Personal Development Planning in Initial Teacher Training: A Case Study from Post-Compulsory Education

ERIC Educational Resources Information Center

Thompson, Ron; Hallwood, Linda; Clements, Christine; Rivron, Helen

2009-01-01

This paper provides a case study of personal development planning (PDP) within an initial teacher training course for the post-compulsory sector, delivered through a large consortium in the north of England. The paper reviews conceptual and empirical studies of PDP in higher education and reports on the practice and perceptions of students and…

The U.S. Army Wounded Warrior Program (AW2): a case study in designing a nonmedical case management program for severely wounded, injured, and ill service members and their families.

PubMed

Hudak, Ronald P; Morrison, Christine; Carstensen, Mary; Rice, James S; Jurgersen, Brent R

2009-06-01

This case study describes the innovative and unique U.S. Army Wounded Warrior Program (AW2), which provides nonmedical case management to the most severely wounded, injured, and ill soldiers and their families. The study describes the program and identifies the features for a successful nonmedical case management program of an identified population who has complex medical needs. Although the article focuses primarily on the role of the AW2 advocate, key components of the program are discussed, including successful initiatives as well as areas that required adjustment. The lessons learned are identified as well as recommendations for future nonmedical case management initiatives.

A Case Study of Team-Initiated Problem Solving Addressing Student Behavior in One Elementary School

ERIC Educational Resources Information Center

Todd, Anne W.; Horner, Robert H.; Berry, Dorothy; Sanders, Carol; Bugni, Michelle; Currier, Allison; Potts, Nicky; Newton, J. Stephen; Algozzine, Bob; Algozzine, Kate

2012-01-01

Team-Initiated Problem Solving (TIPS) is an approach for organizing school team meetings to improve identification of targeted problems, use of data in the development of solutions, and development of implemented action plans. TIPS has been demonstrated in single-case and randomized controlled trial studies to improve the effectiveness of teams to…

Parental Involvement in Active Transport to School Initiatives: A Multi-Site Case Study

ERIC Educational Resources Information Center

Eyler, Amy; Baldwin, Julie; Carnoske, Cheryl; Nickelson, Jan; Troped, Philip; Steinman, Lesley; Pluto, Delores; Litt, Jill; Evenson, Kelly; Terpstra, Jennifer; Brownson, Ross; Schmid, Thomas

2008-01-01

Background: Increasing physical activity in youth is a recommended approach to curbing the childhood obesity epidemic. One way to help increase children's daily activity is to promote active transportation to and from school (ATS). Purpose: The purpose of this case study was to explore parental perception of, and participation in, ATS initiatives.…

Technology Integration in a One-to-One Laptop Initiative: A Multiple Case Study Analysis

ERIC Educational Resources Information Center

Jones, Marsha B.

2013-01-01

The purpose of this multiple case study analysis was to examine teachers' experiences and perceptions in order to understand what actions and interactions supported or inhibited technology integration during a one-to-one laptop initiative. This research sought to gain teachers' perspectives on the challenges and successes they faced as classroom…

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment.

PubMed

Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

2017-01-01

To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4-16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

Enhancing the absorption and energy transfer process via quantum entanglement

NASA Astrophysics Data System (ADS)

Zong, Xiao-Lan; Song, Wei; Zhou, Jian; Yang, Ming; Yu, Long-Bao; Cao, Zhuo-Liang

2018-07-01

The quantum network model is widely used to describe the dynamics of excitation energy transfer in photosynthesis complexes. Different from the previous schemes, we explore a specific network model, which includes both light-harvesting and energy transfer process. Here, we define a rescaled measure to manifest the energy transfer efficiency from external driving to the sink, and the external driving fields are used to simulate the energy absorption process. To study the role of initial state in the light-harvesting and energy transfer process, we assume the initial state of the donors to be two-qubit and three-qubit entangled states, respectively. In the two-qubit initial state case, we find that the initial entanglement between the donors can help to improve the absorption and energy transfer process for both the near-resonant and large-detuning cases. For the case of three-qubit initial state, we can see that the transfer efficiency will reach a larger value faster in the tripartite entanglement case compared to the bipartite entanglement case.

The role of transnational mobility in the local spread of mosquito-borne disease: Measuring the determinants of spatial-temporal lags of imported dengue cases initiating indigenous epidemics in Taiwan

NASA Astrophysics Data System (ADS)

Wen, Tzai-Hung

2014-05-01

Dengue fever is one of the world's most widely spread mosquito-borne diseases. International travelers who acquire dengue infection are important routes for virus transmission from one country to another one. Previous studies have shown that imported dengue cases are able to initiate indigenous epidemics when appropriate weather conditions are present. However, the spatial-temporal associations between imported cases and indigenous epidemics in areas with different social-economic conditions are still unclear. This study investigated determinants of spatial-temporal lags of imported dengue cases who initiated indigenous epidemics from 2003 to 2012 in Taiwan. The quantile regression is used to explore the associations between spatial-temporal lags of imported cases and social-economic indicators with geographic heterogeneity. Our results indicated that imported cases in April and May have statistically significant contribution to initiate indigenous epidemics. Areas with high population density and low average income have significant risk of being imported virus from other areas. However, the areas with imported cases are not significant transmission risk. The results imply that imported cases reported in early summer may be an early-warning indicator of indigenous epidemics. Local demographic and economic conditions, rather than imported cases, may determine the areas with the risk of indigenous epidemics.

[Secondary Splenic Rupture after Initially Inconspicuous CAT Scan].

PubMed

Prokop, A; Koll, S; Chmielnicki, M

2016-04-01

Splenic injuries occur in 1-5 % of blunt abdominal trauma cases. After initial haemorrhagic compression, secondary delayed spleen rupture can occur with a latency of one day to a month or longer. Mortality is then up to 15 %. The spleen injury is almost always recognisable on CT or ultrasound. In one case from our clinic, secondary splenic rupture occurred in a patient after discharge from hospitalisation, even though the initial CT and ultrasound were unremarkable. The patient survived, and underwent emergent splenectomy 8 days after the trauma. An expert review of the case identified no errors in treatment. No case of secondary splenic rupture after initially unremarkable diagnostic studies and clinical course has previously been published. Secondary splenic rupture has a high mortality rate. Patients should be advised of potential complications after hospital discharge, and should return to the hospital immediately in case of symptoms. Georg Thieme Verlag KG Stuttgart · New York.

Epidemiology of urinary tract infection: II. Diet, clothing, and urination habits.

PubMed Central

Foxman, B; Frerichs, R R

1985-01-01

Although several health habits and behaviors are commonly cited in medical and nursing textbooks as potential causes of urinary tract infection (UTI) in women, few have been studied in a systematic fashion. In a case-control study, we evaluated the associations between UTI and the most commonly mentioned risk factors: urination habits, diet, clothing, and soaps. Because sexual intercourse and diaphragm use increase the risk of UTI, we assessed the effect of health habits and behaviors controlling for these two risk factors. Women with initial UTI were compared with controls with no UTI history; women with a second UTI were compared to those with initial UTI. For the 25 initial cases, 19 secondary cases, and 181 controls enrolled in the study from a university health service, we found using tampons and drinking soft drinks to be moderately associated (RR greater than or equal to 1.4) with both initial and recurrent UTI. Although several other individual habits had only small associations with UTI, several of these behaviors together might substantially increase risk of initial or recurring UTI. PMID:4051067

Effect of initial conditions on combustion generated loads

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

Tieszen, S.R.

1991-01-01

This analytical study examines the effect of initial thermodynamic conditions on the loads generated by the combustion of homogeneous hydrogen-air-steam mixtures. The effect of initial temperature, pressure, hydrogen concentration, and steam concentration is evaluated for two cases, (1) constant volume and (2) constant initial pressure. For each case, the Adiabatic, Isochoric, Complete Combustion (AICC), Chapman-Jouguet (CJ), and normally reflected CJ pressures are calculated for a range of hydrogen and steam concentrations representative of the entire flammable regime. For detonation loads, pressure profiles and time-histories are also evaluated in one-dimensional Cartesian geometry. The results show that to a first approximation, themore » AICC and CJ pressures are directly proportional to the initial density. Increasing the hydrogen concentration up to stoichiometric concentrations significantly increases the AICC, CJ, and reflected CJ pressures. For the constant volume case, the AICC, CJ, and reflected CJ pressures increase with increasing hydrogen concentration on the rich side of stoichiometric concentrations. For the constant initial pressure case, the AICC, CJ and reflected CJ pressures decrease with increasing hydrogen concentration on the rich side of stoichiometric values. The addition of steam decreases the AICC, CJ and reflected CJ pressures for the constant initial pressure case, but increases them for the constant volume case. For detonations, the pressure time-histories can be normalized with the AICC pressure and the reverberation time for Cartesian geometry. 35 refs., 16 figs.« less

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PubMed Central

MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

Lack of pre-antiretroviral care and competition from traditional healers, crucial risk factors for very late initiation of antiretroviral therapy for HIV--a case-control study from eastern Uganda.

PubMed

Muhamadi, Lubega; Tumwesigye, Nazarius Mbona; Kadobera, Daniel; Marrone, Gaetano; Wabwire-Mangen, Fred; Pariyo, George; Peterson, Stefan; Ekström, Anna Mia

2011-01-01

Although WHO recommends starting antiretroviral treatment at a CD4 count of 350 cells/[µ]L, many Ugandan districts still struggle with large proportions of clients initiating ART very late at CD4<50 cells/[µ]L. This study seeks to establish crucial risk factors for very late ART initiation in eastern Uganda. All adult HIV-infected clients on ART in Iganga who enrolled between 2005 and 2009 were eligible for this case-control study. Clients who started ART at CD4 cell count of <50 cells/[µ]L (very late initiators) were classified as cases and 50-200 cells/[µ]L (late initiators) as control subjects. A total of 152 cases and 202 controls were interviewed. Multivariate analyses were performed to calculate adjusted odds ratios and 95% confidence intervals. Reported health system-related factors associated with very late ART initiation were stock-outs of antiretroviral drugs stock-outs (affecting 70% of the cases and none of the controls), competition from traditional/spiritual healers (AOR 7.8, 95 CI% 3.7-16.4), and lack of pre-ARV care (AOR 4.6, 95% CI: 2.3-9.3). Men were 60% more likely and subsistence farmers six times more likely (AOR 6.3, 95% CI: 3.1-13.0) to initiate ART very late. Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6). Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility. ART services should be more affordable, accessible and user-friendly to make them more attractive than traditional healers.

A Case Study of Mentoring Relationships between Faculty Ambassadors and First Generation Hispanic Students in a First-Year Initiative Program

ERIC Educational Resources Information Center

Swafford, Clark Elliott

2017-01-01

This qualitative case study sought understanding of unique mentoring relationships of six faculty ambassadors and nine Hispanic first-generation students (HFGS) as part of a first-year initiative program. The single site was a career college in Texas, Taylor College. There were three research questions to guide inquiry comprised of six faculty…

Abriendo Caminos Para La Educacion: A Case Study of a Parent Outreach Initiative Building on the Knowledge, Skills, and Resources of the Latina/o Community

ERIC Educational Resources Information Center

Fernandez, Graciela

2010-01-01

Informed by research studies that demonstrate a positive relationship between parent engagement and student academic attainment, state and national parent outreach initiatives have aimed to bridge the gap between Latina/o parents and schools. Such was the case with the Latina/o Family, School and Community "Avanzando" Project, which…

Sharing health data in Belgium: A home care case study using the Vitalink platform.

PubMed

De Backere, Femke; Bonte, Pieter; Verstichel, Stijn; Ongenae, Femke; De Turck, Filip

2018-01-01

In 2013, the Flemish Government launched the Vitalink platform. This initiative focuses on the sharing of health and welfare data to support primary healthcare. In this paper, the objectives and mission of the Vitalink initiative are discussed. Security and privacy measures are reviewed, and the technical implementation of the Vitalink platform is presented. Through a case study, the possibility of interaction with cloud solutions for healthcare is also investigated upon; this was initially not the focus of Vitalink. The Vitalink initiative provides support for secure data sharing in primary healthcare, which in the long term will improve the efficiency of care and will decrease costs. Based on the results of the case study, Vitalink allowed cloud solutions or applications not providing end-to-end security to use their system. The most important lesson learned during this research was the need for firm regulations and stipulations for cloud solutions to interact with the Vitalink platform. However, these are currently still vague.

Counter-intuitive plasma vitamin D and zinc status in HIV-1-infected adults with persistent low-level viraemia after treatment initiation: a pilot case-control study.

PubMed

Melliez, H; Duhamel, A; Robineau, O; Bocket, L; Kim, I; Sauser, E; Loiseleur, F; Viget, N; Pasquet, A; Senneville, E; Seguy, D

2017-11-01

Determinants of persistent low-level viraemia [PLLV, a viral load (VL) of between 50 and 500 copies/mL] have not been elucidated. In a case-control study, we evaluated the influence of micronutrients on PLLV in a population of 454 HIV-1 adults having initiated antiretroviral therapy (ART) between January 2007 and December 2011. Plasma levels of retinol (vitamin A), 25-OH vitamin D 2  + D 3 , vitamin E and zinc were measured at ART initiation in cases (PLLV after 6 months of ART) and in controls (VL <50 copies/mL after 6 months). Cases and controls were matched for the CD4 cell count (±50/mm 3 ) and ethnic origin. Intergroup differences in demographic, biological and treatment parameters and sunshine intensity at ART initiation were adjusted using a propensity score. A receiver operating characteristic (ROC) curve was used to assess intergroup differences in plasma micronutrient levels. Thirty-three of the 454 patients (7.3%) displayed PLLV (median VL: 92 copies/mL). Patients were predominantly male (89%), Caucasian (64%) and CDC stage C (25%). The median age was 38 years, the median initial VL was 5.2 log 10 copies/mL and the median CD4 count was 74/mm 3 . The 22 cases and matched controls were balanced in these respects, and had similar vitamin A/E levels. Two cases (9%) and 9 controls (41%) had a vitamin D level <10.3 ng/mL (p = 0.0015), and 2 cases (9%) and 10 controls (48%) had a zinc level <74.6 μg/dL (p = 0.04). Our results support in vitro studies suggesting that vitamin D favours HIV-1 replication and that HIV-1 is zinc-dependent. Wide-scale, prospective studies are required.

Managing Dualities in Planned Change Initiatives

ERIC Educational Resources Information Center

Barge, J. Kevin; Lee, Michael; Maddux, Kristy; Nabring, Richard; Townsend, Bryan

2008-01-01

Dualities play an important role in creating the conditions for change and managing planned change initiatives. Building on Seo, Putnam, and Bartunek's (2003) work, this study focuses on the dualities associated with managing change processes. A case study of a planned change process called the Circle of Prosperity Initiative, a multi-stakeholder…

Enhancing Infant Mental Health Using a Capacity-Building Model: A Case Study of a Process Evaluation of the "Ready, Steady, Grow" Initiative

ERIC Educational Resources Information Center

O'Farrelly, Christine; Guerin, Suzanne; Victory, Gerard

2017-01-01

Infant mental health (IMH) is best promoted through a continuum of services underpinned by strong service capacity. However, service providers often lack fundamental IMH knowledge and skills. Using the Ready, Steady, Grow (RSG) initiative as a case study of a capacity-building model (P., Hawe, L., King, M., Noort, C., Jordens, & B., Llyod,…

Barriers to Student Mobilization and Service at Institutions of Higher Education: A Greenbuilding Initiative Case Study on a Historic, Urban Campus in Charleston, South Carolina, USA

ERIC Educational Resources Information Center

Zimmerman, Katherine S.; Halfacre-Hitchcock, Angela

2006-01-01

Purpose: To identify some of the barriers to mobilizing students of higher education in sustainable initiatives, in order to enhance project success on campuses. Design/methodology/approach: Uses a case study of a model green building retrofit on the College of Charleston campus in Charleston, South Carolina, USA. Several constraints already…

Beacons of Light, Rays, or Sun Catchers? A Case Study of the Positioning of Literacy Teachers and Their Knowledge in Neoliberal Times

ERIC Educational Resources Information Center

Hibbert, Kathryn M.; Heydon, Rachel M.; Rich, Sharon J.

2008-01-01

This paper reports on a case study of a "lead literacy teacher" initiative in one Canadian province. This initiative is related to a ''minority world'' trend in teacher in-service that seeks to develop "experts" in a field with the intent that such experts can help other teachers to raise student achievement for the betterment…

The heterogeneous management of pediatric ankle traumas: A retrospective descriptive study.

PubMed

Voizard, Philippe; Moore, James; Leduc, Stéphane; Nault, Marie-Lyne

2018-06-01

Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons.We conducted a retrospective study of all cases of ankle sprains and Salter-Harris one (SH1) fractures referred to our orthopedic surgery service between May and August 2014. Exclusion criteria included ankle fractures other than SH1 types, and cases where treatment was initially undertaken elsewhere before referral to our service. Primary outcome was the difference between initial and final diagnosis.Among 3047 cases reviewed, 31 matched our inclusion criteria. Initial diagnosis was 20 SH1 fractures, 8 acute ankle sprains, and 3 uncertain, with a change in diagnosis for 48.5% at follow-up.Accurate diagnosis can be difficult in pediatric ankle trauma, with case management and specific treatments varying considerably. This study reinforces the need to evaluate the safety of a general treatment algorithm for all lateral ankle trauma with normal radiographs.Level of evidence III.

Retention of Prose Following Testing with Different Types of Tests.

ERIC Educational Resources Information Center

Duchastel, Philippe C.

1981-01-01

Taking a test on a passage one has just studied is known to enhance later retention. This effect was influenced by the type of initial test used. It was evident in the case of the initial short-answer test, but not in the case of multiple choice and free recall tests. (Author/RD)

Case Studies Behavior Modification.

ERIC Educational Resources Information Center

Wark, David M.

The case histories of five students enrolled in a university course in how to study are reported. The students ranged in age from 18 to 35, included two males and three females, and varied in school experience from no college in one case and some college in two cases to college degrees in two cases. Students were initially taught to chart their…

Corporate social responsibility initiatives addressing social exclusion in Bangladesh.

PubMed

Werner, Wendy J

2009-08-01

The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships- collectively labelled corporate social responsibility (CSR) initiatives-may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation.

Genome-wide association analysis of secondary imaging phenotypes from the Alzheimer's disease neuroimaging initiative study.

PubMed

Zhu, Wensheng; Yuan, Ying; Zhang, Jingwen; Zhou, Fan; Knickmeyer, Rebecca C; Zhu, Hongtu

2017-02-01

The aim of this paper is to systematically evaluate a biased sampling issue associated with genome-wide association analysis (GWAS) of imaging phenotypes for most imaging genetic studies, including the Alzheimer's Disease Neuroimaging Initiative (ADNI). Specifically, the original sampling scheme of these imaging genetic studies is primarily the retrospective case-control design, whereas most existing statistical analyses of these studies ignore such sampling scheme by directly correlating imaging phenotypes (called the secondary traits) with genotype. Although it has been well documented in genetic epidemiology that ignoring the case-control sampling scheme can produce highly biased estimates, and subsequently lead to misleading results and suspicious associations, such findings are not well documented in imaging genetics. We use extensive simulations and a large-scale imaging genetic data analysis of the Alzheimer's Disease Neuroimaging Initiative (ADNI) data to evaluate the effects of the case-control sampling scheme on GWAS results based on some standard statistical methods, such as linear regression methods, while comparing it with several advanced statistical methods that appropriately adjust for the case-control sampling scheme. Copyright © 2016 Elsevier Inc. All rights reserved.

A Case Study of "Empathetic Teaching Artistry"

ERIC Educational Resources Information Center

Risner, Doug

2014-01-01

This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

Plasma Assisted Ignition and Combustion at Low Initial Gas Temperatures: Development of Kinetic Mechanism

DTIC Science & Technology

2016-10-05

of these species experimentally challenging. In these cases , TALIF is a good alternative. The energy levels used in this study are shown in Fig. 2.1...flame velocities achieved in lean mixtures (ER=0.5 in our experimental case ) can be an interesting issue for industrial applications. One of the possible...dielectric barrier discharge (nSDBD) was studied experimentally at high initial pressures P = 3 − 6 bar. The discharge was studied in different gas mixtures

Tablet Technology in Teacher Preparation: A Case Study--The Nook Initiative

ERIC Educational Resources Information Center

Jordan, Hope; Hunter, Elizabeth; Douglas, Maegan; Wighting, Mervyn

2015-01-01

Regent University's Special Education and Reading Specialist Programs introduced the Nook Initiative fall 2013. This paper discusses the implementation, the need for integrated tablet technology in teacher preparation, initial outcomes of the study, and offers suggestions for practice. A second tablet pilot program introducing the iPad mini in the…

Intellectual Initiatives at a Research University: Origins, Evolutions, and Challenges.

ERIC Educational Resources Information Center

Frost, Susan H.; Jean, Paul M.; Teodorescu, Daniel; Brown, Amy B.

This qualitative case study explored the origins, evolutions, and challenges of 12 cross-disciplinary intellectual initiatives at 1 research university. Researchers conducted open-ended interviews with leaders of the 12 initiatives and used program literature to support the data gathered from the interviews. The study found that key factors such…

The CAST Initiative in Guam: A Model of Effective Teachers Teaching Teachers

ERIC Educational Resources Information Center

Zuercher, Deborah K.; Kessler, Cristy; Yoshioka, Jon

2011-01-01

The CAST (content area specialized training) model of professional development enables sustainable teacher leadership and is responsive to the need for culturally relevant educational practices. The purpose of this paper is to share the background, methods, findings and recommendations of a case study on the CAST initiative in Guam. The case study…

ICT Integration in Mathematics Initial Teacher Training and Its Impact on Visualization: The Case of GeoGebra

ERIC Educational Resources Information Center

Dockendorff, Monika; Solar, Horacio

2018-01-01

This case study investigates the impact of the integration of information and communications technology (ICT) in mathematics visualization skills and initial teacher education programmes. It reports on the influence GeoGebra dynamic software use has on promoting mathematical learning at secondary school and on its impact on teachers' conceptions…

A Typology of Knowledge Collaboration: A Case Study of an Initiative to Accelerate the Internationalization of Finnish Cleantech Entrepreneurship

ERIC Educational Resources Information Center

Vauterin, Johanna Julia; Virkki-Hatakka, Terhi

2016-01-01

A critical understanding of how knowledge collaboration may work in various configurations is a prerequisite in shedding light on how effective knowledge collaboration affects opportunities for business growth. This article presents a case analysis of a knowledge collaboration initiative between a university and other knowledge organizations. The…

Computational Study of the Richtmyer-Meshkov Instability with a Complex Initial Condition

NASA Astrophysics Data System (ADS)

McFarland, Jacob; Reilly, David; Greenough, Jeffrey; Ranjan, Devesh

2014-11-01

Results are presented for a computational study of the Richtmyer-Meshkov instability with a complex initial condition. This study covers experiments which will be conducted at the newly-built inclined shock tube facility at the Georgia Institute of Technology. The complex initial condition employed consists of an underlying inclined interface perturbation with a broadband spectrum of modes superimposed. A three-dimensional staggered mesh arbitrary Lagrange Eulerian (ALE) hydrodynamics code developed at Lawerence Livermore National Laboratory called ARES was used to obtain both qualitative and quantitative results. Qualitative results are discussed using time series of density plots from which mixing width may be extracted. Quantitative results are also discussed using vorticity fields, circulation components, and energy spectra. The inclined interface case is compared to the complex interface case in order to study the effect of initial conditions on shocked, variable-density flows.

Initiation of non-invasive ventilation in amyotrophic lateral sclerosis and clinical practice guidelines: Single-centre, retrospective, descriptive study in a national reference centre.

PubMed

Georges, Marjolaine; Golmard, Jean-Louis; Llontop, Claudia; Shoukri, Amr; Salachas, François; Similowski, Thomas; Morelot-Panzini, Capucine; Gonzalez-Bermejo, Jésus

2017-02-01

In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure. Non-invasive ventilation (NIV) maintains adequate ventilation in ALS patients. NIV alleviates symptoms and improves survival. In 2006, French guidelines established criteria for NIV initiation based on limited evidence. Their impact on clinical practice remains unknown. Our objective was to describe NIV initiation practices of the main French ALS tertiary referral centre with respect to guidelines. In this retrospective descriptive study, 624 patients followed in a single national reference centre began NIV between 2005 and 2013. We analysed criteria used to initiate NIV, including symptoms, PaCO 2 , forced vital capacity, maximal inspiratory pressures and time spent with SpO 2 <90% at night. At NIV initiation, 90% of patients were symptomatic. Median PaCO 2 was 48 mmHg. The main criterion to initiate NIV was 'symptoms' followed by 'hypercapnia' in 42% and 34% of cases, respectively. NIV was initiated on functional parameters in only 5% of cases. Guidelines were followed in 81% of cases. In conclusion, despite compliance with French guidelines, the majority of patients are treated at the stage of symptomatic daytime hypoventilation, which suggests that NIV is initiated late in the course of ALS. Whether this practice could be improved by changing guidelines or increasing respiratory-dedicated resources remains to be determined.

Digitizing and Preserving Law School Recordings: A Duke Law Case Study

ERIC Educational Resources Information Center

White, Hollie; Bordo, Miguel; Chen, Sean

2015-01-01

Written as a case study, this article outlines Duke Law School Information Services' video digitization, preservation, and access initiative. This article begins with a discussion of the case study environment and the cross-departmental evaluation of in-house video production and processing workflows. The in-house preservation reformatting process…

Financial Indicators of Reduced Impact Logging Performance in Brazil: Case Study Comparisons

Treesearch

Thomas P. Holmes; Frederick Boltz; Douglas R. Carter

2001-01-01

Indicators of financial performance are compared for three case studies in the Brazilian Amazon. Each case study presents parameters obtained from monitoring initial harvest entries into primary forests for reduced impact logging (RIL) and conventional logging (CL) operations. Differences in cost definitions and data collection protocols complicate the analysis, and...

Predictive value of autoantibody testing for validating self-reported diagnoses of rheumatoid arthritis in the Women's Health Initiative.

PubMed

Walitt, Brian; Mackey, Rachel; Kuller, Lewis; Deane, Kevin D; Robinson, William; Holers, V Michael; Chang, Yue-Fang; Moreland, Larry

2013-05-01

Rheumatoid arthritis (RA) research using large databases is limited by insufficient case validity. Of 161,808 postmenopausal women in the Women's Health Initiative, 15,691 (10.2%) reported having RA, far higher than the expected 1% population prevalence. Since chart review for confirmation of an RA diagnosis is impractical in large cohort studies, the current study (2009-2011) tested the ability of baseline serum measurements of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, second-generation assay (anti-CCP2), to identify physician-validated RA among the chart-review study participants with self-reported RA (n = 286). Anti-CCP2 positivity had the highest positive predictive value (PPV) (80.0%), and rheumatoid factor positivity the lowest (44.6%). Together, use of disease-modifying antirheumatic drugs and anti-CCP2 positivity increased PPV to 100% but excluded all seronegative cases (approximately 15% of all RA cases). Case definitions inclusive of seronegative cases had PPVs between 59.6% and 63.6%. False-negative results were minimized in these test definitions, as evidenced by negative predictive values of approximately 90%. Serological measurements, particularly measurement of anti-CCP2, improved the test characteristics of RA case definitions in the Women's Health Initiative.

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

CERN IT Book Fair 2009 - Special talk by Bjarne Stroustrup: "The Design of C++0x"

ScienceCinema

Stroustrup, Bjarne

2018-05-24

A draft for a revised ISO C++ standard, C++0x, has been produced. The speaker will present the background of C++, its aims, the standards process (with opinions), some of the guiding design principles (with tiny code examples), and two case studies.The case studies are initialization (a general and uniform syntax and semantics for initializers in all contexts) and concurrent support facilities (memory model, threads, locks, futures).

Learning from Experience: A Cross-Case Comparison of School-to-Work Transition Reform Initiatives.

ERIC Educational Resources Information Center

Rogers, Anne M.; And Others

A cross-case study approach was used to determine how school-to-work reform affects clients and participants and to identify elements critical to the success of school-to-work systems. Fourteen school-to-work reform initiatives in communities across the United States were examined by using a research protocol that included individual interviews,…

"In the Middle of Difficulty Lies Opportunity"--Using a Case Study to Identify Critical Success Factors Contributing to the Initiation of International Collaborative Projects

ERIC Educational Resources Information Center

Johnson, Ian M.

2005-01-01

This paper identifies factors that contribute to the successful initiation of international collaborative projects intended to support the development of education for librarianship and information sciences. It discusses the widespread failure to analyse the Critical Success Factors in international collaborative projects and proposes a case study…

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report.

PubMed

Soghaier, Mohammed A; Hagar, Ahmed; Abbas, Mohammed A; Elmangory, Mutasim M; Eltahir, Khalid M; Sall, Amadou A

2013-10-01

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF), which is considered to be a very serious illness. Yellow Fever (YF) outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs) are usually very high among the index cases. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Evaluating a Tacit Knowledge Sharing Initiative: A Case Study

ERIC Educational Resources Information Center

Gubbins, Claire; Corrigan, Siobhan; Garavan, Thomas N.; O'Connor, Christy; Leahy, Damien; Long, David; Murphy, Eamonn

2012-01-01

Purpose: This paper aims to present a case study illustrating the issues involved in the tacit knowledge conversion process and to determine whether such conversion delivers value to the organisation in terms of business value and return on investment (ROI). Design/methodology/approach: A single-case multiple baseline participants experimental…

A case study of ‘The Good School:’ Examples of the use of Peterson’s strengths-based approach with students

PubMed Central

White, Mathew A.; Waters, Lea E.

2015-01-01

This applied case study centers on two aspects of Peterson’s research as introduced into a large K-12 school in Australia: (i) creating enabling institutions and (ii) applications of character strengths. The paper describes five character strengths initiatives. Four of the strengths initiatives have been integrated into existing school experiences such as English curriculum, school sport, student leadership, and counseling. The fifth initiative involved a brand new program which introduced a Positive Education Curriculum for years K-10. We describe these five initiatives and then explain how students at the school may experience these in a more holistic and integrated way. We hope that this article will act as a fitting tribute to the legacy of Christopher Peterson. PMID:25431614

[Constraints and opportunities for inter-sector health promotion initiatives: a case study].

PubMed

Magalhães, Rosana

2015-07-01

This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs.

State-Based Case Studies of Assessment Initiatives in Undergraduate Education: Chronology of Critical Points.

ERIC Educational Resources Information Center

Boyer, Carol M.; Ewell, Peter T.

The Education Commission of the States (ECS) together with the American Association for Higher Education recently conducted five case studies of state-based approaches to assessment in undergraduate education in Colorado, Missouri, New Jersey, South Dakota, and Virginia. The case studies, in turn, are part of the Missouri Governor John Ashcroft's…

Case study: the Argentina Road Safety Project: lessons learned for the decade of action for road safety, 2011-2020.

PubMed

Raffo, Veronica; Bliss, Tony; Shotten, Marc; Sleet, David; Blanchard, Claire

2013-12-01

This case study of the Argentina Road Safety Project demonstrates how the application of World Bank road safety project guidelines focused on institution building can accelerate knowledge transfer, scale up investment and improve the focus on results. The case study highlights road safety as a development priority and outlines World Bank initiatives addressing the implementation of the World Report on Road Traffic Injury's recommendations and the subsequent launch of the Decade of Action for Road Safety, from 2011-2020. The case study emphasizes the vital role played by the lead agency in ensuring sustainable road safety improvements and promoting the shift to a 'Safe System' approach, which necessitated the strengthening of all elements of the road safety management system. It summarizes road safety performance and institutional initiatives in Argentina leading up to the preparation and implementation of the project. We describe the project's development objectives, financing arrangements, specific components and investment staging. Finally, we discuss its innovative features and lessons learned, and present a set of supplementary guidelines, both to assist multilateral development banks and their clients with future road safety initiatives, and to encourage better linkages between the health and transportation sectors supporting them.

ITER Side Correction Coil Quench model and analysis

NASA Astrophysics Data System (ADS)

Nicollet, S.; Bessette, D.; Ciazynski, D.; Duchateau, J. L.; Gauthier, F.; Lacroix, B.

2016-12-01

Previous thermohydraulic studies performed for the ITER TF, CS and PF magnet systems have brought some important information on the detection and consequences of a quench as a function of the initial conditions (deposited energy, heated length). Even if the temperature margin of the Correction Coils is high, their behavior during a quench should also be studied since a quench is likely to be triggered by potential anomalies in joints, ground fault on the instrumentation wires, etc. A model has been developed with the SuperMagnet Code (Bagnasco et al., 2010) for a Side Correction Coil (SCC2) with four pancakes cooled in parallel, each of them represented by a Thea module (with the proper Cable In Conduit Conductor characteristics). All the other coils of the PF cooling loop are hydraulically connected in parallel (top/bottom correction coils and six Poloidal Field Coils) are modeled by Flower modules with equivalent hydraulics properties. The model and the analysis results are presented for five quench initiation cases with/without fast discharge: two quenches initiated by a heat input to the innermost turn of one pancake (case 1 and case 2) and two other quenches initiated at the innermost turns of four pancakes (case 3 and case 4). In the 5th case, the quench is initiated at the middle turn of one pancake. The impact on the cooling circuit, e.g. the exceedance of the opening pressure of the quench relief valves, is detailed in case of an undetected quench (i.e. no discharge of the magnet). Particular attention is also paid to a possible secondary quench detection system based on measured thermohydraulic signals (pressure, temperature and/or helium mass flow rate). The maximum cable temperature achieved in case of a fast current discharge (primary detection by voltage) is compared to the design hot spot criterion of 150 K, which includes the contribution of helium and jacket.

Electronic Freight Management Case Studies : a Summary of Results

DOT National Transportation Integrated Search

2012-04-01

The Electronic Freight Management (EFM) initiative is a USDOT-sponsored project that applies Web technologies that improve data and message transmissions between supply chain partners. The EFM implementation case studies contained in this document ex...

"I'll Take Care of the Flowers!" Researching Agency through Initiatives across Different Learning Environments

ERIC Educational Resources Information Center

Kangas, Marjaana; Kopisto, Kaisa; Löfman, Krista; Salo, Laura; Krokfors, Leena

2017-01-01

This case study examined how the agency of a fifth-grade pupil appeared across different learning environments in the primary school context. In this study, agency is defined as the initiatives taken by an individual in interactive situations. The research question is: how does a pupil's agency manifest and vary through taking initiatives across…

Exploring Leadership in Schools-Based iPad Initiatives: A Case Study

ERIC Educational Resources Information Center

Harrold, Richard

2017-01-01

The world's first school-based one-to-one iPad initiative was implemented in a British school in 2010. Every year since, more iPad initiatives have been implemented in British schools, with school leaders citing various reasons for introducing them. However, results of iPad initiatives have not always matched expectations. British schools are also…

Framing Innovation: The Impact of the Superintendent's Technology Infrastructure Decisions on the Acceptance of Large-Scale Technology Initiatives

ERIC Educational Resources Information Center

Arnold, Erik P.

2014-01-01

A multiple-case qualitative study of five school districts that had implemented various large-scale technology initiatives was conducted to describe what superintendents do to gain acceptance of those initiatives. The large-scale technology initiatives in the five participating districts included 1:1 District-Provided Device laptop and tablet…

Fraud and Corruption Control at Education System Level: A Case Study of the Victorian Department of Education and Early Childhood Development in Australia

ERIC Educational Resources Information Center

Bandaranayake, Bandara

2014-01-01

This case describes the implementation of a fraud and corruption control policy initiative within the Victorian Department of Education and Early Childhood Development (the Department) in Australia. The policy initiative was administered and carried out by a small team of fraud control officials, including the author of this article, in the…

Improved fourth-year medical student clinical decision-making performance as a resuscitation team leader after a simulation-based curriculum.

PubMed

Ten Eyck, Raymond P; Tews, Matthew; Ballester, John M; Hamilton, Glenn C

2010-06-01

To determine the impact of simulation-based instruction on student performance in the role of emergency department resuscitation team leader. A randomized, single-blinded, controlled study using an intention to treat analysis. Eighty-three fourth-year medical students enrolled in an emergency medicine clerkship were randomly allocated to two groups differing only by instructional format. Each student individually completed an initial simulation case, followed by a standardized curriculum of eight cases in either group simulation or case-based group discussion format before a second individual simulation case. A remote coinvestigator measured eight objective performance end points using digital recordings of all individual simulation cases. McNemar chi2, Pearson correlation, repeated measures multivariate analysis of variance, and follow-up analysis of variance were used for statistical evaluation. Sixty-eight students (82%) completed both initial and follow-up individual simulations. Eight students were lost from the simulation group and seven from the discussion group. The mean postintervention case performance was significantly better for the students allocated to simulation instruction compared with the group discussion students for four outcomes including a decrease in mean time to (1) order an intravenous line; (2) initiate cardiac monitoring; (3) order initial laboratory tests; and (4) initiate blood pressure monitoring. Paired comparisons of each student's initial and follow-up simulations demonstrated significant improvement in the same four areas, in mean time to order an abdominal radiograph and in obtaining an allergy history. A single simulation-based teaching session significantly improved student performance as a team leader. Additional simulation sessions provided further improvement compared with instruction provided in case-based group discussion format.

Intradiscal injection of triamcinolone hexacetonide for acute, subacute, and chronic sciatica. Results at 3 months an open-prospectus study of 30 cases and review of the literature.

PubMed

Bertin, P; Rochet, N; Arnaud, M; Treves, R; Desproges Gotteron, R; Charissoux, J L

1990-09-01

The authors report an open study of 30 cases of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica. The patients were monitored at months 1 and 3. The results were judged to be good in 36.6% of the cases, moderate in 36.6% and poor in 26.7% of the cases. Two adverse effects were reported: 1 case of reversible urinary retention and 1 case of deficiency of the dorsiflexor muscles of the foot. The good results reported in previous series were only found in this study when the indications were restricted to certain favourable prognostic factors: duration of sciatica less than 6 months and CAT-scan appearance of discal hernia. This technique has the advantage of being simple, economical and nonallergic. On the basis of the encouraging results of the initial series, this technique should be considered as an interesting therapeutic alternative in sciatica. Larger series and double-blind studies, however, are necessary to confirm the initial results.

Reducing maternal mortality from ruptured uterus--the Sokoto initiative.

PubMed

Ahmed, Y; Shehu, C E; Nwobodo, E I; Ekele, B A

2004-06-01

Uterine rupture is the most common cause of maternal mortality in our institution. Case fatality for the year 2001 was 47%. Health care including emergency obstetric care (EmOC) is not free, hence, delays in receiving care could occur in patients with limited resources. The objectives of the study were to promote access to emergency obstetric care through a loan scheme for indigent patients with ruptured uterus and determine the success or otherwise of the scheme. The scheme was initiated in January 2002, with the sum of thirty eight Thousand Naira (about 300 US dollars) by consultant obstetricians in the department. Funds were released to the patient only after assessment of her financial capability to enable her get emergency surgical packs. All that was required was a promise to pay back the loan before discharge. Following resuscitation, surgery was performed by one of the consultants. Eighteen cases of ruptured uterus have been managed. Treatment was initiated within 30 minutes of admission. Admission-laparotomy interval averaged 3.5 hours (+/-1.2). There were two maternal deaths, giving a case fatality of 11% (2/ 18). The case fatality from a previous study from the same centre was 38% (16/42). There was a significant difference in case fatality between the two studies (P<0.05; confidence limits are-0.328 and -0.211). Of the seventeen patients that benefited from the scheme, 16 repaid the loan before discharge (94% loan recovery). Only one patient defaulted with five thousand Naira (40 US dollars). A loan scheme for indigent patients with ruptured uterus that enabled them receive emergency obstetric care reduced case fatality. Loan recovery was good. In our quest to reduce maternal mortality in low-income countries without health insurance policies, there might be a need to extend similar initiative to other obstetric emergencies.

Selective sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer: results of the GEICAM 2005-07 study.

PubMed

Piñero-Madrona, Antonio; Escudero-Barea, María J; Fernández-Robayna, Francisco; Alberro-Adúriz, José A; García-Fernández, Antonio; Vicente-García, Francisco; Dueñas-Rodriguez, Basilio; Lorenzo-Campos, Miguel; Caparrós, Xavier; Cansado-Martínez, María P; Ramos-Boyero, Manuel; Rojo-Blanco, Roberto; Serra-Genís, Constantí

2015-01-01

A controversial aspect of breast cancer management is the use of sentinel lymph node biopsy (SLNB) in patients requiring neoadjuvant chemotherapy (NCT). This paper discusses the detection rate (DT) and false negatives (FN) of SLNB after NCT to investigate the influence of initial nodal disease and the protocols applied. Prospective observational multicenter study in women with breast cancer, treated with NCT and SLNB post-NCT with subsequent lymphadenectomy. DT and FN rates were calculated, both overall and depending on the initial nodal status or the use of diagnostic protocols pre-SLNB. No differences in DT between initial node-negative cases and positive cases were found (89.8 vs. 84.4%, P=.437). Significant differences were found (94.1 vs. 56.5%, P=0,002) in the negative predictive value, which was lower when there was initial lymph node positivity, and a higher rate of FN, not significant (18.2 vs. 43.5%, P=.252) in the same cases. The axillary study before SLNB and after the NCT, significantly decreased the rate of FN in patients with initial involvement (55.6 vs 12.5, P=0,009). NCT means less DT and a higher rate of FN in subsequent SLNB, especially if there is initial nodal involvement. The use of protocols in axillary evaluation after administering the NCT and before BSGC, decreases the FN rate in these patients. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

The Influence of Information Ecology on E-Commerce Initiatives.

ERIC Educational Resources Information Center

Detlor, Brian

2001-01-01

Explores the influence of an organization's information ecology, or internal information environment, on a firm's electronic commerce initiatives and plans. Reports results from a case study investigation on the adoption and use of an e-commerce initiative, a corporate portal, by participants at a large Canadian company. (Author/LRW)

Minority Engineering Programs at a Crossroads: An Empirical Multiple Case Study of Two Historically White Public Research Universities

ERIC Educational Resources Information Center

Newman, Christopher B.

2016-01-01

Purpose: Underrepresented groups have fought for equal access to higher education, which spurred the development of "minority" initiatives. However, the assault on affirmative action and race-based initiatives have led many universities to retreat toward more all-encompassing "diversity" initiatives.…

Research at the Crossroads: How Intellectual Initiatives across Disciplines Evolve

ERIC Educational Resources Information Center

Frost, Susan H.; Jean, Paul M.; Teodorescu, Daniel; Brown, Amy B.

2004-01-01

How do intellectual initiatives across disciplines evolve? This qualitative case study of 11 interdisciplinary research initiatives at Emory University identifies key factors in their development: the passionate commitments of scholarly leaders, the presence of strong collegial networks, access to timely and multiple resources, flexible practices,…

Creating a Minor in Applied Data Science: Case Western Reserve University Engages Business Leaders to Produce T-Shaped Professionals. A BHEF Case Study

ERIC Educational Resources Information Center

Business-Higher Education Forum, 2016

2016-01-01

This case study examines how Business-Higher Education Forum (BHEF) member Case Western Reserve University is integrating T-shaped skills into a minor in applied data science. Through the collaboration of its business and higher education members, BHEF launched the National Higher Education and Workforce Initiative to create new undergraduate…

Rural automated highway systems case study : greater Yellowstone rural ITS corridor : final report

DOT National Transportation Integrated Search

1998-01-01

In cooperation with the National Automated Highway System Consortium (NAHSC), case studies are being conducted on existing transportation corridors to determine the feasibility of AHS. Initial activities by the NAHSC have focused on urbanized areas. ...

IVHS institutional issues and case studies : Travtek case study

DOT National Transportation Integrated Search

1997-11-01

The U.S. Department of Transportation (USDOT) is embarking on a new program called the Intelligent Vehicle Initiative (IVI). The USDOT intends to jointly define the program plan and conduct the IVI in cooperation with the motor vehicle, trucking, and...

Necrotizing Fasciitis of the Abdominal Wall in a Premature Infant: A Case Study.

PubMed

Narvey, Michael; Byrne, Paul; Fraser, Debbie

2017-01-01

We present a first report of necrotizing fasciitis of the abdominal wall in a 23-day-of-age, former 32-week-gestation premature infant. She was successfully treated with antibiotics without the need for initial debridement. After reviewing the etiology of necrotizing fasciitis, we discuss the unique aspects of this case, including the noninvasive approach to initial treatment, which we consider significantly contributed to her survival.

Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

USDA-ARS?s Scientific Manuscript database

Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

Churg-Strauss syndrome: a new endotype of severe asthma? Results of 14 Turkish patients.

PubMed

Yılmaz, İnsu; Çelik, Gülfem; Aydın, Ömür; Özdemir, Seçil Kepil; Soyyiğit, Şadan; Sözener, Zeynep; Özgüçlü, Selcan; Atasoy, Çetin; Düzgün, Nurşen; Mungan, Dilşad; Sin, Betül; Demirel, Yavuz Selim; Mısırlıgil, Zeynep

2015-07-01

Churg-Strauss syndrome (CSS) is a rare multisystem vasculitis. Considering the variation of autoimmune diseases in different races, it is of interest to determine whether any outstanding features exist for Turkish patients with CSS. The aim of this study was to evaluate the clinical and serological features of the disease, the treatment, and long-term follow-up details, and to investigate possible etiological factors of Turkish CSS patients. The study included 14 patients who were diagnosed with CSS, and followed by our department between 2004 and 2012. Possible etiological factors, initial symptoms, clinical presentations, treatment, as well as outcomes were documented. The study was approved by the local ethics. All patients fulfilled the American College of Rheumatology criteria. Initial symptoms were worsening asthma (n = 14; 100%) and skin lesions (n = 6; 43%). All patients had a diagnosis of asthma and nasal polyps, whereas 57.1% had aspirin hypersensitivity at the time of diagnosis. The lungs (100%) and skin (43%) were most commonly involved. Peripheral eosinophilia dominated on initial presentations of all patients. Initial treatments included oral methyl prednisolone in all cases, whereas cyclophosphamide and azathioprine were used in three cases. Relapses were detected in five cases. None of the cases were able to stop the oral corticosteroid treatment. No fatalities were observed. We herein describe a new severe asthma endotype in connection with CSS. We suggest that physicians who deal with uncontrolled severe asthma cases should consider CSS in the presence of nasal polyps, aspirin hypersensitivity, and especially peripheral blood eosinophilia over 10%. © 2014 John Wiley & Sons Ltd.

Improving Dengue Virus Capture Rates in Humans and Vectors in Kamphaeng Phet Province, Thailand, Using an Enhanced Spatiotemporal Surveillance Strategy

PubMed Central

Thomas, Stephen J.; Aldstadt, Jared; Jarman, Richard G.; Buddhari, Darunee; Yoon, In-Kyu; Richardson, Jason H.; Ponlawat, Alongkot; Iamsirithaworn, Sopon; Scott, Thomas W.; Rothman, Alan L.; Gibbons, Robert V.; Lambrechts, Louis; Endy, Timothy P.

2015-01-01

Dengue is of public health importance in tropical and sub-tropical regions. Dengue virus (DENV) transmission dynamics was studied in Kamphaeng Phet Province, Thailand, using an enhanced spatiotemporal surveillance of 93 hospitalized subjects with confirmed dengue (initiates) and associated cluster individuals (associates) with entomologic sampling. A total of 438 associates were enrolled from 208 houses with household members with a history of fever, located within a 200-m radius of an initiate case. Of 409 associates, 86 (21%) had laboratory-confirmed DENV infection. A total of 63 (1.8%) of the 3,565 mosquitoes collected were dengue polymerase chain reaction positive (PCR+). There was a significant relationship between spatial proximity to the initiate case and likelihood of detecting DENV from associate cases and Aedes mosquitoes. The viral detection rate from human hosts and mosquito vectors in this study was higher than previously observed by the study team in the same geographic area using different methodologies. We propose that the sampling strategy used in this study could support surveillance of DENV transmission and vector interactions. PMID:25986580

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.

Agency for Healthcare Research and Quality

MedlinePlus

... improve patient outcomes Opioids Supporting HHS' Opioid Initiative Comparative Health System Performance Initiative AHRQ Releases Compendium of ... the U.S. Health system. More AHRQ IMPACT CASE STUDIES AHRQ’s evidence-based tools and resources are used ...

Adequacy Post-"Rose v. Council for Better Education" in Kentucky Public School Facilities: A Case Study

ERIC Educational Resources Information Center

Wilson, Caroline Ford

2013-01-01

The decision in the 1989 landmark Kentucky case, "Rose v. Council for Better Education," initiated many reforms to ensure that children have access to an adequate education, including funding new construction and renovations for school facilities. The purpose of this instrumental, qualitative case study is to describe how the additional…

Best practices in intercultural health: five case studies in Latin America.

PubMed

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-09-05

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

Recognition and treatment of Alzheimer's disease: a case-based review.

PubMed

Marseille, Dana M; Silverman, Daniel H S

2006-01-01

Early recognition and treatment initiation are pivotal in managing Alzheimer's disease (AD). Once a diagnosis of AD is made, a treatment plan is developed and should include treatment initiation with cholinesterase inhibitors (ChEIs) to improve cognition, management of comorbid conditions, and treat behavioral symptoms. Caregiver compliance is integral to AD treatment success. The purpose of this report is to present two real case studies of "suspected" AD or related dementia and stress the significance of early and accurate diagnosis in disease management. In case 1, a caregiver reports gradual but progressive loss of memory, and the patient himself complains of memory impairment. Neuroimaging analysis confirms "typical " AD. In case 2, initiation of ChEI therapy is followed by substantial clinical improvement in the face of a complex medical picture, and neuroimaging revealing more neurodegenerative changes than could be accounted for by "pure" AD.

[Recurrent bleeding following the renal artery embolization treating post-percutaneous nephrolithotomy hemorrhage: causes and countermeasure].

PubMed

Ren, Y M; Wu, X M; Wen, Y; Lai, Q; Chen, W Z; Qian, Y X; Liang, R G

2017-01-03

Objective: To explore the causes and countermeasure in recurrent bleeding following the selective renal artery embolization treating post-percutaneous nephrolithotomy hemorrhage. Methods: A total of 334 patients of severe renal hemorrhage associated with percutaneous nephrolithotomy (PCNL) from March 2011 to April 2015 were analyzed retrospectively.All the patients underwent super selective angiography and renal artery embolization.The causes of recurrent hemorrhage were analyzed and principles for diagnosis and embolization were studied. Results: The initial embolization was performed in 329 cases hospitalized in the First Affiliated Hospital of Guangzhou Medical University and 318 cases were successfully stopped bleeding with a hemostatic rate of 96.7 %(318/329). Of total 334 consecutive cases, there were 16 cases of recurrent renal hemorrhage, 11 cases were initially embolized in this hospital, and otherwise the other 5 cases were in other hospitals. Causes of recurrent hemorrhage were missed embolization of tiny pseudoaneurysm ( n =12), and two cases of 12, the tiny pseudoaneurysm were feeding by accessory renal arteries, undetected arteriovenous fistula( n =2), recanalization of the embolized arteries ( n =2). Conclusion: The causes of recurrent bleeding fallowing the initial selective renal artery embolization treating post-percutaneous nephrolithotomy hemorrhage are varied, and missed embolization of tiny pseudoaneurysm is the major cause of unsuccessful initial renal artery embolization. To strengthen the understanding of tiny pseudoaneurysm is helpful to improve the success rate of hemostasis.

Enabling Business Processes through Information Management and IT Systems: The FastFit and Winter Gear Distributors Case Studies

ERIC Educational Resources Information Center

Kesner, Richard M.; Russell, Bruce

2009-01-01

The "FastFit Case Study" and its companion, the "Winter Gear Distributors Case Study" provide undergraduate business students with a suitable and even familiar business context within which to initially consider the role of information management (IM) and to a lesser extent the role of information technology (IT) systems in enabling a business.…

Open and Distance Learning: Case Studies from Industry and Education. Open and Distance Learning Series.

ERIC Educational Resources Information Center

Brown, Stephen C., Ed.

This book contains 14 case studies, written by those involved in the teaching and training initiatives, that illustrate the use of open and distance learning strategies. The case studies, drawn from many parts of the world (but mostly British based), feature efforts in large and small companies in a variety of industries. The first part of the…

Using Case Studies of Ethical Dilemmas for the Development of Moral Literacy: Towards Educating for Social Justice

ERIC Educational Resources Information Center

Shapiro, Joan Poliner; Hassinger, Robert E.

2007-01-01

Purpose: The purpose of this paper is to focus on a case study, framed as an ethical dilemma. It serves as an illustration for the teaching of moral literacy, with a special emphasis on social justice. Design/methodology/approach: Initially, the paper provides a rationale for the inclusion of case studies, emphasizing moral problems in university…

Island Roots, Global Reach: A Case Study in Internationalizing Kapi'olani Community College

ERIC Educational Resources Information Center

Richards, Leon; Franco, Robert W.

2007-01-01

This chapter offers a case study of Kapi'olani Community College, an institution that initiated its Asia-Pacific emphasis in 1988, strengthened the emphasis throughout the 1990s, and expanded it to an integrated international emphasis in 2007.

Can a limited double reading/second opinion of initially recalled breast ultrasound screening examinations improve radiologists' performances?

NASA Astrophysics Data System (ADS)

Gur, David; Harnist, Kimberly; Gizienski, Terri-Ann; Zuley, Margarita; Hakim, Christiane; Lu, Amy; Sumkin, Jules; Abrams, Gordon; Ganott, Marie A.; Kelly, Amy E.; Tyma, Cathy S.; Chang, Thomas; BÓ§hm-Vélez, Marcella; Sobolewski, Robin

2018-03-01

Interpretations of breast ultrasound screening examinations result in high recall rates and large inter-radiologist variability, frequently leading to "conservative" recommendations. Double reading of all breast ultrasound screening examinations is cost prohibitive, but double reading of only "initially recalled" cases may prove efficacious. We assessed changes in recommendations, if any, by providing a consensus second opinion in a limited subset of examinations initially recommended for recall. We performed a retrospective reader study with 197 ultrasound examinations (97 not recalled and 100 recalled clinically). First, we generated a consensus "second opinion" consisting of the majority vote of three independent readings of each case by experienced ultrasound interpreters. During the reader study that followed, if the reader recommended a "recall" and the "consensus second opinion" did not, a message to that effect was displayed and the reader was asked to re-review the exam and re-assess if, knowing the second opinion, a re-rating of the case was warranted. We compared performance levels pre- and post- the second opinion. The second opinion resulted in "no recall" recommendations of 141 cases in the entire set, including four cancer cases missed by all three readers. On average, radiologists received "warning" messages in 30 cases (range 15-50), or in 15% of cases. Rating changes (downgrades to no recall) occurred in 36 of these cases. These changes resulted in a possible recall rate reduction of 28% in prompted cases or 14% overall recall reduction, while increasing the false negative rate by only one case missed by 2 readers ( 1%).

Student-Initiated Use of Facebook for Learning Online Journalism

ERIC Educational Resources Information Center

Song, Yang

2017-01-01

This article presents a case study of student-initiated use of Facebook Groups in doing a team project for an online journalism course. Drawing upon the concept of affinity space and a theoretical taxonomy of asynchronous online discussion, the present study triangulates classroom observation, semi-structured student interviews, and microanalysis…

Big Earth Data Initiative: Metadata Improvement: Case Studies

NASA Technical Reports Server (NTRS)

Kozimor, John; Habermann, Ted; Farley, John

2016-01-01

Big Earth Data Initiative (BEDI) The Big Earth Data Initiative (BEDI) invests in standardizing and optimizing the collection, management and delivery of U.S. Government's civil Earth observation data to improve discovery, access use, and understanding of Earth observations by the broader user community. Complete and consistent standard metadata helps address all three goals.

Problematizing Diversity Initiatives: Japanese American Youth Identities and the Politics of Representation with/in School Spaces

ERIC Educational Resources Information Center

Endo, Rachel

2014-01-01

This article reports on a case study that investigated how six Japanese American youth interpreted the effectiveness and relevance of extra-curricular diversity initiatives at their Midwestern middle and secondary public schools. These initiatives were intended to raise cultural awareness, but ultimately promoted cultural fetishism and racially…

Descriptive Case Study of Theories of Action, Strategic Objectives, and Strategic Initiatives Used by California Female County Superintendents to Move Their Organizations from Current State to Desired Future

ERIC Educational Resources Information Center

Park, Valerie Darlene

2014-01-01

The purpose of this study was to describe the theories of action, strategic objectives, and strategic initiatives of school systems led by female county superintendents in California and examine their impact on improving system outcomes. Additionally, the factors influencing theory of action, strategic objective, and initiative development were…

The Exceptional Responders Initiative: Welcoming More Cases

Cancer.gov

The initiative is studying tissue, clinical, and genomic data from patients with cancer who have had dramatic and long-lasting responses to standard and experimental treatments that were not seen in similar patients who received the same treatment.

Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study.

PubMed

Smith, Alan D

2011-01-01

A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

Substantially Higher and Earlier Occurrence of Anti-Tuberculosis Drug-Related Adverse Reactions in HIV Coinfected Tuberculosis Patients: A Matched-Cohort Study.

PubMed

Matono, Takashi; Nishijima, Takeshi; Teruya, Katsuji; Morino, Eriko; Takasaki, Jin; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Kaku, Mitsuo; Oka, Shinichi

2017-11-01

Little information exists on the frequency, severity, and timing of first-line anti-tuberculosis drug-related adverse events (TB-AEs) in HIV-tuberculosis coinfected (HIV-TB) patients in the antiretroviral therapy (ART) era. This matched-cohort study included HIV-TB patients as cases and HIV-uninfected tuberculosis (non-HIV-TB) patients as controls. Tuberculosis was culture-confirmed in both groups. Cases were matched to controls in a 1:4 ratio on age, sex, and year of diagnosis. TB-AEs were defined as Grade 2 or higher requiring drug discontinuation/regimen change. From 2003 to 2015, 94 cases and 376 controls were analyzed (95% men, 98% Asians). Standard four-drug combination therapy was initiated in 91% of cases and 89% of controls (p = 0.45). Cases had a higher frequency of TB-AE [51% (48/94) vs. 10% (39/376), p < 0.001]. Their major TB-AEs were fever (19%), rash (11%), and neutropenia (11%). TB-AEs were more severe in cases [Grade 3 or higher: cases (71%, 34/48) vs. controls (49%, 19/39), p < 0.001]. The time from treatment initiation to TB-AE was shorter in cases [median 18 (interquartile range 12-28) vs. 27 (15-57) days, p = 0.027], and 73% of TB-AEs in cases occurred within 4 weeks of starting anti-tuberculosis treatment. HIV infection was an independent risk factor for TB-AEs in the multivariate Cox analysis [adjusted HR (aHR): 6.96; 95% confidence interval: 3.93-12.3]. TB-AEs occurred more frequently in HIV-TB than in non-HIV-TB patients, and were more severe. The majority of TB-AEs occurred within 4 weeks of initiating anti-tuberculosis treatment. Because TB-AEs may delay ART initiation, careful monitoring during this period is warranted in coinfected patients.

[Usefulness of stratigraphy and computerized tomography in the initial staging of osteosarcoma of the extremities. Retrospective study of 217 cases].

PubMed

Pelotti, P; Ciminari, R; Bacci, G; Avella, M; Briccoli, A

1988-01-01

The value of stratigraphy and pulmonary CT in the initial work-up of osteosarcoma of the extremities is assessed with reference to 217 patients encountered in the Bone Tumour Centre of Rizzoli Orthopaedic Institute in May 1983-May 1986. Stratigraphy revealed lung metastases not identified by standard radiography in 4 patients (1.8%), while CT revealed metastases not identified by either standard X-rays or stratigraphy in a further 6 cases (2.7%). It is concluded that the increase in the percentage of cures (about 30%) reported in the last 10 years in osteosarcoma cases given adjuvant chemotherapy cannot be explained by any difference in initial selection due to the use of these techniques that were not adopted in the historical series.

An Analysis of 19 International Case Studies of Stress Prevention Through Work Reorganization Using the Demand/Control Model

ERIC Educational Resources Information Center

Karasek, Robert A.

2004-01-01

Nineteen international case studies of workplace stress prevention initiatives are analyzed. The focus of these cases, which span a variety of workplaces and locations, is on preventing stress through work reorganization rather than remedial approaches for stress relief. It is found that the majority of the occupations represented in the case…

Corporate Social Responsibility Initiatives Addressing Social Exclusion in Bangladesh

PubMed Central

2009-01-01

The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships—collectively labelled corporate social responsibility (CSR) initiatives—may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation. PMID:19761088

Intensive exposure as a risk factor for severe polio: a study of multiple family cases.

PubMed

Nielsen, N M; Aaby, P; Wohlfahrt, J; Pedersen, J B; Melbye, M; Mølbak, K

2001-01-01

To examine the importance of intensity of exposure for the outcome of the poliomyelitis infection 429 polio cases were identified belonging to families with 2, 3 or 4 polio cases, all hospitalized in Copenhagen from 1919 to 1953. Furthermore, 87 pairs of polio cases living on the same stairway, but not in the same household, were identified. Severity among multiple cases in families analysed according to time of appearance showed a U-shaped curve. Initial cases had a higher risk of developing paralysis [relative risk (RR) = 1.5, 95% confidence interval (CI) 1.2-1.91 and of dying (RR = 2.5, 95% CI 0.9-6.9). Decreased severity was observed among subsequent cases appearing within 11 d after the initial case (RR = 1.0); however, severity increased again, with higher mortality for cases likely to have been infected by the initial case (cases appearing more than 11 d later) (RR = 5.7, 95% CI 1.8-17.8). The pattern described among multiple family cases was not found among cases from the same stairway. Since family cases appearing within 11 d were probably infected simultaneously, a short incubation period is associated with severe disease and a prolonged incubation period with milder infections. Furthermore, intensive exposure from being infected in the household increased severity. These observations therefore suggest that intensity of exposure and dose of infection are important factors in the severity of poliomyelitis.

Research participation experiences of informants of suicide and control cases: taken from a case-control psychological autopsy study of people who died by suicide.

PubMed

Wong, Paul W C; Chan, Wincy S C; Beh, Philip S L; Yau, Fiona W S; Yip, Paul S F; Hawton, Keith

2010-01-01

Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. (1) To investigate whether informants of suicide cases recruited by two approaches (coroners' court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. The acceptance rate for our original psychological autopsy study was modest. The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

29 CFR 101.17 - Initiation of representation cases and petitions for clarification and amendment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 2 2011-07-01 2011-07-01 false Initiation of representation cases and petitions for... BOARD STATEMENTS OF PROCEDURES Representation Cases Under Section 9(c) of the Act and Petitions for... Initiation of representation cases and petitions for clarification and amendment. The investigation of the...

29 CFR 101.17 - Initiation of representation cases and petitions for clarification and amendment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 2 2014-07-01 2014-07-01 false Initiation of representation cases and petitions for... BOARD STATEMENTS OF PROCEDURES Representation Cases Under Section 9(c) of the Act and Petitions for... Initiation of representation cases and petitions for clarification and amendment. The investigation of the...

The value of case reports in human teratology.

PubMed

Goldberg, J D; Golbus, M S

1986-03-01

Birth defects caused by human teratogens are an important and potentially preventable cause of perinatal morbidity and mortality. Case reports provide an initial suggestion that a specific agent may be a human teratogen and provide the basis for further study. This review discusses the importance of case reports in human teratology and provides guidance in evaluating new case reports.

Treatment Effect Heterogeneity in a Science Professional Development Initiative: The Case for School Capacity

ERIC Educational Resources Information Center

Bruch, Sarah; Grigg, Jeffrey; Hanselman, Paul

2010-01-01

This study focuses on how the treatment effects of a teacher professional development initiative in science differed by school capacity. In other words, the authors are primarily concerned with treatment effect heterogeneity. As such, this paper complements ongoing evaluation of the average treatment effects of the initiative over time. The…

Student Initiatives and Missed Learning Opportunities in an IRF Sequence: A Single Case Analysis

ERIC Educational Resources Information Center

Li, Houxiang

2013-01-01

Most conversation analysis (CA) studies of the initiation-response-feedback (IRF; Sinclair & Coulthard, 1975) sequence have focused on teacher actions in the feedback move. In this article, I use CA to analyze student initiatives (Waring, 2011) within an IRF sequence in one excerpt from a Chinese as a foreign language class. The excerpt…

Western U.S.-Canada crossborder case study : activity 2 : task D : conduct regional and local trucking case studies

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

Culturally Responsive Teaching in the Context of Mathematics: A Grounded Theory Case Study

ERIC Educational Resources Information Center

Bonner, Emily P.; Adams, Thomasenia L.

2012-01-01

In this grounded theory case study, four interconnected, foundational cornerstones of culturally responsive mathematics teaching (CRMT), communication, knowledge, trust/relationships, and constant reflection/revision, were systematically unearthed to develop an initial working theory of CRMT that directly informs classroom practice. These…

Motor carrier case study evaluation report : appendix C, Vol. 2 : case study field notes, the Crescent Evaluation

DOT National Transportation Integrated Search

1994-02-01

The Crescent Project element of the HELP Program is a bi-national multi-jurisdictional : cooperative research and demonstration initiative involving the public and private sectors in an : application of advanced technologies for the creation of an in...

Creating a Learning Organization: A Case Study of Outcomes and Lessons Learned.

ERIC Educational Resources Information Center

Bierema, Laura L.; Berdish, David M.

1999-01-01

Discusses how organizations are gaining a competitive edge in a global business environment through learning and highlights a learning organization implementation case study of a division of Ford Motor Company. Examines the strategic initiative; performance improvement results; individual learning, including interpersonal development and…

The Heroes' Journey: A Young Couple's Experience with Choriocarcinoma

ERIC Educational Resources Information Center

Marlowe, Dan; Hodgson, Jennifer; Lamson, Angela

2010-01-01

A 20 year retrospective qualitative case study was conducted to investigate the relational impact of choriocarcinoma (a type of gestational cancer) on a couple of child-bearing age. A unique feature to the study was that the primary investigator was the couple's biological son, initiating the first known auto-case study design. Using holistic…

Understanding the Factors that Characterise School-Community Partnerships: The Case of the Logan Healthy Schools Project

ERIC Educational Resources Information Center

Thomas, Melinda; Rowe, Fiona; Harris, Neil

2010-01-01

Purpose: The purpose of this study is to examine the factors that characterise effective school-community partnerships that support the sustainability of school health initiatives applied within a health-promoting schools approach. Design/methodology/approach: The study used an explanatory case study approach of five secondary schools…

The Bureaucratising of Lesson Study: A Javanese Case

ERIC Educational Resources Information Center

Kusanagi, Kanako N.

2014-01-01

Lesson study developed organically in Japan over a period of 140 years, whereas in Indonesia, lesson study was introduced as a top-down initiative. This research explores beyond general cultural differences by illustrating how the daily concerns of teachers and their social interactions differ in Japan and in the case of an Indonesian school, the…

Resilience of antagonistic networks with regard to the effects of initial failures and degree-degree correlations

NASA Astrophysics Data System (ADS)

Watanabe, Shunsuke; Kabashima, Yoshiyuki

2016-09-01

In this study we investigate the resilience of duplex networked layers α and β coupled with antagonistic interlinks, each layer of which inhibits its counterpart at the microscopic level, changing the following factors: whether the influence of the initial failures in α remains [quenched (case Q )] or not [free (case F )]; the effect of intralayer degree-degree correlations in each layer and interlayer degree-degree correlations; and the type of the initial failures, such as random failures or targeted attacks (TAs). We illustrate that the percolation processes repeat in both cases Q and F , although only in case F are nodes that initially failed reactivated. To analytically evaluate the resilience of each layer, we develop a methodology based on the cavity method for deriving the size of a giant component (GC). Strong hysteresis, which is ignored in the standard cavity analysis, is observed in the repetition of the percolation processes particularly in case F . To handle this, we heuristically modify interlayer messages for macroscopic analysis, the utility of which is verified by numerical experiments. The percolation transition in each layer is continuous in both cases Q and F . We also analyze the influences of degree-degree correlations on the robustness of layer α , in particular for the case of TAs. The analysis indicates that the critical fraction of initial failures that makes the GC size in layer α vanish depends only on its intralayer degree-degree correlations. Although our model is defined in a somewhat abstract manner, it may have relevance to ecological systems that are composed of endangered species (layer α ) and invaders (layer β ), the former of which are damaged by the latter whereas the latter are exterminated in the areas where the former are active.

Organizational Context Matters: A Research Toolkit for Conducting Standardized Case Studies of Integrated Care Initiatives

PubMed Central

Grudniewicz, Agnes; Gray, Carolyn Steele; Wodchis, Walter P.; Carswell, Peter; Baker, G. Ross

2017-01-01

Introduction: The variable success of integrated care initiatives has led experts to recommend tailoring design and implementation to the organizational context. Yet, organizational contexts are rarely described, understood, or measured with sufficient depth and breadth in empirical studies or in practice. We thus lack knowledge of when and specifically how organizational contexts matter. To facilitate the accumulation of evidence, we developed a research toolkit for conducting case studies using standardized measures of the (inter-)organizational context for integrating care. Theory and Methods: We used a multi-method approach to develop the research toolkit: (1) development and validation of the Context and Capabilities for Integrating Care (CCIC) Framework, (2) identification, assessment, and selection of survey instruments, (3) development of document review methods, (4) development of interview guide resources, and (5) pilot testing of the document review guidelines, consolidated survey, and interview guide. Results: The toolkit provides a framework and measurement tools that examine 18 organizational and inter-organizational factors that affect the implementation and success of integrated care initiatives. Discussion and Conclusion: The toolkit can be used to characterize and compare organizational contexts across cases and enable comparison of results across studies. This information can enhance our understanding of the influence of organizational contexts, support the transfer of best practices, and help explain why some integrated care initiatives succeed and some fail. PMID:28970750

Initial Development and Validation of the Youth Internalizing Problems Screener

ERIC Educational Resources Information Center

Renshaw, Tyler L.; Cook, Clayton R.

2018-01-01

The present studies report on the initial development and validation of the Youth Internalizing Problems Screener (YIPS), which is a 10-item self-report rating scale for assessing general internalizing problems and identifying depression and anxiety caseness within the context of school mental health screening. Results from Study 1 (N = 177)…

Framing Innovation: The Role of Distributed Leadership in Gaining Acceptance of Large-Scale Technology Initiatives

ERIC Educational Resources Information Center

Turner, Henry J.

2014-01-01

This dissertation of practice utilized a multiple case-study approach to examine distributed leadership within five school districts that were attempting to gain acceptance of a large-scale 1:1 technology initiative. Using frame theory and distributed leadership theory as theoretical frameworks, this study interviewed each district's…

Examining the Role of Leadership in an Undergraduate Biology Institutional Reform Initiative

ERIC Educational Resources Information Center

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…

State Initiatives on Industry-Based Skill Standards and Credentials.

ERIC Educational Resources Information Center

Ganzglass, Evelyn; Simon, Martin

A study examined state initiatives for industry-based skill standards and credentials. Officials in 19 states were interviewed, case studies of programs in 3 states (Georgia, Pennsylvania, and Texas) were conducted, and focus group discussions were held with 25 individuals. State skill standards were generally found to be tied to broader efforts…

Best practices in intercultural health: five case studies in Latin America

PubMed Central

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-01-01

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

Integration of DNA barcoding for the initial recordings of Lessepsian fishes: a case study of the Indo-Pacific slender ponyfish Equulites elongatus.

PubMed

Sakinan, S; Karahan, A; Ok, M

2017-03-01

In this study, the DNA barcode of a regional Lessepsian sighting of the slender ponyfish Equulites elongatus is integrated with morphometric and meristic descriptors as a case study to address further identification problems in the Mediterranean Sea. The study also aims to contribute to the regional mitochondrial cytochrome oxidase I information pool, to support other potential uses. The initial sighting of E. elongatus from the north-eastern Mediterranean coast of Turkey is provided from a trawl survey on 3 June 2015, where 76 specimens were captured during a 15 min tow. © 2016 The Fisheries Society of the British Isles.

Making intelligent systems team players: Additional case studies

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

1993-01-01

Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

MRI of inflammatory spondyloarthropathy following traumatic cauda equina syndrome.

PubMed

Ginder, L M; Porter, N A; Subedi, N; Singh, J; Lalam, R K; Tins, B J; Tyrrell, P N M; Osman, A; Cassar-Pullicino, V N

2015-03-01

Spondyloarthropathy has been described radiographically in patients following paralysis from spinal cord trauma. Onset of these findings after cauda equina syndrome have not been reported previously. Furthermore, the magnetic resonance documentation of its early evolution has not been recorded. We report a case of early-onset spondyloarthropathy shown by magnetic resonance imaging (MRI) in a patient with cauda equina syndrome due to bilateral sacral insufficiency fractures. Unique case study review, one case. Review of the clinical case notes and imaging including initial and subsequent MR imaging. The initial MRI of the lumbosacral spine showed bilateral sacral insufficiency fractures with a kyphotic deformity. The vertebral bodies were normal on the initial computed tomography and MRI studies, which did not reveal pre-existing features of sacroiliitis. The second MRI performed 5 months later clearly showed spondylitis at multiple vertebral levels with partial resolution 18 months post injury. Spondyloarthropathy in patients with paralysis due to spinal cord injury is well documented in the English language literature, but until now this has not been demonstrated by MRI. It is a rare complication of traumatic cauda equina syndrome that commences soon after the traumatic event and can resolve spontaneously.

Breast mass as the initial presentation of esophageal carcinoma: a case report

PubMed Central

Norooz, Mohammad Tayefeh; Ahmadi, Hamed; Zavarei, Mansour Jamali; Daryaei, Parviz

2009-01-01

Introduction Esophageal cancer is considered as a fatal malignancy. It mostly metastasizes to lung, liver, and bone while breast metastasis has been rarely reported. This is the fifth report of metastatic breast cancer from esophageal cancer, which differs from previous reported cases in terms of initial presentation with metastatic breast mass and no metastatic involvement of other organs. Case presentation We present a 35-year-old Caucasian woman who initially complained of a painful breast mass. Squamous pearls on cytologic evaluation suggested a metastatic lesion. Two months history of dysphagia was extracted through detailed interview with patient and further investigation revealed a stage IV esophageal squamous cell carcinoma. Conclusion In this case, breast lesion as an unusual presentation of esophageal carcinoma emphasizes the great role of thorough medical history taking and cytologic study in evaluating an accidentally detected breast mass. The increasing reports of breast metastasis in patients with esophageal carcinoma necessitate the careful breast examination in visits after treatment of the primary tumor. PMID:19829901

Corticobasal degeneration initially developing motor versus non-motor symptoms: a comparative clinicopathological study.

PubMed

Ikeda, Chikako; Yokota, Osamu; Nagao, Shigeto; Ishizu, Hideki; Morisada, Yumi; Terada, Seishi; Nakashima, Yoshihiko; Akiyama, Haruhiko; Uchitomi, Yosuke

2014-09-01

Clinical presentations of pathologically confirmed corticobasal degeneration (CBD) vary, and the heterogeneity makes its clinical diagnosis difficult, especially when a patient lacks any motor disturbance in the early stage. We compared clinical and pathological features of four pathologically confirmed CBD cases that initially developed non-motor symptoms, including behavioural and psychiatric symptoms but without motor disturbance (CBD-NM), and five CBD cases that initially developed parkinsonism and/or falls (CBD-M). The age range at death for the CBD-NM and CBD-M subjects (58-85 years vs 45-67 years) and the range of disease duration (2-18 years vs 2-6 years) did not significantly differ between the groups. Prominent symptoms in the early stage of CBD-NM cases included self-centred behaviours such as frontotemporal dementia (n = 1), apathy with and without auditory hallucination (n = 2), and aggressive behaviours with delusion and visual hallucination (n = 1). Among the four CBD-NM cases, only one developed asymmetric motor disturbance, and two could walk without support throughout the course. Final clinical diagnoses of the CBD-NM cases were frontotemporal dementia (n = 2), senile psychosis with delirium (n = 1), and schizophrenia (n = 1). Neuronal loss was significantly less severe in the subthalamic nucleus and substantia nigra in the CBD-NM cases than in the CBD-M cases. The severity of tau pathology in all regions examined was comparable in the two groups. CBD cases that initially develop psychiatric and behavioural changes without motor symptoms may have less severe degenerative changes in the subthalamic nucleus and substantia nigra, and some CBD cases can lack motor disturbance not only in the early stage but also in the last stage of the course. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Reflections on Language and Mathematics Problem Solving: A Case Study of a Bilingual First-Grade Teacher

ERIC Educational Resources Information Center

Musanti, Sandra I.; Celedon-Pattichis, Sylvia; Marshall, Mary E.

2009-01-01

This case study investigates a professional development initiative in which a first-grade bilingual teacher engages in learning and teaching Cognitively Guided Instruction, a framework for understanding student thinking through context-rich word-problem lessons. The study explores (a) the impact of classroom-based professional development on a…

A Case Study of Organizational Collaboration in an Institution of Higher Education

ERIC Educational Resources Information Center

Schmaltz, Sarah Katherine Abrams

2010-01-01

The study, A Case Study of Organizational Collaboration in an Institution of Higher Education, is a look into what is working and what is not working inside a collaborative initiative at the University of Virginia called the Partners for Leadership in Education. The Partners for Leadership in Education is one of the longest lasting collaborations…

A Case Study of a National University Research Project and Its Technological Innovation

ERIC Educational Resources Information Center

Ziegel, Melina

2012-01-01

This case study examined the implementation of a major research endeavor in an institution of higher education, Trinity College, Dublin, in Ireland, with particular focus on the change process during the initiation of the project and the subsequent needs assessment and implementation of technological solutions. This study identified the stages,…

Scaling up STEM Academies Statewide: Implementation, Network Supports, and Early Outcomes

ERIC Educational Resources Information Center

Young, Viki; House, Ann; Sherer, David; Singleton, Corinne; Wang, Haiwen; Klopfenstein, Kristin

2016-01-01

This chapter presents a case study of scaling up the T-STEM initiative in Texas. Data come from the four-year longitudinal evaluation of the Texas High School Project (THSP). The evaluation studied the implementation and impact of T-STEM and the other THSP reforms using a mixed-methods design, including qualitative case studies; principal,…

Digital and Online Learning in Vocational Education and Training in Serbia: A Case Study

ERIC Educational Resources Information Center

Brolpito, Alessandro; Lightfoot, Michael; Radišic, Jelena; Šcepanovic, Danijela

2016-01-01

This case study aims to identify relevant policies and practices for digital and online learning (DOL) in vocational education and training (VET) in Serbia, with a focus on initial VET (IVET). The study was commissioned by the European Training Foundation (ETF) with the following specific objectives: (1) gather information and analyse DOL…

Supportive decision making at the point of care: refinement of a case-based reasoning application for use in nursing practice.

PubMed

DI Pietro, Tammie L; Doran, Diane M; McArthur, Gregory

2010-01-01

Variations in nursing care have been observed, affecting patient outcomes and quality of care. Case-based reasoners that benchmark for patient indicators can reduce variation through decision support. This study evaluated and validated a case-based reasoning application to establish benchmarks for nursing-sensitive patient outcomes of pain, fatigue, and toilet use, using patient characteristic variables for generating similar cases. Three graduate nursing students participated. Each ranked 25 patient cases using demographics of age, sex, diagnosis, and comorbidities against 10 patients from a database. Participant judgments of case similarity were compared with the case-based reasoning system. Feature weights for each indicator were adjusted to make the case-based reasoning system's similarity ranking correspond more closely to participant judgment. Small differences were noted between initial weights and weights generated from participants. For example, initial weight for comorbidities was 0.35, whereas weights generated by participants for pain, fatigue, and toilet use were 0.49, 0.42, and 0.48, respectively. For the same outcomes, the initial weight for sex was 0.15, but weights generated by the participants were 0.025, 0.002, and 0.000, respectively. Refinement of the case-based reasoning tool established valid benchmarks for patient outcomes in relation to participants and assisted in point-of-care decision making.

Finding a (W)hole in the Text: A Case Study of Four Readers Reading.

ERIC Educational Resources Information Center

Nance, Mary Moore

The purpose of the study was to examine: (1) which perspectives of Reader Response Theory were most applicable in this study; (2) which factors influenced reader responses; and (3) how readers' responses changed over time. The four participants for this case study were chosen from a subject pool of 10 initiate adult full-time divinity students in…

How a Historically Black College University (HBCU) Established a Sustainable Online Learning Program in Partnership with Quality Matters™

ERIC Educational Resources Information Center

Harkness, S. Suzan J.

2015-01-01

This case study describes an initiative approach to establishing online learning at a medium-size historically black college university. The study reveals the collaborative efforts between university administration and faculty, Quality Matters™, and Blackboard. The strategic initiative spanned a period of five academic years (2010-2014) during…

Student-Initiated Use of Technology--Friend and Foe

ERIC Educational Resources Information Center

Wiklund, Matilda; Andersson, Annika

2018-01-01

A multitude of different technologies are used in school today. Some are provided by the school and others are brought by the individual teacher or student. In addition, different applications are available. In this study the focus is on student-initiated uses of technology and how it conditions learning. Based on a case study with surveys,…

Teaching Traumatic History to Young Children: The Case of Holocaust Studies in Israeli Kindergartens

ERIC Educational Resources Information Center

Ziv, Yair; Golden, Deborah; Goldberg, Tsafrir

2015-01-01

Recently, the Israeli Ministry of Education initiated a mandatory nationwide curriculum for Jewish kindergarten children focusing on the study of the Holocaust. This initiative raises general questions regarding the inclusion of sensitive historical issues in curricula for young children. In this article, we use the new Holocaust curriculum as an…

Community College Responses to Calls for Higher Completion Rates: The Cases of Three Community Colleges

ERIC Educational Resources Information Center

Smock, Elizabeth S.

2013-01-01

The primary purpose of this study was to understand how three diverse community colleges are interpreting and acting on federal initiatives to increase completion rates. The study attempted to answer four main research questions: (1) How do a selection of Kansas community colleges, as organizations, interpret the initiative to increase completion…

Does menopausal hormone therapy reduce myocardial infarction risk if initiated early after menopause? A population-based case-control study.

PubMed

Carrasquilla, Germán D; Berglund, Anita; Gigante, Bruna; Landgren, Britt-Marie; de Faire, Ulf; Hallqvist, Johan; Leander, Karin

2015-06-01

This study aims to assess whether the timing of menopausal hormone therapy initiation in relation to onset of menopause and hormone therapy duration is associated with myocardial infarction risk. This study was based on the Stockholm Heart Epidemiology Program, a population-based case-control study including 347 postmenopausal women who had experienced a nonfatal myocardial infarction and 499 female control individuals matched for age and residential area. Odds ratios (with 95% CIs) for myocardial infarction were calculated using logistic regression. Early initiation of hormone therapy (within 10 y of onset of menopause or before age 60 y), compared with never use, was associated with an odds ratio of 0.87 (95% CI, 0.58-1.30) after adjustments for lifestyle factors, body mass index, and socioeconomic status. For late initiation of hormone therapy, the corresponding odds ratio was 0.97 (95% CI, 0.53-1.76). For hormone therapy duration of 5 years or more, compared with never use, the adjusted odds ratio was 0.64 (95% CI, 0.35-1.18). For hormone therapy duration of less than 5 years, the odds ratio was 0.97 (95% CI, 0.63-1.48). Neither the timing of hormone therapy initiation nor the duration of therapy is significantly associated with myocardial infarction risk.

Agreement between the results of meta-analyses from case reports and from clinical studies regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I who initiated enzyme replacement therapy in adult age: An example of case reports meta-analyses as an useful tool for evidence-based medicine in rare diseases.

PubMed

Sampayo-Cordero, Miguel; Miguel-Huguet, Bernat; Pardo-Mateos, Almudena; Moltó-Abad, Marc; Muñoz-Delgado, Cecilia; Pérez-López, Jordi

2018-02-01

Case reports might have a prominent role in the rare diseases field, due to the small number of patients affected by one such disease. A previous systematic review regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I (MPS-I) who initiated enzyme replacement therapy (ERT) in adult age has been published. The review included a meta-analysis of 19 clinical studies and the description of eleven case reports. It was of interest to perform a meta-analysis of those case reports to explore the role of such meta-analyses as a tool for evidence-based medicine in rare diseases. The study included all case reports with standard treatment regimen. Primary analysis was the percentage of case reports showing an improvement in a specific outcome. Only when that percentage was statistically higher than 5%, the improvement was confirmed as such. The outcomes that accomplished this criterion were ranked and compared to the GRADE criteria obtained by those same outcomes in the previous meta-analysis of clinical studies. There were three outcomes that had a significant improvement: Urine glycosaminoglycans, liver volume and 6-minute walking test. Positive and negative predictive values, sensitivity and specificity for the results of the meta-analysis of case reports as compared to that of clinical studies were 100%, 88.9%, 75% and 100%, respectively. Accordingly, absolute (Rho=0.82, 95%CI: 0.47 to 0.95) and relative agreement (Kappa=0.79, 95%CI: 0.593 to 0.99) between the number of case reports with improvement in a specific outcome and the GRADE evidence score for that outcome were good. Sensitivity analysis showed that agreement between the meta-analysis of case reports and that of the clinical studies were good only when using a strong confirmatory strategy for outcome improvement in case reports. We found an agreement between the results of meta-analyses from case reports and from clinical studies in the efficacy of laronidase therapy in patients with MPS-I who initiated ERT in adult age. This agreement suggests that combining case reports quantitatively, rather than analyzing them separately or qualitatively, may improve conclusions in the field of rare diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

Acute thoracolumbar pain due to cholecystitis: a case study.

PubMed

Carter, Chris T

2015-01-01

This article describes and discusses the case of an adult female with cholecystitis characterized on initial presentation as acute thoracolumbar pain. A 34-year-old female presented for care with a complaint of acute right sided lower thoracic and upper lumbar pain with associated significant hyperalgesia and muscular hypertonicity. The patient was examined, referred, and later diagnosed by use of ultrasound imaging. Despite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. A clinical neurological discussion of cholecystitis visceral pain and referred viscerosomatic phenomena is included.

Beacon communities' public health initiatives: a case study analysis.

PubMed

Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach to evaluation at the beginning of implementation made the work more effective. Supporting evaluation to inform future implementations is important.

Helping Crisis Managers Protect Reputational Assets: Initial Tests of the Situational Crisis Communication Theory.

ERIC Educational Resources Information Center

Coombs, W. Timothy; Holladay, Sherry J.

2002-01-01

Explains a comprehensive, prescriptive, situational approach for responding to crises and protecting organizational reputation: the situational crisis communication theory (SCCT). Notes undergraduate students read two crisis case studies from a set of 13 cases and responded to questions following the case. Validates a key assumption in SCCT and…

Dropout revisited: patient- and therapist-initiated discontinuation of psychotherapy as a function of organizational instability.

PubMed

Werbart, Andrzej; Andersson, Håkan; Sandell, Rolf

2014-01-01

To explore the association between the stability or instability of services' organizational structure and patient- and therapist-initiated discontinuation of therapy in routine mental health. Three groups, comprising altogether 750 cases in routine mental health care in eight different clinics, were included: cases with patient-initiated discontinuation, therapist-initiated discontinuation, and patients remaining in treatment. Multilevel multinomial regression was used to estimate three models: An initial, unconditional intercept-only model, another one including patient variables, and a final model with significant patient and therapist variables including the organizational stability of the therapists' clinic. High between-therapist variability was noted. Odds ratios and significance tests indicated a strong association of organizational instability with patient-initiated premature termination in particular. The question of how organizational factors influence the treatment results needs further research. Future studies have to be designed in ways that permit clinically meaningful subdivision of the patients' and the therapists' decisions for premature termination.

Evaluating the Difference between Virtual and Paper-Based Clinical Cases in Family Medicine Undergraduate Education

PubMed Central

Cagran, Branka

2018-01-01

Introduction A “virtual patient” is defined as a computer program which simulates real patients' cases. The aim of this study was to determine whether the inclusion of virtual patients affects the level of factual knowledge of family medicine students at the undergraduate level. Methods This was a case-controlled prospective study. The students were randomly divided into experimental (EG: N = 51) and control (CG: N = 48) groups. The students in the EG were asked to practice diagnosis using virtual patients instead of the paper-based clinical cases which were solved by the students in the CG. The main observed variable in the study was knowledge of family medicine, determined by 50 multiple choice questions (MCQs) about knowledge of family medicine. Results There were no statistically significant differences in the groups' initial knowledge. At the final assessment of knowledge, there were no statistically significant differences between the groups, but there was a statistically significant difference between their initial and final knowledge. Conclusions The study showed that adding virtual patient cases to the curriculum, instead of paper clinical cases, did not affect the level of factual knowledge about family medicine. Virtual patients can be used, but a significant educational outcome is not expected. PMID:29568779

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.

Case Studies of UMTA Private Sector Initiative Projects in Syracuse, Central New Jersey, and Atlanta

DOT National Transportation Integrated Search

1987-12-01

This report documents the results of three grants awarded in 1983 by the Urban Mass Transportation Administration for Section 8 Private Sector Initiative projects. The grants were intended to encourage cooperative public and private planning for the ...

NUT Midline Carcinoma in Elderly Patients: Usefulness of 18F-FDG PET/CT for Treatment Assessment.

PubMed

Kawase, Takatsugu; Naka, Go; Kubota, Kazuo; Sakashita, Baku; Takeda, Yuichiro

2015-09-01

Nuclear protein in testis (NUT) midline carcinoma is a rare disease that generally arises in adolescents and young adults. However, we encountered a rare NUT midline carcinoma case in an elderly patient. F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (PET/CT) studies were performed before and during the treatment course. In this case, the initial PET/CT study revealed locoregional hypermetabolism in the mediastinal lesion. After then, the interim PET/CT study indicated a clear diminishing response to the initial treatment, whereas the residual masses were morphologically observable. Nuclear imaging may allow visualization of the therapeutic effect of antineoplastic therapies in both young and elderly patients.

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.

78 FR 58546 - State System Development Initiative (SSDI) Grant Program; Single-Case Deviation From Competition...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

... Development Initiative (SSDI) Grant Program; Single- Case Deviation From Competition Requirements AGENCY...). ACTION: Notice of Single-Case Deviation from Competition Requirements for the Maternal and Child Health (MCH) Bureau's States System Development Initiative (SSDI) Grant. SUMMARY: HRSA will be issuing a non...

Anatomy of Advocacy: A Case Study of the White House Petition

ERIC Educational Resources Information Center

Burns, Elizabeth; Kimmel, Sue; Dickinson, Gail

2016-01-01

Little research has been conducted examining advocacy efforts in the school library field despite the fact that program advocate is a prominent role for school librarians. One element of advocacy is the engagement in political initiatives that may affect school library programs. This case study investigates the effectiveness of one advocacy effort…

Theories and Applications of Massive Online Open Courses (MOOCs): The Case for Hybrid Design

ERIC Educational Resources Information Center

Anders, Abram

2015-01-01

Initial studies of learning in massive open online courses (MOOCs) primarily focused on participation patterns and participant experiences. More recently, research has addressed learning theories and offered case studies of different pedagogical designs for MOOCs. Based on a meta-analysis and synthesis of the research literature, this study…

Practices of Management Development: A Malaysian Case Study

ERIC Educational Resources Information Center

Law, Kian Aun

2008-01-01

This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

Language and Communication in the Absence of Speech: A Case Study.

ERIC Educational Resources Information Center

Rogow, Sally M.

This case study reports on the language development of a child with severe speech and multiple handicaps resulting from "severe epileptic encephalopathy" who is, however, able to competently read, write, and comprehend two languages (English and Cantonese) but does not initiate conversations. Data were gathered as a result of weekly home visits…

Factors Influencing Teachers' Technology Self-Efficacy: A Case Study

ERIC Educational Resources Information Center

Farah, Amy Caroline

2012-01-01

Factors influencing teachers' levels of technology self-efficacy were examined through a qualitative multi-site, multi-subject case study research design. An initial survey was administered to all full-time, certified teachers at three school sites in order to gauge teachers' current level of technology self-efficacy. From that…

Employment of Young Adults with Disabilities in Dubai--A Case Study

ERIC Educational Resources Information Center

Alborno, Nadera; Gaad, Eman

2012-01-01

The authors investigated the implementation of the United Arab Emirates Federal Law regarding the employment of people with disabilities. They used a case study evaluation of an employment program initiated by a private national landscaping company in Dubai providing training and employment opportunities for young adults with varied physical and…

Historic Neighborhood Schools: Success Stories. Issues and Initiatives.

ERIC Educational Resources Information Center

National Trust for Historic Preservation, Washington, DC.

This document offers 19 case studies that show how people across the United States have kept historic schools as vital parts of their communities. The case studies address the most important challenges to the continued use of historic schools as educational facilities. They offer concise summaries of information that architects, contractors, and…

Collaboration, Collegiality, and Collective Reflection: A Case Study of Professional Development for Teachers

ERIC Educational Resources Information Center

Kelly, Jennifer; Cherkowski, Sabre

2015-01-01

This case study documents and interprets teachers' experiences in a professional development initiative called Changing Results for Young Readers in British Columbia. The reflections and discussions of a group of teachers in a rural school district were examined in order to understand how the participants constructed their realities relative to…

Instituting Cultural Change at a Major Organization: A Case Study

ERIC Educational Resources Information Center

Dulek, Ronald E.

2015-01-01

This article examines the development and implementation of a strategic cultural change program from a case study perspective. Initially, the article describes how the program was developed, including an explanation as to how a communication component was integrated into the program from inception. This integration helped reduce the anxiety that…

Government Workers Adding Societal Value: The Ohio Workforce Development Program

ERIC Educational Resources Information Center

Guerra, Ingrid; Bernardez, Mariano; Jones, Michael; Zidan, Suhail

2005-01-01

This case study illustrates the application of Mega--adding measurable value for all stakeholders including society--as the central and ultimate focus for needs assessment. In this case, two needs assessment studies were conducted within a five-year period (1999-2003) with the State of Ohio's Workforce Development (WD) program. An initial needs…

A Case Study of Violence Prevention in an Elementary School

ERIC Educational Resources Information Center

Crawford, Diane Lynn

2013-01-01

This case study was initiated to explore how 6 fourth-grade student mediators implemented an inner-city elementary school's violence prevention program based on peer mediation in the context of psychosocial theory. The participants were trained in conflict resolution to intervene with disputants who experienced unresolved disagreements. To…

Adult Education in Development. Methods and Approaches from Changing Societies.

ERIC Educational Resources Information Center

McGivney, Veronica; Murray, Frances

The case studies described in this book provide examples of initiatives illustrating the role of adult education in development and its contribution to the process of change in developing countries. The book is organized in five sections. Case studies in Part 1, "Health Education," illustrate the links between primary health care and…

Answering the Call for Accountability: An Activity and Cost Analysis Case Study

ERIC Educational Resources Information Center

Carducci, Rozana; Kisker, Carrie B.; Chang, June; Schirmer, James

2007-01-01

This article summarizes the findings of a case study on the creation and application of an activity-based cost accounting model that links community college salary expenditures to mission-critical practices within academic divisions of a southern California community college. Although initially applied as a financial management tool in private…

Improving the Quality of Teaching in a State-Owned, Regional University

ERIC Educational Resources Information Center

Ballerini, Aldo A.; Albarran, Manuel I.

2013-01-01

The authors present a case study discussing student-oriented initiatives to enhance academic achievement. They focus on the academic, psychosocial and motivational weaknesses of students showing how these can be overcome with strategic projects to aid students in their first year of higher education. The case study, a multi-million US dollar…

Exploring Curricular Transformation to Promote Innovation and Entrepreneurship: An Institutional Case Study

ERIC Educational Resources Information Center

McClure, Kevin R.

2015-01-01

Colleges and universities in the United States have developed and implemented a wide array of opportunities for undergraduate students to learn about innovation and entrepreneurship. Drawing upon an institutional case study, this article examines why one public research university initiated and supported curricular and co-curricular offerings in…

Recognising and Validating Outcomes of Non-Accredited Learning: A Practical Approach.

ERIC Educational Resources Information Center

Greenwood, Maggie, Ed.; Hayes, Amanda, Ed.; Turner, Cheryl, Ed.; Vorhaus, John, Ed.

A group of adult educators in England conducted seven case studies to identify strategies for recognizing adult students' learning progress in nonaccredited programs. The case studies identified the following elements of good practice in the process of recording and validating achievement: (1) initial identification of learning objectives; (2)…

Case Study of the Triad Approach: Expedited Characterization of Petroleum Constituents and PCBs Using Test Kits and a Mobile Chromatography Laboratory at the Former Cos Cob Power Plant Site

EPA Pesticide Factsheets

The case study was developed as part of EPA's ongoing initiative to promote the use of an integrated Triad approach to limit decision uncertainty at hazardous waste sites through the use of sound science.

Scientists' attitudes on science and values: Case studies and survey methods in philosophy of science.

PubMed

Steel, Daniel; Gonnerman, Chad; O'Rourke, Michael

2017-06-01

This article examines the relevance of survey data of scientists' attitudes about science and values to case studies in philosophy of science. We describe two methodological challenges confronting such case studies: 1) small samples, and 2) potential for bias in selection, emphasis, and interpretation. Examples are given to illustrate that these challenges can arise for case studies in the science and values literature. We propose that these challenges can be mitigated through an approach in which case studies and survey methods are viewed as complementary, and use data from the Toolbox Dialogue Initiative to illustrate this claim. Copyright © 2017 Elsevier Ltd. All rights reserved.

Skid Landings of Airplanes on Rocker-Type Fuselages

NASA Technical Reports Server (NTRS)

Mayo, Wilbur L.

1961-01-01

A study is made of the landing of an airplane on a fuselage with "planned" curvature of its lower surface. Initial contact is considered to stop the vertical motion of a point remote from the center of gravity, thus causing rocking on the curved lower surface which converts sinking-speed energy into angular energy in pitch for dissipation by damping forces. Analysis is made of loads and motions for a given fuselage shape, and the contours required to give desired load histories are determined. Most of the calculations involve initial contact at the tail, but there are two cases of unflared landings with initial contact at the nose. The calculations are checked experimentally for the tail - low case.

Developing a "Semi-Systematic" Approach to Using Large-Scale Data-Sets for Small-Scale Interventions: The "Baby Matterz" Initiative as a Case Study

ERIC Educational Resources Information Center

O'Brien, Mark

2011-01-01

The appropriateness of using statistical data to inform the design of any given service development or initiative often depends upon judgements regarding scale. Large-scale data sets, perhaps national in scope, whilst potentially important in informing the design, implementation and roll-out of experimental initiatives, will often remain unused…

Suicide case with multiple injuries with sharp objects.

PubMed

Черняк, Валентина В; Девяткин, Александр Е; Мустафина, Галия М; Никифоров, Артём Г

The work of forensic - medical expert examination of the corpse at the place of its discovery and further research in the morgue often there are certain difficulties associated with the solution of a number of issues, including the establishment of a kind of death. Bringing the case demonstrates that, during the initial examination of the corpse to the place of its discovery the presence of multiple injuries on the body of a different nature, as a rule, initially suggest investigators to suspect that the murder occurred. But further questioning around him lately those studying survey data and scene study results allowed the corpse to make objective conclusions.

Proposed clinical case definition for cytomegalovirus-immune recovery retinitis.

PubMed

Ruiz-Cruz, Matilde; Alvarado-de la Barrera, Claudia; Ablanedo-Terrazas, Yuria; Reyes-Terán, Gustavo

2014-07-15

Cytomegalovirus (CMV) retinitis has been extensively described in patients with advanced or late human immunodeficiency virus (HIV) disease under ineffective treatment of opportunistic infection and antiretroviral therapy (ART) failure. However, there is limited information about patients who develop active cytomegalovirus retinitis as an immune reconstitution inflammatory syndrome (IRIS) after successful initiation of ART. Therefore, a case definition of cytomegalovirus-immune recovery retinitis (CMV-IRR) is proposed here. We reviewed medical records of 116 HIV-infected patients with CMV retinitis attending our institution during January 2003-June 2012. We retrospectively studied HIV-infected patients who had CMV retinitis on ART initiation or during the subsequent 6 months. Clinical and immunological characteristics of patients with active CMV retinitis were described. Of the 75 patients under successful ART included in the study, 20 had improvement of CMV retinitis. The remaining 55 patients experienced CMV-IRR; 35 of those developed CMV-IRR after ART initiation (unmasking CMV-IRR) and 20 experienced paradoxical clinical worsening of retinitis (paradoxical CMV-IRR). Nineteen patients with CMV-IRR had a CD4 count of ≥50 cells/µL. Six patients with CMV-IRR subsequently developed immune recovery uveitis. There is no case definition for CMV-IRR, although this condition is likely to occur after successful initiation of ART, even in patients with high CD4 T-cell counts. By consequence, we propose the case definitions for paradoxical and unmasking CMV-IRR. We recommend close follow-up of HIV-infected patients following ART initiation. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia.

PubMed

Amante, Tariku Dingeta; Ahemed, Tekabe Abdosh

2015-01-01

Unsuccessful TB treatment outcome is a serious public health concern. It is compelling to identify, and deal with factors determining unsuccessful treatment outcome. Therefore, study was aimed to determine pattern of unsuccessful TB treatment outcome and associated factors in eastern Ethiopia. A case control study was used. Cases were records of TB patients registered as defaulter, dead and/or treatment failure where as controls were those cured or treatment complete. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) at 95% CI to examine the relationship between the unsuccessful TB treatment outcome and patients' characteristics. A total of 990 sample size (330 cases and 660 controls) were included. Among cases (n = 330), majority 212(64.2%) were because of death, 100(30.3%) defaulters and 18(5.5%) were treatment failure. Lack of contact person(OR = 1.37; 95% CI 1.14-2.9, P, .024), sputum smear negative treatment category at initiation of treatment (OR = 1.8; 95% CI 1.3-5.5,P, .028), smear positive sputum test result at 2(nd) month after initiation treatment (OR = 14; 95% CI 5.5-36, P,0.001) and HIV positive status (OR = 2.5; 95% CI 1.34-5.7, P, 0.01) were independently associated with increased risk of unsuccessful TB treatment outcome. Death was the major cause of unsuccessful TB treatment outcome. TB patients do not have contact person, sputum smear negative treatment category at initiation of treatment, smear positive on 2(nd) month after treatment initiation and HIV positive were factors significantly associated unsuccessful treatment outcome. TB patients with sputum smear negative treatment category, HIV positive and smear positive on 2(nd) nd month of treatment initiation need strict follow up throughout DOTs period.

Development, Implementation, and Evaluation of a Professional Skills Development Program: The Case of Concordia University's GradProSkills

ERIC Educational Resources Information Center

Venkatesh, Vivek; Rabah, Jihan; Lamoureux-Scholes, Laurie; Pelczer, Ildiko; Urbaniak, Kathryn; Martin, Frédérica

2014-01-01

The Graduate and Professional Skills (GradProSkills) program is an initiative developed and run by Concordia University's School of Graduate Studies and the university's Office of the Vice-President, Research and Graduate Studies. This paper presents a case study in which we describe the development, implementation, and evaluative components of…

Students' Personal Mobile Devices in the Classroom: A Case Study of a BYOT District

ERIC Educational Resources Information Center

O'Sullivan-Donnell, Becca

2013-01-01

This case study explored the use of students' personal mobile devices in the classroom for learning. The context was a district with an initiative called Bring Your Own Technology (BYOT), whereby students regularly utilized their personal technology as part of the curriculum. The focus of this study was to better understand how students' personal…

New Horizons in a Next Generation School: A Case Study of Rural Alabama Middle School Students in a Transformational Initiative

ERIC Educational Resources Information Center

Lamey, Jack Harley, Sr.

2017-01-01

The purpose of this case study was to understand non-mastery for students in the mBolden Academic Model at Piedmont City Middle School (PCMS). The following research questions guided this study: How does the mBolden Academic Model influence student success at Piedmont City Middle School? Furthermore, this study has answered the following…

The Interactions between Global Education Initiatives and National Education Policy and Planning Processes: A Comparative Case Study of the Education For All Fast Track Initiative in Rwanda and Ethiopia. CREATE Pathways to Access. Research Monograph No. 67

ERIC Educational Resources Information Center

Bermingham, Desmond

2011-01-01

The Education for All Fast Track Initiative (FTI) was launched by the World Bank in 2002 as a global initiative to help low income countries accelerate progress towards the MDG target of universal primary education by 2015. Over the past decade, the FTI has expanded to become one of the most important initiatives to emerge out of the Dakar World…

Judgemental and Developmental Mentoring in Further Education Initial Teacher Education in England: Mentor and Mentee Perspectives

ERIC Educational Resources Information Center

Manning, Catherine; Hobson, Andrew J.

2017-01-01

This article presents findings from a study which sought to identify the extent to which trainee teachers and their mentors considered their mentoring experiences and approaches to be judgemental or developmental. The article draws on a case study of trainee teachers and mentors on an Initial Teacher Education programme at a further education…

Outside the Principal's Office: The Principal's Role in Implementing the Alabama Math, Science, and Technology Initiative (AMSTI)

ERIC Educational Resources Information Center

Foster, Tara M.

2013-01-01

The purpose of the study was to determine the connection between the principals' behaviors, especially their visibility, and the academic success of their schools while participating in the Alabama Math, Science, and Technology Initiative (AMSTI). The qualitative method of gathering and analyzing data was used, and the case study research design…

Faculty Social Capital at Work in a Community College Student Success and Completion Initiative

ERIC Educational Resources Information Center

Funaro, Janette

2017-01-01

The purpose of this case study was to examine the role of social capital in the enactment of a faculty-based initiative designed to improve student success and completion at one community college. The concept of social capital--or the actual and potential resources that are embedded in relationships--has been examined in research studies in many…

Influence of initial stress, irregularity and heterogeneity on Love-type wave propagation in double pre-stressed irregular layers lying over a pre-stressed half-space

NASA Astrophysics Data System (ADS)

Singh, Abhishek Kumar; Das, Amrita; Parween, Zeenat; Chattopadhyay, Amares

2015-10-01

The present paper deals with the propagation of Love-type wave in an initially stressed irregular vertically heterogeneous layer lying over an initially stressed isotropic layer and an initially stressed isotropic half-space. Two different types of irregularities, viz., rectangular and parabolic, are considered at the interface of uppermost initially stressed heterogeneous layer and intermediate initially stressed isotropic layer. Dispersion equations are obtained in closed form for both cases of irregularities, distinctly. The effect of size and shape of irregularity, horizontal compressive initial stress, horizontal tensile initial stress, heterogeneity of the uppermost layer and width ratio of the layers on phase velocity of Love-type wave are the major highlights of the study. Comparative study has been made to identify the effects of different shapes of irregularity, presence of heterogeneity and initial stresses. Numerical computations have been carried out and depicted by means of graphs for the present study.

Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

PubMed

Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

2010-05-01

This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

Biofeedback for anismus in 15 sexually abused women.

PubMed

Leroi, A M; Duval, V; Roussignol, C; Berkelmans, I; Peninque, P; Denis, P

1996-01-01

This work aimed to see whether (1) biofeedback is useful and (2) whether it needs to be combined with psychotherapy in sexually abused patients with anismus. Fifteen women aged 41.2 +/- 4.1 years who had experienced sexual abuse in childhood (9 cases) or adulthood (6 cases) and complained of symptoms of irritable bowel disease were studied. Anismus was recorded during anorectal manometry in all cases. Patients were free to choose biofeedback and/or group psychotherapy and/or individual psychotherapy. When necessary, psychoactive drugs were prescribed after a psychiatric evaluation. Initially all the patients chose biofeedback and none accepted psychotherapy. Eight patients accepted psychotherapy after several weeks of biofeedback. Thirteen patients completed the study: 5 treated by biofeedback alone, 5 with biofeedback and group therapy, and 3 with biofeedback and individual psychotherapy. Eight women recovered completely from their symptoms, only two of whom had had biofeedback without psychotherapy. Biofeedback alone was not always sufficient to cure abused patients, but was chose initially by all the patients. It could initially be a middle path between somatic treatment and psychotherapy, at a time when patients are not yet ready to undertake the latter.

Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case-control study design.

PubMed

Gebrekidan, Kahasse; Worku, Alemayehu

2017-01-01

Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country. The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia. A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case-control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation. The odds of attending ANC late were significantly higher for mothers with a monthly household income of $8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67). Low educational level, low income of the household, unplanned pregnancy, stay for <5 years in Addis Ababa, not getting advice from health extension workers or local TV/radio and higher cost associated with initiation of the first ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened.

Marginal Structural Models for Case-Cohort Study Designs to Estimate the Association of Antiretroviral Therapy Initiation With Incident AIDS or Death

PubMed Central

Cole, Stephen R.; Hudgens, Michael G.; Tien, Phyllis C.; Anastos, Kathryn; Kingsley, Lawrence; Chmiel, Joan S.; Jacobson, Lisa P.

2012-01-01

To estimate the association of antiretroviral therapy initiation with incident acquired immunodeficiency syndrome (AIDS) or death while accounting for time-varying confounding in a cost-efficient manner, the authors combined a case-cohort study design with inverse probability-weighted estimation of a marginal structural Cox proportional hazards model. A total of 950 adults who were positive for human immunodeficiency virus type 1 were followed in 2 US cohort studies between 1995 and 2007. In the full cohort, 211 AIDS cases or deaths occurred during 4,456 person-years. In an illustrative 20% random subcohort of 190 participants, 41 AIDS cases or deaths occurred during 861 person-years. Accounting for measured confounders and determinants of dropout by inverse probability weighting, the full cohort hazard ratio was 0.41 (95% confidence interval: 0.26, 0.65) and the case-cohort hazard ratio was 0.47 (95% confidence interval: 0.26, 0.83). Standard multivariable-adjusted hazard ratios were closer to the null, regardless of study design. The precision lost with the case-cohort design was modest given the cost savings. Results from Monte Carlo simulations demonstrated that the proposed approach yields approximately unbiased estimates of the hazard ratio with appropriate confidence interval coverage. Marginal structural model analysis of case-cohort study designs provides a cost-efficient design coupled with an accurate analytic method for research settings in which there is time-varying confounding. PMID:22302074

A retrospective explanatory case study of the implementation of a bleeding management quality initiative, in an Australian cardiac surgery unit.

PubMed

Pearse, Bronwyn Louise; Rickard, Claire M; Keogh, Samantha; Lin Fung, Yoke

2018-03-09

Bleeding management in cardiac surgery is challenging. Many guidelines exist to support bleeding management; however, literature demonstrates wide variation in practice. In 2012, a quality initiative was undertaken at The Prince Charles Hospital, Australia to improve bleeding management for cardiac surgery patients. The implementation of the quality initiative resulted in significant reductions in the incidence of blood transfusion, re-exploration for bleeding; superficial leg and chest wound infections; length of hospital stay, and cost. Given the success of the initiative, we sought to answer the question; "How and why was the process of implementing a bleeding management quality initiative in the cardiac surgery unit successful, and sustainable?" A retrospective explanatory case study design was chosen to explore the quality initiative. Analysis of the evidence was reviewed through phases of the 'Knowledgeto Action' planned change model. Data was derived from: (1) document analysis, (2) direct observation of the local environment, (3) clinical narratives from interviews, and analysed with a triangulation approach. The study period extended from 10/2011 to 6/2013. Results demonstrated the complexity of changing practice, as well as the significant amount of dedicated time and effort required to support individual, department and system wide change. Results suggest that while many clinicians were aware of the potential to apply improved practice, numerous barriers and challenges needed to be overcome to implement change across multiple disciplines and departments. The key successful components of the QI were revealed through the case study analysis as: (1) an appropriately skilled project manager to facilitate the implementation process; (2) tools to support changes in workflow and decision making including a bleeding management treatment algorithm with POCCTs; (3) strong clinical leadership from the multidisciplinary team and; (4) the evolution of the project manager position into a perpetual clinical position to support sustainability. Copyright © 2018 Australian College of Critical Care Nurses Ltd. All rights reserved.

Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004–2011)

PubMed Central

Moreira, António L.; Fronteira, Inês; Augusto, Gonçalo Figueiredo; Martins, Maria Rosario O.

2016-01-01

Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm3. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care. PMID:26999167

Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004-2011).

PubMed

Moreira, António L; Fronteira, Inês; Augusto, Gonçalo Figueiredo; Martins, Maria Rosario O

2016-03-15

Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm³. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care.

Carpal tunnel syndrome: Investigating the sensitivity of initial-diagnosis with electro-diagnostic tests in 600 cases and associated risk factors especially manual milking.

PubMed

Tunç, Abdulkadir; Güngen, Belma Doğan

2017-01-01

Electro-diagnostic studies are the most reliable methods in diagnosis of carpal tunnel syndrome (CTS). Although there are many risk factors associated with CTS, there are a limited number of studies in the literature indicating that manual milking, which is frequently seen in Turkey, is a risk factor for CTS. The purpose of this study was to evaluate demographic findings of cases referred due to initial diagnosis of CTS as well as aetiological data especially manual milking and to investigate the sensitivity of initial diagnosis of CTS. Six hundred patients, who were referred to our electromyography laboratory due to initial diagnosis of CTS, were included. Demographic findings, duration of complaints, existence of diabetes mellitus, and manual milking histories of all patients were recorded. Sensitivity of initial diagnosis was investigated based on electro-diagnostic test results. According to electro-diagnostic test results, 289 of the patients were diagnosed with CTS (48.17%). 110 (18.3%) of 600 patients had a history of manual milking. In 94 of this group (85.4%), CTS was detected. Statistically significant correlation was found between CTS and age, female gender, duration of complaints, obesity and manual milking. This study confirms that manual milking is an important risk factor for CTS in addition to female gender, age, symptom duration and obesity. The fact that sensitivity of initial diagnosis of CTS was found to be low according to electro-diagnostic test results indicates importance of detailed clinical evaluation.

Contribution of CT scan and CT-guided aspiration in the management of retropharyngeal abscess in children based on a series of 18 cases.

PubMed

Martin, C A; Gabrillargues, J; Louvrier, C; Saroul, N; Mom, T; Gilain, L

2014-11-01

This study was designed to analyse the contribution of CT scan to the management of retropharyngeal abscess in children and the place of CT-guided percutaneous aspiration as an alternative to surgical drainage. Retrospective study including 18 children with a mean age of 38 months [range: 5-67 months] presenting with retropharyngeal infection between 2006 and 2011. All cases were initially assessed by contrast-enhanced CT scan of the neck. Clinical, radiological treatment and bacteriological data were collected. Radiological results were correlated with surgical and percutaneous aspiration findings (presence or absence of an abscess). The initial CT scan detected 14 abscesses, 3 cases of non-suppurative lymphadenitis and one case of retropharyngeal oedema. One case of non-suppurative lymphadenitis progressed to abscess after failure of antibiotic therapy and was treated surgically. Surgical drainage revealed a purulent collection in 11 cases and no collection in 3 cases. Four CT-guided percutaneous aspirations were successfully performed. Three cases were treated by antibiotics alone (2 cases of lymphadenitis and 1 case of retropharyngeal oedema). Bacteriological examinations revealed the presence of Streptococcus pyogenes in 78.5% of cases. The positive predictive value of the initial CT scan was 78.8% in our series. Contrast-enhanced neck CT scan confirmed the diagnosis of retropharyngeal abscess and the indication for surgical drainage. It must be performed urgently, on admission. When it is decided to treat the patient with antibiotics alone, follow-up imaging should be performed in the absence of improvement 24 to 48 hours after starting antibiotics. CT-guided percutaneous aspiration is both a diagnostic modality confirming abscess formation of an inflammatory lesion of the retropharyngeal space as well as a therapeutic tool, sometimes avoiding the need for surgical drainage. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Pre-cART Elevation of CRP and CD4+ T-Cell Immune Activation Associated With HIV Clinical Progression in a Multinational Case-Cohort Study.

PubMed

Balagopal, Ashwin; Asmuth, David M; Yang, Wei-Teng; Campbell, Thomas B; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R; Lalloo, Umesh G; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B; Semba, Richard D; Thomas, David L; Bollinger, Robert C; Gupta, Amita

2015-10-01

Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore, some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. A case-cohort study (n = 470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings clinical trial (1571 HIV treatment-naive adults who initiated cART; CD4 T-cell count <300 cells/mm; 9 countries) was conducted. A subcohort of 30 participants per country was randomly selected; additional cases were added from the main cohort. Cases [n = 236 (random subcohort 36; main cohort 200)] had clinical progression (incident WHO stage 3/4 event or death) within 96 weeks after cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4 T-cell count was 167 cells per cubic millimeter. In multivariate analysis, highest quartile C-reactive protein concentration [adjusted hazard ratio (aHR), 2.53; 95% confidence interval (CI): 1.02 to 6.28] and CD4 T-cell activation (aHR, 5.18; 95% CI: 1.09 to 24.47) were associated with primary outcomes, compared with lowest quartiles. sCD14 had a trend toward association with clinical failure (aHR, 2.24; 95% CI: 0.96 to 5.21). Measuring C-reactive protein and CD4 T-cell activation may identify patients with CD4 T-cell counts <300 cells per cubic millimeter at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART.

Pre-cART Elevation of CRP and CD4+ T-cell Immune Activation Associated with HIV Clinical Progression in a Multinational Case-Cohort Study

PubMed Central

Balagopal, Ashwin; Asmuth, David M.; Yang, Wei-Teng; Campbell, Thomas B.; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R.; Lalloo, Umesh G.; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B.; Semba, Richard D.; Thomas, David L.; Bollinger, Robert C.; Gupta, Amita

2015-01-01

Background Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. Methods A case-cohort study (n=470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings (PEARLS) clinical trial (1571 HIV treatment-naïve adults who initiated cART; CD4+ T cell count <300 cells/mm3; nine countries) was conducted. A subcohort of 30 participants/country was randomly selected; additional cases were added from the main cohort. Cases (n=236 [random subcohort–36; main cohort–200]) had clinical progression (incident WHO Stage 3/4 event or death) within 96 weeks following cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Results Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4+ T-cell count was 167 cells/mm3. In multivariate analysis, highest quartile CRP concentration (adjusted hazards ratio [aHR] 2.53, 95%CI 1.02-6.28) and CD4+ T-cell activation (aHR 5.18, 95CI 1.09-24.47) were associated with primary outcomes, compared to lowest quartiles. sCD14 had a trend towards association with clinical failure (aHR 2.24, 95%CI 0.96–5.21). Conclusions Measuring CRP and CD4+ T-cell activation may identify patients with CD4+ T cell counts < 300 cells/mm3 at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART. PMID:26017661

The Florida State Initial Teacher Certification Test: A Case Study.

ERIC Educational Resources Information Center

Dorn, Charles M.

1989-01-01

Describes the development of the art certification examination which was designed for the Florida State Initial Teacher Certification Test. Discusses problems of subjectivity, content, and question format. Suggests criteria which can guide the development of viable college art education programs that can adequately prepare teachers in the areas of…

Holistic Initiatives for Enhancing Graduate Employability in Zimbabwe

ERIC Educational Resources Information Center

Garwe, Evelyn Chiyevo

2014-01-01

The objective of the study was to document initiatives for enhancing graduate employability and building successful future careers for students. The author used the case of Zimbabwe to explore interventions by higher education institutions, government, industry and commerce as well as professional bodies. The methodology involved a mix of…

Modeling a molecular initiating event to population effects: A case study of aromatase inhibition in fathead minnows

EPA Science Inventory

An adverse outcome pathway (AOP) conceptually links a molecular initiating event with measureable key events at higher levels of biological organization that ultimately result in an adverse outcome. Development of an AOP requires experimental data and scientific expertise to ide...

Sustaining Opportunity in Rural Community Colleges

ERIC Educational Resources Information Center

Torres, Vasti; Viterito, Arthur; Heeter, Aimee; Hernandez, Ebelia; Santiague, Lilia; Johnson, Susan

2013-01-01

This assessment considers the sustainability of initiatives begun as a result of participation in the Rural Community College Initiative (RCCI). Case studies were conducted at eight community colleges, and quantitative data was gathered from the U.S. Census, the Department of Labor, and the Integrated Postsecondary Education Data System (IPEDS).…

Everybody Leads: A Model for Collaborative Leadership

ERIC Educational Resources Information Center

Maxfield, C. Robert; Klocko, Barbara A.

2010-01-01

This mixed-methods case study analyzes the perceptions of participants in a year-long collaborative leadership initiative conducted at a small school district situated between larger urban districts and multiple suburban districts in a midwestern state. The initiative was facilitated by the Galileo Institute for Teacher Leadership in cooperation…

A Case Study in Applying Lean Sustainability Concepts to Universities

ERIC Educational Resources Information Center

Comm, Clare L.; Mathaisel, Dennis F. X.

2005-01-01

Purpose: To apply the concepts of lean and sustainability to higher education. Design/methodology/approach: A questionnaire was developed, administered to 18 public and private universities and analyzed. Findings: The focus in higher education is now on cost reduction or budget containment initiatives. Although these initiatives were not…

A Study of Parameters of the Counterpropagating Leader and its Influence on the Lightning Protection of Objects Using Large-Scale Laboratory Modeling

NASA Astrophysics Data System (ADS)

Syssoev, V. S.; Kostinskiy, A. Yu.; Makalskiy, L. M.; Rakov, A. V.; Andreev, M. G.; Bulatov, M. U.; Sukharevsky, D. I.; Naumova, M. U.

2014-04-01

In this work, the results of experiments on initiating the upward and descending leaders during the development of a long spark when studying lightning protection of objects with the help of large-scale models are shown. The influence of the counterpropagating leaders on the process of the lightning strike of ground-based and insulated objects is discussed. In the first case, the upward negative leader is initiated by the positive downward leader, which propagates from the high-voltage electrode of the "rod-rod"-type Marx generator (the rod is located on the plane and is 3-m high) in the gap with a length of 9-12 m. The positive-voltage pulse with a duration of 7500 μs had an amplitude of up to 3 MV. In the second case, initiation of the positive upward leader was performed in the electric field created by a cloud of negatively charged aerosol, which simulates the charged thunderstorm cell. In this case, all the phases characteristic of the ascending lightnings initiated by the tall ground-based objects and the triggered lightnings during the experiments with an actual thunderstorm cloud were observed in the forming spark discharge with a length of 1.5-2.0 m. The main parameters of the counterpropagating leader, which is initiated by the objects during the large-scale model experiments with a long spark, are shown.

A Case Study on Moving Philosophically Diverse Funders to Common Priorities. Education Funders Research Initiative

ERIC Educational Resources Information Center

Hilliard, Thomas J.

2015-01-01

Collaboration is a recurring theme among philanthropic funders and their grantees. Most funders have engaged in collaboration at some level. A few collaborations achieve outstanding success and are lionized in case studies. Others break up without conclusion or fall short of their original mission and are tactfully forgotten. One standard…

Mathematical Creativity, Cohen Forcing, and Evolving Systems: Elements for a Case Study on Paul Cohen

ERIC Educational Resources Information Center

Dickman, Benjamin

2013-01-01

The Evolving Systems approach to case studies due initially to Piaget-contemporary Howard Gruber, and complemented by subsequent work on sociocultural factors developed by Mihaly Csikszentmihalyi and others, provides an inroad for examining creative achievements in a variety of domains. This paper provides a proof of concept for how one might…

Data Networks and Sustainability Education in African Universities: A Case Study for Sub-Saharan Africa

ERIC Educational Resources Information Center

Bothun, Gregory D.

2016-01-01

Purpose: The purpose of this paper is to provide a case study report of the development of data networks and initial connectivity in the Sub-Saharan African (SSA) region and how that development evolved into the formation of research and education (R&E) networks that enable new collaborations and curriculum potential.…

Receptivity to Library Involvement in Scientific Data Curation: A Case Study at the University of Colorado Boulder

ERIC Educational Resources Information Center

Lage, Kathryn; Losoff, Barbara; Maness, Jack

2011-01-01

Increasingly libraries are expected to play a role in scientific data curation initiatives, i.e., "the management and preservation of digital data over the long-term." This case study offers a novel approach for identifying researchers who are receptive toward library involvement in data curation. The authors interviewed researchers at…

The Contributions of Digital Communications Technology to Human Rights Education: A Case Study of Amnesty International

ERIC Educational Resources Information Center

Norlander, Rebecca Joy

2013-01-01

This dissertation addresses the need for critical assessment and evaluation of human rights education (HRE) programs and activities, especially newer initiatives that incorporate the use of digital information and communications technology (ICT). It provides an in-depth case study of the use of digital ICT in Amnesty International's HRE efforts,…

Bringing the Community Along: A Case Study of a School District's Information Technology Rural Development Initiative

ERIC Educational Resources Information Center

Schafft, Kai A.; Alter, Theodore R.; Bridger, Jeffrey C.

2006-01-01

We draw on interactional community theory to analyze the relationship between information technology and local development through a case study of a geographically isolated and economically disadvantaged rural school district. This district has used state-of-the-art information technology infrastructure in a broad-based community and economic…

Globalization and Multilingualism: Case Studies of Indigenous Culture-Based Education from the Indian Sub-Continent and Their Implications

ERIC Educational Resources Information Center

Singh, Navin Kumar

2013-01-01

This paper presents some of the major program initiatives honoring Indigenous knowledge, culture, heritage, arts, and skills through curricular reforms and culturally appropriate educational practices on the Indian sub-continent. It presents case studies of Indigenous culture-based education, with reference to mother tongue and multicultural…

Initiating Differentiated Instruction in General Education Classrooms with Inclusion Learning Support Students: A Multiple Case Study

ERIC Educational Resources Information Center

Berbaum, K. A.

2009-01-01

The purpose of this multiple case study was to describe and evaluate the experience of 5 general education teachers from a northeastern urban middle school as they integrated differentiated instruction with students who have specific learning disabilities. Educators are challenged to implement instruction that engages students with specific…

Teachers' Initial Orchestration of Students' Dynamic Geometry Software Use: Consequences for Students' Opportunities to Learn Mathematics

ERIC Educational Resources Information Center

Erfjord, Ingvald

2011-01-01

This paper reports from a case study with teachers at two schools in Norway participating in developmental projects aiming for inquiry communities in mathematics teaching and learning. In the reported case study, the teachers participated in one of the developmental projects focusing on implementation and use of computer software in mathematics…

Building a Dangerous Outpost in the Green Mountain State: A Case Study of Educator Preparation Policymaking

ERIC Educational Resources Information Center

McGough, David J.; Bedell, Claudine; Tinkler, Barri

2018-01-01

Poised at a bifurcation, the educator preparation community in Vermont faced either the adoption of a generic product for the assessment of initial educator licensure candidates or the comprehensive revision of a longstanding state-based assessment portfolio. Using a case study approach and narrative methods, specifically the Narrative Policy…

Transformational Leadership & Professional Development for Digitally Rich Learning Environments: A Case Study of the Galileo Educational Network.

ERIC Educational Resources Information Center

Jacobsen, Michele; Clifford, Pat; Friesen, Sharon

The Galileo Educational Network is an innovative educational reform initiative that brings learning to learners. Expert teachers work alongside teachers and students in schools to create new images of engaged learning, technology integration and professional development. This case study is based on the nine schools involved with Galileo in…

Reviving a Community's Adult Education Past: A Case Study of the Library's Role in Learning

ERIC Educational Resources Information Center

Irving, Catherine J.

2010-01-01

Amidst calls for libraries to regain their socially progressive roots and connections to community, this study analyzes two interwoven cases of nonformal, community education in northeastern Nova Scotia, initiated by libraries that aimed to revive those links. Through a reading circle and a people's school, librarians used historical materials on…

A Historical Case Study of Dropout Recovery Programs in the State of Oklahoma

ERIC Educational Resources Information Center

Portis, Dennis L., III

2013-01-01

The purpose of this historical case study was to gain an understanding of dropout recovery programs from an interpretive historical perspective. Dropout Recovery is an Oklahoma Department of Career and Technology Education initiative that provides high school dropouts an opportunity to re-enroll in school, gain academic credit, and participate in…

Ministries of Education in Small States: Case Studies of Organization and Management.

ERIC Educational Resources Information Center

Bray, Mark, Ed.

Case studies on ministries of education were sought from states with populations under 1.5 million and displaying a wide range of economic, geographic, and cultural diversity. The introduction has six main sections: (1) information on definitions and the contents of the book; (2) an account of other Commonwealth Secretariat initiatives on…

Safer Schools in the UK--A Case Study

ERIC Educational Resources Information Center

Hayden, Carol; Holt, Amanda; Martin, Denise; Nee, Claire

2011-01-01

This article reports a research that is based on a European Safer Schools Partnership that included ten countries and specifically the UK case study which was located in London. The initiators of this partnership had been involved in early SSPs in the UK and the educationalists were very much focussed on work that would address problematic…

A Case Study of Tack Tiles[R] Literacy Instruction for a Student with Multiple Disabilities Including Congenital Blindness

ERIC Educational Resources Information Center

Klenk, Jessicia A.; Pufpaff, Lisa A.

2011-01-01

Research on literacy instruction for students with multiple disabilities is limited. Empirical research on braille instruction for students with multiple disabilities that include congenital blindness is virtually nonexistent. This case study offers initial insight into possible methods of early braille literacy instruction for a student with…

Thoracic multidisciplinary tumor board routinely impacts therapeutic plans in patients with lung and esophageal cancer: a prospective cohort study.

PubMed

Schmidt, Henner M; Roberts, John M; Bodnar, Artur M; Kunz, Sonia; Kirtland, Steven H; Koehler, Richard P; Hubka, Michal; Low, Donald E

2015-05-01

National and subspecialty guidelines for lung and esophageal cancers recommend treatment decisions to be made in a multidisciplinary tumor board (MTB). This study prospectively analyzes the actual impact of presentation at the thoracic tumor board on decision making in thoracic cancer cases. During the electronic submission process for presentation at MTB managing physicians documented their current treatment plan. The initial treatment plan was compared with the MTB final recommendation. Patient demographics, physician's proposed treatment plan, MTB recommendation, and documentation of application of MTB recommendations were prospectively recorded in an Institutional Review Board approved database. Between June 2010 and December 2012, 185 patients with esophageal and 294 patients with lung cancer were presented at the MTB. One hundred sixty-six patients were presented on more than 1 occasion, resulting in 724 assessments of 479 patients. In 48 esophageal cancer patients (26%) and 118 lung cancer patients (40%) MTB recommendations differed from the initial treatment plan. Overall, a differing MTB recommendation from the primary treatment plan occurred in 330 of 724 case presentations (46%). The MTB recommendations changed treatment plans in 40% and staging and assessment plans in 60% of patients. Follow-up in a cohort of 249 patients confirmed that MTB recommendations were followed in 97% of cases. This study validates the impact of the thoracic MTB. Recommendations will differ from the managing providers' initial plan in 26% to 40% of cases. However, MTB recommendations can be successfully initiated in the majority of patients. Complex thoracic cancer patients will benefit from multidisciplinary review and should ideally be presented at tumor board. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Manipulation of three-dimensional Richtmyer-Meshkov instability by initial interfacial principal curvatures

NASA Astrophysics Data System (ADS)

Guan, Ben; Zhai, Zhigang; Si, Ting; Lu, Xiyun; Luo, Xisheng

2017-03-01

The characteristics of three-dimensional (3D) Richtmyer-Meshkov instability (RMI) in the early stages are studied numerically. By designing 3D interfaces that initially possess various identical and opposite principal curvature combinations, the growth rate of perturbations can be effectively manipulated. The weighted essentially nonoscillatory scheme and the level set method combined with the real ghost fluid method are used to simulate the flow. The results indicate that the interface development and the shock propagation in 3D cases are much more complicated than those in 2D case, and the evolution of 3D interfaces is heavily dependent on the initial interfacial principal curvatures. The 3D structure of wave patterns induces high pressure zones in the flow field, and the pressure oscillations change the local instabilities of interfaces. In the linear stages, the perturbation growth rate follows regularity as the interfacial principal curvatures vary, which is further predicted by the stability theory of 2D and 3D interfaces. It is also found that hysteresis effects exist at the onset of the linear stages in the 3D case for the same initial perturbations as the 2D case, resulting in different evolutions of 3D RMI in the nonlinear stages.

Improving the Collection of Race, Ethnicity, and Language Data to Reduce Healthcare Disparities: A Case Study from an Academic Medical Center

PubMed Central

Lee, Wei-Chen; Veeranki, Sreenivas P.; Serag, Hani; Eschbach, Karl; Smith, Kenneth D.

2016-01-01

Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program. We also present a plan to address some of the challenges that arose during the course of the project. Our experience at an academic medical center can provide guidance about the likely challenges similar institutions may expect when they implement new initiatives to collect REAL data, particularly challenges regarding scope, personnel, and other resource needs. PMID:27843424

ICT integration in mathematics initial teacher training and its impact on visualization: the case of GeoGebra

NASA Astrophysics Data System (ADS)

Dockendorff, Monika; Solar, Horacio

2018-01-01

This case study investigates the impact of the integration of information and communications technology (ICT) in mathematics visualization skills and initial teacher education programmes. It reports on the influence GeoGebra dynamic software use has on promoting mathematical learning at secondary school and on its impact on teachers' conceptions about teaching and learning mathematics. This paper describes how GeoGebra-based dynamic applets - designed and used in an exploratory manner - promote mathematical processes such as conjectures. It also refers to the changes prospective teachers experience regarding the relevance visual dynamic representations acquire in teaching mathematics. This study observes a shift in school routines when incorporating technology into the mathematics classroom. Visualization appears as a basic competence associated to key mathematical processes. Implications of an early integration of ICT in mathematics initial teacher training and its impact on developing technological pedagogical content knowledge (TPCK) are drawn.

Mesoscale research activities with the LAMPS model

NASA Technical Reports Server (NTRS)

Kalb, M. W.

1985-01-01

Researchers achieved full implementation of the LAMPS mesoscale model on the Atmospheric Sciences Division computer and derived balanced and real wind initial states for three case studies: March 6, April 24, April 26, 1982. Numerical simulations were performed for three separate studies: (1) a satellite moisture data impact study using Vertical Atmospheric Sounder (VAS) precipitable water as a constraint on model initial state moisture analyses; (2) an evaluation of mesoscale model precipitation simulation accuracy with and without convective parameterization; and (3) the sensitivity of model precipitation to mesoscale detail of moisture and vertical motion in an initial state.

It Takes a Toll on Pre-Service Teachers and Programs: Case Studies of Teacher Candidates Who Withdrew from a Teacher Education Program

ERIC Educational Resources Information Center

Lin, Pei-Ying; Childs, Ruth A.; Zhang, Jingshun

2016-01-01

Previous studies have examined patterns of withdrawal from initial teacher education (ITE) programs and have found that pre-service teachers are more likely to withdraw if they are male or older than the typical pre-service teacher. This study presents case studies based on semi-structured interviews with older male pre-service teachers who…

Magnetoelastic shear wave propagation in pre-stressed anisotropic media under gravity

NASA Astrophysics Data System (ADS)

Kumari, Nirmala; Chattopadhyay, Amares; Singh, Abhishek K.; Sahu, Sanjeev A.

2017-03-01

The present study investigates the propagation of shear wave (horizontally polarized) in two initially stressed heterogeneous anisotropic (magnetoelastic transversely isotropic) layers in the crust overlying a transversely isotropic gravitating semi-infinite medium. Heterogeneities in both the anisotropic layers are caused due to exponential variation (case-I) and linear variation (case-II) in the elastic constants with respect to the space variable pointing positively downwards. The dispersion relations have been established in closed form using Whittaker's asymptotic expansion and were found to be in the well-agreement to the classical Love wave equations. The substantial effects of magnetoelastic coupling parameters, heterogeneity parameters, horizontal compressive initial stresses, Biot's gravity parameter, and wave number on the phase velocity of shear waves have been computed and depicted by means of a graph. As a special case, dispersion equations have been deduced when the two layers and half-space are isotropic and homogeneous. The comparative study for both cases of heterogeneity of the layers has been performed and also depicted by means of graphical illustrations.

The Impact of Interrupted Use of a Speech Generating Device on the Communication Acts of a Child with Autism Spectrum Disorder: A Case Study

ERIC Educational Resources Information Center

Neeley, Richard A.; Pulliam, Mary Hannah; Catt, Merrill; McDaniel, D. Mike

2015-01-01

This case study examined the initial and renewed impact of speech generating devices on the expressive communication behaviors of a child with autism spectrum disorder. The study spanned six years of interrupted use of two speech generating devices. The child's communication behaviors were analyzed from video recordings and included communication…

Initiation of movement and energy expenditure in children with developmental delay: a case-control study.

PubMed

Chen, Chiao-Nan Joyce; Hwang, Ai-Wen; Lin, Shang-Ying; Lin, Yu-Chieh

2014-10-01

Lower levels of physical activity in children with developmental delay (DD) usually are attributed to higher energy costs. However, there is no evidence that children with DD spend more energy on daily physical activities, such as walking. The aim of this study was to compare energy costs during walking and movement initiation times in children with DD and children with typical development (TD) and matched for age. This was a case-control study. Children who were 3 and 5 years old and had DD (n=12) or TD (n=12) participated in the study. Measurements included ranges of motion in the lower extremities, physiological costs of walking, and movement initiation times. A task designed to evaluate the initiation of movement (the "go play with the toy" task) was used to examine the reaction times for children's goal-directed walking. The physiological costs of walking were similar in the 2 groups; however, children with DD walked at a lower speed than children with TD. Importantly, children with DD took more time to initiate goal-directed walking. The nature of the study design limited causal inference from the results. Children who were 3 to 5 years old and had DD had delays in goal-directed movement that may not have been attributable to motor impairments. The findings suggest that therapists should evaluate the movement initiation ability of 3- to 5-year-old children with DD as part of the design of an overall intervention plan. © 2014 American Physical Therapy Association.

Making the case: leveraging resources toward public health system improvement in Turning Point states.

PubMed

Bekemeier, Betty; Riley, Catharine M; Padgett, Stephen M; Berkowitz, Bobbie

2007-01-01

Leveraging funds to sustain the efforts of a grant-funded initiative is often an explicit, or implicit, expectation in philanthropy. However, the magnitude of funds leveraged and the factors that facilitate success in leveraging are rarely researched. An example of one of these grant-funded initiatives is the National Turning Point Initiative. Twenty-one states received funding from The Robert Wood Johnson Foundation as part of this initiative to establish and implement strategic goals for achieving significant statewide public health system improvement through diverse, cross-sector partnerships. Leaders from 17 of these 21 states participated in a two-phased study regarding the leveraging of additional funds for their public health infrastructure improvement activities. This article reports on the second phase of the study. In this phase, key informant interviews were conducted to examine how leveraging of resources occurred as part of this large national initiative. Findings indicate that the combination of a comprehensive planning process and a broad-based partnership was crucial in securing resources to expand their efforts. The ability to strategically respond to unexpected events and opportunities also helped states use their plans and partnerships to "make the case" for additional resources to improve their public health infrastructure.

Effectiveness of Emergency Department Based Palliative Care for Adults with Advanced Disease: A Systematic Review

PubMed Central

Nunes, Cristina Moura; Gomes, Barbara

2016-01-01

Abstract Background: Emergency departments (EDs) are seeing more patients with palliative care (PC) needs, but evidence on best practice is scarce. Objectives: To examine the effectiveness of ED-based PC interventions on hospital admissions (primary outcome), length of stay (LOS), symptoms, quality of life, use of other health care services, and PC referrals for adults with advanced disease. Methods: We searched five databases until August 2014, checked reference lists/conference abstracts, and contacted experts. Eligible studies were controlled trials, pre-post studies, cohort studies, and case series reporting outcomes of ED-based PC. Results: Five studies with 4374 participants were included: three case series and two cohort studies. Interventions included a screening tool, traditional ED-PC, and integrated ED-PC. Two studies reported on hospital admissions: in one study there was no statistically significant difference in 90-day readmission rates between patients who initiated integrated PC at the ED (11/50 patients, 22%) compared to those who initiated PC after hospital admission (179/1385, 13%); another study showed a high admission rate (90%) in 14 months following ED-PC, but without comparison. One study showed an LOS reduction (mean 4.32 days in ED-initiated PC group versus 8.29 days in postadmission-initiated group; p < 0.01). There was scarce evidence on other outcomes except for conflicting findings on survival: in one study, ED-PC patients were more likely to experience an interval between ED presentation and death >9 hours (OR 2.75, 95% CI 2.21–3.41); another study showed increased mortality risk in the intervention group; and a case series described a higher in-hospital death rate when PC was ED-initiated (62%), compared to ward (16%) or ICU (50%) (unknown p-value). Conclusions: There is yet no evidence that ED-based PC affects patient outcomes except for indication from one study of no association with 90-day hospital readmission but a possible reduction in LOS if integrated PC is introduced early at ED rather than after hospital admission. There is an urgent need for trials to confirm these findings alongside other potential benefits and survival effects. PMID:27115914

Strengthening health promotion in hospitals with capacity building: a Taiwanese case study.

PubMed

Lee, Chiachi Bonnie; Chen, Michael S; Chien, Sou-Hsin; Pelikan, Jürgen M; Wang, Ying Wei; Chu, Cordia Ming-Yeuk

2015-09-01

Organizational capacity building for health promotion (HP) is beneficial to the effective implementation of HP in organizational settings. The World Health Organization (WHO) Health Promoting Hospitals' (HPHs) initiative encourages hospitals to promote the health of their stakeholders by developing organizational capacity. This study analyzes an application case of one hospital of the HPH initiative in Taiwan, characterizes actions aiming at building organizational support to strengthen health gains and identifies facilitators of and barriers to the implementation of the HP in this hospital. Case study methodology was used with a triangulation of various sources; thematic analysis was used to analyze qualitative information. This study found a positive impact of the HPH initiative on the case hospital, such as more support from leadership, a fine-tuned HP mission and strategy, cultivated pro-HP habits of physical activities, a supportive intramural structure, an HP-inclusive system, improved management practices and enhanced staff participation. Transformational and transactional enablers are of equal importance in implementing HPH. However, it was also found that the case hospital encountered more transactional barriers than transformational ones. This hospital was hindered by insufficient support from external environments, leadership with limited autonomy and authority, a preference for ideals over professionalism, insufficient participation by physicians, a lack of manpower and time, a merit system with limited stimulating effect, ineffective management practices in weak central project management, a lack of integration, insufficient communication and an inability to inculcate the staff on the importance of HP, and inadequate staff participation. Several implications for other hospitals are suggested. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Considering Students' Out-of-School Lives and Values in Designing Learning Environments for Climate Change

NASA Astrophysics Data System (ADS)

Walsh, E.; Tsurusaki, B.

2012-12-01

What are the implications of social controversy for the teaching and learning of climate change science? How do the political dimensions of this controversy affect learners' attitudes towards and reasoning about climate change and climate science? Case studies from a pilot enactment of an ecological impacts of climate change curriculum explore these questions by describing how five high school students' understandings of climate change science developed at the intersection of political and scientific values, attitudes, and ways of knowing. Case studies combine qualitative, ethnographic methods including interviews and classroom video observations with quantitative pre/post-assessments of student conceptual understandings and weekly surveys of student engagement. Data indicate that students had initial perceptions of climate change informed by the media and their families—both supporting and rejecting the scientific consensus—that influenced how they engaged with the scientific evidence. While students who were initially antagonistic to anthropogenic climate change did develop conceptual understandings of the scientific evidence for human-influences on climate change, this work was challenging and at times frustrating for them. These case studies demonstrate the wide range of initial attitudes and understandings that students bring to the study of climate change. They also demonstrate that it is possible to make significant shifts in students' understandings of climate change science, even in students who were initially resistant to the idea of anthropogenic climate change. Finally, multiple case studies discuss ways that the learning that occurred in the classroom crossed out of the classroom into the students' homes and family talk. This work highlights how learners' pathways are shaped not only by their developing understanding of the scientific evidence but also by the political and social influences that learners navigate across the contexts of their lives. It underscores the need to understand and support students as they interact with climate change across the contexts of their lives.

Faculty Roles, Responsibilities, and Involvement in Campus Safety Initiatives as Perceived by Faculty and Administrators: A Case Study at a Large State University

ERIC Educational Resources Information Center

Rollings, Meda Janeen

2010-01-01

The study addressed the problem of campus safety and the extent to which faculty and administrators are aware of institutional security policies. Further, the research compared perceptions of administrators and faculty regarding faculty awareness of and involvement in campus safety policy initiatives. The research sought to determine if the…

Constructing Departmental Culture to Support Student Development: Evidence from a Case Study in Rwanda

ERIC Educational Resources Information Center

Schendel, Rebecca

2016-01-01

In recent years, there have been numerous attempts to improve the quality of higher education in Africa, but there is limited knowledge about the impact of these initiatives on student learning. The results of a study published in 2015 offered some initial data in this regard by identifying a lack of improvement in the critical thinking ability of…

Teacher Career Advancement Initiatives: Lessons Learned from Eight Case Studies. Phase II of Creating Sustainable Teacher Career Pathways: A 21st Century Imperative

ERIC Educational Resources Information Center

Natale, Catherine Fisk; Gaddis, Lynn; Bassett, Katherine; McKnight, Katherine

2016-01-01

The purpose of this report is to describe what the authors learned from studying eight teacher career advancement initiatives implemented across a variety of contexts, including urban, suburban, and rural districts; high poverty and affluent districts; and in schools/districts both with and without strong union presence. They describe key…

The South African Tuberculosis Care Cascade: Estimated Losses and Methodological Challenges

PubMed Central

Naidoo, Pren; Theron, Grant; Rangaka, Molebogeng X; Chihota, Violet N; Vaughan, Louise; Brey, Zameer O; Pillay, Yogan

2017-01-01

Abstract Background While tuberculosis incidence and mortality are declining in South Africa, meeting the goals of the End TB Strategy requires an invigorated programmatic response informed by accurate data. Enumerating the losses at each step in the care cascade enables appropriate targeting of interventions and resources. Methods We estimated the tuberculosis burden; the number and proportion of individuals with tuberculosis who accessed tests, had tuberculosis diagnosed, initiated treatment, and successfully completed treatment for all tuberculosis cases, for those with drug-susceptible tuberculosis (including human immunodeficiency virus (HIV)–coinfected cases) and rifampicin-resistant tuberculosis. Estimates were derived from national electronic tuberculosis register data, laboratory data, and published studies. Results The overall tuberculosis burden was estimated to be 532005 cases (range, 333760–764480 cases), with successful completion of treatment in 53% of cases. Losses occurred at multiple steps: 5% at test access, 13% at diagnosis, 12% at treatment initiation, and 17% at successful treatment completion. Overall losses were similar among all drug-susceptible cases and those with HIV coinfection (54% and 52%, respectively, successfully completed treatment). Losses were substantially higher among rifampicin- resistant cases, with only 22% successfully completing treatment. Conclusion Although the vast majority of individuals with tuberculosis engaged the public health system, just over half were successfully treated. Urgent efforts are required to improve implementation of existing policies and protocols to close gaps in tuberculosis diagnosis, treatment initiation, and successful treatment completion. PMID:29117342

Selectivity in the inelastic rotational scattering of D2 and HD molecules from graphite: Similarities and differences respect to the H2 case

NASA Astrophysics Data System (ADS)

Rutigliano, Maria; Pirani, Fernando

2018-03-01

The inelastic scattering of D2 and HD molecules impinging on a graphite surface in well-defined initial roto-vibrational states has been studied by using the computational setup recently developed to characterize important selectivities in the molecular dynamics occurring at the gas-surface interface. In order to make an immediate comparison of determined elastic and inelastic scattering probabilities, we considered for D2 and HD molecules the same initial states, as well as the same collision energy range, previously selected for the investigation of H2 behaviour. The analysis of the back-scattered molecules shows that, while low-lying initial vibrational states are preserved, the medium-high initial ones give rise to final states covering the complete ladder of vibrational levels, although with different probability for the various cases investigated. Moreover, propensities in the formation of the final rotational states are found to depend strongly on the initial ones, on the collision energy, and on the isotopologue species.

Dynamics of Fermionic Impurity in One Dimension

NASA Astrophysics Data System (ADS)

Guan, Huijie; Andrei, Natan

2014-03-01

We study the dynamics of a fermionic impurity propagating in a one dimensional infinite line. The system is described by the Gaudin-Yang Model and is exactly solvable by the Nested Bethe Ansatz. Starting from a generic initial state, we obtain the time evolution of the wavefunction by the Yudson Approach in which we expand the initial state with the Nested Bethe Ansatz solutions. One situation that we are interested in is where, initially, the impurity is embedded in host fermions with a lattice configuration and one remove the periodic potential at time zero. We calculate the density profile and correlation functions at a later time. Another situation is to shoot an impurity into a cloud of fermions and calculate the probability for it to pass through. While the repulsive case has been studied already[1], we extend it to the attractive case and study the role of bound states in the evolution. We are also interested in boson impurity problem, where not only impurity interacts with host particles, all host particles interact with each other.

Gravity wave initiated convection

NASA Astrophysics Data System (ADS)

Hung, R. J.

1990-09-01

The vertical velocity of convection initiated by gravity waves was investigated. In one particular case, the convective motion-initiated and supported by the gravity wave-induced activity (excluding contributions made by other mechanisms) reached its maximum value about one hour before the production of the funnel clouds. In another case, both rawinsonde and geosynchronous satellite imagery were used to study the life cycles of severe convective storms. Cloud modelling with input sounding data and rapid-scan imagery from GOES were used to investigate storm cloud formation, development and dissipation in terms of growth and collapse of cloud tops, as well as, the life cycles of the penetration of overshooting turrets above the tropopause. The results based on these two approaches are presented and discussed.

Rapid Operational Access and Maneuver Support (ROAMS) Platform for Improved Military Logistics Lines of Communication and Operational Vessel Routing

DTIC Science & Technology

2017-06-01

case study in a northeastern American metropolitan area. METHODOLOGY : The ROAMS platform provides expanded analysis, model automation, and enhanced...shoals. An initial route for such operations is selected much like the military logistics case . Subsequent adjustments to routes may be done on an ad...IX-45 June 2017 8 CASE STUDY: The ROAMS platform was applied to a large, northeast American metropolitan region to demonstrate the capability of

Collaborating for care: initial experience of embedded case managers across five medical homes.

PubMed

Treadwell, Janet; Giardino, Angelo

2014-01-01

The purpose of this intervention was to answer the following question: Does an embedded nurse case manager from a health plan performing embedded care coordination and supporting a quality improvement project impact medical home service use, role satisfaction, and per member per month expense? The setting for this study was primary care medical home practices with a minimum of 1,000 lives, contracted with a health plan delivering Medicaid and Children's Health Insurance coverage. Five medical home practice sites were selected for the intervention. The study began with case manager training and project permission in 5 medical homes, followed by implementation of care coordination with health plan clients. The nurse case manager performed care coordination functions for clients and initiated a Lean Six Sigma quality improvement project at the medical home site. The analysis strategy was to compare each medical home with itself before and after the intervention, as well as to obtain satisfaction information from medical home staff and care coordinators. Reductions in expense, as demonstrated by decreased per member per month claim cost, admissions per thousand, and reduced variation in days per thousand, were documented. Quality projects attained significant improvements in 4 out of 5 sites, and practice staff as well as case managers described satisfaction with the embedded nurse case manager role. These findings support medical homes as being an effective delivery model of the Affordable Care Act. Case managers who practice in primary care sites can make a significant difference in patient outcomes and practice efficiencies. Embedded case managers have the ability to impact the population being served through modeling and supporting interprofessional relationships and case management expertise. Use of motivational interviewing, assessment skills, advocacy, and joint care planning engage patients in their own care, whereas quality initiatives bring efficiencies and effectiveness to overall operations. There is need for research to be conducted across a larger number of practice sites and diverse populations to substantiate the effect of embedded case management in medical home.

Preschool Children's Interpretation of Object-Initial Sentences: Neural Correlates of Their Behavioral Performance

ERIC Educational Resources Information Center

Schipke, Christine S.; Knoll, Lisa J.; Friederici, Angela D.; Oberecker, Regine

2012-01-01

The acquisition of the function of case-marking is a key step in the development of sentence processing for German-speaking children since case-marking reveals the relations between sentential arguments. In this study, we investigated the development of the processing of case-marking and argument structures in children at 3, 4;6 and 6 years of…

Upfront chemotherapy and subsequent resection for molecularly defined gliomas.

PubMed

Sasaki, Hikaru; Hirose, Yuichi; Yazaki, Takahito; Kitamura, Yohei; Katayama, Makoto; Kimura, Tokuhiro; Fujiwara, Hirokazu; Toda, Masahiro; Ohira, Takayuki; Yoshida, Kazunari

2015-08-01

Functional preservation is critical in glioma surgery, and the extent of resection influences survival outcome. Neoadjuvant chemotherapy is a promising option because of its potential to facilitate tumor shrinkage and maximum tumor resection. The object of this study was to assess the utility of the neoadjuvant strategy in a prospective series of gliomas with favorable molecular status. Twenty-six consecutive cases of diffuse gliomas of WHO grade II or III with either 1p19q codeletion or MGMT methylation were treated with upfront chemotherapy following maximal safe removal. In cases of incomplete initial surgery, second-look resection was intended after tumor volume decrease by chemotherapy. Among 22 evaluable cases, chemotherapy led to a median change in the sum of the product of perpendicular diameters of -35 %, and 14 out of the 22 cases (64 %) showed objective response. Second-look resection after tumor volume decrease was performed in 12 out of 19 cases of incomplete initial surgery (GTR/STR 9, removal of residual methionine PET uptake 3). The median progression-free survival among the 22 patients with grade II tumors was 57 months, with some cases showing durable progression-free survival after second-look resection. MIB-1 indices of the second-look resected tumors were lower than those of the initial tumors, and the methylation status of the MGMT gene was unchanged. Neoadjuvant chemotherapy based on molecular guidance often produces significant volume decrease of incompletely resected gliomas. Radical second-look resection is an optional advantage of upfront chemotherapy for chemosensitive gliomas compared with initial radiotherapy.

Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II.

PubMed

Bhatnagar, Vibha; Stoto, Michael A; Morton, Sally C; Boer, Rob; Bozzette, Samuel A

2006-05-05

Because smallpox (variola major) may be used as a biological weapon, we reviewed outbreaks in post-World War II Europe and North America in order to understand smallpox transmission patterns. A systematic review was used to identify papers from the National Library of Medicine, Embase, Biosis, Cochrane Library, Defense Technical Information Center, WorldCat, and reference lists of included publications. Two authors reviewed selected papers for smallpox outbreaks. 51 relevant outbreaks were identified from 1,389 publications. The median for the effective first generation reproduction rate (initial R) was 2 (range 0-38). The majority outbreaks were small (less than 5 cases) and contained within one generation. Outbreaks with few hospitalized patients had low initial R values (median of 1) and were prolonged if not initially recognized (median of 3 generations); outbreaks with mostly hospitalized patients had higher initial R values (median 12) and were shorter (median of 3 generations). Index cases with an atypical presentation of smallpox were less likely to have been diagnosed with smallpox; outbreaks in which the index case was not correctly diagnosed were larger (median of 27.5 cases) and longer (median of 3 generations) compared to outbreaks in which the index case was correctly diagnosed (median of 3 cases and 1 generation). Patterns of spread during Smallpox outbreaks varied with circumstances, but early detection and implementation of control measures is a most important influence on the magnitude of outbreaks. The majority of outbreaks studied in Europe and North America were controlled within a few generations if detected early.

[Invasive aspergillosis in hematooncological patients: advantages and disadvantages of various diagnostic methods, treatment options and financial costs of therapy].

PubMed

Rácil, Z; Mayer, J; Kocmanová, I; Wagnerová, B; Winterová, J; Folber, F; Lengerová, M; Moulis, M; Zácková, D; Smardová, L; Janíková, A; Navrátil, M; Dvoráková, D; Vorlícek, J

2008-02-01

Invasive aspergillosis (IA) is a leading invasive fungal infection in hematooncological patients. The aim of this study was to analyse the incidence, diagnostic procedures and treatment of IA in hematooncological department in large hospital in the Czech Republic. A retrospective analysis of medical and laboratory records from patients hospitalised in our department with proven/probable IA between January 2000 and December 2006 was performed. 52 cases of IA in 51 patients were identified (17.3% proven IA/82.7% probable IA). Number of IA cases notably increased during study period (1 case of IA in 2000 vs 21 cases of IA in 2006) and majority of them was of nosocomial origin (61.5%). Pulmonary aspergillosis was diagnosed in 46 cases (88.5%). Patients treated for acute leukemia or undergoing allogeneic stem cell transplantation represent the group at the highest risk of IA (in total 52% of cases). Fever and signs of pulmonary involvement were the most common clinical signs of infection (presented in 92.3% and 69.2 cases respectively). Conventional diagnostic methods including autopsy were able to diagnose only 15 cases of IA (28.8%). In all other cases (71.2%) the diagnosis was done by detection of galactomannan (GM) in serum. Introduction of GM monitoring enabled erlier initiation of antifungal treatment by 4 days. Initial therapy of IA led to the treatment response (partial and complete) in 18 (34.6%) of infections--the highest percentage of response has been seen in voriconazole monotherapy group (42%) and when combination of voriconazole and caspofungin has been used (83%). Salvage therapy was initiated due to the failure of initial treatment in 21 (40.3%) of cases. Patients were treated mostly with combination ofvoriconazole and caspofungin and/or monotherapy with voriconazole has been used with treatment response 55% and 50% respectively. Introduction of new antifungal drugs together with increased number of patients with IA led to the marked increase of total costs spent on treatment of IA per year--from 11,5 thousands CZK in 2000 to 6,2 millions CZK in 2006. IA is the most frequent cause of infection-related mortality in patients with haematological malignancies. Routine use of non-culture base methods in diagnosis of IA together with treatment using new, effective antifungals can improve prognosis of patients with this life threatening infection.

Greater retention in care among adolescents on antiretroviral treatment accessing "Teen Club" an adolescent-centred differentiated care model compared with standard of care: a nested case-control study at a tertiary referral hospital in Malawi.

PubMed

MacKenzie, Rachel K; van Lettow, Monique; Gondwe, Chrissie; Nyirongo, James; Singano, Victor; Banda, Victor; Thaulo, Edith; Beyene, Teferi; Agarwal, Mansi; McKenney, Allyson; Hrapcak, Susan; Garone, Daniela; Sodhi, Sumeet K; Chan, Adrienne K

2017-11-01

There are numerous barriers to the care and support of adolescents living with HIV (ALHIV) that makes this population particularly vulnerable to attrition from care, poor adherence and virological failure. In 2010, a Teen Club was established in Zomba Central Hospital (ZCH), Malawi, a tertiary referral HIV clinic. Teen Club provides ALHIV on antiretroviral treatment (ART) with dedicated clinic time, sexual and reproductive health education, peer mentorship, ART refill and support for positive living and treatment adherence. The purpose of this study was to evaluate whether attending Teen Club improves retention in ART care. We conducted a nested case-control study with stratified selection, using programmatic data from 2004 to 2015. Cases (ALHIV not retained in care) and controls (ALHIV retained in care) were matched by ART initiation age group. Patient records were reviewed retrospectively and subjects were followed starting in March 2010, the month in which Teen Club was opened. Follow-up ended at the time patients were no longer considered retained in care or on 31 December 2015. Cases and controls were drawn from a study population of 617 ALHIV. Of those, 302 (48.9%) participated in at least two Teen Club sessions. From the study population, 135 (non-retained) cases and 405 (retained) controls were selected. In multivariable analyses, Teen Club exposure, age at the time of selection and year of ART initiation were independently associated with attrition. ALHIV with no Teen Club exposure were less likely to be retained than those with Teen Club exposure (adjusted odds ratio (aOR) 0.27; 95% CI 0.16, 0.45) when adjusted for sex, ART initiation age, current age, reason for ART initiation and year of ART initiation. ALHIV in the age group 15 to 19 were more likely to have attrition from care than ALHIV in the age group 10 to 14 years of age (aOR 2.14; 95% CI 1.12, 4.11). This study contributes to the limited evidence evaluating the effectiveness of service delivery interventions to support ALHIV within healthcare settings. Prospective evaluation of the Teen Club package with higher methodological quality is required for programmes and governments in low- and middle-income settings to prioritize interventions for ALHIV and determine their cost-effectiveness. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Simple estimation of linear 1+1 D tsunami run-up

NASA Astrophysics Data System (ADS)

Fuentes, M.; Campos, J. A.; Riquelme, S.

2016-12-01

An analytical expression is derived concerning the linear run-up for any given initial wave generated over a sloping bathymetry. Due to the simplicity of the linear formulation, complex transformations are unnecessay, because the shoreline motion is directly obtained in terms of the initial wave. This analytical result not only supports maximum run-up invariance between linear and non-linear theories, but also the time evolution of shoreline motion and velocity. The results exhibit good agreement with the non-linear theory. The present formulation also allows computing the shoreline motion numerically from a customised initial waveform, including non-smooth functions. This is useful for numerical tests, laboratory experiments or realistic cases in which the initial disturbance might be retrieved from seismic data rather than using a theoretical model. It is also shown that the real case studied is consistent with the field observations.

Automating Initial Guess Generation for High Fidelity Trajectory Optimization Tools

NASA Technical Reports Server (NTRS)

Villa, Benjamin; Lantoine, Gregory; Sims, Jon; Whiffen, Gregory

2013-01-01

Many academic studies in spaceflight dynamics rely on simplified dynamical models, such as restricted three-body models or averaged forms of the equations of motion of an orbiter. In practice, the end result of these preliminary orbit studies needs to be transformed into more realistic models, in particular to generate good initial guesses for high-fidelity trajectory optimization tools like Mystic. This paper reviews and extends some of the approaches used in the literature to perform such a task, and explores the inherent trade-offs of such a transformation with a view toward automating it for the case of ballistic arcs. Sample test cases in the libration point regimes and small body orbiter transfers are presented.

A collaborative case study: The Office of Native Medicine.

PubMed

Joe, Jennie R; Young, Robert S; Moses, Jill; Knoki-Wilson, Ursula; Dennison, Johnson

2016-01-01

National concerns about reducing the persistent health disparities found among varying racial and ethnic populations have led to initiatives to improve health care delivery systems. Many of these initiatives also promote the cultural competence of health care providers as a way to meet unique patient needs that go beyond immediate health problems, and to account for other critical components of patient care, such as health literacy, health beliefs and behaviors, and cultural practices. This case study describes a patient-centered care model developed by the Chinle Comprehensive Health Care Facility on the Navajo Reservation in Arizona, a model that has added a cadre of traditional tribal practitioners as part of its hospital and other clinical service resources.

The Wisconsin Early Childhood Obesity Prevention Initiative: An Example of Statewide Collective Impact.

PubMed

Meinen, Amy; Hilgendorf, Amy; Korth, Amy L; Christens, Brian D; Breuer, Catherine; Joyner, Hilary; Polzin, Molle; Adams, Alexandra; Wolfe, Daithi; Braun, Abbe; Hoiting, Jill; Paulson, Jeanette; Cullen, Bridget; Stader, Kelli

2016-11-01

The Wisconsin Early Childhood Obesity Prevention Initiative (Initiative), established in 2007, seeks to address and prevent obesity in the early care and education system through nutrition and physical activity environmental and policy changes. The collaborative includes professionals from 3 state of Wisconsin Departments, the University of Wisconsin-Extension, the University of Wisconsin-Madison, and public health and early care and education organizations. This paper explores the efforts of the Initiative to advance our understanding of collective impact in practice and its value to health promotion efforts. Evaluators conducted a mixed methods case study to evaluate the application of collective impact principles by the Initiative. This included a survey of Initiative partners, review of archival documents, and qualitative interviews with Initiative leaders. Initiative partners noted progress in establishing the conditions for collective impact. Archival documents and interviews describe both formal and informal practices that helped set a common agenda, align and coordinate partner activities, and promote communication among Initiative leaders. Results also detail the important current and potential roles of “backbone” staff from healthTIDE to support the Initiative. Additionally, results suggest particularly challenging aspects of the Initiative’s impact model related to shared measurement and broader stakeholder communication. While the Initiative is still setting in place the conditions for collective impact, it has achieved significant policy, systems, and environment changes since its formation. Inclusion of nutrition and physical activity criteria in the state’s quality rating improvement system for child care centers is one of its outcomes. This case study offers several important insights about the application of collective impact in health promotion efforts, particularly in relation to the transition from previous collaborative activities, the value of establishing a clear common agenda among partners, the roles of backbone staff, and time and partner relationships in collective impact.

Objective quantification of perturbations produced with a piecewise PV inversion technique

NASA Astrophysics Data System (ADS)

Fita, L.; Romero, R.; Ramis, C.

2007-11-01

PV inversion techniques have been widely used in numerical studies of severe weather cases. These techniques can be applied as a way to study the sensitivity of the responsible meteorological system to changes in the initial conditions of the simulations. Dynamical effects of a collection of atmospheric features involved in the evolution of the system can be isolated. However, aspects, such as the definition of the atmospheric features or the amount of change in the initial conditions, are largely case-dependent and/or subjectively defined. An objective way to calculate the modification of the initial fields is proposed to alleviate this problem. The perturbations are quantified as the mean absolute variations of the total energy between the original and modified fields, and an unique energy variation value is fixed for all the perturbations derived from different PV anomalies. Thus, PV features of different dimensions and characteristics introduce the same net modification of the initial conditions from an energetic point of view. The devised quantification method is applied to study the high impact weather case of 9-11 November 2001 in the Western Mediterranean basin, when a deep and strong cyclone was formed. On the Balearic Islands 4 people died, and sustained winds of 30 ms-1 and precipitation higher than 200 mm/24 h were recorded. Moreover, 700 people died in Algiers during the first phase of the event. The sensitivities to perturbations in the initial conditions of a deep upper level trough, the anticyclonic system related to the North Atlantic high and the surface thermal anomaly related to the baroclinicity of the environment are determined. Results reveal a high influence of the upper level trough and the surface thermal anomaly and a minor role of the North Atlantic high during the genesis of the cyclone.

Fatal adverse drug reactions of anticancer drugs detected by all-case post-marketing surveillance in Japan.

PubMed

Mori, Jinichi; Tanimoto, Tetsuya; Miura, Yuji; Kami, Masahiro

2015-06-01

All-case post-marketing surveillance of newly approved anticancer drugs is usually conducted on all patients in Japan. The present study investigates whether all-case post-marketing surveillance identifies fatal adverse drug reactions undetected before market entry. We examined fatal adverse drug reactions identified via all-case post-marketing surveillance by reviewing the disclosed post-marketing surveillance results, and determined the time points in which the fatal adverse drug reactions were initially reported by reviewing drug labels. We additionally scanned emergency alerts on the Japanese regulatory authority website to assess the relationship between all-case post-marketing surveillance and regulatory action. Twenty-five all-case post-marketing surveillances were performed between January 1999 and December 2009. Eight all-case post-marketing surveillances with final results included information on all fatal cases. Of these, the median number of patients was 1287 (range: 106-4998), the median number of fatal adverse drug reactions was 14.5 (range: 4-23). Of the 111 fatal adverse drug reactions detected in the eight post-marketing surveillances, only 28 (25.0%) and 22 (19.6%) were described on the initial global and the initial Japanese drug label, respectively, and 58 (52.3%) fatal adverse drug reactions were first described in the all-case post-marketing surveillance reports. Despite this, the regulatory authority issued only four warning letters, and two of these were prompted by case reports from the all-case post-marketing surveillance. All-case post-marketing surveillance of newly approved anticancer drugs in Japan was useful for the rigorous compilation of non-specific adverse drug reactions, but it rarely detected clinically significant fatal adverse drug reactions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Quantifying an Integral Ecology Framework: A Case Study of the Riverina, Australia

NASA Astrophysics Data System (ADS)

Wheeler, Sarah A.; Haensch, Juliane; Edwards, Jane; Schirmer, Jackie; Zuo, Alec

2018-02-01

Communities in Australia's Murray-Darling Basin face the challenge of trying to achieve social, economic, and environmental sustainability; but experience entrenched conflict about the best way to achieve a sustainable future, especially for small rural communities. Integral ecology is a philosophical concept that seeks to address community, economic, social, and environmental sustainability simultaneously. Its inclusive processes are designed to reduce stakeholder conflict. However, to date the application of the integral ecology concept has been largely qualitative in nature. This study developed a quantitative integral ecology framework, and applied this framework to a case study of the Riverina, in the Murray-Darling Basin. Seventy-seven community-focused initiatives were assessed, ranked, and quantified. The majority of the community-focused ranked initiatives did not exhibit all aspects of integral ecology. Initiatives typically prioritized either (1) economic and community development or (2) environmental health; rarely both together. The integral ecology framework developed here enables recommendations on future community initiatives and may provide a pathway for community leaders and other policy-makers to more readily apply integral ecology objectives. Further research refining the framework's operationalization, application and implementation to a wider-scale may enhance communities' capacity to develop and grow sustainably.

Parent-Child Communication and Marijuana Initiation: Evidence Using Discrete-Time Survival Analysis

PubMed Central

Nonnemaker, James M.; Silber-Ashley, Olivia; Farrelly, Matthew C.; Dench, Daniel

2012-01-01

This study supplements existing literature on the relationship between parent-child communication and adolescent drug use by exploring whether parental and/or adolescent recall of specific drug-related conversations differentially impact youth's likelihood of initiating marijuana use. Using discrete-time survival analysis, we estimated the hazard of marijuana initiation using a logit model to obtain an estimate of the relative risk of initiation. Our results suggest that parent-child communication about drug use is either not protective (no effect) or—in the case of youth reports of communication—potentially harmful (leading to increased likelihood of marijuana initiation). PMID:22958867

How does initial treatment choice affect short-term and long-term costs for clinically localized prostate cancer?

PubMed

Snyder, Claire F; Frick, Kevin D; Blackford, Amanda L; Herbert, Robert J; Neville, Bridget A; Carducci, Michael A; Earle, Craig C

2010-12-01

Data regarding costs of prostate cancer treatment are scarce. This study investigates how initial treatment choice affects short-term and long-term costs. This retrospective, longitudinal cohort study followed prostate-cancer cases diagnosed in 2000 for 5 years using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Men age≥66 years, in Medicare fee for service, diagnosed with clinically localized prostate cancer in 2000 while residing in a SEER region, were matched to noncancer controls using age, sex, race, region, comorbidity, and survival. On the basis of treatment received during the first 9 months postdiagnosis, patients were assigned to watchful waiting, radiation, hormonal therapy, hormonal+radiation, and surgery (may have received other treatments). Incremental costs for prostate cancer were the difference in costs for prostate cancer cases versus matched controls. Costs were divided into initial treatment (months -1 to 12), long-term (each 12 months thereafter), and total (months -1 to 60). Sensitivity analyses excluded the last 12 months of life. A total of 13,769 prostate-cancer cases were matched to 13,769 noncancer controls. Watchful waiting had the lowest initial treatment ($4270) and 5-year total costs ($9130). Initial treatment costs were highest for hormonal+radiation ($17,474) and surgery ($15,197). At $26,896, 5-year total costs were highest for hormonal therapy only followed by hormonal+radiation ($25,097) and surgery ($19,214). After excluding the last 12 months of life, total costs were highest for hormonal+radiation ($23,488) and hormonal therapy ($23,199). Patterns of costs vary widely based on initial treatment. These data can inform patients and clinicians considering treatment options and policy makers interested in patterns of costs. Copyright © 2010 American Cancer Society.

The "Yes … But" Dilemma: Implementing Inclusive Education in Emirati Primary Schools

ERIC Educational Resources Information Center

Alborno, Nadera Emran

2017-01-01

The Ministry of Education (MOE) in the United Arab Emirates (UAE) launched the "School for All" inclusive education initiative in 2010. This article investigates the implementation of this initiative in three primary schools from stakeholders' perspectives. Using a multiple case study approach, data were collected over a full school year…

Technology Enhanced Learning: A Case Study of NPTEL

ERIC Educational Resources Information Center

Nitonde, Rohidas

2018-01-01

Technology Enhanced Learning (TEL) is a major 21st century trend in Higher Education. There are several government initiatives in India towards e-learning. National Programme on Technology Enhanced Learning (NPTEL) is one of the major initiatives. The present paper is an assessment of various aspects of this programme. It aims at evaluating the…

Family Literacy Legislation and Initiatives in Eleven States.

ERIC Educational Resources Information Center

Peyton, Tony

This report focuses on 11 states' efforts to develop state-funded family literacy initiatives either through legislation or other actions. An introduction defines family literacy. Part I includes in-depth case studies on seven states that have either passed or attempted to pass state family literacy legislation. For each state (Kentucky,…

The Bring Your Own Technology Initiative: An Examination of Teachers' Adoption

ERIC Educational Resources Information Center

Cardoza, Yanet; Tunks, Jeanne

2014-01-01

This case study explored teachers' concerns, use, and actual practices in their adoption of the Bring Your Own Technology (BYOT) initiative. Participants were 12 secondary teachers in a private school setting. The Concerns-Based Adoption Model tools provided data: Stages of Concern Questionnaire (SoCQ), Levels of Use interview, and the Innovation…

Beyond Backpacks and Bus Tokens: Next Steps for a District Homeless Student Initiative

ERIC Educational Resources Information Center

Hallett, Ronald E.; Low, Justin A.; Skrla, Linda

2015-01-01

How policies get translated and enacted by school districts frame how students experience reforms associated with federal law. This qualitative case study of a Northern California school district explores the importance of integrating homeless student initiatives within all aspects of the district functioning. Drawing from the equity framework of…

One Kid at a Time: Evaluative Case Studies and Description of the Alaska Youth Initiative Demonstration Project.

ERIC Educational Resources Information Center

Burchard, John D.; And Others

This monograph presents an evaluative description of the Alaska Youth Initiative (AYI), a community-based interagency program serving children and adolescents with severe emotional and behavioral disorders. Principles of the program include a no reject policy and a "wraparound" service delivery approach. The monograph offers information…

An Integrated Decision-Making Framework for Sustainability Assessment: A Case Study of Memorial University

ERIC Educational Resources Information Center

Waheed, Bushra; Khan, Faisal; Veitch, Brian; Hawboldt, Kelly

2011-01-01

This article presents an overview of the sustainability initiatives at the St. John's campus of Memorial University in Newfoundland and Labrador (Canada). The key initiatives include setting a realistic goal for energy efficiency, becoming carbon neutral, and conducting various research and outreach projects related to sustainability. As…

Restructuring Kindergarten in an Urban School District: The Case of Newark, New Jersey.

ERIC Educational Resources Information Center

Kopacsi, Rosemarie; Hochwald, Eve

A collaborative project of Bank Street College and the Newark Public Schools, the New Beginnings initiative was designed to bring about progressive restructuring of kindergarten classrooms. This study used a combination of qualitative and quantitative methods to examine the impact of the initiative on curriculum, professional development, and…

The Value of Green Technology at ABC Community College

ERIC Educational Resources Information Center

McAllister, Bernadette

2012-01-01

A challenge facing community colleges nationwide is to reduce the carbon footprint of campuses by initiating green technology initiatives. This case study assessed the effect of switching from paper assignments to a learning management system at ABC Community College. The topic is important because federal and state funding, as well as…

Virtual Virtuosos: A Case Study in Learning Music in Virtual Learning Environments in Spain

ERIC Educational Resources Information Center

Alberich-Artal, Enric; Sangra, Albert

2012-01-01

In recent years, the development of Information and Communication Technologies (ICT) has contributed to the generation of a number of interesting initiatives in the field of music education and training in virtual learning environments. However, music education initiatives employing virtual learning environments have replicated and perpetuated the…

Online Course Design in a Programmatic Framework: A Case from Social Work

ERIC Educational Resources Information Center

Stewart, Patricia Lynn

2014-01-01

The focus of this study centers on the way instructors, and more specifically, instructors within a programmatic initiative, think about teaching and the decision-making process they employ to design learning experiences for an online environment. Often administrative initiatives do not consider the unique individual instructor needs when planning…

Real Options as a Strategic Management Framework: A Case Study of the Operationally Responsive Space Initiative

DTIC Science & Technology

2007-03-01

of the project, and the Weighted Average Cost of Capital ( WACC ). WACC is defined as the after-tax marginal cost of capital (Copeland & Antikarov...Initial Investment t = Life Expectancy of Project (Start =1, to Finish=N) E(FCF) = Expected Free-Cash Flow WACC = Weighted Average Cost of

The Effects of a Midbrain Glioma on Memory and Other Functions: A Longitudinal Single Case Study

ERIC Educational Resources Information Center

Weddell, Rodger A.

2008-01-01

Our understanding of the effects of midbrain damage on cognition is largely based on animal studies, though there have been occasional investigations of the effects of human midbrain lesions on cognition. This investigation of a rare case of a glioma initially confined to the dorsal midbrain explores the effects of disease progression on IQ,…

Reflections on a Career in Second Language Studies: Promising Pathways for Future Research

ERIC Educational Resources Information Center

Cohen, Andrew D.

2018-01-01

This article highlights a series of areas deemed worthy of attention by L2 researchers. In some cases the research effort would entail following up on studies initiated some years ago and in other cases the effort would involve relatively new research thrusts. The article includes ideas about research regarding: (1) "pathways to success in…

Addressing the Local in Localization: A Case Study of Open Textbook Adoption by Three South African Teachers

ERIC Educational Resources Information Center

Jimes, Cynthia; Weiss, Shenandoah; Keep, Renae

2013-01-01

This article presents a case study of the adoption and use of open textbooks by three high school teachers in the KwaZulu-Natal province of South Africa. The textbooks, collaboratively authored and distributed through the South African initiative, Siyavula, are available online and are openly licensed, allowing teachers to freely use, modify,…

Developing Student Voice and Participatory Pedagogy: A Case Study in a Spanish Primary School

ERIC Educational Resources Information Center

Susinos, Teresa; Haya, Ignacio

2014-01-01

This article describes a case study that is part of a broader research project in which schools set up processes of school improvement inspired by the proposals put forward by students. The project furthers the initiatives of the student voice movement and seeks to implement more participative pedagogical models. This as a whole represents a novel…

What Does It Mean to Be Student Centered? An Institutional Case Study of edTPA Implementation

ERIC Educational Resources Information Center

Fayne, Harriet; Qian, Gaoyin

2016-01-01

This longitudinal case study investigated how one School of Education (SOE), situated in an urban, commuter, public university, responded to the New York State mandate to require the edTPA for initial teacher certification. In order to engage faculty in the work of program redesign, SOE administrators employed a covert leadership approach. Based…

Case Studies of Postponement in the Supply Chain

DTIC Science & Technology

2006-06-14

postponement it is still an underutilized strategy across manufacturing. Costs and benefits are sometimes hard to quantify. However, successful case studies...savings in inventory because the value of the product increases through the addition of each successive component. Manufacturing postponement usually...the instrument during the shipment process. Shortly after achieving successful packaging operations, DB initiated another post- ponement strategy in

Nurturing Creativity and Innovation through FabKids: A Case Study

ERIC Educational Resources Information Center

Beyers, Ronald Noel

2010-01-01

This paper will report on a case study that was conducted involving Grade 10 learners who were exposed to a high-tech rapid-prototyping environment of a Fabrication Laboratory as part of a FabKids experience. This project must be viewed in the context of a global shortage of key skills placing a higher priority on the initiation and development of…

Identical, Fraternal, or Separated at Birth: A Case Study of Educator Teams within American-Israeli School Twinning

ERIC Educational Resources Information Center

Chertok, Fern; Mittelberg, David; Laron, Dinah; Koren, Annette

2013-01-01

School-to-school collaboration has emerged as a key paradigm for fostering personal and institutional connections between Israeli and Diaspora youth, educators, and schools. Using the findings of a multi-year case study of a high school level twinning initiative, this article describes the challenges to this form of transnational collaboration and…

Training and Jobs Programs in Action: Case Studies in Private-Sector Initiatives for the Hard-to-Employ.

ERIC Educational Resources Information Center

Robison, David

This book contains fifty-three case studies covering a wide variety of private-sector activities and public-private partnerships designed to increase training and employment opportunities for the hard-to-employ and speed the transition of the unemployed from government support and subsidized jobs to permanent private employment. Compiled from a…

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…

A Case Study in Collaboration: Looking Back at the National Graphic Design Archive

ERIC Educational Resources Information Center

Remington, R. Roger

2004-01-01

Inspired by the 1980s interest in graphic design history, an initially productive, but difficult to sustain, collaboration among three American universities from the late 1980s to the mid-1990s, is the subject of this case study. The ideas behind a much-needed archival consortium, its organization and its difficulties in sustaining collaboration…

Marine Fisheries Case Studies. Appropriate Technologies for Development. Case Study No. 1.

ERIC Educational Resources Information Center

Chakroff, Marilyn; DuBois, Random

This guide was developed to aid Peace Corps volunteers interested in programming marine fisheries projects. Although these projects are not new to the Peace Corps, new staff members may not be aware of the history of marine fisheries efforts in their country. Chapter 1 discusses all past marine fisheries projects initiated by the Peace Corps in…

The California Conservation Corps: A Case Study. Working Paper #5. The State Youth Initiatives Project.

ERIC Educational Resources Information Center

Bailin, Michael A.

Through site visits, a case study was made of the California Conservation Corps (CCC) in order to provide a description of its history, objectives, program features, participants, funding patterns, future plans, and key issues scheduled to be addressed by the program. Descended from similar earlier programs, the CCC was established in 1976. After…

Love-type waves in functionally graded piezoelectric material (FGPM) sandwiched between initially stressed layer and elastic substrate

NASA Astrophysics Data System (ADS)

Saroj, Pradeep K.; Sahu, S. A.; Chaudhary, S.; Chattopadhyay, A.

2015-10-01

This paper investigates the propagation behavior of Love-type surface waves in three-layered composite structure with initial stress. The composite structure has been taken in such a way that a functionally graded piezoelectric material (FGPM) layer is bonded between initially stressed piezoelectric upper layer and an elastic substrate. Using the method of separation of variables, frequency equation for the considered wave has been established in the form of determinant for electrical open and short cases on free surface. The bisection method iteration technique has been used to find the roots of the dispersion relations which give the modes for electrical open and short cases. The effects of gradient variation of material constant and initial stress on the phase velocity of surface waves are discussed. Dependence of thickness on each parameter of the study has been shown explicitly. Study has been also done to show the existence of cut-off frequency. Graphical representation has been done to exhibit the findings. The obtained results are significant for the investigation and characterization of Love-type waves in FGPM-layered media.

A Descriptive Case Study of the Perceptions and Use of Adventist Edge: An Initiative Developed in Response to the North American Division of Seventh-Day Adventists' Document, "Journey to Excellence"

ERIC Educational Resources Information Center

Forbes, Pamela C.

2011-01-01

Problem. The Southern Union started the Adventist EDGE initiative as an action plan in response to the North American Division's document, "Journey to Excellence." The Adventist EDGE became a comprehensive educational reform initiative. However, there were different ideas on how the innovation should look when in action in the schools, and these…

Risk factors for treatment default in close contacts with latent tuberculous infection.

PubMed

Fiske, C T; Yan, F-X; Hirsch-Moverman, Y; Sterling, T R; Reichler, M R

2014-04-01

1) To characterize risk factors for non-completion of latent tuberculous infection treatment (LTBIT), and 2) to assess the impact of LTBIT regimens on subsequent risk of tuberculosis (TB). Close contacts of adults aged ⩾15 years with pulmonary TB were prospectively enrolled in a multi-center study in the United States and Canada from January 2002 to December 2006. Close contacts of TB patients were screened and cross-matched with TB registries to identify those who developed active TB. Of 3238 contacts screened, 1714 (53%) were diagnosed with LTBI. Preventive treatment was recommended in 1371 (80%); 1147 (84%) initiated treatment, of whom 723 (63%) completed it. In multivariate analysis, study site, initial interview sites other than a home or health care setting and isoniazid preventive treatment (IPT) were significantly associated with non-completion of LTBIT. Fourteen TB cases were identified in contacts, all of whom initiated IPT: two TB cases among persons who received ⩾6 months of IPT (66 cases/100 000 person-years [py]), and nine among those who received 0-5 months (median 2 months) of IPT (792 cases/100 000 py, P < 0.001); data on duration of IPT were not available for three cases. Only 53% (723/1371) of close contacts for whom IPT was recommended actually completed treatment. Close contacts were significantly less likely to complete LTBIT if they took IPT. Less than 6 months of IPT was associated with increased risk of active TB.

Initiation of Long-Wave Instability of Vortex Pairs at Cruise Altitudes

NASA Technical Reports Server (NTRS)

Rossow, Vernon J.

2011-01-01

Previous studies have usually attributed the initiation of the long-wave instability of a vortex pair to turbulence in the atmosphere or in the wake of the aircraft. The purpose here is to show by use of observations and photographs of condensation trails shed by aircraft at cruise altitudes that another initiating mechanism is not only possible but is usually the mechanism that initiates the long-wave instability at cruise altitudes. The alternate initiating mechanism comes about when engine thrust is robust enough to form an array of circumferential vortices around each jet-engine-exhaust stream. In those cases, initiation begins when the vortex sheet shed by the wing has rolled up into a vortex pair and descended to the vicinity of the inside bottom of the combined shear-layer vortex arrays. It is the in-and-out (up and down) velocity field between sequential circumferential vortices near the bottom of the array that then impresses disturbance waves on the lift-generated vortex pair that initiate the long-wave instability. A time adjustment to the Crow and Bate estimate for vortex linking is then derived for cases when thrust-based linking occurs.

A case study on open innovation on Procter & Gamble. Part I: Innovation strategy over years

NASA Astrophysics Data System (ADS)

Agafitei, I. G.; Avasilcai, S.

2015-11-01

The purpose of the present paper is to analyse how product innovation process has been organized by a multinational company, such as Procter & Gamble. Since open innovation is a new approach on the local market, we have chosen to conduct a research in form of a case study showing the steps that the company has taken in order to involve other organizations to contribute to the development of new products. The paper will first describe what innovation management theory is suggesting. Following this, the mission and vision of Procter & Gamble will be analysed emphasizing its innovation efforts in time. The approach that the company has nowadays, related to development of new products, has its roots in several complex initiatives in the past, initiatives that have in their central attention the customer. Finally, it provides the research limitations and implications for future analysis on the case of Procter & Gamble open innovation approach.

Effects of footwear on lead limb knee and ankle joint kinematics in a fast bowler with a history of posterior ankle joint impingement-a case report.

PubMed

Bishop, Chris; Bartold, Simon; Thewlis, Dominic

2013-11-01

This case study reports the kinematic effect of 2 different cricket shoes on a fast bowler who reports a history of posterior ankle joint impingement. The participant bowled 6 trials in 2 pairs of cricket shoes. The 3-dimensional kinematics of the joints of the front leg was quantified during stance phase of the delivery stride. Wearing the high-cut shoe resulted in the ankle being 7.7-degree angle more plantarflexed at initial contact compared with the low-cut shoe. Again, when wearing the high-cut shoe compared with the low-cut shoe, the ankle joint was 15.5-degree angle more adducted and the knee was 4.1-degree angle less externally rotated at initial contact. This case study identifies the bowler's preferred shoe (high-cut shoe) as a potential contributing factor to the symptoms he was experiencing.

Cases as Shared Inquiry: A Dialogical Model of Teacher Preparation.

ERIC Educational Resources Information Center

Harrington, Helen L.; Garrison, James W.

1992-01-01

A dialogical model is proposed for connecting theory to practice in teacher education by conceiving of cases from case-based pedagogy as problems that initiate shared inquiry. Cases with genuine cognitive and axiological content can initiate self-directed, student-centered inquiry while building democratic dialogical communities. (SLD)

75 FR 39494 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

...) and 70 FR 62061 (October 28, 2005). Guidance on methodological or analytical issues relevant to the...), we are initiating the Sunset Review of the following antidumping duty orders: DOC Case No. ITC Case... case number listed for Carboxymethylcellulose from Sweden was incorrect. The case number listed above...

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

Atmospheric chemical reactions of alternatives of polybrominated diphenyl ethers initiated by OH: A case study on triphenyl phosphate.

PubMed

Yu, Qi; Xie, Hong-Bin; Chen, Jingwen

2016-11-15

Many studies have been performed to evaluate the environmental risk caused by alternative flame retardants (AFRs) of polybrominated diphenyl ethers due to their ubiquitous occurrence in the environment. However, as an indispensable component of the environmental risk assessment, the information on atmospheric fate of AFRs is limited although some AFRs have been frequently and highly detected in the atmosphere. Here, a combined quantum chemical method and kinetics modeling were used to investigate atmospheric transformation mechanism and kinetics of AFRs initiated by OH in the presence of O2, taking triphenyl phosphate (TPhP) as a case. Results show that the pathway involving initial OH addition to phenyl of TPhP to form TPhP-OH adduct, and subsequent reaction of the TPhP-OH adduct with O2 to finally form phenol phosphate, is the most favorable for the titled reaction. The calculated overall reaction rate constant is 1.6×10(-12)cm(3) molecule(-1)s(-1), translating 7.6days atmospheric lifetime of TPhP. This clarifies that gaseous TPhP has atmospheric persistence. In addition, it was found that ice surface, as a case of ubiquitous water in the atmosphere, has little effect on the kinetics of the rate-determining step in the OH-initiated TPhP reaction. Copyright © 2016 Elsevier B.V. All rights reserved.

[Training of resident physicians in the recognition and treatment of an anaphylaxis case in pediatrics with simulation models].

PubMed

Enríquez, Diego; Lamborizio, María J; Firenze, Lorena; Jaureguizar, María de la P; Díaz Pumará, Estanislao; Szyld, Edgardo

2017-08-01

To evaluate the performance of resident physicians in diagnosing and treating a case of anaphylaxis, six months after participating in simulation training exercises. Initially, a group of pediatric residents were trained using simulation techniques in the management of critical pediatric cases. Based on their performance in this exercise, participants were assigned to one of 3 groups. At six months post-training, 4 residents were randomly chosen from each group to be re-tested, using the same performance measure as previously used. During the initial training session, 56 of 72 participants (78%) correctly identified and treated the case. Six months after the initial training, all 12 (100%) resident physicians who were re-tested successfully diagnosed and treated the simulated anaphylaxis case. The training through simulation techniques allowed correction or optimization of the treatment of simulated anaphylaxis cases in resident physicians evaluated after 6 months of the initial training.

Case management.

PubMed

Woodward, Judy; Rice, Eve

2015-03-01

Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

A Mixed Methods Case Study: Understanding the Experience of Nebraska 4-H Participants Relative to Their Transition and Adaptation to College

ERIC Educational Resources Information Center

Walahoski, Jill

2013-01-01

This mixed methods case study was designed to assess the preparedness of former Nebraska 4-H participants to successfully transition and adjust to college. The study also sought to understand the way that students' experiences in Nebraska 4-H may have influenced their readiness to transition to college. The initial quantitative stage of this case…

Effects of eddy initial conditions on nonlinear forcing of planetary scale waves by amplifying baroclinic eddies

NASA Technical Reports Server (NTRS)

Young, Richard E.

1986-01-01

The previous study of Young and Villere concerning growth of planetary scale waves forced by wave-wave interactions of amplifying intermediate scale baroclinic eddies is extended to investigate effects of different eddy initial conditions. A global, spectral, primitive equation model is used for the calculations. For every set of eddy initial conditions considered, growth rates of planetary modes are considerably greater than growth rates computed from linear instability theory for a fixed zonally independent basic state. However, values of growth rates ranged over a factor of 3 depending on the particular set of eddy initial conditions used. Nonlinear forcing of planetary modes via wave-wave coupling becomes more important than baroclinic growth on the basic state at small values of the intermediate-scale modal amplitudes. The relative importance of direct transfer of kinetic energy from intermediate scales of motion to a planetary mode, compared to baroclinic conversion of available potential energy to kinetic energy within that planetary mode, depends on the individual case. In all cases, however, the transfer of either kinetic or available potential energy to the planetary modes was accomplished principally by wave-wave transfer from intermediate scale eddies, rather than from the zonally averaged state. The zonal wavenumber 2 planetary mode was prominent in all solutions, even in those for which eddy initial conditions were such that a different planetary mode was selectively forced at the start. General characteristics of the structural evolution of the planetary wave components of total heat and momentum flux, and modal structures themselves, were relatively insensitive to variations in eddy initial conditions, even though quantitative details varied from case to case.

Pituitary gigantism: a retrospective case series.

PubMed

Creo, Ana L; Lteif, Aida N

2016-05-01

Pituitary gigantism (PG) is a rare pediatric disease with poorly defined long-term outcomes. Our aim is to describe the longitudinal clinical course in PG patients using a single-center, retrospective cohort study. Patients younger than 19 years diagnosed with PG were identified. Thirteen cases were confirmed based on histopathology of a GH secreting adenoma or hyperplasia and a height >2 SD for age and gender. Laboratory studies, initial pathology, and imaging were abstracted. Average age at diagnosis was 13 years with an average initial tumor size of 7.4×3.8 mm. Initial transsphenoidal surgery was curative in 3/12 patients. Four of the nine patients who failed the initial surgery required a repeat procedure. Octreotide successfully normalized GH levels in 1/6 patients with disease refractory to surgery (1/6). Two out of five patients received pegvisomant after failing octreotide but only one patient responded to treatment. Five patients were ultimately treated with radiosurgery or radiation patients were followed for an average of 10 years. PG is difficult to treat. In most patients, the initial transsphenoidal surgery failed to normalize GH levels. If the initial surgery was unsuccessful, repeat surgery was unlikely to control GH secretion. Treatment with octreotide or pegvisomant was successful in less than half the patients failing surgery. Radiosurgery was curative, but is not an optimal treatment for pediatric patients. Despite the small sample, our study suggests that the treatment outcome of pediatric PG may be different than adults.

PLATINO, a nine-year follow-up study of COPD in the city of São Paulo, Brazil: the problem of underdiagnosis*

PubMed Central

Moreira, Graciane Laender; Manzano, Beatriz Martins; Gazzotti, Mariana Rodrigues; Nascimento, Oliver Augusto; Perez-Padilla, Rogelio; Menezes, Ana Maria Baptista; Jardim, José Roberto

2014-01-01

OBJECTIVE: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. METHODS: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. RESULTS: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. CONCLUSIONS: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention. PMID:24626267

A Preliminary Assessment of the Change Recipients' Perceptions of the "4+4+4 Reform Initiative": Has Anything Changed?

ERIC Educational Resources Information Center

Summak, M. Semih

2016-01-01

The purpose of the present study was to assess change recipients' perceptions of 4+4+4 reform initiative put in effect in Turkish education system and to explore if anything has changed within the one-year interval. This research is a qualitative longitudinal case study conducted in 2013 and 2014 in a large city in Southeastern Turkey. Pragmatist…

Implementing a bar-coded bedside medication administration system.

PubMed

Yates, Cindy

2007-01-01

Hospitals across the nation are struggling with implementing electronic medication administration and reporting (eMAR) systems as part of patient safety programs. St Luke's Hospital in Chesterfield, Mo, initiated their eMAR initiative in June 2003, initiating program start-up in September 2004. This case study documents how the project was approached, its overall success, and what was learned along the way. Also included is a recent update highlighting the expansion of St Luke's patient safety initiative, adapting eMAR to two specialty units: dialysis and laboratory processes.

Three Cases of Teachers' Collaborative Design: Perspectives from Those Involved

ERIC Educational Resources Information Center

Preciado-Babb, Armando Paulino; Liljedahl, Peter

2012-01-01

We present the perspectives of teachers and others involved in the collaborative design of teaching and learning artifacts across three cases: (a) an independent group participating in lesson study; (b) teachers participating in professional development programs; and (c) a district initiative for producing numeracy tasks. Among the results we…

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...

Case 1; An Initial Study of Contingencies Applicable to Special Education.

ERIC Educational Resources Information Center

Cohen, Harold C.; And Others

The first CASE (Contingencies Applicable to Special Education) project, conducted from February to October 1965 with student inmates at the National Training School for Boys (NTSB), used environmental planning concepts and behavioral learning principles to restructure a basic education curriculum in terms of individual performance requirements,…

Case Study: Severe Self-Injurious Behavior in Comorbid Tourette's Disorder and OCD

ERIC Educational Resources Information Center

Hood, Korey K.; Baptista-Neto, Lourival; Beasley, Pamela J.; Lobis, Robert; Pravdova, Iva

2004-01-01

This case report describes the successful treatment of severe self-injurious behavior in a 16-year-old adolescent with Tourette's disorder and obsessive-compulsive disorder. Treatment is described from initial presentation to the emergency department for severe self-inflicted oral lacerations through discharge from the inpatient psychiatric…

Building Perinatal Case Manager Capacity Using Quality Improvement.

PubMed

Fitzgerald, Elaine

2015-01-01

Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum.

The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules.

PubMed

Khalid, Ayesha N; Hollenbeak, Christopher S; Quraishi, Sadeq A; Fan, Chris Y; Stack, Brendan C

2006-03-01

To compare the cost-effectiveness of fine-needle aspiration biopsy, iodine 131 scintigraphy, and ultrasonography for the initial diagnostic workup of a solitary palpable thyroid nodule. A deterministic cost-effectiveness analysis was conducted using a decision tree to model the diagnostic strategies. A single, mid-Atlantic academic medical center. Expected costs, expected number of cases correctly diagnosed, and incremental cost per additional case correctly diagnosed. Relative to the routine use of fine-needle aspiration biopsy, the incremental cost per case correctly diagnosed is 24,554 dollars for the iodine 131 scintigraphy strategy and 1212 dollars for the ultrasound strategy. A diagnostic strategy using initial fine-needle aspiration biopsy for palpable thyroid nodules was found to be cost-effective compared with the other approaches as long as a payor's willingness to pay for an additional correct diagnosis is less than 1212 dollars. Prospective studies are needed to validate these finding in clinical practice.

Incompressible limit of the degenerate quantum compressible Navier-Stokes equations with general initial data

NASA Astrophysics Data System (ADS)

Kwon, Young-Sam; Li, Fucai

2018-03-01

In this paper we study the incompressible limit of the degenerate quantum compressible Navier-Stokes equations in a periodic domain T3 and the whole space R3 with general initial data. In the periodic case, by applying the refined relative entropy method and carrying out the detailed analysis on the oscillations of velocity, we prove rigorously that the gradient part of the weak solutions (velocity) of the degenerate quantum compressible Navier-Stokes equations converge to the strong solution of the incompressible Navier-Stokes equations. Our results improve considerably the ones obtained by Yang, Ju and Yang [25] where only the well-prepared initial data case is considered. While for the whole space case, thanks to the Strichartz's estimates of linear wave equations, we can obtain the convergence of the weak solutions of the degenerate quantum compressible Navier-Stokes equations to the strong solution of the incompressible Navier-Stokes/Euler equations with a linear damping term. Moreover, the convergence rates are also given.

Beacon Communities’ Public Health Initiatives: A Case Study Analysis

PubMed Central

Massoudi, Barbara L.; Marcial, Laura H.; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

Introduction: The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. Background: The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Methods: Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Findings: Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7–14) present for each Beacon compared to barriers (range = 4–6). Discussion: Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. Conclusions: A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach to evaluation at the beginning of implementation made the work more effective. Supporting evaluation to inform future implementations is important. PMID:25848620

Elder Physical Abuse and Failure to Report Cases: Similarities and Differences in Case Type and the Justice System's Response

ERIC Educational Resources Information Center

Payne, Brian K.

2013-01-01

Treated initially as a social problem, elder abuse has only recently been criminalized. The criminalization of elder abuse involves penalizing offenders for actively abusing offenders as well as for violating mandatory reporting laws. Mandatory reporting laws exist to encourage professionals to report suspected cases of elder abuse. In this study,…

Longitudinal survey of the distribution of various serotypes of Streptococcus mutans in infants.

PubMed

Masuda, N; Tsutsumi, N; Sobue, S; Hamada, S

1979-10-01

The establishment of various serotypes of Streptococcus mutans was studied serologically in plaque samples collected from label surfaces of upper primary incisors of 22 infants (starting age, 5 to 13 months) over a period fo 30 months. Clinical examinations were also performed. No clear-cut association between the initiation of dental caries and previous detection of S. mutans was noted. However, all 12 of the infants with caries had S. mutans isolated at some time during the course of this study. The most common serotype isolated at the initial establishment of S. mutans on the tooth surfaces was serotype c, whereas types d, e, and g became established in a few cases. During the test period, changes in the distribution of serotypes of S. mutans were observed in some cases. The initiation of carious lesions could be found in a few cases even when S. mutans comprised about 1% or less of the total streptococcal count of the specimen from the tooth surfaces. Serotype d/g strains tended to develop carious lesions on smooth surfaces, although serotype c was isolated from almost all individuals who developed caries.

[Dissociative disorders and affective disorders].

PubMed

Montant, J; Adida, M; Belzeaux, R; Cermolacce, M; Pringuey, D; Da Fonseca, D; Azorin, J-M

2014-12-01

The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

On non-coplanar Hohmann transfer using angles as parameters

NASA Astrophysics Data System (ADS)

Rincón, Ángel; Rojo, Patricio; Lacruz, Elvis; Abellán, Gabriel; Díaz, Sttiwuer

2015-09-01

We study a more complex case of Hohmann orbital transfer of a satellite by considering non-coplanar and elliptical orbits, instead of planar and circular orbits. We use as parameter the angle between the initial and transference planes that minimizes the energy, and therefore the fuel of a satellite, through the application of two non-tangential impulses for all possible cases. We found an analytical expression that minimizes the energy for each configuration. Some reasonable physical constraints are used: we apply impulses at perigee or apogee of the orbit, we consider the duration of the impulse to be short compared to the duration of the trip, we take the nodal line of three orbits to be coincident and the three semimajor axes to lie in the same plane. We study the only four possible cases but assuming non-coplanar elliptic orbits. In addition, we validate our method through a numerical solution obtained by using some of the actual orbital elements of Sputnik I and Vanguard I satellites. For these orbits, we found that the most fuel-efficient transfer is obtained by applying the initial impulse at apocenter and keeping the transfer orbit aligned with the initial orbit.

Supervised classification in the presence of misclassified training data: a Monte Carlo simulation study in the three group case.

PubMed

Bolin, Jocelyn Holden; Finch, W Holmes

2014-01-01

Statistical classification of phenomena into observed groups is very common in the social and behavioral sciences. Statistical classification methods, however, are affected by the characteristics of the data under study. Statistical classification can be further complicated by initial misclassification of the observed groups. The purpose of this study is to investigate the impact of initial training data misclassification on several statistical classification and data mining techniques. Misclassification conditions in the three group case will be simulated and results will be presented in terms of overall as well as subgroup classification accuracy. Results show decreased classification accuracy as sample size, group separation and group size ratio decrease and as misclassification percentage increases with random forests demonstrating the highest accuracy across conditions.

Poliomyelitis case confirmation: characteristics for use by national eradication programmes.

PubMed Central

Biellik, R. J.; Bueno, H.; Olive, J. M.; de Quadros, C.

1992-01-01

Highly sensitive case definitions were first introduced by national poliomyelitis eradication programmes to avoid missing true cases of the disease, though false-positive diagnostic errors could still occur owing to low specificity. Extensive data from all 1620 cases of acute, flaccid paralysis reported in Brazil during 1987-88 provided an opportunity to study the characteristics of confirmed poliomyelitis cases and epidemiologically to evaluate potential case definitions that maximized both sensitivity and specificity. Cases that had been confirmed by wild poliomyelitis virus isolation were compared with those that had been rejected (non-polio cases). To guarantee the consistency of clinical, epidemiological and laboratory investigations, only cases less than 10 years of age that had been investigated within 15 days of the onset and with complete laboratory specimens were included. No single practical case definition combining both high sensitivity and high specificity emerged from the study. However, the results showed that poliomyelitis endemic countries with limited resources should give priority to the investigation of cases in less than 5-year-olds, cases with prodromal fever, cases without involvement in all four limbs, cases without progression greater than 3 days after the onset, and cases occurring in areas where poliomyelitis had recently been confirmed. In countries without laboratory resources, cases of acute, flaccid paralysis with initial involvement in one or both lower limbs and residual neurological sequelae at 60 days should be confirmed. Countries that are close to eradication may selectively reject any cases lacking laboratory confirmation, despite adequate specimen collection, if they do not have initial involvement in one or both lower limbs and residual neurological sequelae at 60 days. PMID:1314710

Rapid on-site defibrillation versus community program.

PubMed

Fedoruk, J C; Paterson, D; Hlynka, M; Fung, K Y; Gobet, Michael; Currie, Wayne

2002-01-01

For patients who suffer out-of-hospital cardiac arrest, the time from collapse to initial defibrillation is the single most important factor that affects survival to hospital discharge. The purpose of this study was to compare the survival rates of cardiac arrest victims within an institution that has a rapid defibrillation program with those of its own urban community, tiered EMS system. A logistic regression analysis of a retrospective data series (n = 23) and comparative analysis to a second retrospective data series (n = 724) were gathered for the study period September 1994 to September 1999. The first data series included all persons at Casino Windsor who suffered a cardiac arrest. Data collected included: age, gender, death/survival (neurologically intact discharge), presenting rhythm (ventricular fibrillation (VF), ventricular tachycardia (VT), or other), time of collapse, time to arrival of security personnel, time to initiation of cardiopulmonary resuscitation (CPR) prior to defibrillation (when applicable), time to arrival of staff nurse, time to initial defibrillation, and time to return of spontaneous circulation (if any). Significantly, all arrests within this series were witnessed by the surveillance camera systems, allowing time of collapse to be accurately determined rather than estimated. These data were compared to those of similar events, times, and intervals for all patients in the greater Windsor area who suffered cardiac arrest. This second series was based upon the Ontario Prehospital Advanced Life Support (OPALS) Study database, as coordinated by the Clinical Epidemiology Unit of the Ottawa Hospital, University of Ottawa. The Casino Windsor had 23 cases of cardiac arrests. Of the cases, 13 (56.5%) were male and 10 (43.5%) were female. All cases (100%) were witnessed. The average of the ages was 61.1 years, of the time to initial defibrillation was 7.7 minutes, and of the time for EMS to reach the patient was 13.3 minutes. The presenting rhythm was VF/VT in 91% of the case. Fifteen patients were discharged alive from hospital for a 65% survival rate. The Greater Windsor Study area included 668 cases of out-of-hospital cardiac arrest: Of these, 410 (61.4%) were male and 258 (38.6%) were female, 365 (54.6%) were witnessed, and 303 (45.4%) were not witnessed. The initial rhythm was VF/VT was in 34.3%. Thirty-seven (5.5%) were discharged alive from the hospital. This study provides further evidence that PAD Programs may enhance cardiac arrest survival rates and should be considered for any venue with large numbers of adults as well as areas with difficult medical access.

Recurrent Miller Fisher syndrome.

PubMed

Madhavan, S; Geetha; Bhargavan, P V

2004-07-01

Miller Fisher syndrome (MFS) is a variant of Guillan Barre syndrome characterized by the triad of ophthalmoplegia, ataxia and areflexia. Recurrences are exceptional with Miller Fisher syndrome. We are reporting a case with two episodes of MFS within two years. Initially he presented with partial ophthalmoplegia, ataxia. Second episode was characterized by full-blown presentation characterized by ataxia, areflexia and ophthalmoplegia. CSF analysis was typical during both episodes. Nerve conduction velocity study was fairly within normal limits. MRI of brain was within normal limits. He responded to symptomatic measures initially, then to steroids in the second episode. We are reporting the case due to its rarity.

Pigmented extramammary Paget’s disease of the axilla mimicking melanoma: case report and review of the literature

PubMed Central

Hilliard, Nicholaus J; Huang, Conway; Andea, Aleodor

2010-01-01

Pigmented Paget’s disease is a rare variant which is often confused clinically and histologically with melanoma in situ. Herein, we describe a case of pigmented extramammary Paget’s disease involving the axilla of a 79 year old white male thought initially to represent malignant melanoma clinically and histologically. Review of the literature reveals that pigmented variant of Paget’s disease, either mammary or extramammary, could be initially misdiagnosed as melanoma unless this entity is considered in the differential diagnosis and additional confirmatory studies are performed. PMID:19674203

Emergence of power-law scalings in shock-driven mixing transition

NASA Astrophysics Data System (ADS)

Vorobieff, Peter; Wayne, Patrick; Olmstead, Dell; Simons, Dylan; Truman, C. Randall; Kumar, Sanjay

2016-11-01

We present an experimental study of transition to turbulence due to shock-driven instability evolving on an initially cylindrical, diffuse density interface between air and a mixture of sulfur hexafluoride (SF6) and acetone. The plane of the shock is at an initial angle θ with the axis of the heavy-gas cylinder. We present the cases of planar normal (θ = 0) and oblique (θ =20°) shock interaction with the initial conditions. Flow is visualized in two perpendicular planes with planar laser-induced fluorescence (PLIF) triggered in acetone with a pulsed ultraviolet laser. Statistics of the flow are characterized in terms of the second-order structure function of the PLIF intensity. As instabilities in the flow evolve, the structure functions begin to develop power-law scalings, at late times manifesting over a range of scales spanning more than two orders of magnitude. We discuss the effects of the initial conditions on the emergence of these scalings, comparing the fully three-dimensional case (oblique shock interaction) with the quasi-two-dimensional case (planar normal shock interaction). We also discuss the flow anisotropy apparent in statistical differences in data from the two visualization planes. This work is funded by NNSA Grant DE-NA0002913.

Global Magnetospheric Evolution Effected by Sudden Ring Current Injection

NASA Astrophysics Data System (ADS)

Park, Geunseok; No, Jincheol; Kim, Kap-Sung; Choe, Gwangson; Lee, Junggi

2016-04-01

The dynamical evolution of the Earth's magnetosphere loaded with a transiently enhanced ring current is investigated by global magnetohydrodynamic simulations. Two cases with different values of the primitive ring current are considered. In one case, the initial ring current is strong enough to create a magnetic island in the magnetosphere. The magnetic island readily reconnects with the earth-connected ambient field and is destroyed as the system approaches a steady equilibrium. In the other case, the initial ring current is not so strong, and the initial magnetic field configuration bears no magnetic island, but features a wake of bent field lines, which is smoothed out through the relaxing evolution of the magnetosphere. The relaxation time of the magnetosphere is found to be about five to six minutes, over which the ring current is reduced to about a quarter of its initial value. Before reaching a quasi-steady state, the magnetosphere is found to undergo an overshooting expansion and a subsequent contraction. Fast and slow magnetosonic waves are identified to play an important role in the relaxation toward equilibrium. Our study suggests that a sudden injection of the ring current can generate an appreciable global pulsation of the magnetosphere.

Global Evolution of the Earth's Magnetosphere in Response to a Sudden Ring Current Injection

NASA Astrophysics Data System (ADS)

No, Jincheol; Choe, Gwangson; Park, Geunseok

2014-05-01

The dynamical evolution of the Earth's magnetosphere loaded with a transiently enhanced ring current is investigated by global magnetohydrodynamic simulations. Two cases with different values of the primitive ring current are considered. In one case, the initial ring current is strong enough to create a magnetic island in the magnetosphere. The magnetic island readily reconnects with the earth-connected ambient field and is destroyed as the system approaches a steady equilibrium. In the other case, the initial ring current is not so strong, and the initial magnetic field configuration bears no magnetic island, but features a wake of bent field lines, which is smoothed out through the relaxing evolution of the magnetosphere. The relaxation time of the magnetosphere is found to be about five to six minutes, over which the ring current is reduced to about a quarter of its initial value. Before reaching a steady state, the magnetosphere is found to undergo an overshooting expansion and a subsequent contraction. Fast and slow magnetosonic waves are identified to play an important role in the relaxation toward equilibrium. Our study suggests that a sudden injection of the ring current can generate an appreciable global pulsation of the magnetosphere.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis.

PubMed

Romero-Brito, Tania P; Buckley, Ralf C; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis

PubMed Central

Romero-Brito, Tania P.; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes. PMID:27893800

Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports

PubMed Central

Ramírez, J.; Bostock, I. C.; Martin-Onraët, A.; Calleja, S.; Sánchez-Cedillo, A.; Navarro-Vargas, L. A.; Noriega-Salas, A. L.; Martínez-Mijangos, O.; Uribe-Uribe, N. O.; Vilatoba, M.; Gabilondo, B.; Morales-Buenrostro, L. E.; Alberú, J.

2013-01-01

We report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal transplantation. A graft biopsy, analyzed with immunohistochemistry, yielded negative results. However, the diagnosis was confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. The immunosuppression dose was reduced, and ribavirin treatment was started, for which the patient quickly developed toxicity. Antiviral treatment allowed for transient response; however, a relapse occurred. The viral real-time PCR became negative upon immunosuppression reduction and administration of IVIG; graft function normalized. In the second case, the patient presented with fever and dysuria 1 month after transplantation. The initial imaging studies revealed graft enlargement and areas of hypoperfusion. In this case, the diagnosis was also confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. Adenoviral nephritis was confirmed through a graft biopsy analyzed with light microscopy, immunohistochemistry, and PCR in frozen tissue. The immunosuppression dose was reduced, and IVIG was administered obtaining excellent clinical results along with a negative real-time PCR. PMID:24558620

Institutionalizing Blended Learning into Joint Training: A Case Study and Ten Recommendations

DTIC Science & Technology

2014-12-01

mail.mil pbockelman@mesh.dsci.com ABSTRACT In 2011, the Joint Staff J7 (Joint Training) directorate initiated the Continuum of eLearning project in...Orlando, FL. 14. ABSTRACT In 2011, the Joint Staff J7 (Joint Training) directorate initiated the Continuum of eLearning project in order to integrate...dispersed organizations still poses significant challenges. The Joint Staff J7, Deputy Director for Joint Training initiated the Continuum of eLearning

Disease spread across multiple scales in a spatial hierarchy: effect of host spatial structure and of inoculum quantity and distribution.

PubMed

Gosme, Marie; Lucas, Philippe

2009-07-01

Spatial patterns of both the host and the disease influence disease spread and crop losses. Therefore, the manipulation of these patterns might help improve control strategies. Considering disease spread across multiple scales in a spatial hierarchy allows one to capture important features of epidemics developing in space without using explicitly spatialized variables. Thus, if the system under study is composed of roots, plants, and planting hills, the effect of host spatial pattern can be studied by varying the number of plants per planting hill. A simulation model based on hierarchy theory was used to simulate the effects of large versus small planting hills, low versus high level of initial infections, and aggregated versus uniform distribution of initial infections. The results showed that aggregating the initially infected plants always resulted in slower epidemics than spreading out the initial infections uniformly. Simulation results also showed that, in most cases, disease epidemics were slower in the case of large host aggregates (100 plants/hill) than with smaller aggregates (25 plants/hill), except when the initially infected plants were both numerous and spread out uniformly. The optimal strategy for disease control depends on several factors, including initial conditions. More importantly, the model offers a framework to account for the interplay between the spatial characteristics of the system, rates of infection, and aggregation of the disease.

The Garment Industry Development Corporation: A Case Study of a Sectoral Employment Development Approach. Sectoral Employment Development Learning Project Case Studies Series.

ERIC Educational Resources Information Center

Conway, Maureen

The Garment Industry Development Corporation (GIDC) was founded in 1984 by a 3-member partnership that included the local union, industry associations, and local government. GIDC's goal was to support New York City's garment industry, which had been steadily losing jobs. GIDC exhibits the following characteristics of sectoral initiatives: it…

They Give Us Homework! Transition to Higher Education: The Case of Initial Teacher Training

ERIC Educational Resources Information Center

Murtagh, Lisa

2010-01-01

This article examines some issues surrounding transition to higher education. It is based on the case study of a cohort of Year 1 students in a modern university in England. The purpose of the study was to ascertain any potential transitional issues and therefore any areas for development in our Year 1 programmes to aid student progress. Data were…

Life on a Tricycle: A Case Study of Language Impairment from 4 to 19

ERIC Educational Resources Information Center

Brinton, Bonnie; Fujiki, Martin; Robinson, Lee A.

2005-01-01

This article presents a longitudinal case study of a child named Cody identified with specific language impairment. Cody was followed from 4 to 19 years of age, at which time he compared his social skills with those of peers: "It's like they're driving sports car and I'm on a tricycle." His initial long- and short-term intervention goals are…

Making Sense in the City: Dolly Parton, Early Reading and Educational Policy-Making

ERIC Educational Resources Information Center

Hall, Christine; Jones, Susan

2016-01-01

In this paper, we present a case study of a philanthropic literacy initiative, Dolly Parton's Imagination Library, a book-gifting scheme for under 5s, and consider the impact of the scheme on literacy policy in the English city where it was introduced. We bring four lenses to bear on the case study. First, we analyse the operation of the scheme in…

Generating Academic Urgency through Improved Classroom Management: A Case Study of a University and Urban Charter High School Partnership

ERIC Educational Resources Information Center

Morales, Erik E.

2017-01-01

This case study documents a university and secondary school partnership designed to improve classroom management and student time on task at an urban charter high school. The initiative utilized the expertise and knowledge of college of education faculty to identify and ameliorate the high school's observed barriers to students' time on task, and…

A Case Study of Environmental, Health and Safety Issues Involving the Burlington, Massachusetts Public School System. "Tips, Suggestions, and Resources for Investigating and Resolving EHS Issues in Schools."

ERIC Educational Resources Information Center

Dresser, Todd H.

An investigation was initiated concerning the environmental health within the Burlington, Massachusetts public school system to determine what specific environmental hazards were present and determine ways of eliminating them. This report presents 20 case studies that detail the environmental health issues involved, the approaches taken in…

Rural Community Action: A Series of Case Studies of Action Projects in Small New York State Communities. Miscellaneous Bulletin 116.

ERIC Educational Resources Information Center

Preston, James C.; Halton, Katherine B.

The report presents case studies of 7 community action projects which were undertaken by New York communities with populations under 10,000 and which show how local leaders can improve the quality of life in their communities. The report describes the background, initiation, expansion, implementation, consequences, and highlights of the projects,…

Attention Interchanges at Story-Time: A Case Study from a Deaf and Hearing Twin Pair Acquiring Swedish Sign Language in Their Deaf Family

ERIC Educational Resources Information Center

Cramer-Wolrath, Emelie

2012-01-01

This case study longitudinally analyzes and describes the changes of attentional expressions in interchanges between a pair of fraternal twins, 1 deaf and 1 hearing, from the age of 10-40 months, and their Deaf family members. The video-observed attentional expressions of initiating and reestablishing interchange were grouped in 5 functional…

English Teachers in the Digital Age--A Case Study of Policy and Expert Practice from England

ERIC Educational Resources Information Center

Goodwyn, Andy

2011-01-01

This article is a case study of how English teachers in England have coped with the paradigm shift from print to digital literacy. It reviews a large scale national initiative that was intended to upskill all teachers, considers its weak impact and explores the author's involvement in the evaluation of the project's direct value to English…

Older Sibling Support of Younger Siblings' Socio-Emotional Development: A Multiple-Case Study of Second-Generation Mexican and Honduran Children's Initiative and Co-Construction

ERIC Educational Resources Information Center

Palacios, Natalia; Kibler, Amanda K.; Yoder, Michelle; Baird, Ashley Simpson; Bergey, Rebecca

2016-01-01

Siblings play a critical role in the socialization experiences of their younger siblings. Societal values, standards, and customs are transmitted and created through the process of modeling and the construction of shared meaning. It follows, therefore, that the process of socialization may be culturally dependent. Using multiple case studies of…

The Use of First and Second Languages in Primary Education: Selected Case Studies. World Bank Staff Working Paper No. 504.

ERIC Educational Resources Information Center

Dutcher, Nadine

This paper discusses the question of whether, in a multilingual society, the child's first or second language is best as a language of instruction in primary school. Reviewing eight case studies from seven countries in which initial primary schooling was given either in the second or first language, the discussion compares achievement in reading…

Student-Issued One-to-One Laptop Computers on Secondary Campuses in Four Texas School Districts: A Phenomenological Case Study

ERIC Educational Resources Information Center

Hoyer, Randall J.

2011-01-01

The purpose of this phenomenological case study was to investigate the impact of one-to-one student issued laptop computers on secondary campuses in four rural Texas school districts. Data were collected using focus groups which included 27 leaders in four rural Texas school districts that had implemented the one-to-one laptop initiative. The…

Comparison of the initial development of shear layers in two-dimensional and axisymmetric ejector configurations

NASA Technical Reports Server (NTRS)

Dufflocq, M.; Benjamin, M. A.; Roan, V. P.

1993-01-01

A two-phase experimental investigation designed to study the development of shear layers in axisymmetric and two-dimensional single-nozzle ejectors has been completed. In this study, combinations of similar and dissimilar gases were used as the supersonic primary and subsonic secondary. Test cases included combinations of air/air, argon/air and helium/air as the supersonic primary and subsonic secondary, respectively. Similar flow conditions were studied for each ejector configuration. Mixing of the gases occurred in a constant-area tube, where the inlet pressure was maintained at 34.5 kPa. The cases studied resulted in convective Mach numbers that range between 0.06 and 1.9. The data gathered shows differences between the initial shear-layer development for the two ejector geometries, and also between the different test cases studied for each ejector configuration. The measured growth rates for the axisymmetric ejector are more than twice those measured for the two-dimensional ejector. However, in both cases the results show that compressibility has a reducing effect on the growth rate. Further, in the region immediately after the inlet to the mixing tube, compressibility seems to affect the ejector shear layers in a manner similar to that of two-stream two-dimensional mixing layers.

The South African Tuberculosis Care Cascade: Estimated Losses and Methodological Challenges.

PubMed

Naidoo, Pren; Theron, Grant; Rangaka, Molebogeng X; Chihota, Violet N; Vaughan, Louise; Brey, Zameer O; Pillay, Yogan

2017-11-06

While tuberculosis incidence and mortality are declining in South Africa, meeting the goals of the End TB Strategy requires an invigorated programmatic response informed by accurate data. Enumerating the losses at each step in the care cascade enables appropriate targeting of interventions and resources. We estimated the tuberculosis burden; the number and proportion of individuals with tuberculosis who accessed tests, had tuberculosis diagnosed, initiated treatment, and successfully completed treatment for all tuberculosis cases, for those with drug-susceptible tuberculosis (including human immunodeficiency virus (HIV)-coinfected cases) and rifampicin-resistant tuberculosis. Estimates were derived from national electronic tuberculosis register data, laboratory data, and published studies. The overall tuberculosis burden was estimated to be 532005 cases (range, 333760-764480 cases), with successful completion of treatment in 53% of cases. Losses occurred at multiple steps: 5% at test access, 13% at diagnosis, 12% at treatment initiation, and 17% at successful treatment completion. Overall losses were similar among all drug-susceptible cases and those with HIV coinfection (54% and 52%, respectively, successfully completed treatment). Losses were substantially higher among rifampicin- resistant cases, with only 22% successfully completing treatment. Although the vast majority of individuals with tuberculosis engaged the public health system, just over half were successfully treated. Urgent efforts are required to improve implementation of existing policies and protocols to close gaps in tuberculosis diagnosis, treatment initiation, and successful treatment completion. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Massachusetts Expanded Learning Time (ELT) Initiative. Case Studies 2010-2011

ERIC Educational Resources Information Center

Caven, Meghan; Checkoway, Amy; Fisman, Lianne; Gamse, Beth; Fountain, Alyssa Rulf

2012-01-01

The Massachusetts Expanded Learning Time (ELT) initiative was launched in 2005, and it provides grants to selected schools across multiple districts to increase instructional time by at least 300 hours per academic year. Participating schools receive an additional $1,300 per student to lengthen the day and/or year. Schools are expected to use the…

Quality Service in the International Hotel Sector: A Catalyst for Strategic Human Resource Development?

ERIC Educational Resources Information Center

Maxwell, Gill; Watson, Sandra; Quail, Samantha

2004-01-01

This paper analyses the nature of, and relationship between, a quality service initiative and the concept of strategic human resource development. Hilton International is the case study used for this analysis. The principal finding is that the quality initiative is acting as a catalyst for a strategic approach to human resource development to…

Framing Vision: An Examination of Framing, Sensegiving, and Sensemaking during a Change Initiative

ERIC Educational Resources Information Center

Hamilton, William

2016-01-01

The purpose of this short article is to review the findings from an instrumental case study that examines how a college president used what this article refers to as "frame alignment processes" to mobilize internal and external support for a college initiative--one that achieved success under the current president. Specifically, I…

Geography Teachers' Interpretation of a Curriculum Reform Initiative: The Case of the Lesotho Environmental Education Support Project (LEESP)

ERIC Educational Resources Information Center

Raselimo, Mohaeka; Wilmot, Di

2013-01-01

This article addresses how teachers in a specific developing world context interpreted a curriculum reform initiative. It is located within a broader interpretive study that investigated the integration of Environmental Education into the formal education system of Lesotho with particular reference to secondary school geography. More specifically…

Defying Borders: Transforming Learning Through Collaborative Feminist Organizing and Interdisciplinary, Transnational Pedagogy

ERIC Educational Resources Information Center

Carney, T.; Geertsema-Sligh, M.; Savage, A.; Sluis, A.

2012-01-01

The authors provide a case study of how a group of faculty members was able to initiate transformation in student learning and institutional structures at a small university in the Midwestern U.S. through the introduction of collaborative feminist organizing and pedagogy. It details faculty-led initiatives that set the stage for innovative…

Exploring the Evidence: Initiatives in the First College Year. The First-Year Experience Monograph Series No. 49

ERIC Educational Resources Information Center

Troxel, Wendy G., Ed.; Cutright, Marc, Ed.

2008-01-01

For more than 25 years, educators have developed and institutionalized efforts to help first-year students succeed. This monograph collects case studies from 22 institutions that have created programs and initiatives to support their first-year students. The programs range from encouraging civic engagement and academic achievements to…

Practices and Strategies of Self-Initiated Language Learning in an Online Social Network Discussion Forum: A Descriptive Case Study

ERIC Educational Resources Information Center

Hsieh, Hsiu-Wei

2012-01-01

The proliferation of information and communication technologies and the prevalence of online social networks have facilitated the opportunities for informal learning of foreign languages. However, little educational research has been conducted on how individuals utilize those social networks to take part in self-initiated language learning without…

Developing Interview Skills and Visual Literacy: A New Model of Engagement for Academic Libraries

ERIC Educational Resources Information Center

Denda, Kayo

2015-01-01

This case study presents a cocurricular initiative at the Margery Somers Foster Center at Rutgers University Libraries in New Brunswick, NJ. The initiative resulted in an interview workshop for the course Knowledge and Power, a "mission course" of the Douglass Residential College. This discussion-based workshop uses visual and multimedia…

Promoting University Students' Engagement in Learning through Instructor-Initiated EFL Writing Groups

ERIC Educational Resources Information Center

Mutwarasibo, Faustin

2014-01-01

This article examines how to promote university students' engagement in learning by means of instructor-initiated English as a foreign language (EFL) writing groups. The research took place in Rwanda and was undertaken as a case study involving 34 second-year undergraduate students, divided into 12 small working groups, and one instructor. The…

Ten Tonne Plan: Education for Sustainability from a Whole Systems Thinking Perspective

ERIC Educational Resources Information Center

Lewis, Elaine; Mansfield, Caroline; Baudains, Catherine

2014-01-01

The "Ten Tonne Plan" is a greenhouse gas emissions reduction initiative that aimed to reduce school emissions by 10 tonnes (metric tons) in one year. A case study was conducted on the impact of this initiative at a primary school in Western Australia. Research investigated student, staff, parent, and community partner perceptions…

Sustaining Youth Participation in a Long-Term Tobacco Control Initiative: Consideration of a Social Justice Perspective

ERIC Educational Resources Information Center

Ross, Laurie

2011-01-01

This article presents an in-depth case study of the Healthy Options for Prevention and Education Coalition's Teens Tackle Tobacco initiative, a 3-year community-based participatory research (CBPR) project about the distribution of tobacco vendors and tobacco advertising in Worcester, Massachusetts. Using two theoretical frameworks, positive youth…

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…

Gaining Insights from a Case Study of High School Student Performance in Dual-Credit College Chemistry Courses

ERIC Educational Resources Information Center

White, Jacob; Hopkins, Robert; Shockley, Denise

2014-01-01

This report describes student performance in a state-level initiative that provided first-year college coursework in chemistry to high school students. Upon successful completion of the coursework, students received both high school and college credit. In this initiative, high school teachers team taught college-level chemistry courses in…

Undertaking an Institutional "Stock-Take" of SoTL: New Zealand University Case Studies

ERIC Educational Resources Information Center

Haigh, Neil; Gossman, Peter; Jiao, Xiaomin

2011-01-01

A working group was established at AUT University in 2005 with a brief to identify initiatives that might be taken to promote and support staff engagement in the Scholarship of Teaching and Learning (SoTL). The working group recognized that a "stock-taking" exercise would need to be undertaken before appropriate initiatives could be…

Implementation as a Focus of Consultation to Evaluate Academic Tutoring Services in an Urban School District: A Case Study Example

ERIC Educational Resources Information Center

Morrison, Julie Q.; English, Sarah Baker

2012-01-01

This article describes a multiagency initiative to evaluate academic tutoring services by focusing on the processes that contribute to effective program implementation. Community-based tutoring service providers serving students in the Cincinnati Public Schools (OH) partnered to initiate a "Seal of Approval" process for promoting…

The Logistics of Implementing a Field-Based Comprehensive School Reform Initiative

ERIC Educational Resources Information Center

Reeves, Dawn E.

2014-01-01

This research is a qualitative, reflective case study regarding a cohort in the form of a district-university partnership between the Oak Park Schools in Oak Park, Michigan and the College of Education at Western Michigan University in Kalamazoo, Michigan. The initiators of the program envisioned a more successful urban school district by offering…

Frameworks for Change: Four Recurrent Themes for Quality in Early Childhood Curriculum Initiatives

ERIC Educational Resources Information Center

Burgess, Jennifer; Fleet, Alma

2009-01-01

This paper reports on the first phase of a case study that investigated how early childhood teachers experience organisational change. As one of three levels of quality improvement, State government-funded curriculum initiatives were developed with an aim to promote change. Three curriculum documents, one each focusing on literacy, pedagogy and…

Gender, Gender Identity, Rape Myth Acceptance, and Time of Initial Resistance on the Perception of Acquaintance Rape Blame and Avoidability.

ERIC Educational Resources Information Center

Kopper, Beverly A.

1996-01-01

Investigated the role of gender, gender role identity, rape myth acceptance, and initial resistance in assigning blame in the case of acquaintance rape, and studied the perceived avoidability of the assault for 355 female and 179 male college students. The gender differences in responses are discussed. (SLD)

A Case Study of Common Core Implementation in a Linked Learning Environment

ERIC Educational Resources Information Center

Biolchino, Erin Broun

2016-01-01

California is in the midst of significant educational reform initiatives, especially at the secondary level. The Common Core State Standards (CCSS) were adopted in 2010, and these new standards contain significant changes in the areas of math, English, and literacy across all subjects. Many districts are also implementing new initiatives to engage…

Translation Sociology and Social Capital in Rural Development Initiatives. A Case Study from the Italian Alps

ERIC Educational Resources Information Center

Magnani, Natalia; Struffi, Lauro

2009-01-01

This article analyses the results of a European "research and demonstration" project promoting multifunctional and sustainable agriculture in Alpine regions through a participatory approach. It focuses in particular on initiatives undertaken by a local farmers group in the Italian Alpine area of Val di Sole, the purpose being to draw…

Conservative Treatment of Subacute Proximal Hamstring Tendinopathy Using Eccentric Exercises Performed With a Treadmill: A Case Report

PubMed Central

CUSHMAN, DANIEL; RHO, MONICA E.

2015-01-01

STUDY DESIGN Case report. BACKGROUND Proximal hamstring tendinopathy in runners is characterized by pain with passive hip flexion with the knee extended, active hip extension, and pain with sitting. Relatively little literature exists on the condition, and publications on nonsurgical treatment protocols are even more scarce. Surgical intervention, which comprises the majority of literature for treatment of this condition, is an option for cases that fail to respond to nonsurgical treatment. CASE DESCRIPTION The patient was a 34-year-old, otherwise healthy male triathlete with unilateral proximal hamstring tendinopathy diagnosed by ultrasound, who had pain only with running and prolonged sitting. After he failed to respond to 4 weeks of eccentric knee flexion and lumbopelvic musculature strengthening exercises, an eccentric hip extensor strengthening program using a treadmill was initiated. This treadmill exercise was performed on a daily basis, in addition to a lumbopelvic musculature strengthening program. OUTCOMES The patient noted a decrease in pain within 2 weeks of initiating the new exercise, and was able to return to gradual running after 4 weeks and to speed training after 12 weeks. He returned to competition shortly thereafter and had no recurrence for 12 months after the initiation of therapy. His score on the Victorian Institute of Sport Assessment-proximal hamstring tendons improved from 23 on initial presentation to 83 at 12 weeks after the initiation of therapy. DISCUSSION We described the management of a triathlete with subacute proximal hamstring tendinopathy, who responded well to nonsurgical treatment using eccentric hip extension strengthening using a treadmill. LEVEL OF EVIDENCE Therapy, level 4. PMID:25996362

MIS Case Study: I-94 Rehabilitation Project - Detroit, Michigan.

DOT National Transportation Integrated Search

1997-01-01

ISTEA includes specific requirements for inclusion in studies of Major Investment Projects in Metropolitan Planning Areas. The State of Michigan initiated a Major Investment Study (MIS) in October 1994 for the redesign and reconstruction of a 7 mile ...

Logistic regression trees for initial selection of interesting loci in case-control studies

PubMed Central

Nickolov, Radoslav Z; Milanov, Valentin B

2007-01-01

Modern genetic epidemiology faces the challenge of dealing with hundreds of thousands of genetic markers. The selection of a small initial subset of interesting markers for further investigation can greatly facilitate genetic studies. In this contribution we suggest the use of a logistic regression tree algorithm known as logistic tree with unbiased selection. Using the simulated data provided for Genetic Analysis Workshop 15, we show how this algorithm, with incorporation of multifactor dimensionality reduction method, can reduce an initial large pool of markers to a small set that includes the interesting markers with high probability. PMID:18466557

A Multicenter Real-Life Study on the Effect of Flash Glucose Monitoring on Glycemic Control in Patients with Type 1 and Type 2 Diabetes.

PubMed

Anjana, Ranjit Mohan; Kesavadev, Jothydev; Neeta, Deshpande; Tiwaskar, Mangesh; Pradeepa, Rajendra; Jebarani, Saravanan; Thangamani, Suresh; Sastry, Nadiminty Ganapathi; Brijendra Kumar, Srivastava; Ramu, Muthu; Gupta, Pokal Prasanna Kumar; Vignesh, Jayaprakash; Chandru, Sundramoorthy; Kayalvizhi, Sengottuvel; Jagdish, Padoor Sethuraman; Uthra, Subash Chandra Bose; Lovelena, Munawar; Jyoti, Sah; Suguna Priya, Sengodan; Kannan, Alagarsamy; Mohan, Viswanathan; Unnikrishnan, Ranjit

2017-09-01

To assess the efficacy of ambulatory glucose profiling (AGP) generated by FreeStyle LibrePro ™ flash glucose monitoring (FCGM) on glycemic control in patients with uncontrolled type 1 diabetes (T1D) and type 2 diabetes (T2D). Clinical and biochemical data were obtained from 5072 patients with diabetes who had an A1c ≥7% (2536 who had been initiated on FCGM-based AGP between March 2015 and October 2016 [cases] and 2536 age-, gender-, A1c-, site- and time-matched controls who were not initiated on AGP) across seven diabetes clinics in India. Anthropometric and clinical measurements were obtained through standardized techniques. Fasting and postprandial plasma glucose and glycated hemoglobin(A1c) were estimated before and after initiation of AGP. Overall, there was a significant decrease in A1c both in cases and controls; however, the magnitude of reduction was higher among cases (1% vs.0.7%; P < 0.001).The overall reduction in A1c among cases was higher in T2D (9.2% to 8.3%) compared with T1D (9.6% to 9.4%); however, the absolute difference in A1c reduction between cases and controls was higher among T1D (0.5% vs. 0.2%) patients. The reduction in glycemic parameters was irrespective of age or gender (P for trend <0.001) across all study sites. The greatest reductions in A1c were noted within 6 months of AGP initiation. Multiple logistic regression showed that those who did not use AGP had a 1.42 higher risk (95% CI: 1.24-1.64) of not achieving even 0.1% reduction in A1c compared with those who were initiated on AGP even after adjusting for age, gender, body-mass index, systolic blood pressure, time to follow-up A1c, and medication use. This study shows that FCGM-based AGP with FreeStyle LibrePro is associated with significant reductions in A1c levels in both T1D and T2D. In addition, improvement in A1c levels was maintained across all age groups and in patients enrolled at different diabetes clinics in India.

Categorizing accident sequences in the external radiotherapy for risk analysis

PubMed Central

2013-01-01

Purpose This study identifies accident sequences from the past accidents in order to help the risk analysis application to the external radiotherapy. Materials and Methods This study reviews 59 accidental cases in two retrospective safety analyses that have collected the incidents in the external radiotherapy extensively. Two accident analysis reports that accumulated past incidents are investigated to identify accident sequences including initiating events, failure of safety measures, and consequences. This study classifies the accidents by the treatments stages and sources of errors for initiating events, types of failures in the safety measures, and types of undesirable consequences and the number of affected patients. Then, the accident sequences are grouped into several categories on the basis of similarity of progression. As a result, these cases can be categorized into 14 groups of accident sequence. Results The result indicates that risk analysis needs to pay attention to not only the planning stage, but also the calibration stage that is committed prior to the main treatment process. It also shows that human error is the largest contributor to initiating events as well as to the failure of safety measures. This study also illustrates an event tree analysis for an accident sequence initiated in the calibration. Conclusion This study is expected to provide sights into the accident sequences for the prospective risk analysis through the review of experiences. PMID:23865005

Parent-child communication and marijuana initiation: evidence using discrete-time survival analysis.

PubMed

Nonnemaker, James M; Silber-Ashley, Olivia; Farrelly, Matthew C; Dench, Daniel

2012-12-01

This study supplements existing literature on the relationship between parent-child communication and adolescent drug use by exploring whether parental and/or adolescent recall of specific drug-related conversations differentially impact youth's likelihood of initiating marijuana use. Using discrete-time survival analysis, we estimated the hazard of marijuana initiation using a logit model to obtain an estimate of the relative risk of initiation. Our results suggest that parent-child communication about drug use is either not protective (no effect) or - in the case of youth reports of communication - potentially harmful (leading to increased likelihood of marijuana initiation). Copyright © 2012 Elsevier Ltd. All rights reserved.

Building Perinatal Case Manager Capacity Using Quality Improvement

PubMed Central

Fitzgerald, Elaine

2015-01-01

ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

Long-term survival in acute leukemia in Japan. A study of 304 cases.

PubMed

Kawashima, K; Suzuki, H; Yamada, K; Kato, Y; Watanabe, E; Morishima, Y; Takeyama, H; Kobayashi, M

1980-04-15

In a national survey of five-year survivors with acute leukemia, 233 of 304 cases were children under 14 years of age and 71 were adults. There were 107 myeloblastic, 10 promyelocytic, 142 lymphocytic, and 37 undifferentiated leukemias, Forty-five cases at age 3 represented the peak. These long-term survivors have shown a yearly increase in number. In 1972, the number of childhood ALL cases reached 38 with no great changes in ANLL cases. With respect to prognosis among long-term survivors, it seemed that neither type of leukemia nor age at diagnosis were factors influencing the future survival. CNS relapse occurring before the third year was an unfavorable complication for a prognosis beyond five years. Only 8 patients died of leukemia among 155 patients who reached five years in their initial complete remission; 49 of 90 patients who had relapse within five years after diagnosis died of leukemia. From these findings, it seems very important to follow patients for five years in their initial complete remission.

Baseline Serum Estradiol and Fracture Reduction During Treatment With Hormone Therapy: The Women’s Health Initiative Randomized Trial

PubMed Central

Cauley, Jane A.; LaCroix, Andrea Z.; Robbins, John A.; Larson, Joseph; Wallace, Robert; Wactawski-Wende, Jean; Chen, Zhao; Bauer, Douglas C.; Cummings, Steven R.; Jackson, Rebecca

2009-01-01

Purpose To test the hypothesis that the reduction in fractures with hormone therapy (HT) is greater in women with lower estradiol levels. Methods We conducted a nested case-control study within the Women’s Health Initiative HT Trials. The sample included 231 hip fracture case-control pairs and a random sample of 519 all fracture case-control pairs. Cases and controls were matched for age, ethnicity, randomization date, fracture history and hysterectomy status. Hormones were measured prior to randomization. Incident cases of fracture identified over an average follow-up of 6.53 years. Results There was no evidence that the effect of HT on fracture differed by baseline estradiol (E2) or sex hormone binding globulin (SHBG). Across all quartiles of E2 and SHBG, women randomized to HT had about a 50% lower risk of fracture including hip fracture, compared to placebo. Conclusion The effect of HT on fracture reduction is independent of estradiol and SHBG levels. PMID:19436934

Estimating the extent of household contact misclassification with index cases of disease in longitudinal studies using a stochastic simulation model.

PubMed

Chirwa, Tobias; Floyd, Sian; Fine, Paul

2013-01-24

Household contact with an index case of an infectious disease is a known risk factor for infection transmission. However, such contact may be underestimated due to the dynamic nature of households, particularly in longitudinal studies. Such studies generally begin with contact defined at a single point in time ('snap-shot'), leading to contact misclassification for some individuals who actually experienced contact before and after the snapshot. To quantify contact misclassification with index cases of disease in households. Historical data of 112,026 individuals from 17,889 households from an epidemiological study on leprosy in northern Malawi were used. Individuals were interviewed in the early 1980s and followed up over 5 years. It was possible to trace whether individuals died, changed household within the area, or moved out of the area between the two surveys.Using a 10% sample of households as the starting population and parameters for demographic and household changes over 5 years, the extent of contact misclassification was estimated through a simulation model of household dynamics, which traced contact with index cases in households over time. The model thereafter compared initial contact status and 'true' contact status generated from simulations. The starting population had 11,401 individuals, 52% female, and 224 (2%) leprosy index cases. Eleven percent of the households had at least one index case resident and 10% (1, 177) of non-case individuals were initial contacts. Sensitivity of initial contact status ranged from 0.52 to 0.74 and varied by age and sex. Sensitivity was low in those aged 20-29 and under 5 years but high in 5- to 14-year-olds. By gender, there were no differences among those aged under 5; females had lower sensitivity among those aged under 20 and higher for those above 30, respectively. Sensitivity was also low in simulations of long incubation periods. This work demonstrates the implications of changes in households on household contact-associated disease spread, particularly for long durations of follow-up and infections with long incubation periods where earlier unobserved contact is critical.

[Cytopathologic features of childhood acute leukemia at the Hospital de Especialidades Pediátricas, Chiapas, Mexico].

PubMed

Lepe-Zúñiga, José Luis; Jerónimo-López, Francisco Javier; Hernández-Orantes, Jorge Gregorio

Childhood acute leukemia cytological features are unknown in Chiapas, Mexico. Defining these features is important because this is a relatively isolated population with high consanguinity index, and these aspects could determine differences in responses to treatment and outcome. Eighty-one childhood acute leukemia cases treated at the Hospital de Especialidades Pediátricas in Chiapas were characterized by morphology, immunophenotype, genotype, initial risk assignment and status at the time of the study. The proportion of leukemic cell types found in this study was B cell, 75.3%; myeloid, 16%; T cell, 3.7% and NK 1.2%. In B cell leukemia, genetic alterations were present in 40.6% of cases and had a specific outcome regardless of initial risk assessment. Cases with MLL gene alteration died within a month from diagnosis. Translocations were present in 17.5% B cases; t(1;19) was present in those with a favorable outcome. The t(12;21) translocation was related to initial remission and midterm relapse and dead. Hyperdiploidy was present in 20% of B cell cases with good outcome. In 38.5%of myeloid cases were translocations and karyotypic abnormalities. Short-term outcome in this group has been poor; 69% have died or abandoned treatment in relapse from 15 days to 37 months after diagnosis. Relative frequency of different types of acute leukemia in patients treated at a tertiary level pediatric hospital in Chiapas, Mexico, was similar to the one found in other parts of the country. Patients' outcome, under a standardized treatment, differs according to the group, the subgroup and the presence and type of genetic alterations. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

PubMed

Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

2017-04-01

Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Pelvic Actinomycosis

PubMed Central

García-García, Alejandra; Ramírez-Durán, Ninfa; Sandoval-Trujillo, Horacio

2017-01-01

Introduction Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD), final and initial diagnosis, and method of diagnosis. Results 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment. PMID:28684963

The impact of political transition on psychiatric nursing--a case study of twentieth-century Ireland.

PubMed

Sheridan, Ann J

2006-12-01

Using psychiatric nursing education and practice as a case study, this paper examines how the achievement of independence by a nation impacts significantly on the organisations, structures and service provision within that country. Furthermore, it sheds light on how an emerging nation is required to engage in a series of 'trade-offs' between priorities in an attempt to ensure progress towards the greater visioning goals such as the (re)establishing of a national cultural identity, freedom to practice religious beliefs and enhanced economic and practical benefits for all citizens. In the case of Irish psychiatric nursing, the achievement of independence resulted in a diminishing of earlier initiatives related to training and ultimately in a prolonged period of retrenchment, due primarily to competitive pressures and to imposed cultural influences and belief systems. The lesson from this Irish case study indicates that the initial phase of national autonomy can, of necessity, lead to a number of sacrifices as part of the realisation of self-governance and determination; and that this is a necessary prerequisite to gaining the strength to enable a much more confident progression into the future.

The Art of a Deal: A Kyoto Protocol Simulation

ERIC Educational Resources Information Center

Cowlishaw, Richard; Hunter, Charles; Coy, Jason; Tessmer, Michael

2007-01-01

In this case study, groups of students represent countries as they negotiate an agreement to limit greenhouse-gas emissions. While initially developed for and used in an environmental-science course for first-year college students, the case could be applicable to other courses dealing with conflict resolution such as public policy, international…

Criminal Prosecution of Child Sexual Abuse Cases.

ERIC Educational Resources Information Center

Martone, Mary; And Others

1996-01-01

This study of police and hospital records for 451 intrafamilial/caretaker child sexual abuse allegations in Chicago, Illinois, found that few children had to appear as witnesses, as 95% of cases were resolved through plea bargaining. Trial resolution took 12 to 16 months. Of 77 felony complaints initiated, 48 ended in convictions, with 43 convicts…

Sustaining Inquiry-Based Teaching Methods in the Middle School Science Classroom

ERIC Educational Resources Information Center

Murphy, Amy Fowler

2012-01-01

This dissertation used a combination of case study and phenomenological research methods to investigate how individual teachers of middle school science in the Alabama Math, Science, and Technology Initiative (AMSTI) program sustain their use of inquiry-based methods of teaching and learning. While the overall context for the cases was the AMSTI…

Childhood Arthritis and Rheumatology Research Alliance consensus treatment plans for new-onset polyarticular juvenile idiopathic arthritis.

PubMed

Ringold, Sarah; Weiss, Pamela F; Colbert, Robert A; DeWitt, Esi Morgan; Lee, Tzielan; Onel, Karen; Prahalad, Sampath; Schneider, Rayfel; Shenoi, Susan; Vehe, Richard K; Kimura, Yukiko

2014-07-01

There is no standardized approach to the initial treatment of polyarticular juvenile idiopathic arthritis (JIA) among pediatric rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available will result in better health outcomes for polyarticular JIA. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans (CTPs) for use in clinical practice to facilitate such studies. A case-based survey was administered to CARRA members to identify the common treatment approaches for new-onset polyarticular JIA. Two face-to-face consensus conferences employed modified nominal group technique to identify treatment strategies, operational case definition, end points, and data elements to be collected. A core workgroup reviewed the relevant literature, refined plans, and developed medication dosing and monitoring recommendations. The initial case-based survey identified significant variability among treatment approaches for new-onset polyarticular JIA. We developed 3 CTPs based on treatment strategies for the first 12 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The CTPs include a step-up plan (nonbiologic disease-modifying antirheumatic drug [DMARD] followed by a biologic DMARD), an early combination plan (nonbiologic and biologic DMARD combined within a month of treatment initiation), and a biologic only plan. This approach was approved by 96% of the CARRA JIA Research Committee members attending the 2013 CARRA face-to-face meeting. Three standardized CTPs were developed for new-onset polyarticular JIA. Coupled with data collection at defined intervals, use of these CTPs will enable the study of their comparative effectiveness in an observational setting to optimize initial management of polyarticular JIA. Copyright © 2014 by the American College of Rheumatology.

Liquid-based cytology for primary cervical cancer screening: a multi-centre study

PubMed Central

Monsonego, J; Autillo-Touati, A; Bergeron, C; Dachez, R; Liaras, J; Saurel, J; Zerat, L; Chatelain, P; Mottot, C

2001-01-01

The aim of this six-centre, split-sample study was to compare ThinPrep fluid-based cytology to the conventional Papanicolaou smear. Six cytopathology laboratories and 35 gynaecologists participated. 5428 patients met the inclusion criteria (age > 18 years old, intact cervix, informed consent). Each cervical sample was used first to prepare a conventional Pap smear, then the sampling device was rinsed into a PreservCyt vial, and a ThinPrep slide was made. Screening of slide pairs was blinded (n = 5428). All non-negative concordant cases (n = 101), all non-concordant cases (n = 206), and a 5% random sample of concordant negative cases (n = 272) underwent review by one independent pathologist then by the panel of 6 investigators. Initial (blinded) screening results for ThinPrep and conventional smears were correlated. Initial diagnoses were correlated with consensus cytological diagnoses. Differences in disease detection were evaluated using McNemar's test. On initial screening, 29% more ASCUS cases and 39% more low-grade squamous intraepithelial lesions (LSIL) and more severe lesions (LSIL+) were detected on the ThinPrep slides than on the conventional smears (P = 0.001), including 50% more LSIL and 18% more high-grade SIL (HSIL). The ASCUS:SIL ratio was lower for the ThinPrep method (115:132 = 0.87:1) than for the conventional smear method (89:94 = 0.95:1). The same trend was observed for the ASCUS/AGUS:LSIL ratio. Independent and consensus review confirmed 145 LSIL+ diagnoses; of these, 18% more had been detected initially on the ThinPrep slides than on the conventional smears (P = 0.041). The ThinPrep Pap Test is more accurate than the conventional Pap test and has the potential to optimize the effectiveness of primary cervical cancer screening. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11161401

[Central nervous tuberculosis in patients non-VIH: seven case reports].

PubMed

Mazodier, K; Bernit, E; Faure, V; Rovery, C; Gayet, S; Seux, V; Donnet, A; Brouqui, P; Disdier, P; Schleinitz, N; Kaplanski, G; Veit, V; Harlé, J-R

2003-02-01

Tuberculosis involving the central nervous system (CNS) is rarely observed in non immuno-compromised hosts. We report herin the various clinical, biological and radiological manifestations observed in 7 patients with CNS tuberculosis. Clinical and biological records of 7 patients with CNS tuberculosis were retrospectively studied. All patients had encephalic CT-scan and MRI in the course of the disease. 5 women and 2 men with a mean age of 38.4 years initially initially presented with headache (n = 6), fever (n = 5), meningeal irritation (n = 3), localizing neurological signs (n = 1). Lumbar punction revealed lymphocytic meningitis (n = 6/7). Mycobacterium tuberculosis or bovis was isolated in 3 patients only. Cerebral tomodensitography or magnetic resonance imaging were initially normal in most of cases (n = 4/7), but discovered in the course of disease basilar meningitis (n = 6), hydrocephalus (n = 6), abcess or tuberculoma (n = 4). In all the patients, initiation of the treatment was complicated by clinical and/or biological deterioration, called paradoxal reaction, leading in all cases to glucocorticoid adjunction, with various final results. Indeed, 4 patients developed neurological sequelae. No patient died. CNS tuberculosis is a rare disease in non immunocompromised patients whose diagnostic may be difficult due to the absence of specific clinical symptoms, negative initial radiological examination, as well as delayed and often negative bacterial isolation. Paradoxal reaction appeared to be frequent despite specific antibiotherapy and underlines the beneficial effects of addictive corticosteroids.

Stress and serum TNF-alpha levels may predict disease outcome in patients with pemphigus: a preliminary study.

PubMed

Ragab, Nader; Abdallah, Marwa; El-Gohary, Eman; Elewa, Rana

2011-04-01

The aim of the current preliminary case-control study was to estimate the initial serum levels of tumor necrosis factor alpha (TNF-alpha) in case patients with pemphigus vulgaris (PV) and pemphigus foliaceus (PF) and correlate them with history of stress, body surface area (BSA) affected, disease severity, and disease outcome. Ten PV and 4 PF case patients as well as 7 healthy matched controls had their serum levels of TNF-alpha measured by an enzyme-linked immunosorbent assay. Case patients were treated and followed up for 2 months. A statistically significant elevation in serum levels of TNF-alpha in PV case patients compared with controls and in PV case patients compared with PF case patients was detected (P < .05), with no significant difference between PF case patients and controls (P > .05). No significant correlation was detected between the serum levels of TNF-alpha and the BSA affected (P > .05). Four PV case patients had a bad disease outcome, of which 3 had severe emotional stress a month prior to the onset of the attack. All 4 showed significantly elevated initial serum levels of TNF-alpha compared with those who had a good disease outcome (P < .05). Emotional stress is a factor affecting prognosis of the disease. Pretreatment assessment of serum TNF-alpha levels in patients with pemphigus may be a guide to the expected prognosis and selection of the proper treatment regimen.

Provision of pandemic disease information by health sciences librarians: a multisite comparative case series.

PubMed

Featherstone, Robin M; Boldt, R Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

2012-04-01

The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Comparison of the four cases revealed a distinct difference between "client-initiated" and "librarian-initiated" provision of pandemic information. Librarian-initiated projects utilized social software to "push" information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease.

Using technology to enhance the quality of home health care: three case studies of health information technology initiatives at the visiting nurse service of New York.

PubMed

Russell, David; Rosenfeld, Peri; Ames, Sylvia; Rosati, Robert J

2010-01-01

There is a growing recognition among health services researchers and policy makers that Health Information Technology (HIT) has the potential to address challenging issues that face patients and providers of healthcare. The Visiting Nurse Service of New York (VNSNY), a large not-for-profit home healthcare agency, has integrated technology applications into the service delivery model of several programs. Case studies, including the development and implementation, of three informatics initiatives at VNSNY are presented on: (1) Quality Scorecards that utilize process, outcomes, cost, and satisfaction measures to assess performance among clinical staff and programs; (2) a tool to identify patients at risk of being hospitalized, and (3) a predictive model that identifies patients who are eligible for physical rehabilitation services. Following a description of these initiatives, we discuss their impact on quality and process indicators, as well as the opportunities and challenges to implementation. © 2010 National Association for Healthcare Quality.

Lupus pneumonitis as the initial presentation of systemic lupus erythematosus: case series from a single institution.

PubMed

Wan, S A; Teh, C L; Jobli, A T

2016-11-01

Objective The aim of this study was to examine the clinical features, treatment and outcome of systemic lupus erythematosus (SLE) patients in our centre who presented with lupus pneumonitis as the initial manifestation. Methods We performed a retrospective review of all patients who presented with lupus pneumonitis during the initial SLE manifestation from March 2006 to March 2015. Results There were a total of five patients in our study who presented with fever and cough as the main clinical features. All patients had pulmonary infiltrates on chest radiographs. High-resolution computed tomography, which was performed in two patients, showed ground glass opacities with patchy consolidations bilaterally. All patients received high-dose steroids, 80% received intravenous cyclophosphamide and 60% received intravenous immunoglobulin. Two patients died from severe lupus pneumonitis within 2 weeks of admission despite treatment with ventilation, steroids, cyclophosphamide and intravenous immunoglobulin. Conclusions Acute lupus pneumonitis is an uncommon presentation of SLE. Mortality in this case series is 40%.

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.

14 CFR 302.211 - Procedures in certificate cases involving initial or continuing fitness.

Code of Federal Regulations, 2012 CFR

2012-01-01

... initial or continuing fitness. 302.211 Section 302.211 Aeronautics and Space OFFICE OF THE SECRETARY... Disposition of Applications § 302.211 Procedures in certificate cases involving initial or continuing fitness... applicant's fitness to operate. Where such applications propose the operation of scheduled service in...

14 CFR 302.211 - Procedures in certificate cases involving initial or continuing fitness.

Code of Federal Regulations, 2014 CFR

2014-01-01

... initial or continuing fitness. 302.211 Section 302.211 Aeronautics and Space OFFICE OF THE SECRETARY... Disposition of Applications § 302.211 Procedures in certificate cases involving initial or continuing fitness... applicant's fitness to operate. Where such applications propose the operation of scheduled service in...

14 CFR 302.211 - Procedures in certificate cases involving initial or continuing fitness.

Code of Federal Regulations, 2013 CFR

2013-01-01

... initial or continuing fitness. 302.211 Section 302.211 Aeronautics and Space OFFICE OF THE SECRETARY... Disposition of Applications § 302.211 Procedures in certificate cases involving initial or continuing fitness... applicant's fitness to operate. Where such applications propose the operation of scheduled service in...

14 CFR 302.211 - Procedures in certificate cases involving initial or continuing fitness.

Code of Federal Regulations, 2010 CFR

2010-01-01

... initial or continuing fitness. 302.211 Section 302.211 Aeronautics and Space OFFICE OF THE SECRETARY... Disposition of Applications § 302.211 Procedures in certificate cases involving initial or continuing fitness... applicant's fitness to operate. Where such applications propose the operation of scheduled service in...

14 CFR 302.211 - Procedures in certificate cases involving initial or continuing fitness.

Code of Federal Regulations, 2011 CFR

2011-01-01

... initial or continuing fitness. 302.211 Section 302.211 Aeronautics and Space OFFICE OF THE SECRETARY... Disposition of Applications § 302.211 Procedures in certificate cases involving initial or continuing fitness... applicant's fitness to operate. Where such applications propose the operation of scheduled service in...

High cost sharing and specialty drug initiation under Medicare Part D: a case study in patients with newly diagnosed chronic myeloid leukemia.

PubMed

Doshi, Jalpa A; Li, Pengxiang; Huo, Hairong; Pettit, Amy R; Kumar, Rishab; Weiss, Brenda M; Huntington, Scott F

2016-03-01

Specialty drugs often offer medical advances but are frequently subject to high cost sharing. This is particularly true with Medicare Part D, where after meeting a deductible, patients without low-income subsidies (non-LIS) typically face 25% to 33% coinsurance (initial coverage phase with "specialty tier" cost sharing), followed by ~50% coinsurance (coverage gap phase), and then 5% coinsurance (catastrophic phase). Yet, no studies have examined the impact of such high cost sharing on specialty drug initiation under Part D. Oral tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML), making it an apt case study. A retrospective claims-based analysis utilizing 2011 to 2013 100% Medicare claims. TKI initiation rates and time to initiation were compared between fee-for-service non-LIS Part D patients newly diagnosed with CML and their LIS counterparts who faced nominal cost sharing of ≤ $5. The first 30-day TKI fill "straddled" benefit phases, for a mean out-of-pocket cost of $2600 or more for non-LIS patients. Non-LIS patients were less likely than LIS patients to have a TKI claim within 6 months of diagnosis (45.3% vs 66.9%; P < .001) and those initiating a TKI took twice as long to fill it (mean = 50.9 vs 23.7 days; P < .001). Cox regressions controlling for sociodemographic, clinical, and plan characteristics confirmed descriptive findings (hazard ratio, 0.59; 95% CI, 0.45-0.76). Extensive sensitivity analyses confirmed the robustness of our findings. High cost sharing was associated with reduced and/or delayed initiation of TKIs. We discuss policy strategies to reduce current financial barriers that adversely impact access to critical therapies under Medicare Part D.

Influence of the four-photon parametric processes and cross-phase modulation on the relative motion of optical filaments

NASA Astrophysics Data System (ADS)

Kovachev, L. M.; Georgieva, D. A.; Dakova, A. M.

2015-10-01

We investigate two types of nonlinear interaction between collinear femtosecond laser pulses with power slightly above the critical for self-focusing {{P}\\text{cr}} . In the first case we study energy exchange between filaments. The model describes this process through a degenerate four-photon parametric mixing (FPPM) scheme and requests initial phase difference between the waves. When there is no initial phase difference between the pulses, the FPPM process does not work. In this case the second type of interaction is obtained as merging between two, three or four filaments in a single filament with higher power. It is found that in the second case the interflow between the filaments has the potential for interaction due to cross-phase modulation (CPM).

Ewings Sarcoma: A Case of Respiratory Distress and Opacification That Was not Pneumonia.

PubMed

Wells, Jordee M; Spencer, Sandra P

2018-05-01

The Ewing sarcoma family of tumors typically appears in the second decade of life with regional pain and swelling of a long bone. The following case presents a pediatric patient, aged 4 years, given a diagnosis of Ewing sarcoma of the rib with the initial presentation of respiratory distress, hypoxia, and pleural effusion. Respiratory distress accounts for a large majority of emergency department visits annually, so it is the distinct responsibility of the emergency department physician to avoid premature closure in attributing the most common diagnoses to account for the presenting symptoms. In this case, the careful study of the initial radiographic findings led to further identification and characterization of the mass through thoracic computed tomography to suggest Ewing sarcoma, despite the patient's unlikely demographics and presentation.

Impact of inhomogeneity on SH-type wave propagation in an initially stressed composite structure

NASA Astrophysics Data System (ADS)

Saha, S.; Chattopadhyay, A.; Singh, A. K.

2018-02-01

The present analysis has been made on the influence of distinct form of inhomogeneity in a composite structure comprised of double superficial layers lying over a half-space, on the phase velocity of SH-type wave propagating through it. Propagation of SH-type wave in the said structure has been examined in four distinct cases of inhomogeneity viz. when inhomogeneity in double superficial layer is due to exponential variation in density only (Case I); when inhomogeneity in double superficial layers is due to exponential variation in rigidity only (Case II); when inhomogeneity in double superficial layer is due to exponential variation in rigidity, density and initial stress (Case III) and when inhomogeneity in double superficial layer is due to linear variation in rigidity, density and initial stress (Case IV). Closed-form expression of dispersion relation has been accomplished for all four aforementioned cases through extensive application of Debye asymptotic analysis. Deduced dispersion relations for all the cases are found in well-agreement to the classical Love-wave equation. Numerical computation has been carried out to graphically demonstrate the effect of inhomogeneity parameters, initial stress parameters as well as width ratio associated with double superficial layers in the composite structure for each of the four aforesaid cases on dispersion curve. Meticulous examination of distinct cases of inhomogeneity and initial stress in context of considered problem has been carried out with detailed analysis in a comparative approach.

Characteristics of Patient-Centered Medical Home Initiatives that Generated Savings for Medicare: a Qualitative Multi-Case Analysis.

PubMed

Burton, Rachel A; Lallemand, Nicole M; Peters, Rebecca A; Zuckerman, Stephen

2018-02-05

Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not. States' MAPCP Demonstration initiatives were comprehensively profiled in case studies based on secondary document review, three rounds of annual interviews with state staff, payers, practices, and other stakeholders, and other data sources. Case study findings were summarized in a case-ordered predictor-outcome matrix, which identified the presence or absence of key demonstration design features and experiences and arrayed states based on the amount of net savings or losses they generated for Medicare. We then used this matrix to identify initiative features that were present in at least three of the four states that generated net savings and absent from at least three of the four states that did not generate savings. A majority of the states that generated net savings: required practices to be recognized PCMHs to enter the demonstration, did not allow late entrants into the demonstration, used a consistent demonstration payment model across participating payers, and offered practices opportunities to earn performance bonuses. Practices in states that generated net savings also tended to report receiving the demonstration payments and bonuses they expected to receive, without any issues. Designers of future PCMH initiatives may increase their likelihood of generating net savings by incorporating the demonstration features we identified.

[Clinical analysis of 138 multiple primary cancers diagnosed of digestive system malignant tumor initially].

PubMed

Lyu, J M; Xiong, H C; Wu, B; Zhou, X Q; Hu, J

2018-02-23

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P <0.05). Conclusions: The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.

Using the Web as a Higher Order Thinking Partner: Case Study of an Advanced Learner Creatively Synthesizing Knowledge on the Web

ERIC Educational Resources Information Center

DeSchryver, Michael

2017-01-01

Previous work provided foundations for the theory of web-mediated knowledge synthesis, a framework for using the web in more creative and generative ways. This article explores specific instances of the various elements of that theory in a single case from the initial study. That is, a thorough exploration of think-aloud, screen capture, and…

Evolving Pedagogical Perceptions of Teachers Integrating Ubiquitous Computing in Their Classrooms: A Case Study of the South Dakota Laptop Program

ERIC Educational Resources Information Center

Pogany, Wade S.

2009-01-01

With technology changing the world at a rapid rate, the impact of ubiquitous computing in the classroom has had an influence on education. As the number of one-to-one laptop initiatives grows, the need for further research on the effects of teaching and learning also increases. This case study sought to examine changes in teaching that resulted…

Recommendations to Commander, Naval Surface Forces, for Achieving a Strategic Approach to the Acquisition of Information Systems and Services

DTIC Science & Technology

2010-09-01

policy or position of the Department of Defense or the U.S. government . IRB Protocol number _______N/A______. 12a. DISTRIBUTION / AVAILABILITY...72 3. GAO Case Study of Commercial Transformation in Decision Making on IS Acquisition Spending (Case Study Located in Appendix C...Program FRE Fleet Readiness Enterprise GAO government Accountability Office IOC Initial Operating Capability xvi IS Information

Small High Schools at Work: A Case Study of Six Gates-Funded Schools in New York City. A Report to the Bill & Melinda Gates Foundation

ERIC Educational Resources Information Center

Fancsali, Cheri; Jaffe-Walter, Reva; Mitchell-McKnight, Vernay; Nevarez, Nancy; Orellana, Eliana, Williams Rose, Lea

2010-01-01

The Academy for Educational Development (AED) conducted a case study of six public high schools in New York City as part of a multifaceted evaluation of a small schools initiative funded by the Bill & Melinda Gates Foundation. Through surveys, interviews, and focus groups, the authors gathered information and opinions from the schools'…

Two case reports of severe myocarditis associated with the initiation of dolutegravir treatment in HIV patients

PubMed Central

Mahlab-Guri, Keren; Asher, Ilan; Rosenberg-Bezalel, Shira; Elbirt, Daniel; Burke, Michael; Sthoeger, Zev M.

2016-01-01

Abstract Rationale: The integrase inhibitor dolutegravir is now recommended as first-line treatment for HIV. A single case of myocarditis after treatment with dolutegravir was reported in the FLAMINGO trial. We present here 2 cases of severe myocarditis that occurred shortly after the initiation of dolutegravir treatment. Patients concerns: The first case is a 45-year-old female who developed severe congestive heart failure and died, weeks after the initiation of dolutegravir treatment (for simplification of her antiretroviral regimen). The second case was a 51-year-old male who presented with effort dyspnea 3 weeks after the initiation of dolutegravir treatment and was later diagnosed as severe congestive heart failure. The treatment was changed and the patient survived, but he still suffers from severe heart failure with functional impairment. Diagnosis and Outcome: Patient 1 died, patient 2 suffers from severe heart failure. Lessons: We discuss here the possible relationship between the initiation of dolutegravir treatment and the development of lymphocytic myocarditis in our patients, and we suggest a possible mechanism. PMID:27893693

Initiation of Farm Safety Programs in the Arkansas Delta: A Case Study of Participatory Methods

ERIC Educational Resources Information Center

Richter, Jan S.; Hall, Becky G.; Deere, G. David

2007-01-01

Context: Outreach to high-risk communities is one of the goals of Area Health Education Centers. One such population is the farm community, which is known to suffer high rates of traumatic events. Purpose: To describe a participatory methods initiative by the Arkansas Delta Area Health Education Center and other agencies to address farm-related…

A Method for Teacher Inquiry in Cross-Curricular Projects: Lessons from a Case Study

ERIC Educational Resources Information Center

Avramides, Katerina; Hunter, Jade; Oliver, Martin; Luckin, Rosemary

2015-01-01

Many changes in teaching practices (such as introduction of e-assessment) are initiated by school management, or by a lead teacher, but have direct impact on the learning designs of others. However, models of teachers as innovators, conducting evidence-based inquiry into their students' learning, view the teacher as initiator of change in their…

Teaching to Transform, Transforming to Teach: Exploring the Role of Teachers in Human Rights Education in India

ERIC Educational Resources Information Center

Bajaj, Monisha

2011-01-01

Background: Human rights education initiatives have proliferated in the past three decades and can be found in policy discussions, textbook reforms and grassroots initiatives across the globe. This article specifically explores the role of teachers in human rights education (HRE) by focusing on a case study of one non-governmental organisation's…

"Distance Learning" or "Learning at a Distance"? Case Study of an Education Initiative to Deliver an In-Service Bachelors Degree in Zambia

ERIC Educational Resources Information Center

Smith, Christopher J.

2010-01-01

In 1998, as part of what was then Zambia's Department of Technical Education and Vocational Training's (DTEVT) human resources capacity building initiative, under the Ministry of Science, Technology and Vocational Training (MSTVT), donor funding was secured to provide degree-level training for key teachers and managers within the technical…

A Case Study of the Relationship between School Leadership and Mathematics and Reading Performance of Grade 8 Students

ERIC Educational Resources Information Center

Omotoso, Christianah B.

2012-01-01

The No Child Left Behind federal mandate to improve student achievement in reading and math resulted in several initiatives related to educational leadership. However, these initiatives have yet to improve student achievement. Therefore, the research question focused on how school leaders used Senge's five disciplines of a learning…

Effectiveness of Video Self-Modeling to Promote Social Initiations by 3-Year-Olds with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Buggey, Tom

2012-01-01

Video Self-Modeling (VSM) provides individuals the opportunity to view themselves performing a task beyond their present functioning level through the careful editing of videos. In this study, a single-case multiple-baseline design was used to determine whether VSM would facilitate social initiations across three young children (M = 3 years 10…

An Alternative Method for Measuring Cost-Effectiveness: A Case Study of New York City's Annenberg Challenge Grant

ERIC Educational Resources Information Center

Iatarola, Patrice; Fruchter, Norm

2006-01-01

Every school reform initiative promises to improve some aspect of schooling and, ultimately, the academic performance of the target schools and their students. The reform's cost often determines not only whether the particular initiative is implemented but also how the reform is implemented. Analyzing the cost-effectiveness of a programmatic or…

Independence and Interdependence: An Analysis of Pre-Service Candidates' Use of Focused Assignments on an Electronic Discussion Forum during the Initial Field Experience

ERIC Educational Resources Information Center

Fisch, Audrey A.; Bennett, Deborah J.

2011-01-01

This article describes a case study using an electronic learning platform for creating an interactive learning community through asynchronous discussion to enhance the initial field experience of secondary math and English teacher candidates enrolled in Field Experience. We identified three problems with the field experience course--lack of…

A Pedagogical Framework for the Use of Information and Communications Technology in Initial Teacher Training

ERIC Educational Resources Information Center

Hramiak, Alison

2006-01-01

This paper describes the initial findings of a longitudinal case study that investigates the use of e-learning and communications technology to enhance the placement experience for full-time post graduate certificate in education (PGCE) students. It is a work in progress examining how a VLE might be used to support trainees while they are on…

Unlocking the Potential to Influence Government Skills Policy: A Case Study of the UK Construction Industry

ERIC Educational Resources Information Center

Morgan, Arthur; Raiden, Ani; Naylor, Gerald

2008-01-01

Despite a series of national policy initiatives aimed at addressing skills shortages in a number of sectors, little evidence of longer-term change is apparent. This paper examines concerns expressed by small businesses that their local views are not sought or considered when national training policies and initiatives are either being developed or…

Inclusion of Pupils Perceived as Experiencing Social and Emotional Behavioural Difficulties (SEBD): Affordances and Constraints

ERIC Educational Resources Information Center

Mowat, Joan Gaynor

2010-01-01

This paper takes as its principal theme barriers to the inclusion of pupils perceived as experiencing social and emotional behavioural difficulties (SEBD) and how these might be overcome. It draws upon an evaluative case study of an initiative, devised by the author, to support pupils--the Support Group Initiative (SGI)--which was conducted over a…

Social Network Analysis of a Scientist-Practitioner Research Initiative Established to Facilitate Science Dissemination and Implementation within States and Communities

ERIC Educational Resources Information Center

Ginexi, Elizabeth M.; Huang, Grace; Steketee, Michael; Tsakraklides, Sophia; MacAllum, Keith; Bromberg, Julie; Huffman, Amanda; Luke, Douglas A.; Leischow, Scott J.; Okamoto, Janet M.; Rogers, Todd

2017-01-01

This article presents a case study of a scientist-practitioner research network established by the National Cancer Institute's State and Community Tobacco Control Research Initiative. While prior programs have focused on collaboration among scientists, a goal here was to encourage collaborations with non-university, practice-based partners. Two…

Successful Information Technology Outsourcing: A Case Study on How a U.S.-Based Company Achieves Success

ERIC Educational Resources Information Center

Daluisio, Stephen C.

2014-01-01

In the late 1980s, the Eastman Kodak company initiated what would become one of the biggest trends in information technology (IT): outsourcing. IT outsourcing (ITO) allows a company to focus on the services that will differentiate it from its competitors and farm out nondifferentiating services. ITO has grown from the initial landmark effort at…

500 Maori PhDs in Five Years: Insights from a Successful Indigenous Higher Education Initiative

ERIC Educational Resources Information Center

Villegas, Malia Maya

2010-01-01

With this thesis, I present a case study of the effort to graduate 500 "Maori" doctorates in five years in New Zealand in order to advance our understanding of a successful Indigenous higher education initiative. By paying careful attention to contextual factors, I describe the theoretical and practical significance of this effort and…

Maximizing Vocational Teachers' Learning: The Feedback Discussion in The Observation of Teaching for Initial Teacher Training in Further Education

ERIC Educational Resources Information Center

Lahiff, Ann

2015-01-01

This paper draws on case-study research that focused on teaching observations conducted as part of vocational teachers' initial teacher training (ITT) in further education (FE) colleges in England. It analyses the post-observation feedback discussion, drawing on a rich sociocultural tradition within work-based learning literature. It argues that…

A Big Bang versus a Small Bang Approach: A Case Study of the Expeditionary Combat Support System (ECSS) and the Maintenance, Repair, and Overhaul Initiative (MROi)

DTIC Science & Technology

resource planning (ERP) solution called the Expeditionary Combat Support System (ECSS), a big - bang approach. In early 2012, the ECSS program was cancelled...Repair, and Overhaul initiative (MROi), a small- bang approach, to increase enterprise visibility and efficiency across all three Air Logistics

Quality Child Care for Infants and Toddlers: Case Studies of Three Community Strategies. Final Report.

ERIC Educational Resources Information Center

Paulsell, Diane; Nogales, Renee; Cohen, Julie

To address the increasing child care needs of low-income families in the wake of welfare reform, federal and state governments have responded with increased funding for child care and for initiatives to improve quality. Some of these initiatives have been designed specifically to address the unique challenges of infant-toddler care. This report…

Small Island States Green Energy Initiative. Final report

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

Khattak, Nasir

1999-10-15

This report covers the activities carried out during a one year period from 7/15/99 to 7/15/00 as part of the Small Islands Green Energy Initiative. The three activities were: 1) Energy Ministerial conference in the Caribbean; 2) Training session on renewable energy for utility engineers; and 3) Case studies compilation on renewable energy in the Caribbean.

Overcoming the Barriers of Distance: Using Mobile Technology to Facilitate Moderation and Best Practice in Initial Teacher Training

ERIC Educational Resources Information Center

Leggatt, Simon

2016-01-01

This case study describes the development process of a model using readily-available technology to facilitate collaboration, moderation and the dissemination of best practice in initial teacher training in the UK. Students, mentors, tutors and external examiners from a number of educational institutions in a UK, higher education-led Lifelong…

Students' Perceptions of Academic Self-Efficacy and Self-Regulation While Learning in a 1:1 Laptop Environment

ERIC Educational Resources Information Center

Carraher, Joan M.

2014-01-01

1:1 Laptop initiatives continue to grow throughout Nebraska schools. There are many questions regarding their effectiveness in improving student learning, justifications for expenses, and the process to guide such an initiative. The purpose of this case study was to explore students' perceptions of academic self-efficacy and self-regulation while…

Arab Civil Society and Education in Israel: The Arab Pedagogical Council as a Contentious Performance to Achieve National Recognition

ERIC Educational Resources Information Center

Agbaria, Ayman K.

2015-01-01

Focusing on recent developments in the field of education, this article grapples with the educational activism of Arab civil society in Israel. Specifically, it presents a case study of a recent initiative to establish an independent Arab Pedagogical Council (APC). I argue that this initiative, although controversial and challenging to the very…

Competing values: a case study of Pennsylvania's elk herd as a tourism attraction

Treesearch

Jeffrey A. Walsh; Leonard K. Long

2002-01-01

This paper qualitatively investigates the Pennsylvania Game Commission's (POC) "Elk Trap and Transfer Project" as a tourism development initiative. Beginning in 1998, a three-year trap and transfer project was initiated by the POC to relocate 33 elk from Elk County to Clinton County. The ecological goals of this project included re-establishing an elk...

Are Graduates Preferred to Those Completing Initial Vocational Education and Training? Case Studies on Company Recruitment Strategies in Germany, England and Switzerland

ERIC Educational Resources Information Center

Hippach-Schneider, Ute; Weigel, Tanja; Brown, Alan; Gonon, Philipp

2013-01-01

The German and Swiss economies value skilled work highly and initial vocational education and training (IVET) has been the predominant traditional pathway into such work. However, concerns about a more "knowledge-based society" and the "academic shift in the labour market" are starting to undermine the status associated with…

Knowledge Exchange between Universities and the Creative Industries in the UK: A Case Study of Current Practice

ERIC Educational Resources Information Center

Ferguson, Morag

2014-01-01

The importance to the economy of knowledge exchange between universities and industry has long been recognized, and in the UK a number of initiatives are in place to support such activities. These initiatives have helped to stimulate engagement between universities and the creative industries, a sector of increasing importance to the UK economy.…

Learning from New York City : a case study of public health policy practice in the Bloomberg administration.

PubMed

Isett, Kimberley Roussin; Laugesen, Miriam J; Cloud, David H

2015-01-01

To ascertain any lessons learned about how public health reforms undertaken in New York City during the Bloomberg Administration were shepherded through the public policy and administration gauntlet. The question is, how feasible is this approach and would it work outside of New York City? Using a theoretically grounded case study approach, 3 initiatives were examined that were proposed and/or implemented during a 10-year period of the Mayoralty of Michael Bloomberg (2002-2011): transfats restrictions, clean bus transportation policies, and a sugar-sweetened beverages tax (as a counterfactual). The investigation began by performing a comprehensive public documents search and was followed with interviews of 27 individuals involved in the selected policy initiatives. Interviews were coded in Nvivo using an iterative, grounded methodology. Using a theoretical lens, the case study illustrates that the multifaceted role of leadership was not confined to the executives in the City or the Agency. Instead, leadership extended to other administrative officials within the agency and the Board of Health. Second, New York City used reorganization and coordinative mechanisms strategically to ensure achievement of their goals. This included creation of new departments/bureaus and coordinating structures across the City. Evidence of the explicit use of incentives, as initially anticipated from the theoretical framework, was not found. While some aspects of this case study are unique to the context of New York City, 2 approaches used in New York City are feasible for other jurisdictions: harnessing the full scope and breadth of authority of the agency and its associated boards and commissions, and remobilizing existing workforce to explicitly focus on and coordinate targeted policies for issues of concern. Questions for further consideration are posed at the conclusion of the article.

A new DoD initiative: the Computational Research and Engineering Acquisition Tools and Environments (CREATE) program

NASA Astrophysics Data System (ADS)

Arevalo, S.; Atwood, C.; Bell, P.; Blacker, T. D.; Dey, S.; Fisher, D.; Fisher, D. A.; Genalis, P.; Gorski, J.; Harris, A.; Hill, K.; Hurwitz, M.; Kendall, R. P.; Meakin, R. L.; Morton, S.; Moyer, E. T.; Post, D. E.; Strawn, R.; Veldhuizen, D. v.; Votta, L. G.; Wynn, S.; Zelinski, G.

2008-07-01

In FY2008, the U.S. Department of Defense (DoD) initiated the Computational Research and Engineering Acquisition Tools and Environments (CREATE) program, a 360M program with a two-year planning phase and a ten-year execution phase. CREATE will develop and deploy three computational engineering tool sets for DoD acquisition programs to use to design aircraft, ships and radio-frequency antennas. The planning and execution of CREATE are based on the 'lessons learned' from case studies of large-scale computational science and engineering projects. The case studies stress the importance of a stable, close-knit development team; a focus on customer needs and requirements; verification and validation; flexible and agile planning, management, and development processes; risk management; realistic schedules and resource levels; balanced short- and long-term goals and deliverables; and stable, long-term support by the program sponsor. Since it began in FY2008, the CREATE program has built a team and project structure, developed requirements and begun validating them, identified candidate products, established initial connections with the acquisition programs, begun detailed project planning and development, and generated the initial collaboration infrastructure necessary for success by its multi-institutional, multidisciplinary teams.

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…

Coptis teeta-based agroforestry system and its conservation potential: a case study from northwest Yunnan.

PubMed

Huang, Ji; Long, Chunlin

2007-06-01

Coptis teeta (Ranunculaceae), is a nontimber forest product (NTFP) that only grows in northwest Yunnan and northeast India. Its tenuous rhizome, known as "Yunnan goldthread" in the traditional Chinese medicine system, has been used as an antibacterial and as an antiinflammatory medicine for a long time. The increasing demand has resulted in commercial harvesting pressure on wild populations that were already dwindling as a result of deforestation, and wild populations are at risk of extinction. Fortunately, there exists at least 2000 hectares of a C. teeta-based agroforestry system initiated by the Lisu people in Nujiang, northwest Yunnan. This cultivation supplies us with a valuable study case for the balance between conservation and sustainable use. This case study investigated the traditional management system and history of C. teeta in Nujiang through ethnobotanical methods and field investigation. We also contrasted initial costs, economic returns, and labor demands for C. teeta cultivation with other major land uses in the region. Compared with swidden agriculture, the major land-use type in the region, C. teeta cultivation offers high economic returns and low labor and initial costs; moreover, C. teeta cultivation does not interfere with subsistence agricultural duties. This agroforestry system reflected that the cultivation of NTFPs is a conservation strategy for maintaining forest diversity, while providing a stable economic return to local forest communities, and indicates how local people manage biodiversity effectively.

Rates of initial acceptance of PAP masks and outcomes of mask switching.

PubMed

Bachour, Adel; Vitikainen, Pirjo; Maasilta, Paula

2016-05-01

Recently, we noticed a considerable development in alleviating problems related to positive airway pressure (PAP) masks. In this study, we report on the initial PAP mask acceptance rates and the effects of mask switching on mask-related symptoms. We prospectively collected all cases of mask switching in our sleep unit for a period of 14 months. At the time of the study, we used ResMed™ CPAP devices and masks. Mask switching was defined as replacing a mask used for at least 1 day with another type of mask. Changing to a different size but keeping the same type of mask did not count as mask switching. Switching outcomes were considered failed if the initial problem persisted or reappeared during the year that followed switching. Our patient pool was 2768. We recorded 343 cases of mask switching among 267 patients. Of the 566 patients who began new PAP therapy, 108 (39 women) had switched masks, yielding an initial mask acceptance rate of 81 %. The reason for switching was poor-fit/uncomfortable mask in 39 %, leak-related in 30 %, outdated model in 25 %, and nasal stuffiness in 6 % of cases; mask switching resolved these problems in 61 %. Mask switching occurred significantly (p = 0.037) more often in women and in new PAP users. The odds ratio for abandoning PAP therapy within 1 year after mask switching was 7.2 times higher (interval 4.7-11.1) than not switching masks. The initial PAP mask acceptance rate was high. Patients who switched their masks are at greater risk for abandoning PAP therapy.

Different types of pausing modes during transcription initiation.

PubMed

Lerner, Eitan; Ingargiola, Antonino; Lee, Jookyung J; Borukhov, Sergei; Michalet, Xavier; Weiss, Shimon

2017-08-08

In many cases, initiation is rate limiting to transcription. This due in part to the multiple cycles of abortive transcription that delay promoter escape and the transition from initiation to elongation. Pausing of transcription in initiation can further delay promoter escape. The previously hypothesized pausing in initiation was confirmed by two recent studies from Duchi et al. 1 and from Lerner, Chung et al. 2 In both studies, pausing is attributed to a lack of forward translocation of the nascent transcript during initiation. However, the two works report on different pausing mechanisms. Duchi et al. report on pausing that occurs during initiation predominantly on-pathway of transcript synthesis. Lerner, Chung et al. report on pausing during initiation as a result of RNAP backtracking, which is off-pathway to transcript synthesis. Here, we discuss these studies, together with additional experimental results from single-molecule FRET focusing on a specific distance within the transcription bubble. We show that the results of these studies are complementary to each other and are consistent with a model involving two types of pauses in initiation: a short-lived pause that occurs in the translocation of a 6-mer nascent transcript and a long-lived pause that occurs as a result of 1-2 nucleotide backtracking of a 7-mer transcript.

Impalement brain injury from steel rod causing injury to jugular bulb: case report and review of the literature.

PubMed

Grossbach, Andrew J; Abel, Taylor J; Smietana, Janel; Dahdaleh, Nader; Severson, Meryl A; Hasan, David

2014-01-01

The management of impalement penetrating brain injuries (IPBI) from non-missile objects is extremely challenging, especially when vascular structures are involved. Cerebral angiography is a crucial tool in initial evaluation to assess for vascular injury as standard non-invasive imaging modalities are limited by foreign body artifact, especially for metallic objects. This study reports a case of an IPBI caused by a segment of steel rebar resulting in injury to the left jugular bulb and posterior temporal lobe. It describes the initial presentation, radiology, management and outcome in this patient and reviews the literature of similar injuries.

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

[Axillary pathologic response after neoadjuvant chemotherapy in locally advanced breast cancer with axillary involvement].

PubMed

Jiménez-Ballvé, A; Serrano-Palacio, A; García-Sáenz, J A; Ortega Candil, A; Salsidua-Arroyo, O; Román-Santamaría, J M; Pelayo Alarcón, A; Fuentes Ferrer, M E; Carreras-Delgado, J L

2015-01-01

To compare axillary involvement (N+) at initial staging in locally advanced breast cancer (LABC) with axillary lymphadenectomy histologic results after neoadjuvant chemotherapy treatment (NeoChemo). Retrospective study between November 2011 and September 2013 of LABC cases treated with neoadjuvant chemotherapy based on docetaxel (associated with trastuzumab in HER2 positive cases and carboplatin/adriamycin in HER2 negative cases). Those clinically or radiologically suspected cases of axillary involvement were histologically confirmed. When there was no suspicion of axillary involvement, sentinel lymph node radioguided biopsy (SLNRB) was performed using intradermal injection of (99m)Tc-nanocolloid albumin prior to neoadjuvant treatment. Axillary lymphadenectomy after NeoChemo was undertaken in all cases with positive axilla. Final pathologic response was classified as complete (pCR) when there was no evidence of tumoral disease and as non-pathologic complete response (no pCR) in the opposite case. A total of 346 patients treated with docetaxel were reviewed, identifying 105 LABC. Axillary involvement at initial staging was detected in 70 (67%) before starting NeoChemo. From these 70, 73% (n=51) were N+ (fine needle biopsy and/or biopsy) and the remaining 19 (27%) were occult N+ detected by SLNRB. Axillary lymphadenectomy detected pCR in 56% (39/70), increasing up to 84% pCR when initial N+ status was reached using SNLB. On the other hand, when N+ was detected using fine needle biopsy/lymph biopsy, pCR was only 45%. More than 50% of women affected by locally advanced breast cancer with tumoral axillary involvement at initial diagnosis present free metastatic axilla after therapeutic neoadjuvant chemotherapy effect. This increases up to almost 90% in case of occult metastatic axilla detected with sentinel node biopsy prior starting neoadjuvant chemotherapy. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

PubMed

Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

2014-12-01

General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

[Clinical, epidemiological, and etiological studies of adult aseptic meningitis: a report of 12 cases of herpes simplex meningitis, and a comparison with cases of herpes simplex encephalitis].

PubMed

Himeno, Takahiro; Shiga, Yuji; Takeshima, Shinichi; Tachiyama, Keisuke; Kamimura, Teppei; Kono, Ryuhei; Takemaru, Makoto; Takeshita, Jun; Shimoe, Yutaka; Kuriyama, Masaru

2018-01-26

We treated 437 cases of adult aseptic meningitis and 12 cases (including 2 recurrent patients; age, 31.8 ± 8.9 years; 7 females) of herpes simplex meningitis from 2004 to 2016. The incidence rate of adult herpes simplex meningitis in the cases with aseptic meningitis was 2.7%. One patient was admitted during treatment of genital herpes, but no association was observed between genital herpes and herpes simplex meningitis in the other cases. The diagnoses were confirmed in all cases as the cerebrospinal fluid (CSF) was positive for herpes simplex virus (HSV)-DNA. For diagnosis confirmation, the DNA test was useful after 2-7 days following initial disease onset. Among other types of aseptic meningitis, the patients with herpes simplex meningitis showed relatively high white blood cell counts and relatively high CSF protein and high CSF cell counts. CSF cells showed mononuclear cell dominance from the initial stage of the disease. During same period, we also experienced 12 cases of herpes simplex encephalitis and 21 cases of non-hepatic acute limbic encephalitis. Notably, the patients with herpes simplex meningitis were younger and their CSF protein and cells counts were higher than those of the patients with herpes simplex encephalitis.

Autopsy-confirmed hippocampal-sparing Alzheimer's disease with delusional jealousy as initial manifestation.

PubMed

Fujishiro, Hiroshige; Iritani, Shuji; Hattori, Miho; Sekiguchi, Hirotaka; Matsunaga, Shinji; Habuchi, Chikako; Torii, Youta; Umeda, Kentaro; Ozaki, Norio; Yoshida, Mari; Fujita, Kiyoshi

2015-09-01

Alzheimer's disease (AD) is clinically characterized by gradual onset over years with worsening of cognition. The initial and most prominent cognitive deficit is commonly memory dysfunction. However, a subset of AD cases has less hippocampal atrophy than would be expected relative to the predominance of cortical atrophy. These hippocampal-sparing cases have distinctive clinical features, including the presence of focal cortical clinical syndromes. Given that previous studies have indicated that severe hippocampal atrophy corresponds to prominent loss of episodic memory, it is likely that memory impairment is initially absent in hippocampal-sparing AD cases. Here, we report on a patient with an 8-year history of delusional jealousy with insidious onset who was clinically diagnosed as possible AD and pathologically confirmed to have AD with relatively preserved neurons in the hippocampus. This patient had delusional jealousy with a long pre-dementia stage, which initially was characterized by lack of memory impairment. Head magnetic resonance imaging findings showed preserved hippocampal volume with bilateral enlarged ventricles and mild-to-moderate cortical atrophy. Head single-photon emission computed tomography revealed severely decreased regional cerebral blood flow in the right temporal lobe. The resolution of the delusion was attributed to pharmacotherapy by an acetylcholinesterase inhibitor, suggesting that the occurrence of delusional jealousy was due to the disease process of AD. Although the neural basis of delusional jealousy remains unclear, this hippocampal-sparing AD case may be classified as an atypical presentation of AD. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

A Method of Developing and Introducing Case-Based Learning to a Preclinical Veterinary Curriculum

ERIC Educational Resources Information Center

Crowther, Emma; Baillie, Sarah

2016-01-01

Case-based learning (CBL) has been introduced as part of a major review of the veterinary curriculum at the University of Bristol. The initial aim was to improve integration between all first year subjects, i.e., basic science disciplines (anatomy, physiology, and biochemistry), animal management, and professional studies, while highlighting the…

Can Education Innovations Be Sustained after the End of Donor Funding? The Case of a Reading Intervention Programme in Zambia

ERIC Educational Resources Information Center

Kombe, Charity Lengwe Meki Kombe; Herman, Chaya

2017-01-01

This article explores the sustainability of donor-supported innovations in the education sector. Accordingly, a case study was conducted of a programme (Primary Reading Programme) implemented in Zambian primary schools which was intended to improve literacy levels. The programme was initially supported by the Department for International…

Valuing the Adult Learner in E-Learning: Part Two--Insights from Four Companies

ERIC Educational Resources Information Center

Waight, Consuelo L.; Stewart, Barbara L.

2005-01-01

Purpose--To investigate how the adult learner is valued in e-learning corporate settings. Design/methodology/approach--Case study methodology was used for this research. Four Fortune 500 companies that had active e-learning initiatives for a minimum of four years were selected. Data for the development of the four cases were collected via…

[The NETWASS prevention model for early identification and assessment of adolescents in psychosocial crisis].

PubMed

Sommer, Friederike; Fiedler, Nora; Leuschner, Vincenz; Scheithauer, Herbert

2016-01-01

The research-based NETWASS prevention model aims to enable school staff to identify students experiencing a psychosocial crisis that could lead to severe targeted school violence and to initiate appropriate support measures. A detailed analysis of the adolescent psychosocial crisis is conducted at an early stage by evaluating possible warning behaviors, crisis symptoms, a student’s individual and social background, and resources. The model was implemented in 98 schools. During the project duration of seven months staff from 59 schools reported 99 cases of a student’s psychosocial crisis. Three experts conducted a content analysis of the reported qualitative data focusing on crisis symptoms of the students as well as the initiated measures. Results show a broad spectrum of risk factors, whereas aggressive behavior of students was reported most frequently. On the basis of theoretical assumptions, the reported cases were divided into three distinct risk groups. A total of eight high-risk cases were observed and reported by the school staff. The school staff mostly reacted to the student crisis by initiating resource-orientated measures, the expertise of child and youth therapists was mostly requested for the high risk cases. By describing the impact of cases and choice of measures undertaken, the study aims to give an overview of incidents schools as well as clinical psychologists and therapists are confronted with.

Epistemic Beliefs and Conceptual Understanding in Biotechnology: A Case Study

NASA Astrophysics Data System (ADS)

Rebello, Carina M.; Siegel, Marcelle A.; Witzig, Stephen B.; Freyermuth, Sharyn K.; McClure, Bruce A.

2012-04-01

The purpose of this investigation was to explore students' epistemic beliefs and conceptual understanding of biotechnology. Epistemic beliefs can influence reasoning, how individuals evaluate information, and informed decision making abilities. These skills are important for an informed citizenry that will participate in debates regarding areas in science such as biotechnology. We report on an in-depth case study analysis of three undergraduate, non-science majors in a biotechnology course designed for non-biochemistry majors. We selected participants who performed above average and below average on the first in-class exam. Data from multiple sources—interviews, exams, and a concept instrument—were used to construct (a) individual profiles and (b) a cross-case analysis of our participants' conceptual development and epistemic beliefs from two different theoretical perspectives—Women's Ways of Knowing and the Reflective Judgment Model. Two independent trained researchers coded all case records independently for both theoretical perspectives, with resultant initial Cohen's kappa values above .715 (substantial agreement), and then reached consensus on the codes. Results indicate that a student with more sophisticated epistemology demonstrated greater conceptual understandings at the end of the course than a student with less sophisticated epistemology, even though the latter performed higher initially. Also a student with a less sophisticated epistemology and low initial conceptual performance does not demonstrate gains in their overall conceptual understanding. Results suggest the need for instructional interventions fostering epistemological development of learners in order to facilitate their conceptual growth.

Congo crimean hemorrhagic Fever in balochistan.

PubMed

Durrani, Abdul Baqi; Shaikh, Muzaffar; Khan, Zahir

2007-09-01

To observe the pattern and mortality of Congo-Crimean Hemorrhagic Fever (CCHF) in Balochistan. Case series. Department of Medicine, Sandeman Provincial Hospital and Bolan Medical Complex Hospital, Quetta, from September, 1995 to August, 2005. Two hundred and twenty-six febrile patients with bleeding of sudden onset, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, vomiting, red eyes, flushed face, red throat and petechiae on the palate of both sexes were screened for CCHF over a period of 10 years. Clinical criteria for initial diagnosis directed the subsequent diagnostic work-up. The ages of these patients ranged from 7 years to 74 years. Sixty-three percent of these patients were positive for CCHF. Males were 68% of the total patients. Over the years, CCHF showed a gradual increase ranging from 43% to 80%. Total mortality was 15%, all being secondary cases. Death was not observed in primary CCHF cases. In this study, suspicion of viral hemorrhagic fever was raised in 62% cases at the time of admission and the patients were immediately isolated, noninvasive procedures were instigated and barrier nursing was implemented. None of the family and hospital staff members who had close contact with the patient became ill, while those who were not suspected initially (38%) infected the health care workers and the family members. Although CCHF is rare, this study stresses the need for proper health facilities in Pakistan and to include VHF (viral hemorrhagic fevers) in the differential diagnosis of unexplained fever with hemorrhagic tendencies of sudden onset.

Using Case-Based Pedagogy in the Philippines: A Narrative Inquiry

NASA Astrophysics Data System (ADS)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon E.; Tippins, Deborah J.

2001-04-01

This study features use of case-based pedagogy as a context for exploring science teacher education reform. A central premise of the study is that science teacher education reform is a complex process characterised by the individual and collective narrative histories of teachers. The study was conducted at West Visayas State University in the Philippines as a collaborative research endeavour involving two US and four Filipino science teacher educators. The centrepiece of this study was a case experience prompted by reflection on prospective and practicing elementary teachers' written cases. Results of the study are presented here as a layered narrative. An initial layer explores how a case, written by a prospective teacher, was interwoven with her past and future life history. A second layer looks at sociocultural and professional tensions that mediated the participants' case experience. A third layer represents how the case experience provided a community that supported critical reflection among the research team members. Implications from the study emphasise that case-based pedagogy can serve as a basis for critical reflection to inform community-based approaches to science teacher education pedagogical and research reform.

Characteristics of Rib Fractures in Child Abuse-The Role of Low-Dose Chest Computed Tomography.

PubMed

Sanchez, Thomas R; Grasparil, Angelo D; Chaudhari, Ruchir; Coulter, Kevin P; Wootton-Gorges, Sandra L

2018-02-01

Our aim is to describe the radiologic characteristics of rib fractures in clinically diagnosed cases of child abuse and suggest a complementary imaging for radiographically occult injuries in highly suspicious cases of child abuse. Retrospective analysis of initial and follow-up skeletal surveys and computed tomography (CT) scans of 16 patients younger than 12 months were reviewed after obtaining approval from our institutional review board. The number, location, displacement, and age of the rib fractures were recorded. Out of a total 105 rib fractures, 84% (87/105) were detected on the initial skeletal survey. Seventeen percent (18/105) were seen only after follow-up imaging, more than half of which (11/18) were detected on a subsequent CT. Majority of the fractures were posterior (43%) and anterior (30%) in location. An overwhelming majority (96%) of the fractures are nondisplaced. Seventeen percent of rib fractures analyzed in the study were not documented on the initial skeletal survey. Majority of fractures are nondisplaced and located posteriorly or anteriorly, areas that are often difficult to assess especially in the acute stage. The CT scan is more sensitive in evaluating these types of fractures. Low-dose chest CT can be an important imaging modality for suspicious cases of child abuse when initial radiographic findings are inconclusive.

[Nutritional therapy in acute pancreatitis: a practical guide for the initial enteral nutritional support.].

PubMed

Gutiérrez-Salmeán, G; Peláez-Luna, M

2010-01-01

Nutritional support is a cornerstone in acute pancreatitis (AP) treatment, which is a catabolic state that can result in patient's nutritional depletion. First step in the management of AP is to asses its severity. Despite mild AP cases usually do not require nutritional support severe cases benefit from its early initiation. Total enteral nutrition (TEN) decreases the frequency of complications and is the preferred nutrition modality in AP. Availability of nutrition specialists is often limited and usually the primary care physician decides when and how to start nutritional support in AP. To perform a systematic review about nutritional support in AP and create a TEN guide to aid the non nutrition specialist involved in the treatment of AP patients. The search for eligible studies was carried out using the Pub Med and the National Library of Medicine electronic data bases. Controlled clinical trials, treatment guidelines and systematic review articles were selected. It is recommended to initiate nutritional support in AP cases that will be without oral intake longer than a week and TEN is the election modality. We created a TEN guide explaining how to choose and initiate TEN in AP. Early TEN improves AP prognosis and is the nutritional modality of choice in every AP patients that will remain without oral intake longer than a week.

Vortex ring formation at the open end of a shock tube: A particle image velocimetry study

NASA Astrophysics Data System (ADS)

Arakeri, J. H.; Das, D.; Krothapalli, A.; Lourenco, L.

2004-04-01

The vortex ring generated subsequent to the diffraction of a shock wave from the open end of a shock tube is studied using particle image velocimetry. We examine the early evolution of the compressible vortex ring for three-exit shock Mach numbers, 1.1, 1.2, and 1.3. For the three cases studied, the ring formation is complete at about tUb/D=2, where t is time, Ub is fluid velocity behind shock as it exits the tube and D is tube diameter. Unlike in the case of piston generated incompressible vortex rings where the piston velocity variation with time is usually trapezoidal, in the shock-generated vortex ring case the exit fluid velocity doubles from its initial value Ub before it slowly decays to zero. At the end of the ring formation, its translation speed is observed to be about 0.7 Ub. During initial formation and propagation, a jet-like flow exists behind the vortex ring. The vortex ring detachment from the tailing jet, commonly referred to as pinch-off, is briefly discussed.

Febuxostat-associated eosinophilic polymyositis in marginal zone lymphoma.

PubMed

Chahine, Georges; Saleh, Khalil; Ghorra, Claude; Khoury, Nathalie; Khalife, Nadine; Fayad, Fouad

2017-03-01

Febuxostat is an orally administered selective inhibitor of xanthine oxidase approved for the treatment of gout and prevention of tumor lysis syndrome. It is a relatively safe medication. Hypersensitivity reactions associated with the use of febuxostat are quite rare with only one reported case of DRESS syndrome. Recently, two case reports of rhabdomyolysis following the initiation of febuxostat were published. We hereby present the first case of rhabdomyolysis with hypereosinophilia following the administration of febuxostat to a 50-year-old patient newly diagnosed with marginal zone lymphoma. Three weeks after the initiation of febuxostat for tumor lysis syndrome prophylaxis, the patient presented with generalized weakness, diffuse myalgia and low-grade fever. Initial studies showed creatinine kinase level of 4471, hypereosinophilia of 1900/mm 3 , and LDH of 2691. All infectious and autoimmune diseases were ruled out. TSH level was normal. Muscle biopsy showed myonecrosis in addition to an eosinophilic inflammatory infiltrate in the endomysium and perimysium. Discontinuation of febuxostat led to prompt symptom resolution and normalization of blood tests eight days later. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Review Article: Influenza Transmission on Aircraft: A Systematic Literature Review.

PubMed

Leitmeyer, Katrin; Adlhoch, Cornelia

2016-09-01

Air travel is associated with the spread of influenza through infected passengers and potentially through in-flight transmission. Contact tracing after exposure to influenza is not performed systematically. We performed a systematic literature review to evaluate the evidence for influenza transmission aboard aircraft. Using PubMed and EMBASE databases, we identified and critically appraised identified records to assess the evidence of such transmission to passengers seated in close proximity to the index cases. We also developed a bias assessment tool to evaluate the quality of evidence provided in the retrieved studies. We identified 14 peer-reviewed publications describing contact tracing of passengers after possible exposure to influenza virus aboard an aircraft. Contact tracing during the initial phase of the influenza A(H1N1)pdm09 pandemic was described in 11 publications. The studies describe the follow-up of 2,165 (51%) of 4,252 traceable passengers. Altogether, 163 secondary cases were identified resulting in an overall secondary attack rate among traced passengers of 7.5%. Of these secondary cases, 68 (42%) were seated within two rows of the index case. We found an overall moderate quality of evidence for transmission of influenza virus aboard an aircraft. The major limiting factor was the comparability of the studies. A majority of secondary cases was identified at a greater distance than two rows from the index case. A standardized approach for initiating, conducting, and reporting contact tracing could help to increase the evidence base for better assessing influenza transmission aboard aircraft.

Review Article: Influenza Transmission on Aircraft

PubMed Central

Adlhoch, Cornelia

2016-01-01

Background: Air travel is associated with the spread of influenza through infected passengers and potentially through in-flight transmission. Contact tracing after exposure to influenza is not performed systematically. We performed a systematic literature review to evaluate the evidence for influenza transmission aboard aircraft. Methods: Using PubMed and EMBASE databases, we identified and critically appraised identified records to assess the evidence of such transmission to passengers seated in close proximity to the index cases. We also developed a bias assessment tool to evaluate the quality of evidence provided in the retrieved studies. Results: We identified 14 peer-reviewed publications describing contact tracing of passengers after possible exposure to influenza virus aboard an aircraft. Contact tracing during the initial phase of the influenza A(H1N1)pdm09 pandemic was described in 11 publications. The studies describe the follow-up of 2,165 (51%) of 4,252 traceable passengers. Altogether, 163 secondary cases were identified resulting in an overall secondary attack rate among traced passengers of 7.5%. Of these secondary cases, 68 (42%) were seated within two rows of the index case. Conclusion: We found an overall moderate quality of evidence for transmission of influenza virus aboard an aircraft. The major limiting factor was the comparability of the studies. A majority of secondary cases was identified at a greater distance than two rows from the index case. A standardized approach for initiating, conducting, and reporting contact tracing could help to increase the evidence base for better assessing influenza transmission aboard aircraft. PMID:27253070

Impact of prehospital transfer strategies in major trauma and head injury: systematic review, meta-analysis, and recommendations for study design.

PubMed

Pickering, Alastair; Cooper, Katy; Harnan, Susan; Sutton, Anthea; Mason, Suzanne; Nicholl, Jonathan

2015-01-01

It is unclear whether trauma patients should be transferred initially to a trauma center or local hospital. A systematic review and meta-analysis assessed the evidence for direct transport to specialist centers (SCs) versus initial stabilization at non-SCs (NSCs) for major trauma or moderate-to-severe head injury. Nine databases were searched from 1988 to 2012. Limitations in the study design informed recommendations for future studies. Of 19 major trauma studies, five (n = 19,910) included patients not transferred to SCs and adjusted for case mix. Meta-analysis showed no difference in mortality for initial triage to NSCs versus SCs (odds ratio [OR] 1.03; 95% confidence interval [CI], 0.85-1.23). Within studies excluding patients not transferred to SCs, unadjusted analyses of mortality nonsignificantly favored transfer via NSCs (16 studies; n = 37,079; OR, 0.83; 95% CI, 0.68-1.01), whereas adjusted analysis nonsignificantly favored direct triage to SCs (9 studies; n = 34,266; OR, 1.18; 95% CI, 0.96-1.44). Of 11 head injury studies, all excluded patients not transferred to SCs and half were in remote locations. There was no significant mortality difference between initial triage to NSCs versus SCs within adjusted analyses (3 studies; n = 1,507; OR, 0.74; 95% CI, 0.31-1.79) or unadjusted analyses (10 studies; n = 3,671; OR, 0.87; 95% CI, 0.62-1.23). This systematic review demonstrated no difference in outcomes for direct transport to a trauma center versus initial triage to a local hospital. Many studies had significant limitations in the design, and heterogeneity was high. Recommendations for future studies include the following: (i) inclusion of patients not transferred to SCs and those dying during transport; (ii) clear description of centers plus transport distances/times; (iii) adjustments for case mix; and (iv) assessment of morbidity and mortality. Systematic review, level IV.

The life cycles of intense cyclonic and anticyclonic circulation systems observed over oceans

NASA Technical Reports Server (NTRS)

Smith, Phillip J.

1994-01-01

The work over the past six months has focused on the October/November 1985 blocking case study noted in the last progress report. A summary of the results of this effort is contained in the attached preprint papers for the Symposium on the Life Cycles of Extratropical Cyclones. Using this case study as a model, Ph.D. student Anthony Lupo is now initiating the multiple-case diagnosis by first examining two more fall 1985 blocking episodes. In addition, two secondary efforts have been completed, as summarized in the attached M.S. thesis abstracts. Both studies, which were primarily funded by a fellowship and a teaching assistantship, complement the objectives of this study by providing diagnoses of additional cyclone cases to serve as a comparative base for the pre-blocking cyclones to be studied in the multiple-case blocking diagnosis.

An Articulated Pan-Canadian Core Curriculum: Are We Dreaming in Colour? The Tourism Learning System. An Association of Canadian Community Colleges Sponsored Sectoral Case Study.

ERIC Educational Resources Information Center

Bird, Geoffrey; Hood, Terry; White, Brian

This paper offers findings from a case study of western Canada's Tourism Learning System (TLS) initiative. TLS aims to facilitate possible adoption of a national tourism learning system, as well as adaptation of development principles to other industries. The tourism industry now accounts for more than 25% of the world's trade and nearly 10% of…

Best Practices in the Design of Aerobic Training Programs

DTIC Science & Technology

2010-03-02

a pretest - posttest design. To determine the effect size due to training, estimates of the training response were adjusted for the type of research ...studies reviewed here employed pretest - posttest research designs. In such cases, the correlation of pretest scores with posttest scores affects the... pretest - posttest correlation (see Appendix A). was measured more than twice in some studies. When this was the case, ES was computed using the initial and

The Forces Shaping National Response(s) to Global Educational Regulatory Initiatives: The Case for Germany and Ontario

ERIC Educational Resources Information Center

Adam, Edmund G.

2017-01-01

This article argues that the stance toward global regulatory initiatives is influenced by the extent to which these regulatory initiatives threaten the comparative institutional advantages of the national economy. The cases through which this proposition is examined are the showpieces of Germany and Ontario: their system of vocational education…

Development of a mentorship strategy: a knowledge translation case study.

PubMed

Straus, Sharon E; Graham, Ian D; Taylor, Mark; Lockyer, Jocelyn

2008-01-01

There are many theories and frameworks for achieving knowledge translation, and the assortment can be confusing to those responsible for planning, evaluation, or policymaking in knowledge translation. A conceptual framework developed by Graham and colleagues provides an approach that builds on the commonalities found in an assessment of planned-action theories. This article describes the application of this knowledge to action framework to a mentorship initiative in academic medicine. Mentorship influences career success but is threatened in academia by increased clinical, research, and administrative demands. A case study review was undertaken of the role of mentors, the experiences of mentors and mentees, and mentorship initiatives in developing and retaining clinician scientists at two universities in Alberta, Canada. This project involved relevant stakeholders including researchers, university administrators, and research funders. The knowledge to action framework was used to develop a strategy for mentorship for clinician researchers. The framework highlights the need to identify and engage stakeholders in the process of knowledge implementation. A series of initiatives were selected and tailored to barriers and facilitators to implementation of the mentorship initiative; strategies for evaluating the knowledge use and its impact on outcomes were developed. The knowledge to action framework can be used to develop a mentorship initiative for clinician researchers. Future work to evaluate the impact of this intervention on recruitment and retention is planned.

Regionalization as an approach to regulatory systems strengthening: a case study in CARICOM member states.

PubMed

Preston, Charles; Chahal, Harinder S; Porrás, Analia; Cargill, Lucette; Hinds, Maryam; Olowokure, Babatunde; Cummings, Rudolph; Hospedales, James

2016-05-01

Improving basic capacities for regulation of medicines and health technologies through regulatory systems strengthening is particularly challenging in resource-constrained settings. "Regionalization"-an approach in which countries with common histories, cultural values, languages, and economic conditions work together to establish more efficient systems-may be one answer. This report describes the Caribbean Regulatory System (CRS), a regionalization initiative being implemented in the mostly small countries of the Caribbean Community and Common Market (CARICOM). This initiative is an innovative effort to strengthen regulatory systems in the Caribbean, where capacity is limited compared to other subregions of the Americas. The initiative's concept and design includes a number of features and steps intended to enhance sustainability in resource-constrained contexts. The latter include 1) leveraging existing platforms for centralized cooperation, governance, and infrastructure; 2) strengthening regulatory capacities with the largest potential public health impact; 3) incorporating policies that promote reliance on reference authorities; 4) changing the system to encourage industry to market their products in CARICOM (e.g., using a centralized portal of entry to reduce regulatory burdens); and 5) building human resource capacity. If implemented properly, the CRS will be self-sustaining through user fees. The experience and lessons learned thus far in implementing this initiative, described in this report, can serve as a case study for the development of similar regulatory strengthening initiatives in resource-constrained environments.

Plasma Discharge Initiation of Explosives in Rock Blasting Application: A Case Study

NASA Astrophysics Data System (ADS)

Jae-Ou, Chae; Young-Jun, Jeong; V, M. Shmelev; A, A. Denicaev; V, M. Poutchkov; V, Ravi

2006-07-01

A plasma discharge initiation system for the explosive volumetric combustion charge was designed, investigated and developed for practical application. Laboratory scale experiments were carried out before conducting the large scale field tests. The resultant explosions gave rise to less noise, insignificant seismic vibrations and good specific explosive consumption for rock blasting. Importantly, the technique was found to be safe and environmentally friendly.

Addressing Diversity and Inclusion in the Early Years in Conflict-Affected Societies: A Case Study of the Media Initiative for Children--Northern Ireland

ERIC Educational Resources Information Center

Connolly, Paul; Fitzpatrick, Siobhan; Gallagher, Tony; Harris, Paul

2006-01-01

This article reports on the development and systematic evaluation of an innovative early years programme aimed at encouraging young children to respect differences within a deeply divided society that is emerging out of a prolonged period of violent conflict. The programme, the Media Initiative for Children--Northern Ireland, has been the product…

The Role of Education, Training and Skills Development in Social Inclusion: The University of the Heads of the Valley Case Study

ERIC Educational Resources Information Center

Jones, Paul; Miller, Christopher; Pickernell, David; Packham, Gary

2011-01-01

Purpose: The objective of this paper is to examine the initiation of the University of the Heads of the Valley Initiative (UHOVI) project and evaluate the development of its focus, materials and structure. Design/methodology/approach: The methodology employs interviews with a purposive sample of local employer stakeholders. The rationale for this…

Naive Change Agent or Canny Political Collaborator? The Change in Leadership Role from Nursery School to Children's Centre

ERIC Educational Resources Information Center

Curtis, Lesley; Burton, Diana

2009-01-01

This article presents initial findings from a consideration of early years Labour government policy from 1997 to date and from a case study of an early years leadership journey. The article explores the social policies underlying early years initiatives that have impacted upon early years leadership journeys and roles. The challenge of the role is…

[Pathogenetic relationship between pterygium and dry eye syndrome (clinical and cytological study)].

PubMed

Petraevskiĭ, A V; Trishkin, K S

2014-01-01

To study the prevalence of dry eye syndrome in patients with initial primary pterygium for determination of a possible pathogenetic role of dry eye syndrome in the development of pterygium. 30 patients with initial primary pterygium; besides conventional ophthalmic assessment, cytological examination of bulbar conjunctiva was performed in all cases. Signs of dry eye syndrome, of similar severity in both eyes, were found in 100% of patients. Dry eye can be one of the precipitating factors of primary pterygium.

Using causal loop diagrams for the initialization of stakeholder engagement in soil salinity management in agricultural watersheds in developing countries: a case study in the Rechna Doab watershed, Pakistan.

PubMed

Inam, Azhar; Adamowski, Jan; Halbe, Johannes; Prasher, Shiv

2015-04-01

Over the course of the last twenty years, participatory modeling has increasingly been advocated as an integral component of integrated, adaptive, and collaborative water resources management. However, issues of high cost, time, and expertise are significant hurdles to the widespread adoption of participatory modeling in many developing countries. In this study, a step-wise method to initialize the involvement of key stakeholders in the development of qualitative system dynamics models (i.e. causal loop diagrams) is presented. The proposed approach is designed to overcome the challenges of low expertise, time and financial resources that have hampered previous participatory modeling efforts in developing countries. The methodological framework was applied in a case study of soil salinity management in the Rechna Doab region of Pakistan, with a focus on the application of qualitative modeling through stakeholder-built causal loop diagrams to address soil salinity problems in the basin. Individual causal loop diagrams were developed by key stakeholder groups, following which an overall group causal loop diagram of the entire system was built based on the individual causal loop diagrams to form a holistic qualitative model of the whole system. The case study demonstrates the usefulness of the proposed approach, based on using causal loop diagrams in initiating stakeholder involvement in the participatory model building process. In addition, the results point to social-economic aspects of soil salinity that have not been considered by other modeling studies to date. Copyright © 2015 Elsevier Ltd. All rights reserved.

Visual memory effects on intraoperator study design: determining a minimum time gap between case reviews to reduce recall bias.

PubMed

Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Baker, John J; Smith, Lynette M; Hinrichs, Steven H

2015-03-01

The objective of this research was to determine test intervals between intraoperator case reviews to minimize the impact of recall. Three pathologists were presented with a group of 120 slides and subsequently challenged with a study set of 120 slides after 2-week and 4-week intervals. The challenge set consisted of 60 slides seen during the initial review and 60 slides previously unseen within the study. Pathologists rendered a diagnosis for each slide and indicated whether they recalled seeing the slide previously (yes/no). Two weeks after having been shown 60 cases from a challenge set of 120 cases, the pathologists correctly remembered 26, 22, and 24 cases or 40% overall. After 4 weeks, the pathologists correctly recalled 31% of cases previously seen. Pathologists were capable of recalling from memory cases seen previously at 2 and 4 weeks. Recall rates may be sufficiently high to affect intraobserver study design. Copyright© by the American Society for Clinical Pathology.

A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.

PubMed

Yegya-Raman, Nikhil; Aziz, Rehan; Schneider, Daniel; Tobia, Anthony; Leitch, Megan; Nwobi, Onyi

2017-01-01

Background . Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. Methods . PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder". Case . The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder and unspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease. Discussion . This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations.

Initial Technology Assessment for the Large-Aperture UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Division's 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet/optical/infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for biosignatures via direct-imaging and spectroscopic characterization of habitable exoplanets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV/Optical/Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Initial Technology Assessment for the Large UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee D.; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Divisions 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet-optical-infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for bio-signatures via direct-imaging and spectroscopic characterization of habitable exo-planets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV-Optical Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Dark matter relics and the expansion rate in scalar-tensor theories

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

Dutta, Bhaskar; Jimenez, Esteban; Zavala, Ivonne, E-mail: dutta@physics.tamu.edu, E-mail: este1985@physics.tamu.edu, E-mail: e.i.zavalacarrasco@swansea.ac.uk

We study the impact of a modified expansion rate on the dark matter relic abundance in a class of scalar-tensor theories. The scalar-tensor theories we consider are motivated from string theory constructions, which have conformal as well as disformally coupled matter to the scalar. We investigate the effects of such a conformal coupling to the dark matter relic abundance for a wide range of initial conditions, masses and cross-sections. We find that exploiting all possible initial conditions, the annihilation cross-section required to satisfy the dark matter content can differ from the thermal average cross-section in the standard case. We alsomore » study the expansion rate in the disformal case and find that physically relevant solutions require a nontrivial relation between the conformal and disformal functions. We study the effects of the disformal coupling in an explicit example where the disformal function is quadratic.« less

Comparison between retroperitoneal leiomyosarcoma and dedifferentiated liposarcoma.

PubMed

Ishii, Takeaki; Kohashi, Kenichi; Ootsuka, Hiroshi; Iura, Kunio; Maekawa, Akira; Yamada, Yuichi; Bekki, Hirofumi; Yoshimoto, Masato; Yamamoto, Hidetaka; Iwamoto, Yukihide; Oda, Yoshinao

2017-06-01

It is important to distinguish between leiomyosarcoma (LMS) and dedifferentiated liposarcoma (DDLS) in the retroperitoneum. The dedifferentiated component of DDLS shows an LMS-like morphology in some cases; thus, detailed evaluation is necessary to achieve an accurate diagnosis. Immunohistochemically, MDM2 and myogenic markers provide clues for the diagnoses. However, immunoreactivity for MDM2 and myogenic markers has not been well studied in retroperitoneal LMS and DDLS. Here, we compared the clinicopathological data of 20 retroperitoneal tumors initially diagnosed as LMS with that of 36 cases of retroperitoneal DDLS and conducted an immunohistochemical study. Four (20%) of the cases initially diagnosed as LMS were immunoreactive for MDM2. Fifteen cases (41.7%) of DDLS showed positive expression of two or more myogenic markers. The patients with LMS with MDM2 overexpression were older than the patients with LMS without MDM2 overexpression (P=0.0328). LMS with MDM2 overexpression showed a worse prognosis than DDLS (P=0.0408). No significant difference in prognosis was found between LMS without MDM2 overexpression and DDLS with myogenic differentiation. In conclusion, we recommend that systemic MDM2 expression analysis be performed in cases of retroperitoneal sarcoma. Overdependence on the expression of myogenic markers could lead to misdiagnosis in distinguishing LMS from DDLS. Copyright © 2017 Elsevier GmbH. All rights reserved.

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

PubMed

Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

2011-09-27

Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

Influence of different computational approaches for stent deployment on cerebral aneurysm haemodynamics

PubMed Central

Bernardini, Annarita; Larrabide, Ignacio; Morales, Hernán G.; Pennati, Giancarlo; Petrini, Lorenza; Cito, Salvatore; Frangi, Alejandro F.

2011-01-01

Cerebral aneurysms are abnormal focal dilatations of artery walls. The interest in virtual tools to help clinicians to value the effectiveness of different procedures for cerebral aneurysm treatment is constantly growing. This study is focused on the analysis of the influence of different stent deployment approaches on intra-aneurysmal haemodynamics using computational fluid dynamics (CFD). A self-expanding stent was deployed in an idealized aneurysmatic cerebral vessel in two initial positions. Different cases characterized by a progression of simplifications on stent modelling (geometry and material) and vessel material properties were set up, using finite element and fast virtual stenting methods. Then, CFD analysis was performed for untreated and stented vessels. Haemodynamic parameters were analysed qualitatively and quantitatively, comparing the cases and the two initial positions. All the cases predicted a reduction of average wall shear stress and average velocity of almost 50 per cent after stent deployment for both initial positions. Results highlighted that, although some differences in calculated parameters existed across the cases based on the modelling simplifications, all the approaches described the most important effects on intra-aneurysmal haemodynamics. Hence, simpler and faster modelling approaches could be included in clinical workflow and, despite the adopted simplifications, support clinicians in the treatment planning. PMID:22670204

A follow-up study of neonatal interatrial shunt with echocardiography until twelve to fifteen months of age.

PubMed

Ho, Chi-Lin; Jan, Sheng-Ling; Lin, Ming-Chih; Fu, Yun-Ching

2008-12-01

To assess the incidence and natural history of full-term neonates with interatrial shunt (IAS). A follow-up study of 1389 neonates who received screening echocardiography between 2003 and 2006. Babies with IAS at 2 to 4 days of life underwent follow-up echocardiography at 2 to 4 months, 6 to 9 months and 12 to 15 months of age until closure of IAS. The ratio of IAS was 68.3% initially. No significant demographic differences were identified between infants with and without initial IAS. Among 949 neonates with initial IAS, 84.5% infants had a left-to-right interatrial shunt, 13.5% had bidirectional shunt and 2% had predominantly right-to-left shunt. The persistence rate of IAS at 12 to 15 months of age was 3.8% (44/1166). The initial size of IAS ranged from 1.2 to 7.7mm (4.3+/-1.1 mm) detected by color Doppler flow mapping and cases were divided into three groups: small (< or =5 mm), medium (5 to 8 mm) and large group (> or =8 mm). There were 74.6% infants in the small group and 25.4% in the medium group initially. The neonates in the initial small group would always see their IAS close or else they would remain in the small group. Those in the final medium and large size groups always came from the initial medium group. The late closure rate of IAS was 93.9% of infants with initial IAS. The closure curves of initial small and medium sized groups were significantly different, and their late closure rates were 95.1% and 90.4%, respectively. IAS was very common during early neonatal stage, but most cases would close after 1 year. The late closure rate of initial IAS was different if using a cutpoint of 5 mm.

Development of a military competency checklist for case management.

PubMed

Stanton, Marietta P; Swanson, Carol; Baker, Rebecca D

2005-01-01

This presentation will discuss the design, implementation, and evaluation of a competency-based checklist in military nursing network. The checklist was initiated to help assess case manager competency where background and preparation for the case manager role were quite diverse. The checklist assisted initially with the assessment of learning needs; later, it served as a self-assessment for case managers to determine their areas for improvement. Finally, the assessment was used not only to verify competency by the case management supervisor, but also to establish systemwide quality in case management.

Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration.

PubMed

Brown, S Lori; Greene, Mark H; Gershon, Sharon K; Edwards, Evelyne T; Braun, M Miles

2002-12-01

Etanercept and infliximab are tumor necrosis factor (TNF) antagonists that have been recently approved for the treatment of rheumatoid arthritis (RA) and Crohn's disease (CD). This study was undertaken to investigate the occurrence of lymphoproliferative disorders in patients treated with these agents. Relevant data in the MedWatch postmarket adverse event surveillance system run by the US Food and Drug Administration were reviewed. We identified 26 cases of lymphoproliferative disorders following treatment with etanercept (18 cases) or infliximab (8 cases). The majority of cases (81%) were non-Hodgkin's lymphomas. The interval between initiation of therapy with etanercept or infliximab and the development of lymphoma was very short (median 8 weeks). In 2 instances (1 infliximab, 1 etanercept), lymphoma regression was observed following discontinuation of anti-TNF treatment, in the absence of specific cytotoxic therapy directed toward the lymphoma. Although data from a case series such as this cannot establish a clear causal relationship between exposure to these medications and the risk of lymphoproliferative disease, the known predisposition of patients with RA and CD to lymphoma, the known excess of lymphoma in other immunosuppressed populations, and the known immunosuppressive effects of the anti-TNF drugs provide a biologic basis for concern and justification for the initiation of additional epidemiologic studies to formally evaluate this possible association.

The spectrum of progressive derecho formation environments

NASA Astrophysics Data System (ADS)

Guastini, Corey T.

Progressive derechos are severe mesoscale convective systems that often form east of the Rocky Mountains during the warm season (May--August) and cause, by definition, straight-line wind damage along paths upwards of 400 km long. This study develops a subjective, seven-category classification scheme that spans the spectrum of progressive derecho formation environments from those dominated by robust upper-level ridges to those characterized by vigorous upper-level troughs. A climatology of 256 progressive derecho events is created for 1996--2013 and is categorized according to the developed classification scheme. Derecho initiation-relative composites are constructed for each of the seven groups using 0.5° Climate Forecast System Reanalysis data to document the environmental characteristics unique to each group as well as those shared among them. Finally, two in-depth case studies and five cursory case studies provide examples of the seven categories and reveal important nuances in mesoscale dynamic and thermodynamic structure inherent to all derecho cases. Results of the climatology show progressive derecho activity increases from 1 May through 1 July before decreasing again through the end of August and follows a northward trend in latitude from 1 May through 1 August before shifting slightly southward through the end of the warm season. Upslope flow in the vicinity of the Rocky Mountains initiates 28 percent of progressive derechos, upper-level troughs initiate 20 percent, 47 percent form in benign synoptic environments, and 5 percent are unclassifiable. Composite results show all progressive derecho initiation environments are marked by a long axis of instability caused by the overlap of high atmospheric moisture content and steep midlevel lapse rates, but the relative positions and strengths of upper-level troughs and ridges are crucial in determining how the instability axis develops and what its orientation in space will be. Case studies reveal instability axes forming in benign synoptic environments are generally zonally oriented and mainly the result of convergence of low-level moisture, whereas stronger synoptic-scale forcing forms meridionally oriented instability axes through the northward advection of Gulf moisture. The length and magnitude of these instability axes largely determines the duration and severity of a given progressive derecho.

Multicenter study of combination DEP regimen as a salvage therapy for adult refractory hemophagocytic lymphohistiocytosis.

PubMed

Wang, Yini; Huang, Wenqiu; Hu, Liangding; Cen, Xinan; Li, Lihong; Wang, Jijun; Shen, Jianliang; Wei, Na; Wang, Zhao

2015-11-05

Hemophagocytic lymphohistiocytosis (HLH) is a refractory immune disorder with a significant risk of death. Although standard therapy has dramatically improved survival in HLH patients, approximately 30%, especially adults, show no response to current treatment strategies. This prospective study aimed to investigate the efficacy of liposomal doxorubicin treatment combined with etoposide and methylprednisolone (doxorubicin-etoposide-methylprednisolone; DEP) as a salvage therapy for adult refractory HLH. Adult patients who did not achieve at least partial response 2 weeks after initial standard HLH therapy were enrolled in this study between June 2013 and June 2014. Response to salvage therapy was assessed at 2 and 4 weeks after initiation of DEP therapy and patients were followed until death or until November 2014. Sixty-three refractory HLH patients were enrolled, including 29 cases of lymphoma-associated HLH, 22 cases of Epstein-Barr virus-associated HLH, and 4 cases of familial HLH. There were 8 cases with unknown underlying diseases. Seventeen cases (27.0%) achieved complete response and 31 cases (49.2%) achieved partial response. The overall response was 76.2% (48/63). Patients who showed no response to DEP died within 4 weeks after salvage therapy. Twenty-nine of the 48 patients who achieved partial or complete response survived to subsequent chemotherapy, allogenic hematopoietic stem cell transplantation, or splenectomy. Our study suggests that DEP regimen is an effective salvage regimen for adult refractory HLH, which can prolong patient survival as we continue to understand the responsible mechanisms and bridge the gap between HLH and its underlying diseases. This study was registered in the Chinese Clinical Trials Registry Platform (http://www.chictr.org.cn/) as ChiCTR-IPC-14005514. © 2015 by The American Society of Hematology.

Increased suicide risk and clinical correlates of suicide among patients with Parkinson's disease.

PubMed

Lee, Taeyeop; Lee, Hochang Benjamin; Ahn, Myung Hee; Kim, Juyeon; Kim, Mi Sun; Chung, Sun Ju; Hong, Jin Pyo

2016-11-01

Parkinson's disease (PD) is a debilitating, neurodegenerative condition frequently complicated by psychiatric symptoms. Patients with PD may be at higher risk for suicide than the general population, but previous estimates are limited and conflicting. The aim of this study is to estimate the suicide rate based on the clinical case registry and to identify risk factors for suicide among patients diagnosed with PD. The target sample consisted of 4362 patients diagnosed with PD who were evaluated at a general hospital in Seoul, South Korea, from 1996 to 2012. The standardized mortality ratio for suicide among PD patients was estimated. In order to identify the clinical correlates of suicide, case-control study was conducted based on retrospective chart review. The 29 suicide cases (age: 62.3 ± 13.7 years; females: 34.5%) were matched with 116 non-suicide controls (age: 63.5 ± 9.2 years; females 56.9%) by the year of initial PD evaluation. The SMR for suicide in PD patients was 1.99 (95% CI 1.33-2.85). Mean duration from time of initial diagnosis to suicide among cases was 6.1 ± 3.5 years. Case-control analysis revealed that male, initial extremity of motor symptom onset, history of depressive disorder, delusion, any psychiatric disorder, and higher L-dopa dosage were significantly associated with suicide among PD patients. Other PD-related variables such as UPDRS motor score were not significantly associated with death by suicide. Suicide risk in PD patients is approximately 2 times higher than that in the general population. Psychiatric disorders, and also L-dopa medication need further attention with respect to suicide. Copyright © 2016 Elsevier Ltd. All rights reserved.

How Health in All Policies are developed and implemented in a developing country? A case study of a HiAP initiative in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Sedoghi, Zeynab; Mehrolhassani, Mohammad Hossein; Yazdi-Feyzabadi, Vahid

2016-12-01

Population health is influenced by many factors beyond the control of health system which should be addressed by other sectors through inter-sectoral collaboration (ISC). Countries have adopted diverse initiatives to operationalize ISC for health such as establishment of Councils of Health and Food Security (CHFSs) and development of provincial Health Master Plans (HMPs) in Iran. The literature, however, provides meager information on how these initiatives have been moved into the top policy agenda, how and by whom they have been formulated and what factors enable or inhibit their implementation. In addressing these knowledge gaps, we employed a qualitative case study approach, incorporating mixed methods: in-depth interviews and a textual analysis of policy documents. Iran founded the Supreme Council of Health and Food Security (SCHFS) at national level in 2006 followed by provincial and district CHFSs to ensure political commitment to ISC for health and Health in All Policies (HiAPs). In 2009, the SCHFS mandated all provincial CHFSs across the country to develop provincial HMP to operationalize the HiAP approach and Kerman was among the first provinces which responded to this call. We selected Kerman province HMP as a case study to investigate the research questions raised in this study. The study revealed two types of leverage, which played crucial role in agenda setting, policy formulation and implementation of HMP including politics (political commitment) and policy entrepreneurs. The multiple streams model was found to be informative for thinking about different stages of a policy cycle including agenda setting, policy formulation and policy implementation. It was also found to be a useful framework in analyzing HiAP initiatives as these policies do not smoothly and readily reach the policy agenda. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

76 FR 31588 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

...) and 70 FR 62061 (October 28, 2005). Guidance on methodological or analytical issues relevant to the...), we are initiating the Sunset Review of the following antidumping duty orders: DOC case no. ITC case...

77 FR 32527 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

...) and 70 FR 62061 (October 28, 2005). Guidance on methodological or analytical issues relevant to the... initiating the Sunset Review of the following antidumping duty order: DOC Case No. ITC Case No. Country...

77 FR 53867 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

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78 FR 13862 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-01

...) and 70 FR 62061 (October 28, 2005). Guidance on methodological or analytical issues relevant to the... initiating a Sunset Review of the following antidumping duty order: Department DOC Case No. ITC Case No...

75 FR 53664 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

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76 FR 24459 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

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77 FR 19643 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

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76 FR 67412 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

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77 FR 4995 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

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[Pleural metastases of renal carcinoma].

PubMed

Giigoruk, O G; Lazarev, A F; Doroshenko, V S

2007-01-01

Metastases in renal carcinoma are diagnosed at initial diagnosis in 25% examinees. Traditional renal carcinoma has higher metastatic potential, is associated with worse survival of the patients compared to papillary cancer. We studied cytological characteristics of renal carcinoma metastases to the pleura in comparison with histological studies of the primary lesion using immunohistochemical findings. We examined cytologically pleural liquid in renal carcinoma metastases to the pleura in 6 patients (2.3% of carcinomatous pleuricies). High efficacy was shown by a cytocentrifuge CYTOSPIN-4. In 3 cases initial cancer was renal cell carcinoma, pleural exudation developed 2 years later, clear cell carcinoma appeared 6 years later and papillary cancer--10 years later. In the other 3 cases malignant cells were detected in new-onset cases. Renal carcinoma was diagnosed in one case. Cytological preparations were studied with identification of cytological signs typical for classic clear cell, granulocell and papillary renal cancer. Immunohistochemical examination of primary tumor lesion in the kidney discovered high proliferative activity of tumor cells by Ki-67 index to 5.28%. The tumors had solitary Bcl-2 positive cells. Expression of mutant p-53 took place in 0.93%. Her-2/neu hyperexpression was not found in the tumors of the above patients. Such immunohistochemical parameters point to poor prognosis. This is confirmed by renal carcinoma metastases to the pleura.

Mesoscale Simulation Data for Initializing Fast-Time Wake Transport and Decay Models

NASA Technical Reports Server (NTRS)

Ahmad, Nashat N.; Proctor, Fred H.; Vanvalkenburg, Randal L.; Pruis, Mathew J.; LimonDuparcmeur, Fanny M.

2012-01-01

The fast-time wake transport and decay models require vertical profiles of crosswinds, potential temperature and the eddy dissipation rate as initial conditions. These inputs are normally obtained from various field sensors. In case of data-denied scenarios or operational use, these initial conditions can be provided by mesoscale model simulations. In this study, the vertical profiles of potential temperature from a mesoscale model were used as initial conditions for the fast-time wake models. The mesoscale model simulations were compared against available observations and the wake model predictions were compared with the Lidar measurements from three wake vortex field experiments.

Fat embolism syndrome in femoral shaft fractures: does the initial treatment make a difference?

PubMed

Silva, Jânio José Alves Bezerra; Diana, Diogo de Almeida; Salas, Victor Eduardo Roman; Zamboni, Caio; Hungria Neto, José Soares; Christian, Ralph Walter

2017-01-01

To identify the risk factors correlated with the initial treatment performed. This is a retrospective study involving a total of 272 patients diagnosed with femoral shaft fractures. Of the patients, 14% were kept at rest until the surgical treatment, 52% underwent external fixation, 10% received immediate definitive treatment, and 23% remained in skeletal traction (23%) until definitive treatment. There were six cases of fat embolism syndrome (FES), which showed that polytrauma is the main risk factor for its development and that initial therapy was not important. Polytrauma patients have a greater chance of developing FES and there was no influence from the initial treatment.

Differential diffusion effects on buoyancy-driven instabilities of acid-base fronts: the case of a color indicator.

PubMed

Kuster, S; Riolfo, L A; Zalts, A; El Hasi, C; Almarcha, C; Trevelyan, P M J; De Wit, A; D'Onofrio, A

2011-10-14

Buoyancy-driven hydrodynamic instabilities of acid-base fronts are studied both experimentally and theoretically in the case where an aqueous solution of a strong acid is put above a denser aqueous solution of a color indicator in the gravity field. The neutralization reaction between the acid and the color indicator as well as their differential diffusion modifies the initially stable density profile in the system and can trigger convective motions both above and below the initial contact line. The type of patterns observed as well as their wavelength and the speed of the reaction front are shown to depend on the value of the initial concentrations of the acid and of the color indicator and on their ratio. A reaction-diffusion model based on charge balances and ion pair mobility explains how the instability scenarios change when the concentration of the reactants are varied.

Progressing From Initially Ambiguous Functional Analyses: Three Case Examples

PubMed Central

Tiger, Jeffrey H.; Fisher, Wayne W.; Toussaint, Karen A.; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994). These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments. PMID:19233611

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction

PubMed Central

Scheibel, Paula Cabrini; Ramos, Adilson Luiz; Iwaki, Lilian Cristina Vessoni; Micheletti, Kelly Regina

2014-01-01

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction. PMID:25715722

Treatment outcomes in 3 modes of orthodontic practice.

PubMed

Poulton, Donald R; Baumrind, Sheldon; Vlaskalic, Vicki

2002-02-01

This study examined differences in pretreatment severity and treatment outcome among orthodontic patients treated in 3 different practice-management modes. Samples of pretreatment (T1) and end of treatment (T2) study casts were selected from traditional private practices (TPP, 3 offices, 81 cases), a dental corporation (COMP, 2 offices, 53 cases), and a dental management service organization (DMSO, 1 office, 36 cases). Orthodontic specialists had treated all patients. Cases were initially selected on a consecutive start basis. From each practice, the first 30 cases satisfying the study criteria were included in the sample. The T1 and T2 study casts were evaluated with the PAR and HLD indexes. The PAR and HLD indexes showed a high level of agreement on T1 cast scores but not on the T2 casts. Mean T1 scores were highest in the COMP cases, followed by the DMSO and the TPP cases. T2 scores were lowest in the TPP cases, followed by the DMSO and the COMP cases. The percentage of PAR score reduction showed that, in all 3 modes, patients were treated to a high standard.

Another look at roles and functions: has hospital case management lost its way?

PubMed

Reynolds, John J

2013-01-01

The purpose of this study was to identify the roles, functions, and types of activities that hospital case managers engage in on a day-to-day basis and that leverage the most amounts of time. Previous studies superimpose a priori categories on research tools. Hospital case management. This study analyzes 4,064 spontaneous, unstructured list serve postings from the American Case Management Association Learning Link list serve from August 15, 2011, to August 18, 2012. The study group was a cross section of 415 case management professionals. The data suggest that hospital case managers' time is inordinately leveraged by issues related to observation status/leveling of patients and the Centers for Medicare and Medicaid Services compliance. The data also suggest that hospital case management has taken a conceptual trajectory that has deviated significantly from what was initially conceived (quality, advocacy, and care coordination) and what is publicly purported. Case management education and practical orientation will need to be commensurate with this emerging emphasis. Case management leadership will need to be adept at mitigating the stresses of role confusion, role conflict, and role ambiguity.

Students' Experiences With/in Integrated Environmental Studies Programs in Ontario

ERIC Educational Resources Information Center

Breunig, Mary; Murtell, Jocelyn; Russell, Constance

2015-01-01

In Canada there exists a noteworthy educational initiative referred to as Environmental Studies Programs (ESPs). These secondary school programs are interdisciplinary, helping to link subject matter and encouraging student responsibility. The results of three case studies of Ontario ESPs indicate that program participation has "real…

Symptomatic peripheral mycotic aneurysms due to infective endocarditis: a contemporary profile.

PubMed

González, Isabel; Sarriá, Cristina; López, Javier; Vilacosta, Isidre; San Román, Alberto; Olmos, Carmen; Sáez, Carmen; Revilla, Ana; Hernández, Miguel; Caniego, Jose Luis; Fernández, Cristina

2014-01-01

Peripheral mycotic aneurysms (PMAs) are a relatively rare but serious complication of infective endocarditis (IE). We conducted the current study to describe and compare the current epidemiologic, microbiologic, clinical, diagnostic, therapeutic, and prognostic characteristics of patients with symptomatic PMAs (SPMAs). A descriptive, comparative, retrospective observational study was performed in 3 tertiary hospitals, which are reference centers for cardiac surgery. From 922 definite IE episodes collected from 1996 to 2011, 18 patients (1.9%) had SPMAs. Because all SPMAs developed in left-sided IE, we performed a comparative study between 719 episodes of left-sided IE without SPMAs and 18 episodes with SPMAs. We found a higher frequency of intravenous drug abuse, native valve IE, intracranial bleeding, septic emboli, multiple embolisms, and IE diagnostic delay >30 days in patients with SPMAs than in patients without SPMAs. The causal microorganisms were gram-positive cocci (n =10), gram-negative bacilli (n = 2), gram-positive bacilli (n = 3), Bartonella henselae (n = 1), Candida albicans (n = 1), and negative culture (n = 1). The median IE diagnosis delay was 15 days (interquartile range [IQR], 13-33 d) in the case of high-virulence microorganisms versus 45 days (IQR, 30-240 d) in the case of low- to medium-virulence microorganisms. Twelve SPMAs were intracranial and 6 were extracranial. In 10 cases (8 intracranial and 2 extracranial), SPMAs were the initial presentation of IE; the remaining cases developed symptoms during or after finishing parenteral antibiotic treatment. The initial diagnosis of intracranial SPMAs was made by computed tomography (CT) or magnetic resonance imaging in 6 unruptured aneurysms and by angiography in 6 ruptured aneurysms. The initial test in extracranial SPMAs was Doppler ultrasonography in limbs, CT in liver, and coronary angiography in heart. Four (3 intracranial, 1 extracranial) of 7 (6 intracranial, 1 extracranial) patients treated only with antibiotics died. Surgical resection was performed in 7 (3 intracranial, 4 extracranial) and endovascular repair in 4 (3 intracranial, 1 extracranial) patients; all of them survived. In conclusion, we found that SPMAs were a rare complication of IE that developed only in left-sided IE, and especially in native valves. Intracranial hemorrhage, embolism, multiple embolisms, and diagnostic delay of IE were more common in patients with SPMAs. The microbiologic profile was diverse, but microorganisms of low-medium virulence were predominant, and had a greater delayed diagnosis of IE than those caused by microorganisms of high virulence. SPMAs were often the initial presentation of IE. The most common location of SPMAs was intracranial. Noninvasive radiologic imaging techniques were the initial imaging test in intracranial unruptured SPMAs and in most extracranial SPMAs. Surgical and endovascular treatments were safe and effective. Endovascular treatment could be the first line of treatment in selected cases. Mortality was high in those cases treated only with antibiotics.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases.

PubMed

Gong, Li; Liu, Xiao-Yan; Zhang, Wen-Dong; Zhu, Shao-Jun; Yao, Li; Han, Xiu-Juan; Lan, Miao; Li, Yan-Hong; Zhang, Wei

2012-09-19

Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Case Report: Human Bocavirus Associated Pneumonia as Cause of Acute Injury, Cologne, Germany.

PubMed

Krakau, Michael; Gerbershagen, Kathrin; Frost, Ulrich; Hinzke, Markus; Brockmann, Michael; Schildgen, Verena; Gomann, Axel; Limmroth, Volker; Dormann, Arno; Schildgen, Oliver

2015-10-01

Although the human bocavirus (HBoV) is known since a decade, limited information about its pathogenesis is available due to the lack of an animal model. Thus, clinical cases and studies are the major source of novel information about the course of infection and the related pathophysiology.In this context, a clinical case of an adult patient suffering from severe HBoV-pneumonia is described that was associated with loss of consciousness followed by acute rib fracture and subsequent neurological disorder.Following initial global respiratory dysfunction the clinical respiratory symptoms recovered but the neurological symptoms maintained after weaning and intensive care in the stroke unit. During the initial phase, an acute active HBoV infection was confirmed by positive polymerase chain reactions from bronchoalveolar lavage fluid and serum.The case further demonstrates that HBoV can cause severe pneumonia, induce secondary disease also in adults, and may be associated with neurological symptoms as previously assumed.