI-methane hydrate nucleation: A DFT study

NASA Astrophysics Data System (ADS)

Mondal, Sukanta; Goswami, Tamal; Jana, Gourhari; Misra, Anirban; Chattaraj, Pratim Kumar

2018-01-01

In this letter, a possible reason behind selective host-guest organization in the initial stage of sI methane hydrate nucleation is provided, through density functional theory based calculations. In doing so, we have connected earlier experimental and theoretical observations on the structure and energetics of sI methane hydrate to our findings. Geometry and relative stability of small (H2O)5 and (H2O)6 clusters, presence of CH4 guest, integrity and cavity radius of (H2O)20 and (H2O)24, as well as the weak van der Waals type of forces, particularly dispersion interaction, are major factors responsible for initial formation of methane encapsulated dodecahedron cavity over tetrakaidecahedron.

CONDITIONS FOR SUCCESSFUL HELIUM DETONATIONS IN ASTROPHYSICAL ENVIRONMENTS

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

Holcomb, Cole; Guillochon, James; De Colle, Fabio

2013-07-01

Several models for Type Ia-like supernova events rely on the production of a self-sustained detonation powered by nuclear reactions. In the absence of hydrogen, the fuel that powers these detonations typically consists of either pure helium (He) or a mixture of carbon and oxygen (C/O). Studies that systematically determine the conditions required to initiate detonations in C/O material exist, but until now no analogous investigation of He matter has been conducted. We perform one-dimensional reactive hydrodynamical simulations at a variety of initial density and temperature combinations and find critical length scales for the initiation of He detonations that range betweenmore » 1 and 10{sup 10} cm. A simple estimate of the length scales over which the total consumption of fuel will occur for steady-state detonations is provided by the Chapman-Jouguet (CJ) formalism. Our initiation lengths are consistently smaller than the corresponding CJ length scales by a factor of {approx}100, providing opportunities for thermonuclear explosions in a wider range of low-mass white dwarfs (WDs) than previously thought possible. We find that virialized WDs with as little mass as 0.24 M{sub Sun} can be detonated, and that even less massive WDs can be detonated if a sizable fraction of their mass is raised to a higher adiabat. That the initiation length is exceeded by the CJ length implies that certain systems may not reach nuclear statistical equilibrium within the time it takes a detonation to traverse the object. In support of this hypothesis, we demonstrate that incomplete burning will occur in the majority of He WD detonations and that {sup 40}Ca, {sup 44}Ti, or {sup 48}Cr, rather than {sup 56}Ni, is the predominant burning product for many of these events. We anticipate that a measure of the quantity of the intermediate-mass elements and {sup 56}Ni produced in a helium-rich thermonuclear explosion can potentially be used to constrain the nature of the progenitor system.« less

Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART.

PubMed

Hoffman, Susie; Tymejczyk, Olga; Kulkarni, Sarah; Lahuerta, Maria; Gadisa, Tsigereda; Remien, Robert H; Melaku, Zenebe; Nash, Denis; Elul, Batya

2017-12-01

Stigma harms the mental health of HIV-positive individuals and reduces adherence to antiretroviral therapy (ART), but less is known about stigma and other outcomes across the HIV care continuum. Among 1180 Ethiopian adults initiating ART at 6 urban HIV clinics, we examined the relationship of internalized, anticipated, and enacted stigma to HIV care-related outcomes ascertained by interview (repeat HIV-positive testing, provider vs. self-referred testing, missed clinic visit before ART initiation, eagerness to begin ART), and by abstraction of routinely collected clinical data (late ART initiation, 3-month gap in care following ART initiation). Logistic regression was used to assess the association of each type of stigma with each outcome, adjusting for potential confounders. Scoring higher on each stigma domain was associated with 50%-90% higher odds of repeat HIV-positive testing. High internalized stigma was associated with higher odds of provider vs. self-referred test [adjusted odds ratio (aOR)high vs. low: 1.7; 95% confidence interval (CI): 1.3 to 2.2]. Higher anticipated stigma was associated with lower eagerness to begin ART (aORhigh vs. low: 0.55; 0.35-0.87; aORmedium vs. low: 0.45; 95% CI: 0.30 to 0.69). Any enacted stigma was associated with higher odds of a missed visit (aORany vs. none 1.8; 1.2-2.8). Stigma was not associated with late ART-initiation or with a subsequent gap in care. These findings provide further evidence of the importance of measuring and addressing stigma across the entire care continuum. Future work should test hypotheses about specific stigma domains and outcomes in prospective intervention or observational studies.

The Impact of a History of Adverse Childhood Experiences on Breastfeeding Initiation and Exclusivity: Findings from a National Population Health Survey.

PubMed

Ukah, Ugochinyere Vivian; Adu, Prince A; De Silva, Dane A; von Dadelszen, Peter

2016-12-01

Exclusive breastfeeding is strongly recommended by the World Health Organization. Given the low rate of exclusive breastfeeding in Canada and the increasing reports of a history of adverse childhood experiences, this study sought to investigate the association between a history of adverse childhood experiences and breastfeeding initiation and breastfeeding. Data used for this study were based on the 2011-2012 Canadian Community Health Survey, collected using a cross-sectional survey. The outcome measures were breastfeeding initiation and exclusive breastfeeding for 6 months or more. History of adverse childhood experiences was the main explanatory variable. Multivariable logistic regression models were developed to investigate the effect on breastfeeding initiation and on exclusive breastfeeding in women who gave birth within 5 years before when the surveys were conducted. The study sample included 697 and 633 women for analyses on breastfeeding initiation and breastfeeding, respectively. The proportion of women with breastfeeding initiation and exclusive breastfeeding for up to 6 months in this study were 96.8% and 42.8%, respectively. After controlling for age and highest level of education, having a history of adverse childhood experiences was not significantly associated with breastfeeding initiation (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.10-1.87), but mothers with such history were less likely to exclusively breastfeed for up to 6 months compared with those without (OR 0.53, 95% CI 0.31-0.90). These findings suggest the need for more breastfeeding monitoring programs beyond the hospital environment to provide more support to Canadian mothers, especially those who have experienced adverse childhood experiences or trauma in the past.

Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings.

PubMed

Melo, J S; Garfein, R S; Hayashi, K; Milloy, M J; DeBeck, K; Sun, S; Jain, S; Strathdee, S A; Werb, D

2018-01-01

The prevention of drug injecting is often cited as a justification for the deployment of law enforcement and for the continuation of drug criminalization policies. We sought to characterize the impact of law enforcement interactions on the risk that people who inject drugs (PWID) report assisting others with injection initiation in three North American countries. Cross-sectional data from PWID participating in cohort studies in three cities (San Diego, USA; Tijuana, Mexico; Vancouver, Canada) were pooled (August 2014-December 2016). The dependent variable was defined as recently (i.e., past six months) providing injection initiation assistance; the primary independent variable was the frequency of recent law enforcement interactions, defined categorically (0 vs. 1 vs. 2-5 vs. ≥6). We employed multivariable logistic regression analyses to assess this relationship while controlling for potential confounders. Among 2122 participants, 87 (4.1%) reported recently providing injection initiation assistance, and 802 (37.8%) reported recent law enforcement interactions. Reporting either one or more than five recent interactions with law enforcement was not significantly associated with injection initiation assistance. Reporting 2-5 law enforcement interactions was associated with initiation assistance (Adjusted Odds Ratio=1.74, 95% Confidence Interval: 1.01-3.02). Reporting interactions with law enforcement was not associated with a reduced likelihood that PWID reported initiating others into injection drug use. Instead, we identified a positive association between reporting law enforcement interactions and injection initiation assistance among PWID in multiple settings. These findings raise concerns regarding the effectiveness of drug law enforcement to deter injection drug use initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effect of Prospective Payment on Admission and Treatment Policy: Evidence from Inpatient Rehabilitation Facilities

PubMed Central

Sood, Neeraj; Huckfeldt, Peter J; Grabowski, David C; Newhouse, Joseph P; Escarce, José J

2013-01-01

We examine provider responses to the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS), which simultaneously reduced marginal reimbursement and increased average reimbursement. IRFs could respond to the PPS by changing the number of patients admitted, admitting different types of patients, or changing the intensity of care. We use Medicare claims data to separately estimate each type of provider response. We also examine changes in patient outcomes and spillover effects on other post-acute care providers. We find that costs of care initially fell following the PPS, which we attribute to changes in treatment decisions rather than the characteristics of patients admitted to IRFs within the diagnostic categories we examine. However, the probability of admission to IRFs increased after the PPS due to the expanded admission policies of providers. We find modest spillover effects in other post-acute settings and negative health impacts for only one of three diagnostic groups studied. PMID:23994598

Plain radiologic findings and chronological changes of incipient phase osteosarcoma overlooked by primary physicians.

PubMed

Song, Won Seok; Jeon, Dae-Geun; Cho, Wan Hyeong; Kong, Chang-Bae; Cho, Sang Hyun; Lee, Jung Wook; Lee, Soo-Yong

2014-06-01

We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.

Photon Counting as a Probe of Superfluidity in a Two-Band Bose-Hubbard System Coupled to a Cavity Field

NASA Astrophysics Data System (ADS)

Rajaram, Sara; Trivedi, Nandini

2013-12-01

We show that photon number measurement can be used to detect superfluidity for a two-band Bose-Hubbard model coupled to a cavity field. The atom-photon coupling induces transitions between the two internal atomic levels and results in entangled polaritonic states. In the presence of a cavity field, we find different photon numbers in the Mott-insulating versus superfluid phases, providing a method of distinguishing the atomic phases by photon counting. Furthermore, we examine the dynamics of the photon field after a rapid quench to zero atomic hopping by increasing the well depth. We find a robust correlation between the field’s quench dynamics and the initial superfluid order parameter, thereby providing a novel and accurate method of determining the order parameter.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2015-01-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Tales of The Sea: Connecting people with dementia to the UK heritage through maritime archaeology (innovative practice).

PubMed

Cutler, Clare; Palma, Paola; Innes, Anthea

2016-09-20

This paper reports on a pilot study evaluating the impact of a series of interactive and educational maritime archaeological sessions for people with dementia. A typical archaeological approach was adopted including excavations, recovery and reconstruction of artefacts. Findings from this study demonstrate the importance of providing information, delivering alternative activities, enabling educational opportunities and offering support to and for people living with dementia. Our findings further illustrate that people with dementia can be included in maritime archaeology and that including people with dementia in heritage-based initiatives is possible. © The Author(s) 2016.

Complementary and Alternative Approaches to Menopause.

PubMed

Taylor, Maida

2015-09-01

Given the persistent confusion about the risks and benefits of hormone therapy since 2002 and the first publication from the Women's Health Initiative's primary findings, women and health care providers are increasingly motivated to find effective, nonhormonal approaches to treat menopause-related symptoms. Complementary and alternative medicine has grown increasingly popular in the last decade. A wide array of botanic medicines is offered as an alternative approach to hormone therapy for menopause, but data documenting efficacy and safety are limited. None of the available botanicals is as effective as hormone therapy in the management of vasomotor symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

The Individualized Classroom Assessment Scoring System (inCLASS): Preliminary Reliability and Validity of a System for Observing Preschoolers’ Competence in Classroom Interactions

PubMed Central

Downer, Jason T.; Booren, Leslie M.; Lima, Olivia K.; Luckner, Amy E.; Pianta, Robert C.

2012-01-01

This paper introduces the Individualized Classroom Assessment Scoring System (inCLASS), an observation tool that targets children’s interactions in preschool classrooms with teachers, peers, and tasks. In particular, initial evidence is reported of the extent to which the inCLASS meets the following psychometric criteria: inter-rater reliability, normal distributions and adequate range, construct validity, and criterion-related validity. These initial findings suggest that the inCLASS has the potential to provide an authentic, contextualized assessment of young children’s classroom behaviors. Future directions for research with the inCLASS are discussed. PMID:23175598

The Intergenerational Transmission of Implicit and Explicit Attitudes Toward Smoking

PubMed Central

Sherman, Steven J.; Chassin, Laurie; Presson, Clark; Seo, Dong-Chul; Macy, Jonathan T.

2009-01-01

This study examined the intergenerational transmission of implicit and explicit attitudes toward smoking, as well as the role of these attitudes in adolescents’ smoking initiation. There was evidence of intergenerational transmission of implicit attitudes. Mothers who had more positive implicit attitudes had children with more positive implicit attitudes. In turn, these positive implicit attitudes of adolescents predicted their smoking initiation 18-months later. Moreover, these effects were obtained above and beyond the effects of explicit attitudes. These findings provide the first evidence that the intergenerational transmission of implicit cognition may play a role in the intergenerational transmission of an addictive behavior. PMID:20126293

MORAL HAZARD IN HEALTH INSURANCE: DO DYNAMIC INCENTIVES MATTER?

PubMed Central

Aron-Dine, Aviva; Einav, Liran; Finkelstein, Amy; Cullen, Mark

2016-01-01

Using data from employer-provided health insurance and Medicare Part D, we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts. We exploit the fact that, because annual coverage usually resets every January, individuals who join a plan later in the year face the same initial (“spot”) price of healthcare but a higher expected end-of-year (“future”) price. We find a statistically significant response of initial utilization to the future price, rejecting the null that individuals respond only to the spot price. We discuss implications for analysis of moral hazard in health insurance. PMID:26769985

Least squares QR-based decomposition provides an efficient way of computing optimal regularization parameter in photoacoustic tomography.

PubMed

Shaw, Calvin B; Prakash, Jaya; Pramanik, Manojit; Yalavarthy, Phaneendra K

2013-08-01

A computationally efficient approach that computes the optimal regularization parameter for the Tikhonov-minimization scheme is developed for photoacoustic imaging. This approach is based on the least squares-QR decomposition which is a well-known dimensionality reduction technique for a large system of equations. It is shown that the proposed framework is effective in terms of quantitative and qualitative reconstructions of initial pressure distribution enabled via finding an optimal regularization parameter. The computational efficiency and performance of the proposed method are shown using a test case of numerical blood vessel phantom, where the initial pressure is exactly known for quantitative comparison.

Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

PubMed Central

Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

2015-01-01

Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels

PubMed Central

Rankin, Kristin M.; Gavin, Loretta; Moran, John W.; Kroelinger, Charlan D.; Vladutiu, Catherine J.; Goodman, David A.; Sappenfield, William M.

2018-01-01

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists’ contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes. PMID:27423235

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels.

PubMed

Rankin, Kristin M; Gavin, Loretta; Moran, John W; Kroelinger, Charlan D; Vladutiu, Catherine J; Goodman, David A; Sappenfield, William M

2016-11-01

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

Impact of patient-centered medical home assignment on emergency room visits among uninsured patients in a county health system.

PubMed

Roby, Dylan H; Pourat, Nadereh; Pirritano, Matthew J; Vrungos, Shelley M; Dajee, Himmet; Castillo, Dan; Kominski, Gerald F

2010-08-01

The Medical Services Initiative program--a safety net-based system of care--in Orange County included assignment of uninsured, low-income residents to a patient-centered medical home. The medical home provided case management, a team-based approach for treating disease, and increased access to primary and specialty care among other elements of a patient-centered medical home. Providers were paid an enhanced fee and pay-for-performance incentives to ensure delivery of comprehensive treatment. Medical Services Initiative enrollees who were assigned to a medical home for longer time periods were less likely to have any emergency room (ER) visits or multiple ER visits. Switching medical homes three or more times was associated with enrollees being more likely to have any ER visits or multiple ER visits. The findings provide evidence that successful implementation of the patient-centered medical home model in a county-based safety net system is possible and can reduce unnecessary ER use.

Community-Based Participatory Initiatives to Increase Breastfeeding Rates in Indiana.

PubMed

Friesen, Carol A; Hormuth, Laura J; Cardarelli, Tina L

2015-11-01

In 2012, the Centers for Disease Control and Prevention awarded the Indiana State Department of Health funding for breastfeeding activities. The grant, issued in part in response to the 2011 Surgeon General's Call to Action to Support Breastfeeding, focused on providing funding and technical support to small community-based organizations to address challenges encountered by breastfeeding mothers. Indiana used the funds to develop the Community Breastfeeding Support Initiative (CBSI). The goal was to provide funding and technical support to small community-based organizations to carry out self-selected projects in their communities. The 13 CBSI programs served 1345 individual clients (n = 3664 visits) during the 9-month period. This article provides valuable information about collaboration at the state level and the supporting infrastructure in place to carry out this project. Our findings about the number of clients served, number of visits, community-specific programs and activities, and lessons learned can be used by other organizations as they plan breastfeeding support programs for their community. © The Author(s) 2015.

Rapid space trajectory generation using a Fourier series shape-based approach

NASA Astrophysics Data System (ADS)

Taheri, Ehsan

With the insatiable curiosity of human beings to explore the universe and our solar system, it is essential to benefit from larger propulsion capabilities to execute efficient transfers and carry more scientific equipments. In the field of space trajectory optimization the fundamental advances in using low-thrust propulsion and exploiting the multi-body dynamics has played pivotal role in designing efficient space mission trajectories. The former provides larger cumulative momentum change in comparison with the conventional chemical propulsion whereas the latter results in almost ballistic trajectories with negligible amount of propellant. However, the problem of space trajectory design translates into an optimal control problem which is, in general, time-consuming and very difficult to solve. Therefore, the goal of the thesis is to address the above problem by developing a methodology to simplify and facilitate the process of finding initial low-thrust trajectories in both two-body and multi-body environments. This initial solution will not only provide mission designers with a better understanding of the problem and solution but also serves as a good initial guess for high-fidelity optimal control solvers and increases their convergence rate. Almost all of the high-fidelity solvers enjoy the existence of an initial guess that already satisfies the equations of motion and some of the most important constraints. Despite the nonlinear nature of the problem, it is sought to find a robust technique for a wide range of typical low-thrust transfers with reduced computational intensity. Another important aspect of our developed methodology is the representation of low-thrust trajectories by Fourier series with which the number of design variables reduces significantly. Emphasis is given on simplifying the equations of motion to the possible extent and avoid approximating the controls. These facts contribute to speeding up the solution finding procedure. Several example applications of two and three-dimensional two-body low-thrust transfers are considered. In addition, in the multi-body dynamic, and in particular the restricted-three-body dynamic, several Earth-to-Moon low-thrust transfers are investigated.

Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans.

PubMed

Haeder, Simon F; Weimer, David L; Mukamel, Dana B

2016-07-01

The adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act has received much scrutiny recently. Various studies have established that networks are generally narrow. To learn more about network adequacy and access to care, we investigated two questions. First, no matter the nominal size of a network, can patients gain access to primary care services from providers of their choice in a timely manner? Second, how does access compare to plans sold outside insurance Marketplaces? We conducted a "secret shopper" survey of 743 primary care providers from five of California's nineteen insurance Marketplace pricing regions in the summer of 2015. Our findings indicate that obtaining access to primary care providers was generally equally challenging both inside and outside insurance Marketplaces. In less than 30 percent of cases were consumers able to schedule an appointment with an initially selected physician provider. Information about provider networks was often inaccurate. Problems accessing services for patients with acute conditions were particularly troubling. Effectively addressing issues of network adequacy requires more accurate provider information. Project HOPE—The People-to-People Health Foundation, Inc.

Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.

PubMed

Leeman, Jennifer; Blitstein, Jonathan L; Goetz, Joshua; Moore, Alexis; Tessman, Nell; Wiecha, Jean L

2016-08-11

Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs. The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths. We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative. Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan. We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions.

Examination of the placenta: medico-legal implications.

PubMed

Chang, Kenneth Tou-En

2014-10-01

Formal examination of the placenta may provide valuable information to the clinicians, family, and court of law in cases of adverse pregnancy outcome when litigation is initiated. Placental examination contributes towards the identification of specific intrinsic or secondary placental lesions, and understanding the nature of the intrauterine environment. This article provides an update of important placental pathologies that may contribute towards neurologic injury of the newborn child, and describes the role of placental findings in the adjudication of cases of adverse neonatal outcome. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach.

PubMed

Esmaeilzadeh, Pouyan; Sambasivan, Murali

2016-12-01

Literature shows existence of barriers to Healthcare Information Exchange (HIE) assimilation process. A number of studies have considered assimilation of HIE as a whole phenomenon without regard to its multifaceted nature. Thus, the pattern of HIE assimilation in healthcare providers has not been clearly studied due to the effects of contingency factors on different assimilation phases. This study is aimed at defining HIE assimilation phases, recognizing assimilation pattern, and proposing a classification to highlight unique issues associated with HIE assimilation. A literature review of existing studies related to HIE efforts from 2005 was undertaken. Four electronic research databases (PubMed, Web of Science, CINAHL, and Academic Search Premiere) were searched for articles addressing different phases of HIE assimilation process. Two hundred and fifty-four articles were initially selected. Out of 254, 44 studies met the inclusion criteria and were reviewed. The assimilation of HIE is a complicated and a multi-staged process. Our findings indicated that HIE assimilation process consisted of four main phases: initiation, organizational adoption decision, implementation and institutionalization. The data helped us recognize the assimilation pattern of HIE in healthcare organizations. The results provide useful theoretical implications for research by defining HIE assimilation pattern. The findings of the study also have practical implications for policy makers. The findings show the importance of raising national awareness of HIE potential benefits, financial incentive programs, use of standard guidelines, implementation of certified technology, technical assistance, training programs and trust between healthcare providers. The study highlights deficiencies in the current policy using the literature and identifies the "pattern" as an indication for a new policy approach. Copyright © 2016 Elsevier Inc. All rights reserved.

Cumulative Causation of Rural Migration and Initial Peri-Urbanization in China.

PubMed

Hao, Lingxin

2012-01-01

This paper posits that rural migration feeds the high demand for cheap labor in peri-urbanization, which is driven by globalization, flows of foreign capital, and entrepreneurial local governments. While the gravity model and push/pull perspective ignore the dynamics of migratory course, we use the cumulative causation of migration theory to conceptualize social expectations for outmigration and social resources from migrant networks in destinations. Four major findings are drawn from this demographic analysis based on micro data from China's 2000 Census. First, the expectation of outmigration significantly increases outmigration, and this effect is independent of push factors. Second, foreign direct investment (FDI) contributes to attracting rural labor migrants from other provinces to peri-urban areas as it does to cities. Third, social resources from migrant networks play an important role in attracting rural labor migrants to both city and noncity destinations. Fourth, the importance of wage differentials declines in gravitating rural labor migrants to peri-urban areas. These findings provide tentative evidence that rural labor migration is indispensable during initial peri-urbanization. Infused with flows of FDI and entrepreneurial local governments, rural migration has created a favorable initial condition for peri-urbanization.

Cumulative Causation of Rural Migration and Initial Peri-Urbanization in China*

PubMed Central

Hao, Lingxin

2014-01-01

This paper posits that rural migration feeds the high demand for cheap labor in peri-urbanization, which is driven by globalization, flows of foreign capital, and entrepreneurial local governments. While the gravity model and push/pull perspective ignore the dynamics of migratory course, we use the cumulative causation of migration theory to conceptualize social expectations for outmigration and social resources from migrant networks in destinations. Four major findings are drawn from this demographic analysis based on micro data from China’s 2000 Census. First, the expectation of outmigration significantly increases outmigration, and this effect is independent of push factors. Second, foreign direct investment (FDI) contributes to attracting rural labor migrants from other provinces to peri-urban areas as it does to cities. Third, social resources from migrant networks play an important role in attracting rural labor migrants to both city and noncity destinations. Fourth, the importance of wage differentials declines in gravitating rural labor migrants to peri-urban areas. These findings provide tentative evidence that rural labor migration is indispensable during initial peri-urbanization. Infused with flows of FDI and entrepreneurial local governments, rural migration has created a favorable initial condition for peri-urbanization. PMID:25525564

Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

PubMed

Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

2013-01-01

With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

Reintegrating Children into the System of Substitute Care: Evaluation of the Exceptional Care Pilot Project

ERIC Educational Resources Information Center

Armour, Marilyn P.; Schwab, James

2005-01-01

This pilot study presents findings from a project to evaluate a program initiated by a state child welfare agency for its most hard-to-serve youth (N = 46). This emerging population is so dangerous and unmanageable that they are difficult, if not impossible, to place or treat. One state responded to this challenge by providing exceptional care…

Initial Teacher Education Programmes: Providing a Space to Address the Disproportionate Exclusion of Black Pupils from Schools in England?

ERIC Educational Resources Information Center

Gazeley, Louise; Dunne, Máiréad

2013-01-01

Exclusion from school is a disciplinary sanction used in English schools to manage behaviour by limiting a young person's attendance at school and the over-representation of Black pupils in national exclusions statistics has been a long-standing cause of concern. This paper reports on the findings of a small-scale, qualitative study that explored…

Recent insights into brassinosteroid signaling in plants: its dual control of plant immunity and stomatal development.

PubMed

Kong, Xiangpei; Pan, Jiaowen; Cai, Guohua; Li, Dequan

2012-11-01

Brassinosteroid (BR) signaling, plant innate immunity, and stomatal developments are three pathways that are initiated by receptor-like kinases. This commentary focuses on the latest findings in the role of BR signaling in plant immunity and stomatal development that provide some insight into the molecular mechanism of the BR signal pathway interacting with other receptor signaling pathways.

The Identification and Role of School Libraries that Function as Instructional Materials Centers and Implications for Library Education in the United States.

ERIC Educational Resources Information Center

Lohrer, Alice

In 1961, the American Association of School Librarians requested a status study to identify elementary, junior and senior high school library programs which serve as instructional materials centers (IMC). An IMC library provides all types of instructional materials and services for teachers and pupils. Initial findings, which were tabulated after…

School Processes That Can Drive Scaling-Up of an Innovation, or Contribute to Its Abandonment. Conference Paper

ERIC Educational Resources Information Center

Zacamy, Jenna; Newman, Denis; Lazarev, Valeriy; Lin, Li

2015-01-01

This paper reports findings from a multi-year study of the scale-up of Reading Apprenticeship (RA), an approach to improve academic literacy by helping teachers provide the support students need to be successful readers in the content areas. WestEd's Strategic Literacy Initiative (SLI), began developing the program in 1995 and has since reached…

Quantifying and Understanding Effects from Wildlife, Radar, and Public Engagement on Future Wind Deployment

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

Tegen, Suzanne

This presentation provides an overview of findings from a report published in 2016 by researchers at the National Renewable Energy Laboratory, An Initial Evaluation of Siting Considerations on Current and Future Wind Deployment. The presentation covers the background for research, the Energy Department's Wind Vision, research methods, siting considerations, the wind project deployment process, and costs associated with siting considerations.

Finding Funding: A Guide to Federal Sources for Out-of-School TIme and Community School Initiatives. Revised and Updated.

ERIC Educational Resources Information Center

Padgette, Heather Clapp

Noting the growing nation-wide demand for affordable, high-quality, out-of-school time and community school programs, this guide is intended to assist program developers, policy makers, and community leaders identify federal funding sources to support out-of-school time or broader-based community school services. The guide provides an overview of…

More than a Paycheck? The Impact of Summer Youth Employment on Students' Educational Engagement and Success. IESP Policy Brief No. 02-12

ERIC Educational Resources Information Center

Leos-Urbel, Jacob; Schwartz, Amy Ellen; Weinstein, Meryle; Weitzman, Beth C.

2012-01-01

This policy brief presents initial findings of the impact of New York City's Summer Youth Employment Program (SYEP) on academic outcomes for public school students. Despite the broad appeal of providing summer jobs for urban youth, there is little research documenting the relationship between summer employment and educational outcomes for high…

Experimental Civilian Personnel Office Project (EXPO): Final Report for Nonappropriated Fund Sites

DTIC Science & Technology

1991-07-01

existing data bases; budgetary data; and other documents provided by the test sites. The results indicate that EXPO initiatives had a positive impact on...EXPO has had a positive impact on NAF operations and profitability of revenue-generating activities has remained stable. Important findings include...appropriate education and training resources are available. v viii VllI CONTENTS INTRO DU CTIO N

A Journey to Find What's Working in America's Schools

ERIC Educational Resources Information Center

Healy, Michelle

2013-01-01

This article provides a description of the birth of The Odyssey Initiative. As teachers, this group of three, all educators, knew that there was outrage about the state of education in America. Griping about our nation's schools has almost become a pastime, and with very good reason. However, they found the solutions being offered to save our…

The Effects of Classroom Instructional Strategies on Science Achievement of Elementary-School Students in Japan: Findings from the Third International Mathematics and Science Study (TIMSS)

ERIC Educational Resources Information Center

House, J. Daniel

2006-01-01

This article deals with the Third International Mathematics and Science Study (TIMSS). TIMSS has provided a comprehensive assessment of educational contexts and mathematics and science achievement (National Research Council, 1999). The initial TIMSS assessment was conducted in 1995 (TIMSS 1995) and several studies have examined factors related to…

Cytokinin signalling inhibitory fields provide robustness to phyllotaxis

NASA Astrophysics Data System (ADS)

Besnard, Fabrice; Refahi, Yassin; Morin, Valérie; Marteaux, Benjamin; Brunoud, Géraldine; Chambrier, Pierre; Rozier, Frédérique; Mirabet, Vincent; Legrand, Jonathan; Lainé, Stéphanie; Thévenon, Emmanuel; Farcot, Etienne; Cellier, Coralie; Das, Pradeep; Bishopp, Anthony; Dumas, Renaud; Parcy, François; Helariutta, Ykä; Boudaoud, Arezki; Godin, Christophe; Traas, Jan; Guédon, Yann; Vernoux, Teva

2014-01-01

How biological systems generate reproducible patterns with high precision is a central question in science. The shoot apical meristem (SAM), a specialized tissue producing plant aerial organs, is a developmental system of choice to address this question. Organs are periodically initiated at the SAM at specific spatial positions and this spatiotemporal pattern defines phyllotaxis. Accumulation of the plant hormone auxin triggers organ initiation, whereas auxin depletion around organs generates inhibitory fields that are thought to be sufficient to maintain these patterns and their dynamics. Here we show that another type of hormone-based inhibitory fields, generated directly downstream of auxin by intercellular movement of the cytokinin signalling inhibitor ARABIDOPSIS HISTIDINE PHOSPHOTRANSFER PROTEIN 6 (AHP6), is involved in regulating phyllotactic patterns. We demonstrate that AHP6-based fields establish patterns of cytokinin signalling in the meristem that contribute to the robustness of phyllotaxis by imposing a temporal sequence on organ initiation. Our findings indicate that not one but two distinct hormone-based fields may be required for achieving temporal precision during formation of reiterative structures at the SAM, thus indicating an original mechanism for providing robustness to a dynamic developmental system.

Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

PubMed

Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

2015-09-01

Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

Implementing quality initiatives in healthcare organizations: drivers and challenges.

PubMed

Abdallah, Abdallah

2014-01-01

Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

Rethinking sexual initiation: pathways to identity formation among gay and bisexual Mexican male youth.

PubMed

Carrillo, Héctor; Fontdevila, Jorge

2011-12-01

The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzes the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation--one heavily-based on gender roles, one based on homosociality, and one based on object choice--which inform the men's interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups.

ANTICIPATORY POSTURAL ADJUSTMENTS PRIOR TO STEP INITIATION ARE HYPOMETRIC IN UNTREATED PARKINSON'S DISEASE: AN ACCELEROMETER-BASED APPROACH

PubMed Central

Mancini, Martina; Zampieri, Cris; Carlson-Kuhta, Patricia; Chiari, Lorenzo; Horak, Fay B.

2010-01-01

Background and purpose Anticipatory postural adjustments (APAs), prior to step initiation, are bradykinetic in advanced Parkinson's disease (PD) and may be one of the factors associated with ‘start hesitation’. However, little is known about APAs in the early stage of PD. In this study, we determined whether body-worn accelerometers could be used to characterize step initiation deficits in subjects with early-to-moderate, untreated PD. Methods Eleven PD and 12 healthy control subjects were asked to take two steps. Postural adjustments were compared from center of pressure (COP) and from acceleration of the trunk at the center of mass level (L5). Results Our findings show that APAs measured from the peak COP displacement towards the swing leg and the peak trunk acceleration towards the stance leg were smaller in untreated PD compared to control subjects. The magnitude of APAs measured from peak COP displacements and accelerations were correlated. Conclusion These results suggest that quantitative analysis of step initiation from one accelerometer on the trunk could provide useful information for the characterization of patients in early stages of PD, when clinical evidence of start hesitation may not be detectable. Ambulatory monitoring of step initiation is also promising for monitoring patient progression in the home environment, and eventually providing feedback for preventing freezing of gait episodes. PMID:19473350

Encapsulation of a Decision-Making Model to Optimize Supplier Selection via Structural Equation Modeling (SEM)

NASA Astrophysics Data System (ADS)

Sahul Hameed, Ruzanna; Thiruchelvam, Sivadass; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Mat Husin, Norhayati; Ezanee Rusli, Mohd; Yong, Lee Choon; Ghazali, Azrul; Itam, Zarina; Hakimie, Hazlinda; Beddu, Salmia; Liyana Mohd Kamal, Nur

2016-03-01

This paper proposes a conceptual framework to compare criteria/factor that influence the supplier selection. A mixed methods approach comprising qualitative and quantitative survey will be used. The study intend to identify and define the metrics that key stakeholders at Public Works Department (PWD) believed should be used for supplier. The outcomes would foresee the possible initiatives to bring procurement in PWD to a strategic level. The results will provide a deeper understanding of drivers for supplier’s selection in the construction industry. The obtained output will benefit many parties involved in the supplier selection decision-making. The findings provides useful information and greater understanding of the perceptions that PWD executives hold regarding supplier selection and the extent to which these perceptions are consistent with findings from prior studies. The findings from this paper can be utilized as input for policy makers to outline any changes in the current procurement code of practice in order to enhance the degree of transparency and integrity in decision-making.

The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature.

PubMed

Oyesanya, Tolu

2017-01-01

Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyse and synthesize studies' findings separately for the patient and family experience. The initial search provided 2871 records. Ultimately, 11 studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient's injury, a desire to be involved in the patient's care, mixed feelings about staff support and a high perceived need for information. Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centred and directions for future research.

The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature

PubMed Central

Oyesanya, Tolu

2017-01-01

Background Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. Methods A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyze and synthesize studies’ findings separately for the patient and family experience. Results The initial search provided 2,871 records. Ultimately, eleven studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient’s injury, desire to be involved in the patient’s care, mixed feelings about staff support, and high perceived need for information. Conclusions Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centered, and directions for future research. PMID:28055226

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

Mink, S. E. de; Belczynski, K., E-mail: S.E.deMink@uva.nl, E-mail: kbelczyn@astrouw.edu.pl

The initial mass function (IMF), binary fraction, and distributions of binary parameters (mass ratios, separations, and eccentricities) are indispensable inputs for simulations of stellar populations. It is often claimed that these are poorly constrained, significantly affecting evolutionary predictions. Recently, dedicated observing campaigns have provided new constraints on the initial conditions for massive stars. Findings include a larger close binary fraction and a stronger preference for very tight systems. We investigate the impact on the predicted merger rates of neutron stars and black holes. Despite the changes with previous assumptions, we only find an increase of less than a factor ofmore » 2 (insignificant compared with evolutionary uncertainties of typically a factor of 10–100). We further show that the uncertainties in the new initial binary properties do not significantly affect (within a factor of 2) our predictions of double compact object merger rates. An exception is the uncertainty in IMF (variations by a factor of 6 up and down). No significant changes in the distributions of final component masses, mass ratios, chirp masses, and delay times are found. We conclude that the predictions are, for practical purposes, robust against uncertainties in the initial conditions concerning binary parameters, with the exception of the IMF. This eliminates an important layer of the many uncertain assumptions affecting the predictions of merger detection rates with the gravitational wave detectors aLIGO/aVirgo.« less

Patient-centered medical home implementation and primary care provider turnover.

PubMed

Sylling, Philip W; Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Batten, Adam J; Helfrich, Christian D; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2014-12-01

The Veterans Health Administration (VHA) began implementing a patient-centered medical home (PCMH) model of care delivery in April 2010 through its Patient Aligned Care Team (PACT) initiative. PACT represents a substantial system reengineering of VHA primary care and its potential effect on primary care provider (PCP) turnover is an important but unexplored relationship. This study examined the association between a system-wide PCMH implementation and PCP turnover. This was a retrospective, longitudinal study of VHA-employed PCPs spanning 29 calendar quarters before PACT and eight quarters of PACT implementation. PCP employment periods were identified from administrative data and turnover was defined by an indicator on the last quarter of each uncensored period. An interrupted time series model was used to estimate the association between PACT and turnover, adjusting for secular trend and seasonality, provider and job characteristics, and local unemployment. We calculated average marginal effects (AME), which reflected the change in turnover probability associated with PACT implementation. The quarterly rate of PCP turnover was 3.06% before PACT and 3.38% after initiation of PACT. In adjusted analysis, PACT was associated with a modest increase in turnover (AME=4.0 additional PCPs per 1000 PCPs per quarter, P=0.004). Models with interaction terms suggested that the PACT-related change in turnover was increasing in provider age and experience. PACT was associated with a modest increase in PCP turnover, concentrated among older and more experienced providers, during initial implementation. Our findings suggest that policymakers should evaluate potential workforce effects when implementing PCMH.

Concordance of adolescent human papillomavirus vaccination parental report with provider report in the National Immunization Survey-Teen (2008-2013).

PubMed

Hirth, Jacqueline; Kuo, Yong-Fang; Laz, Tabassum Haque; Starkey, Jonathan M; Rupp, Richard E; Rahman, Mahbubur; Berenson, Abbey B

2016-08-17

To examine the accuracy of parental report of HPV vaccination through examination of concordance, with healthcare provider vaccination report as the comparison. The 2008-2013 National Immunization Survey (NIS)-Teen was used to examine accuracy of parent reports of HPV vaccination for their female daughters aged 13-17years, as compared with provider report of initiation and number of doses. Multivariable logistic regression models were used to examine associations related to concordance of parent and provider report. Of 51,746 adolescents, 84% concordance for HPV vaccine initiation and 70% concordance for number of doses was observed. Accuracy varied by race/ethnicity, region, time, and income. The parent report of number of doses was more likely to be accurate among parents of 13 and 14year old females than 17year olds. Accuracy of initiation and number of doses were lower among Hispanic and black adolescents compared to white parents. The odds of over-report was higher among minorities compared to whites, but the odds of underreport was also markedly higher in these groups compared to parents of white teens. Accuracy of parental vaccine report decreased across time. These findings are important for healthcare providers who need to ascertain the vaccination status of young adults. Strengthening existing immunization registries to improve data sharing capabilities and record completeness could improve vaccination rates, while avoiding costs associated with over-vaccination. Copyright © 2016 Elsevier Ltd. All rights reserved.

Promoting gender parity in basic education: Lessons from a technical cooperation project in Yemen

NASA Astrophysics Data System (ADS)

Yuki, Takako; Mizuno, Keiko; Ogawa, Keiichi; Mihoko, Sakai

2013-06-01

Many girls are not sent to school in Yemen, despite basic education being free as well as compulsory for all children aged 6-15. Aiming to improve girls' enrolment by increasing parental and community involvement, the Japan International Cooperation Agency (JICA) offered a technical cooperation project in June 2005 called Broadening Regional Initiative for Developing Girls' Education (BRIDGE). Phase 1 of this project ran for three and a half years, piloting a participatory school management model supported by school grants in six districts of the Taiz Governorate in the Southwest of Yemen. To find out how successful this approach has been in a traditional society, the authors of this paper analysed the gender parity index (GPI) of the project's pilot schools. Based on data collected at three points in time (in the initial and final years of the project, and two years after the project's end), their findings suggest that interventions in school management which strongly emphasise girls' education can be effective in improving gender parity rather quickly, regardless of the schools' initial conditions. However, the authors also observe that the pilot schools' post-project performance in terms of gender parity is mixed. While the local government allocated budgets for school grants to all pilot schools even after the project's end, training and monitoring activities were cut back. The authors further observe that the variation in performance appears to be significantly correlated with school leaders' initial perceptions of gender equality and with the number of female teachers employed. These findings point to the importance of providing schools with continuous long-term guidance and of monitoring those which implement school improvement programmes.

A Review of Smoking Research In Malaysia.

PubMed

Wee, L H; Chan, C M H; Yogarabindranath, S N

2016-06-01

Two hundred and seventy one original published materials related to tobacco use were found in a search through a database dedicated to indexing all original data relevant to Medicine and Health in Malaysia from 1996 - 2015. A total of 147 papers were selected and reviewed on the basis of their relevance and implications for future research. Findings were summarised, categorised and presented according to epidemiology, behaviour, clinical features and management of smoking. Most studies are cross-sectional with small sample sizes. Studies on smoking initiation and prevalence showed mixed findings with many small scale studies within the sub-groups. The majority of the studies were related to factors that contribute to initiation in adolescents. Nonetheless, there are limited studies on intervention strategies to curb smoking among this group. There is a lack of clinical studies to analyse tobacco use and major health problems in Malaysia. In addition, studies on the best treatment modalities on the use of pharmacotherapy and behavioural counselling have also remained unexplored. Reasons why smokers do not seek clinic help to quit smoking need further exploration. A finding on the extent of effort carried out by healthcare providers in assisting smokers to make quit attempts is not known. Studies on economic and government initiatives on policies and tobacco use focus mainly on the effects of cigarette bans, increased cigarettes taxes and the influence of the tobacco industry. Recommendations are given for the government to increase efforts in implementing smoke-free legislation, early and tailored interventions. Clinical studies in this area are lacking, as are opportunities to research on ways to reduce smoking initiation age and the most effective quit smoking strategies.

Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine.

PubMed

Coustasse, Alberto; Cunningham, Brian; Deslich, Stacie; Willson, Eric; Meadows, Pamela

2015-01-01

Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption.

Anatomy of a late spring snowfall on sea ice

NASA Astrophysics Data System (ADS)

Perovich, Donald; Polashenski, Christopher; Arntsen, Alexandra; Stwertka, Carolyn

2017-03-01

Spring melt initiation is a critical process for Arctic sea ice. Melting conditions decrease surface albedo at a time of high insolation, triggering powerful albedo feedback. Weather events during melt initiation, such as new snowfalls, can stop or reverse the albedo decline, however. Here we present field observations of such a snow event and demonstrate its enduring impact through summer. Snow fell 3-6 June 2014 in the Chukchi Sea, halting melt onset. The snow not only raised albedo but also provided a significant negative latent heat flux, averaging -51 W m-2 from 3 to 6 June. The snowfall delayed sustained melt by 11 days, creating cascading impacts on surface energy balance that totaled some 135 MJ/m2 by mid-August. The findings highlight the sensitivity of sea ice conditions on seasonal time scales to melt initiation processes.

Objective analysis of pseudostress over the Indian Ocean using a direct-minimization approach

NASA Technical Reports Server (NTRS)

Legler, David M.; Navon, I. M.; O'Brien, James J.

1989-01-01

A technique not previously used in objective analysis of meteorological data is used here to produce monthly average surface pseudostress data over the Indian Ocean. An initial guess field is derived and a cost functional is constructed with five terms: approximation to initial guess, approximation to climatology, a smoothness parameter, and two kinematic terms. The functional is minimized using a conjugate-gradient technique, and the weight for the climatology term controls the overall balance of influence between the climatology and the initial guess. Results from various weight combinations are presented for January and July 1984. Quantitative and qualitative comparisons to the subject analysis are made to find which weight combination provides the best results. The weight on the approximation to climatology is found to balance the influence of the original field and climatology.

The EuPA Biobank Initiative: Meeting the future challenges of biobanking in proteomics & systems medicine.

PubMed

Wheelock, Åsa M; Paulson, Linda; Litton, Jan-Eric

2015-09-08

In this News & Reviews Discussion, the recently launched EuPA (European Proteomics Association) Biobank Initiative is introduced in the context of current and future challenges in biobanking. The purpose of the initiative is to provide a forumand knowledge platform for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forum and easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, as well as the output and productivity from existing biobanks. The underutilization of biobanks has recently been identified as an emerging issue of biobankingworldwide. Measures to improve our ability to locate and access appropriate sample collections for a wide range of research purposes may enhance both the scientific quality and biobank sustainability, thereby contributing to the important task of moving our research beyond basic findings and mere publications, into clinical practice. This manuscript is intended as a Discussion piece, and represents a recollection of the presentation under the “EuPA Initiative” session at HUPO/EuPA 2014 in Madrid. The launch of the EuPA (European Proteomics Association) Biobank Initiative in the context of current and future challenges in biobanking is discussed. The purpose of the initiative is to provide a forum and knowledge base for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forumand easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, aswell as the output and productivity fromexisting biobanks. The underutilization of biobanks has recently been identified as a challenge to the well-being and economic sustainability of biobanking worldwide. Measures to improve our ability to localize and access appropriate sample collections for validation studies and other research purposes is thus of benefit bothto scientific quality and biobank sustainability, thereby contributing to the important task of moving our research beyond basic findings and mere publications, into clinical practice. This article is part of a Special Issue entitled: HUPO 2014.

The medico-legal prerequisite for initiating quarantine and isolation practices in public health emergency management in hospitals in Ghana.

PubMed

Norman, I D; Aikins, M; Binka, F N

2011-12-01

Hospitals and other health facilities in Ghana do not appear to have standardized practices for quarantine and isolation in public health emergency management. This paper reviews the legislative framework governing the medico-legal prerequisites for initiating quarantine and isolation procedures as articulated in the Infectious Disease Act (Cap 78) 1908 amended, 1935, the Quarantine Act (Cap 77) 1915 amended, 1938, the Emergency Powers Act of 1994, (Act 472), and the National Disaster Management Act, 1996, (Act 517) in consonance with the 1992 Constitution of Ghana. The findings provide that (1) The legislative framework outlines systematic standards and protocols to be followed in the committal of person or persons in quarantine and isolation during public health emergencies. (2) These standards and protocols consider as imperative, the creation of standardized national templates for the initiation of quarantine and isolation measures. (3) The non-compliance of the standards and protocols renders vulnerable medical facilities and hospitals with their personnel to the threat of medical malpractice suits and breach of professional ethics. This paper provides suggestions to hospital administrators and medical personnel of how to develop administrative templates in compliance with the law in managing public health emergencies. It also provides examples of such templates for possible adoption by hospitals and other health administrators.

Global Passivity in Microscopic Thermodynamics

NASA Astrophysics Data System (ADS)

Uzdin, Raam; Rahav, Saar

2018-04-01

The main thread that links classical thermodynamics and the thermodynamics of small quantum systems is the celebrated Clausius inequality form of the second law. However, its application to small quantum systems suffers from two cardinal problems. (i) The Clausius inequality does not hold when the system and environment are initially correlated—a commonly encountered scenario in microscopic setups. (ii) In some other cases, the Clausius inequality does not provide any useful information (e.g., in dephasing scenarios). We address these deficiencies by developing the notion of global passivity and employing it as a tool for deriving thermodynamic inequalities on observables. For initially uncorrelated thermal environments the global passivity framework recovers the Clausius inequality. More generally, global passivity provides an extension of the Clausius inequality that holds even in the presences of strong initial system-environment correlations. Crucially, the present framework provides additional thermodynamic bounds on expectation values. To illustrate the role of the additional bounds, we use them to detect unaccounted heat leaks and weak feedback operations ("Maxwell demons") that the Clausius inequality cannot detect. In addition, it is shown that global passivity can put practical upper and lower bounds on the buildup of system-environment correlations for dephasing interactions. Our findings are highly relevant for experiments in various systems such as ion traps, superconducting circuits, atoms in optical cavities, and more.

Measuring adolescent friendly health services in India: A scoping review of evaluations.

PubMed

Hoopes, Andrea J; Agarwal, Paras; Bull, Sheana; Chandra-Mouli, Venkatraman

2016-11-15

Initiatives to promote adolescent friendly health services (AFHS) have been taking place in India and many low- and middle-income countries for nearly two decades. Evaluations of these initiatives have been placed in the public arena from time to time, but little is known about what they say about the overall situation on AFHS in India. This study aimed to describe how efforts to provide AFHS in India have been evaluated, how well they have been evaluated, and what their findings and implications are. We conducted a scoping review of evaluations of AFHS initiatives in India from 2000 to 2014. An electronic search was carried out in Medline and EMBASE. A manual search of grey literature was also performed, and experts were contacted in order to obtain additional manuscripts and reports. Thirty evaluation reports were identified representing a broad geographic distribution. Evaluations have focused on government-sponsored AFHS programmes or independent non-governmental organization (NGO) initiatives to strengthen government services. The evaluations primarily measured programme outputs (e.g. quality and service utilization) and health behavioural outcomes (e.g. condom use). Study designs were commonly descriptive or quasi-experimental. Most evaluations found improvement in quality and utilization of services, and some demonstrated an increase in adolescent knowledge or health behaviours. Few measured positive project/programme results such as older age at first pregnancy. Strengths of evaluations were clear objectives, frequent use of multiple data sources, and assessment of programmatic outputs as well as health outcomes. Weaknesses were lack of consistency and quality. Our findings confirm that a number of evaluations of AFHS initiatives in India have been carried out. They point to service quality and in behavioural improvements in adolescents. However, their lack of consistency hinders comparison across sites, and their uneven quality means that their findings need to be interpreted with caution.

Timing of the initiation of parenteral nutrition in critically ill children

PubMed Central

Jimenez, Lissette; Mehta, Nilesh M.; Duggan, Christopher

2018-01-01

Purpose of Review To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Recent Findings Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition (EN) generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to EN often leads to reliance on parenteral nutrition (PN). The timing of PN initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with postponing initiation of PN to 1 week after admission to the pediatric intensive care unit (PICU). Summary Although there is no consensus on the optimal timing of PN initiation among critically ill children, recent literature does not support the immediate initiation of PN on PICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate PN. As with all medical interventions, the initiation of PN should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding. PMID:28376054

Distribution and diversity of ribosome binding sites in prokaryotic genomes.

PubMed

Omotajo, Damilola; Tate, Travis; Cho, Hyuk; Choudhary, Madhusudan

2015-08-14

Prokaryotic translation initiation involves the proper docking, anchoring, and accommodation of mRNA to the 30S ribosomal subunit. Three initiation factors (IF1, IF2, and IF3) and some ribosomal proteins mediate the assembly and activation of the translation initiation complex. Although the interaction between Shine-Dalgarno (SD) sequence and its complementary sequence in the 16S rRNA is important in initiation, some genes lacking an SD ribosome binding site (RBS) are still well expressed. The objective of this study is to examine the pattern of distribution and diversity of RBS in fully sequenced bacterial genomes. The following three hypotheses were tested: SD motifs are prevalent in bacterial genomes; all previously identified SD motifs are uniformly distributed across prokaryotes; and genes with specific cluster of orthologous gene (COG) functions differ in their use of SD motifs. Data for 2,458 bacterial genomes, previously generated by Prodigal (PROkaryotic DYnamic programming Gene-finding ALgorithm) and currently available at the National Center for Biotechnology Information (NCBI), were analyzed. Of the total genes examined, ~77.0% use an SD RBS, while ~23.0% have no RBS. Majority of the genes with the most common SD motifs are distributed in a manner that is representative of their abundance for each COG functional category, while motifs 13 (5'-GGA-3'/5'-GAG-3'/5'-AGG-3') and 27 (5'-AGGAGG-3') appear to be predominantly used by genes for information storage and processing, and translation and ribosome biogenesis, respectively. These findings suggest that an SD sequence is not obligatory for translation initiation; instead, other signals, such as the RBS spacer, may have an overarching influence on translation of mRNAs. Subsequent analyses of the 5' secondary structure of these mRNAs may provide further insight into the translation initiation mechanism.

The structure of Turkish trait-descriptive adjectives.

PubMed

Somer, O; Goldberg, L R

1999-03-01

This description of the Turkish lexical project reports some initial findings on the structure of Turkish personality-related variables. In addition, it provides evidence on the effects of target evaluative homogeneity vs. heterogeneity (e.g., samples of well-liked target individuals vs. samples of both liked and disliked targets) on the resulting factor structures, and thus it provides a first test of the conclusions reached by D. Peabody and L. R. Goldberg (1989) using English trait terms. In 2 separate studies, and in 2 types of data sets, clear versions of the Big Five factor structure were found. And both studies replicated and extended the findings of Peabody and Goldberg; virtually orthogonal factors of relatively equal size were found in the homogeneous samples, and a more highly correlated set of factors with relatively large Agreeableness and Conscientiousness dimensions was found in the heterogeneous samples.

Eye on the B-ALL: B-cell receptor repertoires reveal persistence of numerous B-lymphoblastic leukemia subclones from diagnosis to relapse

PubMed Central

Bashford-Rogers, R J M; Nicolaou, K A; Bartram, J; Goulden, N J; Loizou, L; Koumas, L; Chi, J; Hubank, M; Kellam, P; Costeas, P A; Vassiliou, G S

2016-01-01

The strongest predictor of relapse in B-cell acute lymphoblastic leukemia (B-ALL) is the level of persistence of tumor cells after initial therapy. The high mutation rate of the B-cell receptor (BCR) locus allows high-resolution tracking of the architecture, evolution and clonal dynamics of B-ALL. Using longitudinal BCR repertoire sequencing, we find that the BCR undergoes an unexpectedly high level of clonal diversification in B-ALL cells through both somatic hypermutation and secondary rearrangements, which can be used for tracking the subclonal composition of the disease and detect minimal residual disease with unprecedented sensitivity. We go on to investigate clonal dynamics of B-ALL using BCR phylogenetic analyses of paired diagnosis-relapse samples and find that large numbers of small leukemic subclones present at diagnosis re-emerge at relapse alongside a dominant clone. Our findings suggest that in all informative relapsed patients, the survival of large numbers of clonogenic cells beyond initial chemotherapy is a surrogate for inherent partial chemoresistance or inadequate therapy, providing an increased opportunity for subsequent emergence of fully resistant clones. These results frame early cytoreduction as an important determinant of long-term outcome. PMID:27211266

Expanding the Scope of an Automated Radiology Recommendation-Tracking Engine: Initial Experiences and Lessons Learned.

PubMed

Licurse, Mindy Y; Lalevic, Darco; Zafar, Hanna M; Schnall, Mitchell D; Cook, Tessa S

2017-04-01

An automated radiology recommendation-tracking engine for incidental focal masses in the liver, pancreas, kidneys, and adrenal glands was launched within our institution in July 2013. For 2 years, the majority of CT, MR, and US examination reports generated within our health system were mined by the engine. However, the need to expand the system beyond the initial four organs was soon identified. In July 2015, the second phase of the system was implemented and expanded to include additional anatomic structures in the abdomen and pelvis, as well as to provide non-radiology and non-imaging options for follow-up. The most frequent organs with incidental findings, outside of the original four, included the ovaries and the endometrium, which also correlated to the most frequently ordered imaging follow-up study of pelvic ultrasound and non-imaging follow-up study of endometrial biopsies, respectively. The second phase expansion has demonstrated new venues for augmenting and improving radiologist roles in optimal communication and management of incidental findings.

Spectral domain optical coherence tomography and fundus autofluorescence findings in cytomegalovirus retinitis in HIV-infected patients.

PubMed

Yashiro, Shigeko; Nishijima, Takeshi; Yamamoto, Yuuka; Sekine, Yumi; Yoshida-Hata, Natsuyo; Iida, Tomohiro; Oka, Shinichi

2018-05-01

To assess the usefulness of spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) findings in cytomegalovirus (CMV) retinitis. Observational case series. Thirteen eyes of 11 human immunodeficiency virus (HIV)-positive patients with CMV retinitis underwent full ophthalmologic examinations, SD-OCT, and 4 eyes of 4 patients underwent FAF. FAF images included short-wavelength autofluorescence (SW-AF) and near-infrared autofluorescence (IR-AF). CMV retinitis was classified into proposed categories of acute, subacute, remission, and recurrent; the acute stage was further subdivided into initial, early, and late stages. In the initial stage, vertical structural disruption of all retinal layers was observed by SD-OCT, and FAF showed hyperautofluorescence on SW-AF and hypoautofluorescence on IR-AF. In the early stage, SD-OCT showed significant retinal thickening; cells and debris from the retinal surface to the vitreous; enlarged vessels with/without thickened vessel walls; and highly complicated serous retinal detachment. In the late to subacute stage, features observed included rhegmatogenous retinal detachment with shrinking posterior hyaloid membrane and waving from the ellipsoid zone to the retinal pigment epithelium. In remission, FAF findings were hypoautofluorescence on SW-AF and hyperautofluorescence on IR-AF. Although the number of examined eyes was limited, SD-OCT and FAF provide new information in various stages of CMV retinitis in patients with HIV infection that is not obtainable by conventional examination and which may be of great benefit when screening for the initial stage of CMV retinitis.

Frostbite: Spectrum of Imaging Findings and Guidelines for Management

PubMed Central

Brown, Richard K. J.; Levi, Benjamin; Kraft, Casey T.; Jacobson, Jon A.; Gross, Milton D.; Wong, Ka Kit

2016-01-01

Frostbite is a localized cold thermal injury that results from tissue freezing. Frostbite injuries can have a substantial effect on long-term limb function and mobility if not promptly evaluated and treated. Imaging plays a critical role in initial evaluation of frostbite injuries and in monitoring response to treatment. A multimodality approach involving radiography, digital subtraction angiography (DSA), and/or multiphase bone scintigraphy with hybrid single photon emission computed tomography (SPECT)/computed tomography (CT) is often necessary for optimal guidance of frostbite care. Radiographs serve as an initial survey of the affected limb and may demonstrate characteristic findings, depending on the time course and severity of injury. DSA is used to evaluate perfusion of affected soft tissues and identify potential targets for therapeutic intervention. Angiography-directed thrombolysis plays an essential role in tissue preservation and salvage in deep frostbite injuries. Multiphase bone scintigraphy with technetium 99m–labeled diphosphonate provides valuable information regarding the status of tissue viability after initial treatment. The addition of SPECT/CT to multiphase bone scintigraphy enables precise anatomic localization of the level and depth of tissue necrosis before its appearance at physical examination and can help uncover subtle findings that may remain occult at scintigraphy alone. Multiphase bone scintigraphy with SPECT/CT is the modality of choice for prognostication and planning of definitive surgical care of affected limbs. Appropriate use of imaging to direct frostbite care can help limit the effects that these injuries have on limb function and mobility. ©RSNA, 2016 PMID:27494386

Magnetic Fields in Population III Star Formation

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

Turk, Matthew J.; Oishi, Jeffrey S.; Abel, Tom

2012-02-22

We study the buildup of magnetic fields during the formation of Population III star-forming regions, by conducting cosmological simulations from realistic initial conditions and varying the Jeans resolution. To investigate this in detail, we start simulations from identical initial conditions, mandating 16, 32 and 64 zones per Jeans length, and studied the variation in their magnetic field amplification. We find that, while compression results in some amplification, turbulent velocity fluctuations driven by the collapse can further amplify an initially weak seed field via dynamo action, provided there is sufficient numerical resolution to capture vortical motions (we find this requirement tomore » be 64 zones per Jeans length, slightly larger than, but consistent with previous work run with more idealized collapse scenarios). We explore saturation of amplification of the magnetic field, which could potentially become dynamically important in subsequent, fully-resolved calculations. We have also identified a relatively surprising phenomena that is purely hydrodynamic: the higher-resolved simulations possess substantially different characteristics, including higher infall-velocity, increased temperatures inside 1000 AU, and decreased molecular hydrogen content in the innermost region. Furthermore, we find that disk formation is suppressed in higher-resolution calculations, at least at the times that we can follow the calculation. We discuss the effect this may have on the buildup of disks over the accretion history of the first clump to form as well as the potential for gravitational instabilities to develop and induce fragmentation.« less

Examining Physical Activity Service Provision to Culturally and Linguistically Diverse (CALD) Communities in Australia: A Qualitative Evaluation

PubMed Central

Caperchione, Cristina M.; Kolt, Gregory S.; Mummery, W. Kerry

2013-01-01

Strong evidence exists for the role of physical activity in preventing and managing a range of chronic health conditions. A particular challenge in promoting physical activity as a health strategy exists in culturally and linguistically diverse (CALD) groups, as such groups demonstrate high risk for a range of non-communicable diseases. The aim of this research was to examine the perspective of multicultural health service providers for CALD groups with respect to the physical activity services/initiatives on offer, access barriers to these services, and ideas for future service delivery in this area. Semi-structured interviews were conducted with 15 multicultural health service providers across the capital cities of the three most populous states in Australia (New South Wales, Queensland, and Victoria), and thematic content analysis was used to examine the data. Findings indicated that the majority of physical activity initiatives were associated with organizations offering other social services for CALD communities but were greatly restrained by resources. As well, it was found that most services were not designed by taking into account specific cultural requirements for CALD communities or their cultural expectations. Common barriers identified to service uptake were classified as socio-cultural (e.g., gender, language, context of health) and environmental (e.g., transportation) in nature. These findings should be utilized when planning future physical activity and health promotion initiatives for increasing CALD participation. In particular, programs need to be culturally tailored to the specific expectations of CALD groups, addressing cultural safety and sensitivity, and should be in partnership with other organizations to extend the reach and capacity. PMID:23638145

Influences on decision making among primiparous women choosing elective caesarean section in the absence of medical indications: findings from a qualitative investigation.

PubMed

Kornelsen, Jude; Hutton, Eileen; Munro, Sarah

2010-10-01

Patient-initiated elective Caesarean section (PIECS) is increasingly prevalent and is emerging as an urgent issue for individual maternity practitioners, hospitals, and policy makers, as well as for maternity patients. This qualitative study sought to explore women's experiences of the decision-making process leading to elective operative delivery without medical indication. We conducted 17 exploratory qualitative in-depth interviews with primiparous women who had undergone a patient-initiated elective Caesarean section in the absence of any medical indication. The study took place in five hospitals (three urban, two semi-rural) in British Columbia. The findings revealed three themes within the process of women deciding to have a Caesarean section: the reasons for their decision, the qualities of the decision-making process, and the social context in which the decision was made. The factors that influenced a patient-initiated request for delivery by Caesarean section in participants in this study were diverse, culturally dependent, and reflective of varying degrees of emotional and evidence-based influences. PIECS is a rare but socially significant phenomenon. The a priori decision making of some women choosing PIECS does not follow the usual diagnosis-intervention trajectory, and the care provider may have to work in reverse to ensure that the patient fully understands the risks and benefits of her decision subsequent to the decision having been made, while still ensuring patient autonomy. Results from this study provide a context for a woman's request for an elective Caesarean section without medical indication, which may contribute to a more efficacious informed consent process.

Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents

PubMed Central

Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia; Myers, John A.

2011-01-01

The purpose of this school-based cluster-randomized trial was to determine the initial acceptability, feasibility, and efficacy of an existing community-based intervention, In Our Own Voice, in a sample of US adolescent girls aged 13–17 years (n=156). In Our Own Voice is a knowledge-contact intervention that provides knowledge about mental illness to improve mental health literacy and facilitates intergroup contact with persons with mental illness as a means to reduce mental illness stigma. This longitudinal study was set in two public high schools located in a southern urban community of the U.S. Outcomes included measures of mental illness stigma and mental health literacy. Findings support the acceptability and feasibility of the intervention for adolescents who enrolled in the study. Findings to support the efficacy of In Our Own Voice to reduce stigma and improve mental health literacy are mixed. The intervention did not reduce mental illness stigma or improve mental health literacy at one week follow up. The intervention did not reduce mental illness stigma at 4 and 8 weeks follow up. The intervention did improve mental health literacy at 4 and 8 weeks follow up. Previous studies have assessed the preliminary efficacy In Our Own Voice among young adults; rarely has In Our Own Voice been investigated longitudinally and with adolescents in the United States. This study provides initial data on the effects of In Our Own Voice for this population and can be used to further adapt the intervention for adolescents. PMID:21624729

NF-κB activating complex engaged in response to EGFR oncogene inhibition drives tumor cell survival and residual disease in lung cancer

PubMed Central

Blakely, Collin M.; Pazarentzos, Evangelos; Olivas, Victor; Asthana, Saurabh; Yan, Jenny Jiacheng; Tan, Irena; Hrustanovic, Gorjan; Chan, Elton; Lin, Luping; Neel, Dana S.; Newton, William; Bobb, Kathryn; Fouts, Timothy; Meshulam, Jeffrey; Gubens, Matthew A.; Jablons, David M.; Johnson, Jeffrey R.; Bandyopadhyay, Sourav; Krogan, Nevan J.; Bivona, Trever G.

2015-01-01

Summary Although oncogene-targeted therapy often elicits profound initial tumor responses in patients, responses are generally incomplete because some tumor cells survive initial therapy as residual disease that enables eventual acquired resistance. The mechanisms underlying tumor cell adaptation and survival during initial therapy are incompletely understood. Here, through the study of EGFR-mutant lung adenocarcinoma we show that NF-κB signaling is rapidly engaged upon initial EGFR inhibitor treatment to promote tumor cell survival and residual disease. EGFR oncogene inhibition induced an EGFR-TRAF2-RIP1-IKK complex that stimulated an NF-κB-mediated transcriptional survival program. The direct NF-κB inhibitor PBS-1086 suppressed this adaptive survival program and increased the magnitude and duration of initial EGFR inhibitor response in multiple NSCLC models, including a patient-derived xenograft. These findings unveil NF-κB activation as a critical adaptive survival mechanism engaged by EGFR oncogene inhibition and provide rationale for EGFR and NF-κB co-inhibition to eliminate residual disease and enhance patient responses. PMID:25843712

Large grain instruction and phonological awareness skill influence rime sensitivity, processing speed, and early decoding skill in adult L2 learners

PubMed Central

Brennan, Christine; Booth, James R.

2016-01-01

Linguistic knowledge, cognitive ability, and instruction influence how adults acquire a second orthography yet it remains unclear how different forms of instruction influence grain size sensitivity and subsequent decoding skill and speed. Thirty-seven monolingual, literate English-speaking adults were trained on a novel artificial orthography given initial instruction that directed attention to either large or small grain size units (i.e., words or letters). We examined how initial instruction influenced processing speed (i.e., reaction time (RT)) and sensitivity to different orthographic grain sizes (i.e., rimes and letters). Directing attention to large grain size units during initial instruction resulted in higher accuracy for rimes, whereas directing attention to smaller grain size units resulted in slower RTs across all measures. Additionally, phonological awareness skill modulated early learning effects, compensating for the limitations of the initial instruction provided. Collectively, these findings suggest that when adults are learning to read a second orthography, consideration should be given to how initial instruction directs attention to different grain sizes and inherent phonological awareness ability. PMID:27829705

EVIDENCE FOR NEWLY INITIATED RECONNECTION IN THE SOLAR WIND AT 1 AU

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

Xu, Xiaojun; Ma, Yonghui; Wong, Hon-Cheng

2015-08-10

We report the first evidence for a large-scale reconnection exhaust newly initiated in the solar wind using observations from three spacecraft: ACE, Wind, and ARTEMIS P2. We identified a well-structured X-line exhaust using measurements from ARTEMIS P2 in the downstream solar wind. However, in the upstream solar wind, ACE detected the same current sheet that corresponds to the exhaust identified by ARTEMIS P2 data without showing any reconnection signals. We cannot find any reconnection signals from Wind located between ACE and ARTEMIS P2. Within the exhaust, a magnetic island is identified, which is not consistent with the quasi-steady feature asmore » previously reported and provides further evidence that the reconnection is newly initiated. Our observations show that the entering of energetic particles, probably from Earth's bow shock, makes the crucial difference between the non-reconnecting current sheet and the exhaust. Since no obvious driving factors are responsible for the reconnection initiation, we infer that these energetic particles probably play an important role in the reconnection initiation. Theoretical analysis also shows support for this potential mechanism.« less

Problems in Classroom Engagement: Validation of an Assessment for District-Wide Use in the Early Primary Grades

ERIC Educational Resources Information Center

Barghaus, Katherine; Fantuzzo, John; LeBoeuf, Whitney; Henderson, Cassandra; Li, Feifei; McDermott, Paul

2017-01-01

Research Findings: The aim of this study was to provide an initial investigation into the psychometric properties of the Problems in Classroom Engagement Scale (PCES). The PCES was designed and tested for district-wide use as part of the report card system for a large urban school district. The PCES was administered to all 1st-, 2nd-, and…

Behind the Scenes with OpenLearn: The Challenges of Researching the Provision of Open Educational Resources

ERIC Educational Resources Information Center

Godwin, Stephen; McAndrew, Patrick; Santos, Andreia

2008-01-01

Web-enabled technology is now being applied on a large scale. In this paper we look at open access provision of teaching and learning leading to many users with varying patterns and motivations for use. This has provided us with a research challenge to find methods that help us understand and explain such initiatives. We describe ways to model the…

Pennsylvania Action Research Network (PA-ARN) Staff Development through Five Regional Staff Development Centers. Final Report. July 1997-June 1998.

ERIC Educational Resources Information Center

Pennsylvania State Univ., McKeesport.

The Pennsylvania Action Research Network project was initiated in 1995-1996 to provide Pennsylvania literacy educators with the following: a better method for taking published research findings and testing and adapting them in their own classrooms; a way to study their own research ideas on a daily-action basis; and a systematic way to share and…

Experimentally Estimated Impacts of School Vouchers on College Enrollment and Degree Attainment. Program on Education Policy and Governance Working Papers Series. PEPG 15-01

ERIC Educational Resources Information Center

Chingos, Matthew M.; Peterson, Paul E.

2015-01-01

We provide the first experimental estimates of the long-term impacts of a voucher to attend private school by linking data from a privately sponsored voucher initiative in New York City, which awarded the scholarships by lottery to low-income families, to administrative records on college enrollment and degree attainment. We find no significant…

Inflation with Whip-Shaped Suppressed Scalar Power Spectra

NASA Astrophysics Data System (ADS)

Hazra, Dhiraj Kumar; Shafieloo, Arman; Smoot, George F.; Starobinsky, Alexei A.

2014-08-01

Motivated by the idea that inflation occurs at the grand unified theory symmetry breaking scale, in this Letter we construct a new class of large field inflaton potentials where the inflaton starts with a power law potential; after an initial period of relatively fast roll that lasts until after a few e folds inside the horizon it transits to the attractor of the slow roll part of the potential with a lower power. Because of the initial fast roll stages of inflation, we find a suppression in scalar primordial power at large scales and at the same time the choice of the potential can provide us a tensor primordial spectrum with a high amplitude. This suppression in scalar power with a large tensor-to-scalar ratio helps us to reconcile the Planck and BICEP2 data in a single framework. We find that a transition from a cubic to quadratic form of inflaton potential generates an appropriate suppression in the power of the scalar primordial spectrum that provides a significant improvement in fit compared to the power law model when compared with Planck and BICEP2 data together. We calculate the extent of non-Gaussianity, specifically, the bispectrum for the best fit potential, and show that it is consistent with Planck bispectrum constraints.

Psychological factors related to nurses' intentions to initiate an antipsychotic or psychosocial intervention with nursing home residents.

PubMed

Ludwin, Brian M; Meeks, Suzanne

2018-05-03

This study examined the validity of a psychological model for understanding nursing home providers' treatment choices when managing challenging dementia-related behaviors. Ninety-nine nurses from 26 long-term care facilities responded to a case study with their intentions to initiate an antipsychotic or psychosocial intervention and completed self-report measures of their attitudes, descriptive norms, self-efficacy, and outcome expectancies. The multi-level modeling results demonstrated that nurses with more positive outcome expectancies for the effect of an antipsychotic on resident behavior, and those with more positive attitudes towards antipsychotics, had greater intentions to initiate an antipsychotic. Intentions to initiate a psychosocial intervention were greater when nurses perceived a lower prevalence of antipsychotics and in facilities with nurses who collectively had higher self-efficacy to implement such interventions. The findings offer partial support for the proposed model and possible intervention targets to improve psychosocial intervention use and antipsychotic prescribing. Published by Elsevier Inc.

Decomposing mechanisms of abnormal saccade generation in schizophrenia patients: Contributions of volitional initiation, motor preparation, and fixation release.

PubMed

Reuter, Benedikt; Elsner, Björn; Möllers, David; Kathmann, Norbert

2016-11-01

Clinical and theoretical models suggest deficient volitional initiation of action in schizophrenia patients. Recent research provided an experimental model of testing this assumption using saccade tasks. However, inconsistent findings necessitate a specification of conditions on which the deficit may occur. The present study sought to detect mechanisms that may contribute to poor performance. Sixteen schizophrenia patients and 16 healthy control participants performed visually guided and two types of volitional saccade tasks. All tasks varied as to whether the initial fixation stimulus disappeared (fixation stimulus offset) or continued during saccade initiation, and whether a direction cue allowed motor preparation of the specific saccade. Saccade latencies of the two groups were differentially affected by task type, fixation stimulus offset, and cueing, suggesting abnormal volitional saccade generation, fixation release, and motor preparation in schizophrenia. However, substantial performance deficits may only occur if all affected processes are required in a task. © 2016 Society for Psychophysiological Research.

Dynamics of coherent states in regular and chaotic regimes of the non-integrable Dicke model

NASA Astrophysics Data System (ADS)

Lerma-Hernández, S.; Chávez-Carlos, J.; Bastarrachea-Magnani, M. A.; López-del-Carpio, B.; Hirsch, J. G.

2018-04-01

The quantum dynamics of initial coherent states is studied in the Dicke model and correlated with the dynamics, regular or chaotic, of their classical limit. Analytical expressions for the survival probability, i.e. the probability of finding the system in its initial state at time t, are provided in the regular regions of the model. The results for regular regimes are compared with those of the chaotic ones. It is found that initial coherent states in regular regions have a much longer equilibration time than those located in chaotic regions. The properties of the distributions for the initial coherent states in the Hamiltonian eigenbasis are also studied. It is found that for regular states the components with no negligible contribution are organized in sequences of energy levels distributed according to Gaussian functions. In the case of chaotic coherent states, the energy components do not have a simple structure and the number of participating energy levels is larger than in the regular cases.

Exploring the use patterns of a mobile health application for alcohol addiction before the initial lapse after detoxification.

PubMed

Chih, Ming-Yuan

2014-01-01

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS)1, a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial lapse), the active users (with the lowest chance of such behavior) participated more in online social activities, used more sessions, viewed more pages, and used A-CHESS longer. However, the chances of the initial lapse between A-CHESS user profiles were not statistically different. Implications of this finding were provided.

The provider perception inventory: psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior.

PubMed

Windsor, Liliane C; Benoit, Ellen; Ream, Geoffrey L; Forenza, Brad

2013-01-01

Nongay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The provider perception inventory (PPI) is a 39-item scale that measures health services providers' stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: (1) individual attitudes (19 items) and (2) agency environment (11 items). Structural equation modeling analysis supported the scale's predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed.

Internal waves in sheared flows: Lower bound of the vorticity growth and propagation discontinuities in the parameter space

NASA Astrophysics Data System (ADS)

Fraternale, Federico; Domenicale, Loris; Staffilani, Gigliola; Tordella, Daniela

2018-06-01

This study provides sufficient conditions for the temporal monotonic decay of enstrophy for two-dimensional perturbations traveling in the incompressible, viscous, plane Poiseuille, and Couette flows. Extension of Synge's procedure [J. L. Synge, Proc. Fifth Int. Congress Appl. Mech. 2, 326 (1938); Semicentenn. Publ. Am. Math. Soc. 2, 227 (1938)] to the initial-value problem allow us to find the region of the wave-number-Reynolds-number map where the enstrophy of any initial disturbance cannot grow. This region is wider than that of the kinetic energy. We also show that the parameter space is split into two regions with clearly distinct propagation and dispersion properties.

Rocket Propulsion 21 Steering Committee Meeting (RP21) NASA In-Space Propulsion Update

NASA Technical Reports Server (NTRS)

Klem, Mark

2015-01-01

In-house Support of NEXT-C Contract Status Thruster NEXT Long Duration Test post-test destructive evaluation in progress Findings will be used to verify service life models identify potential design improvements Cathode heater fabrication initiated for cyclic life testing Thruster operating algorithm definition verification initiated to provide operating procedures for mission users High voltage propellant isolator life test voluntarily terminated after successfully operating 51,200 h Power processor unit (PPU) Replaced all problematic stacked multilayer ceramic dual inline pin capacitors within PPU Test bed Rebuilt installed discharge power supply primary power board Completed full functional performance characterization Final test report in progress Transferred PPU Testbed to contractor to support prototype design effort.

Meeting Patient and Professional Needs: Views of Stakeholders on a Training Initiative for DwSIs in Endodontics in London.

PubMed

Al-Haboubi, Mustafa; Newton, Paul; Gallagher, Jennifer E

2016-05-01

A pilot scheme was established across London to train NHS primary dental care practitioners to provide endodontic treatment of moderate difficulty. It was co-led by the former London Deanery (Health Education England: North West London) and local NHS commissioners. This research aimed to explore key stakeholders' perceptions about the purpose of the initiative, its advantages, disadvantages and future implications. Nineteen semi-structured interviews were conducted with stakeholders (commissioners and providers of the educational initiative; commissioners and providers of care, including trainees, principal dentists and specialists) involved in establishing, running and participating in the initiative and wider endodontic service provision in London. Interviews were based on a topic guide informed by the literature, and a workshop involving the London trainees. Interviews were recorded, transcribed and analysed using framework methodology. The project was perceived as supporting four key areas: addressing services, improving quality/outcomes, delivering education and enhancing professional status. There was evidence that dentists were harnessing health policy in facilitating 'reprofessionalisation' of dentistry with the creation of dentists with enhanced skills (DwSIs). Learning outcomes from the pilot were related to the accreditation of the participants, service tariffs, reimbursement for endodontic treatment on the NHS, and the need for continuity within and between services across the dental system. Uncertainty about funding and the changes within the NHS were among the concerns expressed regarding the future of the initiative. The findings of this research suggest that extending the skills of primary care practitioners may contribute to the reprofessionalisation of dentistry, which has much to contribute to patient care and the development of an integrated and accessible dental care system of quality, with improved outcomes for patients. The implications for health policy and further research are discussed.

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

PubMed

Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

Researching primary engineering education: UK perspectives, an exploratory study

NASA Astrophysics Data System (ADS)

Clark, Robin; Andrews, Jane

2010-10-01

This paper draws attention to the findings of an exploratory study that critically identified and analysed relevant perceptions of elementary level engineering education within the UK. Utilising an approach based upon grounded theory methodology, 30 participants including teachers, representatives of government bodies and non-profit providers of primary level engineering initiatives were interviewed. Three main concepts were identified during the analysis of findings, each relevant to primary engineering education. These were pedagogic issues, exposure to engineering within the curriculum and children's interest. The paper concludes that the opportunity to make a real difference to children's education by stimulating their engineering imagination suggests this subject area is of particular value.

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation

PubMed Central

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans’ formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning. PMID:27909414

Linking Workplace Aggression to Employee Well-Being and Work: The Moderating Role of Family-Supportive Supervisor Behaviors (FSSB).

PubMed

Yragui, Nanette L; Demsky, Caitlin A; Hammer, Leslie B; Van Dyck, Sarah; Neradilek, Moni B

2017-04-01

The present study examined the moderating effects of family-supportive supervisor behaviors (FSSB) on the relationship between two types of workplace aggression (i.e., patient-initiated physical aggression and coworker-initiated psychological aggression) and employee well-being and work outcomes. Data were obtained from a field sample of 417 healthcare workers in two psychiatric hospitals. Hypotheses were tested using moderated multiple regression analyses. Psychiatric care providers' perceptions of FSSB moderated the relationship between patient-initiated physical aggression and physical symptoms, exhaustion and cynicism. In addition, FSSB moderated the relationship between coworker-initiated psychological aggression and physical symptoms and turnover intentions. Based on our findings, family-supportive supervision is a plausible boundary condition for the relationship between workplace aggression and well-being and work outcomes. This study suggests that, in addition to directly addressing aggression prevention and reduction, family-supportive supervision is a trainable resource that healthcare organizations should facilitate to improve employee work and well-being in settings with high workplace aggression. This is the first study to examine the role of FSSB in influencing the relationship between two forms of workplace aggression: patient-initiated physical and coworker- initiated psychological aggression and employee outcomes.

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation.

PubMed

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans' formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning.

Asthma education: different viewpoints elicited by qualitative and quantitative methods.

PubMed

Damon, Scott A; Tardif, Richard R

2015-04-01

This project began as a qualitative examination of how asthma education provided by health professionals could be improved. Unexpected qualitative findings regarding the use of Asthma Action Plans and the importance of insurance reimbursement for asthma education prompted further quantitative examination. Qualitative individual interviews were conducted with primary care physicians in private practice who routinely provide initial diagnoses of asthma and focus groups were conducted with other clinicians in private primary care practices who routinely provide asthma education. Using the DocStyles quantitative tool two questions regarding Asthma Action Plans and insurance reimbursement were asked of a representative sample of physicians and other clinicians. The utility of Asthma Action Plans was questioned in the 2012 qualitative study. Qualitative findings also raised questions regarding whether reimbursement is the barrier to asthma education for patients performed by medical professionals it is thought to be. 2013 quantitative findings show that the majority of clinicians see Asthma Action Plans as useful. The question of whether reimbursement is a barrier to providing asthma education to patients was not resolved by the quantitative data. The majority of clinicians see Asthma Action Plans as a useful tool for patient education. Clinicians had less clear opinions on whether the lack of defined reimbursement codes acted as a barrier to asthma education. The study also provided useful audience data for design of new asthma educational tools developed by CDC.

Please Ask Gently: Using Culturally Targeted Communication Strategies to Initiate End-of-Life Care Discussions With Older Chinese Americans.

PubMed

Chi, Han-Lin; Cataldo, Janine; Ho, Evelyn Y; Rehm, Roberta S

2018-01-01

Health-care providers (HCPs) find facilitating end-of-life (EOL) care discussions challenging, especially with patients whose ethnicities differ from their own. Currently, there is little guidance on how to initiate and facilitate such discussions with older Chinese Americans (≥55 years) and their families. To explore communication strategies for HCPs to initiate EOL care discussions with older Chinese Americans in the San Francisco Bay Area. This qualitative (focused) ethnographic study included field observations and individual semistructured interviews with 14 community-dwelling older Chinese Americans who lived independently at home, 9 adult children, and 7 HCPs. Responses were analyzed using open coding, memos, and comparison across participants. The study participants emphasized the importance of assessing readiness for early EOL care discussions. All recommended using indirect communication approaches to determine older Chinese Americans' readiness. Indirect communication can be culturally targeted and applied at both system-wide (ie, health-care system) and individual (ie, HCP) levels. To institutionalize the practice, health-care facilities should implement EOL care discussion inquiries as part of routine during check-in or intake questionnaires. In individual practice, using depersonalized communication strategies to initiate the discussion was recommended to determine older Chinese Americans' readiness. Assessing readiness should be an essential and necessary action for early EOL care discussions. Culturally targeted assessment of older Chinese Americans includes using indirect communication approaches to initiate an EOL care discussion to determine their readiness. In addition to health-care system integration, providers should implement and evaluate proposed EOL discussion initiation prompts with their older Chinese American patients.

THE EFFECTS OF INITIAL ABUNDANCES ON NITROGEN IN PROTOPLANETARY DISKS

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

Schwarz, Kamber R.; Bergin, Edwin A.

2014-12-20

The dominant form of nitrogen provided to most solar system bodies is currently unknown, though available measurements show that the detected nitrogen in solar system rocks and ices is depleted with respect to solar abundances and the interstellar medium. We use a detailed chemical/physical model of the chemical evolution of a protoplanetary disk to explore the evolution and abundance of nitrogen-bearing molecules. Based on this model, we analyze how initial chemical abundances provided as either gas or ice during the early stages of disk formation influence which species become the dominant nitrogen bearers at later stages. We find that amore » disk with the majority of its initial nitrogen in either atomic or molecular nitrogen is later dominated by atomic and molecular nitrogen as well as NH{sub 3} and HCN ices, where the dominant species varies with disk radius. When nitrogen is initially in gaseous ammonia, it later becomes trapped in ammonia ice except in the outer disk where atomic nitrogen dominates. For a disk with the initial nitrogen in the form of ammonia ice, the nitrogen remains trapped in the ice as NH{sub 3} at later stages. The model in which most of the initial nitrogen is placed in atomic N best matches the ammonia abundances observed in comets. Furthermore, the initial state of nitrogen influences the abundance of N{sub 2}H{sup +}, which has been detected in protoplanetary disks. Strong N{sub 2}H{sup +} emission is found to be indicative of an N{sub 2} abundance greater than n{sub N{sub 2}}/n{sub H{sub 2}}>10{sup −6} in addition to tracing the CO snow line. Our models also indicate that NO is potentially detectable, with lower N gas abundances leading to higher NO abundances.« less

Systematic Review of Smoking Initiation among Asian Adolescents, 20052015: Utilizing the Frameworks of Triadic Influence and Planned Behavior.

PubMed

Talip, Tajidah; Murang, Zaidah; Kifli, Nurolaini; Naing, Lin

2016-01-01

A recent WHO data report on mortality attributable to tobacco use including cigarette smoking indicated a very high burden of deaths in Asia and that people often initiate smoking as early as young adolescents. The objectives of this study were to systematically review peerreviewed articles on cigarette smoking initiation among Asian adolescents and to develop a conceptual model of factors influencing smoking initiation by integrating all relevant factors based on existing data. Following a PRISMA guideline, a systematic review of articles published between 2005 and June 2015 was conducted using 5 databases on cigarette smoking initiation among adolescents (aged 1019 years) living in Asia. We summarized the main findings of each study according to our research questions and data that emerged during the data extraction process. Analysis and categorization were based on the TTI and TPB models and classification of factors extracted from the study, were as follows: personal factors, social factors, broader environmental factors, mediators, and intention to initiate smoking and smoking behavior. Of 1,227 identified studies, only 20 were included in this review. Our findings found that the mean age of cigarette smoking initiation ranged from 10 to 14 years and those who are more likely to initiate smoking are male, older adolescents, adolescents with low parental SES, individuals with low parental monitoring, low parental education level and having no discussion on smoking at home, those living in public housing and those exhibiting healthrisk behavior. Our study also revealed that the risk of smoking initiation increased when they are exposed to smokers, influenced by peers, exposed to tobacco advertisements, receive pocket money, have lack of knowledge about smoking, have poor school performance, have a family conflict and have psychological problems. The conceptual model developed demonstrated complex networks of factors influencing initiation. This systematic review presents various factors influencing smoking initiation of the Asian adolescents and provides a conceptual framework to further analyze factors. Future studies should have a standard measure of smoking initiation, should analyze interactions and the intensity of relationships between different factors or variables in the conceptual model. This will in turn consolidate the understanding of the different factors affecting smoking initiation and will help to improve interventions in this area.

HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.

PubMed

Joseph, Seth; Sow, Max; Furukawa, Michael F; Posnack, Steven; Chaffee, Mary Ann

2014-09-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted to increase electronic health record (EHR) adoption by providers and hospitals. Experts expressed skepticism about whether the program would indeed hasten adoption and could be implemented in time for the initial reporting period. Could EHR vendors meet the certification requirements, and could the industry innovate to meet small-practice needs? This study, in addition to documenting increased provider adoption, provides the first evidence of increased competitiveness and innovation in the EHR industry spurred by HITECH. For example, the number of EHR vendors certified for e-prescribing with Surescripts increased from 96 to 229 over the program's first 3 years. We also find that prescribers in small practices increasingly adopted lower-cost, Web-based e-prescribing and EHR applications at significantly higher rates (15%-35%) than did large practices (3%-4%), which generally have more human and capital resources to make significant investments. These findings suggest that EHR vendors were highly responsive to HITECH requirements and have been adapting their strategies to meet nuanced market needs, providing reason to be optimistic about the Programs' future.

Viewing social scenes: a visual scan-path study comparing fragile X syndrome and Williams syndrome.

PubMed

Williams, Tracey A; Porter, Melanie A; Langdon, Robyn

2013-08-01

Fragile X syndrome (FXS) and Williams syndrome (WS) are both genetic disorders which present with similar cognitive-behavioral problems, but distinct social phenotypes. Despite these social differences both syndromes display poor social relations which may result from abnormal social processing. This study aimed to manipulate the location of socially salient information within scenes to investigate the visual attentional mechanisms of: capture, disengagement, and/or general engagement. Findings revealed that individuals with FXS avoid social information presented centrally, at least initially. The WS findings, on the other hand, provided some evidence that difficulties with attentional disengagement, rather than attentional capture, may play a role in the WS social phenotype. These findings are discussed in relation to the distinct social phenotypes of these two disorders.

The Provider Perception Inventory: Psychometrics of a Scale Designed to Measure Provider Stigma about HIV, Substance Abuse, and MSM Behavior

PubMed Central

Windsor, Liliane Cambraia; Benoit, Ellen; Ream, Geoffrey; Forenza, Brad

2012-01-01

Non-gay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The Provider Perception Inventory (PPI) is a 39-item scale that measures health services providers’ stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: 1) Individual Attitudes (19 items), and 2) Agency Environment (11 items). Structural equation model analysis supported the scale’s predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed. PMID:23082899

Early age at start of antiretroviral therapy associated with better virologic control after initial suppression in HIV-infected infants.

PubMed

Shiau, Stephanie; Strehlau, Renate; Technau, Karl-Günter; Patel, Faeezah; Arpadi, Stephen M; Coovadia, Ashraf; Abrams, Elaine J; Kuhn, Louise

2017-01-28

The report of the 'Mississippi baby' who was initiated on antiretroviral therapy (ART) within 30 h of birth and maintained viral suppression off ART for 27 months has increased interest in the timing of ART initiation early in life. We examined associations between age at ART initiation and virologic outcomes in five cohorts of HIV-infected infants and young children who initiated ART before 2 years of age in Johannesburg, South Africa. We compared those who initiated ART early (<6 months of age) and those who started ART late (6-24 months of age). Two primary outcomes were examined: initial response to ART in three cohorts and later sustained virologic control after achieving suppression on ART in two cohorts. We did not observe consistent differences in initial viral suppression rates by age at ART initiation. Overall, initial viral suppression rates were low. Only 31, 40.1, and 26.5% of early-treated infants (<6 months of age) in the three cohorts, respectively, were suppressed less than 50 copies/ml of HIV RNA 6 months after starting ART. We did observe better sustained virologic control after achieving suppression on ART among infants starting ART early compared with late. Children who started ART early were less likely to experience viral rebound (>50 copies/ml or >1000 copies/ml) than children who started late in both cohorts. These findings provide additional support for early initiation of ART in HIV-infected infants.

76 FR 61825 - Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition To List 29 Mollusk...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

...We, the U.S. Fish and Wildlife Service announce a 90-day finding on a petition to list 29 mollusk species and subspecies as threatened or endangered, under the Endangered Species Act of 1973, as amended (Act). Based on our review, we find that the petition presents substantial scientific or commercial information indicating that listing 26 of the 29 species and subspecies may be warranted. Therefore, with the publication of this notice, we are initiating a review of the status of the 26 species and subspecies to determine if listing any of them is warranted. To ensure that the status review is comprehensive, we are requesting scientific and commercial data and other information regarding these 26 species and subspecies. Based on the status review, we will issue a 12-month finding on the petition, which will address whether the petitioned action is warranted, as provided in the Act.

Implementation of Cognitive-Behavioral Substance Abuse Treatment in Sub-Saharan Africa: Treatment Engagement and Abstinence at Treatment Exit.

PubMed

Gouse, Hetta; Magidson, Jessica F; Burnhams, Warren; Remmert, Jocelyn E; Myers, Bronwyn; Joska, John A; Carrico, Adam W

2016-01-01

This study documented the treatment cascade for engagement in care and abstinence at treatment exit as well as examined correlates of these outcomes for the first certified Matrix Model® substance abuse treatment site in Sub-Saharan Africa. This retrospective chart review conducted at a resource-limited community clinic in Cape Town, South Africa, assessed treatment readiness and substance use severity at treatment entry as correlates of the number of sessions attended and biologically confirmed abstinence at treatment exit among 986 clients who initiated treatment from 2009-2014. Sociodemographic and clinical correlates of treatment outcomes were examined using logistic regression, modeling treatment completion and abstinence at treatment exit separately. Of the 2,233 clients who completed screening, approximately 44% (n = 986) initiated treatment. Among those who initiated treatment, 45% completed at least four group sessions, 30% completed early recovery skills training (i.e., at least eight group sessions), and 13% completed the full 16-week program. Approximately half (54%) of clients who provided a urine sample had negative urine toxicology results for any substance at treatment exit. Higher motivation at treatment entry was independently associated with greater odds of treatment completion and negative urine toxicology results at treatment exit. Findings provide initial support for the successful implementation the Matrix Model in a resource-limited setting. Motivational enhancement interventions could support treatment initiation, promote sustained engagement in treatment, and achieve better treatment outcomes.

Atlas-based fuzzy connectedness segmentation and intensity nonuniformity correction applied to brain MRI.

PubMed

Zhou, Yongxin; Bai, Jing

2007-01-01

A framework that combines atlas registration, fuzzy connectedness (FC) segmentation, and parametric bias field correction (PABIC) is proposed for the automatic segmentation of brain magnetic resonance imaging (MRI). First, the atlas is registered onto the MRI to initialize the following FC segmentation. Original techniques are proposed to estimate necessary initial parameters of FC segmentation. Further, the result of the FC segmentation is utilized to initialize a following PABIC algorithm. Finally, we re-apply the FC technique on the PABIC corrected MRI to get the final segmentation. Thus, we avoid expert human intervention and provide a fully automatic method for brain MRI segmentation. Experiments on both simulated and real MRI images demonstrate the validity of the method, as well as the limitation of the method. Being a fully automatic method, it is expected to find wide applications, such as three-dimensional visualization, radiation therapy planning, and medical database construction.

Artificial genetic selection for an efficient translation initiation site for expression of human RACK1 gene in Escherichia coli

PubMed Central

Zhelyabovskaya, Olga B.; Berlin, Yuri A.; Birikh, Klara R.

2004-01-01

In bacterial expression systems, translation initiation is usually the rate limiting and the least predictable stage of protein synthesis. Efficiency of a translation initiation site can vary dramatically depending on the sequence context. This is why many standard expression vectors provide very poor expression levels of some genes. This notion persuaded us to develop an artificial genetic selection protocol, which allows one to find for a given target gene an individual efficient ribosome binding site from a random pool. In order to create Darwinian pressure necessary for the genetic selection, we designed a system based on translational coupling, in which microorganism survival in the presence of antibiotic depends on expression of the target gene, while putting no special requirements on this gene. Using this system we obtained superproducing constructs for the human protein RACK1 (receptor for activated C kinase). PMID:15034151

Surrounding community residents’ expectations of HOPE VI for their community, health and physical activity

PubMed Central

Dulin-Keita, Akilah; Hannon, Lonnie; Buys, David; Casazza, Krista; Clay, Olivio

2016-01-01

Using a community-engaged participatory research approach, this study identified surrounding community residents’ expectations for how a HOPE VI housing initiative might affect their community and individual health and physical activity. Fifty-nine women and men engaged in concept mapping, which is a mixed methods approach, where participants generate, sort, and rate ideas. Participants generated 197 unique statements. Thirteen thematic clusters related to expected changes for the community, health and physical activity emerged. Residents’ rated ‘Increased Pride in the Neighborhood’ and ‘Increased Safety’ as the most important factors related to HOPE VI whereas ‘Drawbacks of HOPE VI’ was rated as least important. This research provides insight into the potential impacts of housing initiatives from the perspective of those most affected by such initiatives. The findings also highlight environmental changes as potential mechanisms that may improve residents’ perceptions of the community and encourage healthy lifestyles. PMID:27667912

Initial value sensitivity of the Chinese stock market and its relationship with the investment psychology

NASA Astrophysics Data System (ADS)

Ying, Shangjun; Li, Xiaojun; Zhong, Xiuqin

2015-04-01

This paper discusses the initial value sensitivity (IVS) of Chinese stock market, including the single stock market and the Chinese A-share stock market, with respect to real markets and evolving models. The aim is to explore the relationship between IVS of the Chinese A-share stock market and the investment psychology based on the evolving model of genetic cellular automaton (GCA). We find: (1) The Chinese stock market is sensitively dependent on the initial conditions. (2) The GCA model provides a considerable reliability in complexity simulation (e.g. the IVS). (3) The IVS of stock market is positively correlated with the imitation probability when the intensity of the imitation psychology reaches a certain threshold. The paper suggests that the government should seek to keep the imitation psychology under a certain level, otherwise it may induce severe fluctuation to the market.

Skillful regional prediction of Arctic sea ice on seasonal timescales

NASA Astrophysics Data System (ADS)

Bushuk, Mitchell; Msadek, Rym; Winton, Michael; Vecchi, Gabriel A.; Gudgel, Rich; Rosati, Anthony; Yang, Xiaosong

2017-05-01

Recent Arctic sea ice seasonal prediction efforts and forecast skill assessments have primarily focused on pan-Arctic sea ice extent (SIE). In this work, we move toward stakeholder-relevant spatial scales, investigating the regional forecast skill of Arctic sea ice in a Geophysical Fluid Dynamics Laboratory (GFDL) seasonal prediction system. Using a suite of retrospective initialized forecasts spanning 1981-2015 made with a coupled atmosphere-ocean-sea ice-land model, we show that predictions of detrended regional SIE are skillful at lead times up to 11 months. Regional prediction skill is highly region and target month dependent and generically exceeds the skill of an anomaly persistence forecast. We show for the first time that initializing the ocean subsurface in a seasonal prediction system can yield significant regional skill for winter SIE. Similarly, as suggested by previous work, we find that sea ice thickness initial conditions provide a crucial source of skill for regional summer SIE.

On the no-boundary proposal for ekpyrotic and cyclic cosmologies

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

Battarra, Lorenzo; Lehners, Jean-Luc, E-mail: lorenzo.battarra@aei.mpg.de, E-mail: jlehners@aei.mpg.de

2014-12-01

The no-boundary proposal provides a compelling theory for the initial conditions of our universe. We study the implications of such initial conditions for ekpyrotic and cyclic cosmologies. These cosmologies allow for the existence of a new type of ''ekpyrotic instanton'', which describes the creation of a universe in the ekpyrotic contraction phase. Remarkably, we find that the ekpyrotic attractor can explain how the universe became classical. In a cyclic context, in addition to the ekpyrotic instantons there exist de Sitter-like instantons describing the emergence of the universe in the dark energy phase. Our results show that typically the ekpyrotic instantonsmore » yield a higher probability. In fact, in a potential energy landscape allowing both inflationary and cyclic cosmologies, the no-boundary proposal implies that the probability for ekpyrotic and cyclic initial conditions is vastly higher than that for inflationary ones.« less

Effect of main inclusions on crack initiation in bearing steel in the very high cycle fatigue regime

NASA Astrophysics Data System (ADS)

Gu, Chao; Bao, Yan-ping; Gan, Peng; Wang, Min; He, Jin-shan

2018-06-01

This work aims to investigate the effect of main inclusions on crack initiation in bearing steel in the very high cycle fatigue (VHCF) regime. The size and type of inclusions in the steel were quantitatively analyzed, and VHCF tests were performed. Some fatigue cracks were found to be initiated in the gaps between inclusions (Al2O3, MgO-Al2O3) and the matrix, while other cracks originated from the interior of inclusions (TiN, MnS). To explain the related mechanism, the tessellated stresses between inclusions and the matrix were calculated and compared with the yield stress of the matrix. Results revealed that the inclusions could be classified into two types under VHCF; of these two, only one type could be regarded as holes. Findings in this research provide a better understanding of how inclusions affect the high cycle fatigue properties of bearing steel.

The Cultural Adaptation of a Community-Based Child Maltreatment Prevention Initiative.

PubMed

McLeigh, Jill D; Katz, Carmit; Davidson-Arad, Bilha; Ben-Arieh, Asher

2017-06-01

A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6-year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community-level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community-based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance. © 2015 Family Process Institute.

Rethinking Sexual Initiation: Pathways to Identity Formation among Gay and Bisexual Mexican Male Youth

PubMed Central

Carrillo, Héctor; Fontdevila, Jorge

2010-01-01

The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzed the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation-- one heavily-based on gender roles, one based on homosociality, and one based on object choice-- which inform the men’s interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups. PMID:20838869

Implementation of Community-Wide Teen Pregnancy Prevention Initiatives: Focus on Partnerships.

PubMed

Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H

2017-03-01

Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

'Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation.

PubMed

Damon, Will; Small, Will; Anderson, Solanna; Maher, Lisa; Wood, Evan; Kerr, Thomas; McNeil, Ryan

2017-03-01

Patient attrition is common among people enrolled in methadone maintenance treatment (MMT) programs and most pronounced during the first year of treatment. However, the experiences of patients initiating MMT have been overlooked in the literature. This study explores experiences of MMT initiation among MMT patients, focusing on contextual influences on MMT initiation and perceptions of MMT and their subsequent influence on treatment retention. Semi-structured qualitative interviews were conducted with 39 MMT patients in Vancouver, Canada. Individuals reporting enrolment in MMT were recruited from within two ongoing cohort studies comprised of people who use drugs. Interview transcripts were analysed using an inductive and iterative approach. Two groups of MMT initiators were identified: (i) 'crisis initiators' prescribed methadone following critical transition events, such as incarceration or pregnancy; and (ii) 'everyday initiators' enrolled in MMT as part of routine healthcare utilisation. While most 'crisis initiators' and some 'everyday initiators' described experiencing coercion during MMT initiation, 'crisis initiators' were further subjected to the coercive leveraging of their vulnerability to motivate 'consent' for MMT. 'Crisis initiators' developed negative views towards MMT and were more likely to discontinue treatment. Long-standing patient-provider relationships and open dialogue were associated with more positive views regarding MMT, regardless of the circumstances of initiation. Findings underscore the need for clear and effective communication regarding treatment regimens and expectations during MMT initiation. Furthermore, training in trauma-informed care may help reduce perceptions of coercion and rates of early treatment termination. [Damon W, Small W, Anderson S, Maher L, Wood E, Kerr T, McNeil R. Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation. Drug Alcohol Rev 2017;36:253-260]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Cognitive appraisals and emotional status following a spinal cord injury in post-acute rehabilitation.

PubMed

Eaton, Rebecca; Jones, Kevin; Duff, Jane

2018-06-12

Retrospective, cross-sectional study. To investigate the factor structure of the ADAPSS-short form (ADAPSS-SF) in an acutely injured SCI population and to assess the relationship between cognitive appraisals made in the initial phase of rehabilitation and the experience of anxiety and depression. National Spinal Injuries Centre, UK. Participants were acutely injured patients admitted to the NSIC over 35 months. Cognitive appraisals were measured using the ADAPSS-SF; psychological distress was measured using the HADS. Individual profiles, including demographics and injury characteristics, were collected. Principle Component Analysis with oblique rotation demonstrated a coherent two-factor structure of the ADAPSS-SF: resilience and loss. Correlational analysis found that individuals who negatively appraised their injury were more likely to report lower mood. Findings identified four vulnerable subgroups that were more likely to negatively appraise their injury: females, individuals older at the time of SCI, individuals with AIS-A injuries and individuals whose SCI was acquired through assault. Hierarchical regression analysis reported that resilience and loss factors were significant predictors of depression. Gender, resilience and loss factors were significant predictors of anxiety. Cognitive appraisals accounted for more variance in mood above biological markers. Findings support a two-factor structure and validity of ADAPSS-SF in acute SCI rehabilitation. The study provides support for the role of cognitive appraisals in psychological adjustment in the early phases of rehabilitation, above injury characteristics. Findings highlighted the vulnerable subgroups that are more likely to initially endorse negative appraisals, which may influence clinical practice and provides an avenue for further research.

Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

PubMed Central

Cha, Jang Gyu; Kim, Dong Hun; Kim, Dae Ho; Paik, Sang Hyun; Park, Jai Soung; Park, Seong Jin; Lee, Hae Kyung; Hong, Hyun Sook; Choi, Duek Lin; Chung, Nak Eun; Lee, Bong Woo; Seo, Joong Seok

2010-01-01

Objective We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Materials and Methods Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Results Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. Conclusion A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations. PMID:20592923

The virialization density of peaks with general density profiles under spherical collapse

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

Rubin, Douglas; Loeb, Abraham, E-mail: dsrubin@physics.harvard.edu, E-mail: aloeb@cfa.harvard.edu

2013-12-01

We calculate the non-linear virialization density, Δ{sub c}, of halos under spherical collapse from peaks with an arbitrary initial and final density profile. This is in contrast to the standard calculation of Δ{sub c} which assumes top-hat profiles. Given our formalism, the non-linear halo density can be calculated once the shape of the initial peak's density profile and the shape of the virialized halo's profile are provided. We solve for Δ{sub c} for halos in an Einstein de-Sitter and a ΛCDM universe. As examples, we consider power-law initial profiles as well as spherically averaged peak profiles calculated from the statisticsmore » of a Gaussian random field. We find that, depending on the profiles used, Δ{sub c} is smaller by a factor of a few to as much as a factor of 10 as compared to the density given by the standard calculation ( ≈ 200). Using our results, we show that, for halo finding algorithms that identify halos through an over-density threshold, the halo mass function measured from cosmological simulations can be enhanced at all halo masses by a factor of a few. This difference could be important when using numerical simulations to assess the validity of analytic models of the halo mass function.« less

Creutzfeldt-Jakob Disease Presenting With Dizziness and Gaze-Evoked Nystagmus: A Case Report.

PubMed

Choi, Yun-Ju; Kang, Kyung-Wook; Lee, Sae-Young; Kang, Seung-Ho; Lee, Seung-Han; Kim, Byeong C

2016-02-01

Sporadic Creutzfeldt-Jakob disease (CJD) is clinically characterized by rapidly progressive dementia combined with other cardinal symptoms, such as myoclonus, visual or cerebellar disturbances, extrapyramidal or pyramidal disturbance, and akinetic mutism. However, as an initial manifestation, focal neurologic deficits other than the aforementioned or nonspecific generalized symptoms may lead to a misdiagnosis or a delayed diagnosis. The authors report a case of 66-year-old male patient with sporadic CJD who had dizziness, gaze-evoked nystagmus (GEN), and other central eye signs (impaired smooth pursuit, saccadic dysmetria) as an initial manifestation without dementia. The central eye signs led us to perform brain magnetic resonance images, which showed abnormal cortical high-signal intensity in both the cerebral and cerebellar hemispheres including the vestibulocerebellum. We reached a presumptive diagnosis of CJD, but the findings did not meet diagnostic criteria for probable CJD at that time. Three weeks after the initial work-ups, the patient presented with typical neurological findings of CJD: rapidly progressive dementia, akinetic mutism, and myoclonus of the left arm. Cerebrospinal fluid was positive for 14-3-3 protein, and electroencephalography showed periodic sharp wave complexes. In this patient, GEN and other central eye signs provided diagnostic clues for CJD. These unusual neurological manifestations may help physicians have a thorough knowledge of early deficits of CJD.

Review of implementation strategies to change healthcare provider behaviour in the emergency department.

PubMed

de Wit, Kerstin; Curran, Janet; Thoma, Brent; Dowling, Shawn; Lang, Eddy; Kuljic, Nebojsa; Perry, Jeffrey J; Morrison, Laurie

2018-05-01

Advances in emergency medicine research can be slow to make their way into clinical care, and implementing a new evidence-based intervention can be challenging in the emergency department. The Canadian Association of Emergency Physicians (CAEP) Knowledge Translation Symposium working group set out to produce recommendations for best practice in the implementation of a new science in Canadian emergency departments. A systematic review of implementation strategies to change health care provider behaviour in the emergency department was conducted simultaneously with a national survey of emergency physician experience. We summarized our findings into a list of draft recommendations that were presented at the national CAEP Conference 2017 and further refined based on feedback through social media strategies. We produced 10 recommendations for implementing new evidence-based interventions in the emergency department, which cover identifying a practice gap, evaluating the evidence, planning the intervention strategy, monitoring, providing feedback during implementation, and desired qualities of future implementation research. We present recommendations to guide future emergency department implementation initiatives. There is a need for robust and well-designed implementation research to guide future emergency department implementation initiatives.

Trauma-Informed Care in the Massachusetts Child Trauma Project.

PubMed

Bartlett, Jessica Dym; Barto, Beth; Griffin, Jessica L; Fraser, Jenifer Goldman; Hodgdon, Hilary; Bodian, Ruth

2016-05-01

Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. © The Author(s) 2015.

Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.

PubMed

Lecompte, Emily; Baril, Mireille

2008-01-01

To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers.

[Research and workshop on alternative fuels for aviation. Final report

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

NONE

1999-09-01

The Renewable Aviation Fuels Development Center (RAFDC) at Baylor University was granted U. S. Department of Energy (US DOE) and Federal Aviation Administration (FAA) funds for research and development to improve the efficiency in ethanol powered aircraft, measure performance and compare emissions of ethanol, Ethyl Tertiary Butyl Ether (ETBE) and 100 LL aviation gasoline. The premise of the initial proposal was to use a test stand owned by Engine Components Inc. (ECI) based in San Antonio, Texas. After the grant was awarded, ECI decided to close down its test stand facility. Since there were no other test stands available atmore » that time, RAFDC was forced to find additional support to build its own test stand. Baylor University provided initial funds for the test stand building. Other obstacles had to be overcome in order to initiate the program. The price of the emission testing equipment had increased substantially beyond the initial quote. Rosemount Analytical Inc. gave RAFDC an estimate of $120,000.00 for a basic emission testing package. RAFDC had to find additional funding to purchase this equipment. The electronic ignition unit also presented a series of time consuming problems. Since at that time there were no off-the-shelf units of this type available, one had to be specially ordered and developed. FAA funds were used to purchase a Super Flow dynamometer. Due to the many unforeseen obstacles, much more time and effort than originally anticipated had to be dedicated to the project, with much of the work done on a volunteer basis. Many people contributed their time to the program. One person, mainly responsible for the initial design of the test stand, was a retired engineer from Allison with extensive aircraft engine test stand experience. Also, many Baylor students volunteered to assemble the. test stand and continue to be involved in the current test program. Although the program presented many challenges, which resulted in delays, the RAFDC's test stand is an asset which provides an ongoing research capability dedicated to the testing of alternative fuels for aircraft engines. The test stand is now entirely functional with the exception of the electronic ignition unit which still needs adjustments.« less

Individual Placement and Support: a community mental health center approach to vocational rehabilitation.

PubMed

Becker, D R; Drake, R E

1994-04-01

Individual Placement and Support (IPS) is a vocational rehabilitation intervention for people with severe mental disabilities. IPS draws from components and philosophies of several other models. Employment specialists, who are part of the community mental health center team, provide services in the community. IPS emphasizes client preferences, rapid job finding, continuous assessment, competitive employment, integrated work settings, and follow-along supports. Initial research on IPS shows favorable results.

Finding of No Significant Impact: Environmental Assessment for Military Family Housing Privatization Initiative, Vandenberg Air Force Base, California

DTIC Science & Technology

2007-08-01

Archaeology, University of California, Los Angeles. Kennett, Douglas J. 1998 Behavioral Ecology and the Evolution of Hunter-Gatherer Societies on the...Systematics and Ecology , Department of Ecology , Evolution , and Marine Biology, University of California Santa Barbara. Environmental report No. 10...be anticipated; housing residents would be provided with information on types of native plants that can be used for landscaping to avoid the

Demonstration of Human-Autonomy Teaming Principles

NASA Technical Reports Server (NTRS)

Shively, Robert Jay

2016-01-01

Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. We have identified some critical components of HAT and ran a part-task study to introduce these components to a ground station that supports flight following of multiple aircraft. Our goal was to demonstrate, evaluate, and refine HAT principles. This presentation provides a brief summary of the study and initial findings.

Stop identity cue as a cue to language identity

NASA Astrophysics Data System (ADS)

Castonguay, Paula Lisa

The purpose of the present study was to determine whether language membership could potentially be cued by the acoustic-phonetic detail of word-initial stops and retained all the way through the process of lexical access to aid in language identification. Of particular interest were language-specific differences in CE and CF word-initial stops. Experiment 1 consisted of an interlingual homophone production task. The purpose of this study was to examine how word-initial stop consonants differ in terms of acoustic properties in Canadian English (CE) and Canadian French (CF) interlingual homophones. The analyses from the bilingual speakers in Experiment 1 indicate that bilinguals do produce language-specific differences in CE and CF word-initial stops, and that closure duration, voice onset time, and burst spectral SD may provide cues to language identity in CE and CF stops. Experiment 2 consisted of a Phoneme and Language Categorization task. The purpose of this study was to examine how stop identity cues, such as VOT and closure duration, influence a listener to identify word-initial stop consonants as belonging to Canadian English (CE) or Canadian French (CF). The RTs from the bilingual listeners in this study indicate that bilinguals do perceive language-specific differences in CE and CF word-initial stops, and that voice onset time may provide cues to phoneme and language membership in CE and CF stops. Experiment 3 consisted of a Phonological-Semantic priming task. The purpose of this study was to examine how subphonetic variations, such as changes in the VOT, affect lexical access. The results of Experiment 3 suggest that language-specific cues, such as VOT, affects the composition of the bilingual cohort and that the extent to which English and/or French words are activated is dependent on the language-specific cues present in a word. The findings of this study enhanced our theoretical understanding of lexical structure and lexical access in bilingual speakers. In addition, this study provides further insight on cross-language effects at the subphonetic level.

Culturally competent library services and related factors among health sciences librarians: an exploratory study.

PubMed

Mi, Misa; Zhang, Yingting

2017-04-01

This study investigated the current state of health sciences libraries' provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites ( p =0.04). Those who spoke another language in addition to English had higher self-rated cultural competency ( p =0.01) than those who only spoke English. These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians' perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds.

Culturally competent library services and related factors among health sciences librarians: an exploratory study

PubMed Central

Mi, Misa; Zhang, Yingting

2017-01-01

Objective This study investigated the current state of health sciences libraries’ provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. Methods This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Results Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites (p=0.04). Those who spoke another language in addition to English had higher self-rated cultural competency (p=0.01) than those who only spoke English. Conclusions These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians’ perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds. PMID:28377675

High Speed Research Program Sonic Fatigue

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A. (Technical Monitor); Beier, Theodor H.; Heaton, Paul

2005-01-01

The objective of this sonic fatigue summary is to provide major findings and technical results of studies, initiated in 1994, to assess sonic fatigue behavior of structure that is being considered for the High Speed Civil Transport (HSCT). High Speed Research (HSR) program objectives in the area of sonic fatigue were to predict inlet, exhaust and boundary layer acoustic loads; measure high cycle fatigue data for materials developed during the HSR program; develop advanced sonic fatigue calculation methods to reduce required conservatism in airframe designs; develop damping techniques for sonic fatigue reduction where weight effective; develop wing and fuselage sonic fatigue design requirements; and perform sonic fatigue analyses on HSCT structural concepts to provide guidance to design teams. All goals were partially achieved, but none were completed due to the premature conclusion of the HSR program. A summary of major program findings and recommendations for continued effort are included in the report.

Humor as a Communication Strategy in Provider-Patient Communication in a Chronic Care Setting.

PubMed

Schöpf, Andrea C; Martin, Gillian S; Keating, Mary A

2017-02-01

Humor is a potential communication strategy to accomplish various and potentially conflicting consultation goals. We investigated humor use and its reception in diabetes consultations by analyzing how and why humor emerges and its impact on the interaction. We did this by using an interactional sociolinguistics approach. We recorded 50 consultations in an Irish diabetes setting. Analysis of the humor events drew on framework analysis and on concepts from Conversation Analysis and pragmatics. The study also comprised interviews using tape-assisted recall. We identified 10 humor functions and two umbrella functions. A key finding is that most humor is relationship-protecting humor initiated by patients, that is, they voice serious messages and deal with emotional issues through humor. Our findings imply that patients' and providers' awareness of indirect communication strategies needs to be increased. We also recommend that researchers employ varied methods to adequately capture the interactive nature of humor.

Exact geodesic distances in FLRW spacetimes

NASA Astrophysics Data System (ADS)

Cunningham, William J.; Rideout, David; Halverson, James; Krioukov, Dmitri

2017-11-01

Geodesics are used in a wide array of applications in cosmology and astrophysics. However, it is not a trivial task to efficiently calculate exact geodesic distances in an arbitrary spacetime. We show that in spatially flat (3 +1 )-dimensional Friedmann-Lemaître-Robertson-Walker (FLRW) spacetimes, it is possible to integrate the second-order geodesic differential equations, and derive a general method for finding both timelike and spacelike distances given initial-value or boundary-value constraints. In flat spacetimes with either dark energy or matter, whether dust, radiation, or a stiff fluid, we find an exact closed-form solution for geodesic distances. In spacetimes with a mixture of dark energy and matter, including spacetimes used to model our physical universe, there exists no closed-form solution, but we provide a fast numerical method to compute geodesics. A general method is also described for determining the geodesic connectedness of an FLRW manifold, provided only its scale factor.

Employment among Social Security disability program beneficiaries, 1996-2007.

PubMed

Mamun, Arif; O'Leary, Paul; Wittenburg, David C; Gregory, Jesse

2011-01-01

We use linked administrative data from program and earnings records to summarize the 2007 employment rates of Social Security disability program beneficiaries at the national and state levels, as well as changes in employment since 1996. The findings provide new information on the employment activities of beneficiaries that should be useful in assessing current agency policies and providing benchmarks for ongoing demonstration projects and future return-to-work initiatives. The overall employment rate--which we define as annual earnings over $1,000--was 12 percent in 2007. Substantial variation exists within the population. Disability Insurance beneficiaries and those younger than age 40 were much more likely to work relative to other Social Security beneficiaries. Additionally, substantial regional variation exists across states; employment rates ranged from 7 percent (West Virginia) to 23 percent (North Dakota). Moreover, we find that the employment rates among beneficiaries were sensitive to the business cycle and persistent over time.

Student Teachers' Prior Experiences of History, Geography and Science: Initial Findings of an All-Ireland Survey

ERIC Educational Resources Information Center

Waldron, Fionnuala; Pike, Susan; Varley, Janet; Murphy, Colette; Greenwood, Richard

2007-01-01

Research into student teachers' perceptions, attitudes and prior experiences of learning suggests that these experiences can exert an influence on practice which can be relatively undisturbed by their initial teacher education. This article is based on the initial findings of an all-Ireland survey of all first-year students on B.Ed. courses in…

Implementation of oral health initiatives by Australian rural communities: Factors for success.

PubMed

Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

2018-01-01

In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

Behavioral Health and the Comprehensive Primary Care (CPC) Initiative: findings from the 2014 CPC behavioral health survey.

PubMed

Zivin, Kara; Miller, Benjamin F; Finke, Bruce; Bitton, Asaf; Payne, Perry; Stowe, Edith C; Reddy, Ashok; Day, Timothy J; Lapin, Pauline; Jin, Janel L; Sessums, Laura L

2017-08-29

Incorporating behavioral health care into patient centered medical homes is critical for improving patient health and care quality while reducing costs. Despite documented effectiveness of behavioral health integration (BHI) in primary care settings, implementation is limited outside of large health systems. We conducted a survey of BHI in primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a four-year multi-payer initiative of the Centers for Medicare and Medicaid Services (CMS). We sought to explore associations between practice characteristics and the extent of BHI to illuminate possible factors influencing successful implementation. We fielded a survey that addressed six substantive domains (integrated space, training, access, communication and coordination, treatment planning, and available resources) and five behavioral health conditions (depression, anxiety, pain, alcohol use disorder, and cognitive function). Descriptive statistics compared BHI survey respondents to all CPC practices, documented the availability of behavioral health providers, and primary care and behavioral health provider communication. Bivariate relationships compared provider and practice characteristics and domain scores. One hundred sixty-one of 188 eligible primary care practices completed the survey (86% response rate). Scores indicated basic to good baseline implementation of BHI in all domains, with lowest scores on communication and coordination and highest scores for depression. Higher scores were associated with: having any behavioral health provider, multispecialty practice, patient-centered medical home designation, and having any communication between behavioral health and primary care providers. This study provides useful data on opportunities and challenges of scaling BHI integration linked to primary care transformation. Payment reform models such as CPC can assist in BHI promotion and development.

Prehospital Trauma Triage Decision-making: A Model of What Happens between the 9-1-1 Call and the Hospital.

PubMed

Jones, Courtney Marie Cora; Cushman, Jeremy T; Lerner, E Brooke; Fisher, Susan G; Seplaki, Christopher L; Veazie, Peter J; Wasserman, Erin B; Dozier, Ann; Shah, Manish N

2016-01-01

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated in the prehospital setting; 2) field triage criteria are applied in-practice; and 3) selection of a destination hospital is determined. We conducted separate focus groups with advanced and basic life support providers from rural and urban/suburban regions. Four exploratory focus groups were conducted to identify overarching themes and five additional confirmatory focus groups were conducted to verify initial focus group findings and provide additional detail regarding trauma triage decision-making and application of field triage criteria. All focus groups were conducted by a public health researcher with formal training in qualitative research. A standardized question guide was used to facilitate discussion at all focus groups. All focus groups were audio-recorded and transcribed. Responses were coded and categorized into larger domains to describe how EMS providers approach trauma triage and apply the Field Triage Decision Scheme. We conducted 9 focus groups with 50 EMS providers. Participants highlighted that trauma triage is complex and there is often limited time to make destination decisions. Four overarching domains were identified within the context of trauma triage decision-making: 1) initial assessment; 2) importance of speed versus accuracy; 3) usability of current field triage criteria; and 4) consideration of patient and emergency care system-level factors. Field triage is a complex decision-making process which involves consideration of many patient and system-level factors. The decision model presented in this study suggests that EMS providers place significant emphasis on speed of decisions, relying on initial impressions and immediately observable information, rather than precise measurement of vital signs or systematic application of field triage criteria.

The importance of initial protection of conspicuous mutants for the coevolution of defense and aposematic signaling of the defense: a modeling study.

PubMed

Ruxton, Graeme D; Speed, Michael P; Broom, Mark

2007-09-01

Most models of the evolution of aposematic signaling assume (1) that the secondary defense being signaled is fixed, and (2) that conspicuous mutants arising in a population of defended individuals of cryptic appearance are initially protected from predation. Previous models of ours relaxed the first assumption, here we relax the second and compare with our earlier work to explore the consequences of initial protection from predation on the coevolution of secondary defense and aposematic signaling. As expected, we find that aposematic signaling evolves more easily if initial protection is available. Less obviously, the coevolved level of secondary defense should also be higher if initial protection is provided. Across species or populations, we predict that when initial protection occurs, then strength of aposematic signal should be correlated with the strength of the underlying secondary defense, whereas no such correlation should occur without initial protection. Finally, we demonstrate that species can invest heavily in a secondary defense and remain maximally cryptic (forgoing the advantages of aposematic signaling) and that within a species we should expect strong variation in appearance between populations but much less variation within populations. Hence, we demonstrate that whether conspicuous morphs receive initial protection from predation has powerful and potentially empirically detectible consequences for the coevolution of secondary defenses and aposematic signaling.

The protective effect of parental expectations against early adolescent smoking initiation.

PubMed

Simons-Morton, Bruce G

2004-10-01

Substantial research and theory suggests that smoking initiation is socially mediated, with both peers and parents playing important roles. To learn more about how parenting behaviors influence smoking initiation, students (n=1002) from four middle schools were surveyed at the beginning of the sixth grade (T1), and the end of the sixth (T2) and seventh (T3) grades. T1 and T2-T1 predictors were regressed on smoking initiation at the end of seventh grade. In bivariate logistic regression analyses, association with friends who smoke, attitudes toward deviance, outcome expectations for smoking, perceived school climate, parental expectations, parental involvement at T1 and increases in these variables (T2-T1) were associated with smoking initiation at T3, but only the T1 measures of social competence, academic engagement, school adjustment, perceived prevalence, parental monitoring and parental involvement were associated with smoking initiation at T3. In multivariate logistic regression analyses, parental expectations were negatively associated, and increases in attitudes accepting of deviance and affiliation with friends who smoke were positively associated with smoking initiation. Analysis of interactions indicated that parental expectations and monitoring did not mediate the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke. These findings provide evidence that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking.

“The care is the best you can give at the time”: Health care professionals’ experiences in providing gender affirming care in South Africa

PubMed Central

Spencer, Sarah; Meer, Talia

2017-01-01

Background While the provision of gender affirming care for transgender people in South Africa is considered legal, ethical, and medically sound, and is—theoretically—available in both the South African private and public health sectors, access remains severely limited and unequal within the country. As there are no national policies or guidelines, little is known about how individual health care professionals providing gender affirming care make clinical decisions about eligibility and treatment options. Method Based on an initial policy review and service mapping, this study employed semi-structured interviews with a snowball sample of twelve health care providers, representing most providers currently providing gender affirming care in South Africa. Data were analysed thematically using NVivo, and are reported following COREQ guidelines. Results Our findings suggest that, whilst a small minority of health care providers offer gender affirming care, this is almost exclusively on their own initiative and is usually unsupported by wider structures and institutions. The ad hoc, discretionary nature of services means that access to care is dependent on whether a transgender person is fortunate enough to access a sympathetic and knowledgeable health care provider. Conclusion Accordingly, national, state-sanctioned guidelines for gender affirming care are necessary to increase access, homogenise quality of care, and contribute to equitable provision of gender affirming care in the public and private health systems. PMID:28704458

Why are HIV-infected people not started on antiretroviral therapy? A mixed-methods study from Gujarat, India

PubMed Central

Shringarpure, K.; Modi, B.; Sharma, R.; Rewari, B. B.; Shah, A. N.; Verma, P. B.; Dongre, A. R.; Kumar, A. M. V.

2017-01-01

Setting: Five purposively selected antiretroviral therapy (ART) centres in Gujarat, India. Objectives: To assess the proportion of ART-eligible people living with the human immunodeficiency virus (PLHIV) who were not initiated on ART within 2 months of being recorded as eligible, to identify factors associated with non-initiation and to explore reasons from the provider's perspective. Design: We used a mixed-methods design (triangulation) of 1) a quantitative phase involving record reviews and cohort analysis (Poisson regression) of PLHIV registered during April 2014–March 2015, and 2) a qualitative phase involving one-to-one interviews with 25 providers. Results: Of 2079 ART-eligible PLHIV, 339 (16%) were not started on ART within 2 months. PLHIV with CD4 counts of <350 cells/μl and patients who were labourers, hospitalised, bedridden or registered with certain ART centres were more likely not to be initiated on ART. Qualitative results were categorised into two broad themes: government health system- and patient-related challenges, which validated and complemented the quantitative findings. Conclusion: Several patient subgroups at greater risk of ART non-initiation were identified, along with reasons for risk; this has important programme implications for achieving the UNAIDS 90–90–90 goal, and particularly the second 90 component of having 90% of diagnosed PLHIV start ART. PMID:29201653

The influence of children's pain memories on subsequent pain experience.

PubMed

Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

2012-08-01

Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in Northern Mexico

PubMed Central

Morris, Meghan D.; Lemus, Hector; Wagner, Karla D.; Martinez, Gustavo; Lozada, Remedios; Gómez, Rangel María Gudelia; Strathdee, Steffanie A.

2012-01-01

Aims To identify factors associated with time to initiation of (1) sex work prior to injecting drugs, (2) injection drug use, and (3) concurrent sex work and injection drug use (i.e., initiated at the same age) among female sex workers who currently inject drugs (FSW-IDU). Design Parametric survival analysis of baseline data for time to initiation event. Setting Tijuana and Ciudad Juarez situated on the Mexico-U.S. border. Participants 575 FSW-IDUs aged ≥18. Measurements Interview-administered surveys assessing context of sex work and injection drug use initiation. Findings Nearly half (n=256) initiated sex work prior to beginning to inject, a third (n=163) initiated injection first, and a quarter (n=136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently. Conclusions Among female sex workers who currently inject drugs in two Mexican-US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one third initiate injection drug use before beginning sex work, and one quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention. PMID:22775475

Analysis of k-means clustering approach on the breast cancer Wisconsin dataset.

PubMed

Dubey, Ashutosh Kumar; Gupta, Umesh; Jain, Sonal

2016-11-01

Breast cancer is one of the most common cancers found worldwide and most frequently found in women. An early detection of breast cancer provides the possibility of its cure; therefore, a large number of studies are currently going on to identify methods that can detect breast cancer in its early stages. This study was aimed to find the effects of k-means clustering algorithm with different computation measures like centroid, distance, split method, epoch, attribute, and iteration and to carefully consider and identify the combination of measures that has potential of highly accurate clustering accuracy. K-means algorithm was used to evaluate the impact of clustering using centroid initialization, distance measures, and split methods. The experiments were performed using breast cancer Wisconsin (BCW) diagnostic dataset. Foggy and random centroids were used for the centroid initialization. In foggy centroid, based on random values, the first centroid was calculated. For random centroid, the initial centroid was considered as (0, 0). The results were obtained by employing k-means algorithm and are discussed with different cases considering variable parameters. The calculations were based on the centroid (foggy/random), distance (Euclidean/Manhattan/Pearson), split (simple/variance), threshold (constant epoch/same centroid), attribute (2-9), and iteration (4-10). Approximately, 92 % average positive prediction accuracy was obtained with this approach. Better results were found for the same centroid and the highest variance. The results achieved using Euclidean and Manhattan were better than the Pearson correlation. The findings of this work provided extensive understanding of the computational parameters that can be used with k-means. The results indicated that k-means has a potential to classify BCW dataset.

Computer based imaging and analysis of root gravitropism

NASA Technical Reports Server (NTRS)

Evans, M. L.; Ishikawa, H.

1997-01-01

Two key issues in studies of the nature of the gravitropic response in roots have been the determination of the precise pattern of differential elongation responsible for downward bending and the identification of the cells that show the initial motor response. The main approach for examining patterns of differential growth during root gravitropic curvature has been to apply markers to the root surface and photograph the root at regular intervals during gravitropic curvature. Although these studies have provided valuable information on the characteristics of the gravitropic motor response in roots, their labor intensive nature limits sample size and discourages both high frequency of sampling and depth of analysis of surface expansion data. In this brief review we describe the development of computer-based video analysis systems for automated measurement of root growth and shape change and discuss some key features of the root gravitropic response that have been revealed using this methodology. We summarize the capabilities of several new pieces of software designed to measure growth and shape changes in graviresponding roots and describe recent progress in developing analysis systems for studying the small, but experimentally popular, primary roots of Arabidopsis. A key finding revealed by such studies is that the initial gravitropic response of roots of maize and Arabidopsis occurs in the distal elongation zone (DEZ) near the root apical meristem, not in the main elongation zone. Another finding is that the initiation of rapid elongation in the DEZ following gravistimulation appears to be related to rapid membrane potential changes in this region of the root. These observations have provided the incentive for ongoing studies examining possible links between potential growth modifying factors (auxin, calcium, protons) and gravistimulated changes in membrane potential and growth patterns in the DEZ.

Modeling carbonaceous particle formation in an argon graphite cathode dc discharge

NASA Astrophysics Data System (ADS)

Michau, A.; Lombardi, G.; Colina Delacqua, L.; Redolfi, M.; Arnas, C.; Bonnin, X.; Hassouni, K.

2010-12-01

We develop a model for the nucleation, growth and transport of carbonaceous dust particles in a non-reactive gas dc discharge where the carbon source is provided by cathode sputtering. We consider only the initial phase of the discharge when the dust charge density remains small with respect to the electron density. We find that an electric field reversal at the entrance of the negative glow region promotes trapping of negatively charged clusters and dust particles, confining them for long times in the plasma and favoring molecular growth. An essential ingredient for this process is electron attachment, which negatively charges the initially neutral clusters. We perform sensitivity studies on several number parameters: size of the largest molecular edifice, sticking coefficient, etc.

Finding Minimum-Power Broadcast Trees for Wireless Networks

NASA Technical Reports Server (NTRS)

Arabshahi, Payman; Gray, Andrew; Das, Arindam; El-Sharkawi, Mohamed; Marks, Robert, II

2004-01-01

Some algorithms have been devised for use in a method of constructing tree graphs that represent connections among the nodes of a wireless communication network. These algorithms provide for determining the viability of any given candidate connection tree and for generating an initial set of viable trees that can be used in any of a variety of search algorithms (e.g., a genetic algorithm) to find a tree that enables the network to broadcast from a source node to all other nodes while consuming the minimum amount of total power. The method yields solutions better than those of a prior algorithm known as the broadcast incremental power algorithm, albeit at a slightly greater computational cost.

Lateralized goal framing: how selective presentation impacts message effectiveness.

PubMed

McCormick, Michael; Seta, John J

2012-11-01

We tested whether framing a message as a gain or loss would alter its effectiveness by using a dichotic listening procedure to selectively present a health related message to the left or right hemisphere. A significant goal framing effect (losses > gains) was found when right, but not left, hemisphere processing was initially enhanced. The results support the position that the contextual processing style of the right hemisphere is especially sensitive to the associative implications of the frame. We discussed the implications of these findings for goal framing research, and the valence hypothesis. We also discussed how these findings converge with prior valence framing research and how they can be of potential use to health care providers.

Addictive illegal drugs: structural neuroimaging.

PubMed

Geibprasert, S; Gallucci, M; Krings, T

2010-05-01

Illegal addictive drugs can lead to functional or structural impairment of the central nervous system. This review provides an overview of the structural imaging findings on CT, MR imaging, and conventional angiography related to chronic and acute abuse of the most commonly abused illegal drugs, including cannabis, organic solvents, and amphetamines and opioids and their respective derivatives. Pathomechanisms include excitotoxicity, which may lead to an acute or subacute leukoencephalopathy, and vascular complications, including vasoconstriction, vasculitis, or hypertension, which may lead to intracranial hemorrhage or ischemia. Because clinical findings alone are often nonspecific, and afflicted patients are unlikely to admit to the substance abuse, the neuroradiologist may play an important role in establishing the diagnosis and, thereby, initiating treatment.

Maori women's views on smoking cessation initiatives.

PubMed

Fernandez, Carole; Wilson, Denise

2008-07-01

Smoking is particularly prevalent among Maori women over the age of 15 years and remains a concern despite anti-smoking campaigns. This raises questions about the effectiveness of current smoking cessation initiatives as mainstream tobacco control programmes have not benefited Maori to the same extent as non-Maori. Limited research is available on the effectiveness of smoking cessation initiatives for Maori. In this descriptive qualitative study five Maori women who had ceased smoking were interviewed about such initiatives and what was more likely to influence Maori women to quit. A focus group was used to discuss smoking cessation initiatives and the data were thematically analysed using Boyatzis' (1998) approach. Two themes were identified: (a) Transmission of Whanau (immediate and extended family) Values that includes the sub-categories whanau experiences, being mothers, and role models; and (b) Factors Crucial in Influencing Change that includes the sub-categories choices and exercising own will, a positive perception of self and a Maori approach. The findings provide insight for nurses into Maori women's perspectives. These highlight the importance of whanau and supportive relationships, and can be used to inform strategies to assist Maori women in smoking cessation.

Factors That Influence Breastfeeding Initiation Among African American Women.

PubMed

Hinson, Tyonne D; Skinner, Asheley Cockrell; Lich, Kristen Hassmiller; Spatz, Diane L

2018-05-01

To examine cultural and socioenvironmental factors that affect breastfeeding initiation among African American women. Qualitative descriptive design and conventional content analysis. A large, inner-city, primary care center affiliated with a 500-bed children's hospital within a large, Northeastern U.S. city. Participants were 34 U.S.-born African American mothers of healthy term infants 0 to 3 months of age. Six focus groups were conducted using a 16-question, scripted interview guide. A number of complex factors that influenced breastfeeding initiation included certain cultural beliefs about sexuality, the influence of family and peer networks, information sources, intentions, and a variety of other barriers and facilitators. Our findings suggest that the decision to initiate breastfeeding is not solely determined by the woman within the African American community. Because this decision is contingent on multiple factors external to the woman, it is important to recognize the role that partners, grandmothers, communities, information sources, and health care providers/organizations play in women's decisions. Implementation of multilevel strategies is critical to increase breastfeeding initiation among African American mothers. Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Racial stereotypes impair flexibility of emotional learning

PubMed Central

Kubota, Jennifer T.; Li, Jian; Coelho, Cesar A.O.; Phelps, Elizabeth A.

2016-01-01

Flexibility of associative learning can be revealed by establishing and then reversing cue-outcome discriminations. Here, we used functional MRI to examine whether neurobehavioral correlates of reversal-learning are impaired in White and Asian volunteers when initial learning involves fear-conditioning to a racial out-group. For one group, the picture of a Black male was initially paired with shock (threat) and a White male was unpaired (safe). For another group, the White male was a threat and the Black male was safe. These associations reversed midway through the task. Both groups initially discriminated threat from safety, as expressed through skin conductance responses (SCR) and activity in the insula, thalamus, midbrain and striatum. After reversal, the group initially conditioned to a Black male exhibited impaired reversal of SCRs to the new threat stimulus (White male), and impaired reversals in the striatum, anterior cingulate cortex, midbrain and thalamus. In contrast, the group initially conditioned to a White male showed successful reversal of SCRs and successful reversal in these brain regions toward the new threat. These findings provide new evidence that an aversive experience with a racial out-group member impairs the ability to flexibly and appropriately adjust fear expression towards a new threat in the environment. PMID:27107298

Counseling Services for Asian, Latino/a, and White American Students: Initial Severity, Session Attendance, and Outcome

PubMed Central

Kim, Jin E.; Park, Samuel S.; La, Amy; Chang, Jenss; Zane, Nolan

2015-01-01

Objective The current study examined racial/ethnic differences in initial severity, session attendance, and counseling outcomes in a large and diverse sample of Asian American, Latino/a, and White student clients who utilized university counseling services between 2008 and 2012. Method We used archival data of 5,472 clients (62% female; M age = 23.1, SD = 4.3) who self-identified their race/ethnicity as being Asian American (38.9%), Latino/a (14.9%), or White (46.2%). Treatment engagement was measured by the number of counseling sessions attended; initial severity and treatment outcome were measured using the Outcome Questionnaire-45. Results Asian American clients, particularly Chinese, Filipino/a, Korean, and Vietnamese Americans, had greater initial severity compared to White clients. Asian Indian, Korean, and Vietnamese American clients used significantly fewer sessions of counseling than White clients after controlling for initial severity. All racial/ethnic minority groups continued to have clinically significant distress in certain areas (e.g., social role functioning) at counseling termination. Conclusions These findings highlight the need to devote greater attention to the counseling experiences of racial/ethnic minority clients, especially certain Asian American groups. Further research directions are provided. PMID:26390372

Counseling services for Asian, Latino/a, and White American students: Initial severity, session attendance, and outcome.

PubMed

Kim, Jin E; Park, Samuel S; La, Amy; Chang, Jenss; Zane, Nolan

2016-07-01

The current study examined racial/ethnic differences in initial severity, session attendance, and counseling outcomes in a large and diverse sample of Asian American, Latino/a, and White student clients who utilized university counseling services between 2008 and 2012. We used archival data of 5,472 clients (62% female; M age = 23.1, SD = 4.3) who self-identified their race/ethnicity as being Asian American (38.9%), Latino/a (14.9%), or White (46.2%). Treatment engagement was measured by the number of counseling sessions attended; initial severity and treatment outcome were measured using the Outcome Questionnaire-45. Asian American clients, particularly Chinese, Filipino/a, Korean, and Vietnamese Americans, had greater initial severity compared with White clients. Asian Indian, Korean, and Vietnamese American clients used significantly fewer sessions of counseling than White clients after controlling for initial severity. All racial/ethnic minority groups continued to have clinically significant distress in certain areas (e.g., social role functioning) at counseling termination. These findings highlight the need to devote greater attention to the counseling experiences of racial/ethnic minority clients, especially certain Asian American groups. Further research directions are provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Long-term impact of a chef on school lunch consumption: findings from a 2-year pilot study in Boston middle schools.

PubMed

Cohen, Juliana F W; Smit, Liesbeth A; Parker, Ellen; Austin, S Bryn; Frazier, A Lindsay; Economos, Christina D; Rimm, Eric B

2012-06-01

School cafeterias can play an important role in providing healthy meals. Although schools participating in the National School Lunch Program are required to meet minimum program standards, advocates recommend that innovations be sought to enhance menu dietary quality. This study evaluated the Chef Initiative, a 2-year pilot study in two Boston middle schools, designed to increase the availability and consumption of healthier school foods. Between 2007 and 2009, a professional chef trained cafeteria staff to prepare healthier school lunches (ie, more whole grains, fresh/frozen fruits and vegetables, and less sugar, salt, saturated fats, and trans fats). Meal nutrient compositions were monitored from 2007 to 2009, and a plate waste study conducted in the spring of 2009 compared food selection and consumption patterns among students at Chef Initiative schools, with students receiving standard school lunches at two matched control schools. Paired t tests and descriptive statistics were used to examine differences in menus and mixed-model analysis of variance was used to analyze differences in students' food selection and consumption between Chef Initiative and control schools. Overall, the Chef Initiative schools provided healthier lunches and the percent of foods consumed at Chef Initiative and control schools were similar (61.6% vs 57.3%; P=0.63). Of the areas targeted, there was greater whole-grain selection and vegetable consumption; 51% more students selected whole grains (P=0.02) and students consumed 0.36 more vegetable servings/day (P=0.01) at Chef Initiative schools. The potential of chefs collaborating with cafeteria staff to improve the availability, selection, and consumption of healthier meals is promising. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Is there a weekend bias in clutch-initiation dates from citizen science? Implications for studies of avian breeding phenology.

PubMed

Cooper, Caren B

2014-09-01

Accurate phenology data, such as the timing of migration and reproduction, is important for understanding how climate change influences birds. Given contradictory findings among localized studies regarding mismatches in timing of reproduction and peak food supply, broader-scale information is needed to understand how whole species respond to environmental change. Citizen science-participation of the public in genuine research-increases the geographic scale of research. Recent studies, however, showed weekend bias in reported first-arrival dates for migratory songbirds in databases created by citizen-science projects. I investigated whether weekend bias existed for clutch-initiation dates for common species in US citizen-science projects. Participants visited nests on Saturdays more frequently than other days. When participants visited nests during the laying stage, biased timing of visits did not translate into bias in estimated clutch-initiation dates, based on back-dating with the assumption of one egg laid per day. Participants, however, only visited nests during the laying stage for 25% of attempts of cup-nesting species and 58% of attempts in nest boxes. In some years, in lieu of visit data, participants provided their own estimates of clutch-initiation dates and were asked "did you visit the nest during the laying period?" Those participants who answered the question provided estimates of clutch-initiation dates with no day-of-week bias, irrespective of their answer. Those who did not answer the question were more likely to estimate clutch initiation on a Saturday. Data from citizen-science projects are useful in phenological studies when temporal biases can be checked and corrected through protocols and/or analytical methods.

Ribosomal scanning past the primary initiation codon as a mechanism for expression of CTL epitopes encoded in alternative reading frames

PubMed Central

1996-01-01

An increasing amount of evidence has shown that epitopes restricted to MHC class I molecules and recognized by CTL need not be encoded in a primary open reading frame (ORF). Such epitopes have been demonstrated after stop codons, in alternative reading frames (RF) and within introns. We have used a series of frameshifts (FS) introduced into the Influenza A/PR/8 /34 nucleoprotein (NP) gene to confirm the previous in vitro observations of cryptic epitope expression, and show that they are sufficiently expressed to prime immune responses in vivo. This presentation is not due to sub-dominant epitopes, transcription from cryptic promoters beyond the point of the FS, or internal initiation of translation. By introducing additional mutations to the construct exhibiting the most potent presentation, we have identified initiation codon readthrough (termed scanthrough here, where the scanning ribosome bypasses the conventional initiation codon, initiating translation further downstream) as the likely mechanism of epitope production. Further mutational analysis demonstrated that, while it should operate during the expression of wild-type (WT) protein, scanthrough does not provide a major source of processing substrate in our system. These findings suggest (i) that the full array of self- and pathogen-derived epitopes available during thymic selection and infection has not been fully appreciated and (ii) that cryptic epitope expression should be considered when the specificity of a CTL response cannot be identified or in therapeutic situations when conventional CTL targets are limited, as may be the case with latent viral infections and transformed cells. Finally, initiation codon readthrough provides a plausible explanation for the presentation of exocytic proteins by MHC class I molecules. PMID:8879204

Is there a weekend bias in clutch-initiation dates from citizen science? Implications for studies of avian breeding phenology

NASA Astrophysics Data System (ADS)

Cooper, Caren B.

2014-09-01

Accurate phenology data, such as the timing of migration and reproduction, is important for understanding how climate change influences birds. Given contradictory findings among localized studies regarding mismatches in timing of reproduction and peak food supply, broader-scale information is needed to understand how whole species respond to environmental change. Citizen science—participation of the public in genuine research—increases the geographic scale of research. Recent studies, however, showed weekend bias in reported first-arrival dates for migratory songbirds in databases created by citizen-science projects. I investigated whether weekend bias existed for clutch-initiation dates for common species in US citizen-science projects. Participants visited nests on Saturdays more frequently than other days. When participants visited nests during the laying stage, biased timing of visits did not translate into bias in estimated clutch-initiation dates, based on back-dating with the assumption of one egg laid per day. Participants, however, only visited nests during the laying stage for 25 % of attempts of cup-nesting species and 58 % of attempts in nest boxes. In some years, in lieu of visit data, participants provided their own estimates of clutch-initiation dates and were asked "did you visit the nest during the laying period?" Those participants who answered the question provided estimates of clutch-initiation dates with no day-of-week bias, irrespective of their answer. Those who did not answer the question were more likely to estimate clutch initiation on a Saturday. Data from citizen-science projects are useful in phenological studies when temporal biases can be checked and corrected through protocols and/or analytical methods.

Patient information comes of age.

PubMed

Murphy, Jeannette

2017-12-01

This virtual issue (VI) has been assembled to coincide with the 8th Annual Patient Information Conference 2013 organised by the UK Patient Information Forum (PiF). The conference theme 'Information and support - a service in its own right' is a response to policy documents and initiatives in both Scotland and England which signal the coming of age of patient/consumer information. The VI consists of a collection of open access articles and addresses the question 'What can health science librarians do to ensure that the public are able to find, appraise and use health information?' This material provides research evidence, and examples of the types of initiatives librarians have undertaken to make information a health and care service in its own right. Two recurrent messages are that health science librarians need to form partnerships with healthcare providers and they have a role to play in improving health literacy skills. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Analytic model to estimate thermonuclear neutron yield in z-pinches using the magnetic Noh problem

NASA Astrophysics Data System (ADS)

Allen, Robert C.

The objective was to build a model which could be used to estimate neutron yield in pulsed z-pinch experiments, benchmark future z-pinch simulation tools and to assist scaling for breakeven systems. To accomplish this, a recent solution to the magnetic Noh problem was utilized which incorporates a self-similar solution with cylindrical symmetry and azimuthal magnetic field (Velikovich, 2012). The self-similar solution provides the conditions needed to calculate the time dependent implosion dynamics from which batch burn is assumed and used to calculate neutron yield. The solution to the model is presented. The ion densities and time scales fix the initial mass and implosion velocity, providing estimates of the experimental results given specific initial conditions. Agreement is shown with experimental data (Coverdale, 2007). A parameter sweep was done to find the neutron yield, implosion velocity and gain for a range of densities and time scales for DD reactions and a curve fit was done to predict the scaling as a function of preshock conditions.

Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine

PubMed Central

Coustasse, Alberto; Cunningham, Brian; Deslich, Stacie; Willson, Eric; Meadows, Pamela

2015-01-01

Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption. PMID:26396555

The initial treatment of the concept of function in the selected secondary school mathematics textbooks in the US and China

NASA Astrophysics Data System (ADS)

Son, Ji-Won; Hu, Qintong

2016-05-01

In order to provide insight into cross-national differences in students' achievement, this study compares the initial treatment of the concept of function sections of Chinese and US textbooks. The number of lessons, contents, and mathematical problems were analyzed. The results show that the US curricula introduce the concept of function one year earlier than the Chinese curriculum and provide strikingly more problems for students to work on. However, the Chinese curriculum emphasizes developing both concepts and procedures and includes more problems that require explanations, visual representations, and problem solving in worked-out examples that may help students formulate multiple solution methods. This result could indicate that instead of the number of problems and early introduction of the concept, the cognitive demands of textbook problems required for student thinking could be one reason for differences in American and Chinese students' performances in international comparative studies. Implications of these findings for curriculum developers, teachers, and researchers are discussed.

Initial Weight Loss Response as an Indicator for Providing Early Rescue Efforts to Improve Long-term Treatment Outcomes.

PubMed

Unick, Jessica L; Pellegrini, Christine A; Demos, Kathryn E; Dorfman, Leah

2017-09-01

There is a large variability in response to behavioral weight loss (WL) programs. Reducing rates of obesity and diabetes may require more individuals to achieve clinically significant WL post-treatment. Given that WL within the first 1-2 months of a WL program is associated with long-term WL, it may be possible to improve treatment outcomes by identifying and providing additional intervention to those with poor initial success (i.e., "early non-responders"). We review the current literature regarding early non-response to WL programs and discuss how adaptive interventions can be leveraged as a strategy to "rescue" early non-responders. Preliminary findings suggest that adaptive interventions, specifically stepped care approaches, offer promise for improving outcomes among early non-responders. Future studies need to determine the optimal time point and threshold for intervening and the type of early intervention to employ. Clinicians and researchers should consider the discussed factors when making treatment decisions.

Guidelines for the standardization of preanalytic variables for blood-based biomarker studies in Alzheimer’s disease research

PubMed Central

Gupta, Veer; Henriksen, Kim; Edwards, Melissa; Jeromin, Andreas; Lista, Simone; Bazenet, Chantal; Soares, Holly; Lovestone, Simon; Hampel, Harald; Montine, Thomas; Blennow, Kaj; Foroud, Tatiana; Carrillo, Maria; Graff-Radford, Neill; Laske, Christoph; Breteler, Monique; Shaw, Leslie; Trojanowski, John Q.; Schupf, Nicole; Rissman, Robert A.; Fagan, Anne M.; Oberoi, Pankaj; Umek, Robert; Weiner, Michael W.; Grammas, Paula; Posner, Holly; Martins, Ralph

2015-01-01

The lack of readily available biomarkers is a significant hindrance towards progressing to effective therapeutic and preventative strategies for Alzheimer’s disease (AD). Blood-based biomarkers have potential to overcome access and cost barriers and greatly facilitate advanced neuroimaging and cerebrospinal fluid biomarker approaches. Despite the fact that preanalytical processing is the largest source of variability in laboratory testing, there are no currently available standardized preanalytical guidelines. The current international working group provides the initial starting point for such guidelines for standardized operating procedures (SOPs). It is anticipated that these guidelines will be updated as additional research findings become available. The statement provides (1) a synopsis of selected preanalytical methods utilized in many international AD cohort studies, (2) initial draft guidelines/SOPs for preanalytical methods, and (3) a list of required methodological information and protocols to be made available for publications in the field in order to foster cross-validation across cohorts and laboratories. PMID:25282381

Loop vertex expansion for higher-order interactions

NASA Astrophysics Data System (ADS)

Rivasseau, Vincent

2018-05-01

This note provides an extension of the constructive loop vertex expansion to stable interactions of arbitrarily high order, opening the way to many applications. We treat in detail the example of the (\\bar{φ } φ )^p field theory in zero dimension. We find that the important feature to extend the loop vertex expansion is not to use an intermediate field representation, but rather to force integration of exactly one particular field per vertex of the initial action.

Angiogenesis Research to Improve Therapies for Vascular Leak Syndromes, Intra-Abdominal Adhesions, and Arterial Injuries

DTIC Science & Technology

2006-02-01

production Endostatin protein was initially purified from the urine of tumor-bearing mice, providing a few micrograms for analysis of amino acid...whereas the wild-type bound 10 atoms of Zn per endostatin molecule. This finding is problematic because, in our crystal structure analysis of endostatin...complete prevention of pulmonary metas - tases. Lowest inhibition of tumor growth was ¨40–45% (Table 2B). In transgenic mice overexpressing endostatin, a

UAS Integration into the NAS: HSI Full Mission Simulation Preliminary Results

NASA Technical Reports Server (NTRS)

Shively, Jay; Fern, Lisa; Rorie, Conrad

2014-01-01

The goal of the Full Mission Sim was to examine the effects of different command and control interfaces on UAS pilots' ability to respond to ATC commands and traffic advisories. Results suggest that higher levels of automation (i.e., waypoint-to-waypoint control interfaces) lead to longer initial response times and longer edit times. The findings demonstrate the importance of providing pilots with interfaces that facilitate their ability to get back "in the loop."

A review of cryogenic testing performed by the thermochemical test branch, Manned Spacecraft Center in support of Apollo 13 and14

NASA Technical Reports Server (NTRS)

Propp, C. E.; Mcgee, J. M.

1971-01-01

The Apollo 13 anomaly provided considerable impetus for a variety of types of cryogenic and ignition tests. The logic of the various test program designs, the test techniques, and their final impact upon the investigation findings are described. In addition, several test programs initiated to determine the thermal performance and general performance characteristics of the redesigned Apollo 14 cryogenic storage system are presented.

The Adult Diabetic Patient: An Education Challenge

DTIC Science & Technology

1993-05-01

finding that he/she, too, must care for sicker patients. To better prepare these patients for life after discharge, patient education must be initiated as...admitted, patient education often begins at the physicians’ office. This paper explores diabetes mellitus in relation to concepts of self-care and adult...betting foj.L eduuation and iio.w, wore ofteni, patient education and follow-up sercvices- a:leL beiny p~rovided on ani outpatient bcdtsis" (p. 36) . Thet

Applying observations from technological transformations in complex adaptive systems to inform health policy on technology adoption.

PubMed

Phillips, Andrew B; Merrill, Jacqueline

2012-01-01

Many complex markets such as banking and manufacturing have benefited significantly from technology adoption. Each of these complex markets experienced increased efficiency, quality, security, and customer involvement as a result of technology transformation in their industry. Healthcare has not benefited to the same extent. We provide initial findings from a policy analysis of complex markets and the features of these transformations that can influence health technology adoption and acceptance.

A Preliminary Case Study of SCALE Activities at the University of Wisconsin-Madison: Factors Influencing Change Initiatives in STEM Undergraduate Education, Teacher Training, and Partnerships with K-12 Districts. WCER Working Paper No. 2007-2

ERIC Educational Resources Information Center

Hora, Matthew T.; Millar, Susan B.

2007-01-01

This report on the SCALE Institutions of Higher Education (IHE) Case Studies line of work provides preliminary findings about SCALE activities at the University of Wisconsin-Madison (UW-Madison). This study focuses on the structural and behavioral dynamics influencing the implementation of the four core SCALE strategies for effecting change in…

All That Glitters Isn't Gold--Four Steps to School Improvement.

ERIC Educational Resources Information Center

Huddle, Eugene

1987-01-01

Outlines findings from a study by the United States Department of Education's Office of Educational Research and Improvement of successful school improvement programs. The findings are categorized under four stages: initiation, initial implementation, full implementation, and institutionalization. (MD)

Delineating the relationship between stress mindset and primary appraisals: preliminary findings.

PubMed

Kilby, Christopher J; Sherman, Kerry A

2016-01-01

Stress mindset theory suggests that positive stress beliefs lead to positive, rather than negative, outcomes when engaging with stressors. Similarly, the Transactional Model of Stress predicts that perceiving a stressor as challenging leads to positive outcomes whereas negative perceptions of the stressor as threatening invoke negative outcomes. The aim of this study was to provide preliminary data examining the nature of the relationship between stress mindset and primary appraisals. It was predicted that positive beliefs about stress would be associated with perceiving a stressful situation as more challenging, and inversely related to perceptions of threat. Participants (N = 124) initially completed measures assessing stress mindset, lifetime and current perceived stress, trait anxiety, and self-efficacy. Then participants received a set of instructions regarding a stressful mathematics task, followed by completion of post-manipulation stress mindset and primary appraisals measures, prior to completing the mathematics task. Multiple linear regression analyses revealed that participants who held a greater number of positive beliefs (as opposed to negative beliefs) about stress also perceived the stressor as being more challenging. However, there was no significant relationship between valence of beliefs and threat appraisals. These findings provide initial evidence for the nature of the relationship between valence of stress beliefs and challenge appraisals. Further research is needed to understand how stress beliefs impact on the way in which an individual copes with stressful situations.

Language-based Measures of Mindfulness: Initial Validity and Clinical Utility

PubMed Central

Collins, Susan E.; Chawla, Neharika; Hsu, Sharon H.; Grow, Joel; Otto, Jacqueline M.; Marlatt, G. Alan

2009-01-01

This study examined relationships among language use, mindfulness, and substance-use treatment outcomes in the context of an efficacy trial of mindfulness-based relapse prevention (MBRP) for adults with alcohol and other drug use (AOD) disorders (see Bowen, Chawla, Collins et al., in press). An expert panel generated two categories of mindfulness language (ML) describing the mindfulness state and the more encompassing “mindfulness journey,” which included words describing challenges of developing a mindfulness practice. MBRP participants (n=48) completed baseline sociodemographic and AOD measures, and participated in the 8-week MBRP program. AOD data were collected during the 4-month follow-up. A word count program assessed the frequency of ML and other linguistic markers in participants’ responses to open-ended questions about their postintervention impressions of mindfulness practice and MBRP. Findings supported concurrent validity of ML categories: ML words appeared more frequently in the MBRP manual compared to the 12-step Big Book. Further, ML categories correlated with other linguistic variables related to the mindfulness construct. Finally, predictive validity was supported: greater use of ML predicted fewer AOD use days during the 4-month follow-up. This study provided initial support for ML as a valid, clinically useful mindfulness measure. If future studies replicate these findings, ML could be used in conjunction with self-report to provide a more complete picture of the mindfulness experience. PMID:20025383

Distinct Neural Activities in Premotor Cortex during Natural Vocal Behaviors in a New World Primate, the Common Marmoset (Callithrix jacchus).

PubMed

Roy, Sabyasachi; Zhao, Lingyun; Wang, Xiaoqin

2016-11-30

Although evidence from human studies has long indicated the crucial role of the frontal cortex in speech production, it has remained uncertain whether the frontal cortex in nonhuman primates plays a similar role in vocal communication. Previous studies of prefrontal and premotor cortices of macaque monkeys have found neural signals associated with cue- and reward-conditioned vocal production, but not with self-initiated or spontaneous vocalizations (Coudé et al., 2011; Hage and Nieder, 2013), which casts doubt on the role of the frontal cortex of the Old World monkeys in vocal communication. A recent study of marmoset frontal cortex observed modulated neural activities associated with self-initiated vocal production (Miller et al., 2015), but it did not delineate whether these neural activities were specifically attributed to vocal production or if they may result from other nonvocal motor activity such as orofacial motor movement. In the present study, we attempted to resolve these issues and examined single neuron activities in premotor cortex during natural vocal exchanges in the common marmoset (Callithrix jacchus), a highly vocal New World primate. Neural activation and suppression were observed both before and during self-initiated vocal production. Furthermore, by comparing neural activities between self-initiated vocal production and nonvocal orofacial motor movement, we identified a subpopulation of neurons in marmoset premotor cortex that was activated or suppressed by vocal production, but not by orofacial movement. These findings provide clear evidence of the premotor cortex's involvement in self-initiated vocal production in natural vocal behaviors of a New World primate. Human frontal cortex plays a crucial role in speech production. However, it has remained unclear whether the frontal cortex of nonhuman primates is involved in the production of self-initiated vocalizations during natural vocal communication. Using a wireless multichannel neural recording technique, we observed in the premotor cortex neural activation and suppression both before and during self-initiated vocalizations when marmosets, a highly vocal New World primate species, engaged in vocal exchanges with conspecifics. A novel finding of the present study is the discovery of a subpopulation of premotor cortex neurons that was activated by vocal production, but not by orofacial movement. These observations provide clear evidence of the premotor cortex's involvement in vocal production in a New World primate species. Copyright © 2016 the authors 0270-6474/16/3612168-12$15.00/0.

Neuropsychological sex differences associated with age of initiated use among young adult cannabis users.

PubMed

Crane, Natania A; Schuster, Randi Melissa; Mermelstein, Robin J; Gonzalez, Raul

2015-01-01

Earlier initiation of cannabis use is associated with poorer neuropsychological functioning across several domains. Given well-documented sex differences in neuromaturation during adolescence, initiation of cannabis use during this time may affect neuropsychological functioning differently for males and females. In the current study, we examined sex differences in the relationship between age of initiated cannabis use and neuropsychological performance after controlling for amount of lifetime cannabis use in 44 male and 25 female young adult cannabis users. We found that an earlier age of initiated use was related to poorer episodic memory, especially immediate recall, in females, but not in males. On the other hand, we found that, surprisingly, an earlier age of initiated use was associated with better decision making overall. However, exploratory analyses found sex-specific factors associated with decision making and age of initiated use, specifically that attention-deficit/hyperactivity disorder (ADHD) symptoms in females may drive the relationship between an earlier age of initiated use and better decision making. Further, an earlier age of initiated use was associated with less education, a lower IQ, and fewer years of mother's education for females, but more lifetime cannabis use for males. Taken together, our findings suggest there are sex differences in the associations between age of initiated cannabis use and neuropsychological functioning. The current study provides preliminary evidence that males and females may have different neuropsychological vulnerabilities that place them at risk for initiating cannabis use and continued cannabis use, highlighting the importance of examining the impact of cannabis on neuropsychological functioning separately for males and females.

"We'll call you when the results are in": Preferences for how medical test results are delivered.

PubMed

Dooley, Michael D; Burreal, Shay; Sweeny, Kate

2017-02-01

Whether healthy or sick, adults undergo frequent medical testing; however, no guidelines currently exist as to how patients are informed of their medical test results. This short report provides an initial look at how healthcare professionals deliver medical test results and patient preferences regarding these procedures. We specifically focus on two options for delivery of results: (1) open-ended timing, in which patients are contacted without warning when test results become available; or (2) closed-ended timing, in which patients are provided with a specific day and time when they will learn their test results. Participants who underwent a recent medical test indicated which delivery method their healthcare professional provided and their preferred method. Findings demonstrate a large discrepancy between actual and preferred timing, stemming from a general trend towards providing open-ended timing, whereas patient preferences were evenly split between the two options. This study provides a first step in understanding the merits of two options for delivering medical test results to patients and suggests an opportunity to improve patient care. The findings from this study provide first steps toward the development of guidelines for delivering test results in ways that maximize the quality of patient care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessing Space Weather Applications and Understanding: IMF Bz at L1

NASA Astrophysics Data System (ADS)

Riley, P.; Savani, N.; Mays, M. L.; Austin, H. J.

2017-12-01

The CCMC - International (CCMC-I) is designed as a self-organizing informal forum for facilitating novel global initiatives on space weather research, development, forecasting and education. Here we capitalize on CCMC'AGUs experience in providing highly utilized web-based services, leadership and trusted relationships with space weather model developers. One of the CCMC-I initiatives is the International Forum for Space Weather Capabilities Assessment. As part of this initiative, within the solar and heliosphere domain, we focus our community discussion on forecasting the magnetic structure of interplanetary CMEs and the ambient solar wind. During the International CCMC-LWS Working Meeting in April 2017 the group instigated open communication to agree upon a standardized process by which all current and future models can be compared under an unbiased test. In this poster, we present our initial findings how we expect different models will move forward with validating and forecasting the magnetic vectors of the solar wind at L1. We also present a new IMF Bz Score-board which will be used to assist in the transitioning of research models into more operational settings.

Men's Perceptions of Women's Participation in Development Initiatives in Rural Bangladesh.

PubMed

Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria

2018-03-01

Without taking masculine issues into account, women's participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men's perceptions of women's participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20-76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of "feeling challenged by fears and hopes," indicating variations in men's views on women's participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women's roles in enhancing family welfare, and (c) valuing women's independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men's views, suggesting a need to better engage men during different stages of women-focused development initiatives.

Transcription closed and open complex dynamics studies reveal balance between genetic determinants and co-factors

NASA Astrophysics Data System (ADS)

Sala, Adrien; Shoaib, Muhammad; Anufrieva, Olga; Mutharasu, Gnanavel; Jahan Hoque, Rawnak; Yli-Harja, Olli; Kandhavelu, Meenakshisundaram

2015-05-01

In E. coli, promoter closed and open complexes are key steps in transcription initiation, where magnesium-dependent RNA polymerase catalyzes RNA synthesis. However, the exact mechanism of initiation remains to be fully elucidated. Here, using single mRNA detection and dual reporter studies, we show that increased intracellular magnesium concentration affects Plac initiation complex formation resulting in a highly dynamic process over the cell growth phases. Mg2+ regulates transcription transition, which modulates bimodality of mRNA distribution in the exponential phase. We reveal that Mg2+ regulates the size and frequency of the mRNA burst by changing the open complex duration. Moreover, increasing magnesium concentration leads to higher intrinsic and extrinsic noise in the exponential phase. RNAP-Mg2+ interaction simulation reveals critical movements creating a shorter contact distance between aspartic acid residues and Nucleotide Triphosphate residues and increasing electrostatic charges in the active site. Our findings provide unique biophysical insights into the balanced mechanism of genetic determinants and magnesium ion in transcription initiation regulation during cell growth.

Examining the Role of Leadership in an Undergraduate Biology Institutional Reform Initiative

PubMed Central

Matz, Rebecca L.; Jardeleza, Sarah E.

2016-01-01

Undergraduate science, technology, engineering, and mathematics (STEM) education reform continues to be a national priority. We studied a reform process in undergraduate biology at a research-intensive university to explore what leadership issues arose in implementation of the initiative when characterized with a descriptive case study method. The data were drawn from transcripts of meetings that occurred over the first 2 years of the reform process. Two literature-based models of change were used as lenses through which to view the data. We find that easing the burden of an undergraduate education reform initiative on faculty through articulating clear outcomes, developing shared vision across stakeholders on how to achieve those outcomes, providing appropriate reward systems, and ensuring faculty have ample opportunity to influence the initiative all appear to increase the success of reform. The two literature-based models were assessed, and an extended model of change is presented that moves from change in STEM instructional strategies to STEM organizational change strategies. These lessons may be transferable to other institutions engaging in education reform. PMID:27856545

Linking initial microstructure and local response during quasistatic granular compaction

DOE PAGES

Hurley, R. C.; Lind, J.; Pagan, D. C.; ...

2017-07-24

In this study, we performed experiments combining three-dimensional x-ray diffraction and x-ray computed tomography to explore the relationship between microstructure and local force and strain during quasistatic granular compaction. We found that initial void space around a grain and contact coordination number before compaction can be used to predict regions vulnerable to above-average local force and strain at later stages of compaction. We also found correlations between void space around a grain and coordination number, and between grain stress and maximum interparticle force, at all stages of compaction. Finally, we observed grains that fracture to have an above-average initial localmore » void space and a below-average initial coordination number. In conclusion, our findings provide (1) a detailed description of microstructure evolution during quasistatic granular compaction, (2) an approach for identifying regions vulnerable to large values of strain and interparticle force, and (3) methods for identifying regions of a material with large interparticle forces and coordination numbers from measurements of grain stress and local porosity.« less

In the Dark: Young Men’s Stories of Sexual Initiation in the Absence of Relevant Sexual Health Information

PubMed Central

Kubicek, Katrina; Beyer, William; Weiss, George; Iverson, Ellen; Kipke, Michele D

2009-01-01

A growing body of research is investigating the effectiveness of abstinence only sexual education. There remains a dearth of research on the relevant sexual health information available to young men who have sex with men (YMSM). Drawing on a mixed-methods study with 526 YMSM, this study explores how and where YMSM receive relevant information on sexual health/behavior. Findings indicate that information related to gay men’s sexuality is not readily available from family, friends or schools. At initiation of anal intercourse, respondents generally had limited information about HIV and STIs. In some cases, this resulted in the perception that activities such as unprotected sex were “low risk”. Many mentioned they first learned about anal sex during their sexual debut, describing painful and/or unpleasant experiences. Some relied on older/more experienced partners, the internet and pornography for information. Findings are discussed in relation to how providers can help YMSM build solid foundations of sexual education to protect them from STI and HIV infection. PMID:19574587

Knowledge and beliefs of Malaysian adolescents regarding cancer.

PubMed

Al-Naggar, Redhwan Ahmed; Jillson, Irene Anne; Abu-Hamad, Samir; Mumford, William; Bobryshev, Yuri V

2015-01-01

Few studies have explored the knowledge and attitudes of adolescents toward cancer prevention and treatment. This lack of research and its potential utility in the development of new educational initiatives and screening methods, or the reconstruction of existing ones, provided the impetus for this study. The primary research aim was to assess secondary school student knowledge of cancer and determine whether or not they possessed basic knowledge of cancer symptoms, risk factors, and treatments and to determine the relationship between cancer knowledge and key demographic factors. The Management and Science University conducted a cross-sectional study analyzing responses through cross-tabulation with the socio-demographic data collected. The findings of our quantitative analysis suggest that Malaysian youth generally possess a moderate knowledge about cancer. Quantitative analyses found that socioeconomic inequalities and bias in education present as important factors contributing to cancer awareness, prevention, and treatment among Malaysian adolescents. The findings indicate that Malaysian youth generally possess a moderate knowledge about cancer but the current deficiencies in initiatives directed to cancer awareness continue to hinder the improvement in prevention of cancer among Malaysian adolescents.

St. Michael's Improvement Program - A Collaborative Approach to Sustainable Cost Savings.

PubMed

Trafford, Anne; Jane, Danielle

2017-01-01

In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians. As organizations face similar challenges, this journey can provide key learnings.

An exploratory investigation of hospice marketing: How are palliative care providers marketing their services?

PubMed

Matthews, Michael; Peters, Cara; Lawson, Stephanie

2017-01-01

Hospice and palliative care is a recent, but fast growing, industry in healthcare. Demographics suggest that hospice care will only increase. The purpose of this article is to examine strategic marketing initiatives hospice organizations currently employ. Data were collected at a hospice regional conference, capturing opinions from hospice organizations located in North and South Carolina. The results show that many hospice organizations do not have a dedicated marketing staff person, have a limited marketing budget, do not fully utilize all strategic planning tools, and have yet to differentiate themselves via branding. Implications of these findings for hospice providers are discussed.

Talking about end-of-life preferences in marriage: applying the theory of motivated information management.

PubMed

Rafferty, Katherine A; Cramer, Emily; Priddis, DeAnne; Allen, Mike

2015-01-01

The theory of motivated information management (TMIM) provides one framework to examine information-seeking behaviors, especially in conversations involving sensitive or difficult information such as preferences for end-of-life (EOL) care. The spouse plays a significant role in decision making surrounding EOL care. Consequently, individuals need information about spouses' EOL preferences in order to ensure carrying out those desires. Our findings support the value of TMIM as a framework to understand factors that influence couples' EOL care information-seeking behaviors. In support of the theory, we provide factors that influence the initiation or avoidance of EOL conversations between spouses.

The Southern California Twin Register at the University of Southern California: III

PubMed Central

Baker, Laura A.; Tuvblad, Catherine; Wang, Pan; Gomez, Karina; Bezdjian, Serena; Niv, Sharon; Raine, Adrian

2013-01-01

The Southern California Twin Register at the University of Southern California (USC) was initiated in 1984 and continues to provide an important resource for studies investigating genetic and environmental influences on human behavior. This article provides an update on the current register and its potential for future twin studies using recruitment through school district databases and voter records. An overview is also provided for an ongoing longitudinal twin study investigating the development of externalizing psychopathology from childhood to young adulthood, the USC Study of Risk Factors for Antisocial Behavior. Characteristics of the twins and their families are presented, including recruitment and participation rates, as well as attrition analyses and a summary of key findings to date. PMID:23394193

Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

PubMed

Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

2014-01-01

In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

User testing of an adaptation of fishbone diagrams to depict results of systematic reviews.

PubMed

Gartlehner, Gerald; Schultes, Marie-Therese; Titscher, Viktoria; Morgan, Laura C; Bobashev, Georgiy V; Williams, Peyton; West, Suzanne L

2017-12-12

Summary of findings tables in systematic reviews are highly informative but require epidemiological training to be interpreted correctly. The usage of fishbone diagrams as graphical displays could offer researchers an effective approach to simplify content for readers with limited epidemiological training. In this paper we demonstrate how fishbone diagrams can be applied to systematic reviews and present the results of an initial user testing. Findings from two systematic reviews were graphically depicted in the form of the fishbone diagram. To test the utility of fishbone diagrams compared with summary of findings tables, we developed and pilot-tested an online survey using Qualtrics. Respondents were randomized to the fishbone diagram or a summary of findings table presenting the same body of evidence. They answered questions in both open-ended and closed-answer formats; all responses were anonymous. Measures of interest focused on first and second impressions, the ability to find and interpret critical information, as well as user experience with both displays. We asked respondents about the perceived utility of fishbone diagrams compared to summary of findings tables. We analyzed quantitative data by conducting t-tests and comparing descriptive statistics. Based on real world systematic reviews, we provide two different fishbone diagrams to show how they might be used to display complex information in a clear and succinct manner. User testing on 77 students with basic epidemiological training revealed that participants preferred summary of findings tables over fishbone diagrams. Significantly more participants liked the summary of findings table than the fishbone diagram (71.8% vs. 44.8%; p < .01); significantly more participants found the fishbone diagram confusing (63.2% vs. 35.9%, p < .05) or indicated that it was difficult to find information (65.8% vs. 45%; p < .01). However, more than half of the participants in both groups were unable to find critical information and answer three respective questions correctly (52.6% in the fishbone group; 51.3% in the summary of findings group). Fishbone diagrams are compact visualizations that, theoretically, may prove useful for summarizing the findings of systematic reviews. Initial user testing, however, did not support the utility of such graphical displays.

SOX2 regulates self-renewal and tumorigenicity of human melanoma-initiating cells.

PubMed

Santini, R; Pietrobono, S; Pandolfi, S; Montagnani, V; D'Amico, M; Penachioni, J Y; Vinci, M C; Borgognoni, L; Stecca, B

2014-09-18

Melanoma is one of the most aggressive types of human cancer, characterized by enhanced heterogeneity and resistance to conventional therapy at advanced stages. We and others have previously shown that HEDGEHOG-GLI (HH-GLI) signaling is required for melanoma growth and for survival and expansion of melanoma-initiating cells (MICs). Recent reports indicate that HH-GLI signaling regulates a set of genes typically expressed in embryonic stem cells, including SOX2 (sex-determining region Y (SRY)-Box2). Here we address the function of SOX2 in human melanomas and MICs and its interaction with HH-GLI signaling. We find that SOX2 is highly expressed in melanoma stem cells. Knockdown of SOX2 sharply decreases self-renewal in melanoma spheres and in putative melanoma stem cells with high aldehyde dehydrogenase activity (ALDH(high)). Conversely, ectopic expression of SOX2 in melanoma cells enhances their self-renewal in vitro. SOX2 silencing also inhibits cell growth and induces apoptosis in melanoma cells. In addition, depletion of SOX2 progressively abrogates tumor growth and leads to a significant decrease in tumor-initiating capability of ALDH(high) MICs upon xenotransplantation, suggesting that SOX2 is required for tumor initiation and for continuous tumor growth. We show that SOX2 is regulated by HH signaling and that the transcription factors GLI1 and GLI2, the downstream effectors of HH-GLI signaling, bind to the proximal promoter region of SOX2 in primary melanoma cells. In functional studies, we find that SOX2 function is required for HH-induced melanoma cell growth and MIC self-renewal in vitro. Thus SOX2 is a critical factor for self-renewal and tumorigenicity of MICs and an important mediator of HH-GLI signaling in melanoma. These findings could provide the basis for novel therapeutic strategies based on the inhibition of SOX2 for the treatment of a subset of human melanomas.

Assessment of quality of care among in-patients with postpartum haemorrhage and severe pre-eclampsia at st. Francis hospital nsambya: a criteria-based audit.

PubMed

Lumala, Alfred; Sekweyama, Peter; Abaasa, Andrew; Lwanga, Humphrey; Byaruhanga, Romano

2017-01-13

The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care. This study was a CBA following a time series study design. It was done in St. Francis Hospital Nsambya and it involved assessment of adherence to standards of care for PPH, severe pre-eclampsia and eclampsia. An initial audit was done for 3 consecutive months, then findings were presented to health workers and recommendations made; we implemented the recommendations in a subsequent month and this comprised three interventions namely continuing medical education (CME), drills and displaying guidelines; a re-audit was done in the proceeding 3 consecutive months and analysis compared adherence rates of the initial audit with those of the re-audit. Pearson Chi-Square test revealed that the adherence rates of 7 out of 10 standards of care for severe pre-eclampsia/eclampsia were statistically significantly higher in the re-audit than in the initial audit; also, the adherence rates of 3 out of 4 standards of care for PPH were statistically significantly higher in the re-audit than in the initial audit. The giving of feedback on quality of care and the implementation of recommendations made during the CBA including CME, drills and displaying guidelines was associated with improvements in the quality of care for patients with PPH, severe pre-eclampsia and eclampsia.

Top-down constraints on global N2O emissions at optimal resolution: application of a new dimension reduction technique

NASA Astrophysics Data System (ADS)

Wells, Kelley C.; Millet, Dylan B.; Bousserez, Nicolas; Henze, Daven K.; Griffis, Timothy J.; Chaliyakunnel, Sreelekha; Dlugokencky, Edward J.; Saikawa, Eri; Xiang, Gao; Prinn, Ronald G.; O'Doherty, Simon; Young, Dickon; Weiss, Ray F.; Dutton, Geoff S.; Elkins, James W.; Krummel, Paul B.; Langenfelds, Ray; Steele, L. Paul

2018-01-01

We present top-down constraints on global monthly N2O emissions for 2011 from a multi-inversion approach and an ensemble of surface observations. The inversions employ the GEOS-Chem adjoint and an array of aggregation strategies to test how well current observations can constrain the spatial distribution of global N2O emissions. The strategies include (1) a standard 4D-Var inversion at native model resolution (4° × 5°), (2) an inversion for six continental and three ocean regions, and (3) a fast 4D-Var inversion based on a novel dimension reduction technique employing randomized singular value decomposition (SVD). The optimized global flux ranges from 15.9 Tg N yr-1 (SVD-based inversion) to 17.5-17.7 Tg N yr-1 (continental-scale, standard 4D-Var inversions), with the former better capturing the extratropical N2O background measured during the HIAPER Pole-to-Pole Observations (HIPPO) airborne campaigns. We find that the tropics provide a greater contribution to the global N2O flux than is predicted by the prior bottom-up inventories, likely due to underestimated agricultural and oceanic emissions. We infer an overestimate of natural soil emissions in the extratropics and find that predicted emissions are seasonally biased in northern midlatitudes. Here, optimized fluxes exhibit a springtime peak consistent with the timing of spring fertilizer and manure application, soil thawing, and elevated soil moisture. Finally, the inversions reveal a major emission underestimate in the US Corn Belt in the bottom-up inventory used here. We extensively test the impact of initial conditions on the analysis and recommend formally optimizing the initial N2O distribution to avoid biasing the inferred fluxes. We find that the SVD-based approach provides a powerful framework for deriving emission information from N2O observations: by defining the optimal resolution of the solution based on the information content of the inversion, it provides spatial information that is lost when aggregating to political or geographic regions, while also providing more temporal information than a standard 4D-Var inversion.

Effect of Initial Conditions on Reproducibility of Scientific Research

PubMed Central

Djulbegovic, Benjamin; Hozo, Iztok

2014-01-01

Background: It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. Methods: We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. Results: We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Conclusions: Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings. PMID:25132705

Effect of initial conditions on reproducibility of scientific research.

PubMed

Djulbegovic, Benjamin; Hozo, Iztok

2014-06-01

It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings.

Application of Microprocessor-Based Equipment in Nuclear Power Plants - Technical Basis for a Qualification Methodology

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

Korsah, K.

This document (1) summarizes the most significant findings of the ''Qualification of Advanced Instrumentation and Control (I&C) Systems'' program initiated by the Nuclear Regulatory Commission (NRC); (2) documents a comparative analysis of U.S. and European qualification standards; and (3) provides recommendations for enhancing regulatory guidance for environmental qualification of microprocessor-based safety-related systems. Safety-related I&C system upgrades of present-day nuclear power plants, as well as I&C systems of Advanced Light-Water Reactors (ALWRs), are expected to make increasing use of microprocessor-based technology. The Nuclear Regulatory Commission (NRC) recognized that the use of such technology may pose environmental qualification challenges different from current,more » analog-based I&C systems. Hence, it initiated the ''Qualification of Advanced Instrumentation and Control Systems'' program. The objectives of this confirmatory research project are to (1) identify any unique environmental-stress-related failure modes posed by digital technologies and their potential impact on the safety systems and (2) develop the technical basis for regulatory guidance using these findings. Previous findings from this study have been documented in several technical reports. This final report in the series documents a comparative analysis of two environmental qualification standards--Institute of Electrical and Electronics Engineers (IEEE) Std 323-1983 and International Electrotechnical Commission (IEC) 60780 (1998)--and provides recommendations for environmental qualification of microprocessor-based systems based on this analysis as well as on the findings documented in the previous reports. The two standards were chosen for this analysis because IEEE 323 is the standard used in the U.S. for the qualification of safety-related equipment in nuclear power plants, and IEC 60780 is its European counterpart. In addition, the IEC document was published in 1998, and should reflect any new qualification concerns, from the European perspective, with regard to the use of microprocessor-based safety systems in power plants.« less

Consumer e-health education in HIV/AIDS: a pilot study of a web-based video workshop

PubMed Central

O'Grady, Laura A

2006-01-01

Background Members of the HIV/AIDS community are known to use web-based tools to support learning about treatment issues. Initial research indicated components such as message forums or web-based documentation were effectively used by persons with HIV/AIDS. Video has also shown promise as a technology to aid consumer health education. However, no research has been published thus far investigating the impact of web-based environments combining these components in an educational workshop format. Methods In this qualitative study HIV/AIDS community members provided feedback on an integrated web-based consumer health education environment. Participants were recruited through organizations that serve the HIV/AIDS community located in Toronto, Canada. Demographics, data on Internet use, including messages exchanged in the study environment were collected. A group interview provided feedback on usability of the study environment, preferences for information formats, use of the message forum, and other sources for learning about treatment information. Results In this pilot study analysis of the posted messages did not demonstrate use for learning of the workshop content. Participants did not generally find the environment of value for learning about treatment information. However, participants did share how they were meeting these needs. It was indicated that a combination of resources are being used to find and discuss treatment information, including in-person sources. Conclusion More research on the ways in which treatment information needs are being met by HIV/AIDS community members and how technology fits in this process is necessary before investing large amounts of money into web-based interventions. Although this study had a limited number of participants, the findings were unexpected and, therefore, of interest to those who intend to implement online consumer health education initiatives or interventions. PMID:16504148

Exploratory evidence on the market for effective depression care in Pittsburgh.

PubMed

Schoenbaum, Michael; Kelleher, Kelly; Lave, Judith R; Green, Stephanie; Keyser, Donna; Pincus, Harold

2004-04-01

Despite the existence of effective and relatively cost-effective depression treatments, many depressed patients do not receive appropriate care. The authors assessed opportunities for increasing the rate of effective depression treatment by investigating the market for such treatment in the Pittsburgh area. A conceptual framework was developed to evaluate the market for effective depression care. On the basis of the conceptual framework, interviews were conducted with representatives from seven large employers, two medical health insurance carriers, two behavioral health insurance carriers, four primary care providers, and four behavioral health care providers. Respondents were asked to assess the barriers to and opportunities for increasing the rates of depression treatment from their perspectives. The findings suggest that there is currently little demand among purchasers for improving depression care and little interest among insurers and providers for improving care in the absence of purchaser demand. Even stakeholders who identified depression as an important problem could not come to a consensus about who should be responsible for addressing the problem. Employers reported that they look primarily to their vendors to initiate quality improvement efforts, whereas insurers reported that such improvement efforts were more likely to occur if they were initiated by employers who purchase their health plans; providers, in turn, reported feeling powerless to initiate change. The absence of a clear locus of responsibility for improving depression care lends considerable inertia to the status quo. Because the currently low treatment rates are likely to be socially inefficient, researchers and policy makers should consider strategies to help overcome this inertia.

Calculating the costs of work-based training: the case of NHS Cadet Schemes.

PubMed

Norman, Ian; Normand, Charles; Watson, Roger; Draper, Jan; Jowett, Sandra; Coster, Samantha

2008-09-01

The worldwide shortage of registered nurses [Buchan, J., Calman, L., 2004. The Global Shortage of Registered Nurses: An Overview of Issues And Actions. International Council of Nurses, Geneva] points to the need for initiatives which increase access to the profession, in particular, to those sections of the population who traditionally do not enter nursing. This paper reports findings on the costs associated with one such initiative, the British National Health Service (NHS) Cadet Scheme, designed to provide a mechanism for entry into nurse training for young people without conventional academic qualifications. The paper illustrates an approach to costing work-based learning interventions which offsets the value attributed to trainees' work against their training costs. To provide a preliminary evaluation of the cost of the NHS Cadet Scheme initiative. Questionnaire survey of the leaders of all cadet schemes in England (n=62, 100% response) in December 2002 to collect financial information and data on progression of cadets through the scheme, and a follow-up questionnaire survey of the same scheme leaders to improve the quality of information, which was completed in January 2004 (n=56, 59% response). The mean cost of producing a cadet to progress successfully through the scheme and onto a pre-registration nursing programme depends substantially on the value of their contribution to healthcare work during training and the progression rate of students through the scheme. The findings from this evaluation suggest that these factors varied very widely across the 62 schemes. Established schemes have, on average, lower attrition and higher progression rates than more recently established schemes. Using these rates, we estimate that on maturity, a cadet scheme will progress approximately 60% of students into pre-registration nurse training. As comparative information was not available from similar initiatives that provide access to nurse training, it was not possible to calculate the cost effectiveness of NHS Cadet Schemes. However, this study does show that those cadet schemes which have the potential to offer better value for money, are those where the progression rates are good and where the practical training of cadets is organised such that cadets meet the needs of patients which might otherwise have to be met by non-professionally qualified staff.

Student perception of initial transition into a nursing program: A mixed methods research study.

PubMed

McDonald, Meghan; Brown, Janine; Knihnitski, Crystal

2018-05-01

Transition into undergraduate education programs is stressful and impacts students' well-being and academic achievement. Previous research indicates nursing students experience stress, depression, anxiety, and poor lifestyle habits which interfere with learning. However, nursing students' experience of transition into nursing programs has not been well studied. Incongruence exists between this lack of research and the desire to foster student success. This study analyzed students' experiences of initial transition into a nursing program. An embedded mixed method design. A single site of a direct-entry, four year baccalaureate Canadian nursing program. All first year nursing students enrolled in the fall term of 2016. This study combined the Student Adaptation to College Questionnaire (SACQ) with a subset of participants participating in qualitative focus groups. Quantitative data was analyzed using descriptive statistics to identify statistically significant differences in full-scale and subscale scores. Qualitative data was analyzed utilizing thematic analysis. Significant differences were seen between those who moved to attend university and those who did not, with those who moved scoring lower on the Academic Adjustment subscale. Focus group thematic analysis highlighted how students experienced initial transition into a baccalaureate nursing program. Identified themes included reframing supports, splitting focus/finding focus, negotiating own expectations, negotiating others' expectations, and forming identity. These findings form the Undergraduate Nursing Initial Transition (UNIT) Framework. Significance of this research includes applications in faculty development and program supports to increase student success in the first year of nursing and to provide foundational success for ongoing nursing practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

Prevalence and Determinants of Susceptibility to Tobacco Smoking among Students in The Gambia.

PubMed

Jallow, Isatou K; Britton, John; Langley, Tessa

2018-06-20

Smoking is the biggest preventable cause of death, and kills about 7 million people annually. As smoking prevalence is falling in developed countries, tobacco businesses are turning to low and middle-income countries (LMICs) to generate new tobacco markets. To prevent young people from initiating smoking and becoming regular smokers it is important to understand the causes of susceptibility to smoking. In this study we report a nationwide survey of the prevalence and risk factors of smoking susceptibility among students aged 12-20 in The Gambia. We used two-stage cluster random sampling to select students in secondary schools throughout The Gambia, and questionnaire to collect data on demographic characteristics and indicators on susceptibility to initiating smoking. Among the total sample of 10,289 students, 9831(96%; 55.6% girls and 44.4% boys, (aged 12-20 years) non-smokers were included in the analysis. Of these, 3,333 (33.9%) were found to be susceptible to smoking. Smoking susceptibility was more common among students attending grant-aided schools, non-Muslims, who had smoking allowed at home, had family members or friends who smoke, were sent to purchase cigarettes, had poor knowledge of the harmful effects of smoking, noticed point-of-sale tobacco advertisements and who had positive attitudes towards smoking. This study shows that susceptibility to smoking is common among students and associated with preventable exposures. Although based on cross-sectional data these findings suggest that raising students' awareness of the harmful effects of smoking and reducing the prevalence of adult smoking, extending tobacco advertising restrictions to include point-of-sale, are all important to preventing the uptake of smoking among students. This is the first study to provide detailed data on smoking susceptibility and risk factors in a nationally representative sample of young people in The Gambia. Our findings show that susceptibility to smoking is relatively high and associated with preventable measures. Our results also identify an urgent need to broaden the ban on tobacco advertising to explicitly include point-of-sale advertisements. These findings provide valuable information for tobacco control policies and evidence to enable targeted intervention for young people most at risk of initiating smoking.

New on the Shelf: Teens in the Library. Findings from the Evaluation of Public Libraries as Partners in Youth Development, An Initiative of the Wallace Foundation. Final Report

ERIC Educational Resources Information Center

Spielberger, Julie; Horton, Carol; Michels, Lisa; Halpern, Robert

2004-01-01

Several trends have come together to intensify interest in how public libraries might best support the interests and needs of youth in their communities. This study reports on findings from the Public Libraries as Partners in Youth Development (PLPYD) Initiative, a four-year, nine-site initiative funded by the Wallace Foundation to develop…

Initial Assessment of a Variable-Camber Continuous Trailing-Edge Flap System on a Rigid Wing for Drag Reduction in Subsonic Cruise

NASA Technical Reports Server (NTRS)

Ippolito, Corey; Nguyen, Nhan; Totah, Joe; Trinh, Khanh; Ting, Eric

2013-01-01

In this paper, we describe an initial optimization study of a Variable-Camber Continuous Trailing-Edge Flap (VCCTEF) system. The VCCTEF provides a light-weight control system for aircraft with long flexible wings, providing efficient high-lift capability for takeoff and landing, and greater efficiency with reduced drag at cruising flight by considering the effects of aeroelastic wing deformations in the control law. The VCCTEF system is comprised of a large number of distributed and individually-actuatable control surfaces that are constrained in movement relative to neighboring surfaces, and are non-trivially coupled through structural aeroelastic dynamics. Minimzation of drag results in a constrained, coupled, non-linear optimization over a high-dimension search space. In this paper, we describe the modeling, analysis, and optimization of the VCCTEF system control inputs for minimum drag in cruise. The purpose of this initial study is to quantify the expected benefits of the system concept. The scope of this analysis is limited to consideration of a rigid wing without structural flexibility in a steady-state cruise condition at various fuel weights. For analysis, we developed an optimization engine that couples geometric synthesis with vortex-lattice analysis to automate the optimization procedure. In this paper, we present and describe the VCCTEF system concept, optimization approach and tools, run-time performance, and results of the optimization at 20%, 50%, and 80% fuel load. This initial limited-scope study finds the VCCTEF system can potentially gain nearly 10% reduction in cruise drag, provides greater drag savings at lower operating weight, and efficiency is negatively impacted by the severity of relative constraints between control surfaces.

White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study - teen.

PubMed

Warner, Echo L; Ding, Qian; Pappas, Lisa M; Henry, Kevin; Kepka, Deanna

2017-12-01

Human Papillomavirus (HPV) vaccination coverage is below national goals in the United States. Research is needed to inform strategically designed interventions that target sociodemographic groups with underutilization of HPV vaccination. Secondary data analysis of the National Immunization Survey-Teen 2013 measured association of sociodemographic factors (e.g., ethnicity/race, insurance) with HPV vaccination among females and males ages 13-17 (N = 18,959). Chi-square and multivariable Poisson regressions were conducted using survey-weighted statistics. Having a mother ≥35 years, a mother with some college, being of "Other" ethnicity/race, and having no providers who order vaccines from health departments was negatively associated with females initiating HPV vaccination. Having a mother with some college, being of Non-Hispanic White or "Other" ethnicity/race, and having some or no providers who order vaccines from health departments was negatively associated with males initiating HPV vaccination. These same factors were negatively associated with males completing HPV vaccination with the exception of "Other" ethnicity/race. In contrast, having an unmarried mother, being ages 15-17, having a hospital based provider, and receiving other adolescent vaccinations were positively associated with females initiating and completing HPV vaccination. Having an unmarried mother, health insurance that is not employer or union sponsored, and influenza and meningitis vaccinations was positively associated with male's initiating HPV vaccination. For males, being 15 or 17 years old and having other adolescent vaccinations was positively associated with vaccine completion. All findings p ≤ 0.05. Future HPV vaccination interventions may benefit from targeting certain sociodemographic groups that were negatively associated with HPV vaccination in this study.

Prioritizing the causes and correctors of smoking towards the solution of tobacco free future using enhanced analytic hierarchy process

NASA Astrophysics Data System (ADS)

Halim, Tisya Farida Abdul; Sapiri, Hasimah; Abidin, Norhaslinda Zainal

2017-11-01

This paper presents a method for prioritizing the causes and correctors of smoking habits in Malaysia. In order to identify the driving forces that causes (initiation factors) smoking habits and its correctors (anti-smoking strategies), a method called Enhanced Analytic Hierarchy Process (EAHP) is employed. The EAHP has advantages over normal Analytic Hierarchy Process (AHP) based on its capability to eliminate inconsistency (consistency ratio > 0.1) in evaluating expert's judgment. Based on the Theory of Triadic Influence, the identified initiation factors were personal beliefs and values, personal psychological, family influence, psychosocial influence, culture and legislative. There are five anti-smoking strategies that have been implemented in Malaysia, namely packaging and labelling, pricing and taxation, advertising, smoke-free legislation and education and support. Findings from the study shows that psychosocial influence was considered as the initiation factor of smoking among Malaysian adults, and mass media campaign was the most effective anti-smoking strategies to reduce smoking prevalence. The implementation of an effective anti-smoking strategies should be considered towards the endgame of tobacco by the year 2040 as outlined by the government. The findings in turn can provide insights and guidelines for researchers as well as policy makers to assess the effectiveness of anti-smoking strategies towards a better policy planning decisions in the future.

Nutrient depletion in Bacillus subtilis biofilms triggers matrix production

NASA Astrophysics Data System (ADS)

Zhang, Wenbo; Seminara, Agnese; Suaris, Melanie; Brenner, Michael P.; Weitz, David A.; Angelini, Thomas E.

2014-01-01

Many types of bacteria form colonies that grow into physically robust and strongly adhesive aggregates known as biofilms. A distinguishing characteristic of bacterial biofilms is an extracellular polymeric substance (EPS) matrix that encases the cells and provides physical integrity to the colony. The EPS matrix consists of a large amount of polysaccharide, as well as protein filaments, DNA and degraded cellular materials. The genetic pathways that control the transformation of a colony into a biofilm have been widely studied, and yield a spatiotemporal heterogeneity in EPS production. Spatial gradients in metabolites parallel this heterogeneity in EPS, but nutrient concentration as an underlying physiological initiator of EPS production has not been explored. Here, we study the role of nutrient depletion in EPS production in Bacillus subtilis biofilms. By monitoring simultaneously biofilm size and matrix production, we find that EPS production increases at a critical colony thickness that depends on the initial amount of carbon sources in the medium. Through studies of individual cells in liquid culture we find that EPS production can be triggered at the single-cell level by reducing nutrient concentration. To connect the single-cell assays with conditions in the biofilm, we calculate carbon concentration with a model for the reaction and diffusion of nutrients in the biofilm. This model predicts the relationship between the initial concentration of carbon and the thickness of the colony at the point of internal nutrient deprivation.

Enrolled nurse to registered nurse: is there a link between initial educational preparation and course completion?

PubMed

Rapley, Pat; Davidson, Laura; Nathan, Pauline; Dhaliwal, Satvinder S

2008-01-01

There is a shortage of registered nurses (RN) globally and equally in rural areas of Australia. The sparsely populated areas of rural Australia prompted the development of an external-mode EN-to-RN pathway course for enrolled nurses (EN) who want to complete a nursing degree. However, the awarding of advanced standing for EN clinical experience, regardless of educational background, is a new initiative that needs to be evaluated. Hence, this paper reports on the link between initial EN educational preparation and its impact on course completion. This exploratory correlation study used existing course data from four cohorts between 2000 and 2003. The comparisons included educational background, years of experience, and location of the EN-to-RN students. Significant differences were not found between rural and metropolitan students who completed or who withdrew from the course. Logistic regression analysis indicated that ENs in this sample with a hospital-based certificate rather than a technical college qualification were more likely to complete the course: Location and years of experience as an EN did not contribute significantly to course completion. The findings provide support for the same recognition of prior learning, regardless of educational background, for ENs entering a bachelor level nursing degree. The findings have relevance for Australia and other countries with similar challenges for ENs who want to become RNs without relocating to a city.

Comparative Study of Four Membranes for Evaluation of New Insect/Arthropod Repellents Using Aedes aegypti

DTIC Science & Technology

2008-01-01

market and had no plans to continuously provide the membranes. Thus, in an effort to find an alternative iu t•itro membrane test system, our initial...Professional: R Chandra Sekhar Junior SponsoriDg Editor: Nimisha Gorwami Manager-sales & Marketing : S Girish Controller-Production: Rajender P Ghansela...DDA Market , Paschim Vihar, New Delhi 110 063, and printed at Sai Printo Pack Pvt. Ltd., A-102/4, Okhla Industrial Area, Phase II. New Delhi 110 020

Schwarzschild black holes can wear scalar wigs.

PubMed

Barranco, Juan; Bernal, Argelia; Degollado, Juan Carlos; Diez-Tejedor, Alberto; Megevand, Miguel; Alcubierre, Miguel; Núñez, Darío; Sarbach, Olivier

2012-08-24

We study the evolution of a massive scalar field surrounding a Schwarzschild black hole and find configurations that can survive for arbitrarily long times, provided the black hole or the scalar field mass is small enough. In particular, both ultralight scalar field dark matter around supermassive black holes and axionlike scalar fields around primordial black holes can survive for cosmological times. Moreover, these results are quite generic in the sense that fairly arbitrary initial data evolve, at late times, as a combination of those long-lived configurations.

Additional Actions Needed to Mitigate Risks of Unsuitable Life Insurance Sales to Junior Enlisted Service Members

DTIC Science & Technology

2011-08-23

Service member has no formal banking relationship. 35 • Knowingly offering or giving anything of value to a Service member with a pay grade of E -4...provided briefing charts summarizing our tentative findings to the Committee on Banking , Housing, and Urban Affairs of the Senate and the Committee on...Inspector General of the DoD shall submit an initial report on the results of the study conducted under subsection (a) to the Committee on Banking

Characteristics of difficult-to-place youth in state custody: a profile of the Exceptional Care Pilot Project population.

PubMed

Armour, Marilyn P; Schwab, James

2007-01-01

This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the "Exceptional Care Pilot Project" (N = 46). Findings include, among others, high levels of comorbid psychiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most troubled youth.

A Study on the Commercialization of Space-Based Remote Sensing in the Twenty-First Century and Its Implications to United States National Security

DTIC Science & Technology

2011-06-01

Remote sensing from space provides critical data for many commercial space applications. Due to global market demand, it has undergone tremendous...commercial space imaging capability in the future, remote sensing policy makers, systems engineers, and industry analysts must be aware of the implications to United States National Security....available dissemination and accessibility. The analysis results, together with the findings from a review of commercial programs, initiatives, and remote

Mast Cell Interactions and Crosstalk in Regulating Allergic Inflammation.

PubMed

Velez, Tania E; Bryce, Paul J; Hulse, Kathryn E

2018-04-17

This review summarizes recent findings on mast cell biology with a focus on IgE-independent roles of mast cells in regulating allergic responses. Recent studies have described novel mast cell-derived molecules, both secreted and membrane-bound, that facilitate cross-talk with a variety of immune effector cells to mediate type 2 inflammatory responses. Mast cells are complex and dynamic cells that are persistent in allergy and are capable of providing signals that lead to the initiation and persistence of allergic mechanisms.

Application of persuasion and health behavior theories for behavior change counseling: design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting) program.

PubMed

Lin, Jenny J; Mann, Devin M

2012-09-01

Diabetes incidence is increasing worldwide and providers often do not feel they can effectively counsel about preventive lifestyle changes. The goal of this paper is to describe the development and initial feasibility testing of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) program to enhance counseling about behavior change for patients with pre-diabetes. Primary care providers and patients were interviewed about their perspectives on lifestyle changes to prevent diabetes. A multidisciplinary design team incorporated this data to translate elements from behavior change theories to create the ADAPT program. The ADAPT program was pilot tested to evaluate feasibility. Leveraging elements from health behavior theories and persuasion literature, the ADAPT program comprises a shared goal-setting module, implementation intentions exercise, and tailored reminders to encourage behavior change. Feasibility data demonstrate that patients were able to use the program to achieve their behavior change goals. Initial findings show that the ADAPT program is feasible for helping improve primary care providers' counseling for behavior change in patients with pre-diabetes. If successful, the ADAPT program may represent an adaptable and scalable behavior change tool for providers to encourage lifestyle changes to prevent diabetes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

76 FR 50971 - Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition To List the Leona's...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

...We, the U.S. Fish and Wildlife Service (Service), announce a 90-day finding on a petition to list the Leona's little blue butterfly, Philotiella leona, as threatened or endangered under the Endangered Species Act of 1973, as amended (Act), and to designate critical habitat. Based on our review, we find that the petition presents substantial scientific or commercial information indicating that listing the Leona's little blue butterfly may be warranted. Therefore, with the publication of this notice, we are initiating a review of the status of the species to determine if listing the Leona's little blue butterfly is warranted. To ensure that this status review is comprehensive, we are requesting scientific and commercial data and other information regarding this species. Based on the status review, we will issue a 12-month finding on the petition, which will address whether the petitioned action is warranted, as provided in the Act.

Medication therapy management and condition care services in a community-based employer setting.

PubMed

Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

2010-08-15

A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical outcomes. A business model in which health-system pharmacists provide MTM and condition care services for company employees has demonstrated successful outcomes in terms of patient satisfaction, cost savings, and clinical benefits.

Fatigue crack identification method based on strain amplitude changing

NASA Astrophysics Data System (ADS)

Guo, Tiancai; Gao, Jun; Wang, Yonghong; Xu, Youliang

2017-09-01

Aiming at the difficulties in identifying the location and time of crack initiation in the castings of helicopter transmission system during fatigue tests, by introducing the classification diagnostic criteria of similar failure mode to find out the similarity of fatigue crack initiation among castings, an engineering method and quantitative criterion for detecting fatigue cracks based on strain amplitude changing is proposed. This method is applied on the fatigue test of a gearbox housing, whose results indicates: during the fatigue test, the system alarms when SC strain meter reaches the quantitative criterion. The afterwards check shows that a fatigue crack less than 5mm is found at the corresponding location of SC strain meter. The test result proves that the method can provide accurate test data for strength life analysis.

Verbal marking of affect by children with Asperger Syndrome and high functioning autism during spontaneous interactions with family members.

PubMed

Müller, Eve; Schuler, Adriana

2006-11-01

Verbal marking of affect by older children with Asperger Syndrome (AS) and high functioning autism (HFA) during spontaneous interactions is described. Discourse analysis of AS and HFA and typically developing children included frequency of affective utterances, affective initiations, affective labels and affective explanations, attribution of affective responses to self and others, and positive and negative markers of affect. Findings indicate that children with AS and HFA engaged in a higher proportion of affect marking and provided a higher proportion of affective explanations than typically developing children, yet were less likely to initiate affect marking sequences or talk about the affective responses of others. No significant differences were found between groups in terms of the marking of positive and negative affect.

Expert Recommender: Designing for a Network Organization

NASA Astrophysics Data System (ADS)

Reichling, Tim; Veith, Michael; Wulf, Volker

Recent knowledge management initiatives focus on expertise sharing within formal organizational units and informal communities of practice. Expert recommender systems seem to be a promising tool in support of these initiatives. This paper presents experiences in designing an expert recommender system for a knowledge- intensive organization, namely the National Industry Association (NIA). Field study results provide a set of specific design requirements. Based on these requirements, we have designed an expert recommender system which is integrated into the specific software infrastructure of the organizational setting. The organizational setting is, as we will show, specific for historical, political, and economic reasons. These particularities influence the employees’ organizational and (inter-)personal needs within this setting. The paper connects empirical findings of a long-term case study with design experiences of an expertise recommender system.

Narrative organisation at encoding facilitated children's long-term episodic memory.

PubMed

Wang, Qi; Bui, Van-Kim; Song, Qingfang

2015-01-01

This study examined the effect of narrative organisation at encoding on long-term episodic memory in a sample of five- to seven-year-old children (N = 113). At an initial interview, children were asked to narrate a story from a picture book. Six months later, they were interviewed again and asked to recall the story and answer a series of direct questions about the story. Children who initially encoded more information in narrative and produced more complete, complex, cohesive and coherent narratives remembered the story in greater detail and accuracy following the six-month interval, independent of age and verbal skills. The relation between narrative organisation and memory was consistent across culture and gender. These findings provide new insight into the critical role of narrative in episodic memory.

Digital stethoscope: technology update.

PubMed

Swarup, Supreeya; Makaryus, Amgad N

2018-01-01

Cardiovascular disease (CVD) is recognized as the leading cause of mortality throughout the world. About one-third of global mortality is attributable to CVD. In addition to clinical presentation, specific clinical exam findings can assist in treating and preventing CVD. CVD may initially manifest as pulmonary pathology, and thus, accurate cardiopulmonary auscultation is paramount to establishing accurate diagnosis. One of the most powerful tools available to physicians is the stethoscope. The stethoscope first emerged in the year 1818, invented by a French physician, René Laennec. Since then, the initial modest monaural wooden tube has evolved into a sophisticated digital device. This paper provides an analysis of the evolution of the stethoscope as well as highlights the advancement made by the modern digital stethoscope including the application of this tool in advancing care for patients suffering from CVD.

Factors driving collaboration in natural resource conflict management: Evidence from Romania.

PubMed

Hossu, Constantina Alina; Ioja, Ioan Cristian; Susskind, Lawrence E; Badiu, Denisa L; Hersperger, Anna M

2018-02-03

A critical challenge in natural resource management is to bring all stakeholders together to negotiate solutions to critical problems. However, various collaborative approaches to heading off conflicts and resolving natural resource management disputes have been used. What drives these efforts, however, still needs further research. Our study provides a systematic look at the drivers likely to initiate collaborative problem-solving efforts in four cases in Romania. We use Emerson's et al. (2012) framework for collaborative governance and multi-value qualitative comparative analysis (mvQCA) to analyze cases involving endangered species, restrictions on forest harvest, conflicts associated with infrastructure development projects, and disputes over the management of environmentally sensitive areas. Our findings contribute to the already existing collaborative governance literature indicating which of the four factors: uncertainty, interdependence, consequential incentives, and leadership, in which combination, are necessary and sufficient to spur collaborative resource management efforts. Our results showed that in Romania the initiation of collaboration is best explained by positive consequential incentives (i.e., financial opportunities) which has determined leaders to take initiative. This study provides additional information for the complicated process of natural resource management which is often overriding collaboration by investigating what enables and constrains collaborative efforts in a country where natural resources were managed and used according to the principles of central planning.

Miscoding and other user errors: importance of ongoing education for proper blood glucose monitoring procedures.

PubMed

Schrock, Linda E

2008-07-01

This article reviews the literature to date and reports on a new study that documented the frequency of manual code-requiring blood glucose (BG) meters that were miscoded at the time of the patient's initial appointment in a hospital-based outpatient diabetes education program. Between January 1 and May 31, 2007, the type of BG meter and the accuracy of the patient's meter code (if required) and procedure for checking BG were checked during the initial appointment with the outpatient diabetes educator. If indicated, reeducation regarding the procedure for the BG meter code entry and/or BG test was provided. Of the 65 patients who brought their meter requiring manual entry of a code number or code chip to the initial appointment, 16 (25%) were miscoded at the time of the appointment. Two additional problems, one of dead batteries and one of improperly stored test strips, were identified and corrected at the first appointment. These findings underscore the importance of checking the patient's BG meter code (if required) and procedure for testing BG at each encounter with a health care professional or providing the patient with a meter that does not require manual entry of a code number or chip to match the container of test strips (i.e., an autocode meter).

Meningococcal disease in the Asia-Pacific region: Findings and recommendations from the Global Meningococcal Initiative.

PubMed

Borrow, Ray; Lee, Jin-Soo; Vázquez, Julio A; Enwere, Godwin; Taha, Muhamed-Kheir; Kamiya, Hajime; Kim, Hwang Min; Jo, Dae Sun

2016-11-21

The Global Meningococcal Initiative (GMI) is a global expert group that includes scientists, clinicians, and public health officials with a wide range of specialties. The purpose of the Initiative is to promote the global prevention of meningococcal disease (MD) through education, research, and cooperation. The first Asia-Pacific regional meeting was held in November 2014. The GMI reviewed the epidemiology of MD, surveillance, and prevention strategies, and outbreak control practices from participating countries in the Asia-Pacific region.Although, in general, MD is underreported in this region, serogroup A disease is most prominent in low-income countries such as India and the Philippines, while Taiwan, Japan, and Korea reported disease from serogroups C, W, and Y. China has a mixed epidemiology of serogroups A, B, C, and W. Perspectives from countries outside of the region were also provided to provide insight into lessons learnt. Based on the available data and meeting discussions, a number of challenges and data gaps were identified and, as a consequence, several recommendations were formulated: strengthen surveillance; improve diagnosis, typing and case reporting; standardize case definitions; develop guidelines for outbreak management; and promote awareness of MD among healthcare professionals, public health officials, and the general public. Copyright © 2016. Published by Elsevier Ltd.

Successful treatment of a guitarist with a finger joint injury using instrument-assisted soft tissue mobilization: a case report

PubMed Central

Terry Loghmani, M.; Bayliss, Amy J.; Clayton, Greg; Gundeck, Evelina

2015-01-01

Finger injuries are common and can greatly affect a musician’s quality of life. A 55-year-old man, who had injured the proximal interphalangeal joint of the left index finger 6 months prior to any intervention, was treated with a manual therapy approach incorporating instrument-assisted soft tissue mobilization (IASTM). Initial examination findings included self-reported pain and functional limitations and physical impairments that significantly impeded his ability to play the acoustic guitar. He was treated once a week for 6 weeks with IASTM, joint mobilization, therapeutic exercise, and ice massage. Additionally, a home exercise program and self-care instructions were provided. The patient gained positive outcomes with improvements in pain (Numerical Pain Rating Scale while playing the guitar: initial 5/10, discharge 1/10) and function (Disability Arm Shoulder Hand Sports-Performing Arts Optional Module: initial 75; discharge 6·25), each reaching a minimum clinically important difference. Importantly, he was able to play the guitar with minimal to no pain as desired. Physical measures also improved, including an immediate gain in finger range of motion with IASTM alone. Manual therapy approaches integrating IASTM may provide an effective conservative treatment strategy for patients with finger/hand conditions in the performing arts and other patient populations. PMID:26952165

Technology Estimating: A Process to Determine the Cost and Schedule of Space Technology Research and Development

NASA Technical Reports Server (NTRS)

Cole, Stuart K.; Reeves, John D.; Williams-Byrd, Julie A.; Greenberg, Marc; Comstock, Doug; Olds, John R.; Wallace, Jon; DePasquale, Dominic; Schaffer, Mark

2013-01-01

NASA is investing in new technologies that include 14 primary technology roadmap areas, and aeronautics. Understanding the cost for research and development of these technologies and the time it takes to increase the maturity of the technology is important to the support of the ongoing and future NASA missions. Overall, technology estimating may help provide guidance to technology investment strategies to help improve evaluation of technology affordability, and aid in decision support. The research provides a summary of the framework development of a Technology Estimating process where four technology roadmap areas were selected to be studied. The framework includes definition of terms, discussion for narrowing the focus from 14 NASA Technology Roadmap areas to four, and further refinement to include technologies, TRL range of 2 to 6. Included in this paper is a discussion to address the evaluation of 20 unique technology parameters that were initially identified, evaluated and then subsequently reduced for use in characterizing these technologies. A discussion of data acquisition effort and criteria established for data quality are provided. The findings obtained during the research included gaps identified, and a description of a spreadsheet-based estimating tool initiated as a part of the Technology Estimating process.

Processing Information after a Child’s Cancer Diagnosis – How Parents Learn: A Report from the Children’s Oncology Group

PubMed Central

Rodgers, Cheryl C.; Stegenga, Kristin; Withycombe, Janice S.; Sachse, Karen; Kelly, Katherine Patterson

2016-01-01

Parents of a child newly diagnosed with cancer must receive an extensive amount of information before their child’s initial hospital discharge; however, little is known about best practices for providing this education. An interpretive descriptive study design was used to describe actual and preferred educational content, timing, and methods among parents of children newly diagnosed with cancer prior to their child’s first hospital discharge. Twenty parents of children diagnosed with various malignancies participated in individual interviews 2 to 12 months after their child’s diagnosis. Data were analyzed using constant comparative analysis. Education delivery occurred in a telling manner at diagnosis transitioning to a reciprocal process of teaching during the inpatient stay, then primarily back to telling immediately before discharge. Parents expressed a variety of preferred learning styles but noted that their preferences were rarely assessed by healthcare providers. Multiple factors influenced parents’ ability to process educational information received during their child’s initial hospitalization. Findings suggest that nursing practices should include assessing for influencing factors, providing anticipatory guidance, and incorporating parents’ preferred learning style into the educational plan. PMID:28084180

Applying Social Network Analysis to Identify the Social Support Needs of Adolescent and Young Adult Cancer Patients and Survivors.

PubMed

Koltai, Kolina; Walsh, Casey; Jones, Barbara; Berkelaar, Brenda L

2018-04-01

This article examines how theoretical and clinical applications of social network analysis (SNA) can inform opportunities for innovation and advancement of social support programming for adolescent and young adult (AYA) cancer patients and survivors. SNA can help address potential barriers and challenges to initiating and sustaining AYA peer support by helping to identify the diverse psychosocial needs among individuals in the AYA age range; find strategic ways to support and connect AYAs at different phases of the cancer trajectory with resources and services; and increase awareness of psychosocial resources and referrals from healthcare providers. Network perspectives on homophily, proximity, and evolution provide a foundational basis to explore the utility of SNA in AYA clinical care and research initiatives. The uniqueness of the AYA oncology community can also provide insight into extending and developing current SNA theories. Using SNA in AYA psychosocial cancer research has the potential to create new ideas and pathways for supporting AYAs across the continuum of care, while also extending theories of SNA. SNA may also prove to be a useful tool for examining social support resources for AYAs with various chronic health conditions and other like groups.

Centrioles initiate cilia assembly but are dispensable for maturation and maintenance in C. elegans.

PubMed

Serwas, Daniel; Su, Tiffany Y; Roessler, Max; Wang, Shaohe; Dammermann, Alexander

2017-06-05

Cilia are cellular projections that assemble on centriole-derived basal bodies. While cilia assembly is absolutely dependent on centrioles, it is not known to what extent they contribute to downstream events. The nematode C. elegans provides a unique opportunity to address this question, as centrioles do not persist at the base of mature cilia. Using fluorescence microscopy and electron tomography, we find that centrioles degenerate early during ciliogenesis. The transition zone and axoneme are not completely formed at this time, indicating that cilia maturation does not depend on intact centrioles. The hydrolethalus syndrome protein HYLS-1 is the only centriolar protein known to remain at the base of mature cilia and is required for intraflagellar transport trafficking. Surprisingly, targeted degradation of HYLS-1 after initiation of ciliogenesis does not affect ciliary structures. Taken together, our results indicate that while centrioles are essential to initiate cilia formation, they are dispensable for cilia maturation and maintenance. © 2017 Serwas et al.

Centrioles initiate cilia assembly but are dispensable for maturation and maintenance in C. elegans

PubMed Central

Roessler, Max

2017-01-01

Cilia are cellular projections that assemble on centriole-derived basal bodies. While cilia assembly is absolutely dependent on centrioles, it is not known to what extent they contribute to downstream events. The nematode C. elegans provides a unique opportunity to address this question, as centrioles do not persist at the base of mature cilia. Using fluorescence microscopy and electron tomography, we find that centrioles degenerate early during ciliogenesis. The transition zone and axoneme are not completely formed at this time, indicating that cilia maturation does not depend on intact centrioles. The hydrolethalus syndrome protein HYLS-1 is the only centriolar protein known to remain at the base of mature cilia and is required for intraflagellar transport trafficking. Surprisingly, targeted degradation of HYLS-1 after initiation of ciliogenesis does not affect ciliary structures. Taken together, our results indicate that while centrioles are essential to initiate cilia formation, they are dispensable for cilia maturation and maintenance. PMID:28411189

Evaluation of Event Physical Activity Engagement at an Open Streets Initiative Within a Texas-Mexico Border Town.

PubMed

Salazar-Collier, Cindy Lynn; Reininger, Belinda; Gowen, Rose; Rodriguez, Arturo; Wilkinson, Anna

2018-05-09

Open streets initiatives provide an opportunity to engage in physical activity (PA) freely by temporarily closing streets to motorized traffic. Route counting estimation and event intercept surveys (n = 682) were conducted across 4 CycloBia events in Brownsville, TX, in 2015 to determine sociodemographics, PA engagement at the event, event awareness, and past CycloBia attendance. Cycling was the most commonly observed activity along the route (73.6%) followed by walking (22.9%). Attendees self-reported a median of 120 minutes in PA with 17.3% of attendees meeting recommended weekly PA guidelines at the event. Significant predictors of meeting PA guidelines via event PA engagement were past event attendance, sex, age, and Hispanic ethnicity. Findings suggest that CycloBia reached a large, low-income, predominantly Hispanic population and may be effective in promoting PA. Results help understand the effect of an open streets initiative on attendees living in a midsize, border city.

Road extraction from aerial images using a region competition algorithm.

PubMed

Amo, Miriam; Martínez, Fernando; Torre, Margarita

2006-05-01

In this paper, we present a user-guided method based on the region competition algorithm to extract roads, and therefore we also provide some clues concerning the placement of the points required by the algorithm. The initial points are analyzed in order to find out whether it is necessary to add more initial points, and this process will be based on image information. Not only is the algorithm able to obtain the road centerline, but it also recovers the road sides. An initial simple model is deformed by using region growing techniques to obtain a rough road approximation. This model will be refined by region competition. The result of this approach is that it delivers the simplest output vector information, fully recovering the road details as they are on the image, without performing any kind of symbolization. Therefore, we tried to refine a general road model by using a reliable method to detect transitions between regions. This method is proposed in order to obtain information for feeding large-scale Geographic Information System.

A qualitative study exploring women's journeys to becoming smokers in the social context of urban India.

PubMed

Salvi, Devashri; Nagarkar, Aarti

2018-04-01

In India, the prevalence of smoking among women is increasing, and the reasons behind this are unclear. We aimed to study the factors leading to initiation and maintenance of the smoking habit in women in Pune, India. Twenty-seven urban women smokers, ranging from 21 to 60 years of age (31.96 ± 10.70 years), were interviewed between September 2015 and February 2016. The in-depth interviews consisted of questions on pre-decided categories, including initiation, motivation to continue smoking, and risk perception. Thematic analysis revealed that peer pressure, curiosity, fascination, experimentation, and belonging to a group were factors that led to initiation, while lack of alternatives for stress relief, work environments, and lack of leisure time activities provided circumstances to continue smoking. Participants recognized a sense of liberation and independence from smoking cigarettes and perceived health risks as minor and distant. These findings can be used to develop or modify interventions to prevent and control smoking among urban Indian women.

Self-Initiated Health Behaviors Following a Diagnosis of Mild Cognitive Impairment

PubMed Central

Morgan, Gillian H.; Garand, Linda I.; Lingler, Jennifer H.

2012-01-01

The purpose of this study was to characterize the health related activities that patients self-initiate after being diagnosed with Mild Cognitive Impairment (MCI). Fifty-three persons with MCI were queried regarding health related activity changes made as a direct result of the MCI diagnosis, excluding activities which a) they were performing prior to their diagnosis, or b) were formally recommended by a clinician. Qualitative description was used to analyze responses. Most participants (62%) reported initiating one or more health related activities. The activities fell into three distinct categories: behaviors that were symptom driven (e.g., cognitive exercises), health promoting (e.g., dietary changes), or general increases in activity level. Activities reported by this sample encompassed many practices for which there is limited evidence for a potential impact on the clinical course of MCI. However, findings provide insight into the types of interventions that may be most attractive to those living with an MCI diagnosis. PMID:21928756

The Atg1-kinase complex tethers Atg9-vesicles to initiate autophagy

NASA Astrophysics Data System (ADS)

Rao, Yijian; Perna, Marco G.; Hofmann, Benjamin; Beier, Viola; Wollert, Thomas

2016-01-01

Autophagosomes are double-membrane vesicles that sequester cytoplasmic material for lysosomal degradation. Their biogenesis is initiated by recruitment of Atg9-vesicles to the phagophore assembly site. This process depends on the regulated activation of the Atg1-kinase complex. However, the underlying molecular mechanism remains unclear. Here we reconstitute this early step in autophagy from purified components in vitro. We find that on assembly from its cytoplasmic subcomplexes, the Atg1-kinase complex becomes activated, enabling it to recruit and tether Atg9-vesicles. The scaffolding protein Atg17 targets the Atg1-kinase complex to autophagic membranes by specifically recognizing the membrane protein Atg9. This interaction is inhibited by the two regulatory subunits Atg31 and Atg29. Engagement of the Atg1-Atg13 subcomplex restores the Atg9-binding and membrane-tethering activity of Atg17. Our data help to unravel the mechanism that controls Atg17-mediated tethering of Atg9-vesicles, providing the molecular basis to understand initiation of autophagosome-biogenesis.

Inevitable power-law behavior of isolated many-body quantum systems and how it anticipates thermalization

NASA Astrophysics Data System (ADS)

Távora, Marco; Torres-Herrera, E. J.; Santos, Lea F.

2016-10-01

Despite being ubiquitous, out-of-equilibrium quantum systems are much less understood than systems at equilibrium. Progress in the field has benefited from a symbiotic relationship between theoretical studies and new experiments on coherent dynamics. The present work strengthens this connection by providing a general picture of the relaxation process of isolated lattice many-body quantum systems that are routinely studied in experiments with cold atoms, ions traps, and nuclear magnetic resonance. We show numerically and analytically that the long-time decay of the probability for finding the system in its initial state necessarily shows a power-law behavior ∝t-γ . This happens independently of the details of the system, such as integrability, level repulsion, and the presence or absence of disorder. Information about the spectrum, the structure of the initial state, and the number of particles that interact simultaneously is contained in the value of γ . From it, we can anticipate whether the initial state will or will not thermalize.

Nonadiabatic effect on the quantum heat flux control.

PubMed

Uchiyama, Chikako

2014-05-01

We provide a general formula of quantum transfer that includes the nonadiabatic effect under periodic environmental modulation by using full counting statistics in Hilbert-Schmidt space. Applying the formula to an anharmonic junction model that interacts with two bosonic environments within the Markovian approximation, we find that the quantum transfer is divided into the adiabatic (dynamical and geometrical phases) and nonadiabatic contributions. This extension shows the dependence of quantum transfer on the initial condition of the anharmonic junction just before the modulation, as well as the characteristic environmental parameters such as interaction strength and cut-off frequency of spectral density. We show that the nonadiabatic contribution represents the reminiscent effect of past modulation including the transition from the initial condition of the anharmonic junction to a steady state determined by the very beginning of the modulation. This enables us to tune the frequency range of modulation, whereby we can obtain the quantum flux corresponding to the geometrical phase by setting the initial condition of the anharmonic junction.

Online support and education for dementia caregivers: overview, utilization, and initial program evaluation.

PubMed

Glueckauf, Robert L; Ketterson, Timothy U; Loomis, Jeffrey S; Dages, Pat

2004-01-01

Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are confronted with a variety of challenges in providing assistance to their loved ones, such as dealing with persistent, repetitive questions, managing episodes of agitation and aggressive responding, as well as monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, a significant proportion of dementia caregivers in the United States continue to receive little or no formal instruction in responding effectively to these anxiety-provoking situations. This paper describes the development and implementation of Alzheimer's Caregiver Support Online (also known as AlzOnline), an Internet- and telephone-based education and support network for caregivers of individuals with progressive dementia. An outcome analysis of a Robert Wood Johnson Foundation-funded strategic marketing initiative to promote the use of AlzOnline is reviewed, followed by a presentation of the findings of an initial program evaluation. Finally, future directions for online caregiver evaluation research are proposed.

Contemporary post surgical management of differentiated thyroid carcinoma.

PubMed

Tala, H; Tuttle, R M

2010-08-01

Risk assessment is the cornerstone of contemporary management of thyroid cancer. Following thyroid surgery, an initial risk assessment of recurrence and disease-specific mortality is made using important intra-operative findings, histologic characteristics of the tumor, molecular profile of the tumor, post-operative serum thyroglobulin and any available cross-sectional imaging studies. This initial risk assessment is used to guide recommendations regarding the need for remnant ablation, external beam irradiation, systemic therapy, degree of TSH suppression, and follow-up disease detection strategy over the first 2 years after initial therapy. While this initial risk stratification provides valuable information, it is a static representation of the patient in the first few weeks post-operatively that does not change over time. Depending on how the patient responds to our initial therapies, the risk of recurrence and death may change significantly during follow-up. In order to account for differences in response to therapy in individual patients and to incorporate the impact of treatment on our initial risk estimates, we recommend a re-stratification of risk at the 2-year point of follow-up. This re-stratification provides an updated risk estimate that can be used to guide ongoing management recommendations including the frequency and intensity of follow-up, degree of ongoing TSH suppression, and need for additional therapies. Ongoing management recommendations must be tailored to realistic, evolving risk estimates that are actively updated during follow-up. By individualizing therapy on the basis of initial and ongoing risk assessments, we can maximize the beneficial effects of aggressive therapy in patients with thyroid cancer who are likely to benefit from it, while minimizing potential complications and side effects in low-risk patients destined to have a full healthy and productive life after minimal therapeutic intervention. Copyright (c) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Performance comparisons between PCA-EA-LBG and PCA-LBG-EA approaches in VQ codebook generation for image compression

NASA Astrophysics Data System (ADS)

Tsai, Jinn-Tsong; Chou, Ping-Yi; Chou, Jyh-Horng

2015-11-01

The aim of this study is to generate vector quantisation (VQ) codebooks by integrating principle component analysis (PCA) algorithm, Linde-Buzo-Gray (LBG) algorithm, and evolutionary algorithms (EAs). The EAs include genetic algorithm (GA), particle swarm optimisation (PSO), honey bee mating optimisation (HBMO), and firefly algorithm (FF). The study is to provide performance comparisons between PCA-EA-LBG and PCA-LBG-EA approaches. The PCA-EA-LBG approaches contain PCA-GA-LBG, PCA-PSO-LBG, PCA-HBMO-LBG, and PCA-FF-LBG, while the PCA-LBG-EA approaches contain PCA-LBG, PCA-LBG-GA, PCA-LBG-PSO, PCA-LBG-HBMO, and PCA-LBG-FF. All training vectors of test images are grouped according to PCA. The PCA-EA-LBG used the vectors grouped by PCA as initial individuals, and the best solution gained by the EAs was given for LBG to discover a codebook. The PCA-LBG approach is to use the PCA to select vectors as initial individuals for LBG to find a codebook. The PCA-LBG-EA used the final result of PCA-LBG as an initial individual for EAs to find a codebook. The search schemes in PCA-EA-LBG first used global search and then applied local search skill, while in PCA-LBG-EA first used local search and then employed global search skill. The results verify that the PCA-EA-LBG indeed gain superior results compared to the PCA-LBG-EA, because the PCA-EA-LBG explores a global area to find a solution, and then exploits a better one from the local area of the solution. Furthermore the proposed PCA-EA-LBG approaches in designing VQ codebooks outperform existing approaches shown in the literature.

New insights into the pathways initiating and driving pancreatitis

PubMed Central

Gukovskaya, Anna S.; Pandol, Stephen J.; Gukovsky, Ilya

2016-01-01

Purpose of review In this article, we discuss recent studies that advance our understanding of molecular and cellular factors initiating and driving pancreatitis, with the emphasis on the role of acinar cell organelle disorders. Recent findings The central physiologic function of the pancreatic acinar cell – to synthesize, store, and secrete digestive enzymes – critically relies on coordinated actions of the endoplasmic reticulum (ER), the endolysosomal system, mitochondria, and autophagy. Recent studies begin to unravel the roles of these organelles’ disordering in the mechanism of pancreatitis. Mice deficient in key autophagy mediators Atg5 or Atg7, or lysosome-associated membrane protein-2, exhibit dysregulation of multiple signaling and metabolic pathways in pancreatic acinar cells and develop spontaneous pancreatitis. Mitochondrial dysfunction caused by sustained opening of the permeability transition pore is shown to mediate pancreatitis in several clinically relevant experimental models, and its inhibition by pharmacologic or genetic means greatly reduces local and systemic pathologic responses. Experimental pancreatitis is also alleviated with inhibitors of ORAI1, a key component of the plasma membrane channel mediating pathologic rise in acinar cell cytosolic Ca2+. Pancreatitis-promoting mutations are increasingly associated with the ER stress. These findings suggest novel pathways and drug targets for pancreatitis treatment. In addition, the recent studies identify new mediators (e.g., neutrophil extracellular traps) of the inflammatory and other responses of pancreatitis. Summary The recent findings illuminate a critical role of organelles regulating the autophagic, endolysosomal, mitochondrial, and ER pathways in maintaining pancreatic acinar cell homeostasis and secretory function; provide compelling evidence that organelle disordering is a key pathogenic mechanism initiating and driving pancreatitis; and identify molecular and cellular factors that could be targeted to restore organellar functions and thus alleviate or treat pancreatitis. PMID:27428704

Facilitating consumer participation: an approach to finding the 'right' consumer.

PubMed

Happell, Brenda

2010-01-01

Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the "right" consumer, including: finding a consumer without an axe to grind; ensuring the consumer is representative of broader views; health professionals as consumer representatives. While these concerns are common they have not yet been extensively debated and discussed in the broader Literature. Strategies necessary to support consumers in participatory roles are also considered and the controversial subject of financial remuneration for consumers is also explored.

Centres for Leadership: a strategy for academic integration.

PubMed

King, Gillian; Parker, Kathryn; Peacocke, Sean; Curran, C J; McPherson, Amy C; Chau, Tom; Widgett, Elaine; Fehlings, Darcy; Milo-Manson, Golda

2017-05-15

Purpose The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization. Design/methodology/approach Historical documents, tracked output information, and staff members' insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization. Findings The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting "way stations" on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values. Practical implications Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered. Originality/value A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

Shining lights: studies that have most influenced the understanding of health promotion's financial impact.

PubMed

Golaszewski, T

2001-01-01

To examine the literature from the past 20 years and identify those studies that support the economic merit of health promotion. A panel of experts was used to identify the top studies supporting the purpose of this article. Studies were chosen based on the following criteria: the study (1) examined the relationship between health risks and financial outcomes, or health promotion programs and financial outcomes; (2) provided strong and compelling financial data supporting the worth of health promotion; (3) had a high-quality methodology; (4) answered an important question or replicated important findings with superior methodology; and (5) represented U.S.-based initiatives published since 1980. After initially nominating a group of studies for consideration, panelists rated each on a scale from 1 to 3 representing their opinion of importance. Studies rating the highest were included for this discussion. Studies were analyzed by population characteristics, design, statistical tests, limitations, and results. This information was summarized for each identified article. A relationship between modifiable health risk factors and health care costs is supported by research. Health promotion interventions appear to provide positive financial returns, most notably for health care costs and absenteeism reduction. Private sector initiatives seem to be driving economic-based research. Overall, health promotion shows promising results for providing financial advantages for its sponsors; however, if this discipline is to show its true worth, considerable funding is needed from government or philanthropic sources to cover the substantial costs of quality research.

Public health approaches to end-of-life care in the UK: an online survey of palliative care services.

PubMed

Paul, Sally; Sallnow, Libby

2013-06-01

The public health approach to end-of-life care has gained recognition over the past decade regarding its contribution to palliative care services. Terms, such as health-promoting palliative care, and compassionate communities, have entered the discourse of palliative care and practice; examples exist in the UK and globally. This scoping study aimed to determine if such initiatives were priorities for hospices in the UK and, if so, provide baseline data on the types of initiatives undertaken. An online survey was designed, piloted and emailed to 220 palliative care providers across the four UK countries. It included a total of six questions. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. There was a 66% response rate. Of those providers, 60% indicated that public health approaches to death, dying and loss were a current priority for their organisation. Respondents identified a range of work being undertaken currently in this area. The most successful were felt to be working with schools and working directly with local community groups. The findings demonstrate the relevance of a public health approach for palliative care services and how they are currently engaging with the communities they serve. Although the approach was endorsed by the majority of respondents, various challenges were highlighted. These related to the need to balance this against service provision, and the need for more training and resources to support these initiatives, at both national and community levels.

CT findings in ulcerative, granulomatous, and indeterminate colitis

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

Gore, R.M.; Marn, C.S.; Kirby, D.F.

1984-08-01

Eight patients with ulcerative colitis, three with colitis indeterminate, and 15 patients with Crohn disease were studied by computed tomography (CT) to establish CT criteria for each disorder in hopes of providing a new diagnostic perspective useful in the radiographic evaluation of inflammatory colitis. The CT findings in ulcerative colitis included thickening of the colon wall, which was characterized by inhomogeneous attenuation and a target appearance of the rectum, and proliferation of perirectal fat. Bowel wall thickening with homogeneous attenuation, fistula and abscess formation, and mesenteric abnormalities were observed in patients with Crohn colitis. Patients with colitis indeterminate showed colonicmore » changes on CT observed in both disorders. Initial experience suggests that CT can differentiate patients with well established ulcerative and Crohn colitis.« less

Finding your first job in academics: interviewing strategies.

PubMed

Siegel, Jodi

2011-12-01

Successfully obtaining your first academic orthopaedic surgery position is a daunting adventure, but one in which you can succeed with proper preparation. First, you must identify specifically what you want to be doing on a daily basis at work. Then, you find places where you can potentially do those things. The interview will provide more definitive information and will allow you to assess if you can happily work in that environment. Remember that you must have balance in your life, so consider if the area is suitable to your and to your family's needs. By identifying your personal goals and desires of this initial position and thoroughly preparing for the entire interview process, you will be able to locate the most desirable opportunity available.

Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition

PubMed Central

Potgieser, A. R. E.; de Jong, B. M.; Wagemakers, M.; Hoving, E. W.; Groen, R. J. M.

2014-01-01

The supplementary motor area (SMA) syndrome is a characteristic neurosurgical syndrome that can occur after unilateral resection of the SMA. Clinical symptoms may vary from none to a global akinesia, predominantly on the contralateral side, with preserved muscle strength and mutism. A remarkable feature is that these symptoms completely resolve within weeks to months, leaving only a disturbance in alternating bimanual movements. In this review we give an overview of the old and new insights from the SMA syndrome and extrapolate these findings to seemingly unrelated diseases and symptoms such as Parkinson’s disease (PD) and tics. Furthermore, we integrate findings from lesion, stimulation and functional imaging studies to provide insight in the motor function of the SMA. PMID:25506324

Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit.

PubMed

Miljeteig, Ingrid; Sayeed, Sadath Ali; Jesani, Amar; Johansson, Kjell Arne; Norheim, Ole Frithjof

2009-08-01

The aim of this article was to describe how providers in an Indian NICU reach life-or-death treatment decisions. Qualitative in-depth interviews, field observations, and document analysis were conducted at an Indian nonprofit private tertiary institution that provided advanced neonatal care under conditions of resource scarcity. Compared with American and European units with similar technical capabilities, the unit studied maintained a much higher threshold for treatment initiation and continuation (range: 28-32 completed gestational weeks). We observed that complex, interrelated socioeconomic reasons influenced specific treatment decisions. Providers desired to protect families and avoid a broad range of perceived harms: they were reluctant to risk outcomes with chronic disability; they openly factored scarcity of institutional resources; they were sensitive to local, culturally entrenched intrafamilial dynamics; they placed higher regard for "precious" infants; and they felt relatively powerless to prevent gender discrimination. Formal or regulatory guidelines were either lacking or not controlling. In a tertiary-level academic Indian NICU, multiple factors external to predicted clinical survival of a preterm newborn influence treatment decisions. Providers adjust their decisions about withdrawing or withholding treatment on the basis of pragmatic considerations. Numerous issues related to resource scarcity are relevant, and providers prioritize outcomes that affect stakeholders other than the newborn. These findings may have implications for initiatives that seek to improve global neonatal health.

Characteristics of successful asthma programs.

PubMed

Clark, Noreen; Lachance, Laurie; Milanovich, Amy Friedman; Stoll, Shelley; Awad, Daniel F

2009-01-01

We identified characteristics of interventions associated with positive asthma outcomes to understand how programs can be improved. We identified asthma interventions from the peer-reviewed literature or through a nomination process for unpublished programs. Initially, we identified 532 interventions. Of those, 223 met our eligibility criteria (e.g., focus on asthma, completed an evaluation, and demonstrated at least one asthma-related health outcome) and provided information on program components and processes, administration, evaluation, and findings through telephone interviews, program documents, and published reports. We analyzed bivariate relationships between programmatic factors and outcomes using Chi-square statistics, Fisher's exact tests, and unconditional logistic regression. We confirmed findings for all programs by analyzing the subset with published results in peer-reviewed journals. Our findings indicated that programs were more likely to report a positive impact on health outcomes if they (1) were community based, (2) engaged the participation of community-based organizations, (3) provided program components in a clinical setting, (4) provided asthma training to health-care providers, (5) collaborated with other organizations and institutions and with government agencies, (6) designed a program for a specific racial/ethnic group, (7) tailored content or delivery based on individual health or educational needs, and (8) conducted environmental assessments and tailored interventions based on these assessments. Positive asthma outcomes were associated with specific program characteristics: being community centered, clinically connected, and continuously collaborative. Program developers and implementers who build these characteristics into their interventions will be more likely to realize desired asthma outcomes.

The building of knowledge, language, and decision-making about climate change science: a cross-national program for secondary students

NASA Astrophysics Data System (ADS)

Arya, Diana; Maul, Andrew

2016-04-01

The United Nations' declaration on climate change education in December 2014 has sparked a renewal of policies and programs initiated during the 'Decade of Education for Sustainable Development' (DESD, 2005-2014), aimed at promoting awareness, understanding, and civic action for environmental sustainability within learning communities all around the world. We present findings from a dialogic, multimodal, and literacies-based educational project designed to provide secondary students (N = 141) from four countries with the resources to read about and discuss evidence regarding climate change from seminal studies with peers and a core group of scientists (N = 7). Post-program interviews revealed a significant increase in language use related to evidence-based reasoning. Students also demonstrated an increased propensity to recycle. These findings support the hypothesis that providing opportunities for students to read and discuss seminal scientific sources incites positive changes in beliefs, attitudes, and behaviors related to climate change and climate science, and understandings of the nature of scientific evidence and argumentation.

High-resolution structure of TBP with TAF1 reveals anchoring patterns in transcriptional regulation.

PubMed

Anandapadamanaban, Madhanagopal; Andresen, Cecilia; Helander, Sara; Ohyama, Yoshifumi; Siponen, Marina I; Lundström, Patrik; Kokubo, Tetsuro; Ikura, Mitsuhiko; Moche, Martin; Sunnerhagen, Maria

2013-08-01

The general transcription factor TFIID provides a regulatory platform for transcription initiation. Here we present the crystal structure (1.97 Å) and NMR analysis of yeast TAF1 N-terminal domains TAND1 and TAND2 bound to yeast TBP, together with mutational data. We find that yeast TAF1-TAND1, which in itself acts as a transcriptional activator, binds TBP's concave DNA-binding surface by presenting similar anchor residues to TBP as does Mot1 but from a distinct structural scaffold. Furthermore, we show how TAF1-TAND2 uses an aromatic and acidic anchoring pattern to bind a conserved TBP surface groove traversing the basic helix region, and we find highly similar TBP-binding motifs also presented by the structurally distinct TFIIA, Mot1 and Brf1 proteins. Our identification of these anchoring patterns, which can be easily disrupted or enhanced, provides insight into the competitive multiprotein TBP interplay critical to transcriptional regulation.

Interdisciplinary Priorities for Dissemination, Implementation, and Improvement Science: Frameworks, Mechanics, and Measures.

PubMed

Brunner, Julian W; Sankaré, Ibrahima C; Kahn, Katherine L

2015-12-01

Much of dissemination, implementation, and improvement (DII) science is conducted by social scientists, healthcare practitioners, and biomedical researchers. While each of these groups has its own venues for sharing methods and findings, forums that bring together the diverse DII science workforce provide important opportunities for cross-disciplinary collaboration and learning. In particular, such forums are uniquely positioned to foster the sharing of three important components of research. First: they allow the sharing of conceptual frameworks for DII science that focus on the use and spread of innovations. Second: they provide an opportunity to share strategies for initiating and governing DII research, including approaches for eliciting and incorporating the research priorities of patients, study participants, and healthcare practitioners, and decision-makers. Third: they allow the sharing of outcome measures well-suited to the goals of DII science, thereby helping to validate these outcomes in diverse contexts, improving the comparability of findings across settings, and elevating the study of the implementation process itself. © 2015 Wiley Periodicals, Inc.

Interdisciplinary Priorities for Dissemination, Implementation, and Improvement Science: Frameworks, Mechanics, and Measures

PubMed Central

Brunner, Julian W.; Sankaré, Ibrahima C.

2015-01-01

Abstract Much of dissemination, implementation, and improvement (DII) science is conducted by social scientists, healthcare practitioners, and biomedical researchers. While each of these groups has its own venues for sharing methods and findings, forums that bring together the diverse DII science workforce provide important opportunities for cross‐disciplinary collaboration and learning. In particular, such forums are uniquely positioned to foster the sharing of three important components of research. First: they allow the sharing of conceptual frameworks for DII science that focus on the use and spread of innovations. Second: they provide an opportunity to share strategies for initiating and governing DII research, including approaches for eliciting and incorporating the research priorities of patients, study participants, and healthcare practitioners, and decision‐makers. Third: they allow the sharing of outcome measures well‐suited to the goals of DII science, thereby helping to validate these outcomes in diverse contexts, improving the comparability of findings across settings, and elevating the study of the implementation process itself. PMID:26349456

Allosteric substrate switching in a voltage sensing lipid phosphatase

PubMed Central

Grimm, Sasha S.; Isacoff, Ehud Y.

2016-01-01

Allostery provides a critical control over enzyme activity, biasing the catalytic site between inactive and active states. We find the Ciona intestinalis voltage-sensing phosphatase (Ci-VSP), which modifies phosphoinositide signaling lipids (PIPs), to have not one but two sequential active states with distinct substrate specificities, whose occupancy is allosterically controlled by sequential conformations of the voltage sensing domain (VSD). Using fast FRET reporters of PIPs to monitor enzyme activity and voltage clamp fluorometry to monitor conformational changes in the VSD, we find that Ci-VSP switches from inactive to a PIP3-preferring active state when the VSD undergoes an initial voltage sensing motion and then into a second PIP2-preferring active state when the VSD activates fully. This novel 2-step allosteric control over a dual specificity enzyme enables voltage to shape PIP concentrations in time, and provides a mechanism for the complex modulation of PIP-regulated ion channels, transporters, cell motility and endo/exocytosis. PMID:26878552

How to conduct a qualitative meta-analysis: Tailoring methods to enhance methodological integrity.

PubMed

Levitt, Heidi M

2018-05-01

Although qualitative research has long been of interest in the field of psychology, meta-analyses of qualitative literatures (sometimes called meta-syntheses) are still quite rare. Like quantitative meta-analyses, these methods function to aggregate findings and identify patterns across primary studies, but their aims, procedures, and methodological considerations may vary. This paper explains the function of qualitative meta-analyses and their methodological development. Recommendations have broad relevance but are framed with an eye toward their use in psychotherapy research. Rather than arguing for the adoption of any single meta-method, this paper advocates for considering how procedures can best be selected and adapted to enhance a meta-study's methodological integrity. Through the paper, recommendations are provided to help researchers identify procedures that can best serve their studies' specific goals. Meta-analysts are encouraged to consider the methodological integrity of their studies in relation to central research processes, including identifying a set of primary research studies, transforming primary findings into initial units of data for a meta-analysis, developing categories or themes, and communicating findings. The paper provides guidance for researchers who desire to tailor meta-analytic methods to meet their particular goals while enhancing the rigor of their research.

Occupational upheaval during resettlement and migration: findings of global ethnography with refugees with disabilities.

PubMed

Mirza, Mansha

2012-01-01

There is an emerging interest in issues of occupational justice and occupational deprivation within contemporary occupational therapy practice and theory. To inform this emerging agenda, research with populations at risk of occupational injustice is crucial. This study used a global ethnography framework to explore disabled refugees' access to occupational participation in the context of the U.S. refugee resettlement program. Narrative data from eight Cambodian and seven Somali refugees were combined with documentary analysis and information obtained from service providers. Data were analyzed using grounded theory techniques. Findings revealed a strong policy emphasis on employment and self-sufficiency within the U.S. refugee resettlement program. Consequently, resettlement service providers focused on the dichotomous options of work or welfare, overlooking the broader occupational needs of disabled refugees. Lacking supportive services for developing vocational skills or exploring occupational alternatives, the refugees struggled to find occupational avenues that would earn them social validity and integration into American society, leading to feelings of isolation and inadequacy. Research and practice initiatives with this population need to consider the role of institutional factors in shaping their occupational participation and evolving occupational needs. Copyright 2012, SLACK Incorporated.

A qualitative meta-summary using Sandelowski and Barroso's method for integrating qualitative research to explore barriers and facilitators to self-care in heart failure patients.

PubMed

Herber, Oliver Rudolf; Bücker, Bettina; Metzendorf, Maria-Inti; Barroso, Julie

2017-12-01

Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary. A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences. Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.

Are We Using Abdominal Radiographs Appropriately in the Management of Pediatric Constipation?

PubMed

Beinvogl, Beate; Sabharwal, Sabina; McSweeney, Maireade; Nurko, Samuel

2017-12-01

To identify the reasons why pediatric gastroenterologists obtain abdominal radiographs in the management of pediatric constipation. This was a prospective study surveying providers regarding their rationale, interpretation, resultant change, and confidence in their management before and after obtaining KUBs in patients seen for suspected constipation. Demographics and clinical findings were obtained from medical records. A total of 24 providers were surveyed after 72 patient encounters. Reasons for obtaining an abdominal radiograph included evaluation of stool burden (70%), need for a clean out (35%), fecal impaction (27%), cause of abdominal pain (24%), demonstration of stool burden to families (14%), assessment of response to therapy (13%), or encopresis (10%). The plan was changed in 47.6% of cases based on radiographic findings. In cases in which a plan was outlined before obtaining the radiograph (69%), the initial plan was implemented on average in 52.5%. In cases with no plans before obtaining the radiograph, previously unconsidered plans were implemented in 8.7%. Provider confidence in the management plan increased from 2.4 ± 2.7 to 4.1 ± 1.8 (P < .05) after the abdominal radiograph. Abdominal radiographs commonly are obtained by pediatric gastroenterologists in the evaluation and management of constipation. The majority used it to make a diagnosis, and nearly one-half changed their management based on the imaging findings. Overall, they reported an improved confidence in their management plan, despite evidence that radiographic findings poorly correlate with clinical severity. This study highlights the need for further provider education regarding the recommendations delineated in existing constipation guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

Serial magnetic resonance imaging findings in subarachnoid hemorrhage due to an initially angiographically occult type II spinal aneurysm: Case report.

PubMed

Kogan, Michael; Morr, Simon; Siddiqui, Adnan H

2017-04-28

Spinal aneurysms are rare causes of spontaneous subarachnoid hemorrhage. We present an unusual, initially occult, case of an upper thoracic intradural extramedullary isolated aneurysm arising from the T2 intercostal-radicular circulation that was initially angiographically occult but was discovered due to unique, albeit nonspecific, magnetic resonance imaging findings of spinal cord T2 hyperintensity and contrast enhancement that were noted to progress with a clinical picture of ictal rehemorrhage. Repeat spinal angiography revealed a spinal aneurysm that was treated surgically. In cases of sufficient clinical suspicion and nonspecific imaging findings, continued vigilance is advised in seeking an underlying pathoanatomic etiology.

Quality and consumer decision making in the market for health insurance and health care services.

PubMed

Kolstad, Jonathan T; Chernew, Michael E

2009-02-01

This article reviews the literature relating quality to consumer choice of health plan or health care provider. Evidence suggests that consumers tend to choose better performing health plans and providers and are responsive to initiatives that provide quality information. The response to quality and quality information differs significantly among consumers and across population subgroups. As such the effect of quality information on choice is apparent in only a relatively small, though perhaps consequential, number of consumers. Despite the wealth of findings on the topic to date, the authors suggest directions for future work, including better assessment of the dynamic issues related to information release, as well as a better understanding of how the response to information varies across different groups of patients.

Ecodevelopmental Predictors of Early Initiation of Alcohol, Tobacco, and Drug Use Among Hispanic Adolescents

PubMed Central

Bacio, Guadalupe A.; Estrada, Yannine; Huang, Shi; Martínez, Marcos; Sardinas, Krystal; Prado, Guillermo

2015-01-01

The purpose of this cross-sectional study was to test the transactional relationships of risk and protective factors that influence initiation of alcohol, tobacco, and drug use among Hispanic youth. Ecodevelopmental theory was used to identify factors at multiple ecological levels with a focus on four school-level characteristics (i.e. school socioeconomic status, school climate, school acculturation, and school ethnic composition). A sample of 741 Hispanic adolescents (M age =13.9, SD =.67) and their caregivers were recruited from 18 participating middle schools in Miami-Dade County, FL. Structural equation modeling was used to test the hypothesized ecodevelopmental model of early substance use, accounting for school clustering effects. Results provided strong support for the model (CFI = .95; RMSEA =.03). School SES was indirectly related to the likelihood of starting to use substances through perceived peer use norms (β =.03, p <.02). Similarly, school climate had an indirect effect on substance use initiation through family functioning and perceptions of peer use norms (β = −.03, p < .01). Neither school ethnic composition nor school acculturation had indirect effects on initiation of substance use. Results highlight the importance of the interplay of risk and protective factors at multiple ecological levels that impact early substance use initiation. Further, findings underscore the key role of school level characteristics on initiation of substance use and present opportunities for intervention. PMID:26054814

Making a distinction between the effect of initial stock and investment in health determinants.

PubMed

Robledo, Esther Lafuente; Rodriguez-Alvarez, Ana; Shmarev, Andrey Shmarev

2017-04-01

The objective of this paper was to propose a health production model that distinguishes between the initial stock of health determinants and the subsequent investment in them, with a view to providing information to policy-makers regarding the effects of determinant-aimed policies. In this sense, the main contributions of the paper stem from the development of a theoretical and empirical model that distinguishes between the effect of the initial stock and that of investment in health determinants. To do this, we estimated the health production function using a stochastic frontier model. We present an empirical example using data for the years 2002 and 2008. The results support our decision to analyse the effects of the initial values attributable to health determinants separately from those arising following investment in the period. Concretely, we find significant differences for the determinants EMPLOY, SOCIALCLASS and NON-DRINKER. The results seem to indicate that, for variables labelled with the behavioural aspects of health such as NON-DRINKER, the effect over time of a change in investment in health is significantly greater than that resulting from a variation in initial values. In contrast, for socioeconomic variables such as SOCIAL CLASS or EMPLOY, for which effects on health tend to be more long-term in nature, the opposite occurs, with the effect of the investment during the time period proving significantly lower than the effect of the initial provision.

Initial velocity V-shapes of young asteroid families

NASA Astrophysics Data System (ADS)

Bolin, Bryce T.; Walsh, Kevin J.; Morbidelli, Alessandro; Delbó, Marco

2018-01-01

Ejection velocity fields of asteroid families are largely unconstrained due to the fact that members disperse relatively quickly on Myr time-scales by secular resonances and the Yarkovsky effect. The spreading of fragments in a by the Yarkovsky effect is indistinguishable from the spreading caused by the initial ejection of fragments. By examining families <20 Myr old, we can use the V-shape identification technique to separate family shapes that are due to the initial ejection velocity field and those that are due to the Yarkovsky effect. Asteroid families that are <20 Myr old provide an opportunity to study the velocity field of family fragments before they become too dispersed. Only the Karin family's initial velocity field has been determined and scales inversely with diameter, D-1. We have applied the V-shape identification technique to constrain young families' initial ejection velocity fields by measuring the curvature of their fragments' V-shape correlation in semimajor axis, a, versus D-1 space. Curvature from a straight line implies a deviation from a scaling of D-1. We measure the V-shape curvature of 11 young asteroid families including the 1993 FY12, Aeolia, Brangane, Brasilia, Clarissa, Iannini, Karin, Konig, Koronis(2), Theobalda and Veritas asteroid families. We find that the majority of asteroid families have initial ejection velocity fields consistent with ∼D-1 supporting laboratory impact experiments and computer simulations of disrupting asteroid parent bodies.

The Collaboration Readiness of Transdisciplinary Research Teams and Centers

PubMed Central

Hall, Kara L.; Stokols, Daniel; Moser, Richard P.; Taylor, Brandie K.; Thornquist, Mark D.; Nebeling, Linda C.; Ehret, Carolyn C.; Barnett, Matthew J.; McTiernan, Anne; Berger, Nathan A.; Goran, Michael I.; Jeffery, Robert W.

2009-01-01

Growing interest in promoting cross-disciplinary collaboration among health scientists has prompted several federal agencies, including the NIH, to establish large, multicenter initiatives intended to foster collaborative research and training. In order to assess whether these initiatives are effective in promoting scientific collaboration that ultimately results in public health improvements, it is necessary to develop new strategies for evaluating research processes and products as well as the longer-term societal outcomes associated with these programs. Ideally, evaluative measures should be administered over the entire course of large initiatives, including their near-term and later phases. The present study focuses on the development of new tools for assessing the readiness for collaboration among health scientists at the outset (during Year One) of their participation in the National Cancer Institute’s Transdisciplinary Research on Energetics and Cancer (TREC) initiative. Indexes of collaborative readiness, along with additional measures of near-term collaborative processes, were administered as part of the TREC Year-One evaluation survey. Additionally, early progress toward scientific collaboration and integration was assessed, using a protocol for evaluating written research products. Results from the Year-One survey and the ratings of written products provide evidence of cross-disciplinary collaboration among participants during the first year of the initiative, and also reveal opportunities for enhancing collaborative processes and outcomes during subsequent phases of the project. The implications of these findings for future evaluations of team science initiatives are discussed. PMID:18619396

Association of FOXO3A variation with human longevity confirmed in German centenarians

PubMed Central

Flachsbart, Friederike; Caliebe, Amke; Kleindorp, Rabea; Blanché, Hélène; von Eller-Eberstein, Huberta; Nikolaus, Susanna; Schreiber, Stefan; Nebel, Almut

2009-01-01

The human forkhead box O3A gene (FOXO3A) encodes an evolutionarily conserved key regulator of the insulin–IGF1 signaling pathway that is known to influence metabolism and lifespan in model organisms. A recent study described 3 SNPs in the FOXO3A gene that were statistically significantly associated with longevity in a discovery sample of long-lived men of Japanese ancestry [Willcox et al. (2008) Proc Natl Acad Sci USA 105:13987–13992]. However, this finding required replication in an independent population. Here, we have investigated 16 known FOXO3A SNPs in an extensive collection of 1,762 German centenarians/nonagenarians and younger controls and provide evidence that polymorphisms in this gene were indeed associated with the ability to attain exceptional old age. The FOXO3A association was considerably stronger in centenarians than in nonagenarians, highlighting the importance of centenarians for genetic longevity research. Our study extended the initial finding observed in Japanese men to women and indicates that both genders were likely to be equally affected by variation in FOXO3A. Replication in a French centenarian sample generated a trend that supported the previous results. Our findings confirmed the initial discovery in the Japanese sample and indicate FOXO3A as a susceptibility gene for prolonged survival in humans. PMID:19196970

Women recovering from first-time myocardial infarction (MI): a feminist qualitative study.

PubMed

Jackson, D; Daly, J; Davidson, P; Elliott, D; Cameron-Traub, E; Wade, V; Chin, C; Salamonson, Y

2000-12-01

Although myocardial infarction (MI) is a leading cause of death and disablement for women internationally, little is known about women's recovery. This paper describes an exploratory descriptive study that was informed by feminist principles, and which aimed to explore the recovery experiences of a group of women survivors of first-time MI in the initial period following discharge from hospital. A total of 10 female survivors were interviewed using an open-ended semi-structured interview schedule administered at 7, 14 and 21 days post-hospital discharge. Findings revealed that recovery was experienced as a complex process, initially characterized by fear and uncertainty. Over the duration of the study these feelings were replaced with a more positive outlook, a return of energy, and a sense of confidence in the future. Participants identified an unmet need for reliable information which persisted over the duration of the study. The findings of this study have implications for nursing practice and research. Chief among these is the issue of effective provision of information to women following an acute MI. The importance of providing relevant information to be understood and retained by people experiencing crisis cannot be overstated. Equally important are the provision of opportunities for patients to have regular contact with health professionals to question and seek clarifying information. These findings should now be tested on larger populations.

Key issues affecting quality of life and patient-reported outcomes in prostate cancer: an analysis conducted in 2128 patients with initial psychometric assessment of the prostate cancer symptom scale (PCSS).

PubMed

Msaouel, Pavlos; Gralla, Richard J; Jones, Randy A; Hollen, Patricia J

2017-09-01

Evidence-based quality of life (QL) questionnaires require the identification of issues of importance to patients. The primary aim of this study was to inform providers on patient-expressed issues while enhancing the content validity of instruments assessing QL and patient-reported outcomes (PROs) in prostate cancer. The study provided additional psychometric properties for the new PRO and QL instrument, the Prostate Cancer Symptom Scale (PCSS). An anonymous web-based survey of 2128 patients with prostate cancer was conducted with patients rating 18 QL items on a five-point scale. Most respondents (74%) were aged 55-74 years, had early stage disease at diagnosis (81%) and were diagnosed within 2 years of the survey (81%). The top five-rated issues were: overall QL, ability to perform normal activities, maintaining independence, ability to sleep and not being a burden. These items were ranked as either 'very important' or 'important' by at least 88% of patients. None of the most highly ranked issues were symptoms. Instead, the highest ranked items were global issues reflecting the impact of symptoms on patients. In addition to the enhanced content validity findings, good reliability results and initial support for construct validity are reported for the PCSS. This is the largest survey providing patient-expressed background for content validity for QL and PRO measures. The findings of this study should aid development of newer practical questionnaires, such as the PCSS, which can be adapted to electronic platforms enhancing rapid and accurate PRO and QL evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Dual-energy computed tomographic virtual noncalcium algorithm for detection of bone marrow edema in acute fractures: early experiences.

PubMed

Reagan, Adrian C; Mallinson, Paul I; O'Connell, Timothy; McLaughlin, Patrick D; Krauss, Bernhard; Munk, Peter L; Nicolaou, Savvas; Ouellette, Hugue A

2014-01-01

Computed tomography (CT) is often used to assess the presence of occult fractures when plain radiographs are equivocal in the acute traumatic setting. While providing increased spatial resolution, conventional computed tomography is limited in the assessment of bone marrow edema, a finding that is readily detectable on magnetic resonance imaging (MRI).Dual-energy CT has recently been shown to demonstrate patterns of bone marrow edema similar to corresponding MRI studies. Dual-energy CT may therefore provide a convenient modality for further characterizing acute bony injury when MRI is not readily available. We report our initial experiences of 4 cases with imaging and clinical correlation.

Accountable care organizations: financial advantages of larger hospital organizations.

PubMed

Camargo, Rodrigo; Camargo, Thaisa; Deslich, Stacie; Paul, David P; Coustasse, Alberto

2014-01-01

Accountable care organizations (ACOs) are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success. Findings of this study suggest that ACOs based in a larger hospital organization are more likely to meet Centers for Medicare and Medicaid Services criteria for formation because of financial and structural assets of those entities.

Application of Appropriate Use Criteria for Initial Transthoracic Echocardiography in an Academic Outpatient Pediatric Cardiology Program.

PubMed

Safa, Raya; Aggarwal, Sanjeev; Misra, Amrit; Kobayashi, Daisuke

2017-08-01

Transthoracic echocardiography (TTE) is a non-invasive diagnostic modality for children with suspected heart disease. The American College of Cardiology published Appropriate Use Criteria (AUC) for an initial outpatient pediatric TTE in 2014 to promote effective care and improve resource utilization. The objective was to determine the appropriateness of TTE per the published AUC in a single academic pediatric cardiology clinic as a baseline performance quality measure. The echocardiography database was used to identify initial outpatient TTE in children during January-March 2014. TTE indications (appropriate [A], may be appropriate [M], or rarely appropriate [R]) and findings (normal, incidental, or abnormal) were recorded. The effect of AUC and age groups on yield of abnormal TTE findings was analyzed. Of the 2166 screened studies, our study cohort consisted of 247 TTEs. Indications rated A, M, and R were found in 129, 27, and 90, respectively, and 1 was unclassifiable. Majority of TTE (n = 183) were normal, although incidental findings were noted in 32 and abnormal findings in 32 cases. Abnormal findings were noted in 26/129 of A, 2/27 of M, and 4/90 of R. Indications rated A were significantly associated with yield of abnormal TTE findings, adjusted by age group. Infants and adolescents were more likely to have abnormal TTE findings compared to young children. Recently published AUC were validated for initial TTE in the outpatient pediatric cardiology clinic. Appropriateness rated by AUC was highly associated with yield of abnormal TTE findings and worked best in infants and adolescent.

Perceived Utility of the RE-AIM Framework for Health Promotion/Disease Prevention Initiatives for Older Adults: A Case Study from the U.S. Evidence-Based Disease Prevention Initiative.

PubMed

Ory, Marcia G; Altpeter, Mary; Belza, Basia; Helduser, Janet; Zhang, Chen; Smith, Matthew Lee

2014-01-01

Dissemination and implementation (D&I) frameworks are increasingly being promoted in public health research. However, less is known about their uptake in the field, especially for diverse sets of programs. Limited questionnaires exist to assess the ways that frameworks can be utilized in program planning and evaluation. We present a case study from the United States that describes the implementation of the RE-AIM framework by state aging services providers and public health partners and a questionnaire that can be used to assess the utility of such frameworks in practice. An online questionnaire was developed to capture community perspectives about the utility of the RE-AIM framework. Distributed to project leads in 27 funded states in an evidence-based disease prevention initiative for older adults, 40 key stakeholders responded representing a 100% state-participation rate among the 27 funded states. Findings suggest that there is perceived utility in using the RE-AIM framework when evaluating grand-scale initiatives for older adults. The RE-AIM framework was seen as useful for planning, implementation, and evaluation with relevance for evaluators, providers, community leaders, and policy makers. Yet, the uptake was not universal, and some respondents reported difficulties in use, especially adopting the framework as a whole. This questionnaire can serve as the basis to assess ways the RE-AIM framework can be utilized by practitioners in state-wide D&I efforts. Maximal benefit can be derived from examining the assessment of RE-AIM-related knowledge and confidence as part of a continual quality assurance process. We recommend such an assessment be performed before the implementation of new funding initiatives and throughout their course to assess RE-AIM uptake and to identify areas for technical assistance.

Identifying Perceived Barriers along the HIV Care Continuum: Findings from Providers, Peer Educators, and Observations of Provider–Patient Interactions in Ethiopia

PubMed Central

Kulkarni, Sarah; Hoffman, Susie; Gadisa, Tsigereda; Melaku, Zenebe; Fantehun, Mesganaw; Yigzaw, Muluneh; El-Sadr, Wafaa; Remien, Robert; Tymejczyk, Olga; Nash, Denis; Elul, Batya

2015-01-01

Increasing the proportion of HIV-positive individuals who link promptly to and are retained in care remains challenging in sub- Saharan Africa, but little evidence is available from the provider perspective. In 4 Ethiopian health facilities, we (1) interviewed providers and peer educators about their perceptions of service delivery- and patient-level barriers and (2) observed provider–patient interactions to characterize content and interpersonal aspects of counseling. In interviews, providers and peer educators demonstrated empathy and identified nonacceptance of HIV status, anticipated stigma from unintended disclosure, and fear of antiretroviral therapy as patient barriers, and brusque counseling and insufficient counseling at provider-initiated testing sites as service delivery-related. However, observations from the same clinics showed that providers often failed to elicit patients’ barriers to retention, making it unlikely these would be addressed during counseling. Training is needed to improve interpersonal aspects of counseling and ensure providers elicit and address barriers to HIV care experienced by patients. PMID:26173944

Behaviour change techniques and contraceptive use in low and middle income countries: a review.

PubMed

Phiri, Mwelwa; King, R; Newell, J N

2015-10-30

We aimed to identify effective behaviour change techniques to increase modern contraceptive use in low and middle income countries (LMICs). Literature was identified in Global Health, Web of Science, MEDLINE, PsycINFO and Popline, as well as peer reviewed journals. Articles were included if they were written in English, had an outcome evaluation of contraceptive use, modern contraceptive use, contraceptive initiation/uptake, contraceptive adherence or continuation of contraception, were a systematic review or randomised controlled trial, and were conducted in a low or middle income country. We assessed the behaviour change techniques used in each intervention and included a new category of male partner involvement. We identified six studies meeting the inclusion criteria. The most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use. The findings also suggest that providing access to contraceptives in the community promotes their use. The interventions that had positive effects on contraceptive use used a combination of behaviour change techniques. Performance techniques were not used in any of the interventions. The use of social support techniques, which are meant to improve wider social acceptability, did not appear except in two of the interventions. Our findings suggest that when information and contraceptives are provided, contraceptive use improves. Recommendations include reporting of behaviour change studies to include more details of the intervention and techniques employed. There is also a need for further research to understand which techniques are especially effective.

Convergence of quasiparticle self-consistent G W calculations of transition-metal monoxides

NASA Astrophysics Data System (ADS)

Das, Suvadip; Coulter, John E.; Manousakis, Efstratios

2015-03-01

Finding an accurate ab initio approach for calculating the electronic properties of transition-metal oxides has been a problem for several decades. In this paper, we investigate the electronic structure of the transition-metal monoxides MnO, CoO, and NiO in their undistorted rocksalt structure within a fully iterated quasiparticle self-consistent G W (QPsc G W ) scheme. We study the convergence of the QPsc G W method, i.e., how the quasiparticle energy eigenvalues and wave functions converge as a function of the QPsc G W iterations, and we compare the converged outputs obtained from different starting wave functions. We find that the convergence is slow and that a one-shot G0W0 calculation does not significantly improve the initial eigenvalues and states. It is important to notice that in some cases the "path" to convergence may go through energy band reordering which cannot be captured by the simple initial unperturbed Hamiltonian. When we reach a fully iterated solution, the converged density of states, band gaps, and magnetic moments of these oxides are found to be only weakly dependent on the choice of the starting wave functions and in reasonably good agreement with the experiment. Finally, this approach provides a clear picture of the interplay between the various orbitals near the Fermi level of these simple transition-metal monoxides. The results of these accurate ab initio calculations can provide input for models aiming at describing the low-energy physics in these materials.

Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews.

PubMed

Fisher, Edwin B; Boothroyd, Renée I; Elstad, Emily A; Hays, Laura; Henes, Amy; Maslow, Gary R; Velicer, Clayton

2017-01-01

Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

Categorial Compositionality III: F-(co)algebras and the Systematicity of Recursive Capacities in Human Cognition

PubMed Central

Phillips, Steven; Wilson, William H.

2012-01-01

Human cognitive capacity includes recursively definable concepts, which are prevalent in domains involving lists, numbers, and languages. Cognitive science currently lacks a satisfactory explanation for the systematic nature of such capacities (i.e., why the capacity for some recursive cognitive abilities–e.g., finding the smallest number in a list–implies the capacity for certain others–finding the largest number, given knowledge of number order). The category-theoretic constructs of initial F-algebra, catamorphism, and their duals, final coalgebra and anamorphism provide a formal, systematic treatment of recursion in computer science. Here, we use this formalism to explain the systematicity of recursive cognitive capacities without ad hoc assumptions (i.e., to the same explanatory standard used in our account of systematicity for non-recursive capacities). The presence of an initial algebra/final coalgebra explains systematicity because all recursive cognitive capacities, in the domain of interest, factor through (are composed of) the same component process. Moreover, this factorization is unique, hence no further (ad hoc) assumptions are required to establish the intrinsic connection between members of a group of systematically-related capacities. This formulation also provides a new perspective on the relationship between recursive cognitive capacities. In particular, the link between number and language does not depend on recursion, as such, but on the underlying functor on which the group of recursive capacities is based. Thus, many species (and infants) can employ recursive processes without having a full-blown capacity for number and language. PMID:22514704

Commitment to sustainability: A content analysis of website for university organisations

NASA Astrophysics Data System (ADS)

Hasim, M. S.; Hashim, A. E.; Ariff, N. R. M.; Sapeciay, Z.; Abdullah, A. S.

2018-02-01

This research aim on investigating the commitments of organisations towards sustainability. For this research context, ‘commitment’ refers to the extent of information provided by universities in their website which demonstrated initiatives towards achieving the sustainability goal. The objective of this study was to identify sustainability initiatives highlighted within university websites using Australia as a case study. Thirty-nine (39) websites were reviewed and web content analysis was performed to publicly available data including any relevant accessible PDF documents attached to the universities website. Specific websites information was reviewed to detect sustainability themes in the broad university management and operations (i.e., in general policies, corporate mission statements, research activities, positions available and strategies). The commitment of Australian universities was significant and well established with a set of twenty (20) related themes were identified. The findings have some limitations because the established themes only emerged from the websites’ content without human validation which possibly weakens the correlations between website information and organisations actual practice. This possibility is recognised and for this reason, further assessment may be advantageous to provide verification of the findings. Therefore, further studies using other techniques are suggested such as interviews or observations for validation of data and reinforce the entire conclusions. An interesting aspect of this study is the validity of reviewing organisational websites for gauging actual practice and a number of researchers supporting this approached as indicated in methodology section of this paper.

Subharmonic Solutions of Order One-Third

ERIC Educational Resources Information Center

Fay, Temple H.

2005-01-01

Finding a periodic solution to a nonlinear ordinary differential equation is in general a difficult task. Only in a very few cases can direct methods be applied to an equation to find initial values leading to a solution of the corresponding initial value problem that is periodic. Oscillatory periodic solutions have such practical importance that…

Advancing Achievement: Findings from an Independent Evaluation of a Major After-School Initiative

ERIC Educational Resources Information Center

Arbreton, Amy; Sheldon, Jessica; Bradshaw, Molly; Goldsmith, Julie

2008-01-01

This report presents outcomes from Public/Private Ventures research on CORAL, an eight-year, $58 million after-school initiative of The James Irvine Foundation. Findings described in the report demonstrate the relationship between high-quality literacy programming and academic gains and underscore the potential role that quality programs may play…

Asclepius or Hippocrates? Differing Interpretations of Post-Compulsory Initial Teacher Training Mentoring

ERIC Educational Resources Information Center

Ingleby, Ewan

2011-01-01

This article discusses qualitative research findings on mentoring within PCET ITT (post-compulsory education and training initial teacher training). The article complements the findings of Tedder and Lawy (2009) and Ingleby (2010). The article develops Downie and Randall's consideration of the merits or otherwise of mirroring either "Asclepius" or…