12 CFR 370.5 - Participation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

12 CFR 370.5 - Participation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

Raising awareness of assistive technology in older adults through a community-based, cooperative extension program.

PubMed

Sellers, Debra M; Markham, Melinda Stafford

2012-01-01

The Fashion an Easier Lifestyle with Assistive Technology (FELAT) curriculum was developed as a needs-based, community educational program provided through a state Cooperative Extension Service. The overall goal for participants was to raise awareness of assistive technology. Program evaluation included a postassessment and subsequent interview to determine short-term knowledge gain and longer term behavior change. The sample consisted of mainly older, married females. The FELAT program was effective at raising awareness and increasing knowledge of assistive technology, and for many participants, the program acted as a catalyst for planning to or taking action related to assistive technology.

Entering Industry: A Case Study of Links between a School Vocational Program and the Building and Construction Industry

ERIC Educational Resources Information Center

Taylor, Anthea

2004-01-01

Few studies have tracked youth transition beyond the immediate post-school period or have looked at the longer-term outcomes of post-school programs. This study reports the findings of a case study investigating links between an industry-specific school vocational education and training (VET) program and subsequent work transitions to the building…

Exploratory Advanced Research Program

DOT National Transportation Integrated Search

2014-12-31

Exploratory advanced research focuses on longer-term, higher-risk research with a high payoff potential. It matches opportunities from discoveries in science and technology with the needs of specific industries. The uncertainties in the research appr...

Exploratory Advanced Research Program

DOT National Transportation Integrated Search

2016-12-15

Exploratory advanced research focuses on longer term, higher risk research with a high payoff potential. It matches opportunities from discoveries in science and technology with the needs of specific industries. The uncertainties in the research appr...

Hawai'i Youth at Risk? Conceptual Challenges in Communicating a Statewide Mentoring Initiative.

ERIC Educational Resources Information Center

Pollard, Vincent Kelly

This paper discusses several issues considered as part of a statewide mentoring initiative. It is divided into three sections. The first section summarizes the key issues associated with short-term mentoring and mentoring in a longer-term, socially transformative context. Data from Comprehensive School Alienation Program is discussed concerning…

Full-Day Kindergarten: Indicators on Children and Youth

ERIC Educational Resources Information Center

Child Trends, 2015

2015-01-01

Overall, children who spend time in full-day kindergarten programs are more likely than children who spend time in half-day kindergarten programs to devote time every day to reading, mathematics, and social studies. Research is inconclusive on longer-term impacts. Trends identified in this report include: (1) since 1977, the percentage of…

Public-Interest Values and Program Sustainability: Some Implications for Evaluation Practice

ERIC Educational Resources Information Center

Chelimsky, Eleanor

2014-01-01

Evaluating the longer-term sustainability of government programs and policies seems in many ways to go beyond the boundaries of typical evaluation practice. Not only have intervention failures over time been difficult to predict, but the question of sustainability itself tends to fall outside current evaluation thinking, timing and functions. This…

Bridging Troubled Waters: Helping Students Make the Transition from High School to University

ERIC Educational Resources Information Center

Pancer, S. Mark; Pratt, Michael; Hunsberger, Bruce; Alisat, Susan

2004-01-01

This article discusses recent programs and procedures based at Wilfrid Laurier University in Waterloo, Ontario, designed to help students' transition from high school to university. Students are poorly prepared for university, and the meagre assistance they get from pre-university orientations, or even from longer-term programs such as University…

U.S. - African Partnerships: Advancing Common Interests

DTIC Science & Technology

2017-12-01

discussions on: – Governance, institutions, and effective partnerships – Prospects for enhancing economic partnerships – Opportunities and challenges in...U.S. administrations, emphasizing peace and security, countering terrorism, increasing economic growth, and promoting democracy and good governance...often focused on short- term security or economic objectives, while neglecting infrastructure projects and longer term programs that would empower

Schools as Incubators of Democratic Participation: Building Long-Term Political Efficacy with Civic Education

ERIC Educational Resources Information Center

Pasek, Josh; Feldman, Lauren; Romer, Daniel; Jamieson, Kathleen Hall

2008-01-01

Despite a growing consensus that civic education is an important aspect of political socialization, little research has prospectively examined how gains made during civics courses are maintained after high school. This study used a quasi-experimental design to examine longer-term effects of the Student Voices program, which was originally…

Doing More with Less: Civic Practices for Longer-Term Impact in Global Service-Learning

ERIC Educational Resources Information Center

Alonso García, Nuria; Longo, Nicholas V.

2017-01-01

This essay explores the potential value of short-term study abroad experiences within the unique framework of a new global service-learning program at Providence College which connects international with local engagement as a way to "do more with less." The authors first introduce a typology for global service-learning, illustrating how…

Using Photo-Elicitation Methods to Understand Resilience among Ultra-Poor Youth and Their Caregivers in Malawi

ERIC Educational Resources Information Center

Barrington, Clare; Villa-Torres, Laura; Abdoulayi, Sara; Tsoka, Maxton Grant; Mvula, Peter Matthias

2017-01-01

Unconditional cash transfer programs are a form of structural intervention to address poverty, a "fundamental cause" of disease. Such programs increasingly aim to build resilience to sustain improved outcomes and provide a solid foundation for longer term transformations. As such, there is a need to understand what resilience means in…

Do Conditional Cash Transfers for Schooling Generate Lasting Benefits? A Five-Year Followup of PROGRESA/Oportunidades

ERIC Educational Resources Information Center

Behrman, Jere R.; Parker, Susan W.; Todd, Petra E.

2011-01-01

Conditional cash transfer (CCT) programs link public transfers to human capital investment in hopes of alleviating current poverty and reducing its intergenerational transmission. However, little is known about their long-term impacts. This paper evaluates longer-run impacts on schooling and work of the best-known CCT program, Mexico's…

Environmental restoration and waste management: Robotics technology development program: Robotics 5-year program plan. [Contains glossary

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

Not Available

This plan covers robotics Research, Development, Demonstration, Testing, activities in the Program for the next five years. These activities range from bench-scale R D to fullscale hot demonstrations at DOE sites. This plan outlines applications of existing technology to near-term needs, the development and application of enhanced technology for longer-term needs, and an initiation of advanced technology development to meet those needs beyond the five-year plan. The objective of the Robotic Technology Development (RTDP) is to develop and apply robotics technologies that will enable Environmental Restoration and Waste Management operations at DOE sites to be safer, faster and cheaper. Fivemore » priority DOE sites were visited in March 1990 to identify needs for robotics technology in ER WM operations. This 5-Year Program Plan for the RTDP detailed annual plans for robotics technology development based on identified needs. This 5-Year Program Plan discusses the overall approach to be adopted by the RTDP to aggressively develop robotics technology and contains discussions of the Program Management Plan, Site Visit and Needs Summary, Approach to Needs-Directed Technical Development, Application-Specific Technical Development, and Cross-Cutting and Advanced Technology. Integrating application-specific ER WM needs, the current state of robotics technology, and the potential benefits (in terms of faster, safer, and cheaper) of new technology, the Plan develops application-specific road maps for robotics RDDT E for the period FY 1991 through FY 1995. In addition, the Plan identifies areas where longer-term research in robotics will have a high payoff in the 5- to 20-year time frame. 12 figs.« less

Assessing Global Learning in Short-Term Study Abroad: Population, Environment, and Society in Shanghai

ERIC Educational Resources Information Center

Core, Rachel S.

2017-01-01

This teaching note suggests that a short-term study abroad program embedded within a longer course can be a tool for enhancing global learning. The work uses the Association of American Colleges and Universities (AAC&U) Global Learning VALUE rubric to evaluate student work from a spring break seminar to Shanghai, China. The seminar was…

Promoting Critical Reflection: An Evaluation of the Longer-Term Impact of a Substantial Faculty Development Program

ERIC Educational Resources Information Center

Calkins, Susanna; Harris, Muveddet

2017-01-01

For many faculty, critical reflection on teaching and learning requires space and time that is not readily available. For fifteen years, we have run a substantial year-long faculty development program designed to help participants: (1) reflect critically on their teaching and their students' learning; and (2) develop a project related to their…

Seattle's Law Enforcement Assisted Diversion (LEAD): Program effects on recidivism outcomes.

PubMed

Collins, Susan E; Lonczak, Heather S; Clifasefi, Seema L

2017-10-01

Drug users and dealers frequently cycle through the criminal justice system in what is sometimes referred to as a "revolving door." Arrest, incarceration and prosecution have not deterred this recidivism. Seattle's Law Enforcement Assisted Diversion (LEAD) program was established to divert these individuals to case management and supportive services instead of jail and prosecution. A nonrandomized controlled evaluation was conducted to examine LEAD effects on criminal recidivism (i.e., arrests, criminal charges). The sample included 318 people suspected of low-level drug and prostitution activity in downtown Seattle: 203 received LEAD, and 115 experienced the system-as-usual control condition. Analyses were conducted using logistic generalized estimating equation models over both the shorter term (i.e., six months prior and subsequent to evaluation entry) and longer term (i.e., two years prior to the LEAD start date through July 2014). Compared to controls, LEAD participants had 60% lower odds of arrest during the six months subsequent to evaluation entry; and both a 58% lower odds of arrest and 39% lower odds of being charged with a felony over the longer term. These statistically significant differences in arrests and felony charges for LEAD versus control participants indicated positive effects of the LEAD program on recidivism. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mini-dome Fresnel lens photovoltaic concentrator development

NASA Technical Reports Server (NTRS)

Oneill, Mark J.; Piszczor, Michael F., Jr.

1991-01-01

Since 1986 work on a new high-performance, light-weight space photovoltaic concentration array has been conducted. An update on the mini-dome lens concentrator array development program is provided. Recent prototype cell and lens test results indicate that near-term array performance goals of 300 w/sq m and 100 w/kg are feasible, and that a longer-term goal of 200 w/kg is reasonable.

Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

ERIC Educational Resources Information Center

Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

2011-01-01

Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

PubMed

Stice, Eric; Marti, C Nathan; Rohde, Paul; Shaw, Heather

2011-06-01

Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Testing Mediators Hypothesized to Account for the Effects of a Dissonance Eating Disorder Prevention Program Over Longer-Term Follow-Up

PubMed Central

Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

2011-01-01

Objective Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method Data were drawn from a randomized effectiveness trial in which 306 female high school students (M age = 15.7 SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results Dissonance participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions Findings provided support for the intervention theory of this eating disorder prevention program over longer-term follow-up, extending the evidence base for this effective intervention. PMID:21500884

National Study of Chronic Disease Self-Management: Age Comparison of Outcome Findings

ERIC Educational Resources Information Center

Ory, Marcia G.; Smith, Matthew Lee; Ahn, SangNam; Jiang, Luohua; Lorig, Kate; Whitelaw, Nancy

2014-01-01

Introduction: The adult population is increasingly experiencing one or more chronic illnesses and living with such conditions longer. The Chronic Disease Self-Management Program (CDSMP) helps participants cope with chronic disease-related symptomatology and improve their health-related quality of life. Nevertheless, the long-term effectiveness of…

Student Success Factors in Graduate Psychology Professional Programs

ERIC Educational Resources Information Center

Newhouse, Noelle K.; Cerniak, Jessica

2016-01-01

Research examining factors contributing to online students' success typically focuses on a single point in time or completion of a single course, as well as individual difference variables, such as learning style or motivation, that may predispose a student to succeed. However, research concerning longer term online student outcomes, such as…

A Cognitive- Behavioral Therapeutic Program for Patients with Obesity and Binge Eating Disorder: Short- and Long- Term Follow-Up Data of a Prospective Study

ERIC Educational Resources Information Center

Vanderlinden, Johan; Adriaensen, An; Vancampfort, Davy; Pieters, Guido; Probst, Michel; Vansteelandt, Kristof

2012-01-01

The goal of this study is to investigate the efficacy of a manualized cognitive-behavioral therapeutic (CBT) approach for patients with obesity and binge eating disorder (BED) on the short and longer term. A prospective study without a control group consisting of three measurements (a baseline measurement and two follow-up assessments up to 5…

NASA Research on General Aviation Power Plants

NASA Technical Reports Server (NTRS)

Stewart, W. L.; Weber, R. J.; Willis, E. A.; Sievers, G. K.

1978-01-01

Propulsion systems are key factors in the design and performance of general aviation airplanes. NASA research programs that are intended to support improvements in these engines are described. Reciprocating engines are by far the most numerous powerplants in the aviation fleet; near-term efforts are being made to lower their fuel consumption and emissions. Longer-term work includes advanced alternatives, such as rotary and lightweight diesel engines. Work is underway on improved turbofans and turboprops.

DO FAMILY PLANNING PROGRAMS DECREASE POVERTY? EVIDENCE FROM PUBLIC CENSUS DATA

PubMed Central

Bailey, Martha J.; Malkova, Olga; Norling, Johannes

2014-01-01

This paper provides new evidence that family planning programs are associated with a decrease in the share of children and adults living in poverty. Our research design exploits the county roll-out of U.S. family planning programs in the late 1960s and early 1970s and examines their relationship with poverty rates in the short and longer-term in public census data. We find that cohorts born after federal family planning programs began were less likely to live in poverty in childhood and that these same cohorts were less likely to live in poverty as adults. PMID:25346655

Social Justice Activism: Feminism and Strategies for Action

ERIC Educational Resources Information Center

Fernflores, Rachel

2016-01-01

Success in social justice activism often hinges on judging when to employ the most effective strategy for action. Strategies for action include militancy, peaceful protest, and sometimes, engaging in a longer term program of "marginal gains." The militant feminism of many 19th century suffragettes, such as Emmeline Pankhurst, is a good…

Xenopus laevis Müllerian ducts are sensitive indicators of estrogenic or androgenic chemical exposure in vivo

EPA Science Inventory

The Larval Amphibian Growth and Development Assay (LAGDA) is one of a series of Tier 2 test guidelines being developed by the US EPA under the Endocrine Disruptor Screening Program. The LAGDA was designed to evaluate effects of lower-dose, longer-term chemical exposure on (a) am...

The United Kingdom's School Asset Management Plans.

ERIC Educational Resources Information Center

Jones, Alan

1999-01-01

Examines the U.K.'s Asset Management Plans (AMPs) designed to help Local Education Authorities (LEAs) identify and address the most important priorities in their school capital programs, and to help in their longer term planning and management of the school estate. Discusses AMP objectives, the stages of developing an AMP, and how the Department…

Development of an engineering model atmosphere for Mars

NASA Technical Reports Server (NTRS)

Justus, C. G.

1988-01-01

An engineering model atmosphere for Mars is being developed with many of the same features and capabilities for the highly successful Global Reference Atmospheric Model (GRAM) program for Earth's atmosphere. As an initial approach, the model is being built around the Martian atmosphere model computer subroutine (ATMOS) of Culp and Stewart (1984). In a longer-term program of research, additional refinements and modifications will be included. ATMOS includes parameterizations to stimulate the effects of solar activity, seasonal variation, diurnal variation magnitude, dust storm effects, and effects due to the orbital position of Mars. One of the current shortcomings of ATMOS is the neglect of surface variation effects. The longer-term period of research and model building is to address some of these problem areas and provide further improvements in the model (including improved representation of near-surface variations, improved latitude-longitude gradient representation, effects of the large annual variation in surface pressure because of differential condensation/sublimation of the CO2 atmosphere in the polar caps, and effects of Martian atmospheric wave perturbations on the magnitude of the expected density perturbation.

76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... and Bonds of Specified Maturities (in percent) 3-Year 5-Year 7-Year 10-Year 20-Year 30-Year 1.4 1.9 2...-Year 5-Year 7-Year 10-Year 20-Year 30-Year 0.0 0.4 0.8 1.3 2.1 2.3 Analyses of programs with terms... longer than 30 years may use the 30-year interest rate. [FR Doc. 2011-3044 Filed 2-10-11; 8:45 am...

US Army battery needs -- Present and future

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

Hamlen, R.P.; Christopher, H.A.; Gilman, S.

1995-07-01

The purpose of this paper is to describe the needs of the US Army for silent portable power sources, both in the near and longer term future. As a means of doing this, the programs of the Power Sources Division of the Army Research Laboratory will be discussed. The six program areas in which the Power Sources Division is engaged are: primary batteries, rechargeable batteries, reserve/fuze batteries, pulse batteries and capacitors, fuel cells, and thermophotovoltaic power generation.

'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

PubMed

Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

2011-11-24

It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000890932.

Relative to open surgery, minimally-invasive renal and ureteral pediatric surgery offers no improvement in 30-day complications, yet requires longer operative time: Data from the National Surgical Quality Improvement Program Pediatrics.

PubMed

Colaco, Marc; Hester, Austin; Visser, William; Rasper, Alison; Terlecki, Ryan

2018-05-01

Performance of minimally-invasive surgery (MIS) is increasing relative to open surgery. We sought to compare the contemporary rates of short-term complications of open versus laparoscopic renal and ureteral surgery in pediatric patients. A retrospective cross-sectional analysis of the National Surgical Quality Improvement Program Pediatrics database was performed of all cases in 2014 identified using CPT procedure codes for nephrectomy, partial nephrectomy (PN), ureteroneocystostomy (UNC), and pyeloplasty, and reviewed for postoperative complications. Univariate analysis was performed to determine 30-day complications, with comparison between open and MIS approaches. Receiver operator curve (ROC) analysis was performed to determine differences in body surface area (BSA) and age for open versus MIS. Review identified 207 nephrectomies, 72 PN, 920 UNC, and 625 pyeloplasties. MIS was associated with older age and larger BSA except for cases of UNC. Apart from PN, operative durations were longer with MIS. However, only PN was associated with significantly longer length of hospital stay (LOS). There was no difference in incidence of all other 30-day complications. When evaluating BSA via ROC, the area under the curve (AUC) was found to be 0.730 and was significant. Children with a BSA greater than 0.408 m 2 were more likely to have MIS (sensitivity, 66.9%; specificity, 69.3%). Regarding age, the AUC was 0.732. Children older than 637.5 days were more likely to have MIS (sensitivity, 72.8%; specificity, 63.3%). Pediatric MIS is associated with longer operative time for nephrectomy, but shorter LOS following PN. Surgical approach was not associated with difference in short-term complications.

Implementing the Fussy Baby Network[R] Approach

ERIC Educational Resources Information Center

Gilkerson, Linda; Hofherr, Jennifer; Heffron, Mary Claire; Sims, Jennifer Murphy; Jalowiec, Barbara; Bromberg, Stacey R.; Paul, Jennifer J.

2012-01-01

Erikson Institute Fussy Baby Network[R] (FBN) developed an approach to engaging parents around their urgent concerns about their baby's crying, sleeping, or feeding in a way which builds their longer-term capacities as parents. This approach, called the FAN, is now in place in new Fussy Baby Network programs around the country and is being infused…

Effective Practices for Evaluating Education and Public Outreach Programs

NASA Astrophysics Data System (ADS)

Wilkerson, S.

2013-12-01

Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation practices include selecting appropriate data collection methods given a program's duration and corresponding intended outcomes. Data collection methods for programs of short duration might involve simple evaluation activities, whereas programs of longer duration might involve ongoing data collection measures including longitudinal student surveys, implementation logs, student journals, and student achievement measures. During our presentation, we will share examples from our own experience to illustrate how effective evaluation practices can be applied to various EPO programs based on program duration. Irrespective of duration, we find that EPO program developers and providers want both formative feedback to guide improvements and summative feedback on outcomes. More often than not, evaluation budgets for EPO programs are meager at best, yet come with the same information needs and priorities as programs with larger evaluation budgets. So how do program providers get the information they need given their limited funds for evaluation? We will offer several recommendations for helping EPO program providers work with evaluators to become better-informed consumers of evaluation by maximizing evaluation offerings and minimizing costs. During our presentation we also will share examples of communicating and reporting results for EPO program developers, EPO facilitators and practitioners, and funders.

Extrapolating Survival from Randomized Trials Using External Data: A Review of Methods

PubMed Central

Jackson, Christopher; Stevens, John; Ren, Shijie; Latimer, Nick; Bojke, Laura; Manca, Andrea; Sharples, Linda

2016-01-01

This article describes methods used to estimate parameters governing long-term survival, or times to other events, for health economic models. Specifically, the focus is on methods that combine shorter-term individual-level survival data from randomized trials with longer-term external data, thus using the longer-term data to aid extrapolation of the short-term data. This requires assumptions about how trends in survival for each treatment arm will continue after the follow-up period of the trial. Furthermore, using external data requires assumptions about how survival differs between the populations represented by the trial and external data. Study reports from a national health technology assessment program in the United Kingdom were searched, and the findings were combined with “pearl-growing” searches of the academic literature. We categorized the methods that have been used according to the assumptions they made about how the hazards of death vary between the external and internal data and through time, and we discuss the appropriateness of the assumptions in different circumstances. Modeling choices, parameter estimation, and characterization of uncertainty are discussed, and some suggestions for future research priorities in this area are given. PMID:27005519

Enzyme replacement therapy with velmanase alfa (human recombinant alpha-mannosidase): Novel global treatment response model and outcomes in patients with alpha-mannosidosis.

PubMed

Harmatz, Paul; Cattaneo, Federica; Ardigò, Diego; Geraci, Silvia; Hennermann, Julia B; Guffon, Nathalie; Lund, Allan; Hendriksz, Christian J; Borgwardt, Line

2018-06-01

Alpha-mannosidosis is an ultra-rare monogenic disorder resulting from a deficiency in the lysosomal enzyme alpha-mannosidase, with a prevalence estimated to be as low as 1:1,000,000 live births. The resulting accumulation of mannose-rich oligosaccharides in all tissues leads to a very heterogeneous disorder with a continuum of clinical manifestations with no distinctive phenotypes. Long-term enzyme replacement therapy (ERT) with velmanase alfa is approved in Europe for the treatment of non-neurological manifestations in patients with mild to moderate alpha-mannosidosis. The clinical heterogeneity and rarity of the disease limit the sensitivity of single parameters to detect clinically relevant treatment effects. Thus, we propose a novel multiple variable responder analysis to evaluate the efficacy of ERT for alpha-mannosidosis and present efficacy analyses for velmanase alfa using this method. Global treatment response to velmanase alfa (defined by response to ≥2 domains comprising pharmacodynamic, functional, and quality of life outcomes) was applied post hoc to data from the pivotal placebo-controlled rhLAMAN-05 study and to the longer-term integrated data from all patients in the clinical development program (rhLAMAN-10). After 12 months of treatment, a global treatment response was achieved by 87% of patients receiving velmanase alfa (n = 15) compared with 30% of patients receiving placebo (n = 10). Longer-term data from all patients in the clinical program (n = 33) showed 88% of patients were global responders, including all (100%) pediatric patients (n = 19) and the majority (71%) of adult patients (n = 14). The responder analysis model demonstrates a clinically meaningful treatment effect with velmanase alfa and supports the early initiation and continued benefit of longer-term treatment of all patients with alpha-mannosidosis with this ERT. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Improving adherence to physical activity.

PubMed

Bélisle, M; Roskies, E; Lévesque, J M

1987-01-01

Two studies tested the efficacy of Marlatt and Gordon's relapse-prevention approach in increasing attendance during an exercise program (short-term adherence) and continuation of exercise activities for 12 weeks following termination of the formal program (longer term adherence). Participants in both studies were registrants in 10-week exercise groups (jogging, aerobic dance, and pre-ski training) sponsored by the Université de Montréal Sports Centre. The intervention, designed to increase awareness of obstacles to exercise and to develop appropriate techniques for coping with them, was delivered by group leaders within the context of the regular program. Results of both studies indicate a small but consistent superiority of adherence in the experimental condition compared to the control condition. The low cost of this intervention, however, makes even small gains cost effective. Possible methods for strengthening the treatment effect are discussed.

Urban biodiversity, city-dwellers and conservation: how does an outdoor activity day affect the human-nature relationship?

PubMed

Shwartz, Assaf; Cosquer, Alix; Jaillon, Alexandre; Piron, Armony; Julliard, Romain; Raymond, Richard; Simon, Laurent; Prévot-Julliard, Anne-Caroline

2012-01-01

Urban conservation education programs aim to increase knowledge and awareness towards biodiversity and to change attitudes and behaviour towards the environment. However, to date, few urban conservation education studies have evaluated to what extent these programs have managed to achieve their goals. In this study, we experimentally explored the influence of an urban conservation activity day on individual knowledge, awareness and actions towards biodiversity, in both the short and longer term.We organised three activity days in Paris (France), during which people were invited to participate in urban conservation efforts. Both quantitative (questionnaire) and qualitative (interviews) methods were employed to investigate the influence of this short urban nature experience on the relationships that city-dwellers develop with nearby biodiversity. We found a strong positive correlation between the levels of participation and an immediate interest towards local urban biodiversity. In the longer term, however, although participants claimed to have gained more knowledge, local awareness and interest for species in their daily environment, they did not seem to extend this interest to participating in other related activities. These results highlight the complexity of validating the effectiveness of this type of education program for achieving conservation goals. Although such a short activity may only have a limited environmental impact, it nevertheless seems to increase people's knowledge, awareness, interest and concern. We therefore believe that when repeated locally, these short conservation education programs could enhance people's experience with nature in cities and achieve conservation goals more fully.

Urban Biodiversity, City-Dwellers and Conservation: How Does an Outdoor Activity Day Affect the Human-Nature Relationship?

PubMed Central

Jaillon, Alexandre; Piron, Armony; Julliard, Romain; Raymond, Richard; Simon, Laurent; Prévot-Julliard, Anne-Caroline

2012-01-01

Urban conservation education programs aim to increase knowledge and awareness towards biodiversity and to change attitudes and behaviour towards the environment. However, to date, few urban conservation education studies have evaluated to what extent these programs have managed to achieve their goals. In this study, we experimentally explored the influence of an urban conservation activity day on individual knowledge, awareness and actions towards biodiversity, in both the short and longer term. We organised three activity days in Paris (France), during which people were invited to participate in urban conservation efforts. Both quantitative (questionnaire) and qualitative (interviews) methods were employed to investigate the influence of this short urban nature experience on the relationships that city-dwellers develop with nearby biodiversity. We found a strong positive correlation between the levels of participation and an immediate interest towards local urban biodiversity. In the longer term, however, although participants claimed to have gained more knowledge, local awareness and interest for species in their daily environment, they did not seem to extend this interest to participating in other related activities. These results highlight the complexity of validating the effectiveness of this type of education program for achieving conservation goals. Although such a short activity may only have a limited environmental impact, it nevertheless seems to increase people's knowledge, awareness, interest and concern. We therefore believe that when repeated locally, these short conservation education programs could enhance people's experience with nature in cities and achieve conservation goals more fully. PMID:22715403

Home for now: A mixed-methods evaluation of a short-term housing support program for homeless families.

PubMed

Meschede, Tatjana; Chaganti, Sara

2015-10-01

The use of short-term rental subsidy vouchers offers a new approach to addressing the housing needs of families facing homelessness. In Massachusetts, the Family Home pilot program placed homeless families in housing instead of shelter, providing two years of rental subsidy plus support services with the goal of enabling families to maintain market rate housing. This mixed-method case study complements staff and participant interview data with participant survey and administrative data to evaluate the implementation and short-term outcomes of Family Home in one region. Data point to improved family well-being in housing but also persistent barriers to achieving longer-term housing and economic stability. Of the families who had exited the program at the end of the study, one quarter were able to retain their housing at market rate, only 9% returned to shelter, and one in five moved in with families/friends. Lack of affordable housing in a high rental cost region and jobs that pay living wages were among the major reasons that families struggled to maintain housing. This research points to the need for integrating supportive services from the program's start, including targeted workforce development, to plan for the end of the short-term rental subsidy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strategies to Increase the Physical Activity Participation of Young Adults with Asperger Syndrome in Community Programs

ERIC Educational Resources Information Center

Hamm, Jessica; Driver, Simon

2015-01-01

Currently one in 50 American school-age children is diagnosed with Autism. Although Asperger Syndrome is no longer acknowledged as a separate diagnosis, this article refers to high-functioning individuals with Autism as having Asperger Syndrome, since it is a culturally relevant term. One of the most challenging times for individuals with Asperger…

Launching Kindergarten Math Clubs: The Implementation of High 5s in New York City

ERIC Educational Resources Information Center

Jacob, Robin; Erickison, Anna; Mattera, Shira K.

2018-01-01

Early math has been shown to predict not only longer-term math achievement, but also future reading achievement, high school completion, and college attendance. Yet effects from early math programs often fade out as children move into more varied instructional contexts in elementary school. This fade-out suggests the need for an alignment of math…

76 FR 9329 - Efficiency Initiative Effort To Reduce Non-Value-Added Costs Imposed on Industry by Department of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

..., backed by specific, credible, convincing data. DoD's goal is to develop a fact-based program to reform... changes that can only be made over the longer term or require additional follow-up data before they are... data that it needs along with information about some additional areas of non-value- added cost...

Preventing adolescent drug use: long-term results of a junior high program.

PubMed Central

Ellickson, P L; Bell, R M; McGuigan, K

1993-01-01

OBJECTIVES. Although several studies have reported short-term gains for drug-use prevention programs targeted at young adolescents, few have assessed the long-term effects of such programs. Such information is essential for judging how long prevention benefits last. This paper reports results over a 6-year period for a multisite randomized trial that achieved reductions in drug use during the junior high school years. METHODS. The 11-lesson curriculum, which was tested in 30 schools in eight highly diverse West Coast communities, focused on helping 7th and 8th grade students develop the motivation and skills to resist drugs. Schools were randomly assigned to treatment and control conditions. About 4000 students were assessed in grade 7 and six times thereafter through grade 12. Program effects were adjusted for pretest covariates and school effects. RESULTS. Once the lessons stopped, the program's effects on drug use stopped. Effects on cognitive risk factors persisted for a longer time (many through grade 10), but were not sufficient to produce corresponding reductions in use. CONCLUSIONS. It is unlikely that early prevention gains can be maintained without additional prevention efforts during high school. Future research is needed to develop and test such efforts. PMID:8498624

A Japanese Stress Check Program screening tool predicts employee long-term sickness absence: a prospective study.

PubMed

Tsutsumi, Akizumi; Shimazu, Akihito; Eguchi, Hisashi; Inoue, Akiomi; Kawakami, Norito

2018-01-25

On December 1, 2015, the Japanese government launched the Stress Check Program, a new occupational health policy to screen employees for high psychosocial stress in the workplace. As only weak evidence exists for the effectiveness of the program, we sought to estimate the risk of stress-associated long-term sickness absence as defined in the program manual. Participants were 7356 male and 7362 female employees in a financial service company who completed the Brief Job Stress Questionnaire (BJSQ). We followed them for 1 year and used company records to identify employees with sickness absence of 1 month or longer. We defined high-risk employees using the BJSQ and criteria recommended by the program manual. We used the Cox proportional regression model to evaluate the prospective association between stress and long-term sickness absence. During the follow-up period, we identified 34 male and 35 female employees who took long-term sickness absence. After adjustment for age, length of service, job type, position, and post-examination interview, hazard ratios (95% confidence intervals) for incident long-term sickness absence in high-stress employees were 6.59 (3.04-14.25) for men and 2.77 (1.32-5.83) for women. The corresponding population attributable risks for high stress were 23.8% (10.3-42.6) for men and 21.0% (4.6-42.1) for women. During the 1-year follow-up, employees identified as high stress (as defined by the Stress Check Program manual) had significantly elevated risks for long-term sickness absence.

Clinical Outcome Metrics for Optimization of Robust Training

NASA Technical Reports Server (NTRS)

Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M,; Foy, M. H.; Dulchavsky, S. A.;

Autonomous Rendezvous and Docking Conference, volume 2

NASA Technical Reports Server (NTRS)

1990-01-01

Autonomous Rendezvous and Docking (ARD) will be a requirement for future space programs. Clear examples include satellite servicing, repair, recovery, and reboost in the near term, and the longer range lunar and planetary exploration programs. ARD will permit more aggressive unmanned space activities, while providing a valuable operational capability for manned missions. The purpose of the conference is to identify the technologies required for an on-orbit demonstration of ARD, assess the maturity of those technologies, and provide the necessary insight for a quality assessment of programmatic management, technical, schedule, and cost risks.

Implications of longer term rest from grazing in the sagebrush steppe

Treesearch

K.W. Davies; M. Vavra; B. Schultz; N. Rimbey

2014-01-01

Longer term grazing rest has occurred or been proposed in large portions of the sagebrush steppe based on the assumption that it will improve ecosystem properties. However, information regarding the influence of longer term rest from grazing is limited and has not been summarized. We synthesized the scientific literature on long-term rest in the sagebrush steppe to...

Immediate and Longer-Term Stressors and the Mental Health of Hurricane Ike Survivors

PubMed Central

Lowe, Sarah R.; Tracy, Melissa; Cerdá, Magdalena; Norris, Fran H.; Galea, Sandro

2014-01-01

Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning, however. Additionally, studies have inadequately explored whether postdisaster psychological symptoms influence longer-term stressors. In the current study, we aimed to fill these gaps. Participants (N = 448) were from population-based study of Hurricane Ike survivors and completed assessments 2–5 months (Wave 1), 5–9 months (Wave 2) and 14–18 months (Wave 3) postdisaster. Through path analysis, we found that immediate stressors, assessed at Wave 1, were positively associated with Wave 2 and Wave 3 stressors, which in turn were positively associated with Wave 2 and Wave 3 posttraumatic stress and depressive symptoms. Wave 2 posttraumatic stress symptoms were positively associated with Wave 3 stressors, and Wave 1 depressive symptoms were positively associated with Wave 2 stressors. The findings suggest that policies and interventions can reduce the impact of disasters on mental health by preventing and alleviating both immediate and longer-term postdisaster stressors. PMID:24343752

Sustained impact of the "Healthy Habits, Healthy Girls – Brazil" school-based randomized controlled trial for adolescents living in low-income communities

USDA-ARS?s Scientific Manuscript database

Pediatric obesity is a major public health concern in low- and middle-income countries, such as Brazil. There is an urgent need for preventive programs for adolescents and, the assessment of their sustained impact. This paper reports the longer-term (6-month post intervention) effects of the "H3G-Br...

Aid alignment: a longer term lens on trends in development assistance for health in Uganda

PubMed Central

2013-01-01

Background Over the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health. Yet primary health care and other priorities identified in Uganda’s health sector strategic plan remain underfunded. Methods Using data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, we examined trends in how donors channel DAH and the extent to which DAH is aligned with sector priorities. The study follows the flow of DAH from the donor to the implementing organization, specifying the modality used for disbursing funds and categorizing funds based on program area or support function. Findings Despite efforts to improve alignment through the formation of a sector-wide approach (SWAp) for health in 1999 and the creation of a fund to pool resources for identified priorities, increasingly DAH is provided as short-term, project-based support for disease-specific initiatives, in particular HIV/AIDS. Conclusion These findings highlight the need to better align external resources with country priorities and refocus attention on longer-term sector-wide objectives. PMID:23425287

Automation and robotics technology for intelligent mining systems

NASA Technical Reports Server (NTRS)

Welsh, Jeffrey H.

1989-01-01

The U.S. Bureau of Mines is approaching the problems of accidents and efficiency in the mining industry through the application of automation and robotics to mining systems. This technology can increase safety by removing workers from hazardous areas of the mines or from performing hazardous tasks. The short-term goal of the Automation and Robotics program is to develop technology that can be implemented in the form of an autonomous mining machine using current continuous mining machine equipment. In the longer term, the goal is to conduct research that will lead to new intelligent mining systems that capitalize on the capabilities of robotics. The Bureau of Mines Automation and Robotics program has been structured to produce the technology required for the short- and long-term goals. The short-term goal of application of automation and robotics to an existing mining machine, resulting in autonomous operation, is expected to be accomplished within five years. Key technology elements required for an autonomous continuous mining machine are well underway and include machine navigation systems, coal-rock interface detectors, machine condition monitoring, and intelligent computer systems. The Bureau of Mines program is described, including status of key technology elements for an autonomous continuous mining machine, the program schedule, and future work. Although the program is directed toward underground mining, much of the technology being developed may have applications for space systems or mining on the Moon or other planets.

An organizational perspective on the long-term sustainability of a nursing best practice guidelines program: a case study.

PubMed

Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2015-12-03

Many healthcare innovations are not sustained over the long term, wasting costly implementation efforts and often desperately-needed initial improvements. Although there have been advances in knowledge about innovation implementation, there has been considerably less attention focused on understanding what happens following the early stages of change. Research is needed to determine how to improve the 'staying power' of healthcare innovations. As almost no empirical knowledge exists about innovation sustainability in nursing, the purpose of our study was to understand how a nursing best practice guidelines (BPG) program was sustained over a long-term period in an acute healthcare centre. We conducted a qualitative descriptive case study to examine the program's sustainability at the nursing department level of the organization. The organization was a large, urban, multi-site acute care centre in Canada. The patient safety-oriented BPG program, initiated in 2004, consisted of an organization-wide implementation of three BPGs: falls prevention, pressure ulcer prevention, and pain management. Data were collected eight years following program initiation through 14 key informant interviews, document reviews, and observations. We developed a framework for the sustainability of healthcare innovations to guide data collection and content analysis. Program sustainability entailed a combination of three essential characteristics: benefits, institutionalization, and development. A constellation of 11 factors most influenced the long-term sustainability of the program. These factors were innovation-, context-, leadership-, and process-related. Three key interactions between factors influencing program sustainability and characteristics of program sustainability accounted for how the program had been sustained. These interactions were between: leadership commitment and benefits; complementarity of leadership actions and both institutionalization and development; and a reflection-and-course-correction strategy and development. Study findings indicate that the successful initial implementation of an organizational program does not automatically lead to longer-term program sustainability. The persistent, complementary, and aligned actions of committed leaders, in a variety of roles across a health centre department, seem necessary. Organizational leaders should consider a broad conceptualization of sustainability that extends beyond program institutionalization and/or program benefits. The development of an organizational program may be necessary for its long-term survival.

The Effectiveness of Suicide Prevention Education Programs for Nurses.

PubMed

Ferguson, Monika S; Reis, Julie A; Rabbetts, Lyn; Ashby, Heather-Jean; Bayes, Miriam; McCracken, Tara; Ross, Christine; Procter, Nicholas G

2018-03-01

Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.

Working Group 1: Current plans of various organisations for lunar activities

NASA Technical Reports Server (NTRS)

Balsiger, H.; Pilcher, C.

1994-01-01

Summaries of presentations by representatives of several space agencies and the International Academy of Astronautics concerning lunar activities are presented. Participating space agencies reported two different types of lunar planning, long term planning and scenarios and lunar missions competing within regular programs. The long term plans of the various agencies look remarkably similar. They all involve a phased approach (coincidentally all incorporating four phases) and all address three prime scientific elements: science of, on, and from the Moon. The missions under consideration by the second group of agencies could readily fit as elements in the longer term program. There is great interest in lunar astronomy. There is a great deal of potential infrastructure and lunar transport capability already available. There is also a wide range of interesting technological developments that could form part of a lunar program. A well concerted and coordinated international effort could lead to an affordable program. Recommendations are: an international conference on lunar exploration should be held every other year; an electronic network should be established for the daily exchange of information; and a mechanism should be established for regular working level coordination of activities.

Component technology for stirling power converters

NASA Technical Reports Server (NTRS)

Thieme, Lanny G.

1991-01-01

NASA Lewis Research Center has organized a component technology program as part of the efforts to develop Stirling converter technology for space power applications. The Stirling Space Power Program is part of the NASA High Capacity Power Project of the Civil Space Technology Initiative (CSTI). NASA Lewis is also providing technical management for the DOE/Sandia program to develop Stirling converters for solar terrestrial power producing electricity for the utility grid. The primary contractors for the space power and solar terrestrial programs develop component technologies directly related to their goals. This Lewis component technology effort, while coordinated with the main programs, aims at longer term issues, advanced technologies, and independent assessments. An overview of work on linear alternators, engine/alternator/load interactions and controls, heat exchangers, materials, life and reliability, and bearings is presented.

"Are Your Clients Having Fun?" The Implications of Respondents' Preferences for the Delivery of Group Exercise Programs for Falls Prevention.

PubMed

McPhate, Lucy; Simek, Emily M; Haines, Terry P; Hill, Keith D; Finch, Caroline F; Day, Lesley

2016-01-01

Group exercise has been shown to be effective in preventing falls; however, adherence to these interventions is often poor. Older adults' preferences for how these programs can be delivered are unknown. To identify older people's preferences for how group exercise programs for falls prevention can be delivered. A two-wave, cross-sectional, state-wide telephone survey was undertaken. Respondents were community-dwelling men and women aged 70+ in Victoria, Australia. Open-ended questions were asked to elicit information regarding respondent preferences of the program, which were analyzed using a framework approach. Ninety-seven respondents completed the follow-up survey. The results indicate that older adults most frequently report the short-term advantages and disadvantages when describing their preferences for group exercise, such as enjoyment, social interaction, and leader qualities. Longer-term advantages such as falls prevention were described less frequently. This study indicates the importance of interpersonal skills, and that the opportunity for social interaction should not be overlooked as a positive feature of a group exercise program.

State of the science on implementation research in early child development and future directions.

PubMed

Aboud, Frances E; Yousafzai, Aisha K; Nores, Milagros

2018-05-01

We summarize the state of the field of implementation research and practice for early child development and propose recommendations. First, conclusions are drawn regarding what is generally known about the implementation of early childhood development programs, based on papers and discussions leading to a published series on the topic. Second, recommendations for short-term activities emphasize the use of newly published guidelines for reporting data collection methods and results for implementation processes; knowledge of the guidelines and a menu of measures allows for planning ahead. Additional recommendations include careful documentation of early-stage implementation, such as adapting a program to a different context and assessing feasibility, as well as the process of sustaining and scaling up a program. Using existing implementation information by building on and improving past programs and translating them into policy are recommended. Longer term goals are to identify implementation characteristics of effective programs and determinants of these characteristics. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

Convergence and accommodation development is pre-programmed in premature infants

PubMed Central

Horwood, Anna M; Toor, Sonia S; Riddell, Patricia M

2015-01-01

Purpose This study investigated whether vergence and accommodation development in pre-term infants is pre-programmed or is driven by experience. Methods 32 healthy infants, born at mean 34 weeks gestation (range 31.2-36 weeks) were compared with 45 healthy full-term infants (mean 40.0 weeks) over a 6 month period, starting at 4-6 weeks post-natally. Simultaneous accommodation and convergence to a detailed target were measured using a Plusoptix PowerRefII infra-red photorefractor as a target moved between 0.33m and 2m. Stimulus/response gains and responses at 0.33m and 2m were compared by both corrected (gestational) age and chronological (post-natal) age. Results When compared by their corrected age, pre-term and full-term infants showed few significant differences in vergence and accommodation responses after 6-7 weeks of age. However, when compared by chronological age, pre-term infants’ responses were more variable, with significantly reduced vergence gains, reduced vergence response at 0.33m, reduced accommodation gain, and increased accommodation at 2m, compared to full-term infants between 8-13 weeks after birth. Conclusions When matched by corrected age, vergence and accommodation in pre-term infants show few differences from full-term infants’ responses. Maturation appears pre-programmed and is not advanced by visual experience. Longer periods of immature visual responses might leave pre-term infants more at risk of development of oculomotor deficits such as strabismus. PMID:26275135

Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task.

PubMed

Case, Julie; Grigos, Maria I

2016-12-01

Articulatory control and speech production accuracy were examined in children with childhood apraxia of speech (CAS) and typically developing (TD) controls within a novel word-learning task to better understand the influence of planning and programming deficits in the production of unfamiliar words. Participants included 16 children between the ages of 5 and 6 years (8 CAS, 8 TD). Short- and long-term changes in lip and jaw movement, consonant and vowel accuracy, and token-to-token consistency were measured for 2 novel words that differed in articulatory complexity. Children with CAS displayed short- and long-term changes in consonant accuracy and consistency. Lip and jaw movements did not change over time. Jaw movement duration was longer in children with CAS than in TD controls. Movement stability differed between low- and high-complexity words in both groups. Children with CAS displayed a learning effect for consonant accuracy and consistency. Lack of change in movement stability may indicate that children with CAS require additional practice to demonstrate changes in speech motor control, even within production of novel word targets with greater consonant and vowel accuracy and consistency. The longer movement duration observed in children with CAS is believed to give children additional time to plan and program movements within a novel skill.

Mediation of Short and Longer Term Effects of an Intervention Program to Enhance Resilience in Immigrants from Mainland China to Hong Kong

PubMed Central

Yu, Nancy X.; Lam, T. H.; Liu, Iris K. F.; Stewart, Sunita M.

2015-01-01

Few clinical trials report on the active intervention components that result in outcome changes, although this is relevant to further improving efficacy and adapting effective programs to other populations. This paper presents follow-up analyses of a randomized controlled trial to enhance adaptation by increasing knowledge and personal resilience in two separate brief interventions with immigrants from Mainland China to Hong Kong (Yu et al., 2014b). The present paper extends our previous one by reporting on the longer term effect of the interventions on personal resilience, and examining whether the Resilience intervention worked as designed to enhance personal resilience. The four-session intervention targeted at self-efficacy, positive thinking, altruism, and goal setting. In this randomized controlled trial, 220 immigrants were randomly allocated to three arms: Resilience, Information (an active control arm), and Control arms. Participants completed measures of the four active components (self-efficacy, positive thinking, altruism, and goal setting) at baseline and immediately after the intervention. Personal resilience was assessed at baseline, post-intervention, and 3- and 6-month follow-ups. The results showed that the Resilience arm had greater increases in the four active components post-intervention. Changes in each of the four active components at the post-intervention assessment mediated enhanced personal resilience at the 3-month follow-up in the Resilience arm. Changes in self-efficacy and goal setting showed the largest effect size, and altruism showed the smallest. The arm effects of the Resilience intervention on enhanced personal resilience at the 6-month follow-up were mediated by increases of personal resilience post-intervention (Resilience vs. Control) and at the 3-month follow-up (Resilience vs. Information). These findings showed that these four active components were all mediators in this Resilience intervention. Our results of the effects of short term increases in personal resilience on longer term increase in personal resilience in some models suggest how changes in intervention outcomes might persist over time. PMID:26640446

The Longer School Day and Five Term Year in CTCs: Some Initial Observations.

ERIC Educational Resources Information Center

Hagedorn, Julia

To satisfy the requirements of the British national curriculum and to provide greater emphasis on the teaching of mathematics, science, and technology, city technical colleges (CTCs) have adopted a longer working week and, in several cases, a longer school year. This document examines outcomes of the longer school day and the five-term year, 4…

Initiating the 2002 Mars Science Laboratory (MSL) Focused Technology Program

NASA Technical Reports Server (NTRS)

Caffrey, Robert T.; Udomkesmalee, Gabriel; Hayati, Samad A.

2004-01-01

The Mars Science Laboratory (MSL) Project is an aggressive mission launching in 2009 to deliver a new generation of rover safely to the surface of Mars and conduct comprehensive in situ investigations using a new generation of instruments. This system will be designed to land with precision and be capable of operating over a large percentage on the surface of Mars. It will have capabilities that will support NASA's scientific goals into the next decade of exphation. The MSL Technology program is developing a wide-range of technologies needed for this Mission and potentially other space missions. The MSL Technology Program reports to both the MSL Project and the Mars Technology Program (MTP). The dual reporting process creates a challenging management situation, but ensures the new technology meets both the specific MSL requirements and the broader Mars Program requirements. MTP is a NASA-wide technology development program managed by the Jet Propulsion Laboratory (JPL) and is divided into a Focused Program and a Base Program. The Focused Technology Program addresses technologies that are specific and critical to near-term missions, while the Base Technology Program addresses those technologies that are applicable to multiple missions and which can be characterized as longer term, higher risk, and high payoff technologies. The MSL Technology Program is under the Focused Program and is tightly coupled to MSL's mission milestones and deliverables. The technology budget is separate from the flight Project budget, but the technology s requirements and the development process are tightly coordinated with the Project. The Technology Program combines proven management techniques of flight projects with commercial and academic technology management strategies, to create a technology management program that meets the near-term requirements of MSL and the long-term requirements of MTP. This paper examines the initiation of 2002 MSL Technology program. Some of the areas discussed in this paper include technology definition, task selection, technology management, and technology assessment.

Short Term Fluctuations in Income and Their Relationship to the Characteristics of the Low Income Population: New Data from the SIPP. Project Report 3751-02.

ERIC Educational Resources Information Center

Ruggles, Patricia

This paper compares the characteristics of those experiencing short spells of low income with those having longer spells. Data from the 1984 panel of the Survey of Income and Program Participation (SIPP) was examined. It was found that short spells--less than six months--are quite common, and make up a substantial proportion of all poverty spells.…

An international surgical exchange program for children with cleft lip/cleft palate in Manaus, Brazil: patient and family expectations of outcome.

PubMed

Reeve, Mary-Elizabeth; Groce, Nora E; Persing, John A; Magge, Sheela N

2004-01-01

Increasingly, surgeons are traveling from the developed to the developing world to volunteer their services. They can often make an enormous difference in the lives of patients they serve, but they must understand that these patients exist in a sociocultural matrix in which the meaning of the condition they have and the future they face are determined by a host of factors over and above the specific surgery itself. This means that programs in which teams quickly go in and out of a country must take into account and plan for longer term follow-up by colleagues within that country as well as develop and target rehabilitation services and educational messages to ensure maximum benefits from the intervention performed. This study examines the long-term implications of a short-term surgical team intervention for pediatric patients with cleft lip/cleft palate and their families in the Amazon region of Brazil.

Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X†

PubMed Central

Bailey, Martha J.

2012-01-01

Almost 50 years after domestic US family planning programs began, their effects on childbearing remain controversial. Using the county-level roll-out of these programs from 1964 to 1973, this paper reevaluates their shorter and longer term effects on US fertility rates. I find that the introduction of family planning is associated with significant and persistent reductions in fertility driven both by falling completed childbearing and childbearing delay. Although federally funded family planning accounted for a small portion of the post-baby boom US fertility decline, my estimates imply that they reduced childbearing among poor women by 19 to 30 percent. (JEL I38, J12, J13, J18) PMID:22582135

Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well.

PubMed

Howell, Doris D

2018-03-01

As individuals are living longer with cancer as a chronic disease, they face new health challenges that require the application of self-management behaviors and skills that may not be in their usual repertoire of self-regulatory health behaviors. Increasing attention is focused on supported self-management (SSM) programs to enable survivors in managing the long-term biopsychosocial consequences and health challenges of survivorship. This review explores current directions and evidence for SSM programs that enable survivors to manage these consequences and optimize health. Cancer survivors face complex health challenges that affect daily functioning and well being. Multiple systematic reviews show that SSM programs have positive effects on health outcomes in typical chronic diseases. However, the efficacy of these approaches in cancer survivors are in their infancy; and the 'one-size' fits all approach for chronic disease self-management may not be adequate for cancer as a complex chronic illness. This review suggests that SSM has promising potential for improving health and well being of cancer survivors, but there is a need for standardizing SSM for future research. Although there is increasing enthusiasm for SSM programs tailored to cancer survivors, there is a need for further research of their efficacy on long-term health outcomes.

Modernization of the NASA scientific and technical information program

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Hunter, Judy F.; Ostergaard, K.

1993-01-01

The NASA Scientific and Technical Information Program utilizes a technology infrastructure assembled in the mid 1960s to late 1970s to process and disseminate its information products. When this infrastructure was developed it placed NASA as a leader in processing STI. The retrieval engine for the STI database was the first of its kind and was used as the basis for developing commercial, other U.S., and foreign government agency retrieval systems. Due to the combination of changes in user requirements and the tremendous increase in technological capabilities readily available in the marketplace, this infrastructure is no longer the most cost-effective or efficient methodology available. Consequently, the NASA STI Program is pursuing a modernization effort that applies new technology to current processes to provide near-term benefits to the user. In conjunction with this activity, we are developing a long-term modernization strategy designed to transition the Program to a multimedia, global 'library without walls.' Critical pieces of the long-term strategy include streamlining access to sources of STI by using advances in computer networking and graphical user interfaces; creating and disseminating technical information in various electronic media including optical disks, video, and full text; and establishing a Technology Focus Group to maintain a current awareness of emerging technology and to plan for the future.

The J-Staff System, Network Synchronisation and Noise

DTIC Science & Technology

2014-06-01

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S... work . A key challenge of such structures is their tendency to fall into extreme dynamical modes. One is a ‘two-speed’ mode, where units interacting with...longer term planning, led by the J5 Planning Branch, fall into a slow cycle of work , while those entities interacting predominately with operations

Training the next generation of physician researchers - Vanderbilt Medical Scholars Program.

PubMed

Brown, Abigail M; Chipps, Teresa M; Gebretsadik, Tebeb; Ware, Lorraine B; Islam, Jessica Y; Finck, Luke R; Barnett, Joey; Hartert, Tina V

2018-01-04

As highlighted in recent reports published by the Physician-Scientist Workforce Working Group at the National Institutes of Health, the percentage of physicians conducting research has declined over the past decade. Various programs have been put in place to support and develop current medical student interest in research to alleviate this shortage, including The Vanderbilt University School of Medicine Medical Scholars Program (MSP). This report outlines the long-term program goals and short-term outcomes on career development of MSP alumni, to shed light on the effectiveness of research training programs during undergraduate medical training to inform similar programs in the United States. MSP alumni were asked to complete an extensive survey assessing demographics, accomplishments, career progress, future career plans, and MSP program evaluation. Fifty-five (81%) MSP alumni responded, among whom 12 had completed all clinical training. The demographics of MSP alumni survey respondents are similar to those of all Vanderbilt medical students and medical students at all other Association of American Medical College (AAMC) medical schools. MSP alumni published a mean of 1.9 peer-reviewed manuscripts (95% CI:1.2, 2.5), and 51% presented at national meetings. Fifty-eight percent of respondents reported that MSP participation either changed their career goals or helped to confirm or refine their career goals. Results suggest that the MSP program both prepares students for careers in academic medicine and influences their career choices at an early juncture in their training. A longer follow-up period is needed to fully evaluate the long-term outcomes of some participants.

Health promotion and disease prevention: a look at demand management programs.

PubMed

Fronstin, P

1996-09-01

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health care expenditures while improving overall health. This goal can be achieved through the use of health risk appraisals, organizational health risk appraisals, high risk programs, awareness programs, medical call centers, return to work programs, EAPs, and smoking cessation programs. Studies of a health program's cost effectiveness must disentangle the effects of many competing factors on cost effectiveness. For example, a health risk appraisal program may identify health problems of which the patient and the health care provider were unaware, resulting in the treatment of these health problems. At the same time, the employer may have switched from a nonmanaged pharmaceutical program to a managed program with incentives for participants to utilize generic and/or mail order drugs. As a result, when evaluating a health promotion program, the long-run impact on the program's cost effectiveness is most important.

PCB remediation in schools: a review.

PubMed

Brown, Kathleen W; Minegishi, Taeko; Cummiskey, Cynthia Campisano; Fragala, Matt A; Hartman, Ross; MacIntosh, David L

2016-02-01

Growing awareness of polychlorinated biphenyls (PCBs) in legacy caulk and other construction materials of schools has created a need for information on best practices to control human exposures and comply with applicable regulations. A concise review of approaches and techniques for management of building-related PCBs is the focus of this paper. Engineering and administrative controls that block pathways of PCB transport, dilute concentrations of PCBs in indoor air or other exposure media, or establish uses of building space that mitigate exposure can be effective initial responses to identification of PCBs in a building. Mitigation measures also provide time for school officials to plan a longer-term remediation strategy and to secure the necessary resources. These longer-term strategies typically involve removal of caulk or other primary sources of PCBs as well as nearby masonry or other materials contaminated with PCBs by the primary sources. The costs of managing PCB-containing building materials from assessment through ultimate disposal can be substantial. Optimizing the efficacy and cost-effectiveness of remediation programs requires aligning a thorough understanding of sources and exposure pathways with the most appropriate mitigation and abatement methods.

Design and Delivery of Professional Development Through Partnerships: Long-Term, Short-Term, and Everything In-Between

NASA Astrophysics Data System (ADS)

Urquhart, M. L.; Curry, B.; Hairston, M. R.

2009-12-01

Professional development for teachers can take a variety of forms, each with unique challenges and needs. At the University of Texas at Dallas (UTD), we have leveraged partnerships between multiple groups including the Masters of Arts in Teaching program in Science Education, the joint US Air Force/NASA CINDI mission, an ionospheric explorer built at UTD, and the UTD Regional Collaborative for Excellence in Science Teaching. Each effort models, and in the case of the later two has created, inquiry-based lessons around Earth-systems science. A space science mission, currently in low Earth orbit aboard the Air Force satellite C/NOFS, provides real world connections to classroom science, scientific data and visualizations, and funding to support delivery of professional development in short courses and workshops at teacher conferences. Workshops and short course in turn often serve to recruit teachers into our longer-term programs. Long-term professional development programs such as the Collaborative provide opportunities to test curriculum and teacher learning, an interface to high-quality sustained efforts within talented communities of teachers, and much more. From the birth of our CINDI Educational Outreach program to the Collaborative project that produced geoscience kit-based modules and associated professional development adopted throughout the state of Texas, we will share highlights of our major professional development initiatives and how our partnerships have enabled us to better serve the needs of K-12 teachers expected to deliver geoscience and space science content in their classrooms.

Facilitating adaptive management in a government program: A household energy efficiency case study.

PubMed

Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

2017-02-01

Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

PubMed Central

Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

2017-01-01

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

PubMed

Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

2017-10-27

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

The Treatment of Obesity in Cardiac Rehabilitation

PubMed Central

Ades, Philip A.; Savage, Patrick D.; Harvey-Berino, Jean

2010-01-01

Obesity is an independent risk factor for the development of coronary heart disease (CHD). At entry into cardiac rehabilitation (CR) over 80% of patients are overweight and over 50% have the metabolic syndrome. Yet, CR programs do not generally include weight loss programs as a programmatic component and weight loss outcomes in CR have been abysmal. A recently published study outlines a template for weight reduction based upon a combination of behavioral weight loss counseling and an approach to exercise that maximized exercise-related caloric expenditure. This approach to exercise optimally includes walking as the primary exercise modality and eventually requires almost daily longer distance exercise to maximize caloric expenditure. Additionally, lifestyle exercise such as stair climbing and avoidance of energy-saving devices should be incorporated into the daily routine. Risk factor benefits of weight loss and exercise training in overweight patients with coronary heart disease are broad and compelling. Improvements in insulin resistance, lipid profiles, blood pressure, clotting abnormalities, endothelial-dependent vasodilatory capacity, and measures of inflammation such as C-reactive protein have all been demonstrated. CR/secondary prevention programs can no longer ignore the challenge of obesity management in patients with CHD. Individual programs need to develop clinically effective and culturally sensitive approaches to weight control. Finally, multicenter randomized clinical trials of weight loss in CHD patients with assessment of long-term clinical outcomes need to be performed. PMID:20436355

TLINES: A Computer Program for Circuits of Transmission Lines.

DTIC Science & Technology

1983-12-01

of various lengths are handled by stringing together many short lines, with the assumption that each of the longer lines has a length approximated as...expressed in terms of transmission lines numbered from 2 through CAPM , connected in numerical sequence as in figure 3. Line 1 is a dummy element disconnected...from line 2 and the rest of the circuit. Lines 2 through CAPM can each be set to any impedance the user desires. Line CAPM +1 is a zero-impedance line

Development of an Intellectual Property Strategy: Research Notes to Support Department of Defense Programs

DTIC Science & Technology

2014-09-01

shredding material when no longer needed [ USDA 2014]. 2.4.2 Terms of Trade Secret Ownership A trade secret owner is the person or entity “in whom or...of the DoD’s licensing rights in non-federal works is governed by the DFARS. According to information from CENDI (Commerce, Energy, NASA , Defense...Professionals. March 2014. https://acc.dau.mil/CommunityBrowser.aspx?id=431675 [ USDA 2014] U.S. Department of Agriculture. Proprietary Information

The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature.

PubMed

Edwards, Katherine; Jones, Natasha; Newton, Julia; Foster, Charlie; Judge, Andrew; Jackson, Kate; Arden, Nigel K; Pinedo-Villanueva, Rafael

2017-10-19

This descriptive review aimed to assess the characteristics and methodological quality of economic evaluations of cardiac rehabilitation (CR) programs according to updated economic guidelines for healthcare interventions. Recommendations will be made to inform future research addressing the impact of a physical exercise component on cost-effectiveness. Electronic databases were searched for economic evaluations of exercise-based CR programs published in English between 2000 and 2014. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to review the methodological quality of included economic evaluations. Fifteen economic evaluations met the review inclusion criteria. Assessed study characteristics exhibited wide variability, particularly in their economic perspective, time horizon, setting, comparators and included costs, with significant heterogeneity in exercise dose across interventions. Ten evaluations were based on randomised controlled trials (RCTs) spanning 6-24 months but often with weak or inconclusive results; two were modelling studies; and the final three utilised longer time horizons of 3.5-5 years from which findings suggest that long-term exercise-based CR results in lower costs, reduced hospitalisations and a longer cumulative patient lifetime. None of the 15 articles met all the CHEERS quality criteria, with the majority either fully or partially meeting a selection of the assessed variables. Evidence exists supporting the cost-effectiveness of exercise-based CR for cardiovascular disease patients. However, variability in CR program delivery and weak consistency between study perspective and design limits study comparability and therefore the accumulation of evidence in support of a particular exercise regime. The generalisability of study findings was limited due to the exclusion of patients with comorbidities as would typically be found in a real-world setting. The use of longer time-horizons would be more comparable with a chronic condition and enable economic assessments of the long-term effects of CR. As none of the articles met recent reporting standards for the economic assessment of healthcare interventions, it is recommended that future studies adhere to such guidelines.

Surviving and Thriving-Shifting the Public Health Response to HIV-Exposed Uninfected Children: Report of the 3rd HIV-Exposed Uninfected Child Workshop.

PubMed

Slogrove, Amy L; Becquet, Renaud; Chadwick, Ellen G; Côté, Hélène C F; Essajee, Shaffiq; Hazra, Rohan; Leroy, Valériane; Mahy, Mary; Murenga, Maurine; Wambui Mwangi, Jacqueline; Oyiengo, Laura; Rollins, Nigel; Penazzato, Martina; Seage, George R; Serghides, Lena; Vicari, Marissa; Powis, Kathleen M

2018-01-01

Great gains were achieved with the introduction of the United Nations' Millennium Development Goals, including improved child survival. Transition to the Sustainable Development Goals (SDGs) focused on surviving, thriving, and transforming, representing an important shift to a broader public health goal, the achievement of which holds the promise of longer-term individual and societal benefits. A similar shift is needed with respect to outcomes for infants born to women living with HIV (WLHIV). Programming to prevent vertical HIV transmission has been successful in increasingly achieving a goal of HIV-free survival for infants born to WLHIV. Unfortunately, HIV-exposed uninfected (HEU) children are not achieving comparable health and developmental outcomes compared with children born to HIV-uninfected women under similar socioeconomic circumstances. The 3rd HEU Child Workshop, held as a satellite session of the International AIDS Society's 9th IAS Conference in Paris in July 2017, provided a venue to discuss HEU child health and development disparities. A summary of the Workshop proceedings follows, providing current scientific findings, emphasizing the gap in systems for long-term monitoring, and highlighting the public health need to establish a strategic plan to better quantify the short and longer-term health and developmental outcomes of HEU children.

Particle astrophysics

NASA Technical Reports Server (NTRS)

Sadoulet, Bernard; Cronin, James; Aprile, Elena; Barish, Barry C.; Beier, Eugene W.; Brandenberger, Robert; Cabrera, Blas; Caldwell, David; Cassiday, George; Cline, David B.

1991-01-01

The following scientific areas are reviewed: (1) cosmology and particle physics (particle physics and the early universe, dark matter, and other relics); (2) stellar physics and particles (solar neutrinos, supernovae, and unconventional particle physics); (3) high energy gamma ray and neutrino astronomy; (4) cosmic rays (space and ground observations). Highest scientific priorities for the next decade include implementation of the current program, new initiatives, and longer-term programs. Essential technological developments, such as cryogenic detectors of particles, new solar neutrino techniques, and new extensive air shower detectors, are discussed. Also a certain number of institutional issues (the funding of particle astrophysics, recommended funding mechanisms, recommended facilities, international collaborations, and education and technology) which will become critical in the coming decade are presented.

"Patients, not criminals"? An assessment of Thailand's compulsory drug dependence treatment system.

PubMed

Pearshouse, Richard

2009-05-01

Since the enactment of a new law on addiction treatment in 2002, Thailand has sharply increased the number of people in compulsory drug treatment programs. This article provides an overview of the system, particularly the custodial programs. It also provides some preliminary observations on the implementation of the legislation on its own terms--namely, that people who are dependent on drugs should be "treated as patients and not criminals." While diverting people with drug dependence from the criminal justice system is important, this stated approach is undermined in a number of ways by the law's implementation. This article is based on a longer report released by the Canadian HIV/AIDS Legal Network in 2009.

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

Bird, L.; Reger, A.; Heeter, J.

Based on lessons from recent program experience, this report explores best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. The findings of this paper are relevant to both new incentive programs as well as those undergoing modifications. The report covers factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, administrative issues such as providing equitable access to incentives and customer protection. It also explores how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-termmore » and stable environment for the solar industry. The findings are based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs. These best practices consider the perspectives of various stakeholders and the broad objectives of reducing solar costs, encouraging long-term market viability, minimizing ratepayer costs, and protecting consumers.« less

A randomized controlled trial of a supported employment program for persons with long-term mental illness in Hong Kong.

PubMed

Kin Wong, Kenny; Chiu, Rose; Tang, Betty; Mak, Donald; Liu, Joanne; Chiu, Siu Ning

2008-01-01

Supported employment is an evidence-based practice that has proved to be consistently more effective than conventional vocational rehabilitation in helping people with severe mental illness find and sustain competitive employment. Most research on the effectiveness of supported employment comes from the United States. This study examined the effectiveness and applicability of a supported employment program based on the individual placement and support model in a Hong Kong setting. Ninety-two unemployed individuals with long-term mental illness who desired competitive employment were randomly assigned to either a supported employment program or a conventional vocational rehabilitation program and followed up for 18 months. Both vocational and nonvocational outcomes were measured. Over the 18-month study period, compared with participants in the conventional vocational rehabilitation program, those in the supported employment group were more likely to work competitively (70% versus 29%; odds ratio=5.63, 95% confidence interval=2.28-13.84), held a greater number of competitive jobs, earned more income, worked more days, and sustained longer job tenures. Repeated-measures analysis of variance found no substantive differences between participants in the two groups and no significant change from baseline over time for psychiatric symptoms and self-perceived quality of life. Consistent with previous research findings in the United States, the supported employment program was more effective than the conventional vocational rehabilitation program in helping individuals with long-term mental illness find and sustain competitive employment in a Hong Kong setting. The supported employment program based on the individual placement and support model can thus be recommended for wider use in local mental health practice.

Technology opportunities in a restructured electric industry

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

Gehl, S.

1995-12-31

This paper describes the Strategic Research & Development (SR&D) program of the Electric Power Research Institute (EPRI). The intent of the program is to anticipate and shape the scientific and technological future of the electricity enterprise. SR&D serves those industry R&D needs that are more exploratory, precompetitive, and longer-term. To this end, SR&D seeks to anticipate technological change and, where possible, shape that change to the advantage of the electric utility enterprise and its customers. SR&D`s response to this challenge is research and development program that addresses the most probable future of the industry, but at the same time ismore » robust against alternative futures. The EPRI SR&D program is organized into several vectors, each with a mission that relates directly to one or more EPRI industry goals, which are summarized in the paper. 1 fig., 2 tabs.« less

Phased Array Feeds

NASA Astrophysics Data System (ADS)

Fisher, J. Richard; Bradley, Richard F.; Brisken, Walter F.; Cotton, William D.; Emerson, Darrel T.; Kerr, Anthony R.; Lacasse, Richard J.; Morgan, Matthew A.; Napier, Peter J.; Norrod, Roger D.; Payne, John M.; Pospieszalski, Marian W.; Symmes, Arthur; Thompson, A. Richard; Webber, John C.

2009-03-01

This white paper offers cautionary observations about the planning and development of new, large radio astronomy instruments. Complexity is a strong cost driver so every effort should be made to assign differing science requirements to different instruments and probably different sites. The appeal of shared resources is generally not realized in practice and can often be counterproductive. Instrument optimization is much more difficult with longer lists of requirements, and the development process is longer and less efficient. More complex instruments are necessarily further behind the technology state of the art because of longer development times. Including technology R&D in the construction phase of projects is a growing trend that leads to higher risks, cost overruns, schedule delays, and project de-scoping. There are no technology breakthroughs just over the horizon that will suddenly bring down the cost of collecting area. Advances come largely through careful attention to detail in the adoption of new technology provided by industry and the commercial market. Radio astronomy instrumentation has a very bright future, but a vigorous long-term R&D program not tied directly to specific projects needs to be restored, fostered, and preserved.

Large Instrument Development for Radio Astronomy

NASA Astrophysics Data System (ADS)

Fisher, J. Richard; Warnick, Karl F.; Jeffs, Brian D.; Norrod, Roger D.; Lockman, Felix J.; Cordes, James M.; Giovanelli, Riccardo

2009-03-01

This white paper offers cautionary observations about the planning and development of new, large radio astronomy instruments. Complexity is a strong cost driver so every effort should be made to assign differing science requirements to different instruments and probably different sites. The appeal of shared resources is generally not realized in practice and can often be counterproductive. Instrument optimization is much more difficult with longer lists of requirements, and the development process is longer and less efficient. More complex instruments are necessarily further behind the technology state of the art because of longer development times. Including technology R&D in the construction phase of projects is a growing trend that leads to higher risks, cost overruns, schedule delays, and project de-scoping. There are no technology breakthroughs just over the horizon that will suddenly bring down the cost of collecting area. Advances come largely through careful attention to detail in the adoption of new technology provided by industry and the commercial market. Radio astronomy instrumentation has a very bright future, but a vigorous long-term R&D program not tied directly to specific projects needs to be restored, fostered, and preserved.

Violation of eating expectancies does not reduce conditioned desires for chocolate.

PubMed

van den Akker, Karolien; van den Broek, Myrr; Havermans, Remco C; Jansen, Anita

2016-05-01

Although eating desires can be easily learned, their extinction appears more difficult. The present two-session study aimed to investigate the role of eating expectancies in the short and longer-term extinction of eating desires. In addition, the relationship between eating desires and conditioned evaluations was examined to test whether they might share a similar mechanism. It was hypothesized that the short-term extinction of eating desires would be more successful after the disconfirmation of eating expectancies (instructed extinction or IE), while resulting in worse longer-term extinction because omission of the food reward during extinction is not surprising. In contrast to the hypotheses, it was found that IE had no effect on the short-term and longer-term extinction of eating desires. Eating desires correlated with conditioned evaluations only to some extent. It is concluded that eating expectancies do not mediate the short-term extinction of conditioned eating desires. In addition, their longer-term extinction does not appear to be facilitated by a greater violation of eating expectancies. This suggests that it might not be necessary to focus on expectancy violation in cue exposure therapy to reduce eating desires. Copyright © 2016 Elsevier Ltd. All rights reserved.

Financial impact of population health management programs: reevaluating the literature.

PubMed

Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

2012-06-01

Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

Integrating NASA Earth Observations into the Global Indicator Framework for Monitoring the United Nations' Sustainable Development Goals

NASA Astrophysics Data System (ADS)

Crepps, G.; Gotschalk, E.; Childs-Gleason, L. M.; Favors, J.; Ruiz, M. L.; Allsbrook, K. N.; Rogers, L.; Ross, K. W.

2016-12-01

The NASA DEVELOP National Program conducts rapid 10-week feasibility projects that build decision makers' capacity to utilize NASA Earth observations in their decision making. Teams, in collaboration with partner organizations, conduct projects that create end products such as maps, analyses, and automated tools tailored for their partners' specific decision making needs. These projects illustrate the varied applications about which Earth observations can assist in making better informed decisions, such topics as land use changes, ecological forecasting, public health, and species habitats. As a capacity building program, DEVELOP is interested in understanding how these end products are utilized once the project is over and if Earth observations become a regular tool in the partner's decision making toolkit. While DEVELOP's niche is short-term projects, to assess the impacts of these projects, a longer-term scale is needed. As a result, DEVELOP has created a project strength metrics, and partner assessments, pre- and post-project, as well as a follow up form. This presentation explores the challenges in both quantitative and qualitative assessments of valuing the contributions of these Earth observation tools. This proposal lays out the assessment framework created within the program, and illustrates case studies in which projects have been assessed and long-term partner use of tools examined and quantified.

Estimating Viscoelastic Deformation Due to Seasonal Loading

NASA Technical Reports Server (NTRS)

Sauber, Jeanne

2015-01-01

Scientists have been making summer-­-time geodetic measurements in south central Alaska for decades to estimate the rate at which a continental-­-ocean terrane is accreting to the North American continent. Southern Alaska has big earthquakes every century and large, rapidly changing glaciers. In the last decade, primarily as part of the EarthScope Plate Boundary Observatory project, continuous GPS measurements have recorded the response of sites such as the near-­-coastal geodetic site, AB35 to competing processes: uplift and movement to the northwest due to tectonic forces and the response of the solid Earth to seasonal and longer-­-term changes in the cryosphere (snow and ice) surrounding the site. Which process causes the largest displacements of the site? Figure 1 (Blewitt, Nevada Geodetic Lab, 2015) shows the Northward, Eastward, and Upward motion of AB35 between 2007 and 2015. The site is moving rapidly to the north and west reflecting the tectonic convergence of site toward interior Alaska but there is small wiggle on the North component reflecting seasonal displacements of the site associated with snow loading and unloading. However, the Up component, shows a large seasonal signal due to snow loading in the winter (down) and ice and snow melting in the warmer months (site goes up). Between 2007 and the present, the site position is slowly moving upward, due to tectonic forcing but probably associated with longer-­- term ice melting as well. We are using the CIG finite element modeling (FEM) program Pylith to estimate the surface displacements and stresses associated with seasonal loading changes (top figure and Figure 2 far right) for water year 2012, 2011.8 - 2012.8) and the longer-­-term retreat of the surrounding glaciers.

Exercise motivation, eating, and body image variables as predictors of weight control.

PubMed

Teixeira, Pedro J; Going, Scott B; Houtkooper, Linda B; Cussler, Ellen C; Metcalfe, Lauve L; Blew, Rob M; Sardinha, Luis B; Lohman, Timothy G

2006-01-01

This study investigated changes in psychosocial variables related to exercise, eating, and body image during a weight reduction program and evaluated their association with weight loss in middle-aged overweight and obese women up to 1 yr after intervention. The 136 participants (age, 48.1 +/- 4.4 yr; weight, 30.6 +/- 5.6 kg x m(-2)) who completed the 4-month lifestyle weight reduction program (86% retention), losing -6.2 +/- 4.6% (P < 0.001) of their initial weight, were followed up for 12 additional months. Of these, 82% completed 16-month assessments (weight change, -5.5 +/- 7.7%, P < 0.001). Psychosocial variables were assessed by validated instruments in standardized conditions at baseline and after the intervention (4 months). Compared with 4-month assessments, body weight did not change at 16 months (P > 0.09). Changes in eating restraint, disinhibition, and hunger; exercise, self-efficacy, and intrinsic motivation; body shape concerns; and physical self-worth were associated with weight change at 4 months (P < 0.001, except hunger, P < 0.05). Baseline-adjusted 4-month scores in all psychosocial variables also predicted weight change from baseline to 16 months (P < 0.01), except hunger (P > 0.05). After controlling for 4-month weight change and other covariates, increases in exercise intrinsic motivation remained predictive of weight loss at 16 months (P < 0.05). Multiple linear regression showed that eating variables were significant and independent correlates of short-term weight change, whereas changes in exercise variables were stronger predictors of longer term weight outcomes. Results highlight the importance of cognitive processes during weight control and support the notion that initial focus on diet is associated with short-term weight loss, while change in exercise-related motivational factors, with a special emphasis on intrinsic sources of motivation (e.g., interest and enjoyment in exercise), play a more important role in longer term weight management.

Massed versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Training versus a Longer-Term Traditional Voice Training

ERIC Educational Resources Information Center

Meerschman, Iris; Van Lierde, Kristiane; Van Puyvelde, Caro; Bostyn, Astrid; Claeys, Sofie; D'haeseleer, Evelien

2018-01-01

Background: In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. Aims: The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy…

The unintended consequences of maternity leaves: How agency interventions mitigate the negative effects of longer legislated maternity leaves.

PubMed

Hideg, Ivona; Krstic, Anja; Trau, Raymond N C; Zarina, Tanya

2018-06-07

To support women in the workplace, longer legislated maternity leaves have been encouraged in Scandinavian countries and recently in Canada. Yet, past research shows that longer legislated maternity leaves (i.e., 1 year and longer) may unintentionally harm women's career progress. To address this issue, we first sought to identify one potential mechanism underlying negative effects of longer legislated maternity leaves: others' lower perceptions of women's agency. Second, we utilize this knowledge to test interventions that boost others' perceptions of women's agency and thus mitigate negative effects of longer legislated maternity leaves. We test our hypotheses in three studies in the context of Canadian maternity leave policies. Specifically, in Study 1, we found that others' lower perceptions of women's agency mediated the negative effects of a longer legislated maternity leave, that is, 1 year (vs. shorter, i.e., 1 month maternity leave) on job commitment. In Study 2, we found that providing information about a woman's agency mitigates the unintended negative effects of a longer legislated maternity leave on job commitment and hireability. In Study 3, we showed that use of a corporate program that enables women to stay in touch with the workplace while on maternity leave (compared to conditions in which no such program was offered; a program was offered but not used by the applicant; and the program was offered, but there was no information about its usage by the applicant) enhances agency perceptions and perceptions of job commitment and hireability. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts.

PubMed

Barton, Christopher A; Dobson, Annette; Treloar, Susan A; McClintock, Christine; McFarlane, Alexander C

2008-12-01

The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross-sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.

A multicenter randomized controlled trial of two group education programs for fatigue in multiple sclerosis: Long-term (12-month) follow-up at one site.

PubMed

Hugos, Cinda L; Cameron, Michelle H; Chen, Zunqiu; Chen, Yiyi; Bourdette, Dennis

2018-05-01

A four-site RCT of Fatigue: Take Control (FTC), a multicomponent group program, found no significant differences from a control program, MS: Take Control (MSTC), in fatigue on the Modified Fatigue Impact Scale (MFIS) through 6 months. Assess FTC for a delayed effect on fatigue. Of 78 subjects at one site, 74 randomized to FTC or MSTC completed the MFIS at 12 months. Compared to baseline, FTC produced greater improvements in MFIS scores than MSTC (FTC -8.9 (confidence interval (CI): 32.2, 45), MSTC -2.5 (CI 39.6, 47.7), p = 0.03) at 12 months. The delayed effect of FTC on fatigue suggests the need for longer follow-up when assessing interventions for fatigue.

A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study.

PubMed

Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2016-01-01

Best practice guidelines are a tool for narrowing research-to-practice gaps and improving care outcomes. There is some empirical understanding of guideline implementation in nursing settings, yet there has been almost no consideration of the longer-term sustainability of guideline-based practice improvements. Many healthcare innovations are not sustained, underscoring the need for knowledge about how to promote their survival. To understand how a nursing best practice guidelines program was sustained on acute healthcare center nursing units. We undertook a qualitative descriptive case study of an organization-wide nursing best practice guidelines program with four embedded nursing unit subcases. The setting was a large, tertiary/quaternary urban health center in Canada. The nursing department initiated a program to enhance patient safety through the implementation of three guidelines: falls prevention, pressure ulcer prevention, and pain management. We selected four inpatient unit subcases that had differing levels of program sustainability at an average of almost seven years post initial program implementation. Data sources included 39 key informant interviews with nursing leaders/administrators and frontline nurses; site visits; and program-related documents. Data collection and content analysis were guided by a framework for the sustainability of healthcare innovations. Program sustainability was characterized by three elements: benefits, routinization, and development. Seven key factors most accounted for the differences in the level of program sustainability between subcases. These factors were: perceptions of advantages, collaboration, accountability, staffing, linked levels of leadership, attributes of formal unit leadership, and leaders' use of sustainability activities. Some prominent relationships between characteristics and factors explained long-term program sustainability. Of primary importance was the extent to which unit leaders used sustainability-oriented activities in both regular and responsive ways to attend to the relationships between sustainability characteristics and factors. Continued efforts are required to ensure long-term program sustainability on nursing units. Persistent and adaptive orchestration of sustainability-oriented activities by formal unit leadership teams is necessary for maintaining best practice guidelines over the long term. Leaders should consider a broad conceptualization of sustainability, beyond guideline-based benefits and routinization, because the development of unit capacity in response to changing circumstances appears essential. Copyright © 2015 Elsevier Ltd. All rights reserved.

Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods

PubMed Central

Rogers, Laura Q.; McAuley, Edward; Anton, Philip M.; Courneya, Kerry S.; Vicari, Sandra; Hopkins-Price, Patricia; Verhulst, Steven; Mocharnuk, Robert; Hoelzer, Karen

2011-01-01

Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change intervention to usual care on short and longer term physical activity adherence among breast cancer survivors. Secondary aims include examining social cognitive theory mechanisms of physical activity behavior change and health benefits of the intervention. Study recruitment goal is 256 breast cancer survivors with a history of ductal carcinoma in situ or Stage I, II, or IIIA disease who have completed primary cancer treatment. Outcome measures are obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months and include physical activity, psychosocial factors, fatigue, sleep quality, lower extremity joint dysfunction, cardiorespiratory fitness, muscle strength, and waist-to-hip ratio. Confirming behavior change effectiveness, health effects, and underlying mechanisms of physical activity behavior change interventions will facilitate translation to community settings for improving the health and well-being of breast cancer survivors. PMID:21983625

School-based internet obesity prevention programs for adolescents: a systematic literature review.

PubMed

Whittemore, Robin; Chao, Ariana; Popick, Rachel; Grey, Margaret

2013-03-01

In response to the childhood obesity epidemic, numerous studies on school-based Internet obesity prevention interventions have been conducted. The purpose of this systematic review is to describe, synthesize, and evaluate the research on school-based Internet obesity prevention programs for adolescents. Medline, CINAHL, and PsycInfo were searched from January 1995 to August 2012 to locate relevant studies. Ninety-one reports were initially identified, with 12 meeting the inclusion criteria. Studies had variable control groups, program content, and sample characteristics. Though few authors reported on implementation processes or body mass index (BMI) outcomes, the majority of studies were effective in improving health behaviors in the short term. Most studies were judged to have a high or unclear risk of bias in at least two domains, thus the quality of evidence for this body of literature is moderate. Further research is needed to examine programs of longer duration, optimal dose and timing of programs, cost-effectiveness, and mediators and moderators of intervention outcomes.

Providing More Home-Delivered Meals Is One Way To Keep Older Adults With Low Care Needs Out Of Nursing Homes

PubMed Central

Thomas, Kali S.; Mor, Vincent

2014-01-01

Programs that help older adults live independently in the community can also deliver net savings to states on the costs of long-term supports and services. We estimate that if all states had increased by 1 percent the number of adults age sixty-five or older who received home-delivered meals in 2009 under Title III of the Older Americans Act, total annual savings to states’ Medicaid programs could have exceeded $109 million. The projected savings primarily reflect decreased Medicaid spending for an estimated 1,722 older adults with low-care needs who would no longer require nursing home care— instead, they could remain at home, sustained by home-delivered meals. Twenty-six states could have realized net savings in 2009 from the expansion of their home-delivered meals programs, while twenty-two states would have incurred net costs. Programs such as home-delivered meals have the potential to provide substantial savings to some states’ Medicaid programs. PMID:24101071

Sleep education improves the sleep duration of adolescents: a randomized controlled pilot study.

PubMed

Kira, Geoff; Maddison, Ralph; Hull, Michelle; Blunden, Sarah; Olds, Timothy

2014-07-15

To determine the feasibility and pilot a sleep education program in New Zealand high school students. A parallel, two-arm randomized controlled pilot trial was conducted. High school students (13 to 16 years) were randomly allocated to either a classroom-based sleep education program intervention (n = 15) or to a usual curriculum control group (n = 14). The sleep education program involved four 50-minute classroom-based education sessions with interactive groups. Students completed a 7-day sleep diary, a sleep questionnaire (including sleep hygiene, knowledge and problems) at baseline, post-intervention (4 weeks) and 10 weeks follow-up. An overall treatment effect was observed for weekend sleep duration (F 1,24 = 5.21, p = 0.03). Participants in the intervention group slept longer during weekend nights at 5 weeks (1:37 h:min, p = 0.01) and 10 weeks: (1:32 h:min, p = 0.03) compared to those in the control group. No differences were found between groups for sleep duration on weekday nights. No significant differences were observed between groups for any of the secondary outcomes (sleep hygiene, sleep problems, or sleep knowledge). A sleep education program appears to increase weekend sleep duration in the short term. Although this program was feasible, most schools are under time and resource pressure, thus alternative methods of delivery should be assessed for feasibility and efficacy. Larger trials of longer duration are needed to confirm these findings and determine the sustained effect of sleep education on sleep behavior and its impact on health and psychosocial outcomes. A commentary on this article appears in this issue on page 793.

Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community.

PubMed

Tosh, Jonathan; Kearns, Ben; Brennan, Alan; Parry, Glenys; Ricketts, Thomas; Saxon, David; Kilgarriff-Foster, Alexis; Thake, Anna; Chambers, Eleni; Hutten, Rebecca

2013-04-26

The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression. Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs). Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty. Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.

Exploring experiences, barriers, and enablers to home- and class-based exercise in rotator cuff tendinopathy: A qualitative study.

PubMed

Sandford, Fiona M; Sanders, Thomas A B; Lewis, Jeremy S

Qualitative study. Adherence is paramount to the successful outcome of exercise-based treatment. The barriers and enablers to adherence to a home- and class-based exercise program were explored in this qualitative study. Semi-structured interviews were carried out to establish common themes relating to the participants' experiences during a year-long randomized controlled trial. Twelve participants were interviewed. The main enablers to exercise were highlighted as equipment, perceived benefit from the exercises, and longer and more intensive monitoring. Barriers included the lack of motivation, lack of equipment, and pain. Implications for practice are incorporating enablers and addressing barriers including self-discharge from classes; the importance of longer term follow-up and the benefits of adopting exercise into a well-established routine may provide potential benefits. N/A. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists

PubMed Central

Fois, Romano A.; McLachlan, Andrew J.; Chen, Timothy F.

2017-01-01

Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns’ patient safety attitudes. However, other factors likely influenced their attitudes in the longer term. PMID:28289295

Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists.

PubMed

Walpola, Ramesh L; Fois, Romano A; McLachlan, Andrew J; Chen, Timothy F

2017-02-25

Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns' patient safety attitudes. However, other factors likely influenced their attitudes in the longer term.

IRAS low resolution spectra of 26 symbiotic stars

NASA Technical Reports Server (NTRS)

Stencel, Robert E.; Brugel, Edward W.; Goodwill, Michael E.

1990-01-01

Data related to the spectral scans for 26 symbiotic stars are described which were extracted from the IRAS low resolution database. Data from the 8-15- and 15-23-micron bands are merged in a program that scales the longer wavelength and produces a weighted average of the spectral scans for each source. The survey shows that active dust producers can probably be isolated and some theories related to the presence of dust emission features are discussed in terms of source variability for measurements made with low resolution spectra.

The application of remote sensing to resource management and environmental quality programs in Kansas

NASA Technical Reports Server (NTRS)

Barr, B. G.; Martinko, E. A. (Principal Investigator)

1982-01-01

Capabilities to process data for state agencies in Kansas were upgraded through the vehicle of a low cost data processing system. Short term projects in which agencies identified areas of immediate needs, and longer terms projects, continued from previous years, are described including studies of Arkansas River irrigation; evaluation of rangeland in the Cimarron National Grassland; a model of the Walnut Creek watershed groundwater; selection of a pronghorn antelope release site; the establishment of a geographical data base for tax reassessment in Finney County; a land use/land cover inventory and hazards assessment; and applied R & D in agricultural remote sensing. The topics discussed at a short course in remote sensing and publications are listed.

Hydrographic Data Curation and Stewardship: GO-SHIP

NASA Astrophysics Data System (ADS)

Stephen, Diggs; Lynne, Talley; Martin, Kramp; Bernadette, Sloyan

2014-05-01

Expert data management (access, formats, data life-cycle) facilitates the successful re-use of information which address many important scientific questions such as detecting decadal and longer-term changes in global ocean heat and freshwater content. Modern hydrographic data management has its origins in the WOCE program where new and existing distributed resources were identified and organized into an effective "super DAC". Data from this program are referenced in hundreds of scientific papers. The distributed hydrographic data system, now under the name GO-SHIP, exists today and has adapted to the new geoscience demands of the 21st century. This presentation will describe science drivers and the required data center resources (CCHDO, CDIAC, JCOMMOPS) which together provide reliable access for the global research community.

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

Stein, Joshua S.; Rautman, Christopher Arthur

The Bryan Mound salt dome, located near Freeport, Texas, is home to one of four underground crude oil-storage facilities managed by the U. S. Department of Energy Strategic Petroleum Reserve (SPR) Program. Sandia National Laboratories, as the geotechnical advisor to the SPR, conducts site-characterization investigations and other longer-term geotechnical and engineering studies in support of the program. This report describes the conversion of two-dimensional geologic interpretations of the Bryan Mound site into three-dimensional geologic models. The new models include the geometry of the salt dome, the surrounding sedimentary units, mapped faults, and the 20 oil-storage caverns at the site. Thismore » work provides an internally consistent geologic model of the Bryan Mound site that can be used in support of future work.« less

Effect of drug-related cues on response inhibition through abstinence: A pilot study in male heroin abstainers.

PubMed

Su, Bobo; Yang, Ling; Wang, Grace Y; Wang, Sha; Li, Shaomei; Cao, Hua; Zhang, Yan

2017-11-01

Chronic heroin use can cause a deficit of inhibitory function, leading to a loss of control over drug use. Exposure to drug-related cues is considered as one of the contributing factors. However, it is unclear whether there are dynamic changes on the effect of drug-related cues on response inhibition following prolonged abstinence. The present study investigated the effect of drug-related cues on response inhibition in heroin abstainers at different abstinent phases. 26 shorter-term (2-6 months) and 26 longer-term (19-24 months) male heroin abstainers performed on a modified two-choice Oddball task, which included two conditions: in the cued condition, neutral pictures served as the background of standard stimuli (yellow frame) and heroin-related pictures served as the background of deviant stimuli (blue frame), reversed in the controlled conditions. Compared to longer-term abstainers, mean reaction time (RT) for drug deviants in shorter-term abstainers was significantly longer. Shorter-term abstainers also showed markedly slower response to neutral deviants relative to drug deviants, but this tendency was not observed in longer-term abstainers. Nevertheless, both groups had similar RT for standard stimuli regardless of their paired background pictures. Effect of drug-related cues on response inhibition remains at the early stage of abstinence; however, this effect may be reduced following a longer period of drug abstinence. Our findings highlight the importance of assessing and improving the ability of inhibiting drug-related cue reactivity during treatment.

Effects of enhanced foster care on the long-term physical and mental health of foster care alumni.

PubMed

Kessler, Ronald C; Pecora, Peter J; Williams, Jason; Hiripi, Eva; O'Brien, Kirk; English, Diana; White, James; Zerbe, Richard; Downs, A Chris; Plotnick, Robert; Hwang, Irving; Sampson, Nancy A

2008-06-01

Child maltreatment is a significant risk factor for adult mental disorders and physical illnesses. Although the child welfare system routinely places severely abused and/or neglected children in foster care, no controlled studies exist to determine the effectiveness of this intervention in improving the long-term health of maltreated youth. To present results of the first quasi-experimental study, to our knowledge, to evaluate the effects of expanded foster care treatment on the mental and physical health of adult foster care alumni. We used a quasi-experimental design to compare adult outcomes of alumni of a model private foster care program and 2 public programs. The latter alumni were eligible for but not selected by the private program because of limited openings. Propensity score weights based on intake records were adjusted for preplacement between-sample differences. Personal interviews administered 1 to 13 years after leaving foster care assessed the mental and physical health of alumni. A representative sample of 479 adult foster care alumni who were placed in foster care as adolescents (14-18 years of age) between January 1, 1989, and September 30, 1998, in private (n = 111) or public (n = 368) foster care programs in Oregon and Washington. More than 80% of alumni were traced, and 92.2% of those traced were interviewed. Caseworkers in the model program had higher levels of education and salaries, lower caseloads, and access to a wider range of ancillary services (eg, mental health counseling, tutoring, and summer camps) than caseworkers in the public programs. Youth in the model program were in foster care more than 2 years longer than those in the public programs. Private program alumni had significantly fewer mental disorders (major depression, anxiety disorders, and substance use disorders), ulcers, and cardiometabolic disorders, but more respiratory disorders, than did public program alumni. Public sector investment in higher-quality foster care services could substantially improve the long-term mental and physical health of foster care alumni.

Integrated monitoring and assessment of soil restoration treatments in the Lake Tahoe Basin.

PubMed

Grismer, M E; Schnurrenberger, C; Arst, R; Hogan, M P

2009-03-01

Revegetation and soil restoration efforts, often associated with erosion control measures on disturbed soils, are rarely monitored or otherwise evaluated in terms of improved hydrologic, much less, ecologic function and longer term sustainability. As in many watersheds, sediment is a key parameter of concern in the Tahoe Basin, particularly fine sediments less than about ten microns. Numerous erosion control measures deployed in the Basin during the past several decades have under-performed, or simply failed after a few years and new soil restoration methods of erosion control are under investigation. We outline a comprehensive, integrated field-based evaluation and assessment of the hydrologic function associated with these soil restoration methods with the hypothesis that restoration of sustainable function will result in longer term erosion control benefits than that currently achieved with more commonly used surface treatment methods (e.g. straw/mulch covers and hydroseeding). The monitoring includes cover-point and ocular assessments of plant cover, species type and diversity; soil sampling for nutrient status; rainfall simulation measurement of infiltration and runoff rates; cone penetrometer measurements of soil compaction and thickness of mulch layer depths. Through multi-year hydrologic and vegetation monitoring at ten sites and 120 plots, we illustrate the results obtained from the integrated monitoring program and describe how it might guide future restoration efforts and monitoring assessments.

Environmental restoration and waste management: Robotics technology development program: Robotics 5-year program plan

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

Not Available

This plan covers robotics Research, Development, Demonstration, Testing and Evaluation activities in the Program for the next five years. These activities range from bench-scale R D to full-scale hot demonstrations at DOE sites. This plan outlines applications of existing technology to near-term needs, the development and application of enhanced technology for longer-term needs, and initiation of advanced technology development to meet those needs beyond the five-year plan. The objective of the Robotic Technology Development Program (RTDP) is to develop and apply robotics technologies that will enable Environmental Restoration and Waste Management (ER WM) operations at DOE sites to be safer,more » faster and cheaper. Five priority DOE sites were visited in March 1990 to identify needs for robotics technology in ER WM operations. This 5-Year Program Plan for the RTDP detailed annual plans for robotics technology development based on identified needs. In July 1990 a forum was held announcing the robotics program. Over 60 organizations (industrial, university, and federal laboratory) made presentations on their robotics capabilities. To stimulate early interactions with the ER WM activities at DOE sites, as well as with the robotics community, the RTDP sponsored four technology demonstrations related to ER WM needs. These demonstrations integrated commercial technology with robotics technology developed by DOE in support of areas such as nuclear reactor maintenance and the civilian reactor waste program. 2 figs.« less

Financing state newborn screening programs: sources and uses of funds.

PubMed

Johnson, Kay; Lloyd-Puryear, Michele A; Mann, Marie Y; Ramos, Lauren Raskin; Therrell, Bradford L

2006-05-01

Financing for newborn screening is different from virtually all other public health programs. All except 5 screening programs collect fees as the primary source of program funding. A fee-based approach to financing newborn screening has been adopted by most states, to ensure consistent funding for this critical public health activity. Two types of data are reported here, ie, primary data from a survey of 37 state public health agencies and findings from exploratory case studies from 7 states. Most of the programs that participated in this survey (73%) reported that their newborn screening funding increased between 2002 and 2005, typically through increased fees and to a lesser extent through Medicaid, Title V Maternal and Child Health Services Block Grant, and state general revenue funding. All of the responding states that collect fees (n = 31) use such funds to support laboratory expenses, and most (70%) finance short-term follow-up services and program management. Nearly one half (47%) finance longer-term follow-up services, case management, or family support beyond diagnosis. Other states (43%) finance genetic or nutritional counseling and formula foods or treatment. Regardless of the source of funds, the available evidence indicates that states are committed to maintaining their programs and securing the necessary financing for the initial screening through diagnosis. Use of federal funding is currently limited; however, pressure to provide dedicated federal funding would likely increase if national recommendations for a uniform newborn screening panel were issued.

Workshop: Theory an Applications of Coupled Cell Networks

DTIC Science & Technology

2006-03-22

physical location and environment and the scientific inter- actions with the longer term participants in the PFD programme. Furthermore, the Institute...in generating a tangible air of excitement about the challenges posed by coupled cell systems, both in terms of the mathematical questions, and in the...longer term visitors interacted with the workshop participants, and by focusing on a slightly different collection of themes, the workshop participants

Deficits in verbal long-term memory and learning in children with poor phonological short-term memory skills.

PubMed

Gathercole, Susan E; Briscoe, Josie; Thorn, Annabel; Tiffany, Claire

2008-03-01

Possible links between phonological short-term memory and both longer term memory and learning in 8-year-old children were investigated in this study. Performance on a range of tests of long-term memory and learning was compared for a group of 16 children with poor phonological short-term memory skills and a comparison group of children of the same age with matched nonverbal reasoning abilities but memory scores in the average range. The low-phonological-memory group were impaired on longer term memory and learning tasks that taxed memory for arbitrary verbal material such as names and nonwords. However, the two groups performed at comparable levels on tasks requiring the retention of visuo-spatial information and of meaningful material and at carrying out prospective memory tasks in which the children were asked to carry out actions at a future point in time. The results are consistent with the view that poor short-term memory function impairs the longer-term retention and ease of learning of novel verbal material.

Playing piano can improve upper extremity function after stroke: case studies.

PubMed

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

Effect of a chronic disease management service for patients with diabetes on hospitalisation and acute care costs.

PubMed

Rasekaba, Tshepo M; Lim, W Kwang; Hutchinson, Anastasia F

2012-05-01

To evaluate the effect of a diabetes-management program for patients with type 2 diabetes and related comorbidities on acute healthcare utilisation and costs. This was a retrospective administrative dataset analysis using data for patients enrolled from 2007 to 2008. Inpatient admissions for diabetes-related conditions were compared before, during and following enrolment. Costs per episode were estimated from Weighted Inlier Equivalent Separations (WIES) funding. A cost model was then developed based on admission rates per 100 patients. Data were retrieved for 357 patients; 49% males, mean age 62 years. The mean per-patient cost of the program was AU$524 (s.d. $213). The mean cost of an inpatient admission was $4357(95% CI 2743-5971) pre-enrolment and $4396 (95% CI 2888-5904) post-enrolment. Following program completion the annual costs (per 100 patients) for managing 'diabetes with multiple complications' and hypoglycaemia decreased from $10181 to $1710 and $9947 to $7800. In contrast, the annual cost of cardiovascular disorders increased from $14485 to $40071 per 100 patients. In the short-term diabetes-management programs for patients with comorbid vascular disease may reduce hospital utilisation for diabetes but not for cardiovascular disease. Longer-term follow-up is needed to determine whether intensive management of vascular complications can reduce costs.

Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

PubMed Central

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

Thrombopoietin treatment of one graft in a double cord blood transplant provides early platelet recovery while contributing to long-term engraftment in NSG mice.

PubMed

van der Garde, Mark; van Hensbergen, Yvette; Brand, Anneke; Slot, Manon C; de Graaf-Dijkstra, Alice; Mulder, Arend; Watt, Suzanne M; Zwaginga, Jaap Jan

2015-01-01

Human cord blood (CB) hematopoietic stem cell (HSC) transplants demonstrate delayed early neutrophil and platelet recovery and delayed longer term immune reconstitution compared to bone marrow and mobilized peripheral blood transplants. Despite advances in enhancing early neutrophil engraftment, platelet recovery after CB transplantation is not significantly altered when compared to contemporaneous controls. Recent studies have identified a platelet-biased murine HSC subset, maintained by thrombopoietin (TPO), which has enhanced capacity for short- and long-term platelet reconstitution, can self-renew, and can give rise to myeloid- and lymphoid-biased HSCs. In previous studies, we have shown that transplantation of human CB CD34(+) cells precultured in TPO as a single graft accelerates early platelet recovery as well as yielding long-term repopulation in immune-deficient mice. In this study, using a double CB murine transplant model, we investigated whether TPO cultured human CB CD34(+) cells have a competitive advantage or disadvantage over untreated human CB CD34(+) cells in terms of (1) short-term and longer term platelet recovery and (2) longer term hematological recovery. Our studies demonstrate that the TPO treated graft shows accelerated early platelet recovery without impairing the platelet engraftment of untreated CD34(+) cells. Notably, this was followed by a dominant contribution to platelet production through the untreated CD34(+) cell graft over the intermediate to longer term. Furthermore, although the contribution of the TPO treated graft to long-term hematological engraftment was reduced, the TPO treated and untreated grafts both contributed significantly to long-term chimerism in vivo.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial.

PubMed

Tucker, Joan S; Edelen, Maria Orlando; Huang, Wenjing

2017-03-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N = 111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention.

Pathfinder technologies for bold new missions. [U.S. research and development program for space exploration

NASA Technical Reports Server (NTRS)

Sadin, Stanley R.; Rosen, Robert

1987-01-01

Project Pathfinder is a proposed U.S. Space Research and Technology program intended to enable bold new missions of space exploration. Pathfinder continues the advancement of technological capabilities and extends the foundation established under the Civil Space Technology Initiative, CSTI. By filling critical technological gaps, CSTI enhances access to Earth orbit and supports effective operations and science missions therein. Pathfinder, with a longer-term horizon, looks to a future that builds on Shuttle and Space Station and addresses technologies that support a range of exploration missions including: a return to the Moon to build an outpost; piloted missions to Mars; and continued scientific exploration of Earth and the other planets. The program's objective is to develop, within reasonable time frames, those emerging and innovative technologies that will make possible both new and enhanced missions and system concepts.

Proceedings of the 18th Annual Conference on Fossil Energy Materials.

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

Judkins, RR

2004-11-02

The 18th Annual conference on Fossil Energy Materials was held in Knoxville, Tennessee, on June 2 through June 4, 2004. The meeting was sponsored by the U.S. Department of Energy's (DOE) Office of Fossil Energy through the Advanced Research Materials Program (ARM). The objective of the ARM Program is to conduct research and development on materials for longer-term fossil energy applications, as well as for generic needs of various fossil fuel technologies. The management of the program has been decentralized to the DOE Oak Ridge Operations Office and Oak Ridge National Laboratory (ORNL). The research is performed by staff membersmore » at ORNL and by researchers at other national laboratories, universities, and in private industry. The work is divided into the following categories: (1) structural, ceramics, (2) new alloys and coatings, (3) functional materials, and (4) technology development and transfer.« less

Problem severity and motivation for treatment in incarcerated substance abusers.

PubMed

Hiller, Matthew L; Narevic, Egle; Webster, J Matthew; Rosen, Paul; Staton, Michele; Leukefeld, Carl; Garrity, Thomas F; Kayo, Rebecca

2009-01-01

Studies of community-based treatment programs for substance users document that motivation for treatment is a consistent predictor of clients remaining under treatment for a longer period of time. Recent research has replicated this in prison-based treatment programs, implying that motivation is clinically important regardless of setting. The current study examines predictors of treatment motivation using data collected from 661 male drug-involved inmates during in-depth interviews that include components of the Addiction Severity Index, TCU Motivation Scale, and the Heath Services Research Instrument. Findings showed treatment motivation can be measured effectively in prison-based settings. Motivation scores were not significantly different between individuals in a prison-based treatment program and those in the general prison population. Furthermore, higher motivation for treatment scores were associated with greater levels of problem severity, suggesting that individuals with more drug-use related life problems may recognize this need and desire help for beginning long-term recovery.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial

PubMed Central

Tucker, Joan S.; Edelen, Maria Orlando; Huang, Wenjing

2016-01-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N=111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention. PMID:26762375

Museums, zoos, and gardens: how formal-informal partnerships can impact urban students' performance in science.

PubMed

Weinstein, Meryle; Whitesell, Emilyn Ruble; Schwartz, Amy Ellen

2014-12-01

Informal science education institutions (ISEIs) are critical partners in public science education, as they support the science efforts of school systems by providing authentic opportunities for scientific inquiry. This study reports findings from an evaluation of urban advantage (UA), a collaboration between the New York City Department of Education and eight ISEIs designed to improve science education in New York City (NYC) middle schools. Now in its 10th year, the program harnesses the resources and expertise of NYC's ISEIs to (a) enhance the science content knowledge of middle school science teachers, (b) develop teachers' skills at using inquiry-based approaches in their classrooms, and (c) improve the science achievement of middle school students. We examine whether the UA program has led to increased student achievement on the eighth-grade New York State standardized science exam for students in participating schools; in supplemental analyses, we examine the effects on longer term (ninth-grade) outcomes. We use a difference-in-differences framework with school fixed effects to estimate the impact of attending a UA school in eighth grade on science achievement. Our key outcome is performance on New York State's eighth-grade intermediate-level science assessment; longer term outcomes include enrollment at specialized science, technology, engineering, and math high schools as well as taking and passing the high school (Regents) science exams. We find that attending a UA school increases student performance on the eighth-grade science exam by approximately 0.05 SD, and there is some evidence of small effects on Regents taking and passing rates. © The Author(s) 2014.

Evaluation of a Speed Mentoring Program: Achievement of Short-Term Mentee Goals and Potential for Longer-Term Relationships.

PubMed

Cellini, Melissa M; Serwint, Janet R; D'Alessandro, Donna M; Schulte, Elaine E; Osman, Cynthia

2017-07-01

Speed mentoring provides brief mentoring and networking opportunities. We evaluated 1) a national speed mentoring program's ability to encourage in-person networking and advice-sharing, and 2) 2 potential outcomes: helping mentees achieve 3-month goals, and fostering mentoring relationships after the program. An outcome approach logic model guided our program evaluation. Sixty mentees and 60 mentors participated. Each mentee met with 6 mentors for 10 minutes per pairing. At the program, mentees created goals. At 3 months, mentors sent mentees a reminder e-mail. At 4 months, participants received a Web-based survey. Forty-two (70%) mentees and 46 (77%) mentors completed the survey. Participants reported the program allowed them to share/receive advice, to network, to provide/gain different perspectives, and to learn from each other. Mentors as well as mentees identified shared interests, mentor-mentee chemistry, mentee initiative, and mentor approachability as key qualities contributing to ongoing relationships. Many mentor-mentee dyads had additional contact (approximately 60%) after the program and approximately one-third thought they were likely to continue the relationship. Goal-setting encouraged subsequent mentor-mentee contact and motivated mentees to work toward attaining their 3-month goals. The mentors aided mentees goal attainment by providing advice, offering support, and holding mentees accountable. A national speed mentoring program was an effective and efficient way to establish national connections, obtain different perspectives, and receive advice. Goal-setting helped mentees in achieving 3-month goals and fostering mentoring relationships outside of the program. These elements continue to be a part of this program and might be valuable for similar programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Parental distress in response to childhood medical trauma: A mediation model.

PubMed

Currie, Roseanne; Anderson, Vicki A; McCarthy, Maria C; Burke, Kylie; Hearps, Stephen Jc; Muscara, Frank

2018-04-01

This study explored the relationship between individual and family-level risk in predicting longer-term parental distress following their child's unexpected diagnosis of serious illness. A mediation model was tested, whereby parents' pre-existing psychosocial risk predicts longer-term posttraumatic stress symptoms, indirectly through parents' acute stress response. One hundred and thirty-two parents of 104 children participated. Acute stress response partially mediated the relationship between psychosocial risk and posttraumatic stress symptoms, with a moderate indirect effect ( r 2 = .20, P M = .56, p < .001). Findings demonstrated that cumulative psychosocial risk factors predispose parents to acute stress and longer-term posttraumatic stress symptoms, highlighting the need for psychosocial screening in this population.

Inter-Annual and Shorter-Term Variability in Physical and Biological Characteristics Across Barrow Canyon in August - September 2005-2014

NASA Astrophysics Data System (ADS)

Ashjian, C. J.; Okkonen, S. R.; Campbell, R. G.; Alatalo, P.

2014-12-01

Late summer physical and biological conditions along a 37-km transect crossing Barrow Canyon have been described for the past ten years as part of an ongoing program, supported by multiple funding sources including the NSF AON, focusing on inter-annual variability and the formation of a bowhead whale feeding hotspot near Barrow. These repeated transects (at least two per year, separated in time by days-weeks) provide an opportunity to assess the inter-annual and shorter term (days-weeks) changes in hydrographic structure, ocean temperature, current velocity and transport, chlorophyll fluorescence, nutrients, and micro- and mesozooplankton community composition and abundance. Inter-annual variability in all properties was high and was associated with larger scale, meteorological forcing. Shorter-term variability could also be high but was strongly influenced by changes in local wind forcing. The sustained sampling at this location provided critical measures of inter-annual variability that should permit detection of longer-term trends that are associated with ongoing climate change.

Pulmonary rehabilitation. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).

PubMed

Güell Rous, María Rosa; Díaz Lobato, Salvador; Rodríguez Trigo, Gema; Morante Vélez, Fátima; San Miguel, Marta; Cejudo, Pilar; Ortega Ruiz, Francisco; Muñoz, Alejandro; Galdiz Iturri, Juan Bautista; García, Almudena; Servera, Emilio

2014-08-01

Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Progress and challenges to male and female condom use in South Africa.

PubMed

Beksinska, Mags E; Smit, Jennifer A; Mantell, Joanne E

2012-03-01

South Africa has responded to the sexually transmissible infection and HIV epidemic with a rapid expansion of its national-level public sector condom program. Male condoms are available widely at no cost in the public sector, with expanded access via social marketing and the private sector. The female condom program is one of the largest and best established globally. National surveys show progressive increases in rates of condom use at last sex. However, inconsistent and incorrect condom use and the likelihood that condoms are discontinued in longer-term partnerships are some of the challenges impeding the condom program's successes in the fight against sexually transmissible infections and HIV. This article reviews the current condom program, related guidelines and policies, and the existing data on male and female condom use, including distribution and uptake. We discuss the main challenges to condom use, including both user and service-related issues and finally how these challenges could be addressed.

Short-Term Adverse Outcomes After Deep Brain Stimulation Treatment in Patients with Parkinson Disease.

PubMed

Hu, Kejia; Moses, Ziev B; Hutter, Matthew M; Williams, Ziv

2017-02-01

Despite ongoing progress in our understanding of long-term outcomes after neuromodulation procedures, acute adverse outcomes shortly after deep brain stimulation (DBS) treatment have remained remarkably limited. To identify risk factors associated with acute 30-day outcomes after DBS treatment in patients with Parkinson disease (PD). We evaluated patients who underwent DBS treatment for PD from 2005 to 2014 through the American College of Surgeons National Surgical Quality Improvement Program database. We used bivariate analysis and multivariate logistic regression to identify short-term postoperative outcomes, including 30-day complication, discharge destination, and unplanned readmission. Overall, 650 patients with PD underwent DBS procedures and complications were identified in 32 patients (4.9%). Of 481 patients who had complete discharge data, 18 patients (3.7%) were discharged to a facility and 16 patients (3.3%) experienced an unplanned readmission. Patients with PD who were obese (P = 0.045), who had preoperative anemia (P = 0.008), and who experienced longer operative durations (P = 0.01) had increased odds of postoperative complications. Inpatient status (P = 0.001), dependent functional status (P < 0.001), and anemia (P = 0.043) were all associated with discharge to a facility other than home. Longer operative duration (P = 0.013), anemia (P = 0.036), and dependent functional status (P = 0.03) were significantly associated with unplanned readmission. As expected, complications increased the likelihood of unplanned readmission (P < 0.001). This study provides individualized estimates of the risks associated with short-term adverse outcomes based on patient demographics and comorbidities. These data can be used as an adjunct for short-term risk stratification of patients with PD being considered for DBS treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

The longer term experiences of parent training: a qualitative analysis.

PubMed

Furlong, M; McGilloway, S

2015-09-01

Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term. This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory. Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes. Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families. © 2014 John Wiley & Sons Ltd.

waterData--An R package for retrieval, analysis, and anomaly calculation of daily hydrologic time series data, version 1.0

USGS Publications Warehouse

Ryberg, Karen R.; Vecchia, Aldo V.

2012-01-01

Hydrologic time series data and associated anomalies (multiple components of the original time series representing variability at longer-term and shorter-term time scales) are useful for modeling trends in hydrologic variables, such as streamflow, and for modeling water-quality constituents. An R package, called waterData, has been developed for importing daily hydrologic time series data from U.S. Geological Survey streamgages into the R programming environment. In addition to streamflow, data retrieval may include gage height and continuous physical property data, such as specific conductance, pH, water temperature, turbidity, and dissolved oxygen. The package allows for importing daily hydrologic data into R, plotting the data, fixing common data problems, summarizing the data, and the calculation and graphical presentation of anomalies.

Toward Augmented Radiologists: Changes in Radiology Education in the Era of Machine Learning and Artificial Intelligence.

PubMed

Tajmir, Shahein H; Alkasab, Tarik K

2018-06-01

Radiology practice will be altered by the coming of artificial intelligence, and the process of learning in radiology will be similarly affected. In the short term, radiologists will need to understand the first wave of artificially intelligent tools, how they can help them improve their practice, and be able to effectively supervise their use. Radiology training programs will need to develop curricula to help trainees acquire the knowledge to carry out this new supervisory duty of radiologists. In the longer term, artificially intelligent software assistants could have a transformative effect on the training of residents and fellows, and offer new opportunities to bring learning into the ongoing practice of attending radiologists. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Flame Retardant Fibers for Human Space Exploration - Past, Present, and Future

NASA Technical Reports Server (NTRS)

Orndoff, Evelyne

2017-01-01

The National Aeronautics and Space Administration (NASA) has led the development of unique flame retardant fibers for the specific requirements of different space programs. Three of these fibers have greatly contributed to the safety of all the space missions since the Apollo program. Beta alumina-silica microfiber developed for the outer layer of the space suit after the Apollo 1 fire is no longer used and has been replaced by other glass fibers. Expanded polytetrafluoroethylene (e-PTFE) fiber used in the current spacesuit is mostly known today through its trade mark Gore-Tex®. Polybenzimidazole (PBI) filament fiber used in many applications from the Apollo to the Space Shuttle program is no longer available. More recently, TOR"TM" copolymer of polyimide fiber developed during the space shuttle program to resist the atomic oxygen present in Low Earth Orbit has been barely used. The high cost and narrow range of aeronautical and aerospace applications have, however, led to a limited production of these fibers. Only fibers that found niche markets survived. Yet, deep space exploration will require more of these inherently flame retardant fibers than what is available today. There is a need for new flame retardant fabrics inside the space vehicles as well as a need for logistics reduction for long term space missions. Materials like modacrylic and polyimide are good candidates for future flame retardant aerospace fabrics. New fabrics must be developed for astronauts' clothing, as well as crew quarters and habitat. Therefore, both staple and filament fibers of various linear densities are needed for a three years mission to Mars.

The Science Manager's Guide to Case Studies

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

Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

2001-09-24

This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

Animals in biomedical space research

NASA Technical Reports Server (NTRS)

Phillips, R. W.

1986-01-01

Rat and squirrel monkeys experiments have been planned in concert with human experiments to help answer fundamental questions concerning the effect of weightlessness on mammalism function. For the most part, these experiments focus on identified changes noted in humans during space flight. Utilizing space laboratory facilities, manipulative experiments can be completed while animals are still in orbit. Other experiments are designed to study changes in gravity receptor structure and function and the effect of weightlessness on early vertibrate development. Following these preliminary animal experiments on Spacelab Shuttle flights, longer term programs of animal investigation will be conducted on Space Station.

Long-term efficacy of an ergonomics program that includes patient-handling devices on reducing musculoskeletal injuries to nursing personnel.

PubMed

Garg, Arun; Kapellusch, Jay M

2012-08-01

The aim of this study was to evaluate long-term efficacy of an ergonomics program that included patient-handling devices in six long-term care facilities (LTC) and one chronic care hospital (CCH). Patient handling is recognized as a major source of musculoskeletal disorders (MSDs) among nursing personnel, and several studies have demonstrated effectiveness of patient-handling devices in reducing those MSDs. However, most studies have been conducted in a single facility, for a short period, and/or without a comprehensive ergonomics program. Patient-handling devices along with a comprehensive ergonomics program was implemented in six LTC facilities and one CCH. Pre- and postintervention injury data were collected for 38.9 months (range = 29 to 54 months) and 51.2 months (range = 36 to 60 months), respectively. Postintervention patient-handling injuries decreased by 59.8% (rate ratio [RR] = 0.36, 95% confidence interval [CI] [0.28, 0.49], p < .001), lost workdays by 86.7% (RR = 0.16, 95% CI [0.13, 0.18], p < .001), modified-duty days by 78.8% (RR = 0.25, 95% CI [0.22, 0.28], p < .001), and workers' compensation costs by 90.6% (RR = 0.12, 95% CI [0.09, 0.15], p < .001). Perceived stresses to low back and shoulders among nursing staff were fairly low. A vast majority of patients found the devices comfortable and safe. Longer transfer times with the use of devices was not an issue. Implementation of patient-handling devices along with a comprehensive program can be effective in reducing MSDs among nursing personnel. Strategies to expand usage of patient-handling devices in most health care settings should be explored.

Development of a Long-Life-Cycle, Highly Water-Resistant Solar Reflective Retrofit Roof Coating

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

Polyzos, Georgios; Hunter, Scott; Sharma, Jaswinder

2016-03-04

Highly water-resistant and solar-reflective coatings for low-slope roofs are potentially among the most economical retrofit approaches to thermal management of the building envelope. Therefore, they represent a key building technology research program within the Department of Energy. Research efforts in industry and the Department of Energy are currently under way to increase long-term solar reflectance on a number of fronts. These include new polymer coatings technologies to provide longer-lasting solar reflectivity and improved test methodologies to predict long-term soiling and microbial performance. The focus on long-term improvements in soiling and microbial resistance for maximum reflectance does not address the singlemore » most important factor impacting the long-term sustainability of low-slope roof coatings: excellent water resistance. The hydrophobic character of asphaltic roof products makes them uniquely suitable for water resistance, but their low albedo and poor exterior durability are disadvantages. A reflective coating that maintains very high water resistance with increased long-term resistance to soiling and microbial activity would provide additional energy savings and extend roof service life.« less

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes.

PubMed

Ogiso, Satoshi; Yamaguchi, Takashi; Hata, Hiroaki; Kuroyanagi, Hiroya; Sakai, Yoshiharu

2010-11-01

Laparoscopic surgery for rectal cancer is unpopular because it is technically challenging. Suitable training systems have not been widely studied or established despite the steep learning curve for this procedure. We developed a systematic training program that enables resident surgeons to perform laparoscopic low anterior resection (LLAR) for rectal cancer and evaluated the safety and feasibility of this training program. We analyzed prospectively gathered data on all LLARs for rectal cancer performed at a single center over a 7-year period. Patients were assessed for demographic characteristics, tumor characteristics, operative procedure, operative time, blood loss, conversion to open surgery, complications, time to bowel recovery, distal margin, and number of lymph nodes harvested. We compared the early surgical, oncological, and functional outcomes of LLARs performed by expert surgeons with those of LLARs performed by resident surgeons for both intraperitoneal and extraperitoneal rectal cancer. All analyses were performed on an intention-to-treat basis. A total of 137 patients met the inclusion criteria for this study. Of the 75 LLARs for intraperitoneal rectal cancer, 40 were performed by expert surgeons (I-E group) and 35 by resident surgeons (I-R group). Of the 62 LLARs for extraperitoneal rectal cancer, 51 were performed by expert surgeons (E-E group) and 11 by resident surgeons (E-R group). The operative time was longer in the E-R group than in the E-E group. The time to resumption of diet was longer in the I-E group than in the I-R group. The other early outcomes, including blood loss, anastomotic leakage, conversion to open surgery, and number of lymph nodes harvested, were similar in the I-E and I-R groups and in the E-E and E-R groups. Our systematic training program on LLAR for rectal cancer enables resident surgeons to perform this procedure safely early during residency, with acceptable short-term outcomes.

Applied design methodology for lunar rover elastic wheel

NASA Astrophysics Data System (ADS)

Cardile, Diego; Viola, Nicole; Chiesa, Sergio; Rougier, Alessandro

2012-12-01

In recent years an increasing interest in the Moon surface operations has been experienced. In the future robotic and manned missions of Moon surface exploration will be fundamental in order to lay the groundwork for more ambitious space exploration programs. Surface mobility systems will be the key elements to ensure an efficient and safe Moon exploration. Future lunar rovers are likely to be heavier and able to travel longer distances than the previously developed Moon rover systems. The Lunar Roving Vehicle (LRV) is the only manned rover, which has so far been launched and used on the Moon surface. Its mobility system included flexible wheels that cannot be scaled to the heavier and longer range vehicles. Thus the previously developed wheels are likely not to be suitable for the new larger vehicles. Taking all these considerations into account, on the basis of the system requirements and assumptions, several wheel concepts have been discussed and evaluated through a trade-off analysis. Semi-empirical equations have been utilized to predict the wheel geometrical characteristics, as well as to estimate the motion resistances and the ability of the system to generate thrust. A numerical model has also been implemented, in order to define more into the details the whole wheel design, in terms of wheel geometry and physical properties. As a result of the trade-off analysis, the ellipse wheel concept has shown the best behavior in terms of stiffness, mass budget and dynamic performance. The results presented in the paper have been obtained in cooperation with Thales Alenia Space-Italy and Sicme motori, in the framework of a regional program called STEPS . STEPS-Sistemi e Tecnologie per l'EsPlorazione Spaziale is a research project co-financed by Piedmont Region and firms and universities of the Piedmont Aerospace District in the ambit of the P.O.R-F.E.S.R. 2007-2013 program.

Longer-term effects of selective thinning on microarthropod communities in a late-successional coniferous forest.

Treesearch

Robert W. Peck; Christine G. Niwa

2005-01-01

Microarthropod densities within late-successional coniferous forests thinned 16-41 yr before sampling were compared with adjacent unthinned stands to identify longer term effects of thinning on this community. Soil and forest floor layers were sampled separately on eight paired sites. Within the forest floor oribatid, mesostigmatid, and to a marginal extent,...

12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

ERIC Educational Resources Information Center

Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

2012-01-01

Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…

Mutual Adaptation: Enhancing Longer-Term Sustainability of Cross-Cultural In-Service Teacher Training Initiatives in China

ERIC Educational Resources Information Center

Yan, Chunmei

2008-01-01

This paper reports on a study that examines decisive factors for longer-term sustainability of cross-cultural teacher training initiatives in China. It focuses on teacher trainees' perspectives of a Sino-British adult education English language teaching project based in Central China. Questionnaires and semi-structured interviews were employed to…

NASA's Biomedical Research Program

NASA Technical Reports Server (NTRS)

Ahn, Chung-Hae

1981-01-01

The biomedical research program has been established to investigate the major physiological and psychological problems encountered by man when he undertakes spaceflight. The program seeks to obtain a better definition of each problem, an understanding of its underlying mechanism, and ultimately a means of prevention. In pursuing these goals the program also includes a major effort to develop the research tools and procedures it needs where these are not being developed elsewhere. After almost twenty years of manned spaceflight activities and after a much longer period of space related ground-based research, the program now recognizes two characteristics of spaceflight which are truly unique to space. These are weightlessness and one specific form of radiation. In its present stage of maturity much of the research focuses on mechanisms underlying the basic responses of man and animals to weightlessness. The program consists of nine elements. Eight of these are referable to specific physiological problems that have either been encountered in previous manned spaceflight or which are anticipated to occur as spaceflights last longer, traverse steeper orbital inclinations, or are otherwise different from previous missions. The ninth addresses problems that have neither arisen nor can be reasonably predicted but are suspected on the basis of theoretical models, ground-based animal research, or for other reasons. The program's current emphasis is directed toward the motion sickness problem because of its relevance to Space Shuttle operations. Increased awareness and understanding of the radiation hazard has resulted in more emphasis being placed on the biological effects of high energy, high mass number particulate radiation and upon radiation protection . Cardiovascular and musculoskeleta1 studies are pursued in recognition of the considerable fundamental knowledge that must be acquired in these areas before effective countermeasures to the effects of repetitive or long-term flight can be devised. Major new avenues of research will deal with the psychological accompaniments of spaceflight and with mathematical modelling of physiological systems.

The Stanford Medical Youth Science Program: educational and science-related outcomes.

PubMed

Crump, Casey; Ned, Judith; Winkleby, Marilyn A

2015-05-01

Biomedical preparatory programs (pipeline programs) have been developed at colleges and universities to better prepare youth for entering science- and health-related careers, but outcomes of such programs have seldom been rigorously evaluated. We conducted a matched cohort study to evaluate the Stanford Medical Youth Science Program's Summer Residential Program (SRP), a 25-year-old university-based biomedical pipeline program that reaches out to low-income and underrepresented ethnic minority high school students. Five annual surveys were used to assess educational outcomes and science-related experience among 96 SRP participants and a comparison group of 192 youth who applied but were not selected to participate in the SRP, using ~2:1 matching on sociodemographic and academic background to control for potential confounders. SRP participants were more likely than the comparison group to enter college (100.0 vs. 84.4 %, p = 0.002), and both of these matriculation rates were more than double the statewide average (40.8 %). In most areas of science-related experience, SRP participants reported significantly more experience (>twofold odds) than the comparison group at 1 year of follow-up, but these differences did not persist after 2-4 years. The comparison group reported substantially more participation in science or college preparatory programs, more academic role models, and less personal adversity than SRP participants, which likely influenced these findings toward the null hypothesis. SRP applicants, irrespective of whether selected for participation, had significantly better educational outcomes than population averages. Short-term science-related experience was better among SRP participants, although longer-term outcomes were similar, most likely due to college and science-related opportunities among the comparison group. We discuss implications for future evaluations of other biomedical pipeline programs.

Mentoring Program Enhancements Supporting Effective Mentoring of Children of Incarcerated Parents.

PubMed

Stump, Kathryn N; Kupersmidt, Janis B; Stelter, Rebecca L; Rhodes, Jean E

2018-04-26

Children of incarcerated parents (COIP) are at risk for a range of negative outcomes; however, participating in a mentoring relationship can be a promising intervention for these youth. This study examined the impact of mentoring and mentoring program enhancements on COIP. Secondary data analyses were conducted on an archival database consisting of 70,729 matches from 216 Big Brothers Big Sisters (BBBS) local agencies to establish the differential effects of mentoring on COIP. A subset of 45 BBBS agencies, representing 25,252 matches, participated in a telephone interview about program enhancements for better serving COIP. Results revealed that enhanced program practices, including having specific program goals, providing specialized mentor training, and receiving additional funding resulted in better outcomes for COIP matches. Specifically, specialized mentor training and receiving additional funding for serving matches containing COIP were associated with longer and stronger matches. Having specific goals for serving COIP was associated with higher educational expectations in COIP. Results are discussed in terms of benefits of a relationship-based intervention for addressing the needs of COIP and suggestions for program improvements when mentoring programs are serving this unique population of youth. © Society for Community Research and Action 2018.

77 FR 61462 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

...-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for Commission Action on Proceedings To Determine Whether To Approve or Disapprove Proposed Rule Change Proposing a Pilot Program To... change to create and implement, on a pilot basis, a Lead Market Maker (``LMM'') Issuer Incentive Program...

Integrating long-term science projects into K-12 curriculum: Fostering teacher-student engagement in urban environmental research through an NSF UCLA GK-12 program

NASA Astrophysics Data System (ADS)

Hogue, T. S.; Moldwin, M.; Nonacs, P.; Daniel, J.; Shope, R.

2009-12-01

A National Science Foundation Graduate Teaching Fellows in K- 12 Education program at UCLA (SEE-LA; http://measure.igpp.ucla.edu/GK12-SEE-LA) has just completed its first year (of a five-year program) and has greatly expanded UCLA’s science and engineering partnerships with LA Unified and Culver City Unified School Districts. The SEE-LA program partners UCLA faculty, graduate students (fellows), middle and high school science teachers and their students into a program of science and engineering exploration that brings the environment of Los Angeles into the classroom. UCLA graduate fellows serve as scientists-in-residence at the four partner schools to integrate inquiry-based science and engineering lessons, facilitate advancements in science content teaching, and ultimately, to improve their own science communication skills. As part of their fellowship, graduate students are required to develop three inquiry-based lessons in their partner classroom, including a lesson focused on their dissertation research, a lesson focused on the environmental/watershed theme of the project, and a lesson that involves longer-term data collection and synthesis with the grade 6-12 teachers and students. The developed long-term projects ideally involve continued observations and analysis through the five-year project and beyond. During the first year of the project, the ten SEE-LA fellows developed a range of long-term research projects, from seasonal invertebrate observations in an urban stream system, to home energy consumption surveys, to a school bioblitz (quantification of campus animals and insects). Examples of lesson development and integration in the classroom setting will be highlighted as well as tools required for sustainability of the projects. University and local pre-college school partnerships provide an excellent opportunity to support the development of graduate student communication skills while also contributing significantly to the integration of sustainable research projects into K-12 curriculum.

Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study.

PubMed

Phelan, Suzanne; Kanaya, Alka M; Ma, Yong; Vittinghoff, Eric; Barrett-Connor, Elizabeth; Wing, Rena; Kusek, John W; Orchard, Trevor J; Crandall, Jill P; Montez, Maria G; Brown, Jeanette S

2015-02-01

To examine the long-term prevalence and predictors of weekly urinary incontinence in the Diabetes Prevention Program Outcomes Study, a follow-up study of the Diabetes Prevention Program randomized clinical trial of overweight adults with impaired glucose tolerance. This analysis included 1778 female participants of the Diabetes Prevention Program Outcomes Study who had been randomly assigned during the Diabetes Prevention Program to intensive lifestyle intervention (n = 582), metformin (n = 589) or placebo (n = 607). The study participants completed semi-annual assessments after the final Diabetes Prevention Program visit and for 6 years until October 2008. At the study entry, the prevalence of weekly urinary incontinence was lower in the intensive lifestyle intervention group compared with the metformin and placebo groups (44.2% vs 51.8%, 48.0% urinary incontinence/week, P = 0.04); during the 6-year follow-up period, these lower rates in intensive lifestyle intervention were maintained (46.7%, 53.1%, 49.9% urinary incontinence/week; P = 0.03). Statistically adjusting for urinary incontinence prevalence at the end of the Diabetes Prevention Program, the treatment arm no longer had a significant impact on urinary incontinence during the Diabetes Prevention Program Outcomes Study. Independent predictors of lower urinary incontinence during the Diabetes Prevention Program Outcomes Study included lower body mass index (odds ratio 0.988, 95% confidence interval 0.982-0.994) and greater physical activity (odds ratio 0.999, 95% confidence interval 0.998-1.000) at the Diabetes Prevention Program Outcomes Study entry, and greater reductions in body mass index (odds ratio 0.75, 95% confidence interval 0.60-0.94) and waist circumference (odds ratio 0.998, 95% confidence interval 0.996-1.0) during the Diabetes Prevention Program Outcomes Study. Diabetes was not significantly related to urinary incontinence. Intensive lifestyle intervention has a modest positive and enduring impact on urinary incontinence, and should be considered for the long-term prevention and treatment of urinary incontinence in overweight/obese women with glucose intolerance. © 2014 The Japanese Urological Association.

NICU management and outcomes of infants with trisomy 21 without major anomalies.

PubMed

McAndrew, Sarah; Acharya, Krishna; Nghiem-Rao, T Hang; Leuthner, Steven; Clark, Reese; Lagatta, Joanne

2018-05-25

To describe how trisomy 21 affects neonatal intensive care management and outcomes of full-term infants without congenital anomalies. Retrospective cohort of full-term infants without anomalies with and without trisomy 21 admitted to Pediatrix NICUs from 2005 to 2012. We compared diagnoses, management, length of stay, and discharge outcomes. In all, 4623 infants with trisomy 21 and 606 770 infants without trisomy 21 were identified. One-third of infants in the NICU with and without trisomy 21 were full term without major anomalies. Trisomy 21 infants had more respiratory distress, thrombocytopenia, feeding problems, and pulmonary hypertension. They received respiratory support for a longer period of time and had a longer length of stay. One-third of infants with trisomy 21 admitted to the NICU are full term without major anomalies. Common diagnoses and greater respiratory needs place infants with trisomy 21 at risk for longer length of stay.

The impact on taxpayer costs of a jail diversion program for people with serious mental illness.

PubMed

Cowell, Alexander J; Hinde, Jesse M; Broner, Nahama; Aldridge, Arnie P

2013-12-01

Mental illness is prevalent among those incarcerated. Jail diversion is one means by which people with mental illness are treated in the community - often with some criminal justice system oversight - instead of being incarcerated. Jail diversion may lead to immediate reductions in taxpayer costs because the person is no longer significantly engaged with the criminal justice system. It may also lead to longer term reductions in costs because effective treatment may ameliorate symptoms, reduce the number of future offenses, and thus subsequent arrests and incarceration. This study estimates the impact on taxpayer costs of a model jail diversion program for people with serious mental illness. Administrative data on criminal justice and treatment events were combined with primary and secondary data on the costs of each event. Propensity score methods and a quasi-experimental design were used to compare treatment and criminal justice costs for a group of people who were diverted to a group of people who were not diverted. Diversion was associated with approximately $2800 lower taxpayer costs per person 2 years after the point of diversion (p<.05). Reductions in criminal justice costs drove this result. Jail diversion for people with mental illness may thus be justified fiscally. Copyright © 2013 Elsevier Ltd. All rights reserved.

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis.

PubMed

Jonkman, Nini H; Westland, Heleen; Groenwold, Rolf H H; Ågren, Susanna; Anguita, Manuel; Blue, Lynda; Bruggink-André de la Porte, Pieta W F; DeWalt, Darren A; Hebert, Paul L; Heisler, Michele; Jaarsma, Tiny; Kempen, Gertrudis I J M; Leventhal, Marcia E; Lok, Dirk J A; Mårtensson, Jan; Muñiz, Javier; Otsu, Haruka; Peters-Klimm, Frank; Rich, Michael W; Riegel, Barbara; Strömberg, Anna; Tsuyuki, Ross T; Trappenburg, Jaap C A; Schuurmans, Marieke J; Hoes, Arno W

2016-11-01

To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97-0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96-0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92-0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics. No specific program characteristics were consistently associated with better effects of self-management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

How Are They Now? Longer Term Effects of eCoaching through Online Bug-in-Ear Technology

ERIC Educational Resources Information Center

Rock, Marcia L.; Schumacker, Randall E.; Gregg, Madeleine; Howard, Pamela W.; Gable, Robert A.; Zigmond, Naomi

2014-01-01

In this study, using mixed methods, we investigated the longer term effects of eCoaching through advanced online bug-in-ear (BIE) technology. Quantitative data on five dependent variables were extracted from 14 participants' electronically archived video files at three points in time--Spring 1 (i.e., baseline, which was the first semester of…

A Mixed-Methods Evaluation of the Longer-Term Implementation and Utility of a Teacher Classroom Management Training Programme in Irish Primary Schools

ERIC Educational Resources Information Center

Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad

2016-01-01

Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…

The Future Is More than Just Tomorrow: Higher Education, the Economy and the Longer Term

ERIC Educational Resources Information Center

Crossick, Geoffrey

2010-01-01

In this commentary the author reflects on longer-term issues facing higher education in the context of recession and crisis in public finance. The views expressed are written from a personal perspective with the aim of stimulating and encouraging a wider and ongoing debate around the themes presented. The author draws upon the findings of three…

77 FR 38116 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

...-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change Proposing a Pilot Program To Create a Lead Market Maker Issuer Incentive Program for...'') \\1\\ and Rule 19b-4 thereunder,\\2\\ a proposed rule change to create and implement, on a pilot basis, a...

Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors.

PubMed

Kampshoff, C S; van Dongen, J M; van Mechelen, W; Schep, G; Vreugdenhil, A; Twisk, J W R; Bosmans, J E; Brug, J; Chinapaw, M J M; Buffart, Laurien M

2018-06-01

This study aimed to evaluate the long-term effectiveness and cost-effectiveness of high intensity (HI) versus low-to-moderate intensity (LMI) exercise on physical fitness, fatigue, and health-related quality of life (HRQoL) in cancer survivors. Two hundred seventy-seven cancer survivors participated in the Resistance and Endurance exercise After ChemoTherapy (REACT) study and were randomized to 12 weeks of HI (n = 139) or LMI exercise (n = 138) that had similar exercise types, durations, and frequencies, but different intensities. Measurements were performed at baseline (4-6 weeks after primary treatment), and 12 (i.e., short term) and 64 (i.e., longer term) weeks later. Outcomes included cardiorespiratory fitness, muscle strength, self-reported fatigue, HRQoL, quality-adjusted life years (QALYs) and societal costs. Linear mixed models were conducted to study (a) differences in effects between HI and LMI exercise at longer term, (b) within-group changes from short term to longer term, and (c) the cost-effectiveness from a societal perspective. At longer term, intervention effects on role (β = 5.9, 95% CI = 0.5; 11.3) and social functioning (β = 5.7, 95%CI = 1.7; 9.6) were larger for HI compared to those for LMI exercise. No significant between-group differences were found for physical fitness and fatigue. Intervention-induced improvements in cardiorespiratory fitness and HRQoL were maintained between weeks 12 and 64, but not for fatigue. From a societal perspective, the probability that HI was cost-effective compared to LMI exercise was 0.91 at 20,000€/QALY and 0.95 at 52,000€/QALY gained, mostly due to significant lower healthcare costs in HI exrcise. At longer term, we found larger intervention effects on role and social functioning for HI than for LMI exercise. Furthermore, HI exercise was cost-effective with regard to QALYs compared to LMI exercise. This study is registered at the Netherlands Trial Register [NTR2153 [ http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2153

Integrating nutrition security with treatment of people living with HIV: lessons from Kenya.

PubMed

Byron, Elizabeth; Gillespie, Stuart; Nangami, Mabel

2008-06-01

The increased caloric requirements of HIV-positive individuals, undesirable side effects of treatment that may be worsened by malnutrition (but alleviated by nutritional support), and associated declines in adherence and possible increased drug resistance are all justifications for developing better interventions to strengthen the nutrition security of individuals receiving antiretroviral treatment. To highlight key benefits and challenges relating to interventions aimed at strengthening the nutrition security of people living with HIV who are receiving antiretroviral treatment. Qualitative research was undertaken on a short-term nutrition intervention linked to the provision of free antiretroviral treatment for people living with HIV in western Kenya in late 2005 and early 2006. Patients enrolled in the food program while on treatment regimens self-reported greater adherence to their medication, fewer side effects, and a greater ability to satisfy increased appetite. Most clients self-reported weight gain, recovery of physical strength, and the resumption of labor activities while enrolled in dual (food supplementation and treatment) programs. Such improvements were seen to catalyze increased support from family and community. These findings provide further empirical support to calls for a more holistic and comprehensive response to the coexistence of AIDS epidemics with chronic nutrition insecurity. Future work is needed to clarify ways of bridging the gap between short-term nutritional support to individuals and longer-term livelihood security programming for communities affected by AIDS. Such interdisciplinary research will need to be matched by intersectoral action on the part of the agriculture and health sectors in such environments.

Feasibility of antiretroviral treatment monitoring in the era of decentralized HIV care: a systematic review.

PubMed

Pham, Minh D; Romero, Lorena; Parnell, Bruce; Anderson, David A; Crowe, Suzanne M; Luchters, Stanley

2017-01-19

Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings. A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference websites were searched to identify relevant studies conducted in LMICs, published in English between Jan 2006 and Dec 2015. Outcomes of interest included the proportion of patients who received treatment monitoring and health system factors related to monitoring of patients on ART under decentralized HIV service delivery models. From 5363 records retrieved, twenty studies were included in the review; all but one was conducted in sub-Saharan African countries. The majority of studies (15/20) had relatively short follow-up duration (≤24 months), and only two studies were specifically designed to assess treatment monitoring practices. The most frequently studied follow-up period was 12 months and a wide range of treatment monitoring coverage was observed. The reported proportions of patients on ART who received CD4 monitoring ranged from very low (6%; N = 2145) to very high (95%; N = 488). The median uptake of viral load monitoring was 86% with studies in program settings reporting coverage as low as 14%. Overall, the longer the follow-up period, the lower the proportion of patients who received regular monitoring tests; and programs in rural areas reported low coverage of laboratory monitoring. Moreover, uptake in the context of research had significantly better where monitoring was done by dedicated research staff. In the absence of point of care (POC) testing, the limited capacity for blood sample transportation between clinic and laboratory and poor quality of nursing staff were identified as a major barrier for treatment monitoring practice. There is a paucity of data on the uptake of treatment monitoring, particularly with longer-term follow-up. Wide variation in access to both virological and immunological regular monitoring was observed, with some clinics in well-resourced settings supported by external donors achieving high coverage. The feasibility of treatment monitoring, particularly in decentralized settings of HIV treatment and care may thus be of concern and requires further study. Significant investment in POC diagnostic technologies and, improving the quality of and training for nursing staff is required to ensure effective scale up of ART programs towards the targets of 90-90-90 by the year 2020.

Vertical distribution of clouds over Hampton, Virginia observed by lidar under the ECLIPS and FIRE ETO programs

NASA Technical Reports Server (NTRS)

Vaughan, M. A.; Winker, D. M.

1994-01-01

Intensive cloud lidar observations have been made by NASA Langley Research Center during the two observation phases of the ECLIPS project. Less intensive but longer term observations have been conducted as part of the FIRE extended time observation (ETO) program since 1987. We present a preliminary analysis of the vertical distribution of clouds based on these observations. A mean cirrus thickness of just under 1 km has been observed with a mean altitude of about 80 percent of the tropopause height. Based on the lidar data, cirrus coverage was estimated to be just under 20 percent, representing roughly 50 percent of all clouds studied. Cirrus was observed to have less seasonal variation than lower clouds. Mid-level clouds are found to occur primarily in association with frontal activity.

The Effect of Breakfast in the Classroom on Obesity and Academic Performance: Evidence from New York City.

PubMed

Corcoran, Sean P; Elbel, Brian; Schwartz, Amy Ellen

2016-01-01

Participation in the federally subsidized school breakfast program often falls well below its lunchtime counterpart. To increase take-up, many districts have implemented Breakfast in the Classroom (BIC), offering breakfast directly to students at the start of the school day. Beyond increasing participation, advocates claim BIC improves academic performance, attendance, and engagement. Others caution BIC has deleterious effects on child weight. We use the implementation of BIC in New York City (NYC) to estimate its impact on meals program participation, body mass index (BMI), achievement, and attendance. While we find large effects on participation, our findings provide no evidence of hoped-for gains in academic performance, or of feared increases in obesity. The policy case for BIC will depend upon reductions in hunger and food insecurity for disadvantaged children, or its longer-term effects.

National Space Transportation System (NSTS) technology needs

NASA Technical Reports Server (NTRS)

Winterhalter, David L.; Ulrich, Kimberly K.

1990-01-01

The National Space Transportation System (NSTS) is one of the Nation's most valuable resources, providing manned transportation to and from space in support of payloads and scientific research. The NSTS program is currently faced with the problem of hardware obsolescence, which could result in unacceptable schedule and cost impacts to the flight program. Obsolescence problems occur because certain components are no longer being manufactured or repair turnaround time is excessive. In order to achieve a long-term, reliable transportation system that can support manned access to space through 2010 and beyond, NASA must develop a strategic plan for a phased implementation of enhancements which will satisfy this long-term goal. The NSTS program has initiated the Assured Shuttle Availability (ASA) project with the following objectives: eliminate hardware obsolescence in critical areas, increase reliability and safety of the vehicle, decrease operational costs and turnaround time, and improve operational capability. The strategy for ASA will be to first meet the mandatory needs - keep the Shuttle flying. Non-mandatory changes that will improve operational capability and enhance performance will then be considered if funding is adequate. Upgrade packages should be developed to install within designated inspection periods, grouped in a systematic approach to reduce cost and schedule impacts, and allow the capability to provide a Block 2 Shuttle (Phase 3).

Employee suggestion programs: the rewards of involvement.

PubMed

Mishra, J M; McKendall, M

1993-09-01

Successful ESPs are the products of a great deal of effort by managers, administrators, teams, individuals, and reviewers, who are all striving to achieve the goals of increased profitability and enhanced employee involvement. A review of the literature indicates that there are several prescriptions that will increase the likelihood of a successful ESP (see the box). Today's American business prophets sound ceaseless calls to arms in the name of "world class performance," "global competitiveness," "total quality management," and a variety of other buzz terms. A burgeoning industry has evolved that promises, through speeches, teleconferences, seminars, and consulting contracts, to teach American organizations how to achieve excellence. In the face of a sputtering economy and unrelenting competitive pressure, today's managers must translate these laudatory ideals into hands-on reality without sacrificing the firm's profit margin to experimentation. If any idea can help an organization achieve improvement through a workable program, then that idea and that program deserve real consideration. An ESP represents an opportunity to tap the intelligence and resourcefulness of an organization's employees, and by doing so, reap significant cost savings. Those companies and managers that have an ESP program uniformly list economic advantages first when describing the benefits of their employee suggestion programs. But there is another deeper and longer term benefit inherent in an ESP. These programs allow employees to become involved in their organization; they drive deaccession to lower levels, they give employees more responsibility, they foster creative approaches to work, and they encourage creativity in pursuit of company goals.(ABSTRACT TRUNCATED AT 250 WORDS)

Effectiveness of Start to Run, a 6-week training program for novice runners, on increasing health-enhancing physical activity: a controlled study

PubMed Central

2013-01-01

Background The use of the organized sports sector as a setting for health-promotion is a relatively new strategy. In the past few years, different countries have been investing resources in the organized sports sector for promoting health-enhancing physical activity. In the Netherlands, National Sports Federations were funded to develop and implement “easily accessible” sporting programs, aimed at the least active population groups. Start to Run, a 6-week training program for novice runners, developed by the Dutch Athletics Organization, is one of these programs. In this study, the effects of Start to Run on health-enhancing physical activity were investigated. Methods Physical activity levels of Start to Run participants were assessed by means of the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH) at baseline, immediately after completing the program and six months after baseline. A control group, matched for age and sex, was assessed at baseline and after six months. Compliance with the Dutch physical activity guidelines was the primary outcome measure. Secondary outcome measures were the total time spent in physical activity and the time spent in each physical activity intensity category and domain. Changes in physical activity within groups were tested with paired t-tests and McNemar tests. Changes between groups were examined with multiple linear and logistic regression analyses. Results In the Start to Run group, the percentage of people who met the Dutch Norm for Health-enhancing Physical Activity, Fit-norm and Combi-norm increased significantly, both in the short- and longer-term. In the control group, no significant changes in physical activity were observed. When comparing results between groups, significantly more Start to Run participants compared with control group participants were meeting the Fit-norm and Combi-norm after six months. The differences in physical activity between groups in favor of the Start to Run group could be explained by an increase in the time spent in vigorous-intensity activities and sports activities. Conclusions Start to Run positively influences levels of health-enhancing physical activity of participants, both in the short- and longer-term. Based on these results, the use of the organized sports sector as a setting to promote health-enhancing physical activity seems promising. PMID:23898920

Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review

PubMed Central

Morad, Anna; Sathe, Nila A.; Francis, David O.; McPheeters, Melissa L.

2017-01-01

CONTEXT: The effectiveness of tonsillectomy or adenotonsillectomy (“tonsillectomy”) for recurrent throat infection compared with watchful waiting is uncertain. OBJECTIVE: To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. DATA SOURCES: MEDLINE, Embase, and the Cochrane Library. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION: One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. RESULTS: Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. LIMITATIONS: Few studies fully categorized infection/sore throat severity; attrition was high. CONCLUSIONS: Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. PMID:28096515

Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review.

PubMed

Morad, Anna; Sathe, Nila A; Francis, David O; McPheeters, Melissa L; Chinnadurai, Sivakumar

2017-02-01

The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. MEDLINE, Embase, and the Cochrane Library. Two investigators independently screened studies against predetermined criteria. One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. Few studies fully categorized infection/sore throat severity; attrition was high. Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. Copyright © 2017 by the American Academy of Pediatrics.

Prevalence of NRT use and associated nicotine intake in smokers, recent ex-smokers and longer-term ex-smokers.

PubMed

Shahab, Lion; Beard, Emma; Brown, Jamie; West, Robert

2014-01-01

Nicotine replacement therapy (NRT) is used by smokers wanting to reduce their smoking and to quit. However, there are very little data on nicotine intake associated with NRT use in representative population samples. This study aimed to provide estimates for NRT use and associated nicotine exposure among smokers, recent and longer-term ex-smokers in England, a country with a permissive regulatory regime for nicotine substitution. In the Smoking Toolkit Study, a monthly series of representative household surveys of adults aged 16+ in England, current and recent ex-smokers who agreed to be re-contacted were followed up 6 months later and standard socio-demographic and smoking characteristics assessed (N = 5,467, response rate 25.1%). A random sub-sample (N = 1,614; 29.5%) also provided saliva, analysed for cotinine. The sample followed up was broadly representative of the original sample. At follow-up, 11.8% (95%CI 10.9-12.8, N = 565) of current smokers, 34.8% (95%CI 28.9-41.3, N = 77) of recent (≤ 3 months) ex-smokers, and 7.8% (95%CI 5.6-10.6, N = 36) of longer-term (> 3 months) ex-smokers reported using NRT. Smokers who used NRT had similar saliva cotinine concentrations to smokers who did not use NRT (mean ± sd  = 356.0 ± 198.6 ng/ml vs. 313.1 ± 178.4 ng/ml). Recent ex-smokers who used NRT had levels that were somewhat lower, but not significantly so, than current smokers (216.7 ± 179.3 ng/ml). Longer-term ex-smokers using NRT had still lower levels (157.3 ± 227.1 ng/ml), which differed significantly from smokers using NRT (p = 0.024). Concurrent use of nicotine replacement therapy while smoking is relatively uncommon and is not associated with higher levels of nicotine intake. Among ex-smokers, NRT use is common in the short but not longer-term and among longer-term users is associated with lower nicotine intake than in smokers.

Grammar Predicts Procedural Learning and Consolidation Deficits in Children with Specific Language Impairment

PubMed Central

Hedenius, Martina; Persson, Jonas; Tremblay, Antoine; Adi-Japha, Esther; Veríssimo, João; Dye, Cristina D.; Alm, Per; Jennische, Margareta; Tomblin, J. Bruce; Ullman, Michael T.

2011-01-01

The Procedural Deficit Hypothesis (PDH) posits that Specific Language Impairment (SLI) can be largely explained by abnormalities of brain structures that subserve procedural memory. The PDH predicts impairments of procedural memory itself, and that such impairments underlie the grammatical deficits observed in the disorder. Previous studies have indeed reported procedural learning impairments in SLI, and have found that these are associated with grammatical difficulties. The present study extends this research by examining the consolidation and longer-term procedural sequence learning in children with SLI. The Alternating Serial Reaction Time (ASRT) task was given to children with SLI and typically-developing (TD) children in an initial learning session and an average of three days later to test for consolidation and longer-term learning. Although both groups showed evidence of initial sequence learning, only the TD children showed clear signs of consolidation, even though the two groups did not differ in longer-term learning. When the children were re-categorized on the basis of grammar deficits rather than broader language deficits, a clearer pattern emerged. Whereas both the grammar impaired and normal grammar groups showed evidence of initial sequence learning, only those with normal grammar showed consolidation and longer-term learning. Indeed, the grammar-impaired group appeared to lose any sequence knowledge gained during the initial testing session. These findings held even when controlling for vocabulary or a broad non-grammatical language measure, neither of which were associated with procedural memory. When grammar was examined as a continuous variable over all children, the same relationships between procedural memory and grammar, but not vocabulary or the broader language measure, were observed. Overall, the findings support and further specify the PDH. They suggest that consolidation and longer-term procedural learning are impaired in SLI, but that these impairments are specifically tied to the grammatical deficits in the disorder. The possibility that consolidation and longer-term learning are problematic in the disorder suggests a locus of potential study for therapeutic approaches. In sum, this study clarifies our understanding of the underlying deficits in SLI, and suggests avenues for further research. PMID:21840165

Utilizing global data to estimate analytical performance on the Sigma scale: A global comparative analysis of methods, instruments, and manufacturers through external quality assurance and proficiency testing programs.

PubMed

Westgard, Sten A

2016-06-01

To assess the analytical performance of instruments and methods through external quality assessment and proficiency testing data on the Sigma scale. A representative report from five different EQA/PT programs around the world (2 US, 1 Canadian, 1 UK, and 1 Australasian) was accessed. The instrument group standard deviations were used as surrogate estimates of instrument imprecision. Performance specifications from the US CLIA proficiency testing criteria were used to establish a common quality goal. Then Sigma-metrics were calculated to grade the analytical performance. Different methods have different Sigma-metrics for each analyte reviewed. Summary Sigma-metrics estimate the percentage of the chemistry analytes that are expected to perform above Five Sigma, which is where optimized QC design can be implemented. The range of performance varies from 37% to 88%, exhibiting significant differentiation between instruments and manufacturers. Median Sigmas for the different manufacturers in three analytes (albumin, glucose, sodium) showed significant differentiation. Chemistry tests are not commodities. Quality varies significantly from manufacturer to manufacturer, instrument to instrument, and method to method. The Sigma-assessments from multiple EQA/PT programs provide more insight into the performance of methods and instruments than any single program by itself. It is possible to produce a ranking of performance by manufacturer, instrument and individual method. Laboratories seeking optimal instrumentation would do well to consult this data as part of their decision-making process. To confirm that these assessments are stable and reliable, a longer term study should be conducted that examines more results over a longer time period. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Building an undergraduate physics program with Learning Assistants

NASA Astrophysics Data System (ADS)

Price, Edward

2013-04-01

In 2007, the CSUSM Physics Department began offering a B.S. in Applied Physics, its first physics bachelors degree program. The program has grown from 11 majors in 2008 to over 80 in 2012, due in part to recruiting students from local high schools and community colleges. More broadly, because most CSUSM students come from the local region, the longer-term health of the Department is coupled with the vitality and strength of local high school physics education. In addition, establishing a new physics degree required curriculum development and offered the opportunity to incorporate recent innovations in physics education when developing courses. A Learning Assistants (LA) Program, established by the Department in 2008, has been a critical component in these efforts to recruit students, build local educational networks, and implement innovative curricula. In an LA Program, undergraduate Learning Assistants assist faculty in class, meet regularly with the course instructor, and participate in a weekly seminar on teaching and learning, which provides guidance on effective instruction and an opportunity to reflect on their experiences in the classroom. The LA program promotes course transformation, improved student learning, and teacher recruitment. This talk will describe the CSUSM LA Program and its role in support of our growing applied physics degree program.

Out of place: mediating health and social care in Ontario's long-term care sector.

PubMed

Daly, Tamara

2007-01-01

The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which types of home care and home support services receive public funding. It addresses the effects of these reforms on the state–non-profit relationship, and the shifting balance between public funding of health and social care. At a program level, and with few exceptions, homemaking services have been cut from home care, and home support services are more medicalized. With these changes, growing numbers of people no longer eligible to receive publicly funded home care services look for other alternatives: they draw available resources from home support, they draw on family and friend networks, they hire privately and pay out of pocket, they leave home and enter an institution, or they do without.

Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

PubMed

Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

2015-01-01

The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

Status of Commercial Programs at NASA

NASA Technical Reports Server (NTRS)

Groen, Frank

2011-01-01

NASA's strategy is two-fold: (1) Use Space Act Agreements to support the development of commercial crew transportation capabilities. (2) Use FAR-based contracts for the certification of commercially developed capabilities and for the procurement of crew transportation services to and from the ISS to meet NASA requirements. Focus is on reducing the risk and uncertainties of the development environment and on the incentives provided through competition by separating the design and early development content from the longer-term CTS Certification activities. CCP expects to develop, demonstrate, and certify U.S. commercial crew space transportation capabilities that meet ISS crew transportation needs by the end of FY 2017.

GOES-S NASA Social

NASA Image and Video Library

2018-02-28

Tim Walsh, GOES-R System Program director for the National Oceanic and Atmospheric Administration, or NOAA, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on the Geostationary Operational Environmental Satellite, or GOES-S, the second spacecraft in a series of next-generation NOAA weather satellites. It will launch to a geostationary position over the U.S. to provide images of storms and help predict weather forecasts, severe weather outlooks, watches, warnings, lightning conditions and longer-term forecasting. GOES-S is slated to lift off at 5:02 p.m. EST on March 1, 2018 aboard a United Launch Alliance Atlas V rocket.

Lamont-Doherty's Secondary School Field Research Program: Institutionalizing outreach to secondary school students at a soft-money research institute

NASA Astrophysics Data System (ADS)

Sambrotto, R.

2015-12-01

The Secondary School Field Research Program is a field and laboratory internship for high school students at the Lamont-Doherty Earth Observatory. Over the past 11 years it has grown into a significant program, engaging approximately 50 high school and college students each summer, most of them from ethnic and economic groups that are under-represented in the STEM fields. The internships are based on research-driven science questions on estuarine physics, chemistry, ecology and the paleo-environment. Field studies are linked to associated laboratory analyses whose results are reported by the students as a final project. For the past two years, we have focused on the transition to an institutional program, with sustainable funding and organizational structures. At a grant-driven institution whose mission is largely restricted to basic research, institutionalization has not been an easy task. To leverage scarce resources we have implemented a layered structure that relies on near-peer mentoring. So a typical research team might include a mix of new and more experienced high school students, a college student, a high school science teacher and a Lamont researcher as a mentor. Graduates of the program are employed to assist with administration. Knowledge and best practices diffuse through the organization in an organic, if not entirely structured, fashion. We have found that a key to long-term funding has been survival: as we have sustained a successful program and developed a model adapted to Lamont's unique environment, we have attracted longer term core financing on which grant-driven extensions can be built. The result is a highly flexible program that is student-centered in the context of a broader research culture connecting our participants with the advantages of working at a premier soft-money research institution.

Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

PubMed

Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

2017-06-01

Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs

PubMed Central

Ozminkowski, Ronald J.; McGinn, Michael P.; Hawkins, Kevin; Bhattarai, Gandhi R.; Serxner, Seth A.; Greame, Chris

2017-01-01

Abstract Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes. PMID:27575977

Educational intervention on physical restraint use in long-term care facilities - Systematic review and meta-analysis.

PubMed

Lan, Shao-Huan; Lu, Li-Chin; Lan, Shou-Jen; Chen, Jong-Chen; Wu, Wen-Jun; Chang, Shen-Peng; Lin, Long-Yau

2017-08-01

"Physical restraint" formerly used as a measure of protection for psychiatric patients is now widely used. However, existing studies showed that physical restraint not only has inadequate effect of protection but also has negative effects on residents. To analyzes the impact of educational program on the physical restraint use in long-term care facilities. A systematic review with meta-analysis and meta-regression. Eight databases, including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, Ovid Medline and Physiotherapy Evidence Database (PEDro), were searched up to January 2017. Eligible studies were classified by intervention and accessed for quality using the Quality Assessment Tool for quantitative studies. Sixteen research articles were eligible in the final review; 10 randomize control trail studies were included in the analysis. The meta-analysis revealed that the use of physical restraint was significantly less often in the experimental (education) group (OR = 0.55, 95% CI: 0.39 to 0.78, p < 0.001) compared to the control group. Meta-regression revealed the period of post education would have decreased the effect of the restraint educational program (β: 0.08, p = 0.002); instead, the longer education period and more times of education would have a stronger effect of reducing the use of physical restraint (β: -0.07, p < 0.001; β: -0.04, p = 0.056). The educational program had an effect on the reduced use of physical restraint. The results of meta-regression suggest that long-term care facilities should provide a continuous education program of physical restraint for caregivers. Copyright © 2017. Published by Elsevier Taiwan.

Long-Term Effects of a Screening Intervention for Depression on Suicide Rates among Japanese Community-Dwelling Older Adults.

PubMed

Oyama, Hirofumi; Sakashita, Tomoe

2016-04-01

To explore the long-term impact of a universal screening intervention for depression on suicide rates among older community-dwelling adults, with gender as an effect modifier. Controlled cohort study reporting long-term follow-up of previous research. Two sets of three municipalities in Japan were assigned as intervention and control regions and compared with the surrounding zone and prefecture. Intervention area residents aged 60 years and older (14,291) were invited to participate in a 2-year intervention (2005-2006). Four population-based dynamic cohorts of residents aged 65 years and older (1999-2010) were included as subjects, 6 years before and after the intervention started. At-risk residents within the intervention region (4,918) were invited for a two-step screening program; 2,552 participated in the program linked with care/support services for 2 years. An education program open to the public was held. Changes in suicide from a 6-year baseline to the 2-year intervention and a 4-year follow-up in the intervention region (11,700 adults ≥65 years) were compared with a matched control and two comparison areas using mixed-effects negative binomial regression models. Suicide rates among older adults exposed to screening were compared with those of the control region. Suicide rates in the intervention region decreased by 48%, which was significantly greater than in the three comparison areas. The program's benefits lasted longer for women than men. Screening exposure may be associated with decreased suicide risk over the 4-year follow-up. Universal screening may decrease suicide rates among older adults, with potential gender differences in treatment response. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Effects of Exposures on Superalloys for Space Applications

NASA Technical Reports Server (NTRS)

Gabb, Tim; Garg, Anita; Gayda, John

2007-01-01

The industry is demanding longer term service at high temperatures for nickel-base superalloys in gas turbine engine as well as potential space applications. However, longer term service can severely tax alloy phase stability, to the potential detriment of mechanical properties. Cast Mar-M247LC and wrought Haynes 230 superalloys were exposed and creep tested for extended times at elevated temperature. Microstructure and phase evaluations were then undertaken for comparisons.

42 CFR 137.78 - May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one year? 137.78 Section 137.78 Public Health PUBLIC HEALTH... SERVICES TRIBAL SELF-GOVERNANCE Funding General § 137.78 May a Self-Governance Tribe negotiate a funding...

A review of characteristics and outcomes of Australia's undergraduate medical education rural immersion programs.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Russell, Deborah; Chambers, Helen; Major, Laura

2018-01-31

A key strategy for increasing the supply of rural doctors is rurally located medical education. In 2000, Australia introduced a national policy to increase rural immersion for undergraduate medical students. This study aims to describe the characteristics and outcomes of the rural immersion programs that were implemented in Australian medical schools. Information about 19 immersion programs was sourced in 2016 via the grey and published literature. A scoping review of the published peer-reviewed studies via Ovid MEDLINE and Informit (2000-2016) and direct journal searching included studies that focused on outcomes of undergraduate rural immersion in Australian medical schools from 2000 to 2016. Programs varied widely by selection criteria and program design, offering between 1- and 6-year immersion. Based on 26 studies from 10 medical schools, rural immersion was positively associated with rural practice in the first postgraduate year (internship) and early career (first 10 years post-qualifying). Having a rural background increased the effects of rural immersion. Evidence suggested that longer duration of immersion also increases the uptake of rural work, including by metropolitan-background students, though overall there was limited evidence about the influence of different program designs. Most evidence was based on relatively weak, predominantly cross-sectional research designs and single-institution studies. Many had flaws including small sample sizes, studying internship outcomes only, inadequately controlling for confounding variables, not using metropolitan-trained controls and providing limited justification as to the postgraduate stage at which rural practice outcomes were measured. Australia's immersion programs are moderately associated with an increased rural supply of early career doctors although metropolitan-trained students contribute equal numbers to overall rural workforce capacity. More research is needed about the influence of student interest in rural practice and the duration and setting of immersion on rural work uptake and working more remotely. Research needs to be more nationally balanced and scaled-up to inform national policy development. Critically, the quality of research could be strengthened through longer-term follow-up studies, adjusting for known confounders, accounting for postgraduate stages and using appropriate controls to test the relative effects of student characteristics and program designs.

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

PubMed Central

Clarke, David

2017-01-01

Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. PMID:28988185

Respiratory consequences of prematurity: evolution of a diagnosis and development of a comprehensive approach.

PubMed

Maitre, Nathalie L; Ballard, Roberta A; Ellenberg, Jonas H; Davis, Stephanie D; Greenberg, James M; Hamvas, Aaron; Pryhuber, Gloria S

2015-05-01

Bronchopulmonary dysplasia (BPD) is the most common respiratory consequence of premature birth and contributes to significant short- and long-term morbidity, mortality and resource utilization. Initially defined as a radiographic, clinical and histopathological entity, the chronic lung disease known as BPD has evolved as obstetrical and neonatal care have improved the survival of lower gestational age infants. Now, definitions based on the need for supplementary oxygen at 28 days and/or 36 weeks provide a useful reference point in the neonatal intensive-care unit (NICU), but are no longer based on histopathological findings, and are neither designed to predict longer term respiratory consequences nor to study the evolution of a multifactorial disease. The aims of this review are to critically examine the evolution of the diagnosis of BPD and the challenges inherent to current classifications. We found that the increasing use of respiratory support strategies that administer ambient air without supplementary oxygen confounds oxygen-based definitions of BPD. Furthermore, lack of reproducible, genetic, biochemical and physiological biomarkers limits the ability to identify an impending BPD for early intervention, quantify disease severity for standardized classification and approaches and reliably predict the long-term outcomes. More comprehensive, multidisciplinary approaches to overcome these challenges involve longitudinal observation of extremely preterm infants, not only those with BPD, using genetic, environmental, physiological and clinical data as well as large databases of patient samples. The Prematurity and Respiratory Outcomes Program (PROP) will provide such a framework to address these challenges through high-resolution characterization of both NICU and post-NICU discharge outcomes.

Long-Term Breastfeeding in African American Mothers.

PubMed

Gross, Tyra Toston; Davis, Marsha; Anderson, Alex K; Hall, Jori; Hilyard, Karen

2017-02-01

According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.

Rehabilitation After International Space Station Flights

NASA Technical Reports Server (NTRS)

Chauvin, S. J.; Shepherd, B. A. S.; Guilliams, M. E.; Taddeo, T.

2003-01-01

Rehabilitating U.S. crew members to preflight status following flights on the Russian Mir Space Station required longer than six months for full functional recovery of some of the seven crew members. Additional exercise hardware has been added on the International Space Station as well as a rehabilitative emphasis on functional fitness/agility and proprioception. The authors will describe and present the results of the rehabilitation program for ISS and evaluate rehabilitative needs for longer missions. Pre- and in-flight programs emphasize strength and aerobic conditioning. One year before launch, crew members are assigned an Astronaut Strength and Conditioning specialist. Crew members are scheduled for 2 hours, 3 days a week, for pre-flight training and 2.5 hours, six days a week, for in-flight training. Crewmembers are tested on functional fitness, agility, isokinetic strength, and submaximal cycle ergometer evaluation before and after flight. The information from these tests is used for exercise prescriptions, comparison, and evaluation of the astronaut and training programs. The rehabilitation program lasts for 45 days and is scheduled for 2 hours during each crew workday. Phase 1 of the rehabilitation program starts on landing day and places emphasis on ambulation, flexibility, and muscle strengthening. Phase 2 adds proprioceptive exercise and cardiovascular conditioning. Phase 3 (the longest phase) focuses on functional development. All programs are tailored specifically for each individual according to their test results, preferred recreational activities, and mission roles and duties. Most crew members reached or exceeded their preflight test values 45 days after flight. Some crew members subjectively indicated the need for a longer rehabilitation period. The current rehabilitation program for returning ISS crew members seems adequate in content but may need to be extended for longer expeditions.

Randomized controlled trial of ionization and photoelectric smoke alarm functionality.

PubMed

Mueller, B A; Sidman, E A; Alter, H; Perkins, R; Grossman, D C

2008-04-01

To compare functionality, reasons for non-function, and nuisance alarm levels of two common types of smoke alarms after installation in low- to mid-level income households in King County, Washington. Randomized controlled trial of 761 households. An ionization or photoelectric smoke alarm was installed between June 1, 2000 and July 31, 2002. Main outcome measures were: percentage of study alarms that were working, observed reasons for non-functional status, and self-reported frequency of nuisance alarms at 9 and 15 months of follow-up. At 9 months after installation, 20% of ionization, vs 5% of photoelectric alarms were non-functional, a difference that persisted at 15 months, with the most common reasons for both types being a disconnected or absent battery. The risk ratio for ionization, relative to photoelectric alarms, being non-functional or removed was 2.7 (95% CI 1.8 to 4.1) at 15 months of follow-up. These findings were not altered by educational level, or the presence of smokers, children <5 years, or adults > or =65 years. Burn prevention efforts are geared towards increasing smoke alarm ownership and improving maintenance of functional status. Results suggest that the selective use of photoelectric alarms by fire injury prevention programs or consumers may provide longer-term protection in similar populations. Designing smoke alarms that minimize nuisance alarming may also result in longer term functionality.

A brief cognitive-behavioral stress management program for secondary school teachers.

PubMed

Leung, Sharron S K; Chiang, Vico C L; Chui, Y Y; Mak, Y W; Wong, Daniel F K

2011-01-01

This study aimed to assess the efficacy of a brief cognitive-behavioral program that was designed to reduce the work-related stress levels of secondary school teachers. A quasi-experimental design was used to compare the intervention groups with the wait-list control groups. Seventy teachers from the intervention groups and 54 from the control groups completed a set of validated scales at the baseline and 3-4 wk later. The scales included the Depression Anxiety Stress Scale, the Dysfunctional Attitude Scale-Form A, the Health-Promoting Lifestyle Profile II, and the Occupational Stress Inventory Revised Edition. After controlling for the baseline measures, the intervention groups had significantly lower role stress, personal strain and overall work-related stress 3-4 wk after the baseline measurements. The intervention groups also had significantly higher stress management behaviors, and less general stress and dysfunctional thoughts than the control groups (all p≤0.05). The levels of dysfunctional thoughts and stress management behaviors significantly predicted general stress after intervention and personal resource deficits. The level of dysfunctional thoughts also predicted the personal strain of work-related stresses (all p<0.05). The brief program reported in this study was efficacious in reducing the work-related stress of secondary teachers. Teachers experienced less work-related stress after the program, and they reported reduced dysfunctional thoughts and enhanced stress management behaviors. This program may be considered as an initial strategy for teachers to develop skills to cope with their work-related stress in the short term and could be incorporated with other strategies to achieve longer-term effects.

The Effect of Exercise Training on Serum Lipids in the Elderly.

PubMed

Ades, Philip A.; Poehlman, Eric T.

1996-10-01

Numerous intervention trials in young subjects suggest that aerobic exercise training exerts favorable effects on specific lipid subfractions, in particular serum triglycerides and high density lipoprotein (HDL) cholesterol. Cross sectional studies in older individuals suggest that active individuals have more favorable lipid profiles than inactive individuals. However, it remains controversial as to whether leisure time activity or fitness levels per se are independent predictors of lipid measures in the elderly versus their intermediate effects on body composition and body fat distribution. That is, a greater deposition of abdominal fat in the least fit individuals is associated with adverse lipid profiles. Short-term (8-weeks) aerobic exercise in elders is not associated with any significant changes in lipid profiles, however, longer term programs, particularly if associated with improvements in body fat distribution and/or weight loss, have been demonstrated to yield significant improvements in lipid subfractions, in particular triglycerides and HDL cholesterol.

Oral ketamine for the treatment of pain and treatment-resistant depression†.

PubMed

Schoevers, Robert A; Chaves, Tharcila V; Balukova, Sonya M; Rot, Marije Aan Het; Kortekaas, Rudie

2016-02-01

Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. © The Royal College of Psychiatrists 2016.

Essentials for starting a pediatric clinical study (4): Clinical pediatric safety planning based on preclinical toxicity studies and pediatric pharmacovigilance guidance.

PubMed

Sheth, Neha

2009-01-01

Juvenile toxicology studies in animals provide useful information to guide monitoring of potential adverse effects in children especially on growth and development. In order to continue to gain knowledge and build upon these preclinical studies, recent experience has suggested that additional approaches for monitoring of safety concerns in the pediatric population may be required. Recently, pediatric guidance has become available from the health authorities which provide pharmacovigilance concepts as they specifically relate to drugs being developed for pediatric indications. Clinical trials are typically not robust enough to detect rare or delayed safety effects as the pediatric trials are relatively short-term. Furthermore, such long term or rare effects may not be detected via standard voluntary postmarketing surveillance. Safety monitoring of children with Juvenile Inflammatory Arthritis (JIA) taking nonsteroid anti-inflammatory drug (NSAID)s will be used as an example to describe a post-marketing risk management and pharmacovigilance program that serves to better evaluate safety data from various sources. The intent of this program is to identify adverse events (AE), including events with longer latency, which may be associated with NSAID use in a pediatric population. In this presentation, the 4 major components of the program are to be addressed. Such a program may serve as a model to proactively generate and monitor safety data in order to identify AEs that may be associated with new therapeutics for a pediatric population.

An Overview Of NASA's Solar Sail Propulsion Project

NASA Technical Reports Server (NTRS)

Garbe, Gregory; Montgomery, Edward E., IV

2003-01-01

Research conducted by the In-Space Propulsion (ISP) Technologies Projects is at the forefront of NASA's efforts to mature propulsion technologies that will enable or enhance a variety of space science missions. The ISP Program is developing technologies from a Technology Readiness Level (TRL) of 3 through TRL 6. Activities under the different technology areas are selected through the NASA Research Announcement (NRA) process. The ISP Program goal is to mature a suite of reliable advanced propulsion technologies that will promote more cost efficient missions through the reduction of interplanetary mission trip time, increased scientific payload mass fraction, and allowing for longer on-station operations. These propulsion technologies will also enable missions with previously inaccessible orbits (e.g., non-Keplerian, high solar latitudes). The ISP Program technology suite has been prioritized by an agency wide study. Solar Sail propulsion is one of ISP's three high-priority technology areas. Solar sail propulsion systems will be required to meet the challenge of monitoring and predicting space weather by the Office of Space Science s (OSS) Living with a Star (LWS) program. Near-to-mid-term mission needs include monitoring of solar activity and observations at high solar latitudes. Near-term work funded by the ISP solar sail propulsion project is centered around the quantitative demonstration of scalability of present solar sail subsystem designs and concepts to future mission requirements through ground testing, computer modeling and analytical simulations. This talk will review the solar sail technology roadmap, current funded technology development work, future funding opportunities, and mission applications.

The PIP-II Conceptual Design Report

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

Ball, M.; Burov, A.; Chase, B.

2017-03-01

The Proton Improvement Plan-II (PIP-II) encompasses a set of upgrades and improvements to the Fermilab accelerator complex aimed at supporting a world-leading neutrino program over the next several decades. PIP-II is an integral part of the strategic plan for U.S. High Energy Physics as described in the Particle Physics Project Prioritization Panel (P5) report of May 2014 and formalized through the Mission Need Statement approved in November 2015. As an immediate goal, PIP-II is focused on upgrades to the Fermilab accelerator complex capable of providing proton beam power in excess of 1 MW on target at the initiation of themore » Long Baseline Neutrino Facility/Deep Underground Neutrino Experiment (LBNF/DUNE) program, currently anticipated for the mid- 2020s. PIP-II is a part of a longer-term goal of establishing a high-intensity proton facility that is unique within the world, ultimately leading to multi-MW capabilities at Fermilab....« less

A Grounded Theory of Mothering in the Early Years for Women Recovering From Substance Use.

PubMed

Marcellus, Lenora

2017-08-01

Women in recovery from addiction experience significant sociostructural barriers to reestablishing self, family, and home after having a baby. The aim of this grounded theory study was to describe pathways that women and their families followed and how transitions were experienced in the early years after receiving services through an integrated community-based maternity program. Eighteen women completed questionnaires and participated in a series of semistructured interviews over 2 years. The overall process women experienced was that of holding it together, which women did by restoring their sense of self during recovery, becoming a strong center for their family, and creating a sense of home no matter what the circumstances. Key elements supporting women in their transition to recovery and parenthood included longer term health, social, and recovery programs and services that addressed determinants of health (in particular, gender, housing, and income), and receiving support provided from strengths-based perspectives.

Manned Venus Flyby

NASA Technical Reports Server (NTRS)

Feldman, M. S.; Ferrara, L. A.; Havenstein, P. L.; Volonte, J. E.; Whipple, P. H.

1967-01-01

This study is one of several being conducted at Bellcomm and in Manned Space Flight whose purpose is to give guidance to the Apollo Applications Program's technical objectives by focusing on a longer range goal. The assumed mission in this case is a three-man flyby of Venus launched in November, 1973 on a single standard Saturn V. The selected flight configuration includes a Command and Service Module similar in some respects to Apollo, an Environmental Support Module which occupies the adapter area and a spent S-IVB stage which is utilized for habitable volume and structural support of a solar cell electrical power system. The total injected weight, 106,775 lbs., is within the capability of a single Saturn V of the early 1970's. The study is focused on the selection of subsystem technologies appropriate to long duration flight. The conclusions are reported in terms of the technical characteristics to be achieved as part of the Apollo Applications Program's long duration objectives.

Examining the response programming function of the Quiet Eye: Do tougher shots need a quieter eye?

PubMed

Walters-Symons, Rosanna; Wilson, Mark; Klostermann, Andre; Vine, Samuel

2018-02-01

Support for the proposition that the Quiet Eye (QE) duration reflects a period of response programming (including task parameterisation) has come from research showing that an increase in task difficulty is associated with increases in QE duration. Here, we build on previous research by manipulating three elements of task difficulty that correspond with different parameters of golf-putting performance; force production, impact quality and target line. Longer QE durations were found for more complex iterations of the task and furthermore, more sensitive analyses of the QE duration suggest that the early QE proportion (prior to movement initiation) is closely related to force production and impact quality. However, these increases in QE do not seem functional in terms of supporting improved performance. Further research is needed to explore QE's relationship with performance under conditions of increased difficulty.

The Effect of Breakfast in the Classroom on Obesity and Academic Performance: Evidence from New York City

PubMed Central

Corcoran, Sean P.; Elbel, Brian; Schwartz, Amy Ellen

2016-01-01

Participation in the federally subsidized school breakfast program often falls well below its lunchtime counterpart. To increase take-up, many districts have implemented Breakfast in the Classroom (BIC), offering breakfast directly to students at the start of the school day. Beyond increasing participation, advocates claim BIC improves academic performance, attendance, and engagement. Others caution BIC has deleterious effects on child weight. We use the implementation of BIC in New York City (NYC) to estimate its impact on meals program participation, body mass index (BMI), achievement, and attendance. While we find large effects on participation, our findings provide no evidence of hoped-for gains in academic performance, or of feared increases in obesity. The policy case for BIC will depend upon reductions in hunger and food insecurity for disadvantaged children, or its longer-term effects. PMID:27314139

Behavioral and Physiological Response of Baleen Whales to Ships and Ship Noise

DTIC Science & Technology

2014-09-30

student Angela Szesciorka) on tag designs to provide longer term deployments of archival tags especially for work with humpback whales off northern...California. 2. Conduct test deployments of dart-attached archival tags in 2014 on humpback whales in Monterey Bay and the Gulf of the Farallones on... humpback whales to tests different dart attachment configurations and develop a new longer term dart-attached archival tag system. 3. Successfully

Education and home based training for intermittent claudication: functional effects and quality of life.

PubMed

Prévost, Alain; Lafitte, Marianne; Pucheu, Yann; Couffinhal, Thierry

2015-03-01

Supervised exercise programs increase physical performance in patients with peripheral artery disease (PAD). However, there are a limited number of programs, and to date they have failed to provide evidence of long-term adherence to exercise or any meaningful effect on Quality of Life (QoL). We created a program of therapeutic education and a personalized program of reconditioning exercise for patients with PAD. Patients with an ankle-brachial index (ABI) below 0.9 in at least one limb, and an absolute claudication distance (ACD) ≤500 meters, were included in the study. Quality of Life (QoL) as measured by SF-36, cardiovascular risk factors and functional parameters were evaluated at 0, 3, 6 and 12 months. Forty-six patients completed the program. Cardiovascular risks were controlled and stabilized over time. SF-36 scores improved significantly and remained stable. Initial and absolute claudication distance (ICD and ACD) as well as other functional parameters improved significantly (6 months: +138 m or +203% ICD and +139 m or +84% ACD). Ten patients (22%) did not show improvement in ICD or ACD within the first 3 months, but their SF-36 score did increase at subsequent visits. Interestingly, these patients had a significantly lower ACD at baseline. This study measured beneficial effects of an educational therapeutic program for patients with PAD. The results demonstrate a significant improvement in functional and QoL parameters during the first 3 months of coaching, and long-term persistence of the results even when patients were no longer coached. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia.

PubMed

Hobbs, Emma C; Mwape, Kabemba Evans; Van Damme, Inge; Berkvens, Dirk; Zulu, Gideon; Mambwe, Moses; Chembensofu, Mwelwa; Phiri, Isaac Khozozo; Masuku, Maxwell; Bottieau, Emmanuel; Devleesschauwer, Brecht; Speybroeck, Niko; Colston, Angela; Dorny, Pierre; Willingham, Arve Lee; Gabriël, Sarah

2018-03-01

The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Evolution of the phase 2 preparation and observation tools at ESO

NASA Astrophysics Data System (ADS)

Dorigo, D.; Amarand, B.; Bierwirth, T.; Jung, Y.; Santos, P.; Sogni, F.; Vera, I.

2012-09-01

Throughout the course of many years of observations at the VLT, the phase 2 software applications supporting the specification, execution and reporting of observations have been continuously improved and refined. Specifically the introduction of astronomical surveys propelled the creation of new tools to express more sophisticated, longer-term observing strategies often consisting of several hundreds of observations. During the execution phase, such survey programs compete with other service and visitor mode observations and a number of constraints have to be considered. In order to maximize telescope utilization and execute all programs in a fair way, new algorithms have been developed to prioritize observable OBs taking into account both current and future constraints (e.g. OB time constraints, technical telescope time) and suggest the next OB to be executed. As a side effect, a higher degree of observation automation enables operators to run telescopes mostly autonomously with little supervision by a support astronomer. We describe the new tools that have been deployed and the iterative and incremental software development process applied to develop them. We present our key software technologies used so far and discuss potential future evolution both in terms of features as well as software technologies.

Eclipse-Free-Time Assessment Tool for IRIS

NASA Technical Reports Server (NTRS)

Eagle, David

2012-01-01

IRIS_EFT is a scientific simulation that can be used to perform an Eclipse-Free- Time (EFT) assessment of IRIS (Infrared Imaging Surveyor) mission orbits. EFT is defined to be those time intervals longer than one day during which the IRIS spacecraft is not in the Earth s shadow. Program IRIS_EFT implements a special perturbation of orbital motion to numerically integrate Cowell's form of the system of differential equations. Shadow conditions are predicted by embedding this integrator within Brent s method for finding the root of a nonlinear equation. The IRIS_EFT software models the effects of the following types of orbit perturbations on the long-term evolution and shadow characteristics of IRIS mission orbits. (1) Non-spherical Earth gravity, (2) Atmospheric drag, (3) Point-mass gravity of the Sun, and (4) Point-mass gravity of the Moon. The objective of this effort was to create an in-house computer program that would perform eclipse-free-time analysis. of candidate IRIS spacecraft mission orbits in an accurate and timely fashion. The software is a suite of Fortran subroutines and data files organized as a "computational" engine that is used to accurately predict the long-term orbit evolution of IRIS mission orbits while searching for Earth shadow conditions.

Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program.

PubMed

Jacob, Alexandra; Kaelin, Darryl; Roach, Abbey; Ziegler, Craig; LaFaver, Kathrin

2018-05-18

Functional movement disorders (FMDs) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurologic practice, and prognosis is often poor. No consensus treatment guidelines have been established; however, the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. To assess outcomes of FMD patients undergoing a multidisciplinary treatment program and determine factors predictive of treatment success. Retrospective chart review. University-affiliated rehabilitation institute. Thirty-two consecutive FMD patients admitted to the MoRe program from July 2014-July 2016. Patients participated in a 1-week, multidisciplinary inpatient treatment program with daily physical, occupational, speech therapy, and psychotherapy interventions. Primary outcome measures were changes in the patient-rated Clinical Global Impression Scale (CGI) and the physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS) based on review of standardized patient videos. Measurements were taken as part of the clinical evaluation of the program. Twenty-four of the 32 patients were female with a mean age of 49.1 (±14.2) years and mean symptom duration of 7.4 (±10.8) years. Most common movement phenomenologies were abnormal gait (31.2%), hyperkinetic movements (31.2%), and dystonia (31.2%). At discharge, 86.7% of patients reported symptom improvement on the CGI, and self-reported improvement was maintained in 69.2% at the 6-month follow-up. PMDRS scores improved by 59.1% from baseline to discharge. Longer duration of symptoms, history of abuse, and comorbid psychiatric disorders were not significant predictors of treatment outcomes. The majority of FMD patients experienced improvement from a 1-week multidisciplinary inpatient rehabilitation program. Treatment outcomes were not negatively correlated with longer disease duration or psychiatric comorbidities. The results from our study are encouraging, although further long-term prospective randomized studies are needed. Level III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients.

PubMed

Attenberger, Corinna; Amsler, Felix; Gross, Thomas

2012-09-01

No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data. Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.). This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future. Copyright © 2011 Elsevier Ltd. All rights reserved.

The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): Part I: The Uptake of the Ottawa Panel clinical practice guidelines (CPGs)

PubMed Central

2012-01-01

Background The implementation of evidence based clinical practice guidelines on self-management interventions to patients with chronic diseases is a complex process. A multifaceted strategy may offer an effective knowledge translation (KT) intervention to promote knowledge uptake and improve adherence in an effective walking program based on the Ottawa Panel Evidence Based Clinical Practice Guidelines among individuals with moderate osteoarthritis (OA). Methods A single-blind, randomized control trial was conducted. Patients with mild to moderate (OA) of the knee (n=222) were randomized to one of three KT groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking for OA; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period. Results Short-term program adherence was greater in WB compared to C (p<0.012) after 3 months. No statistical significance (p> 0.05) was observed for long-term adherence (6 to 12 months), and total adherence between the three groups. The three knowledge translation strategies demonstrated equivalent long-term results for the implementation of a walking program for older individuals with moderate OA. Lower dropout rates as well as higher retention rates were observed for WB at 12 and 18 months. Conclusion The additional knowledge translation behavioural component facilitated the implementation of clinical practice guidelines on walking over a short-term period. More studies are needed to improve the long-term walking adherence or longer guidelines uptake on walking among participants with OA. Particular attention should be taken into account related to patient’s characteristic and preference. OA can be managed through the implementation of a walking program based on clinical practice guidelines in existing community-based walking clubs as well as at home with the minimal support of an exercise therapist or a trained volunteer. Trial Registration Current Controlled Trials IRSCTNO9193542 PMID:23061875

Acute and medium term effects of a 10-week running intervention on mood state in apprentices

PubMed Central

Walter, Katrin; von Haaren, Birte; Löffler, Simone; Härtel, Sascha; Jansen, Carl-Philipp; Werner, Christian; Stumpp, Jürgen; Bös, Klaus; Hey, Stefan

2013-01-01

Exercise and physical activity have proven benefits for physical and psychological well-being. However, it is not clear if healthy young adults can enhance mood in everyday life through regular exercise. Earlier studies mainly showed positive effects of acute exercise and exercise programs on psychological well-being in children, older people and in clinical populations. Few studies controlled participants' physical activity in daily life, performed besides the exercise program, which can impact results. In addition the transition from mood enhancement induced by acute exercise to medium or long-term effects due to regular exercise is not yet determined. The purpose of this pilot study was to examine the acute effects of an aerobic running training on mood and trends in medium term changes of mood in everyday life of young adults. We conducted a 10-week aerobic endurance training with frequent mood assessments and continuous activity monitoring. 23 apprentices, separated into experimental and control group, were monitored over 12 weeks. To control the effectiveness of the aerobic exercise program, participants completed a progressive treadmill test pre and post the intervention period. The three basic mood dimensions energetic arousal, valence and calmness were assessed via electronic diaries. Participants had to rate their mood state frequently on 3 days a week at five times of measurement within 12 weeks. Participants' physical activity was assessed with accelerometers. All mood dimensions increased immediately after acute endurance exercise but results were not significant. The highest acute mood change could be observed in valence (p = 0.07; η2 = 0.27). However, no medium term effects in mood states could be observed after a few weeks of endurance training. Future studies should focus on the interaction between acute and medium term effects of exercise training on mood. The decreasing compliance over the course of the study requires the development of strategies to maintain compliance over longer periods. PMID:23847579

Associations between infant feeding and the size, tempo and velocity of infant weight gain: SITAR analysis of the Gemini twin birth cohort

PubMed Central

Johnson, L; van Jaarsveld, C H M; Llewellyn, C H; Cole, T J; Wardle, J

2014-01-01

Objective: Infant growth trajectories, in terms of size, tempo and velocity, may programme lifelong obesity risk. Timing of breastfeeding cessation and weaning are both implicated in rapid infant growth; we examined the association of both simultaneously with a range of growth parameters. Design: Longitudinal population-based twin birth cohort. Subjects: The Gemini cohort provided data on 4680 UK infants with a median of 10 (interquartile range=8–15) weight measurements between birth and a median of 6.5 months. Age at breastfeeding cessation and weaning were reported by parents at mean age 8.2 months (s.d.=2.2, range=4–20). Growth trajectories were modelled using SuperImposition by Translation And Rotation (SITAR) to generate three descriptors of individual growth relative to the average trajectory: size (grams), tempo (weeks, indicating the timing of the peak growth rate) and velocity (% difference from average, reflecting mean growth rate). Complex-samples general linear models adjusting for family clustering and confounders examined associations between infant feeding and SITAR parameters. Results: Longer breastfeeding (>4 months vs never) was independently associated with lower growth velocity by 6.8% (s.e.=1.3%) and delayed growth tempo by 1.0 (s.e.=0.2 weeks), but not with smaller size. Later weaning (⩾6 months vs <4 months) was independently associated with lower growth velocity by 4.9% (s.e.=1.1%) and smaller size by 102 g (s.e.=25 g). Conclusions: Infants breastfed for longer grew slower for longer after birth (later peak growth rate) but were no different in size, while infants weaned later grew slower overall and were smaller but the timing of peak growth did not differ. Slower trajectories with a delayed peak in growth may have beneficial implications for programming later obesity risk. Replication in cohorts with longer follow-up, alternative confounding structures or randomised controlled trials are required to confirm the long-term effects and directionality, and to rule out residual confounding. PMID:24722545

Job satisfaction and short-term sickness absence among Dutch workers.

PubMed

Notenbomer, Annette; Roelen, Corné A M; Groothoff, Johan W

2006-06-01

Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.

Optimising resource management in neurorehabilitation.

PubMed

Wood, Richard M; Griffiths, Jeff D; Williams, Janet E; Brouwers, Jakko

2014-01-01

To date, little research has been published regarding the effective and efficient management of resources (beds and staff) in neurorehabilitation, despite being an expensive service in limited supply. To demonstrate how mathematical modelling can be used to optimise service delivery, by way of a case study at a major 21 bed neurorehabilitation unit in the UK. An automated computer program for assigning weekly treatment sessions is developed. Queue modelling is used to construct a mathematical model of the hospital in terms of referral submissions to a waiting list, admission and treatment, and ultimately discharge. This is used to analyse the impact of hypothetical strategic decisions on a variety of performance measures and costs. The project culminates in a hybridised model of these two approaches, since a relationship is found between the number of therapy hours received each week (scheduling output) and length of stay (queuing model input). The introduction of the treatment scheduling program has substantially improved timetable quality (meaning a better and fairer service to patients) and has reduced employee time expended in its creation by approximately six hours each week (freeing up time for clinical work). The queuing model has been used to assess the effect of potential strategies, such as increasing the number of beds or employing more therapists. The use of mathematical modelling has not only optimised resources in the short term, but has allowed the optimality of longer term strategic decisions to be assessed.

The role of a microfinance program on HIV risk behavior among Haitian women.

PubMed

Rosenberg, Molly S; Seavey, Brian K; Jules, Reginal; Kershaw, Trace S

2011-07-01

Microfinance loans targeted at vulnerable female populations have the potential to foster female economic independence, possibly leading to the negotiation of safer sexual practices and reduced HIV risk. This study assessed the relationship between experience with microfinance loans and HIV risk behavior among 192 female clients of the Haitian microfinance organization Fonkoze. Clients with longer microfinance experience were generally found to have lower indicators of HIV risk behavior and higher indicators of relationship power compared to those with shorter experience. In particular, those with longer memberships were 72% less likely to report partner infidelity, were 3.95 times more likely to use condoms with an unfaithful partner, and had higher average general power index scores compared to those with shorter experience. This study provides evidence that long-term exposure to microfinance is associated with reduced HIV risk behavior in Haitian women and that this reduction may be partly regulated by influencing relationship power. These results suggest the need to further explore the use of microfinance as a tool to prevent the spread of HIV.

The effect of preterm birth on brainstem, middle latency and cortical auditory evoked responses (BMC AERs).

PubMed

Pasman, J W; Rotteveel, J J; de Graaf, R; Stegeman, D F; Visco, Y M

1992-12-01

Recent studies on the maturation of auditory brainstem evoked responses (ABRs) present conflicting results, whereas only sparse reports exist with respect to the maturation of middle latency auditory evoked responses (MLRs) and auditory cortical evoked responses (ACRs). The present study reports the effect of preterm birth on the maturation of auditory evoked responses in low risk preterm infants (27-34 weeks conceptional age). The ABRs indicate a consistent trend towards longer latencies for all individual ABR components and towards longer interpeak latencies in preterm infants. The MLR shows longer latencies for early component P0 in preterm infants. The ACRs show a remarkable difference between preterm and term infants. At 40 weeks CA the latencies of ACR components Na and P2 are significantly longer in term infants, whereas at 52 weeks CA the latencies of the same ACR components are shorter in term infants. The results support the hypothesis that retarded myelination of the central auditory pathway is partially responsible for differences found between preterm infants and term infants with respect to late ABR components and early MLR component P0. Furthermore, mild conductive hearing loss in preterm infants may also play its role. A more complex mechanism is implicated to account for the findings noted with respect to MLR component Na and ACR components Na and P2.

Sustaining new parents in home visitation services: key participant and program factors.

PubMed

Daro, Deborah; McCurdy, Karen; Falconnier, Lydia; Stojanovic, Daniela

2003-10-01

As prevention efforts have adopted more intensive service models, concerns over initial enrollment and retention rates have become more salient. This study examines the participant, provider and program factors that contribute to a longer length of stay and greater number of home visits for new parents enrolling in one national home visitation program. Retrospective data were collected on a random sample of 816 participants served by one of 17 Healthy Families America (HFA) program sites around the country. Using case record reviews, research staff documented each participant's characteristics and service experiences. To capture relevant staff and program information, research staff collected basic descriptive information from published documents and interviews with program managers. All home visitors who had contact with sample families also completed a self-assessment instrument regarding personal and professional characteristics. Hierarchical linear modeling allowed us to examine the unique role of participant, provider and program characteristics while recognizing the lack of independence among these three sets of variables. The combined provider and program levels in the HLM model accounted for one-third of the variance in service duration and one-quarter of the variance in the number of home visits. Older participants, those unemployed, and those who enrolled in the program early in their pregnancy were more likely to remain in services longer and to complete a greater number of home visits. Compared to White participants, African Americans and Hispanics were significantly more likely to remain in services longer and, in the case of African Americans, to receive a greater number of home visits. Participants who were enrolled in school were more likely to remain in services longer. Age was the only consistent provider characteristic associated with positive results in both models, with younger home visitors performing better. Prior experience showed a significant relationship only in the service dosage model and African American workers demonstrated greater success than White home visitors did in retaining families in service. At the program level, programs with lower caseloads and greater success in matching their participants and providers on parenting status and race/ethnicity were significantly more likely to demonstrate stronger enrollment patterns.

Examining Incentives to Promote Physical Activity Maintenance Among Hospital Employees Not Achieving 10,000 Daily Steps: A Web-Based Randomized Controlled Trial Protocol

PubMed Central

White, Lauren; Oh, Paul; Kwan, Matthew; Gove, Peter; Leahey, Tricia; Faulkner, Guy

2016-01-01

Background The economic burden of physical inactivity in Canada is estimated at Can $6.8 billion (US $5 billion) per year. Employers bear a substantial proportion of the economic costs, as they pay more for inactive workers in health care and other organizational costs. In response, many Canadian employers offer wellness programs, though these are often underutilized. While financial health incentives have been proposed as one way of increasing participation, their longer term effects (ie postintervention effects) are not clear. Objective The objective of this paper is to outline the methodology for a randomized control trial (RCT) examining the longer term impact of an existing physical activity promotion program that is enhanced by adding guaranteed rewards (Can $1 [US $0.74] per day step goal met) in a lower active hospital employee population (less than 10,000 steps per day). Methods A 12-week, parallel-arm RCT (with a 12-week postintervention follow-up) will be employed. Employees using Change4Life (a fully automated, incentive-based wellness program) and accumulating fewer than 10,000 steps per day at baseline (weeks 1 to 2) will be randomly allocated (1:1) to standard care (wellness program, accelerometer) or an intervention group (standard care plus guaranteed incentives). All study participants will be asked to wear the accelerometer and synchronize it to Change4Life daily, although only intervention group participants will receive guaranteed incentives for reaching tailored daily step count goals (Can $1 [US $0.74] per day; weeks 3 to 12). The primary study outcome will be mean proportion of participant-days step goal reached during the postintervention follow-up period (week 24). Mean proportion of participant-days step goal reached during the intervention period (week 12) will be a secondary outcome. Results Enrollment for the study will be completed in February 2017. Data analysis will commence in September 2017. Study results are to be published in the winter of 2018. Conclusions This protocol was designed to examine the impact of guaranteed rewards on physical activity maintenance in lower active hospital employees. ClinicalTrial ClinicalTrials.gov NCT02638675; https://clinicaltrials.gov/ct2/show/NCT0 2638675 (Archived by WebCite at http://www.webcitation.org/6g4pvZvhW) PMID:27956377

Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: a community guide systematic review.

PubMed

Hahn, Robert A; Rammohan, Veda; Truman, Benedict I; Milstein, Bobby; Johnson, Robert L; Muntañer, Carles; Jones, Camara P; Fullilove, Mindy T; Chattopadhyay, Sajal K; Hunt, Pete C; Abraido-Lanza, Ana F

2014-03-01

Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health. A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time. FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK. There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity. Published by Elsevier Inc.

Radiation Protection in Canada

PubMed Central

Brown, John R.; Jarvis, Anita A.

1964-01-01

A recent survey was carried out with respect to radiobiological and radiological health projects in Canada. Letters of inquiry, followed by two questionnaires, were sent out to every institution where radiation research was likely to have been undertaken. Approximately 75% of those contacted replied. Of the total of 200 studies, 84% were classified as biological and medical studies, the remaining 16% as environmental radiation studies. Responses to the inquiry stressed the inadequacy of the present governmental budget for radiation research, the need for higher salaries for research workers, and the necessity of a more intensive teaching program for technicians and professional personnel. The granting of longer-term grants, rather than annually renewable grants, is urged. PMID:14226104

20 CFR 416.1338 - If you are participating in an appropriate program of vocational rehabilitation services...

Code of Federal Regulations, 2014 CFR

2014-04-01

... AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1338 If you are participating in an... or blindness may be continued after your impairment is no longer disabling, you are no longer blind...

Perceptual learning of degraded speech by minimizing prediction error.

PubMed

Sohoglu, Ediz; Davis, Matthew H

2016-03-22

Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech.

Perceptual learning of degraded speech by minimizing prediction error

PubMed Central

Sohoglu, Ediz

2016-01-01

Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech. PMID:26957596

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

PubMed

Wray, Faye; Clarke, David

2017-10-06

To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Factors related to risky sexual behaviors and effective STI/HIV and pregnancy intervention programs for African American adolescents.

PubMed

Lee, Young Me; Cintron, Adanisse; Kocher, Surinder

2014-01-01

The purpose of this integrative literature review study was to investigate factors related to risky sexual behaviors among African American adolescents, to evaluate which of the factors are common across successful and effective STI/HIV and pregnancy intervention programs, and finally, to propose suggestions for future intervention programs for African American adolescents in West Englewood, Chicago. An integrative literature review was conducted. Using CINAHL, PubMed, and ProQuest database, the following terms were searched: African American, Black, adolescents, teenagers, sexual behavior, cultural factors, pregnancy, STIs/HIV/AIDS, and intervention programs. A total of 18 articles were reviewed, findings indicated there were five major contributing factors related to risky sexual behaviors: substance use, gender roles, peer influences, parental involvement, and level of knowledge and information on sex and STIs. Six successful STI/HIV and pregnancy programs that incorporated those factors to effectively reduce risky sexual behaviors were identified. After analyzing six national intervention programs proven to be effective, the findings suggest that future prevention programs should be designed with more emphasis on avoidance or limited substance use, increased parental involvement, integration of cultural teaching components such as storytelling and history as suggested from the Aban Aya Youth Project. This study also concluded that future prevention programs should consider the length of programs be longer than 1 year, as it has been shown to be more effective than shorter programs. © 2014 Wiley Periodicals, Inc.

Evaluating the feasibility of biological waste processing for long term space missions.

PubMed

Garland, J L; Alazraki, M P; Atkinson, C F; Finger, B W

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

NASA's advanced space transportation system launch vehicles

NASA Technical Reports Server (NTRS)

Branscome, Darrell R.

1991-01-01

Some insight is provided into the advanced transportation planning and systems that will evolve to support long term mission requirements. The general requirements include: launch and lift capacity to low earth orbit (LEO); space based transfer systems for orbital operations between LEO and geosynchronous equatorial orbit (GEO), the Moon, and Mars; and Transfer vehicle systems for long duration deep space probes. These mission requirements are incorporated in the NASA Civil Needs Data Base. To accomplish these mission goals, adequate lift capacity to LEO must be available: to support science and application missions; to provide for construction of the Space Station Freedom; and to support resupply of personnel and supplies for its operations. Growth in lift capacity must be time phased to support an expanding mission model that includes Freedom Station, the Mission to Planet Earth, and an expanded robotic planetary program. The near term increase in cargo lift capacity associated with development of the Shuttle-C is addressed. The joint DOD/NASA Advanced Launch System studies are focused on a longer term new cargo capability that will significantly reduce costs of placing payloads in space.

Evaluating the feasibility of biological waste processing for long term space missions

NASA Technical Reports Server (NTRS)

Garland, J. L.; Alazraki, M. P.; Atkinson, C. F.; Finger, B. W.; Sager, J. C. (Principal Investigator)

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

Impact of TimeSlips creative expression program on behavioral symptoms and psychotropic medication use in persons with dementia in long-term care: a cluster-randomized pilot study.

PubMed

Houser, Winona S; George, Daniel R; Chinchilli, Vernon M

2014-04-01

To evaluate whether involvement in TimeSlips, a creative storytelling program, reduced mood and behavioral symptoms as well as psychotropic medication use in persons with dementia. A cluster-randomized pilot study compared two discrete dementia care units in one nursing home. The control cohort (N = 10) received standard-of-care activity programming, and the intervention cohort (N = 10) received standard-of-care plus two one-hour TimeSlips sessions per week for six weeks. Data on mood and behavioral symptoms and psychotropic drug prescriptions were collected, and within-group and between-group comparisons were performed. Between-group comparisons did not reveal statistically significant differences in mood and behavioral symptoms. No differences in psychotropic drug prescriptions were found. Larger trials of longer duration are needed to determine whether involvement in TimeSlips reduces mood and behavioral symptoms that compromise quality of life for persons with dementia. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Differential spontaneous recovery across cognitive abilities during detoxification period in alcohol-dependence

PubMed Central

Petit, Géraldine; Luminet, Olivier; Cordovil de Sousa Uva, Mariana; Zorbas, Alexis; Maurage, Pierre; de Timary, Philippe

2017-01-01

Objective There is a lack of consensus regarding the extent to which cognitive dysfunctions may recover upon cessation of alcohol intake by alcohol-dependents (AD), and the divergent findings are most likely due to methodological differences between the various studies. The present study was aimed at conducting a very strict longitudinal study of cognitive recovery in terms of assessment points, the duration of abstinence, control of age and duration of the addiction, and by use of individual analyses in addition to mean group comparisons. Our study further focused on the 2–3 week phase of alcohol detoxification that is already known to positively affect many biological, emotional, motivational, as well as neural variables, followed by longer-term therapies for which good cognitive functioning is needed. Methods 41 AD inpatients undergoing a detoxification program, and 41 matched controls, were evaluated twice in terms of five cognitive functions (i.e., short-term memory, working memory, inhibition, cognitive flexibility, and verbal fluency) within a three-week interval [on the first day (T1) and the 18th day (T2) of abstinence for AD patients]. Emotional (positive and negative affectivity and depression) and motivational (craving) variables were also measured at both evaluation times. Results Although verbal fluency, short-term memory, and cognitive flexibility did not appear to be affected, the patients exhibited impaired inhibition and working memory at T1. While no recovery of inhibition was found to occur, the average working memory performance of the patients was comparable to that of the controls at T2. Improvements in emotional and motivational dimensions were also observed, although they did not correlate with the ones in working memory. Individual analysis showed that not all participants were impaired or recover the same functions. Conclusions While inhibition deficits appear to persist after 18 days of detoxification, deficits in working memory, which is a central component of cognition, are greatly reduced after alcohol detoxification. Individual differences in the trajectory of recovery do arise however, and it might be worth implementing individual assessments of impaired functions at the end of the detoxification phase in order to maximize the chances of success in longer-term treatments and abstinence. PMID:28767647

Effects of contact-based mental illness stigma reduction programs: age, gender, and Asian, Latino, and White American differences.

PubMed

Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer L; Yu, Jennifer W; Seelam, Rachana

2018-03-01

Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants. Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs. Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively. Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.

Short- and long-term efficacy of forest thinning to mitigate drought impacts in mountain forests in the European Alps.

PubMed

Elkin, Ché; Giuggiola, Arnaud; Rigling, Andreas; Bugmann, Harald

2015-06-01

In many regions of the world, drought is projected to increase under climate change, with potential negative consequences for forests and their ecosystem services (ES). Forest thinning has been proposed as a method for at least temporarily mitigating drought impacts, but its general applicability and longer-term impacts are unclear. We use a process-based forest model to upscale experimental data for evaluating the impacts of forest thinning in a drought-susceptible valley in the interior of the European Alps, with the specific aim of assessing (1) when and where thinning may be most effective and (2) the longer-term implications for forest dynamics. Simulations indicate that forests will be impacted by climate-induced increases in drought across a broad elevation range. At lower elevations, where drought is currently prevalent, thinning is projected to temporarily reduce tree mortality, but to have minor impacts on forest dynamics in the longer term. Thinning may be particularly useful at intermediate and higher elevations as a means of temporarily reducing mortality in drought-sensitive species such as Norway spruce and larch, which currently dominate these elevations. However, in the longer term, even intense thinning will likely not be sufficient to prevent a climate change induced dieback of these species, which is projected to occur under even moderate climate change. Thinning is also projected to have the largest impact on long-term forest dynamics at intermediate elevations, with the magnitude of the impact depending on the timing and intensity of thinning. More intense thinning that is done later is projected to more strongly promote a transition to more drought-tolerant species. We conclude that thinning is a viable option for temporarily reducing the negative drought impacts on forests, but that efficient implementation of thinning should be contingent on a site-specific evaluation of the near term risk of significant drought, and how thinning will impact the rate and direction of climate driven forest conversion.

Gait retraining using real-time feedback in patients with medial knee osteoarthritis: Feasibility and effects of a six-week gait training program.

PubMed

Richards, R; van den Noort, J C; van der Esch, M; Booij, M J; Harlaar, J

2018-06-20

The knee adduction moment (KAM) is often elevated in medial knee osteoarthritis (KOA). The aim of this study was to evaluate effects on KAM and patient-reported outcomes of a six-week gait training program. Twenty-one patients (61 ± 6 years) with KOA participated in a six-week biofeedback training program to encourage increased toe-in (all patients) and increased step-width (five patients). Patients received real-time visual feedback while walking on an instrumented treadmill. We analysed the effect of the gait modification(s) on peak KAM in week six and three and six months post-training. We also evaluated the effect on pain and functional ability. Of 21 patients starting the program, 16 completed it with high attendance (15 and 16 respectively) at the three and six month follow-ups. First peak KAM was significantly reduced by up to 14.0% in week six with non-significant reductions of 8.2% and 5.5% at the follow-ups. Functional ability (assessed using the WOMAC questionnaire) improved significantly after the training (eight point reduction, p = 0.04 in week six and nine point reduction, p = 0.04 at six-month follow-up). There was also a trend towards reduction in WOMAC pain (p = 0.06) at follow-up. Biofeedback training to encourage gait modifications is feasible and leads to short-term benefits. However, at follow-up, reductions in KAM were less pronounced in some participants suggesting that to influence progression of KOA in the longer term, a permanent regime to reinforce the effects of the training program is needed. Trial number: ISRCTN14687588. Copyright © 2018 Elsevier B.V. All rights reserved.

Focusing on Short-Term Achievement Gains Fails to Produce Long-Term Gains

ERIC Educational Resources Information Center

Grissmer, David W.; Ober, David R.; Beekman, John A.

2014-01-01

The short-term emphasis engendered by No Child Left Behind (NCLB) has focused research predominantly on unraveling the complexities and uncertainties in assessing short-term results, rather than developing methods and assessing results over the longer term. In this paper we focus on estimating long-term gains and address questions important to…

Long-Term In Vitro Degradation of a High-Strength Brushite Cement in Water, PBS, and Serum Solution

PubMed Central

Ajaxon, Ingrid; Öhman, Caroline; Persson, Cecilia

2015-01-01

Bone loss and fractures may call for the use of bone substituting materials, such as calcium phosphate cements (CPCs). CPCs can be degradable, and, to determine their limitations in terms of applications, their mechanical as well as chemical properties need to be evaluated over longer periods of time, under physiological conditions. However, there is lack of data on how the in vitro degradation affects high-strength brushite CPCs over longer periods of time, that is, longer than it takes for a bone fracture to heal. This study aimed at evaluating the long-term in vitro degradation properties of a high-strength brushite CPC in three different solutions: water, phosphate buffered saline, and a serum solution. Microcomputed tomography was used to evaluate the degradation nondestructively, complemented with gravimetric analysis. The compressive strength, chemical composition, and microstructure were also evaluated. Major changes from 10 weeks onwards were seen, in terms of formation of a porous outer layer of octacalcium phosphate on the specimens with a concomitant change in phase composition, increased porosity, decrease in object volume, and mechanical properties. This study illustrates the importance of long-term evaluation of similar cement compositions to be able to predict the material's physical changes over a relevant time frame. PMID:26587540

THE LONG-TERM EFFICACY OF ACUTE-PHASE PSYCHOTHERAPY FOR DEPRESSION: A META-ANALYSIS OF RANDOMIZED TRIALS.

PubMed

Karyotaki, Eirini; Smit, Yolba; de Beurs, Derek P; Henningsen, Kirsten Holdt; Robays, Jo; Huibers, Marcus J H; Weitz, Erica; Cuijpers, Pim

2016-05-01

Understanding the effectiveness of treatment for depression in both the short term and long term is essential for clinical decision making. The present meta-analysis examined treatment effects on depression and quality of life in acute-phase psychotherapeutic interventions compared to no treatment control groups for adult depression at 6 months or longer postrandomization. A systematic literature search resulted in 44 randomized controlled trials with 6,096 participants. Acute-phase psychotherapy was compared to control groups at 6-month or longer postrandomization. Odds ratios of a positive outcome were calculated. Psychotherapy outperformed control groups at 6 months or longer postrandomization (OR = 1.92, 95% CI: 1.60-2.31, P < .001). Heterogeneity was moderate (I²: 65, 95% CI: 53-74, P < .001). However, effects significantly decreased with longer follow-up periods. Additionally, a small positive effect of psychotherapy was observed for quality of life, while similar effects were obtained in separate analyses of each type of psychotherapy, with the exception of nondirective supportive therapy. Studies that provided booster sessions had better treatment results compared with studies that did not provide any further sessions. Finally, we found that trials on psychotherapy aimed at major depressive disorder (MDD) had better outcomes than those that were aimed at elevated depressive symptoms. There is substantial evidence that acute-phase psychotherapy results in a better treatment effects on depression and quality of life in the long term for adult patients with depression. © 2016 Wiley Periodicals, Inc.

Pilot test of a home-based program to prevent perceived insufficient milk.

PubMed

Wood, Natsuko K; Sanders, Elizabeth A; Lewis, Frances M; Woods, Nancy F; Blackburn, Susan T

2017-12-01

Although the World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first six months, only 22% of U.S. mothers do so. Mothers' perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. There are two changeable causes of PIM: (1) mothers' misinterpretation of their infant's behavior, and (2) mothers' lack of confidence in their ability to breastfeed. The purpose of this study was to evaluate the short-term effect of a home-based intervention designed to prevent and/or reduce PIM. A mixed-methods, single-group, pretest-midtest-posttest design was used for evaluating a home-based breastfeeding program. The program was implemented during three 1.0- to 1.5-h home intervention sessions at 6, 13, and 27 days postpartum, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. We found significant increases over time in mothers' sensitivity to infant behavior and breastfeeding self-efficacy as well as significant decreased attribution of infant crying to PIM. Exit interviews indicated that the program was accepted by participating mothers. This is the first intervention study that has directly targeted the causes of PIM. The home-based intervention has the potential to add to maternal competencies both in correctly assessing their infants' behavior, thereby preventing erroneous attribution of infant behavior to PIM, as well as simultaneously bolstering maternal confidence in breastfeeding skills. By building maternal competencies, the home-based intervention has a longer-range potential to prevent breastfeeding discontinuation. Further evaluation is warranted. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Publications of the Fossil Energy Advanced Research and Technology Development Materials Program: April 1, 1993-March 31, 1995

NASA Astrophysics Data System (ADS)

Carlson, Paul T.

1995-04-01

The objective of the Fossil Energy Advanced Research and Technology Development (AR and TD) Materials Program is to conduct research and development on materials for fossil energy applications, with a focus on the longer-term needs for materials with general applicability to the various fossil fuel technologies. The Program includes research aimed at a better understanding of materials behavior in fossil energy environments and on the development of new materials capable of substantial improvement in plant operations and reliability. The scope of the Program addresses materials requirements for all fossil energy systems, including materials for coal preparation, coal liquefaction, coal gasification, heat engines and heat recovery, combustion systems, and fuel cells. Work on the Program is conducted at national and government laboratories, universities, and industrial research facilities. This bibliography covers the period of April 1, 1993, through March 31, 1995, and is a supplement to previous bibliographies in this series. It is the intent of this series of bibliographies to list only those publications that can be conveniently obtained by a researcher through relatively normal channels. The publications listed in this document have been limited to topical reports, open literature publications in referred journals, full-length papers in published proceedings of conferences, full-length papers in unreferred journals, and books and book articles.

NASA Technology Plan 1998

NASA Technical Reports Server (NTRS)

1998-01-01

This NASA Strategic Plan describes an ambitious, exciting vision for the Agency across all its Strategic Enterprises that addresses a series of fundamental questions of science and research. This vision is so challenging that it literally depends on the success of an aggressive, cutting-edge advanced technology development program. The objective of this plan is to describe the NASA-wide technology program in a manner that provides not only the content of ongoing and planned activities, but also the rationale and justification for these activities in the context of NASA's future needs. The scope of this plan is Agencywide, and it includes technology investments to support all major space and aeronautics program areas, but particular emphasis is placed on longer term strategic technology efforts that will have broad impact across the spectrum of NASA activities and perhaps beyond. Our goal is to broaden the understanding of NASA technology programs and to encourage greater participation from outside the Agency. By relating technology goals to anticipated mission needs, we hope to stimulate additional innovative approaches to technology challenges and promote more cooperative programs with partners outside NASA who share common goals. We also believe that this will increase the transfer of NASA-sponsored technology into nonaerospace applications, resulting in an even greater return on the investment in NASA.

Implementation of a Nutrition Program Reduced Post-Discharge Growth Restriction in Thai Very Low Birth Weight Preterm Infants.

PubMed

Japakasetr, Suchada; Sirikulchayanonta, Chutima; Suthutvoravut, Umaporn; Chindavijak, Busba; Kagawa, Masaharu; Nokdee, Somjai

2016-12-17

Very low birth weight (VLBW) preterm infants are vulnerable to growth restriction after discharge due to cumulative protein and energy deficits during their hospital stay and early post-discharge period. The current study evaluated the effectiveness of the preterm infant, post-discharge nutrition (PIN) program to reduce post-discharge growth restriction in Thai VLBW preterm infants. A prospective, non-randomized interventional cohort study was undertaken to assess the growth of 22 VLBW preterm infants who received the PIN program and compared them with 22 VLBW preterm infants who received conventional nutrition services. Infant's growth was recorded monthly until the infants reached six months' corrected age (6-moCA). Intervention infants had significantly greater body weights ( p = 0.013) and head circumferences ( p = 0.009). Also, a greater proportion of the intervention group recovered their weight to the standard weight at 4-moCA ( p = 0.027) and at 6-moCA ( p = 0.007) and their head circumference to the standard head circumference at 6-moCA ( p = 0.004) compared to their historical comparison counterparts. Enlistment in the PIN program thus resulted in significantly reduced post-discharge growth restriction in VLBW preterm infants. Further research on longer term effects of the program on infant's growth and development is warranted.

Design of the Quality of Life in Motion (QLIM) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical exercise and psychosocial training program to improve physical fitness in children with cancer.

PubMed

Braam, Katja I; van Dijk, Elisabeth M; Veening, Margreet A; Bierings, Marc B; Merks, Johannes H M; Grootenhuis, Martha A; Chinapaw, Mai J M; Sinnema, Gerben; Takken, Tim; Huisman, Jaap; Kaspers, Gertjan J L; van Dulmen-den Broeder, Eline

2010-11-11

Childhood cancer and its treatment have considerable impact on a child's physical and mental wellbeing. Especially long-term administration of chemotherapy and/or radiotherapy impairs physical fitness both during and after therapy, when children often present with muscle weakness and/or low cardiorespiratory fitness. Physical exercise can improve these two elements of physical fitness, but the positive effects of physical exercise might be further increased when a child's wellbeing is simultaneously enhanced by psychosocial training. Feeling better may increase the willingness and motivation to engage in sports activities. Therefore, this multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy, using a combined physical exercise and psychosocial intervention program, implemented during or shortly after treatment. Also examined is whether positive effects on physical fitness reduce inactivity-related adverse health problems, improve quality of life, and are cost-effective. This multi-centre randomized controlled trial compares a combined physical and psychosocial intervention program for children with cancer, with care as usual (controls). Children with cancer (aged 8-18 years) treated with chemotherapy and/or radiotherapy, and who are no longer than 1 year post-treatment, are eligible for participation. A total of 100 children are being recruited from the paediatric oncology/haematology departments of three Dutch university medical centres. Patients are stratified according to pubertal stage (girls: age ≤10 or >10 years; boys: ≤11 or >11 years), type of malignancy (haematological or solid tumour), and moment of inclusion into the study (during or after treatment), and are randomly assigned to the intervention or control group. Childhood cancer patients undergoing long-term cancer therapy may benefit from a combined physical exercise and psychosocial intervention program since it may maintain or enhance their physical fitness and increase their quality of life. However, the feasibility, patient need, and effectiveness of such a program should be established before the program can be implemented as part of standard care. NTR1531 (The Netherlands National Trial Register).

Mental health court and assisted outpatient treatment: perceived coercion, procedural justice, and program impact.

PubMed

Munetz, Mark R; Ritter, Christian; Teller, Jennifer L S; Bonfine, Natalie

2014-03-01

Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system. Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The MacArthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers. Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants. Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants' perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.

77 FR 5193 - Retrospective Review Under E.O. 13563: Shipping-Removal of Obsolete Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... Program, which replaced the Operating-Differential Subsidy (ODS) Program. Therefore, the regulations pertaining to the ODS Program and the Construction-Differential (CDS) Program are no longer in use. In... regulations 46 CFR parts 251, 252, 276, 280, 281,282, and 283. The regulations related to the ODS Program are...

Effects of supervised exercise on motivational outcomes in breast cancer survivors at 5-year follow-up.

PubMed

Trinh, Linda; Mutrie, Nanette; Campbell, Anna M; Crawford, Jennifer J; Courneya, Kerry S

2014-12-01

Short-term physical activity (PA) has beneficial effects on symptom management and quality of life, however, longer-term adherence is likely needed for improved disease outcomes in breast cancer survivors (BCS). This study examined the effects of a supervised group exercise program on motivational outcomes and PA among BCS at 5-year follow-up. The original study was a two-armed, randomized controlled trial comparing a 12-week supervised group exercise program to usual care among 203 BCS. BCS for this follow-up study were contacted at 60 months postintervention and asked to complete assessments of motivational outcomes from the Theory of Planned Behavior and PA behavior using the Scottish Physical Activity Questionnaire. Overall, 87 participants provided 5-year follow-up data with no differences in participation by group. Analyses of covariance (ANCOVAs) revealed that supervised exercise had a significant positive effect on descriptive norm at 5-year follow-up (mean = +0.6; 95% CI = +0.1 to +1.1; d = +0.48; p = 0.021). Small positive effects were also noted for perceived behavioral control (d = +0.18), instrumental attitude (d = +0.26), and injunctive norm (d = +0.35), although they were not statistically significant. Moreover, BCS who were more active at 5-year follow-up also reported more favorable perceived behavioral control (d = +0.16), instrumental attitude (d = +0.28), injunctive norm (d = +0.24), and descriptive norm (d = +0.31), although these differences were not statistically significant. This trial provides suggestive evidence that a supervised exercise program has positive effects on motivational outcomes even after 5 years. Additional intervention strategies during follow-up may further improve long-term adherence and health outcomes in BCS. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Long-term effect of a cognitive intervention on learning and participation in a significant leisure activity in early dementia of Alzheimer type: a case study].

PubMed

Provencher, Véronique; Bier, Nathalie; Audet, Thérèse; Gagnon, Lise

2009-06-01

Decreased ability to accomplish significant leisure activities often occurs in early stages of dementia of Alzheimer type (DAT). As a long term effect, it may eventually affect the quality of life of the patient as well as that of the caregiver's. In a previous study, a woman with early DAT (77 years old, MMSE: 24/30) improved her participation in 2 leisure activities (listening to music and praying in a group) following the learning of a few tasks (e.g. using a radio cassette, remembering the significance of an pre-programmed ring) as a result of a cognitive intervention. The present study presents the long term effect of this intervention on the retention of the learned tasks and on spontaneous participation in both leisure activities of her daily living. Measures of tasks' learning and spontaneous participation in activities have been obtained through direct observation (ex: ability to use the tasks learned without assistance) and telephone conversations with the caregiver. The measures were taken 9 to 15 months post-intervention. Nine months after the end of the intervention, the participant could no longer use the radio cassette, but was able to remember the significance of the pre-programmed ring. Similarly, she stopped listening to music, but still attended her prayer group. The intervention appears to maintain participation in a leisure activity for several months in a patient with early DAT, in spite of expected functional decline. This functional impact can be achieved through retention of specific learned tasks as well as by strong external cues (daily pre-programmed ring), and can increase the quality of life for patients with DAT.

Jumping combined exercise programs reduce fall risk and improve balance and life quality of elderly people who live in a long-term care facility.

PubMed

Cakar, E; Dincer, U; Kiralp, M Z; Cakar, D B; Durmus, O; Kilac, H; Soydan, F C; Sevinc, S; Alper, C

2010-03-01

The objective of this study was to determine whether regular combined exercise program, which consists strength, stretching and aerobic exercises and additional jumping training, improve balance, fall risk, quality of life and depression status of older people living in a residential care. A total of 168 residents who live in a long term care facility were screened. The trial began with 78 eligible participants and they were randomly grouped as combined exercises program (COM) group that includes stretching, strength and aerobic exercises, and COM plus jumping (COMpJ) group. 66 of the participants finished the trial. The groups were convened three times a week for six weeks. Each group had a warm-up, effective training and a cooling down periods. The total exercising time was no longer than 45 minutes in each group. Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk, short form 36 (SF 36) for the health related quality of life and Geriatric Depression Scale (GDS) for evaluation of the depression status were used. The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial; however, the improvements were statistically better in jumping combined group. Also health related quality of life improved in both groups. Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement, fall risk reduction and quality of life. The addition of jumping to strength, stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction.

Evaluation of the sustained implementation of a mental health learning initiative in long-term care.

PubMed

McAiney, Carrie A; Stolee, Paul; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

2007-10-01

This paper describes an innovative education program for the management of mental health problems in long-term care (LTC) homes and the evaluation of its longer-term sustainability. Since 1998, the "Putting the P.I.E.C.E.S. Together" learning initiative has been providing education sessions and related learning strategies aimed at developing the knowledge and skills of health professionals who care for older persons with complex physical and mental health needs and associated behaviors, in Ontario, Canada. A major focus of this province-wide initiative was the development of in-house Psychogeriatric Resource Persons (PRPs). Evaluation of this initiative included the completion of pre- and post-education questionnaires (over three data collection time periods) assessing learner confidence (N = 1,024 and 792, for pre- and post-education, respectively) and session evaluation questionnaires gathering feedback on the session (N = 2,029 across all sessions). A survey of LTC homes in Ontario (N = 439, 79% of the homes in the province) was conducted to assess longer-term sustainability. Ratings of the sessions indicated that they were relevant to learners' clinical practice. There were significant increases in ratings of ability to recognize and understand challenging behaviors and mental health problems, and in ability to use a variety of assessment tools. Few homes (15%) do not have a PRP; over 50% of the staff who completed the first session in 1999 continue to serve as a PRP and to apply learned skills. A learning initiative with supportive and reinforcing strategies can develop in-house PRPs to enhance the care of the elderly in LTC. Incorporation of PRP functions into job descriptions and management support contributed to the success of this initiative. This study highlights the importance of work environments that support and reinforce the use of learned skills to the success of continuing education and quality improvement initiatives in LTC.

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making

PubMed Central

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-01-01

Background In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Methods Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Results Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Conclusion Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health. PMID:19094194

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

PubMed

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-12-18

In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

Optimizing life success through residential immersive life skills programs for youth with disabilities: study protocol of a mixed-methods, prospective, comparative cohort study.

PubMed

McPherson, Amy C; King, Gillian; Rudzik, Alanna; Kingsnorth, Shauna; Gorter, Jan Willem

2016-09-06

Young people with disabilities often lag behind their typically developing peers in the achievement of adult roles, which has been attributed to a lack of opportunities to develop critical life skills. Residential Immersive Life Skills (RILS) programs provide situated learning opportunities to develop life skills alongside peers and away from home in real-world settings. Retrospective research suggests that attending RILS programs is a transformative experience that empowers youth, provides parental hope, and increases service provider expertise. However, prospective, comparative research is needed to determine longer term benefits of these programs on youth life trajectories, in addition to exploring the program features and participant experiences that optimize program success. This protocol describes a 5-year, multi-site prospective study examining the effects of RILS programs for youth with disabilities. The study involves RILS programs at three sites in Ontario, Canada. Cohorts of treatment and control groups will receive the study protocol over 3 successive years. Thirty English-speaking participants aged 14-21 years with a child-onset disability and the cognitive capacity to engage in goal setting will be recruited every year for 3 years in the following groups: youth attending a RILS program (Group A); a deferred RILS control group of youth (Group B); a control group of youth attending a non-residential life skills program (Group C); and a control group matched on age, diagnoses, and cognitive capacity not receiving any life skills intervention (Group D). All participants will complete measures of self-determination and self-efficacy at four time points. Program opportunities and experiences will also be assessed in-the-moment at the RILS programs. Qualitative interviews pre-program and at 3- and 12-months post-program will be undertaken with a sub-sample of youth and parents to explore their expectations and experiences. This study will address key gaps in the literature pertaining to the long-term impact of RILS programs and the role of immersive environments in shaping youth outcomes and experiences. Our research program aims to uncover transferable processes and essential features by which RILS programs have their effects on attitudes, cognitions, and behaviour. The trial registration number on clinicaltrials.gov is NCT02753452 (retrospectively registered 26 April 2016). Trial sponsor: Holland Bloorview Kids Rehabilitation Hospital.

Boxing training for patients with Parkinson disease: a case series.

PubMed

Combs, Stephanie A; Diehl, M Dyer; Staples, William H; Conn, Lindsay; Davis, Kendra; Lewis, Nicole; Schaneman, Katie

2011-01-01

A nontraditional form of exercise recently applied for patients with Parkinson disease (PD) is boxing training. The primary purpose of this case series is to describe the effects of disease severity and duration of boxing training (short term and long term) on changes in balance, mobility, and quality of life for patients with mild or moderate to severe PD. The feasibility and safety of the boxing training program also were assessed. Six patients with idiopathic PD attended 24 to 36 boxing training sessions for 12 weeks, with the option of continuing the training for an additional 24 weeks (a seventh patient attended sessions for only 4 weeks). The 90-minute sessions included boxing drills and traditional stretching, strengthening, and endurance exercises. Outcomes were tested at the baseline and after 12, 24, and 36 weeks of boxing sessions (12-, 24-, and 36-week tests). The outcome measures were the Functional Reach Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Timed "Up & Go" Test, Six-Minute Walk Test, gait speed, cadence, stride length, step width, activities of daily living and motor examination subscales of the Unified Parkinson Disease Rating Scale, and Parkinson Disease Quality of Life Scale. Six patients completed all phases of the case series, showed improvements on at least 5 of the 12 outcome measures over the baseline at the 12-week test, and showed continued improvements at the 24- and 36-week tests. Patients with mild PD typically showed improvements earlier than those with moderate to severe PD. Despite the progressive nature of PD, the patients in this case series showed short-term and long-term improvements in balance, gait, activities of daily living, and quality of life after the boxing training program. A longer duration of training was necessary for patients with moderate to severe PD to show maximal training outcomes. The boxing training program was feasible and safe for these patients with PD.

Aquatic Plant Control Research Program. Proceedings, Annual Meeting, Aquatic Plant Control Research Program (23rd) Held in West Palm Beach, Florida on 14-17 November 1988

DTIC Science & Technology

1989-06-01

stage lasted 3 days, and complete development took 23 days in both species. Adult longevity averaged about 18 days, which was about 7 days longer than...hydrilla leaf Australian hydrilla fly in hydrilla destroys fewer leaves. In the field, however, its longer adult longevity might favor it. Together, the...trials. It appears to us that, as well as pioneering a novel ecosystems-compatible approach, the transition from basic research in an academic setting

School-Based Sleep Education Programs for Short Sleep Duration in Adolescents: A Systematic Review and Meta-Analysis.

PubMed

Chung, Ka-Fai; Chan, Man-Sum; Lam, Ying-Yin; Lai, Cindy Sin-Yee; Yeung, Wing-Fai

2017-06-01

Insufficient sleep among students is a major school health problem. School-based sleep education programs tailored to reach large number of students may be one of the solutions. A systematic review and meta-analysis was conducted to summarize the programs' effectiveness and current status. Electronic databases were searched up until May 2015. Randomized controlled trials of school-based sleep intervention among 10- to 19-year-old students with outcome on total sleep duration were included. Methodological quality of the studies was assessed using the Cochrane's risk of bias assessment. Seven studies were included, involving 1876 students receiving sleep education programs and 2483 attending classes-as-usual. Four weekly 50-minute sleep education classes were most commonly provided. Methodological quality was only moderate, with a high or an uncertain risk of bias in several domains. Compared to classes-as-usual, sleep education programs produced significantly longer weekday and weekend total sleep time and better mood among students at immediate post-treatment, but the improvements were not maintained at follow-up. Limited by the small number of studies and methodological limitations, the preliminary data showed that school-based sleep education programs produced short-term benefits. Future studies should explore integrating sleep education with delayed school start time or other more effective approaches. © 2017, American School Health Association.

A Comparison of Internal Dispositions and Career Trajectories after Collaborative versus Apprenticed Research Experiences for Undergraduates

PubMed Central

Frantz, Kyle J.; Demetrikopoulos, Melissa K.; Britner, Shari L.; Carruth, Laura L.; Williams, Brian A.; Pecore, John L.; DeHaan, Robert L.; Goode, Christopher T.

2017-01-01

Undergraduate research experiences confer benefits on students bound for science, technology, engineering, and mathematics (STEM) careers, but the low number of research professionals available to serve as mentors often limits access to research. Within the context of our summer research program (BRAIN), we tested the hypothesis that a team-based collaborative learning model (CLM) produces student outcomes at least as positive as a traditional apprenticeship model (AM). Through stratified, random assignment to conditions, CLM students were designated to work together in a teaching laboratory to conduct research according to a defined curriculum led by several instructors, whereas AM students were paired with mentors in active research groups. We used pre-, mid-, and postprogram surveys to measure internal dispositions reported to predict progress toward STEM careers, such as scientific research self-efficacy, science identity, science anxiety, and commitment to a science career. We are also tracking long-term retention in science-related career paths. For both short- and longer-term outcomes, the two program formats produced similar benefits, supporting our hypothesis that the CLM provides positive outcomes while conserving resources, such as faculty mentors. We discuss this method in comparison with course-based undergraduate research and recommend its expansion to institutional settings in which mentor resources are scarce. PMID:28130268

Evaluation of the Responsible, Engaged, and Loving (REAL) Fathers Initiative on Physical Child Punishment and Intimate Partner Violence in Northern Uganda.

PubMed

Ashburn, Kim; Kerner, Brad; Ojamuge, Dickens; Lundgren, Rebecka

2017-10-01

Violence against women and violence against children in Uganda are recognized as significant public health concerns. Exposure to violence at home as a child can increase the likelihood of perpetrating or experiencing violence later in life. These two forms of violence share similar risk factors and often, but not always, co-occur at the household level. Parenting programs have shown promise in reducing physical child punishment. Targeting men has also been proven effective in transforming attitudes related to gender roles and expectations and intimate partner violence (IPV) against women. The REAL Fathers Initiative is a 12-session father mentoring program implemented by volunteers that is designed to reduce child exposure to violence at home, breaking the cycle of intergenerational violence. Evaluation results comparing survey data among men exposed to the intervention and those unexposed demonstrate significant reductions in IPV at end line (aOR 0.48, CI 0.31, 0.76, p < 0.001) and over the longer term follow-up (aOR 0.47, CI 0.31, 0.77, p < 0.001) and significant reductions in physical child punishment at long-term follow-up (aOR 0.52, CI 0.32, 0.82, p < 0.001).

Survival of HIV-1 vertically infected children

PubMed Central

Davies, Mary-Ann; Gibb, Diana; Turkova, Anna

2017-01-01

Purpose of review It is 20 years since the start of the combination antiretroviral therapy (cART) era and >10 years since cART scale-up began in resource-limited settings. We examined survival of vertically HIV-infected infants and children in the cART era. Recent findings Good survival has been achieved on cART in all settings with up to ten-fold mortality reductions compared to before cART availability. Although mortality risk remains high in the first few months after cART initiation in young children with severe disease, it drops rapidly thereafter even for those who started with advanced disease, and longer term mortality risk is low. However, suboptimal retention on cART in routine programs threatens good survival outcomes and even on treatment children continue to experience high comorbidity risk; infections remain the major cause of death. Interventions to address infection risk include co-trimoxazole prophylaxis, isoniazid preventive therapy, routine childhood and influenza immunization and improving maternal survival. Summary Pediatric survival has improved substantially with cART and HIV-infected children are aging into adulthood. It is important to ensure access to diagnosis and early cART, good program retention and optimal co-morbidity prophylaxis and treatment to achieve the best possible long-term survival and health outcomes for vertically infected children. PMID:27716730

Mnemonic anosognosia in Alzheimer's disease is caused by a failure to transfer online evaluations of performance: Evidence from memory training programs.

PubMed

Silva, Ana Rita; Pinho, Maria Salomé; Macedo, Luís; Souchay, Céline; Moulin, Christopher

2017-06-01

There is a debate about the ability of patients with Alzheimer's disease to build an up-to-date representation of their memory function, which has been termed mnemonic anosognosia. This form of anosognosia is typified by accurate online evaluations of performance, but dysfunctional or outmoded representations of function more generally. We tested whether people with Alzheimer's disease could adapt or change their representations of memory performance across three different six-week memory training programs using global judgements of learning. We showed that whereas online assessments of performance were accurate, patients continued to make inaccurate overestimations of their memory performance. This was despite the fact that the magnitude of predictions shifted according to the memory training. That is, on some level patients showed an ability to change and retain a representation of performance over time, but it was a dysfunctional one. For the first time in the literature we were able to use an analysis using correlations to support this claim, based on a large heterogeneous sample of 51 patients with Alzheimer's disease. The results point not to a failure to retain online metamemory information, but rather that this information is never used or incorporated into longer term representations, supporting but refining the mnemonic anosognosia hypothesis.

12 CFR 370.11 - Enforcement mechanisms.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.11 Enforcement mechanisms. (a) Termination of Participation. If... participate in the temporary liquidity guarantee program, the FDIC will inform the entity that it will no longer be provided the protections of the temporary liquidity guarantee program. (1) Termination of...

Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth.

PubMed

Widman, Laura; Nesi, Jacqueline; Kamke, Kristyn; Choukas-Bradley, Sophia; Stewart, J L

2018-06-01

Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth. Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English. Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016). After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Clinician as Leader: Why, How, and When.

PubMed

Stoller, James K

2017-11-01

Clinicians are inveterate leaders. We lead patients through the difficult maze of illness, families through the travails of ill loved ones, and physicians-in-training through the gauntlet of learning medicine. Yet, in the context of a range of leadership styles that effective leaders must be able to deploy situationally, physician leaders have traditionally defaulted to a "command and control" style that fosters the concept of physicians as "Viking warriors" or "heroic lone healers." The perverse effects of "command and control" are that this style conspires against collaboration and tends to be perpetuated as aspiring leaders emulate their predecessors. Because healthcare faces challenges of cost, access, and quality and is in the throes of change, the current landscape requires effective leadership. Though still relatively uncommon among healthcare organizations, frontrunner organizations are offering leadership development programs. The design of such programs requires clarity about requisite leadership competencies and about how and when to best to deliver such curricula. As one example, the American Thoracic Society has launched its Emerging Leaders Program (ELP), which is currently offering a leadership development curriculum to 18 selected emerging leaders. The ATS ELP curriculum focuses on awareness of self and system and incorporates highly participatory sessions on emotional intelligence, teambuilding, change management, situational leadership, appreciative inquiry, process and quality improvement, strategic planning, and organizational culture. Short-term deliverables are the development and presentation of business plans for innovations proposed by the group. Hoped for longer-term outcomes include an enhanced leadership pipeline for global respiratory health.

Stigma of epilepsy.

PubMed

Bandstra, Nancy F; Camfield, Carol S; Camfield, Peter R

2008-09-01

Epilepsy directly affects 50 million people worldwide. Most can achieve excellent seizure control; however, people living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions and misunderstandings that have persisted for thousands of years. This paper reviews the frequency and nature of stigma toward epilepsy. Significant negative attitudes prevail in the adolescent and adult public worldwide leading to loneliness and social avoidance both in school and in the workplace. People with epilepsy are often wrongly viewed as having mental health and antisocial issues and as being potentially violent toward others. Twenty-five percent of adults having epilepsy describe social stigma as a result of their epilepsy. They fear rejection and often feel shame or loneliness from this diagnosis. The psychosocial and social impact of epilepsy is significant. Yet few specific interventions have been demonstrated to alter this perception. The effect on public education is primarily short-term, while change over the long-term in attitudes and inaccurate beliefs have not presently been proven effective. School education programming demonstrates improved knowledge and attitude a month after a classroom intervention, but persisting change over a longer period of time has not been evaluated. In-depth adult psycho-educational programs for adults with epilepsy improves knowledge, coping skills and level of felt stigma. However these gains have not demonstrated persistence over time. Myths, misconceptions and misunderstandings about epilepsy continue and programs aimed at increasing knowledge and reducing negative public attitudes should be enhanced.

Multiwavelength Opportunities for GeV and TeV Telescopes

NASA Technical Reports Server (NTRS)

Thompson, David J.

2010-01-01

With AGILE and Fermi now in orbit and TeV telescopes continuing to improve their performance, a variety of multiwavelength opportunities is increasingly available. One goal of such programs is to take advantage of the complementary capabilities of the two types of telescopes: the wide field surveys of the satellite detectors and the high sensitivity and resolution of the ground-based telescopes. Some aspects of these multiwavelength efforts will be carried out in near-real-time but must be anticipated with advance preparation. These include gamma-ray burst follow-ups and flare campaigns. Other projects such as long-term variability studies and gammaray source identification require deep observations and cooperative work with astrophysicists at longer wavelengths, along with the theoretical studies that tie the observations together.

Animals in biomedical space research

NASA Astrophysics Data System (ADS)

Phillips, Robert W.

The use of experimental animals has been a major component of biomedical research progress. Using animals in space presents special problems, but also provides special opportunities. Rat and squirrel monkeys experiments have been planned in concert with human experiments to help answer fundamental questions concerning the effect of weightlessness on mammalian function. For the most part, these experiments focus on identified changes noted in humans during space flight. Utilizing space laboratory facilities, manipulative experiments can be completed while animals are still in orbit. Other experiments are designed to study changes in gravity receptor structure and function and the effect of weightlessness on early vertebrate development. Following these preliminary animals experiments on Spacelab Shuttle flights, longer term programs of animal investigation will be conducted on Space Station.

Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

PubMed

Brent, David

2016-04-01

In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. © 2016 The American Association of Suicidology.

Access to safe water in rural Artibonite, Haiti 16 months after the onset of the cholera epidemic.

PubMed

Patrick, Molly; Berendes, David; Murphy, Jennifer; Bertrand, Fabienne; Husain, Farah; Handzel, Thomas

2013-10-01

Haiti has the lowest improved water and sanitation coverage in the Western Hemisphere and is suffering from the largest cholera epidemic on record. In May of 2012, an assessment was conducted in rural areas of the Artibonite Department to describe the type and quality of water sources and determine knowledge, access, and use of household water treatment products to inform future programs. It was conducted after emergency response was scaled back but before longer-term water, sanitation, and hygiene activities were initiated. The household survey and source water quality analysis documented low access to safe water, with only 42.3% of households using an improved drinking water source. One-half (50.9%) of the improved water sources tested positive for Escherichia coli. Of households with water to test, 12.7% had positive chlorine residual. The assessment reinforces the identified need for major investments in safe water and sanitation infrastructure and the importance of household water treatment to improve access to safe water in the near term.

In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP.

PubMed

Turnbull, Christopher D; Bratton, Daniel J; Craig, Sonya E; Kohler, Malcolm; Stradling, John R

2016-02-01

Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2-4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2-4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2-4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made.

Space power technology 21: Photovoltaics

NASA Astrophysics Data System (ADS)

Wise, Joseph

1989-04-01

The Space Power needs for the 21st Century and the program in photovoltaics needed to achieve it are discussed. Workshops were conducted in eight different power disciplines involving industry and other government agencies. The Photovoltaics Workshop was conducted at Aerospace Corporation in June 1987. The major findings and recommended program from this workshop are discussed. The major finding is that a survivable solar power capability is needed in photovoltaics for critical Department of Defense missions including Air Force and Strategic Defense Initiative. The tasks needed to realize this capability are described in technical, not financial, terms. The second finding is the need for lightweight, moderately survivable planar solar arrays. High efficiency thin III-V solar cells can meet some of these requirements. Higher efficiency, longer life solar cells are needed for application to both future planar and concentrator arrays with usable life up to 10 years. Increasing threats are also anticipated and means for avoiding prolonged exposure, retraction, maneuvering and autonomous operation are discussed.

Effective Use of Household Water Treatment and Safe Storage in Response to the 2010 Haiti Earthquake

PubMed Central

Lantagne, Daniele; Clasen, Thomas

2013-01-01

When water supplies are compromised during an emergency, responders often recommend household water treatment and safe storage (HWTS) methods, such as boiling or chlorination. We evaluated the near- and longer-term impact of chlorine and filter products distributed shortly after the 2010 earthquake in Haiti. HWTS products were deemed as effective to use if they actually improved unsafe household drinking water to internationally accepted microbiological water quality standards. The acute emergency survey (442 households) was conducted within 8 weeks of emergency onset; the recovery survey (218 households) was conducted 10 months after onset. Effective use varied by HWTS product (from 8% to 63% of recipients in the acute phase and from 0% to 46% of recipients in the recovery phase). Higher rates of effective use were associated with programs that were underway in Haiti before the emergency, had a plan at initial distribution for program continuation, and distributed products with community health worker support and a safe storage container. PMID:23836571

A New NOAA Research Initiative on the Seasonal Prediction of U.S. Coastal High Water Levels

NASA Astrophysics Data System (ADS)

Mariotti, A.; Archambault, H. M.; Barrie, D.; Huang, J.

2017-12-01

A crucial part of NOAA's service mission is to make U.S. communities more resilient to rises in coastal sea level, which on a seasonal timescale may increase the threat for nuisance ("sunny day") flooding, as well as enhance the severity of storm surge events. Over a season, variability in climate or ocean dynamics, in combination with longer-term trends, can influence coastal sea level in a way that is potentially predictable. To leverage these emerging scientific findings, the Climate Program Office's Modeling, Analysis, Predictions, and Projections Program, in partnership with the National Marine Fisheries Service, has funded a set of three-year projects starting in FY 2017 to help develop NOAA's capability to produce skillful seasonal (i.e, 2-9 month) predictions of coastal high water levels as well as changing living marine resources. This presentation will describe the goals, scope and intended activities of this research initiative and its coordination via a new MAPP Ocean Prediction Task Force.

Spectroscopy of Kepler Exo-planet Transit Candidate Stars

NASA Astrophysics Data System (ADS)

Howell, Steve B.; Everett, Mark; Silva, David; Rowe, Jason; Szkody, Paula; Mighell, Ken; Ciardi, David

2012-02-01

We propose a long term spectroscopic follow-up program in support of the NASA Kepler exo-planet mission. The Kepler project is now focusing on exo-planet candidates which are smaller in radius (down to Earth- size), have longer period orbits and many of which orbit fainter stars. Our program will spend 85% of the time on our primary goal, spectroscopy of the host stars of exoplanet candidates, and 15% of the time on investigation of other astrophysically interesting stars discovered by Kepler. Our prime goal is to obtain reconnaissance spectra of newly discovered exo-planet stars yielding model fits to T_eff and log g. Secondary goals are to obtain velocity information on EBs with a third component aimed toward discovery of circumbinary planets (such as Kepler 16b) and identification spectra of U-band selected targets in order to find more white dwarfs for Kepler focal plane calibration purposes. All of these tasks can be accomplished using the Kitt Peak 4-m telescope and RCspec as shown by our previous time allocations.

24 CFR 984.102 - Program objectives.

Code of Federal Regulations, 2014 CFR

2014-04-01

... higher paying jobs; no longer need benefits received under one or more welfare programs; obtain a high school diploma or higher education degree; or accomplish similar goals that will assist the family in...

24 CFR 984.102 - Program objectives.

Code of Federal Regulations, 2011 CFR

2011-04-01

... higher paying jobs; no longer need benefits received under one or more welfare programs; obtain a high school diploma or higher education degree; or accomplish similar goals that will assist the family in...

24 CFR 984.102 - Program objectives.

Code of Federal Regulations, 2012 CFR

2012-04-01

... higher paying jobs; no longer need benefits received under one or more welfare programs; obtain a high school diploma or higher education degree; or accomplish similar goals that will assist the family in...

24 CFR 984.102 - Program objectives.

Code of Federal Regulations, 2013 CFR

2013-04-01

... higher paying jobs; no longer need benefits received under one or more welfare programs; obtain a high school diploma or higher education degree; or accomplish similar goals that will assist the family in...

Sizzling Summer Reading Programs for Young Adults: Second Edition

ERIC Educational Resources Information Center

Kan, Katharine L.

2006-01-01

Summer reading programs are a staple in libraries nationwide and provide a valuable service: keeping teens productive and occupied when they are no longer busy in school. Producing creative programs at the library can be challenging when faced with this easily distracted teen demographic; that's where "Sizzling Summer Reading Programs" steps in.…

Strengthening Scientific Verbal Behavior: An Experimental Comparison of Progressively Prompted and Unprompted Programmed Instruction and Prose Tutorials

ERIC Educational Resources Information Center

Davis, Darrel R.; Bostow, Darrel E.; Heimisson, Gudmundur T.

2007-01-01

Web-based software was used to deliver and record the effects of programmed instruction that progressively added formal prompts until attempts were successful, programmed instruction with one attempt, and prose tutorials. Error-contingent progressive prompting took significantly longer than programmed instruction and prose. Both forms of…

Measuring single constructs by single items: Constructing an even shorter version of the “Short Five” personality inventory

PubMed Central

Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

2017-01-01

The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item “Short Five” (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5. PMID:28800630

Measuring single constructs by single items: Constructing an even shorter version of the "Short Five" personality inventory.

PubMed

Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

2017-01-01

The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item "Short Five" (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5.

Using Microenterprise Programs in the Rural United States.

ERIC Educational Resources Information Center

Wallace, George

2000-01-01

Directed at the chronically unemployed, poor single parents, and welfare recipients, microenterprise programs provide access to loans and technical training for the express purpose of creating small-scale self-sufficient entrepreneurs no longer dependent on public support. Lessons from international microenterprise programs, federal funding…

Crisaborole Ointment 2%: A Review in Mild to Moderate Atopic Dermatitis.

PubMed

Hoy, Sheridan M

2017-12-01

Crisaborole ointment 2% (Eucrisa™) is a novel, anti-inflammatory inhibitor of phosphodiesterase 4 (PDE4) that is available in the USA for the topical treatment of mild to moderate atopic dermatitis in patients aged ≥ 2 years. In two short-term (28 days), identically designed, multicentre, phase III studies in this patient population, topical therapy with crisaborole ointment 2% reduced disease severity and pruritus severity compared with vehicle, with the effect established early and sustained over the course of treatment. Improvements in the other signs of atopic dermatitis (erythema, exudation, excoriation, induration/papulation, and lichenification) were also seen. Crisaborole ointment 2% was generally well tolerated in the short-term studies, with its favorable safety profile maintained over the longer term (up to 52 weeks) in a multicentre, extension study. Most treatment-emergent adverse events (TEAEs) were of mild to moderate severity and considered unrelated to the study medication. Moreover, the incidence of application-site pain following short- and longer-term topical therapy with crisaborole ointment 2% was low. In conclusion, crisaborole ointment 2% is an effective and generally well tolerated new topical option for the management of mild to moderate atopic dermatitis in patients aged ≥ 2 years, with the potential to effectively treat this patient population over the longer term without the safety concerns associated with other current topical anti-inflammatory agents.

Impact of a Patient Navigator Program on Hospital-Based and Outpatient Utilization Over 180 Days in a Safety-Net Health System.

PubMed

Balaban, Richard B; Zhang, Fang; Vialle-Valentin, Catherine E; Galbraith, Alison A; Burns, Marguerite E; Larochelle, Marc R; Ross-Degnan, Dennis

2017-09-01

With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. Randomized controlled trial conducted October 2011 through April 2013. Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease. The analytic sample included 739 intervention patients, 1182 controls. Through hospital visits and 30 days of post-discharge telephone outreach, PNs provided coaching and assistance with medications, appointments, transportation, communication with primary care, and self-care. Primary outcomes: (1) hospital-based utilization, a composite of ED visits and hospital admissions; (2) hospital admissions; (3) ED visits; and (4) outpatient visits. We evaluated outcomes following an index discharge, stratified by patient age (≥ 60 and < 60 years), using a 180-day time frame divided into six 30-day periods. The PN program produced starkly different outcomes by patient age. Among older PN patients, hospital-based utilization was consistently lower than controls, producing an 18.7% cumulative decrease at 180 days (p = 0.038); outpatient visits increased in the critical first 30-day period (p = 0.006). Among younger PN patients, hospital-based utilization was 31.7% (p = 0.038) higher at 180 days, largely reflecting sharply higher utilization in the initial 30 days (p = 0.002), with non-significant changes thereafter; outpatient visits experienced no significant changes. A PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. Our findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time periods.

A neuromorphic circuit mimicking biological short-term memory.

PubMed

Barzegarjalali, Saeid; Parker, Alice C

2016-08-01

Research shows that the way we remember things for a few seconds is a different mechanism from the way we remember things for a longer time. Short-term memory is based on persistently firing neurons, whereas storing information for a longer time is based on strengthening the synapses or even forming new neural connections. Information about location and appearance of an object is segregated and processed by separate neurons. Furthermore neurons can continue firing using different mechanisms. Here, we have designed a biomimetic neuromorphic circuit that mimics short-term memory by firing neurons, using biological mechanisms to remember location and shape of an object. Our neuromorphic circuit has a hybrid architecture. Neurons are designed with CMOS 45nm technology and synapses are designed with carbon nanotubes (CNT).

78 FR 12116 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... from NASDAQ Rule 2460 (Payment for Market Making). Accordingly, the Commission, pursuant to Section 19...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer Period for... Market Quality Program February 14, 2013. On December 7, 2012, The NASDAQ Stock Market LLC (``Exchange...

Gun control saves lives.

PubMed

Matzopoulos, Richard

2016-05-19

Reducing firearm mortality by means of stricter gun control is one of the most important short- to medium-term measures to address the burden of violence in South Africa, while longer-term interventions and policy measures take effect.

Amitraz

EPA Science Inventory

Amitraz (CAS 33089-61-1) is a formamidine insecticide and acaricide used on crops, livestock, and pets. Neurotoxicity is the primary endpoint of concern for short-term exposures in nontarget species. Amitraz has hepatic, reproductive, and developmental effects with longer-term...

Social support and education groups for single mothers: a randomized controlled trial of a community-based program.

PubMed

Lipman, Ellen L; Boyle, Michael H

2005-12-06

Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting. We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting. Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood (p < 0.01, standardized effect = 0.55) and self-esteem (p < 0.05, standardized effect = 0.29) compared with mothers in the control group; scores for the other 2 measures did not differ between the groups. Growth curve analysis of program effects over the follow-up period showed improvement in all 4 outcomes, with no significant difference between the intervention and control groups. This community-based program of group sessions offering social support and education to low-income single mothers had positive short-term effects on mood and self-esteem but not on social support and parenting. Longer follow-up showed attenuation of these effects.

The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review.

PubMed

Mendelson, Aaron; Kondo, Karli; Damberg, Cheryl; Low, Allison; Motúapuaka, Makalapua; Freeman, Michele; O'Neil, Maya; Relevo, Rose; Kansagara, Devan

2017-03-07

The benefits of pay-for-performance (P4P) programs are uncertain. To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. PubMed from June 2007 to October 2016; MEDLINE, PsycINFO, CINAHL, Business Economics and Theory, Business Source Elite, Scopus, Faculty of 1000, and Gartner Research from June 2007 to February 2016. Trials and observational studies in ambulatory and inpatient settings reporting process-of-care, health, or utilization outcomes. Two investigators extracted data, assessed study quality, and graded the strength of the evidence. Among 69 studies, 58 were in ambulatory settings, 52 reported process-of-care outcomes, and 38 reported patient outcomes. Low-strength evidence suggested that P4P programs in ambulatory settings may improve process-of-care outcomes over the short term (2 to 3 years), whereas data on longer-term effects were limited. Many of the positive studies were conducted in the United Kingdom, where incentives were larger than in the United States. The largest improvements were seen in areas where baseline performance was poor. There was no consistent effect of P4P on intermediate health outcomes (low-strength evidence) and insufficient evidence to characterize any effect on patient health outcomes. In the hospital setting, there was low-strength evidence that P4P had little or no effect on patient health outcomes and a positive effect on reducing hospital readmissions. Few methodologically rigorous studies; heterogeneous population and program characteristics and incentive targets. Pay-for-performance programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting. U.S. Department of Veterans Affairs.

Integration and Evaluation of Substance Abuse Research Education Training (SARET) into a Master of Social Work program.

PubMed

Tuchman, Ellen; Hanley, Kathleen; Naegle, Madeline; More, Frederick; Bereket, Sewit; Gourevitch, Marc N

2017-01-01

The Substance Abuse Research and Education Training (SARET) program is funded by the National Institutes of Drug Abuse in 2006 as a novel approach to spark interest in substance abuse research among medical, dental, nursing, and social work graduate students through a Web-based curriculum and research mentorships. This report presents the initial integration of the intervention in a Master of Social Work (MSW) program, the components of the program, and the mixed-methods evaluation of its effect on students' attitudes towards substance abuse research and treatment. SARET comprises 2 main components: stipend-supported research mentorships and a Web-based module series, consisting of 6 interactive, multimedia modules addressing core SA research topics, delivered via course curricula and in the research mentorships. An initial evaluation was designed to assess SARET's acceptability and short-term impact on participants' interest in SA research. The components of this Web-based curriculum evaluation include focus group feedback on the relevance of the modules to SW students, number of courses into which the modules were integrated with number of module completions, changes in interest in SA research associated with module completion. The full series of Web-based modules has been integrated across several courses in the social work curriculum, and social work students have become integral participants in the summer mentored research experience. One hundred eighteen students completed at least 1 module and 42 students completed all 6 modules. Neurobiology, Screening, and Epidemiology were the most widely viewed modules. Students reported positive impact on their vision of SA-related clinical care, more positive attitudes about conducting research, and in some cases, change in career. The SARET program's modules and summer mentored research increased clinical and research interest related to SUDs, as well as interprofessional attitudes among social work students. Participants have shown some early research success. Longer-term follow-up will enable us to continue to assess the effectiveness of the program.

How much is tuberculosis screening worth? Estimating the value of active case finding for tuberculosis in South Africa, China, and India.

PubMed

Azman, Andrew S; Golub, Jonathan E; Dowdy, David W

2014-10-30

Current approaches are unlikely to achieve the aggressive global tuberculosis (TB) control targets set for 2035 and beyond. Active case finding (ACF) may be an important tool for augmenting existing strategies, but the cost-effectiveness of ACF remains uncertain. Program evaluators can often measure the cost of ACF per TB case detected, but how this accessible measure translates into traditional metrics of cost-effectiveness, such as the cost per disability-adjusted life year (DALY), remains unclear. We constructed dynamic models of TB in India, China, and South Africa to explore the medium-term impact and cost-effectiveness of generic ACF activities, conceptualized separately as discrete (2-year) campaigns and as continuous activities integrated into ongoing TB control programs. Our primary outcome was the cost per DALY, measured in relationship to the cost per TB case actively detected and started on treatment. Discrete campaigns costing up to $1,200 (95% uncertainty range [UR] 850-2,043) per case actively detected and started on treatment in India, $3,800 (95% UR 2,706-6,392) in China, and $9,400 (95% UR 6,957-13,221) in South Africa were all highly cost-effective (cost per DALY averted less than per capita gross domestic product). Prolonged integration was even more effective and cost-effective. Short-term assessments of ACF dramatically underestimated potential longer term gains; for example, an assessment of an ACF program at 2 years might find a non-significant 11% reduction in prevalence, but a 10-year evaluation of that same intervention would show a 33% reduction. ACF can be a powerful and highly cost-effective tool in the fight against TB. Given that short-term assessments may dramatically underestimate medium-term effectiveness, current willingness to pay may be too low. ACF should receive strong consideration as a basic tool for TB control in most high-burden settings, even when it may cost over $1,000 to detect and initiate treatment for each extra case of active TB.

A comparison of isometric, isotonic concentric and isotonic eccentric exercises in the physiotherapy management of subacromial pain syndrome/rotator cuff tendinopathy: study protocol for a pilot randomised controlled trial.

PubMed

Kinsella, Rita; Cowan, Sallie M; Watson, Lyn; Pizzari, Tania

2017-01-01

Subacromial pain syndrome (SPS) involving rotator cuff tendinopathy is a common cause of shoulder pain and disability. Evidence suggests that structured physiotherapy may be as effective as surgery in this condition with significant improvements demonstrated in trials involving scapular retraining, rotator cuff strengthening and flexibility exercises. Most published programs typically utilise isotonic concentric and/or eccentric strengthening modes. Recently, immediate analgesic effects and muscle strength gains following heavy-load isometric exercises in lower limb tendinopathy conditions have been observed. It is pertinent to ascertain whether such outcomes can be replicated in SPS/rotator cuff tendinopathy. The primary aim of this study is to establish the feasibility of undertaking a full-scale randomised controlled trial (RCT) that compares the effects of isometric, isotonic concentric and isotonic eccentric rotator cuff contractions when used as part of a semi-standardised exercise-based physiotherapy program in patients diagnosed with SPS. The secondary aim is to explore potential trends or treatment effects of the exercise intervention. Thirty-six participants diagnosed with SPS will be randomised to one of three intervention groups and undergo a one-on-one exercise-based physiotherapy intervention, involving scapular and rotator cuff muscle retraining and strengthening. Each group will utilise a different mode of rotator cuff strengthening-isometric, isotonic concentric or isotonic eccentric. Rotator cuff tendon responses to isometric loading are not yet established in the literature; hence, individualised, progressive loading will be used in this pilot study in accordance with symptoms. The intervention will involve two phases: during Phase 1 (weeks 1-6) participants undertake the active group-specific physiotherapy treatment; in Phase 2 (weeks 6-12), they undertake a progressive, but no longer group-specific exercise program. To determine feasibility, an evaluation of key study parameters including (a) ease of recruitment (rate and number as well as suitability of the assessment algorithm), (b) adherence to all phases of the exercise intervention including home program compliance and logbook completion, (c) participant non-completion (drop out number and rate) and (d) adverse events (nature and number) will be undertaken. Secondary outcomes will measure immediate effects: (i) within-treatment changes in pain perception (verbal rating scale (VRS) and shoulder muscle strength (hand-held dynamometer) as well as longer-term changes: (ii) shoulder-related symptoms and disability (Western Ontario Rotator Cuff Index (WORC) and Shoulder Pain and Disability Index (SPADI)), (iii) perception of pain (11-point numerical rating scale (NRS), (iv) shoulder muscle strength (hand-held dynamometer) and (v) perceived global rating of change score. The immediate within-treatment assessment of pain and muscle strength will be undertaken in treatments 2 and 3, and the longer term measures will be collected at the primary (conclusion of Phase 1 at 6 weeks) and secondary (conclusion of Phase 2 at 12 weeks) end-points of the study. The findings of this pilot study will permit evaluation of this study design for a full-scale RCT. Australian New Zealand Clinical Trials Registry, ACTRN12616001676404.

Long-Term Effects of a Home-Visiting Intervention for Depressed Mothers and Their Infants

ERIC Educational Resources Information Center

Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; Van Doesum, Karin T. M.; Hoefnagels, Cees

2010-01-01

Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum…

Examining Incentives to Promote Physical Activity Maintenance Among Hospital Employees Not Achieving 10,000 Daily Steps: A Web-Based Randomized Controlled Trial Protocol.

PubMed

Mitchell, Marc; White, Lauren; Oh, Paul; Kwan, Matthew; Gove, Peter; Leahey, Tricia; Faulkner, Guy

2016-12-12

The economic burden of physical inactivity in Canada is estimated at Can $6.8 billion (US $5 billion) per year. Employers bear a substantial proportion of the economic costs, as they pay more for inactive workers in health care and other organizational costs. In response, many Canadian employers offer wellness programs, though these are often underutilized. While financial health incentives have been proposed as one way of increasing participation, their longer term effects (ie postintervention effects) are not clear. The objective of this paper is to outline the methodology for a randomized control trial (RCT) examining the longer term impact of an existing physical activity promotion program that is enhanced by adding guaranteed rewards (Can $1 [US $0.74] per day step goal met) in a lower active hospital employee population (less than 10,000 steps per day). A 12-week, parallel-arm RCT (with a 12-week postintervention follow-up) will be employed. Employees using Change4Life (a fully automated, incentive-based wellness program) and accumulating fewer than 10,000 steps per day at baseline (weeks 1 to 2) will be randomly allocated (1:1) to standard care (wellness program, accelerometer) or an intervention group (standard care plus guaranteed incentives). All study participants will be asked to wear the accelerometer and synchronize it to Change4Life daily, although only intervention group participants will receive guaranteed incentives for reaching tailored daily step count goals (Can $1 [US $0.74] per day; weeks 3 to 12). The primary study outcome will be mean proportion of participant-days step goal reached during the postintervention follow-up period (week 24). Mean proportion of participant-days step goal reached during the intervention period (week 12) will be a secondary outcome. Enrollment for the study will be completed in February 2017. Data analysis will commence in September 2017. Study results are to be published in the winter of 2018. This protocol was designed to examine the impact of guaranteed rewards on physical activity maintenance in lower active hospital employees. ClinicalTrials.gov NCT02638675; https://clinicaltrials.gov/ct2/show/NCT0 2638675 (Archived by WebCite at http://www.webcitation.org/6g4pvZvhW). ©Marc Mitchell, Lauren White, Paul Oh, Matthew Kwan, Peter Gove, Tricia Leahey, Guy Faulkner. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.12.2016.

Effects of red-cell storage duration on patients undergoing cardiac surgery.

PubMed

Steiner, Marie E; Ness, Paul M; Assmann, Susan F; Triulzi, Darrell J; Sloan, Steven R; Delaney, Meghan; Granger, Suzanne; Bennett-Guerrero, Elliott; Blajchman, Morris A; Scavo, Vincent; Carson, Jeffrey L; Levy, Jerrold H; Whitman, Glenn; D'Andrea, Pamela; Pulkrabek, Shelley; Ortel, Thomas L; Bornikova, Larissa; Raife, Thomas; Puca, Kathleen E; Kaufman, Richard M; Nuttall, Gregory A; Young, Pampee P; Youssef, Samuel; Engelman, Richard; Greilich, Philip E; Miles, Ronald; Josephson, Cassandra D; Bracey, Arthur; Cooke, Rhonda; McCullough, Jeffrey; Hunsaker, Robert; Uhl, Lynne; McFarland, Janice G; Park, Yara; Cushing, Melissa M; Klodell, Charles T; Karanam, Ravindra; Roberts, Pamela R; Dyke, Cornelius; Hod, Eldad A; Stowell, Christopher P

2015-04-09

Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable to the adverse effects of transfusion. We conducted a randomized trial at multiple sites from 2010 to 2014. Participants 12 years of age or older who were undergoing complex cardiac surgery and were likely to undergo transfusion of red cells were randomly assigned to receive leukocyte-reduced red cells stored for 10 days or less (shorter-term storage group) or for 21 days or more (longer-term storage group) for all intraoperative and postoperative transfusions. The primary outcome was the change in Multiple Organ Dysfunction Score (MODS; range, 0 to 24, with higher scores indicating more severe organ dysfunction) from the preoperative score to the highest composite score through day 7 or the time of death or discharge. The median storage time of red-cell units provided to the 1098 participants who received red-cell transfusion was 7 days in the shorter-term storage group and 28 days in the longer-term storage group. The mean change in MODS was an increase of 8.5 and 8.7 points, respectively (95% confidence interval for the difference, -0.6 to 0.3; P=0.44). The 7-day mortality was 2.8% in the shorter-term storage group and 2.0% in the longer-term storage group (P=0.43); 28-day mortality was 4.4% and 5.3%, respectively (P=0.57). Adverse events did not differ significantly between groups except that hyperbilirubinemia was more common in the longer-term storage group. The duration of red-cell storage was not associated with significant differences in the change in MODS. We did not find that the transfusion of red cells stored for 10 days or less was superior to the transfusion of red cells stored for 21 days or more among patients 12 years of age or older who were undergoing complex cardiac surgery. (Funded by the National Heart, Lung, and Blood Institute; RECESS ClinicalTrials.gov number, NCT00991341.).

Calciphylaxis: no longer rare; no longer calciphylaxis? A paradigm shift for wound, ostomy and continence nursing.

PubMed

Feeser, Dianne L

2011-01-01

This article challenges conventional wisdom that calciphylaxis is a rare condition. Rather, emerging evidence suggests that calciphylaxis is neither rare nor uncommon. In addition, the term calciphylaxis is questioned because misrepresents the underlying etiology of the condition. Multiple researchers and clinicians advocate abandoning the use of the term, but nursing literature has not yet followed suit. This article reviews the epidemiology, clinical manifestations, diagnosis, prevention, and treatment of this condition and associated wounds, and suggests areas for future research. The WOC nurse's role as an educator, leader, researcher, clinical expert, and patient advocate is summarized.

Prevention of type 2 diabetes through lifestyle modification: is there a role for higher-protein diets?

PubMed

Liu, Amy Y; Silvestre, Marta P; Poppitt, Sally D

2015-11-01

Type 2 diabetes (T2D) incidence is increasing worldwide, driven by a rapidly changing environment and lifestyle and increasing rates of overweight and obesity. Prevention of diabetes is key and is most likely achieved through prevention of weight gain and/or successful long-term weight loss maintenance. Weight loss is readily achievable but there is considerable challenge in maintaining that weight loss over the long term. Lower-fat carbohydrate-based diets are widely used for T2D prevention. This is supported primarily by 3 successful long-term interventions, the US Diabetes Prevention Program, the Finnish Diabetes Prevention Study, and the Chinese Da Qing Study, but evidence is building in support of novel higher-protein (>20% of energy) diets for successful weight loss maintenance and prevention of T2D. Higher-protein diets have the advantage of having relatively low energy density, aiding longer-term appetite suppression, and preserving lean body mass, all central to successful weight loss and prevention of weight regain. Here, we review the carbohydrate-based intervention trials and present mechanistic evidence in support of increased dietary protein for weight loss maintenance and a possible novel role in prevention of dysglycemia and T2D. © 2015 American Society for Nutrition.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

PubMed

Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

2014-11-01

In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Recovering Radioactive Materials with OSRP team

ScienceCinema

None

2017-12-09

The National Nuclear Security Administration sponsors a program, executed by Los Alamos National Laboratory, to recover radioisotopes used by industry and academia and no longer needed. Called the "Offsite Source Recovery Program (OSRP), it has recovered

34 CFR 674.17 - Federal interest in allocated funds-transfer of Fund.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM General... for a Federal Perkins Loan fund closes or no longer wants to participate in the program, the Secretary...

34 CFR 674.17 - Federal interest in allocated funds-transfer of Fund.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM General... for a Federal Perkins Loan fund closes or no longer wants to participate in the program, the Secretary...

Modelling the effects of booster dose vaccination schedules and recommendations for public health immunization programs: the case of Haemophilus influenzae serotype b.

PubMed

Charania, Nadia A; Moghadas, Seyed M

2017-09-13

Haemophilus influenzae serotype b (Hib) has yet to be eliminated despite the implementation of routine infant immunization programs. There is no consensus regarding the number of primary vaccine doses and an optimal schedule for the booster dose. We sought to evaluate the effect of a booster dose after receiving the primary series on the long-term disease incidence. A stochastic model of Hib transmission dynamics was constructed to compare the long-term impact of a booster vaccination and different booster schedules after receiving the primary series on the incidence of carriage and symptomatic disease. We parameterized the model with available estimates for the efficacy of Hib conjugate vaccine and durations of both vaccine-induced and naturally acquired immunity. We found that administering a booster dose substantially reduced the population burden of Hib disease compared to the scenario of only receiving the primary series. Comparing the schedules, the incidence of carriage for a 2-year delay (on average) in booster vaccination was comparable or lower than that observed for the scenario of booster dose within 1 year after primary series. The temporal reduction of symptomatic disease was similar in the two booster schedules, suggesting no superiority of one schedule over the other in terms of reducing the incidence of symptomatic disease. The findings underscore the importance of a booster vaccination for continued decline of Hib incidence. When the primary series provides a high level of protection temporarily, delaying the booster dose (still within the average duration of protection conferred by the primary series) may be beneficial to maintain longer-term protection levels and decelerate the decline of herd immunity in the population.

Assessment of diurnal systemic dose of agrochemicals in regulatory toxicity testing--an integrated approach without additional animal use.

PubMed

Saghir, Shakil A; Bartels, Michael J; Rick, David L; McCoy, Alene T; Rasoulpour, Reza J; Ellis-Hutchings, Robert G; Sue Marty, M; Terry, Claire; Bailey, Jason P; Billington, Richard; Bus, James S

2012-07-01

Integrated toxicokinetics (TK) data provide information on the rate, extent and duration of systemic exposure across doses, species, strains, gender, and life stages within a toxicology program. While routine for pharmaceuticals, TK assessments of non-pharmaceuticals are still relatively rare, and have never before been included in a full range of guideline studies for a new agrochemical. In order to better understand the relationship between diurnal systemic dose (AUC(24h)) and toxicity of agrochemicals, TK analyses in the study animals is now included in all short- (excluding acute), medium- and long-term guideline mammalian toxicity studies including reproduction/developmental tests. This paper describes a detailed procedure for the implementation of TK in short-, medium- and long-term regulatory toxicity studies, without the use of satellite animals, conducted on three agrochemicals (X11422208, 2,4-D and X574175). In these studies, kinetically-derived maximum doses (KMD) from short-term studies instead of, or along with, maximum tolerated doses (MTD) were used for the selection of the high dose in subsequent longer-term studies. In addition to leveraging TK data to guide dose level selection, the integrated program was also used to select the most appropriate method of oral administration (i.e., gavage versus dietary) of test materials for rat and rabbit developmental toxicity studies. The integrated TK data obtained across toxicity studies (without the use of additional/satellite animals) provided data critical to understanding differences in response across doses, species, strains, sexes, and life stages. Such data should also be useful in mode of action studies and to improve human risk assessments. Copyright © 2012 Elsevier Inc. All rights reserved.

Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

PubMed Central

Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

2016-01-01

ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

Proceedings of the sixth annual conference on fossil energy materials

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

Cole, N.C.; Judkins, R.R.

1992-07-01

The Sixth Annual Conference on Fossil Energy Materials was held in Oak Ridge, Tennessee, on May 12--14, 1992. The meeting was sponsored by the US Department of Energy's Office of Fossil Energy through the Advanced Research and Technology Development (AR TD) Materials Program, and ASM International. The objective of the AR TD Materials Program is to conduct research and development on materials for longer-term fossil energy applications as well as for generic needs of various fossil fuel technologies. The management of the Program has been decentralized to the DOE Field Office, Oak Ridge with Oak Ridge National Laboratory (ORNL) asmore » the technical support contractor. The research is performed by staff members at ORNL and by a substantial number of researchers at other national laboratories, universities, and in private industry. The work is divided into the following categories: (1) ceramics, (2) development and corrosion resistance of iron aluminide, advanced austenitic and chromium-niobium alloys, and (3) technology assessment and technology transfer. This conference is held each year to review the work on all of the projects of the Program. The agenda for the meeting is given in Appendix A, and a list of attendees is presented in Appendix B. ASM International cosponsored the conference, for which we are especially grateful.« less

G-REALM: A lake/reservoir monitoring tool for drought monitoring and water resources management.

NASA Astrophysics Data System (ADS)

Birkett, C. M.; Ricko, M.; Beckley, B. D.; Yang, X.; Tetrault, R. L.

2017-12-01

G-REALM is a NASA/USDA funded operational program offering water-level products for lakes and reservoirs and these are currently derived from the NASA/CNES Topex/Jason series of satellite radar altimeters. The main stakeholder is the USDA/Foreign Agricultural Service (FAS) though many other end-users utilize the products for a variety of interdisciplinary science and operational programs. The FAS utilize the products within their CropExplorer Decision Support System (DSS) to help assess irrigation potential, and to monitor both short-term (agricultural) and longer-term (hydrological) drought conditions. There is increasing demand for a more global monitoring service that in particular, captures the variations in the smallest (1 to 100km2) reservoirs and water holdings in arid and semi-arid regions. Here, water resources are critical to both agriculture and regional security. A recent G-REALM 10-day resolution product upgrade and expansion has allowed for more accurate lake level products to be released and for a greater number of water bodies to be monitored. The next program phase focuses on the exploration of the enhanced radar altimeter data sets from the Cryosat-2 and Sentinel-3 missions with their improved spatial resolution, and the expansion of the system to the monitoring of 1,000 water bodies across the globe. In addition, a new element, the monitoring of surface water levels in wetland zones, is also being introduced. This aims to satisfy research and stakeholder requirements with respect to programs examining the links between inland fisheries catch potential and declining water levels, and to those monitoring the delicate balance between water resources, agriculture, and fisheries management in arid basins.

Short-term vegetation response following mechanical control of saltcedar (Tamarix spp.) on the Virgin River, Nevada, USA

USGS Publications Warehouse

Ostoja, Steven M.; Brooks, Matthew L.; Dudley, Tom; Lee, Steven R.

2014-01-01

and species diversity were very low, suggesting that targets of restoring vegetation to pre-invasion conditions were not met. Longer evaluation periods are needed to adequately evaluate how short-term post-treatment patterns translate to long-term patterns of plant community dynamics.

Young driver education programs that build resilience have potential to reduce road crashes.

PubMed

Senserrick, Teresa; Ivers, Rebecca; Boufous, Soufiane; Chen, Huei-Yang; Norton, Robyn; Stevenson, Mark; van Beurden, Eric; Zask, Avigdor

2009-11-01

The research aimed to explore associations between participation in 2 education programs for school-based learner drivers and subsequent road traffic offenses and crashes among a large cohort of newly licensed drivers. DRIVE is a prospective cohort study of 20822 first-year drivers aged 17 to 24 in New South Wales (NSW), Australia. Participants completed a detailed questionnaire and consented to data linkage in 2003-2004. Questionnaire items included year of participation in 2 specific education programs: a 1-day workshop-only program focusing on driving risks ("driver-focused") and a whole-of-community program also including a 1-day workshop but also longer term follow-up activities and a broader focus on reducing risk-taking and building resilience ("resilience-focused"). Survey data were subsequently linked to police-reported crash and offense data for 1996-2005. Poisson regression models that adjusted for multiple confounders were created to explore offenses and crashes as a driver (dichotomized as 0 vs >or=1) after program participation. Offenses did not differ between groups; however, whereas the driver-focused program was not associated with reduced crash risk, the resilience-focused program was associated with a 44% reduced relative risk for crash (0.56 [95% confidence interval: 0.34-0.93]). The large effect size observed and complementary findings from a comparable randomized, controlled trial in the United States suggest programs that focus more generally on reducing risks and building resilience have the potential to reduce crashes. A large, representative, randomized, controlled trial is urgently needed to confirm road safety benefits and ensure evidence-based spending and practitioner recommendations in this field.

Follow-up study for a disease management program for chronic heart failure 24 months after program commencement.

PubMed

Otsu, Haruka; Moriyama, Michiko

2012-12-01

There are few studies dealing with comprehensive chronic heart failure (CHF) disease management programs, which are based on self-management, in Japan. We developed and conducted a comprehensive educational program for CHF for 6 months that aimed to improve self-management and prevent the deterioration of outpatients with CHF. Our follow-up research focused on whether performance of self-management in the intervention group continued for 24 months after commencement. Participants were selected from patients who went for follow-up visits to one Japanese clinic, which specialized in cardiovascular internal medicine, that were diagnosed with CHF. During the first follow-up period, 7 to 12 months after program commencement, 47 participants in the intervention group and 47 participants in the control group were analyzed. During the second follow-up period, 13 to 24 months after program commencement, 41 participants in the intervention group were analyzed. Participants in the intervention group acquired self-management skills and activities and these continued up to 24 months after the program commencement. As a result, no deterioration in symptoms related to CHF was demonstrated. Meanwhile, quitting smoking and drinking depended on individual preference and it was difficult to improve. The educational program was effective in the long term and the program is significant for use in busy medical situations that do not offer sufficient follow-up support for patients. Regular intervention and ways that produce longer-lasting effects should be further developed. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

Transitional Class Program, 1979-80. OEE Evaluation Report.

ERIC Educational Resources Information Center

Opperman, Prudence Ward; And Others

This evaluation report describes the implementation and results of the 1979-80 Transitional Class Program. Although the program no longer exists as a centrally-coordinated effort, it serves as a final summary of the program's two years of operation by comparing the results from one year (1978-1979) to the next (1979-1980), and provides guidance to…

Retention of movement pattern changes after a lower extremity injury prevention program is affected by program duration.

PubMed

Padua, Darin A; DiStefano, Lindsay J; Marshall, Stephen W; Beutler, Anthony I; de la Motte, Sarah J; DiStefano, Michael J

2012-02-01

Changes in movement patterns have been repeatedly observed immediately after completing a lower extremity injury prevention program. However, it is not known if movement pattern changes are maintained after discontinuing the training program. The ability to maintain movement pattern changes after training has ceased may be influenced by the program's duration. The authors hypothesized that among individuals who completed either a 3-month or 9-month training program and who demonstrated immediate movement pattern changes, only those who completed the 9-month training program would maintain movement pattern changes after a 3-month period of no longer performing the exercises. Cohort study; Level of evidence, 2. A total of 140 youth soccer athletes from 15 separate teams volunteered to participate. Athletes' movement patterns were assessed using the Landing Error Scoring System (LESS) at pretest, posttest, and 3 months after ceasing the program (retention test). Eighty-four of the original 140 participants demonstrated improvements in their LESS scores between pretest and posttest (change in LESS score >0) and were included in the final analyses for this study (n = 84; 20 boys and 64 girls; mean age, 14 ± 2 years; age range, 11-17 years). Teams performed 3-month (short-duration group) and 9-month (extended-duration group) injury prevention programs. The exercises performed were identical for both groups. Teams performed the programs as part of their normal warm-up routine. Although both groups improved their total LESS scores from pretest to posttest, only the extended-duration training group retained their improvements 3 months after ceasing the injury prevention program (F(2,137) = 3.38; P = .04). Results suggest that training duration may be an important factor to consider when designing injury prevention programs that facilitate long-term changes in movement control.

Vermont's Program of Individualized Driver Education for the Handicapped.

ERIC Educational Resources Information Center

Vermont State Dept. of Education, Montpelier.

Described is Vermont's program of individualized driver education for handicapped secondary students 15 years or older and for disabled adults no longer in school. Sections outline the following program components: three R's of driver's education (responsibilities of the schools, regulations of motor vehicles, and rights of the handicapped…

34 CFR 668.32 - Student eligibility-general.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Direct Loan programs, is enrolled for no longer than one twelve-month period in a course of study... student enrolled in a post-baccalaureate program, has not completed the requirements for a first baccalaureate degree; or (ii) For the purposes of a student in a first post-baccalaureate program, has not...

34 CFR 668.32 - Student eligibility-general.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Direct Loan programs, is enrolled for no longer than one twelve-month period in a course of study... student enrolled in a post-baccalaureate program, has not completed the requirements for a first baccalaureate degree; or (ii) For the purposes of a student in a first post-baccalaureate program, has not...

34 CFR 668.32 - Student eligibility-general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Direct Loan programs, is enrolled for no longer than one twelve-month period in a course of study... student enrolled in a post-baccalaureate program, has not completed the requirements for a first baccalaureate degree; or (ii) For the purposes of a student in a first post-baccalaureate program, has not...

34 CFR 668.32 - Student eligibility-general.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Direct Loan programs, is enrolled for no longer than one twelve-month period in a course of study... student enrolled in a post-baccalaureate program, has not completed the requirements for a first baccalaureate degree; or (ii) For the purposes of a student in a first post-baccalaureate program, has not...

34 CFR 668.32 - Student eligibility-general.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Direct Loan programs, is enrolled for no longer than one twelve-month period in a course of study... student enrolled in a post-baccalaureate program, has not completed the requirements for a first baccalaureate degree; or (ii) For the purposes of a student in a first post-baccalaureate program, has not...

5 CFR 412.401 - Continuing executive development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 412.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Executive Development § 412.401 Continuing executive... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial...

5 CFR 412.401 - Continuing executive development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial improvement, and organizational results; (2) Address enhancement of existing executive competencies and such other competencies as will strengthen the executive's performance; (3) Outline developmental...

Learning and the Spiral Illusion

ERIC Educational Resources Information Center

Houtman, S. D.

1974-01-01

The purpose of the experiment was to ascertain whether the duration of the spiral illusion could be extended by a 'learning procedure' which would distinguish a longer-term learning effect from short-term adaptive changes due to inhibition. (Author)

Is There a Delay in Diagnosis of Duchenne Muscular Dystrophy Among Preterm-Born Males?

PubMed

Soim, Aida; Smith, Michael G; Kwon, Jennifer M; Mann, Joshua R; Thomas, Shiny; Ciafaloni, Emma

2018-07-01

The objective of this study was to investigate whether males who were born preterm took longer to receive a Duchenne muscular dystrophy diagnosis than term males. Data for males with Duchenne muscular dystrophy identified through a population-based surveillance system were analyzed using a Kaplan-Meier estimator. The first signs and symptoms were noted at a median age of 2 years in both groups. Median age when first signs and symptoms prompted medical evaluation was 2.59 years among preterm and 4.01 years among term males. Median age at definitive diagnosis was 4.25 years and 4.92 years for preterm and term males, respectively. Neither difference was statistically significant. Preterm males tended to be seen for their initial medical evaluation earlier than term males, though they were not diagnosed significantly earlier. It may take clinicians longer after the initial evaluation of preterm males to arrive at a Duchenne muscular dystrophy diagnosis.

Proceedings of the sixth annual conference on fossil energy materials. Fossil Energy AR and TD Mateials Program

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

Cole, N.C.; Judkins, R.R.

1992-07-01

The Sixth Annual Conference on Fossil Energy Materials was held in Oak Ridge, Tennessee, on May 12--14, 1992. The meeting was sponsored by the US Department of Energy`s Office of Fossil Energy through the Advanced Research and Technology Development (AR&TD) Materials Program, and ASM International. The objective of the AR&TD Materials Program is to conduct research and development on materials for longer-term fossil energy applications as well as for generic needs of various fossil fuel technologies. The management of the Program has been decentralized to the DOE Field Office, Oak Ridge with Oak Ridge National Laboratory (ORNL) as the technicalmore » support contractor. The research is performed by staff members at ORNL and by a substantial number of researchers at other national laboratories, universities, and in private industry. The work is divided into the following categories: (1) ceramics, (2) development and corrosion resistance of iron aluminide, advanced austenitic and chromium-niobium alloys, and (3) technology assessment and technology transfer. This conference is held each year to review the work on all of the projects of the Program. The agenda for the meeting is given in Appendix A, and a list of attendees is presented in Appendix B. ASM International cosponsored the conference, for which we are especially grateful.« less

Publications of the Fossil Energy Advanced Research and Technology Development Materials Program: April 1, 1993--March 31, 1995

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

Carlson, P.T.

1995-04-01

The objective of the Fossil Energy Advanced Research and Technology Development (AR and TD) Materials Program is to conduct research and development on materials for fossil energy applications, with a focus on the longer-term needs for materials with general applicability to the various fossil fuel technologies. The Program includes research aimed at a better understanding of materials behavior in fossil energy environments and on the development of new materials capable of substantial improvement in plant operations and reliability. The scope of the Program addresses materials requirements for all fossil energy systems, including materials for coal preparation, coal liquefaction, coal gasification,more » heat engines and heat recovery, combustion systems, and fuel cells. Work on the Program is conducted at national and government laboratories, universities, and industrial research facilities. This bibliography covers the period of April 1, 1993, through March 31, 1995, and is a supplement to previous bibliographies in this series. It is the intent of this series of bibliographies to list only those publications that can be conveniently obtained by a researcher through relatively normal channels. The publications listed in this document have been limited to topical reports, open literature publications in refereed journals, full-length papers in published proceedings of conferences, full-length papers in unrefereed journals, and books and book articles. 159 refs.« less

Using an Accountability Program to Improve Psychiatry Resident Scores on In-Service Examinations.

PubMed

Ferrell, Brandon T; Tankersley, William E; Morris, Clayton D

2015-12-01

The Psychiatry Resident-In-Training Examination (PRITE) is a standardized examination that measures residents' educational progress during residency training. It also serves as a moderate-to-strong predictor of later performance on the board certification examination. This study evaluated the effectiveness of an accountability program used by a public psychiatric hospital to increase its residents' PRITE scores. A series of consequences and incentives were developed based on levels of PRITE performance. Poor performance resulted in consequences, including additional academic assignments. Higher performance led to residents earning external moonlighting privileges. Standardized PRITE scores for all residents (N = 67) over a 10-year period were collected and analyzed. The PRITE examination consists of 2 subscales-psychiatry and neurology. Change in the overall level of PRITE scores following the implementation of the accountability program was estimated using a discontinuous growth curve model for each subscale. Standardized scores on the psychiatry subscale were 51.09 points, approximately 0.50 SD change, which was higher after the accountability program was implemented. Standardized scores on the neurology subscale did not change. An accountability program that assigns consequences based on examination performance may be moderately successful in improving scores on the psychiatry subscale scores of the PRITE. This likely has longer-term benefits for residents due to the relationship between PRITE and board certification examination performance.

Whatever Became of the Learning City?

ERIC Educational Resources Information Center

Yarnit, Martin

2015-01-01

During the 1990s, the UK Learning City Network was a large and influential movement with government support, the most significant national body of its kind anywhere. Yet, less than a decade later, it was in decline and now no longer exists. But while few UK towns or cities any longer use the term "learning city", the notion lives on as…

The challenges and benefits of lunar exploration

NASA Technical Reports Server (NTRS)

Cohen, Aaron

1992-01-01

Three decades into the Space Age, the United States is experiencing a fundamental shift in space policy with the adoption of a broad national goal to expand human presence and activity beyond Earth orbit and out into the Solar System. These plans mark a turning point in American space exploration, for they entail a shift away from singular forays to a long-term, evolutionary program of exploration and utilization of space. No longer limited to the technical and operational specifics of any one vehicle or any one mission plan, this new approach will involve a fleet of spacecraft and a stable of off-planet research laboratories, industrial facilities, and exploration programs. The challenges inherent in this program are immense, but so too are the benefits. Central to this new space architecture is the concept of using a lunar base for in-situ resource utilization, and for the development of planetary surface exploration systems, applicable to the Moon, Mars, and other planetary bodies in the Solar System. This paper discusses the technical, economic, and political challenges involved in this new approach, and details the latest thinking on the benefits that could come from bold new endeavors on the final frontier.

Scientific Data Stewardship in the 21'st Century

NASA Astrophysics Data System (ADS)

Mabie, J. J.; Redmon, R.; Bullett, T.; Kihn, E. A.; Conkright, R.; Manley, J.; Horan, K.

2008-12-01

The Ionosonde Program at the National Geophysical Data Center (NGDC) serves as a case study for how to approach data stewardship in the 21'st century. As the number and sophistication of scientific instruments increase, along with the volumes and complexity of data that need to be preserved for future generations, the old approach of simply storing data in a library, physical or electronic, is no longer sufficient to ensure the long term preservation of our important environmental data. To ensure the data can be accessed, understood, and used by future generations, the data stewards must be familiar with the observation process before the data reach the archive and the scientific applications to which the data may be called to serve. This familiarity is best obtained by active participation. In the NGDC Ionosonde Program team, we strive to have activity and expertise in ionosonde field operations and scientific data analysis in addition to our core mission of preservation and distribution of data and metadata. We believe this approach produces superior data quality, proper documentation and evaluation tools for data customers as part of the archive process. We are presenting the Ionosonde Program as an example of modern scientific data stewardship.

Entertainment-education radio serial drama and outcomes related to HIV testing in Botswana.

PubMed

Pappas-DeLuca, Katina A; Kraft, Joan Marie; Galavotti, Christine; Warner, Lee; Mooki, Maungo; Hastings, Phil; Koppenhaver, Todd; Roels, Thierry H; Kilmarx, Peter H

2008-12-01

Makgabaneng is an entertainment-education radio serial drama written and produced in Botswana to promote prevention of HIV. This effort is part of the national response to HIV/AIDS. Broadcast of the serial drama began in August 2001, and two new 15-minute episodes air each week. We examined associations between exposure to Makgabaneng and outcomes related to HIV testing, including stigmatizing attitudes, intention to be tested, talking with a partner about testing, and testing for HIV, among 555 sexually active respondents. The four measures of exposure to Makgabaneng were frequency of listening, duration of listening, talking about the program, and attentiveness to and identification with relevant characters. Data were collected approximately 18 months after the drama began airing. We found positive associations between exposure to the program and intermediate outcomes, including lower level of stigmatizing attitudes, stronger intention to have HIV testing, and talking to a partner about testing. Although associations were identified with all four measures of exposure, increased duration of listening was associated with more positive outcomes than the other measures. This finding suggests that longer term exposure to entertainment-education programming may be important for behavior change.

Comparison of Postural Recovery Following Short and Long Duration Spaceflights

NASA Technical Reports Server (NTRS)

Wood, S. J.; Fiedler, J.; Taylor, L. C.; Kozlovskaya, I.; Black, F. O.; Paloski, W. H.

2010-01-01

INTRODUCTION: Post-flight postural ataxia reflects adaptive changes to vestibulo-spinal reflexes and control strategies adopted for movement in weightlessness. Quantitative measures obtained during computerized dynamic posturography (CDP) from US and Russian programs provide insight into the effect of spaceflight duration in terms of both the initial decrements and recovery of postural stability. METHODS: CDP was obtained on 117 crewmembers following Shuttle flights lasting 4-17 days, and on 64 crewmembers following long-duration missions lasting 48-380 days. Although the number and timing of sessions varied, the goal was to characterize postural recovery pooling similar measures from different research and flight medicine programs. This report focuses on eyes closed, head erect conditions with either a fixed or sway-referenced base of support. A smaller subset of subjects repeated the sway-referenced condition while making pitch head movements (+/- 20deg at 0.33Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Fall probability was modeled using Bayesian statistical methods to estimate parameters of a logit function. RESULTS: The standard Romberg condition was the least sensitive. Longer duration flights led to larger decrements in stability with sway-reference support during the first 1-2 days, although the timecourse of recovery was similar across flight duration with head erect. Head movements led to increased incidence of falls during the first week, with a significantly longer recovery following long duration flights. CONCLUSIONS: The diagnostic assessment of postural instability, and differences in the timecourse of postural recovery between short and long flight durations, are more pronounced during unstable support conditions requiring active head movements.

What Disorders Are Newborns Screened for in the United States?

MedlinePlus

... of newborn screening successes? Many conditions included in today's U.S. newborn screening programs no longer cause serious ... and developmental disabilities (IDD) in the United States. Today, as a result of newborn screening programs that ...

Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function.

PubMed

Sherr, Jennifer; Tamborlane, William V; Xing, Dongyuan; Tsalikian, Eva; Mauras, Nelly; Buckingham, Bruce; White, Neil H; Arbelaez, Ana Maria; Beck, Roy W; Kollman, Craig; Ruedy, Katrina

2012-04-01

To determine exposure to hyper- and hypoglycemia using blinded continuous glucose monitoring (CGM) profiles in youth with type 1 diabetes (T1D) with residual β-cell function during the first year of insulin treatment. Blinded, 3-7 day CGM profiles were obtained in 16 short-term T1D patients (age 8-18 years, T1D duration 6-52 weeks) who had peak C-peptide levels ranging from 0.46 to 1.96 nmol/L during a mixed-meal tolerance test. Results in this short-term group were compared with those in 34 patients with well-controlled, longer-term T1D (duration ≥5 years), matched for age and A1C with the short-term T1D group, and with those in 26 age-matched nondiabetic individuals. Despite matching for A1C, and therefore similar mean sensor glucose levels in the two T1D groups, short-term T1D participants had a lower frequency of hypoglycemia (0.3 vs. 7.6%, P < 0.001), a trend toward less hyperglycemia (17 vs. 32%, P = 0.15), and a greater percentage in the target range (median 77 vs. 60%, P = 0.02). Indeed, the percentage of sensor glucose levels ≤70 mg/dL in the short-term T1D group (0.3%) did not differ from those in the nondiabetic group (1.7%, P = 0.73). The coefficient of variation of sensor glucose levels (an index of glucose variability) was lower in short-term vs. longer-term T1D participants (27 vs. 42%, respectively, P < 0.001). In youth with short-term T1D who retain residual β-cell function, there is negligible exposure to hypoglycemia and lower glucose variability than in youth with well-controlled T1D of longer duration.

42 CFR 424.535 - Revocation of enrollment and billing privileges in the Medicare program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... application applicable for its provider or supplier type, and has not submitted a plan of corrective action as... supplier is no longer operational to furnish Medicare covered items or services, or is not meeting Medicare... A provider is no longer operational to furnish Medicare covered items or services, or the provider...

Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

PubMed

Forster, Anne; Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

2015-08-01

We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. © 2015 Bradford Teaching Hospitals NHS Foundation Trust.

Breast feeding and child behaviour in the Millennium Cohort Study.

PubMed

Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A

2011-07-01

To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.

A Systematic Review and Meta-Analysis of Yoga and Mindfulness Meditation in Prison.

PubMed

Auty, Katherine M; Cope, Aiden; Liebling, Alison

2017-05-01

This article presents results from a systematic review and two meta-analyses that examine whether prison yoga and meditation programs are significantly related to increased psychological well-being and improvements in the behavioural functioning of prisoners. Comprehensive searches of the empirical literature were conducted up to December 2014. Participants who completed yoga or meditation program in prison experienced a small increase in their psychological well-being (Cohen's d = 0.46, 95% confidence interval [CI] = [0.39, 0.54]) and a small improvement in their behavioural functioning (Cohen's d = 0.30, 95% CI = [0.20, 0.40]). Moderator analyses suggested that there was a significant difference in effect sizes for programs of longer duration and less intensity, compared with those that were shorter and more intensive, for psychological well-being. Programs of longer duration had a slightly larger positive effect on behavioural functioning ( d = 0.424), compared with more intensive programs ( d = 0.418). Overall, the evidence suggests that yoga and meditation have favourable effects on prisoners.

Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review

PubMed Central

Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan

2015-01-01

Background Evaluation of treatments for attention-deficit/hyperactivity disorder (ADHD) previously focused on symptom control, but attention has shifted to functional outcomes. The effect of different ADHD treatment periods and modalities (pharmacological, non-pharmacological, and combination) on long-term outcomes needs to be more comprehensively understood. Methods A systematic search of 12 literature databases using Cochrane’s guidelines yielded 403 English-language peer-reviewed, primary studies reporting long-term outcomes (≥2 years). We evaluated relative effects of treatment modalities and durations and effect sizes of outcomes reported as statistically significantly improved with treatment. Results The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. A majority of outcomes improved regardless of age of treatment initiation (60%–75%) or treatment duration (62%–72%). Studies with short treatment duration had shorter follow-up times (mean 3.2 years total study length) than those with longer treatment durations (mean 7.1 years total study length). Studies with follow-up times <3 years reported benefit with treatment for 93% of outcomes, whereas those with follow-up times ≥3 years reported treatment benefit for 57% of outcomes. Post-hoc analysis indicated that this result was related to the measurement of outcomes at longer periods (3.2 versus 0.4 years) after treatment cessation in studies with longer total study length. Conclusions While the majority of long-term outcomes of ADHD improve with all treatment modalities, the combination of pharmacological and non-pharmacological treatment was most consistently associated with improved long-term outcomes and large effect sizes. Older treatment initiation age or longer durations did not markedly affect proportion of improved outcomes reported, but measurement of outcomes long periods after treatment cessation may attenuate results. PMID:25714373

Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.

PubMed

Greenhalgh, Trisha; Clinch, Megan; Afsar, Nur; Choudhury, Yasmin; Sudra, Rita; Campbell-Richards, Desirée; Claydon, Anne; Hitman, Graham A; Hanson, Philippa; Finer, Sarah

2015-05-21

Diabetes in pregnancy is common in South Asians, especially those from low-income backgrounds, and leads to short-term morbidity and longer-term metabolic programming in mother and offspring. We sought to understand the multiple influences on behaviour (hence risks to metabolic health) of South Asian mothers and their unborn child, theorise how these influences interact and build over time, and inform the design of culturally congruent, multi-level interventions. Our sample for this qualitative study was 45 women of Bangladeshi, Indian, Sri Lankan, or Pakistani origin aged 21-45 years with a history of diabetes in pregnancy, recruited from diabetes and antenatal services in two deprived London boroughs. Overall, 17 women shared their experiences of diabetes, pregnancy, and health services in group discussions and 28 women gave individual narrative interviews, facilitated by multilingual researchers, audiotaped, translated, and transcribed. Data were analysed using the constant comparative method, drawing on sociological and narrative theories. Key storylines (over-arching narratives) recurred across all ethnic groups studied. Short-term storylines depicted the experience of diabetic pregnancy as stressful, difficult to control, and associated with negative symptoms, especially tiredness. Taking exercise and restricting diet often worsened these symptoms and conflicted with advice from relatives and peers. Many women believed that exercise in pregnancy would damage the fetus and drain the mother's strength, and that eating would be strength-giving for mother and fetus. These short-term storylines were nested within medium-term storylines about family life, especially the cultural, practical, and material constraints of the traditional South Asian wife and mother role and past experiences of illness and healthcare, and within longer-term storylines about genetic, cultural, and material heritage - including migration, acculturation, and family memories of food insecurity. While peer advice was familiar, meaningful, and morally resonant, health education advice from clinicians was usually unfamiliar and devoid of cultural meaning. 'Behaviour change' interventions aimed at preventing and managing diabetes in South Asian women before and during pregnancy are likely to be ineffective if delivered in a socio-cultural vacuum. Individual education should be supplemented with community-level interventions to address the socio-material constraints and cultural frames within which behavioural 'choices' are made.

Breaking down the communication barrier.

PubMed

Hawkins, R A

1991-01-01

Dr. Hawkins addresses the problem of how QA managers can best persuade physicians of the importance of QA programs. Since communication is the basis of educating clinicians, the author analyzes the diametrically opposite perspectives of QA managers and physicians even as they pursue the common goal of quality healthcare. While doctors are primarily loyal to patients and peers with an immediate care focus, process-oriented QA managers emphasize the institution and its longer-term goals. To overcome physician resistance to change, Dr. Hawkins offers an adult learner model that stresses understanding the medical staff's viewpoint, negotiation and respect. Physicians are enthusiastic about QA when it helps solve "the endemic daily system problems." The author concludes by recommending that QA managers join physicians on their clinical rounds to bridge the gap between their different approaches.

Building a balanced scorecard for a burn center.

PubMed

Wachtel, T L; Hartford, C E; Hughes, J A

1999-08-01

The Balanced Scorecard provides a model that can be adapted to the management of any burn center, burn service or burn program. This model enables an organization to translate its mission and vision into specific strategic objectives across the four perspective: (1) the financial perspective; (2) the customer service perspective; (3) the internal business perspective; and (4) the growth and learning perspective. Once the appropriate objectives are identified, the Balanced Scorecard guides the organization to develop reasonable performance measures and establishes targets, initiatives and alternatives to meet programmatic goals and pursue longer-term visionary improvements. We used the burn center at the University of Colorado Health Sciences Center to test whether the Balanced Scorecard methodology was appropriate for the core business plan of a healthcare strategic business unit (i.e. a burn center).

The Economic Lives of People with Disabilities in Vietnam

PubMed Central

Palmer, Michael; Groce, Nora; Mont, Daniel; Nguyen, Oanh Hong; Mitra, Sophie

2015-01-01

Through a series of focus group discussions conducted in northern and central Vietnam, this study gives voice to the lived economic experience of families with disabilities and how they manage the economic challenges associated with disability. The dynamic of low and unstable income combined with on-going health care and other disability-related costs gives rise to a range of coping mechanisms (borrowing, reducing and foregoing expenditures, drawing upon savings and substituting labour) that helps to maintain living standards in the short-run yet threatens the longer-term welfare of both the individual with disability and their household. Current social protection programs were reported as not accessible to all and while addressing some immediate economic costs of disability, do not successfully meet current needs nor accommodate wider barriers to availing benefits. PMID:26197034

GOES-S NASA Social

NASA Image and Video Library

2018-02-28

Mic Woltman, chief of the Fleet Systems Integration Branch of NASA's Launch Services Program, left, and Gabriel Rodriguez-Mena, a United Launch Alliance systems test engineer, speak to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on the National Oceanic and Atmospheric Administration's, or NOAA's, Geostationary Operational Environmental Satellite, or GOES-S. The spacecraft is the second satellite in a series of next-generation NOAA weather satellites. It will launch to a geostationary position over the U.S. to provide images of storms and help predict weather forecasts, severe weather outlooks, watches, warnings, lightning conditions and longer-term forecasting. GOES-S is slated to lift off at 5:02 p.m. EST on March 1, 2018 aboard a United Launch Alliance Atlas V rocket.

Dose-time relationships for post-irradiation cutaneous telangiectasia

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

Cohen, L.; Ubaldi, S.E.

1977-01-01

Seventy-five patients who had received electron beam radiation a year or more previously were studied. The irradiated skin portals were photographed and late reactions graded in terms of the number and severity of telangiectatic lesions observed. The skin dose, number of fractions, overall treatment time and irradiated volume were recorded in each case. A Strandqvist-type iso-effect line was derived for this response. A multi-probit search program also was used to derive best-fitting cell population kinetic parameters for the same data. From these parameters a comprehensive iso-effect table could be computed for a wide range of treatment schedules including daily treatmentmore » as well as fractionation at shorter and longer intervals; this provided a useful set of normal tissue tolerance limits for late effects.« less

The Improvement Cycle: Analyzing Our Experience

NASA Technical Reports Server (NTRS)

Pajerski, Rose; Waligora, Sharon

1996-01-01

NASA's Software Engineering Laboratory (SEL), one of the earliest pioneers in the areas of software process improvement and measurement, has had a significant impact on the software business at NASA Goddard. At the heart of the SEL's improvement program is a belief that software products can be improved by optimizing the software engineering process used to develop them and a long-term improvement strategy that facilitates small incremental improvements that accumulate into significant gains. As a result of its efforts, the SEL has incrementally reduced development costs by 60%, decreased error rates by 85%, and reduced cycle time by 25%. In this paper, we analyze the SEL's experiences on three major improvement initiatives to better understand the cyclic nature of the improvement process and to understand why some improvements take much longer than others.

A Virtual Notebook for biomedical work groups.

PubMed Central

Gorry, G A; Burger, A M; Chaney, R J; Long, K B; Tausk, C M

1988-01-01

During the past several years, Baylor College of Medicine has made a substantial commitment to the use of information technology in support of its corporate and academic programs. The concept of an Integrated Academic Information Management System (IAIMS) has proved central in our planning, and the IAIMS activities that we have undertaken with funding from the National Library of Medicine have proved to be important extensions of our technology development. Here we describe our Virtual Notebook system, a conceptual and technologic framework for task coordination and information management in biomedical work groups. When fully developed and deployed, the Virtual Notebook will improve the functioning of basic and clinical research groups in the college, and it currently serves as a model for the longer-term development of our entire information management environment. PMID:3046694

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-03-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

18 CFR 806.31 - Term of approvals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... approval issued under this part shall be no longer than 15 years or the anticipated life of the project... AND APPROVAL OF PROJECTS Terms and Conditions of Approval § 806.31 Term of approvals. (a) Approvals... approval of a project shall expire three years from the date of such approval if the withdrawal, diversion...

75 FR 47465 - Pymetrozine; Regulation Denying NRDC's Objections on Remand

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... adverse effects are caused by either short-term (e.g., acute) or longer-term (e.g., chronic) pesticide... correspondingly levels of concern, for both short and long exposure periods as well as for the different routes of..., short-term, chronic, and cancer risks and EPA quantitatively assessed these risks in making its safety...

In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP

PubMed Central

Bratton, Daniel J.; Craig, Sonya E.; Kohler, Malcolm; Stradling, John R.

2016-01-01

Background Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. Methods The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2–4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. Results One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2–4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2–4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. Conclusions In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made. PMID:26904268

75 FR 69454 - Emergency Homeowners' Loan Program: Notice of Allocation of Funding for Substantially Similar...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

..., sex, familial status, national origin, or disability. 5. Operation of the program in a cost-effective... homeowner no longer resides in, sells, transfers or otherwise conveys, or refinances, in which the borrower...

Infrared Imaging of Boundary Layer Transition Flight Experiments

NASA Technical Reports Server (NTRS)

Berry, Scott A.; Horvath, Thomas J., Jr.; Schwartz, Richard; Ross, Martin; Anderson, Brian; Campbell, Charles H.

2008-01-01

The Hypersonic Thermodynamic Infrared Measurement (HYTHIRM) project is presently focused on near term support to the Shuttle program through the development of an infrared imaging capability of sufficient spatial and temporal resolution to augment existing on-board Orbiter instrumentation. Significant progress has been made with the identification and inventory of relevant existing optical imaging assets and the development, maturation, and validation of simulation and modeling tools for assessment and mission planning purposes, which were intended to lead to the best strategies and assets for successful acquisition of quantitative global surface temperature data on the Shuttle during entry. However, there are longer-term goals of providing global infrared imaging support to other flight projects as well. A status of HYTHIRM from the perspective of how two NASA-sponsored boundary layer transition flight experiments could benefit by infrared measurements is provided. Those two flight projects are the Hypersonic Boundary layer Transition (HyBoLT) flight experiment and the Shuttle Boundary Layer Transition Flight Experiment (BLT FE), which are both intended for reducing uncertainties associated with the extrapolation of wind tunnel derived transition correlations for flight application. Thus, the criticality of obtaining high quality flight data along with the impact it would provide to the Shuttle program damage assessment process are discussed. Two recent wind tunnel efforts that were intended as risk mitigation in terms of quantifying the transition process and resulting turbulent wedge locations are briefly reviewed. Progress is being made towards finalizing an imaging strategy in support of the Shuttle BLT FE, however there are no plans currently to image HyBoLT.

Recidivism among Participants of a Reentry Program for Prisoners Released without Supervision

ERIC Educational Resources Information Center

Wikoff, Nora; Linhorst, Donald M.; Morani, Nicole

2012-01-01

As higher numbers of individuals are released from prison and rejoin society, reentry programs can help former offenders reintegrate into society without continuing to engage in crime. This quasi-experimental study examined whether participation in reentry programming was associated with reduced recidivism among offenders who were no longer under…

75 FR 50847 - Cotton Program Changes for Upland Cotton, Adjusted World Price, and Active Shipping Orders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... Cotton Program Changes for Upland Cotton, Adjusted World Price, and Active Shipping Orders AGENCY... previous final rule that implemented the 2008 Farm Bill provisions for the cotton program. The correction removes definitions that are no longer used concerning Northern Europe prices for cotton. CCC is also...

An evaluation of the Participatory Action-Oriented Training (PAOT) program in small enterprises in Vietnam.

PubMed

Nguyen, Toai Phuong; Khai, Ton That

2014-01-01

Participatory Action-Oriented Training (PAOT) has been known as a practical training methodology for improving health and safety at work, particularly for small- and medium-sized enterprises (SMEs). Our hypothesis is that PAOT is a better approach than a traditional local method, and the objective of this study was to evaluate the efficacy of PAOT and to make suggestions for improvement. An intervention was performed for one year at 20 volunteer SMEs. PAOT was applied in 10 factories, and a traditional local method was applied in the other 10 SMEs as a control. Two cross-sectional studies were performed consisting of a questionnaire and environmental measurements. Data were also collected on the number of factory improvements, productivity, worker income, accidents, and health costs. There were significant improvements among the intervention factories in terms of work environment, number of improvements and health costs between the pre- and post- intervention phases. In terms of productivity, significant increases were seen in the civil engineering, metal, garment, and rice mill industries in the intervention group, while the metal casting and, garment industries in the control group also showed significant increase in productivity. The findings support the idea that a PAOT program produces better outcomes in SMEs. It is recommended that a PAOT program be widely applied to SMEs to improve health and safety. A fuller examination could be obtained with more environmental measurements taken over a much longer period of time, together with data on sickness absence and accidents that have been independently validated.

Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery.

PubMed

Lau, Susie; Vaknin, Zvi; Ramana-Kumar, Agnihotram V; Halliday, Darron; Franco, Eduardo L; Gotlieb, Walter H

2012-04-01

To evaluate the effect of introducing a robotic program on cost and patient outcome. This was a prospective evaluation of clinical outcome and cost after introducing a robotics program for the treatment of endometrial cancer and a retrospective comparison to the entire historical cohort. Consecutive patients with endometrial cancer who underwent robotic surgery (n=143) were compared with all consecutive patients who underwent surgery (n=160) before robotics. The rate of minimally invasive surgery increased from 17% performed by laparoscopy to 98% performed by robotics in 2 years. The patient characteristics were comparable in both eras, except for a higher body mass index in the robotics era (median 29.8 compared with 27.6; P<.005). Patients undergoing robotics had longer operating times (233 compared with 206 minutes), but fewer adverse events (13% compared with 42%; P<.001), lower estimated median blood loss (50 compared with 200 mL; P<.001), and shorter median hospital stay (1 compared with 5 days; P<.001). The overall hospital costs were significantly lower for robotics compared with the historical group (Can$7,644 compared with Can$10,368 [Canadian dollars]; P<.001) even when acquisition and maintenance cost were included (Can$8,370 compared with Can$10,368; P=.001). Within 2 years after surgery, the short-term recurrence rate appeared lower in the robotics group compared with the historic cohort (11 recurrences compared with 19 recurrences; P<.001). Introduction of robotics for endometrial cancer surgery increased the proportion of patients benefitting from minimally invasive surgery, improved short-term outcomes, and resulted in lower hospital costs. II.

Forging T-Lymphocyte Identity: Intersecting Networks of Transcriptional Control

PubMed Central

Rothenberg, Ellen V.; Ungerbäck, Jonas; Champhekar, Ameya

2016-01-01

T lymphocyte development branches off from other lymphoid developmental programs through its requirement for sustained environmental signals through the Notch pathway. In the thymus, Notch signaling induces a succession of T-lineage regulatory factors that collectively create the T-cell identity through distinct steps. This process involves both the staged activation of T-cell identity genes and the staged repression of progenitor-cell-inherited regulatory genes once their roles in self-renewal and population expansion are no longer needed. With the recent characterization of Innate Lymphoid Cells (ILCs) that share transcriptional regulation programs extensively with T cell subsets, T-cell identity can increasingly be seen as defined in modular terms, as the processes selecting and actuating effector function are potentially detachable from the processes generating and selecting clonally unique T-cell receptor structures. The developmental pathways of different classes of T cells and ILCs are distinguished by the numbers of prerequisites of gene rearrangement, selection, and antigen contact before the cells gain access to nearly-common regulatory mechanisms for choosing effector function. Here, the major classes of transcription factors that interact with Notch signals during T-lineage specification are discussed in terms of their roles in these programs, the evidence for their spectra of target genes at different stages, and their cross-regulatory and cooperative actions with each other. Specific topics include Notch modulation of PU.1 and GATA-3, PU.1-Notch competition, the relationship between PU.1 and GATA-3, and the roles of E proteins, Bcl11b, and GATA-3 in guiding acquisition of T-cell identity while avoiding redirection to an ILC fate. PMID:26791859

Can we reduce the burden of depression? The Australian experience with beyondblue: the national depression initiative.

PubMed

Hickie, Ian

2004-01-01

Throughout the Asia Pacific region, there is an urgent need to reduce the burden of depression by increasing depression awareness, reducing stigma and dismantling those social barriers that prevent full participation by people with depression. This paper describes the development and early achievements of the Australian depression initiative, beyondblue. A review of the key priorities of beyondblue and their impacts during the first three years of operation (2001-03). Key achievements include: the degree of national recognition of beyondblue; size and scope of media impact; growth in website utilisation; increased reporting of the community's recognition of people with depression; genuine reforms in life insurance and income protection; development of a new national consumer and carer organisation; establishment of major population-based preventative and early intervention programs; system-wide reform of primary care-based mental health services; national educational program uptake by general practitioners; and, development of key awareness and intervention programs for use in schools and the workplace. In its first three years of operation, beyondblue has had a major impact on depression awareness in Australia and demonstrable gains have been made in reducing stigma and major social barriers. A pre-existing national mental health policy and implementation plan, a substantial funding base and participation by key political, media and community leaders have been essential elements of its short-term success. Its longer-term impact will now depend on more sustainable community and business partnerships as well as the growth of a more influential consumer and carer voice.

Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article

PubMed Central

French, Dustin D.; Dixon, Brian E.; Perkins, Susan M.; Myers, Laura J.; Weiner, Michael; Zillich, Allan J.; Haggstrom, David A.

2016-01-01

Abstract The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans’ electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers. The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs. A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation. Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office. VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment. There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807–1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees. Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons. PMID:26765453

Longer term impact of the mass media campaign to promote the Get Healthy Information and Coaching Service®: increasing the saliency of a new public health program.

PubMed

O'Hara, Blythe J; Phongsavan, Philayrath; Gebel, Klaus; Banovic, Debbie; Buffett, Kym M; Bauman, Adrian E

2014-11-01

The Get Healthy Information and Coaching Service® (GHS) was introduced in New South Wales in February 2009. It used mass reach media advertising and direct mail and/or proactive marketing to recruit participants. This article reports on the long-term impact of the campaign on GHS participation from July 2011 to June 2012. A stand-alone population survey collected awareness, knowledge, and behavioral variables before the first advertising phase, (n = 1,544, August-September 2010), during the advertising period (n = 1,500, February-March 2011; n = 1,500, June-July 2011; n = 1,500, February 2012), and after the advertising period (n = 1,500, June-July 2012). GHS usage data (n = 6,095) were collated during July 2011-June 2012. Unprompted and prompted awareness of GHS mass media significantly increased (0% to 8.0%, p < .001; and 14.1% to 43.9%, p < .001, respectively) as well as knowledge and perceived effectiveness of the GHS. Those from the lowest three quintiles of socioeconomic disadvantage and respondents who were overweight or obese were significantly more likely to report prompted campaign awareness. The majority (84.4%) of new GHS calls occurred when television advertising was present. Participants who cited mass media as their referral source were significantly more likely to enroll in the intensive coaching program. Mass media campaigns remain an effective method of promoting a telephone-based statewide lifestyle program. © 2014 Society for Public Health Education.

Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons.

PubMed

Johns, David J; Hartmann-Boyce, Jamie; Jebb, Susan A; Aveyard, Paul

2014-10-01

Weight loss can reduce the health risks associated with being overweight or obese. However, the most effective method of weight loss remains unclear. Some programs emphasize physical activity, others diet, but existing evidence is mixed as to whether these are more effective individually or in combination. We aimed to examine the clinical effectiveness of combined behavioral weight management programs (BWMPs) targeting weight loss in comparison to single component programs, using within study comparisons. We included randomized controlled trials of combined BWMPs compared with diet-only or physical activity-only programs with at least 12 months of follow-up, conducted in overweight and obese adults (body mass index ≥25). Systematic searches of nine databases were run and two reviewers extracted data independently. Random effects meta-analyses were conducted for mean difference in weight change at 3 to 6 months and 12 to 18 months using a baseline observation carried forward approach for combined BWMPs vs diet-only BWMPs and combined BWMPs vs physical activity-only BWMPs. In total, eight studies were included, representing 1,022 participants, the majority of whom were women. Six studies met the inclusion criteria for combined BWMP vs diet-only. Pooled results showed no significant difference in weight loss from baseline or at 3 to 6 months between the BWMPs and diet-only arms (-0.62 kg; 95% CI -1.67 to 0.44). However, at 12 months, a significantly greater weight-loss was detected in the combined BWMPs (-1.72 kg; 95% CI -2.80 to -0.64). Five studies met the inclusion criteria for combined BWMP vs physical activity-only. Pooled results showed significantly greater weight loss in the combined BWMPs at 3 to 6 months (-5.33 kg; 95% CI -7.61 to -3.04) and 12 to 18 months (-6.29 kg; 95% CI -7.33 to -5.25). Weight loss is similar in the short-term for diet-only and combined BWMPs but in the longer-term weight loss is increased when diet and physical activity are combined. Programs based on physical activity alone are less effective than combined BWMPs in both the short and long term. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Efficacy of team-based financial incentives for smoking cessation in the workplace.

PubMed

Yeo, Chang Dong; Lee, Hea Yeon; Ha, Jick Hwan; Kang, Hyeon Hui; Kang, Ji Young; Kim, Sung Kyoung; Kim, Myung Sook; Moon, Hwa Sik; Lee, Sang Haak

2015-01-01

Worksite smoking cessation programs offer accessibility of the target population, availability of occupational health support, and the potential for peer pressure and peer support. The purpose of this study was to identify the efficacy of the financial incentives given to various teams in the workplace. St. Paul's Hospital's employees were enrolled. Each team of employees consisted of smoking participants and non-smoking fellow workers from the same department. The financial incentive of 50000 won (about $45) was rewarded to the team for each successful participant-not to individual members-after the first week and then after one month. If the smokers in the team remained abstinent for a longer time period, the team was given an incentive of 100000 won for each successful participant after 3 and 6 months. A total 28 smoking participants and 6 teams were enrolled. Self-reported abstinence rates validated by urinary cotinine test at 3, 6, and 12 months after the initial cessation were 61%, 54%, and 50%, respectively. Smokers with high nicotine dependence scores or those who began participation 1 month after enrollment initiation had a lower abstinence rate at 3 months, but not at 6 and 12 months. Participants who succeeded at smoking cessation at 12 months were more likely to be older and have a longer smoking duration history. The financial incentives given to teams could be promising and effective to improve long-term rates of smoking cessation. This approach could use peer pressure and peer support in the workplace over a longer period.

26 CFR 25.2512-5A - Valuation of annuities, unitrust interests, interests for life or term of years, and remainder or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Estate and Gift Tax,” (Rev. 5-59). This publication is no longer available for purchase from the... (CONTINUED) ESTATE AND GIFT TAXES GIFT TAX; GIFTS MADE AFTER DECEMBER 31, 1954 Actuarial Tables Applicable... One and Two Lives” (12-70). These publications are no longer available for purchase from the...

How does temperature affect forest "fungus breath"? Diurnal non-exponential temperature-respiration relationship, and possible longer-term acclimation in fungal sporocarps

Treesearch

Erik A. Lilleskov

2017-01-01

Fungal respiration contributes substantially to ecosystem respiration, yet its field temperature response is poorly characterized. I hypothesized that at diurnal time scales, temperature-respiration relationships would be better described by unimodal than exponential models, and at longer time scales both Q10 and mass-specific respiration at 10 °...

Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness: Green Skills Training for Workers. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eleventh Congress, First Session on Examining Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness, Focusing on Green Skills Training for Workers (April 21, 2009). Senate Hearing 111-813

ERIC Educational Resources Information Center

US Senate, 2011

2011-01-01

Among the topics discussed in this hearing were: what constitutes green energy, how workers can best be provided the skills to thrive in green industries, and the future of America's energy and environmental policies. Statements were presented by: Honorable Patty Murray, a U.S. Senator from the State of Washington, opening statement; Honorable…

A new initiative on precision medicine.

PubMed

Collins, Francis S; Varmus, Harold

2015-02-26

President Obama has announced a research initiative that aims to accelerate progress toward a new era of precision medicine, with a near-term focus on cancers and a longer-term aim to generate knowledge applicable to the whole range of health and disease.

78 FR 50476 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Designation of a Longer Period for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70166; File No. SR-BATS-2013-035] Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change, as Modified by Amendment No. 1 Thereto, To Amend the Competitive Liquidity Provider Program August 13, 2013. On June 17,...

42 CFR 60.59 - Records and Federal access after a school is no longer a HEAL school.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Records and Federal access after a school is no longer a HEAL school. 60.59 Section 60.59 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM The School § 60.59 Records and Federal...

Using Appreciative Inquiry for an e-Learning Change Management Programme: The ENTICE Project at Brunel University

NASA Astrophysics Data System (ADS)

Murray, Linda A.; Alberts, Philip P.; Stephenson, Julia E.

Brunel University's e-Learning strategy provides direction for the teaching staff, but remains flexible. Although all Schools had engaged with e-Learning in the past, detailed consideration of effective e-Learning and the e-experience of students had not been generally in evidence. We sought to address this gap in the strategic work of schools by implementing a change management program, the major elements of which were the development of a local evidence-base of effectiveness of e-Learning practices and conversations for change. Our program was based on the Appreciative Inquiry (AI) method, which we adapted for this educational context. The aim was to identify the pedagogic value of the diverse range of e-Learning activities already being undertaken and to encourage more widespread use. There was also a longer-term objective of assisting schools to establish or review their own e-Learning strategies and action plans. In terms of the effectiveness of the process, it is evident that the AI methodology was very beneficial. There is greater awareness among academic staff of the range of e-Learning activities that are currently being used in teaching designs of teaching staff at the University and about student use and attitudes to those activities. The evidence provides inputs to the development/review of e-Learning action plans and strategies for each school, usually within the context of the overall school plan.

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

Eichman, Josh; Flores-Espino, Francisco

Flexible operation of electrolysis systems represents an opportunity to reduce the cost of hydrogen for a variety of end-uses while also supporting grid operations and thereby enabling greater renewable penetration. California is an ideal location to realize that value on account of growing renewable capacity and markets for hydrogen as a fuel cell electric vehicle (FCEV) fuel, refineries, and other end-uses. Shifting the production of hydrogen to avoid high cost electricity and participation in utility and system operator markets along with installing renewable generation to avoid utility charges and increase revenue from the Low Carbon Fuel Standard (LCFS) program canmore » result in around $2.5/kg (21%) reduction in the production and delivery cost of hydrogen from electrolysis. This reduction can be achieved without impacting the consumers of hydrogen. Additionally, future strategies for reducing hydrogen cost were explored and include lower cost of capital, participation in the Renewable Fuel Standard program, capital cost reduction, and increased LCFS value. Each must be achieved independently and could each contribute to further reductions. Using the assumptions in this study found a 29% reduction in cost if all future strategies are realized. Flexible hydrogen production can simultaneously improve the performance and decarbonize multiple energy sectors. The lessons learned from this study should be used to understand near-term cost drivers and to support longer-term research activities to further improve cost effectiveness of grid integrated electrolysis systems.« less

Clinical aviation medicine : a physical-conditioning program for cardiac patients - a progress report.

DOT National Transportation Integrated Search

1966-06-01

Twenty men with well-documented episodes of myocardial infarction participated in a physical-conditioning program for 3 months or longer during the past 2 years. The activity consisted of intermittent jogging, calesthenics [sic], and competitive game...

Carpeting/Flooring: Revitalizing Carpets.

ERIC Educational Resources Information Center

Woolford, Alison; Hill, Michael

2003-01-01

With properly specified fiber and a comprehensive maintenance program, school carpets can retain their appearance longer. Discusses carpet characteristics; proper carpet installation; effective preventive-maintenance programs (keep outside areas clean, use soil barriers, protect desk areas, maintain HVAC systems, and specify eating, drinking, and…

Interventions to reduce discrimination and stigma: the state of the art.

PubMed

Gronholm, Petra C; Henderson, Claire; Deb, Tanya; Thornicroft, Graham

2017-03-01

There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. However, applying this knowledge to deliver and evaluate interventions to reduce discrimination and stigma in a lasting way is a complex and long-term challenge. We conducted a narrative synthesis of systematic reviews published since 2012, and supplemented this with papers published subsequently as examples of more recent work. There is evidence for small to moderate positive impacts of both mass media campaigns and interventions for target groups in terms of stigma-related knowledge, attitudes, and intended behaviour in terms of desire for contact. However, the limited evidence from longer follow-up times suggests that it is not clear whether short-term contact interventions have a lasting impact. The risk that short-term interventions may only have a short-term impact suggests a need to study longer term interventions and to use interim process and outcome data to improve interventions along the way. There is scope for more thorough application of intergroup contact theory whenever contact is used and of evidence-based teaching and assessment methods when skills training is used for target groups.

Long-term outcomes of children undergoing video-assisted gastrostomy.

PubMed

Salö, Martin; Santimano, Ana; Helmroth, Sofia; Stenström, Pernilla; Arnbjornsson, Einar Ólafur

2017-01-01

The aims of this study were to assess the short- and long-term complication rates after video-assisted gastrostomy (VAG), the effects of age and gender on long-term complications and the effect of duration of gastrostomy tube retention on the need for gastroraphy when the gastrostomy device was removed. This was a retrospective study of children undergoing VAG at a single institution. Children who died or moved from the area were excluded. The rates of short- and long-term complications developing at 3-6 months or 2 or more years, respectively, were compared. A total of 170 children were studied, out of a cohort of 303 children. The median age at surgery was 2 years. The median duration of postoperative long-term follow-up was 5 years (2-9 years). The complications at the respective short and long-term follow-ups were as follows: granulation tissue, leakage, infection and vomiting. There were no differences in the short- versus long-term complication rates for gender and age. Children needing gastroraphy had used a gastrostomy device significantly longer compared with children with spontaneous closure. Complications after VAG decrease over time. A longer duration of gastrostomy device retention leads to increased need for gastroraphy.

Innovative Self-Healing Seals for Solid Oxide Fuel Cells (SOFC)

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

Raj Singh

Solid oxide fuel cell (SOFC) technology is critical to several national initiatives. Solid State Energy Conversion Alliance (SECA) addresses the technology needs through its comprehensive programs on SOFC. A reliable and cost-effective seal that works at high temperatures is essential to the long-term performance of the SOFC for 40,000 hours at 800°C. Consequently, seals remain an area of highest priority for the SECA program and its industry teams. An innovative concept based on self-healing glasses was advanced and successfully demonstrated through seal tests for 3000 hours and 300 thermal cycles to minimize internal stresses under both steady state and thermalmore » transients for making reliable seals for the SECA program. The self-healing concept requires glasses with low viscosity at the SOFC operating temperature of 800°C but this requirement may lead to excessive flow of the glass in areas forming the seal. To address this challenge, a modification to glass properties by addition of particulate fillers is pursued in the project. The underlying idea is that a non-reactive ceramic particulate filler is expected to form glass-ceramic composite and increase the seal viscosity thereby increasing the creep resistance of the glass-composite seals under load. The objectives of the program are to select appropriate filler materials for making glass-composite, fabricate glass-composites, measure thermal expansion behaviors, and determine stability of the glass-composites in air and fuel environments of a SOFC. Self-healing glass-YSZ composites are further developed and tested over a longer time periods under conditions typical of the SOFCs to validate the long-term stability up to 2000 hours. The new concepts of glass-composite seals, developed and nurtured in this program, are expected to be cost-effective as these are based on conventional processing approaches and use of the inexpensive materials.« less

Archipelago-wide island restoration in the Galápagos Islands: reducing costs of invasive mammal eradication programs and reinvasion risk.

PubMed

Carrion, Victor; Donlan, C Josh; Campbell, Karl J; Lavoie, Christian; Cruz, Felipe

2011-05-11

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance.

Archipelago-Wide Island Restoration in the Galápagos Islands: Reducing Costs of Invasive Mammal Eradication Programs and Reinvasion Risk

PubMed Central

Carrion, Victor; Donlan, C. Josh; Campbell, Karl J.; Lavoie, Christian; Cruz, Felipe

2011-01-01

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance. PMID:21589656

Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

PubMed

Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P

2017-07-24

Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P =0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; P <0.01). In the 6 months before exit, the negative disposition group had significantly more in-center respite dialysis sessions, had more and longer hospitalizations, and required more on-call care team support in terms of phone calls and drop-in visits (each P <0.05). The most common reason for modality conversion was medical instability in 15 of 23 (65%) followed by caregiver or care partner burnout in three of 23 (13%) each. The 90-day mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization ( e.g. , hospitalization, respite treatments, nursing time, etc. ). Copyright © 2017 by the American Society of Nephrology.

Aligning Assessment with Long-Term Learning. Special Issue: Learning-Oriented Assessment: Principles and Practice

ERIC Educational Resources Information Center

Boud, David; Falchikov, Nancy

2006-01-01

Assessment in higher education is commonly held to contribute to feedback to students on their learning and the certification of their achievement. This paper argues that this short-term focus must be balanced against a longer-term emphasis for learning-oriented assessment to foster future learning after graduation. The paper proposes that…

The Cementitious Barriers Partnership (CBP) Software Toolbox Capabilities in Assessing the Degradation of Cementitious Barriers - 13487

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

Flach, G.P.; Burns, H.H.; Langton, C.

2013-07-01

The Cementitious Barriers Partnership (CBP) Project is a multi-disciplinary, multi-institutional collaboration supported by the U.S. Department of Energy (US DOE) Office of Tank Waste and Nuclear Materials Management. The CBP program has developed a set of integrated tools (based on state-of-the-art models and leaching test methods) that help improve understanding and predictions of the long-term structural, hydraulic and chemical performance of cementitious barriers used in nuclear applications. Tools selected for and developed under this program have been used to evaluate and predict the behavior of cementitious barriers used in near-surface engineered waste disposal systems for periods of performance up tomore » 100 years and longer for operating facilities and longer than 1000 years for waste disposal. The CBP Software Toolbox has produced tangible benefits to the DOE Performance Assessment (PA) community. A review of prior DOE PAs has provided a list of potential opportunities for improving cementitious barrier performance predictions through the use of the CBP software tools. These opportunities include: 1) impact of atmospheric exposure to concrete and grout before closure, such as accelerated slag and Tc-99 oxidation, 2) prediction of changes in K{sub d}/mobility as a function of time that result from changing pH and redox conditions, 3) concrete degradation from rebar corrosion due to carbonation, 4) early age cracking from drying and/or thermal shrinkage and 5) degradation due to sulfate attack. The CBP has already had opportunity to provide near-term, tangible support to ongoing DOE-EM PAs such as the Savannah River Saltstone Disposal Facility (SDF) by providing a sulfate attack analysis that predicts the extent and damage that sulfate ingress will have on the concrete vaults over extended time (i.e., > 1000 years). This analysis is one of the many technical opportunities in cementitious barrier performance that can be addressed by the DOE-EM sponsored CBP software tools. Modification of the existing tools can provide many opportunities to bring defense in depth in prediction of the performance of cementitious barriers over time. (authors)« less

POLLUTION CONTROL FOR UTILITY POWER GENERATION, 1990-2020

EPA Science Inventory

The paper discusses pollution control for utility power generation between the years 1990 and 2020, when the major anticipated environmental challenges facing the utility industry will be acid deposition control in the near term and global warming mitigation in the longer term. T...

Precision Education Initiative: Moving toward Personalized Education

ERIC Educational Resources Information Center

Hart, Sara A.

2016-01-01

This article proposes the Precision Education Initiative, which is the tailoring of education to the specific characteristics of the individual student. Mirroring precision medicine, the author lays out both near-term and longer term goals that educational research, and importantly educational practice, should follow.

Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study

PubMed Central

2013-01-01

Background Patients newly-diagnosed with diabetes require self-management education to help them understand and manage the disease. The goals of the study were to determine the frequency of diabetes self-management education program utilization by newly-diagnosed patients, and to evaluate whether there were any demographic or clinical disparities in utilization. Methods Using population-level health care data, all 46,553 adults who were diagnosed with any type of non-gestational diabetes in Ontario, Canada between January and June 2006 were identified. They were linked with a diabetes self-management education program registry to identify those who attended within 6 months of diagnosis. The demographic and clinical characteristics of attendees and non-attendees were compared. Results A total of 9,568 (20.6%) patients attended a diabetes self-management education program within 6 months of diagnosis. Younger age, increasing socioeconomic status, and the absence of mental health conditions or other medical comorbidity were associated with attendance. Patients living in rural areas, where access to physicians may be limited, were markedly more likely to attend. Recent immigrants were 40% less likely to attend self-management education programs than longer-term immigrants or nonimmigrants. Conclusion Only one in five newly-diagnosed diabetes patients attended a diabetes self-management education program. Demographic and clinical disparities in utilization persisted despite a publicly-funded health care system where patients could access these services without direct charges. Primary care providers and education programs must ensure that more newly-diagnosed diabetes patients receive self-management education, particularly those who are older, poorer, sicker, or recent immigrants. PMID:23360373

The Indiana Chronic Disease Management Program's impact on medicaid claims: a longitudinal, statewide evaluation.

PubMed

Katz, Barry P; Holmes, Ann M; Stump, Timothy E; Downs, Steven M; Zillich, Alan J; Ackermann, Ronald T; Inui, Thomas S

2009-02-01

: Disease management programs have grown in popularity over the past decade as a strategy to curb escalating healthcare costs for persons with chronic diseases. : To evaluate the effect of the Indiana Chronic Disease Management Program (ICDMP) on the longitudinal changes in Medicaid claims statewide. : Phased implementation of a chronic disease management program in 3 regions of the state. Fourteen repeated cohorts of Medicaid members were drawn over a period of 3.5 years and the trends in claims were evaluated using a repeated measures model. : A total of 44,218 Medicaid members with diabetes and/or congestive heart failure in 3 geographic regions in Indiana. : Across all 3 regions and both disease classes, we found a flattening of cost trends between the pre- and post-ICDMP-initiation periods. This change in the slopes was significant for all of the models except for congestive heart failure in southern Indiana. Thus, the average per member claims paid was increasing at a faster rate before ICDMP but slowed once the program was initiated. To distinguish shorter and longer-term effects related to ICDMP, we estimated annual slopes within the pre- and post-ICDMP- time periods. A similar pattern was found in all regions: claims were increasing before ICDMP, flattened in the years around program initiation, and remained flat in the final year of follow-up. : This analysis shows that the trend in average total claims changed significantly after the implementation of ICDMP, with a decline in the rate of increase in claims paid observed for targeted Medicaid program populations across the state of Indiana.

A comparative approach to assess drivers of success in mammalian conservation recovery programs.

PubMed

Crees, Jennifer J; Collins, Amy C; Stephenson, P J; Meredith, Helen M R; Young, Richard P; Howe, Caroline; Price, Mark R Stanley; Turvey, Samuel T

2016-08-01

The outcomes of species recovery programs have been mixed; high-profile population recoveries contrast with species-level extinctions. Each conservation intervention has its own challenges, but to inform more effective management it is imperative to assess whether correlates of wider recovery program success or failure can be identified. To contribute to evidence-based improvement of future conservation strategies, we conducted a global quantitative analysis of 48 mammalian recovery programs. We reviewed available scientific literature and conducted semistructured interviews with conservation professionals involved in different recovery programs to investigate ecological, management, and political factors associated with population recoveries or declines. Identifying and removing threats was significantly associated with increasing population trend and decreasing conservation dependence, emphasizing that populations are likely to continue to be compromised in the absence of effective threat mitigation and supporting the need for threat monitoring and adaptive management in response to new and potential threats. Lack of habitat and small population size were cited as limiting factors in 56% and 42% of recovery programs, respectively, and both were statistically associated with increased longer term dependence on conservation intervention, demonstrating the importance of increasing population numbers quickly and restoring and protecting habitat. Poor stakeholder coordination and management were also regularly cited by respondents as key weaknesses in recovery programs, indicating the importance of effective leadership and shared goals and management plans. Project outcomes were not influenced by biological or ecological variables such as body mass or habitat, which suggests that these insights into correlates of conservation success and failure are likely to be generalizable across mammals. © 2016 Society for Conservation Biology.

Addressing engagement, anger and aggression through the Rock Water Program: Rural adolescent males' perceptions.

PubMed

Edwards, Paul; van de Mortel, Thea; Stevens, John

2017-08-01

The Rock and Water Program (RWP) has been implemented in some Australian schools as a means of addressing school disengagement, anger and aggression, which are significant determinants of mental illness. However, much of the evidence supporting the RWP is anecdotal. This project explored rural adolescent males' perceptions of the RWP. Questionnaires were used to gather data about the students prior to their commencement in the RWP. Focus group interviews were conducted with students at weeks 5 and 9 of the 9-week program. Data were analysed using thematic analysis. The RWP was facilitated in four schools in rural NSW over three terms for a total of 12 program deliveries. One hundred and eighty-seven rural adolescent males participated in the focus groups. The participants were identified by their school as disengaged in schoolwork and either perpetrators and/or victims of anger and aggression. Participants liked the 'learning by doing' action-oriented approach, and reported learning strategies that could reduce aggression in the school and wider community. The focus groups provided insight into why these adolescent boys engaged with this program when generally engagement in school, overall, was reported as poor. Suggestions for program improvement included more or longer sessions, and the inclusion of girls. This study found that the RWP engaged rurally based boys, who spoke positively about the action-oriented program. Future research could examine if this translates into reduced incidents of anger and violence at school and improved school engagement and overall physical and mental health. © 2016 National Rural Health Alliance Inc.

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial.

PubMed

Burton, Elissa; Lewin, Gill; Clemson, Lindy; Boldy, Duncan

2013-10-18

Restorative home care services help older people maximise their independence using a multi-dimensional approach. They usually include an exercise program designed to improve the older person's strength, balance and function. The types of programs currently offered require allocation of time during the day to complete specific exercises. This is not how the majority of home care clients prefer to be active and may be one of the reasons that few older people do the exercises regularly and continue the exercises post discharge.This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) is undertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greater functional gains compared to a standard exercise program for older people receiving a restorative home care service. A pragmatic randomised controlled trial (RCT) design was employed with two study arms: LiFE program (intervention) and the current exercise program (control). Silver Chain, a health and community care organisation in Perth, Western Australia. One hundred and fifty restorative home care clients, aged 65 years and older. The primary outcome is a composite measure incorporating balance, strength and mobility. Other outcome measures include: physical functioning, falls efficacy, and levels of disability and functioning. If LiFE is more effective than the current exercise program, the evidence will be presented to the service management accompanied by the recommendation that it be adopted as the generic exercise program to be used within the restorative home care service. Australian and New Zealand Clinical Trials Registry ACTRN12611000788976.

Assessment of beach and dune erosion and accretion using LiDAR: Impact of the stormy 2013-14 winter and longer term trends on the Sefton Coast, UK

NASA Astrophysics Data System (ADS)

Pye, Kenneth; Blott, Simon J.

2016-08-01

An important question for coastal management concerns the importance of individual storms and clusters of storms on longer term beach sediment budgets, beach and dune erosion, and coastal flood risk. Between October 2013 and March 2014 a series of deep Atlantic low pressure systems crossed the Northeast Atlantic, and strong winds, high waves and high water levels affected many coastal areas in the UK and other parts of western Europe. Net dune recession of up to 12.1 m occurred around Formby Point. On 5 December 2013 the highest water level ever recorded at Liverpool (6.22 m ODN) coincided with waves of Hs of 4.55 m and Tp of 9.3 s in Liverpool Bay. Wave trimming of the dune toe occurred along the entire length of the Sefton coast, but significant dune erosion occurred only where the upper beach (between the mean high water spring tide level and the dune toe) was < 25 m wide. Sediment budget calculations based on LiDAR surveys in October 2013 and May 2014 indicated a net loss of 127 × 103 m3 of sediment from the beach (above 0 m ODN) and a loss of 268 × 103 m3 from the frontal dune system, mostly at Formby Point. However, some parts of the beach to the south of Formby Point gained sediment, indicating net north to south transport over the winter. When considered in a longer term context, the 2013-14 winter represents only a small perturbation on the longer-term coast trend of erosion at Formby Point and progradation to the north and south. Analysis of LiDAR data over a longer time period 1999-2014 indicated upper beach and dune sediment loss of 780 × 103 m3 from the north-central part of Formby Point, with net gains of 806 × 103 m3 and 2116 × 103 m3 in areas to the north and south, respectively. This indicates a net onshore transport of 2142 × 103 m3 from Liverpool Bay towards the coast between Birkdale and Altcar, with a further net total of 210 × 103 m3 transported towards the shore between Altcar and Crosby. In view of the demonstrated value of airborne LiDAR surveys for the quantification of storm impacts and longer term coastal changes, it is recommended that such surveys should be undertaken before and after each winter storm period, covering the area between mean low water spring tide level and a line 200 m landward of the dune toe, of as a part of the regional coastal monitoring programme.

Lacosamide: A Review in Focal-Onset Seizures in Patients with Epilepsy.

PubMed

Hoy, Sheridan M

2018-05-01

Lacosamide (Vimpat ® ) is a functionalized amino acid (available orally and intravenously) approved in the EU and the USA for use as monotherapy and adjunctive therapy for the treatment of focal-onset seizures in adults, adolescents and children aged ≥ 4 years with epilepsy. In adults and adolescents (aged ≥ 16 years), oral lacosamide as adjunctive therapy to other antiepileptic drugs was generally effective in reducing seizure frequency during short-term (up to 18 weeks) treatment, with efficacy sustained over the longer-term (up to 8 years). Moreover, patients were effectively switched from adjunctive oral lacosamide to the same dosage of intravenous lacosamide. Oral lacosamide was an effective conversion to monotherapy agent in this patient population and as monotherapy demonstrated noninferiority to carbamazepine controlled release in terms of seizure freedom. Antiepileptic benefits were maintained during longer-term (≤ 2 years) monotherapy. The antiepileptic efficacy of lacosamide in children aged ≥ 4 years has been extrapolated from data from adults and adolescents, with a similar response expected provided paediatric dosage adaptations are used and safety is demonstrated. Indeed, preliminary data demonstrated the efficacy of short-term (16 weeks) adjunctive lacosamide in patients aged ≥ 4 to < 17 years. Oral lacosamide was generally well tolerated over the short- and longer-term when administered as adjunctive therapy, a conversion to monotherapy agent and monotherapy in adults and adolescents and when administered as adjunctive therapy in children aged ≥ 4 years. Thus, lacosamide is a useful option for the management of focal-onset seizures across a broad age range, starting as early as 4 years of age.

Recovering Radioactive Materials with ORSP Team

ScienceCinema

LANL

2017-12-09

The National Nuclear Security Administration sponsors a program, executed by Los Alamos National Laboratory, to recover radioisotopes used by industry and academia and no longer needed. Called the "Offsite Source Recovery Program (OSRP), it has recovered more than 16,000 orphan sources as of 2008.

40 CFR 33.104 - May recipients apply for a waiver from the requirements of this part?

Code of Federal Regulations, 2010 CFR

2010-07-01

... this part; (2) There is a reasonable limitation on the duration of the recipient's modified program... extension shall be for no longer than the period originally set for the duration of the program waiver. ...

Investigating the Female Subaltern, Colonial Discourse and False Consciousness: A Spivakian Marxist-Postcolonialist Reading of Chinua Achebe's "Things Fall Apart" and "No Longer at Ease"

ERIC Educational Resources Information Center

Mostafaee, Jalal

2016-01-01

The present research study attempts to investigate Chinua Achebe's "Things Fall Apart" and "No Longer at Ease" in terms of Gayatri Spivak Marxist-Post colonialist conceptions of subaltern, colonial discourse and false consciousness. In Postmodernist fiction, there is anxiety that historical concerns such as the scale of…

Access to Safe Water in Rural Artibonite, Haiti 16 Months after the Onset of the Cholera Epidemic

PubMed Central

Patrick, Molly; Berendes, David; Murphy, Jennifer; Bertrand, Fabienne; Husain, Farah; Handzel, Thomas

2013-01-01

Haiti has the lowest improved water and sanitation coverage in the Western Hemisphere and is suffering from the largest cholera epidemic on record. In May of 2012, an assessment was conducted in rural areas of the Artibonite Department to describe the type and quality of water sources and determine knowledge, access, and use of household water treatment products to inform future programs. It was conducted after emergency response was scaled back but before longer-term water, sanitation, and hygiene activities were initiated. The household survey and source water quality analysis documented low access to safe water, with only 42.3% of households using an improved drinking water source. One-half (50.9%) of the improved water sources tested positive for Escherichia coli. Of households with water to test, 12.7% had positive chlorine residual. The assessment reinforces the identified need for major investments in safe water and sanitation infrastructure and the importance of household water treatment to improve access to safe water in the near term. PMID:24106191

E-learning: Web-based education.

PubMed

Sajeva, Marco

2006-12-01

This review introduces state-of-the-art Web-based education and shows how the e-learning model can be applied to an anaesthesia department using Open Source solutions, as well as lifelong learning programs, which is happening in several European research projects. The definition of the term e-learning is still a work in progress due to the fact that technologies are evolving every day and it is difficult to improve teaching methodologies or to adapt traditional methods to a new or already existing educational model. The European Community is funding several research projects to define the new common market place for tomorrow's educational system; this is leading to new frontiers like virtual Erasmus inter-exchange programs based on e-learning. The first step when adapting a course to e-learning is to re-define the educational/learning model adopted: cooperative learning and tutoring are the two key concepts. This means that traditional lecture notes, books and exercises are no longer effective; teaching files must use rich multimedia content and have to be developed using the new media. This can lead to several pitfalls that can be avoided with an accurate design phase.

TECHNICAL AND REGULATORY CONSIDERATIONS IN USING FREIGHT CONTAINERS AS INDUSTRIAL PACKAGES

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

Opperman, E; Mark Hawk, M; Ron Natali, R

2007-10-16

The United States (US) Department of Energy (DOE), Office of Environmental Management (EM), is actively pursuing activities to reduce the radiological risk and clean up the environmental legacy of the nation's nuclear weapons programs. EM has made significant progress in recent years in the clean-up and closure of sites and is also focusing on longer-term activities necessary for the completion of the clean-up program. The packaging and transportation of contaminated demolition debris and low-level waste (LLW) materials in a safe and cost-effective manner are essential in completing this mission. Toward this end, the US Department of Transportation's (DOT) Final Rulemore » on Hazardous Materials Regulation Final Rule issued January 26, 2004, included a new provision authorizing the use of Freight Containers (e.g., 20 and 40-foot ISO Containers) as Industrial Packages Type 1, 2, or 3 (IP-1, IP-2, and IP-3). This paper will discuss the technical and regulatory considerations in using these newly authorized and large packages for the packaging and transportation of LLW materials.« less

Determinants of longer job tenure among home care aides: what makes some stay on the job while others leave?

PubMed

Butler, Sandra S; Brennan-Ing, Mark; Wardamasky, Sara; Ashley, Alison

2014-03-01

An inadequate supply of direct care workers and a high turnover rate in the workforce has resulted in a "care gap" in our long-term care system. As people are increasingly choosing community-based care, retention of home care workers is particularly important. The mixed-method study described herein explored determinants of longer job tenure for home care aides (n = 261). Study participants were followed for 18 months, completing two mail surveys and one telephone interview each. Predictors of longer job tenure included older age, living rurally, lower physical function, higher wages, a greater sense of autonomy on the job, and less frequent feelings of personal accomplishment. Thematic analysis of telephone interviews revealed long-term stayers to be less concerned about low wages and inconsistent hours than those who left their jobs within a year; both groups of workers reported high levels of job satisfaction. Policy implications of study findings are discussed.

Long-term precommercial thinning effects on Larix occidentalis (western larch) tree and stand characteristics

Treesearch

Michael S. Schaedel; Andrew J. Larson; David L. R. Affleck; R. Travis Belote; John M. Goodburn; David K. Wright; Elaine Kennedy Sutherland

2017-01-01

Precommercial thinning (PCT) is used to increase tree size and shorten harvest rotation time. Short-term results from PCT studies often show a trade-off between individual-tree growth and net stand yield, while longer-term effects of PCT on tree growth and stand yield are less well documented. We used a 54-year-old PCT study to test long-term effects of forest density...

Racial Disparities in Access to Care Under Conditions of Universal Coverage.

PubMed

Siddiqi, Arjumand A; Wang, Susan; Quinn, Kelly; Nguyen, Quynh C; Christy, Antony Dennis

2016-02-01

Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage. To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada. Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health. Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor. Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Making the hard work of recovery more attractive for those with substance use disorders

PubMed Central

McKay, James R.

2016-01-01

Background Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. Argument/analysis This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Second, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. Conclusions To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to more strongly incentivize longer-term recoveries. PMID:27535787

Making the hard work of recovery more attractive for those with substance use disorders.

PubMed

McKay, James R

2017-05-01

Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Secondly, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to incentivize longer-term recoveries more strongly. © 2016 Society for the Study of Addiction.

Description of the CERES Ocean Validation Experiment (COVE), A Dedicated EOS Validation Test Site

NASA Astrophysics Data System (ADS)

Rutledge, K.; Charlock, T.; Smith, B.; Jin, Z.; Rose, F.; Denn, F.; Rutan, D.; Haeffelin, M.; Su, W.; Xhang, T.; Jay, M.

2001-12-01

A unique test site located in the mid-Atlantic coastal marine waters has been used by several EOS projects for validation measurements. A common theme across these projects is the need for a stable measurement site within the marine environment for long-term, high quality radiation measurements. The site was initiated by NASA's Clouds and the Earths Radiant Energy System (CERES) project. One of CERES's challenging goals is to provide upwelling and downwelling shortwave fluxes at several pressure altitudes within the atmosphere and at the surface. Operationally the radiative transfer model of Fu and Liou (1996, 1998), the CERES instrument measured radiances and various other EOS platform data are being used to accomplish this goal. We present here, a component of the CERES/EOS validation effort that is focused to verify and optimize the prediction algorithms for radiation parameters associated with the marine coastal and oceanic surface types of the planet. For this validation work, the CERES Ocean Validation Experiment (COVE) was developed to provide detailed high-frequency and long-duration measurements for radiation and their associated dependent variables. The CERES validations also include analytical efforts which will not be described here (but see Charlock et.al, Su et.al., Smith et.al-Fall 2001 AGU Meeting) The COVE activity is based on a rigid ocean platform which is located approximately twenty kilometers off of the coast of Virginia Beach, Virginia. The once-manned US Coast Guard facility rises 35 meters from the ocean surface allowing the radiation instruments to be well above the splash zone. The depth of the sea is eleven meters at the site. A power and communications system has been installed for present and future requirements. Scientific measurements at the site have primarily been developed within the framework of established national and international monitoring programs. These include the Baseline Surface Radiation Network of the World Meteorological Organization, NASA's robotic aerosol measurement program - AERONET, NOAA's GPS Water Vapor Demonstration Network, NOAA's National Buoy Data Center and GEWEX's Global Aerosol Climate Program. Other EOS projects have utilized the COVE platform for validation measurements (short term: MODIS, MISR intermediate term: SEAWIFS). A longer term measurement program for the AIRS instrument to be deployed on the AQUA satellite is underway. The poster will detail the unique measurement and infrastructure assets of the COVE site and present example 1.5 year time series of the major radiometric parameters. Lastly, the near term measurement augmentations that are anticipated at COVE will be discussed.

Can data from disparate long-term fish monitoring programs be used to increase our understanding of regional and continental trends in large river assemblages?

USGS Publications Warehouse

Counihan, Timothy D.; Waite, Ian R.; Casper, Andrew F.; Ward, David L.; Sauer, Jennifer S.; Irwin, Elise R.; Chapman, Colin G.; Ickes, Brian; Paukert, Craig P.; Kosovich, John J.; Bayer, Jennifer M.

2018-01-01

Understanding trends in the diverse resources provided by large rivers will help balance tradeoffs among stakeholders and inform strategies to mitigate the effects of landscape scale stressors such as climate change and invasive species. Absent a cohesive coordinated effort to assess trends in important large river resources, a logical starting point is to assess our ability to draw inferences from existing efforts. In this paper, we use a common analytical framework to analyze data from five disparate fish monitoring programs to better understand the nature of spatial and temporal trends in large river fish assemblages. We evaluated data from programs that monitor fishes in the Colorado, Columbia, Illinois, Mississippi, and Tallapoosa rivers using non-metric dimensional scaling ordinations and associated tests to evaluate trends in fish assemblage structure and native fish biodiversity. Our results indicate that fish assemblages exhibited significant spatial and temporal trends in all five of the rivers. We also document native species diversity trends that were variable within and between rivers and generally more evident in rivers with higher species richness and programs of longer duration. We discuss shared and basin-specific landscape level stressors. Having a basic understanding of the nature and extent of trends in fish assemblages is a necessary first step towards understanding factors affecting biodiversity and fisheries in large rivers.

Paired kidney donations to expand the living donor pool.

PubMed

Ferrari, Paolo; de Klerk, Marry

2009-01-01

The shortage of available deceased donors and the longer kidney transplant waiting lists in many countries around the world have placed greater emphasis on living donation (LD) as a means of meeting demand for transplantation in patients with end-stage kidney disease (ESKD). Increased LD rates are also driven by less invasive approaches to donor nephrectomy and by the excellent long-term results. LD kidney transplant outcomes are equivalent, if not superior, to those from deceased donors, even when donor and recipient are not genetically related, as is the case with spousal donations, the most frequent cohort of LD. Approximately 30% of willing and otherwise appropriate kidney donor/recipient pairs are biologically incompatible and do not proceed to live donor transplantation. In recent years, a number of strategies have been introduced to expand living donation programs beyond the classical direct donation, to overcome immunological barriers of blood group or HLA sensitization of recipients. New strategies in LD include paired kidney exchange (PKE), altruistic donation, altruistic donor chains and list exchange programs. Other alternative programs are desensitization and transplantation across the blood-type barrier. Regular PKE programs operate nationally in The Netherlands and the United Kingdom, or regionally in South Korea, Romania, the United States and Australia. If PKE were performed routinely using 2-way or 3-way PKE and altruistic donor chains, the rate of kidney transplants could increase by between 7% and 10%.

Can data from disparate long-term fish monitoring programs be used to increase our understanding of regional and continental trends in large river assemblages?

PubMed Central

Waite, Ian R.; Casper, Andrew F.; Ward, David L.; Sauer, Jennifer S.; Irwin, Elise R.; Chapman, Colin G.; Ickes, Brian S.; Paukert, Craig P.; Kosovich, John J.; Bayer, Jennifer M.

2018-01-01

Understanding trends in the diverse resources provided by large rivers will help balance tradeoffs among stakeholders and inform strategies to mitigate the effects of landscape scale stressors such as climate change and invasive species. Absent a cohesive coordinated effort to assess trends in important large river resources, a logical starting point is to assess our ability to draw inferences from existing efforts. In this paper, we use a common analytical framework to analyze data from five disparate fish monitoring programs to better understand the nature of spatial and temporal trends in large river fish assemblages. We evaluated data from programs that monitor fishes in the Colorado, Columbia, Illinois, Mississippi, and Tallapoosa rivers using non-metric dimensional scaling ordinations and associated tests to evaluate trends in fish assemblage structure and native fish biodiversity. Our results indicate that fish assemblages exhibited significant spatial and temporal trends in all five of the rivers. We also document native species diversity trends that were variable within and between rivers and generally more evident in rivers with higher species richness and programs of longer duration. We discuss shared and basin-specific landscape level stressors. Having a basic understanding of the nature and extent of trends in fish assemblages is a necessary first step towards understanding factors affecting biodiversity and fisheries in large rivers. PMID:29364953

What Does Attending Early Childhood Program Mean for Child Health in India?

PubMed

Sarkar, Dipanwita; Sarkar, Jayanta

2017-11-01

The health impact of attending early childhood development programs in developing countries remains largely unknown. In this study, we focus on the health consequences of attending preschool programs in India. Using a unique longitudinal dataset, we allow for heterogeneity in the impact of preschool across the distribution of health outcomes while controlling for time-invariant unobservables. We detect unique temporal variation in the effect of preschool attendance - growth of preschool attendees is slower than non-attendees in various parts of the distributions of several anthropometric measures when evaluated in the early years between ages 1 and 5. This effect is likely to reverse in the longer term at age 8. The early years' adverse effect can be explained in part by over-attendance in the form of long daily hours, excessive attendance days, and early entry. The findings are insensitive to nutritional incentives like free meals provided in public schools. The growth-retarding effect remains robust for weight-for-age z-scores, implying that the impact of preschool attendance is not only heterogeneous, but differs across dimensions of health status. Our study highlights the need for strengthening the delivery of childhood programs in developing countries in order to prevent adverse health effects in the critical years. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

In-Space Propulsion Program Overview and Status

NASA Technical Reports Server (NTRS)

Wercinski, Paul F.; Johnson, Les; Baggett, Randy M.

2003-01-01

NASA's In-Space Propulsion (ISP) Program is designed to develop advanced propulsion technologies that can enable or greatly enhance near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. These technologies include: Solar Electric Propulsion, Aerocapture, Solar Sails, Momentum Exchange Tethers, Plasma Sails and other technologies such as Advanced Chemical Propulsion. The ISP Program intends to develop cost-effective propulsion technologies that will provide a broad spectrum of mission possibilities, enabling NASA to send vehicles on longer, more useful voyages and in many cases to destinations that were previously unreachable using conventional means. The ISP approach to identifying and prioritizing these most promising technologies is to use mission and system analysis and subsequent peer review. The ISP program seeks to develop technologies under consideration to Technology Readiness Level (TRL) -6 for incorporation into mission planning within 3-5 years of initiation. The NASA TRL 6 represents a level where a technology is ready for system level demonstration in a relevant environment, usually a space environment. In addition, maximum use of open competition is encouraged to seek optimum solutions under ISP. Several NASA Research Announcements (NRA's) have been released asking industry, academia and other organizations to propose propulsion technologies designed to improve our ability to conduct scientific study of the outer planets and beyond. The ISP Program is managed by NASA Headquarters Office of Space Science and implemented by the Marshall Space Flight Center in Huntsville, Alabama.

A merged model of quality improvement and evaluation: maximizing return on investment.

PubMed

Woodhouse, Lynn D; Toal, Russ; Nguyen, Trang; Keene, DeAnna; Gunn, Laura; Kellum, Andrea; Nelson, Gary; Charles, Simone; Tedders, Stuart; Williams, Natalie; Livingood, William C

2013-11-01

Quality improvement (QI) and evaluation are frequently considered to be alternative approaches for monitoring and assessing program implementation and impact. The emphasis on third-party evaluation, particularly associated with summative evaluation, and the grounding of evaluation in the social and behavioral science contrast with an emphasis on the integration of QI process within programs or organizations and its origins in management science and industrial engineering. Working with a major philanthropic organization in Georgia, we illustrate how a QI model is integrated with evaluation for five asthma prevention and control sites serving poor and underserved communities in rural and urban Georgia. A primary foundation of this merged model of QI and evaluation is a refocusing of the evaluation from an intimidating report card summative evaluation by external evaluators to an internally engaged program focus on developmental evaluation. The benefits of the merged model to both QI and evaluation are discussed. The use of evaluation based logic models can help anchor a QI program in evidence-based practice and provide linkage between process and outputs with the longer term distal outcomes. Merging the QI approach with evaluation has major advantages, particularly related to enhancing the funder's return on investment. We illustrate how a Plan-Do-Study-Act model of QI can (a) be integrated with evaluation based logic models, (b) help refocus emphasis from summative to developmental evaluation, (c) enhance program ownership and engagement in evaluation activities, and (d) increase the role of evaluators in providing technical assistance and support.

Monitoring multiple species: Estimating state variables and exploring the efficacy of a monitoring program

USGS Publications Warehouse

Mattfeldt, S.D.; Bailey, L.L.; Grant, E.H.C.

2009-01-01

Monitoring programs have the potential to identify population declines and differentiate among the possible cause(s) of these declines. Recent criticisms regarding the design of monitoring programs have highlighted a failure to clearly state objectives and to address detectability and spatial sampling issues. Here, we incorporate these criticisms to design an efficient monitoring program whose goals are to determine environmental factors which influence the current distribution and measure change in distributions over time for a suite of amphibians. In designing the study we (1) specified a priori factors that may relate to occupancy, extinction, and colonization probabilities and (2) used the data collected (incorporating detectability) to address our scientific questions and adjust our sampling protocols. Our results highlight the role of wetland hydroperiod and other local covariates in the probability of amphibian occupancy. There was a change in overall occupancy probabilities for most species over the first three years of monitoring. Most colonization and extinction estimates were constant over time (years) and space (among wetlands), with one notable exception: local extinction probabilities for Rana clamitans were lower for wetlands with longer hydroperiods. We used information from the target system to generate scenarios of population change and gauge the ability of the current sampling to meet monitoring goals. Our results highlight the limitations of the current sampling design, emphasizing the need for long-term efforts, with periodic re-evaluation of the program in a framework that can inform management decisions.

Characteristics of exercise training interventions to improve cardiorespiratory fitness after stroke: a systematic review with meta-analysis.

PubMed

Marsden, Dianne L; Dunn, Ashlee; Callister, Robin; Levi, Christopher R; Spratt, Neil J

2013-01-01

Cardiorespiratory fitness is low after stroke. Improving fitness has the potential to improve function and reduce secondary cardiovascular events. . This review with meta-analysis aims to identify characteristics and determine the effectiveness of interventions to improve cardiorespiratory fitness after stroke. A systematic search and review with meta-analysis was undertaken. Key inclusion criteria were the following: peer-reviewed articles published in English, adult stroke survivors, an intervention with the potential to improve cardiorespiratory fitness, and peak oxygen consumption (VO2peak) assessed preintervention and postintervention via a progressive aerobic exercise test. From 3209 citations identified, 28 studies were included, reporting results for 920 participants. Studies typically included chronic, ambulant participants with mild to moderate deficits; used an aerobic or mixed (with an aerobic component) intervention; and prescribed 3 sessions per week for 30 to 60 minutes per session at a given intensity. Baseline VO2peak values were low (8-23 mL/kg/min). Meta-analysis of the 12 randomized controlled trials demonstrated overall improvements in VO2peak of 2.27 (95% confidence interval = 1.58, 2.95) mL/kg/min postintervention. A similar 10% to 15% improvement occurred with both aerobic and mixed interventions and in shorter (≤ 3 months) and longer (>3 months) length programs. Only 1 study calculated total dose received and only 1 included long-term follow-up. The results demonstrate that interventions with an aerobic component can improve cardiorespiratory fitness poststroke. Further investigation is required to determine effectiveness in those with greater impairment and comorbidities, optimal timing and dose of intervention, whether improvements can be maintained in the longer term, and whether improved fitness results in better function and reduced risk of subsequent cardiovascular events.

Social costs of expanding access to evidence-based supported employment: concepts and interpretive review of evidence.

PubMed

Salkever, David

2013-02-01

A recent policy analysis argued that expanding access to evidence-based supported employment can provide savings in major components of social costs. This article extends the scope of this policy analysis by placing the argument within a recently developed economic framework for social cost-effectiveness analysis that defines a program's social cost impact as its effect on net consumption of all goods and services. A total of 27 studies over the past two decades are reviewed to synthesize evidence of the social cost impacts of expanding access to the individual placement and support model of supported employment (IPS-SE). Most studies have focused primarily on agency costs of providing IPS-SE services, cost offsets when clients shift from "traditional" rehabilitation to IPS-SE, and impacts on clients' earnings. Because costs and cost offsets are similar in magnitude, incremental costs of expanding services to persons who would otherwise receive traditional services are probably small or even negative. The population served by an expansion could be sizable, but the feasibility of a policy targeting IPS-SE expansion in this way has yet to be demonstrated. IPS-SE has positive impacts on competitive job earnings, but these may not fully translate into social cost offsets. Additional empirical support is needed for the argument that large-scale expansion would yield substantial mental health treatment cost offsets. Other gaps in evidence of policy impacts include take-up rate estimates, cost impact estimates from longer-term studies (exceeding two years), and longer-term studies of whether IPS-SE prevents younger clients from becoming recipients of Supplemental Security Income or Social Security Disability Insurance

Building the green way.

PubMed

Lockwood, Charles

2006-06-01

Just five or six years ago, the term "green building" evoked visions of barefoot, tie-dyed, granola-munching denizens. There's been a large shift in perception. Of course, green buildings are still known for conserving natural resources by, for example, minimizing on-site grading, using alternative materials, and recycling construction waste. But people now see the financial advantages as well. Well-designed green buildings yield lower utility costs, greater employee productivity, less absenteeism, and stronger attraction and retention of workers than standard buildings do. Green materials, mechanical systems, and furnishings have become more widely available and considerably less expensive than they used to be-often cheaper than their standard counterparts. So building green is no longer a pricey experiment; just about any company can do it on a standard budget by following the ten rules outlined by the author. Reliable building-rating systems like the U.S. Green Building Council's rigorous Leadership in Energy and Environmental Design (LEED) program have done much to underscore the benefits of green construction. LEED evaluates buildings and awards points in several areas, such as water efficiency and indoor environmental quality. Other rating programs include the UK's BREEAM (Building Research Establishment's Environmental Assessment Method) and Australia's Green Star. Green construction is not simply getting more respect; it is rapidly becoming a necessity as corporations push it fully into the mainstream over the next five to ten years. In fact, the author says, the owners of standard buildings face massive obsolescence. To avoid this problem, they should carry out green renovations. Corporations no longer have an excuse for eschewing environmental and economic sustainability. They have at their disposal tools proven to lower overhead costs, improve productivity, and strengthen the bottom line.

Psychosocial intervention in at-risk adolescents: using event-related potentials to assess changes in decision making and feedback processing.

PubMed

Pincham, H L; Bryce, D; Fonagy, P; Fearon, R M Pasco

2018-05-25

Decision making and feedback processing are two important cognitive processes that are impacted by social context, particularly during adolescence. The current study examined whether a psychosocial intervention could improve psychological wellbeing in at-risk adolescent boys, thereby improving their decision making and feedback processing skills. Two groups of at-risk adolescents were compared: those who were relatively new to a psychosocial intervention, and those who had engaged over a longer time period. Electroencephalography was recorded while the young people participated in a modified version of the Taylor Aggression Paradigm. The late positive potential (LPP) was measured during the decision phase of the task (where participants selected punishments for their opponents). The feedback-related negativity (FRN) and P3 components were measured during the task's outcome phase (where participants received 'win' or 'lose' feedback). Adolescents who were new to the intervention (the minimal-intervention group) were harsher in their punishment selections than those who had been engaged in the program for much longer. The minimal-intervention group also showed an enhanced LPP during the decision phase of the task, which may be indicative of immature decision making in that group. Analysis of the FRN and P3 amplitudes revealed that the minimal-intervention group was physiologically hypo-sensitive to feedback, compared with the extended-intervention group. Overall, these findings suggest that long-term community-based psychosocial intervention programs are beneficial for at-risk adolescents, and that event-related potentials can be employed as biomarkers of therapeutic change. However, because participants were not randomly allocated to treatment groups, alternative explanations cannot be excluded until further randomized controlled trials are undertaken.

Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception

PubMed Central

Bailey, Martha J.

2014-01-01

This paper assembles new evidence on some of the longer-term consequences of U.S. family planning policies, defined in this paper as those increasing legal or financial access to modern contraceptives. The analysis leverages two large policy changes that occurred during the 1960s and 1970s: first, the interaction of the birth control pill’s introduction with Comstock-era restrictions on the sale of contraceptives and the repeal of these laws after Griswold v. Connecticut in 1965; and second, the expansion of federal funding for local family planning programs from 1964 to 1973. Building on previous research that demonstrates both policies’ effects on fertility rates, I find suggestive evidence that individuals’ access to contraceptives increased their children’s college completion, labor force participation, wages, and family incomes decades later. PMID:25339778

The need for economic evaluation of telemedicine to evolve: the experience in Alberta, Canada.

PubMed

Hailey, David; Jennett, Penny

2004-01-01

Economic evaluation of telemedicine applications is required to provide decision makers in health care with appropriate information on costs and benefits of this information and communications technology. The level of economic evaluation should evolve as telemedicine applications mature. At the basic level, economic evaluation may include basic cost analysis and primarily observational data on nonmonetary benefits. The focus will change as telemedicine programs develop. At this intermediate level, practice patterns and workforce issues are addressed as they affect utilization and costs of telemedicine services. Longer-term economic evaluation, thus far not achieved in telemedicine assessment, should focus on assessment of health outcomes and economic impact. Alberta, Canada has made progress assessing telemedicine applications in psychiatry, radiology, rheumatology, and rehabilitation. Data availability and analytic resources continue to present challenges to economic assessment of telemedicine.

Robot Swarms

NASA Technical Reports Server (NTRS)

Morring, Frank, Jr.

2005-01-01

Engineers and interns at this NASA field center are building the prototype of a robotic rover that could go where no wheeled rover has gone before-into the dark cold craters at the lunar poles and across the Moon s rugged highlands-like a walking tetrahedron. With NASA pushing to meet President Bush's new exploration objectives, the robots taking shape here today could be on the Moon in a decade. In the longer term, the concept could lead to shape-shifting robot swarms designed to explore distant planetary surfaces in advance of humans. "If you look at all of NASA s projections of the future, anyone s projections of the space program, they re all rigid-body architecture," says Steven Curtis, principal investigator on the effort. "This is not rigid-body. The whole key here is flexibility and reconfigurability with a capital R."

Laboratory Reflectance Spectra in the Middle-infrared: Effects of Grain Size on Spectral Features

NASA Astrophysics Data System (ADS)

Le Bras, A.; Erard, S.; Fulchignoni, M.

2000-10-01

Since spectral mineral features are sensitive to surface parameters, interpretation of remote-sensing asteroids spectra in terms of mineral composition is not easy nor unique, and laboratory spectra are needed in order to understand the influence of each parameter. We developped an experimental program at IAS, using the 2.5-120 microns interferometer spectrometer, to study the influence of surface parameters on mineral features. We present here the results obtained variing the grain size. We studied grain size effects with two types of terrestrial rocks: anorthosite (bright) and basalte (dark) in the 2-40 microns range. We observed variations of the spectral contrast with grain size, shifts in wavelengths and variations of the intensity of some characteristic spectral features, and appearence of transparency features at wavelengths longer than 8 microns.

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-01-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services. Copyright 2010 The American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Long-Term Biological Consequences of Nuclear War.

ERIC Educational Resources Information Center

Ehrlich, Paul R.; And Others

1983-01-01

Presents evidence suggesting that the longer-term biological effects resulting from climactic changes may be at least as serious as the immediate ones. Primarily considers results of a nuclear war in which sufficient dust/soot are injected into the atmosphere to attenuate most incident solar radiation. (JN)

Clinical outcomes of a 2-y soy isoflavone supplementation in menopausal women

USDA-ARS?s Scientific Manuscript database

Soy isoflavones are naturally occurring phytochemicals with weak estrogenic cellular effects. Despite numerous clinical trials of short-term isoflavone supplementation, there is a paucity of data regarding longer-term outcomes and safety. Our aim was to evaluate the clinical outcomes of soy hypocoty...

Value of Underground Storage in Today's Natural Gas Industry, The

EIA Publications

1995-01-01

This report explores the significant and changing role of storage in the industry by examining the value of natural gas storage; short-term relationships between prices, storage levels, and weather; and some longer term impacts of the Federal Energy Regulatory Commission's (FERC) Order 636.

Psychodynamic group psychotherapy: impact of group length and therapist professional characteristics on development of therapeutic alliance.

PubMed

Lorentzen, Steinar; Bakali, Jan Vegard; Hersoug, Anne Grete; Hagtvet, Knut A; Ruud, Torleif; Høglend, Per

2012-09-01

Little research has been done on therapeutic alliance in group psychotherapy, especially the impact of treatment duration and therapist professional characteristics. Therapeutic alliance was rated by patients on the Working Alliance Inventory-Short Form at three time points (sessions 3, 10 and 17) in a randomized controlled trial of short-term and long-term psychodynamic group psychotherapy. As predictors we selected therapist clinical experience and length of didactic training, which have demonstrated ambiguous results in previous research. Linear latent variable growth curve models (structural equation modeling) were developed for the three Working Alliance Inventory-Short Form subscales bond, task and goal. We found a significant variance in individual growth curves (intercepts and slopes) but no differential development due to group length. Longer therapist formal training had a negative impact on early values of subscale task in both treatments. There was an interaction between length of the therapists' clinical experience and group length on early bond, task and goal: therapists with longer clinical experience were rated lower on initial bond in the long-term group but less so in the short-term group. Longer clinical experience influenced initial task and goal positively in the short-term group but was unimportant for task or significantly negative for goal in the long-term group. There was no mean development of alliance, and group length did not differentially impact the alliance during 6 months. Early ratings of the three Working Alliance Inventory-Short Form subscales partly reflected different preparations of patients in the two group formats, partly therapist characteristics, but more research is needed to see how these aspects impact alliance development and outcome. Therapists should pay attention to all three aspects of the alliance, when they prepare patients for group therapy. In psychodynamic groups, length of therapy does not differentiate the overall level or the development of member-leader alliance. Within psychodynamic groups, each individual appear to have their unique perception of the member-leader alliance. Therapists with longer formal psychotherapy training may be less successful in establishing early agreement with patients on the tasks of psychodynamic group psychotherapy. Patients perceive a somewhat lower degree of early emotional bonding with the more clinically experienced therapists in long-term psychodynamics groups. Therapists with more clinical experience may contribute to a stronger degree of initial agreement with patients on the tasks and goals of short-term group psychotherapy. Copyright © 2011 John Wiley & Sons, Ltd.

National Clearinghouse for Drug Abuse Information Report Series, Series 22, No. 1. Community Action Programs.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD. National Clearinghouse for Drug Abuse Information.

Based on the principle that drug abuse is no longer a problem restricted to certain economic, social, educational, or intellectual levels or ethnic groups, this pamphlet relates some examples of on-going community action programs and projects. Essentially, these programs are striving to solve some of the drug related problems in their immediate…

The School Lunch Lobby: A Charmed Federal Food Program that No Longer Just Feeds the Hungry

ERIC Educational Resources Information Center

Haskins, Ron

2005-01-01

Consistent with the intent of the original school-lunch program, created by Congress in 1946 to provide "nutritious agricultural commodities" to children, the major purpose of today's school-lunch program is to ensure that children, especially those from poor and low-income families, have nutritious food at school. Even as contentious and partisan…

Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation.

PubMed

Hadjistavropoulos, Thomas; Williams, Jaime; Kaasalainen, Sharon; Hunter, Paulette V; Savoie, Maryse L; Wickson-Griffiths, Abigail

2016-01-01

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

Visual implant elastomer and anchor tag retention in largemouth bass

USGS Publications Warehouse

Hartman, K.J.; Janney, E.C.

2006-01-01

We double-marked largemouth bass Micropterus salmoides with Floy FD-68B anchor tags and visible implant elastomer (VIE) marks before stocking to compare retention of the two marks for age-0 (178 mm total length [TL]) and age-1 (273 mm TL) largemouth bass. In a short-term (31-d) evaluation, retention rate of anchor tags was over 94% for each age-class and retention of VIE marks was 98% in both age-classes. In a longer-term comparison of fish stocked into the Ohio River, retention was substantially higher for VIE marks (92.9%) than for anchor tags (42.9%) after 403 d (ages combined). Although anchor tags had high retention in two sizes of largemouth bass during the short-term experiment, they should not be used in situations where accurate identification of marked fish is required for periods longer than 123 d. ?? Copyright by the American Fisheries Society 2006.

The Historical Context of the 2017 Hurricane Season's Ocean Warmth

NASA Astrophysics Data System (ADS)

Jacobs, P.; Akella, S.; Trenberth, K. E.; Lijing, C.; Abraham, J. P.

2017-12-01

Public discussion of the unusually active 2017 North Atlantic Hurricane Season quickly focused on the role of sea surface temperatures (SSTs) in the North Atlantic. Some meteorologists characterized them as near-normal, while climate-focused voices tended to characterize them as warmer than average, placing them in the context of anthropogenic warming. Much of this divergence in views can be explained by the relatively recent, relatively warm baseline (1981-2010) used for daily SST information, such as provided by OISSTv2. Longer term records of SSTs, such as HadISST, HadSST, and ERSST only attempt to provide monthly averages, while tropical cyclones have lifetimes on the timescale of days. Further, hurricanes create a cold wake which can impact storm movement and intensity, as well as subsequent storms, but is gradually wiped out by the sun. This process is further complicated by the role of ocean heat content (OHC), an increase in which can mitigate the impact of upwelled water. Here we examine the statistical characteristics of daily SSTs and OHC during the satellite record, including their temporal autocorrelation, and use this information in conjunction with longer term monthly records to bound what we can and cannot confidently say about the longer term historical context of the storms Harvey, Irma, and Maria.

Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

PubMed

Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

2016-01-01

Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

Continuous Timescale Long-Short Term Memory Neural Network for Human Intent Understanding

PubMed Central

Yu, Zhibin; Moirangthem, Dennis S.; Lee, Minho

2017-01-01

Understanding of human intention by observing a series of human actions has been a challenging task. In order to do so, we need to analyze longer sequences of human actions related with intentions and extract the context from the dynamic features. The multiple timescales recurrent neural network (MTRNN) model, which is believed to be a kind of solution, is a useful tool for recording and regenerating a continuous signal for dynamic tasks. However, the conventional MTRNN suffers from the vanishing gradient problem which renders it impossible to be used for longer sequence understanding. To address this problem, we propose a new model named Continuous Timescale Long-Short Term Memory (CTLSTM) in which we inherit the multiple timescales concept into the Long-Short Term Memory (LSTM) recurrent neural network (RNN) that addresses the vanishing gradient problem. We design an additional recurrent connection in the LSTM cell outputs to produce a time-delay in order to capture the slow context. Our experiments show that the proposed model exhibits better context modeling ability and captures the dynamic features on multiple large dataset classification tasks. The results illustrate that the multiple timescales concept enhances the ability of our model to handle longer sequences related with human intentions and hence proving to be more suitable for complex tasks, such as intention recognition. PMID:28878646

Personality Differences of Adult Men Before and After a Physical Fitness Program

ERIC Educational Resources Information Center

Young, R. John; Ismail, A. H.

1976-01-01

While all subjects improved on personality factors measuring social precision, persistence, and control after a physical fitness program of jogging, calisthenics, and recreational activities, a longer and intensified period of regular exercise is necessary to cause a dramatic change in personality parameters.

Assessment of educational research capabilities at selected minority institutions

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

Jones, W.J.

1983-07-01

A university, or consortia, to be engaged in DOE R and D programs, must be a source of high quality science, be able to mount multidisciplinary efforts, be dedicated to the agency mission, and be able to bring together unique outside resources if not available elsewhere. The DOE should establish a process through which the minority institutions can more fully participate in the funded research process and not be subjected to criticism which has any reasonable chance of being valid. The DOE should support efforts to establish opportunity for access to and participation in all of the DOE programs bymore » minority colleges and universities so that they can become resources that can contribute to the solution of the nation's energy problems through: involvement in research and development programs of the DOE, and eventually in those of other agencies and industry; education and training of the quantities of personnel needed in energy, energy technology, energy-related issues and disciplines; planning, decision and preparation of quality interdisciplinary curricula; acquisition of the understanding of energy, energy technology, and energy-related issues and policy necessary for technology and information transfer to the local community, industry, academia, and governments; and support of exploratory research in unique projects and new ideas prior to the researcher's obtaining longer-term support elsewhere.« less

Correlates of improvement in substance abuse among dually diagnosed veterans with post-traumatic stress disorder in specialized intensive VA treatment.

PubMed

Coker, Kendell L; Stefanovics, Elina; Rosenheck, Robert

2016-01-01

Substantial rates of substance use comorbidity have been observed among veterans with Post-Traumatic Stress Disorder (PTSD), highlighting the need to identify patient and program characteristics associated with improved outcomes for substance abuse. Data were drawn from 12,270 dually diagnosed veterans who sought treatment from specialized intensive Veterans Health Administration PTSD programs between 1993 and 2011. The magnitude of the improvement in Addiction Severity Index (ASI) alcohol and drug use composite scores from baseline was moderate, with effect sizes (ES) of -.269 and -.287, respectively. Multivariate analyses revealed that treatment in longer-term programs, being prescribed psychiatric medication, and planned participation in reunions were all associated with slightly improved outcomes. Reductions in substance use measures were associated with robust improvements in PTSD symptoms and violent behavior. These findings suggest not only synergistic treatment effects linking improvement in PTSD symptoms with substance use disorders among dually diagnosed veterans with PTSD, but also to reductions in violent behavior. Furthermore, the findings indicate that proper discharge planning in addition to intensity and duration of treatment for dually diagnosed veterans with severe PTSD may result in better outcomes. Further dissemination of evidence-based substance abuse treatment may benefit this population. (c) 2016 APA, all rights reserved).

Characterizing Durations of Heroin Abstinence in the California Civil Addict Program: Results From a 33-Year Observational Cohort Study

PubMed Central

Nosyk, Bohdan; Anglin, M. Douglas; Brecht, Mary-Lynn; Lima, Viviane Dias; Hser, Yih-Ing

2013-01-01

In accordance with the chronic disease model of opioid dependence, cessation is often observed as a longitudinal process rather than a discrete endpoint. We aimed to characterize and identify predictors of periods of heroin abstinence in the natural history of recovery from opioid dependence. Data were collected on participants from California who were enrolled in the Civil Addict Program from 1962 onward by use of a natural history interview. Multivariate regression using proportional hazards frailty models was applied to identify independent predictors and correlates of repeated abstinence episode durations. Among 471 heroin-dependent males, 387 (82.2%) reported 932 abstinence episodes, 60.3% of which lasted at least 1 year. Multivariate analysis revealed several important findings. First, demographic factors such as age and ethnicity did not explain variation in durations of abstinence episodes. However, employment and lower drug use severity predicted longer episodes. Second, abstinence durations were longer following sustained treatment versus incarceration. Third, individuals with multiple abstinence episodes remained abstinent for longer durations in successive episodes. Finally, abstinence episodes initiated >10 and ≤20 years after first use lasted longer than others. Public policy facilitating engagement of opioid-dependent individuals in maintenance-oriented drug treatment and employment is recommended to achieve and sustain opioid abstinence. PMID:23445901

Tracing Impacts of Science and Technology Development

NASA Astrophysics Data System (ADS)

Powell, Jeanne

2003-03-01

ATP's Mission and Operations. The ATP partners with industry to accelerate the development of innovative technologies for broad national economic benefit. The program's focus is on co-funding collaborative, multi-disciplinary technologies and enabling technology platforms that appear likely to be commercialized, with private sector funding, once the high technical risks are reduced. Industry-led projects are selected for funding in rigorous competitions on the basis of technical and economic merit. Since 1990, ATP has co-funded 642 projects, with 1,329 participants and another 1,300 subcontractors. Measuring to Mission: Overview of ATP's Evaluation Program. ATP's multi-component evaluation strategy provides measures of progress and performance matched to the stage of project evolution; i.e., for the short-term, from the time of project selection and over the course of the R for the mid-term, as commercial applications are pursued, early products reach the market, and dissemination of knowledge created in the R projects occurs; and for the longer-term, as more fully-developed technologies diffuse across multiple products and industries. The approach is applicable to all public S programs and adaptable to private or university projects ranging from basic research to applied industrial R. Examples of Results. ATP's composite performance rating system assesses ATP's completed projects against multi-faceted performance criteria of Knowledge Creation and Dissemination and Commercialization Progress 2-3 years after the end of ATP-funded R. It generates scores ranging from zero to four stars. Results for ATP's first 50 completed projects show that 16are in the bottom group of zero or one stars. 60the middle group. It is understood that not all ATP projects will be successful given the program's emphasis on funding high-risk technology development that the private sector is unwilling and unable to fund alone. Different technologies have different timelines for commercialization and diffusion. ATP has contracted a number of in-depth case studies of individual projects and groups of related projects. Given that the full timeline for economic impact extends many years after ATP funding ends, some studies are prospective, and others are retrospective. Some are a mix of the two. Quantitative economic impacts from just a few or the projects funded to date provide strong evidence that the ATP is addressing its ultimate goal of broad economic benefits to the nation and generating value that vastly exceeds the cost of the program to date.

Brownfields opportunity -- A product of a probusiness USEPA

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

Anderson, K.E.

Brownfields are former industrial facilities, office buildings or other properties that have been abandoned or are no longer in use. They may be returned as a beneficial asset of a company with prudent planning and by completing selected activities. The tangible economic impacts of a Brownfield property often result in lost taxes and lost jobs. In order to return a Brownfield property to beneficial use various activities are involved, which may include the services provided by many or all of the following: attorneys, financiers, insurance firms, business planners and operators, and environmental consultants. The melding of these diverse resources formore » a specific project must be determined on a case-by-case basis in a flexible manner. Consistent with the desire of much of the populace to return Brownfields to meaningful assets, the US Environmental Protection Agency (USEPA) has now adopted a practical, profitable and reasonably low-risk program termed the Brownfields Incentive. Included in the Brownfields Incentive program are more reasonable, yet safe, cleanup levels. Additionally, this program provides specific protection for Brownfields participants from fines, sanctions and legal actions. Consistent with the USEPA`s program, approximately 40 states have also initiated or are planning to initiate Brownfields programs. It is obvious that programs exist at the Federal and State levels to enable the reasonable redevelopment of existing abandoned or vacant properties. The ability to form a team of professionals to redevelop a Brownfield property is required. A proper team of professionals, each performing activities required to return the property to a functioning status, will assure the success of a Brownfield project.« less

Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study.

PubMed

Bourmaud, A; Anota, A; Moncharmont, C; Tinquaut, F; Oriol, M; Trillet-Lenoir, V; Bajard, A; Parnalland, S; Rotonda, C; Bonnetain, F; Pérol, D; Chauvin, F

2017-03-28

To assess the efficacy of a patient educational program built according to guidelines that aims at reducing cancer-related fatigue (CRF). Randomised controlled trial, multicentre, comparing a patient education program, vs the standard of care. Patients were adult cancer outpatients with any tumour site. The primary outcome was fatigue severity assessed with a visual analogical scale (VAS), between the day of randomisation and week 7. Secondary outcomes were fatigue assessed with other scales, health-related quality of life, anxiety and depression. The time to fatigue severity deterioration was assessed. Analyses were performed in a modified intent-to-treat way, that is, including all patients with at least one baseline and 1 week 7 score. A total of 212 patients were included. Fatigue severity assessment was made on 79 patients in the experimental group and 65 in the control group. Between randomisation and week 7, the fatigue (VAS) improved by 0.96 (2.85) points in the experimental group vs 1.63 (2.63) points in the control group (P=0.15). No differences with the secondary outcomes were highlighted between two groups. No other factors were found to be associated with fatigue severity deterioration. Despite rigorous methodology, this study failed to highlight the program efficacy in fatigue reduction for cancer patients. Other assessment tools should be developed to measure the effect of the program on CRF and behaviour. The implementation of the program should also be explored in order to identify its mechanisms and longer-term impact.

Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study

PubMed Central

Bourmaud, A; Anota, A; Moncharmont, C; Tinquaut, F; Oriol, M; Trillet-Lenoir, V; Bajard, A; Parnalland, S; Rotonda, C; Bonnetain, F; Pérol, D; Chauvin, F

2017-01-01

Background: To assess the efficacy of a patient educational program built according to guidelines that aims at reducing cancer-related fatigue (CRF). Methods: Randomised controlled trial, multicentre, comparing a patient education program, vs the standard of care. Patients were adult cancer outpatients with any tumour site. The primary outcome was fatigue severity assessed with a visual analogical scale (VAS), between the day of randomisation and week 7. Secondary outcomes were fatigue assessed with other scales, health-related quality of life, anxiety and depression. The time to fatigue severity deterioration was assessed. Analyses were performed in a modified intent-to-treat way, that is, including all patients with at least one baseline and 1 week 7 score. Results: A total of 212 patients were included. Fatigue severity assessment was made on 79 patients in the experimental group and 65 in the control group. Between randomisation and week 7, the fatigue (VAS) improved by 0.96 (2.85) points in the experimental group vs 1.63 (2.63) points in the control group (P=0.15). No differences with the secondary outcomes were highlighted between two groups. No other factors were found to be associated with fatigue severity deterioration. Conclusions: Despite rigorous methodology, this study failed to highlight the program efficacy in fatigue reduction for cancer patients. Other assessment tools should be developed to measure the effect of the program on CRF and behaviour. The implementation of the program should also be explored in order to identify its mechanisms and longer-term impact. PMID:28196066

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

PubMed

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

2012-01-01

The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy.

Head-and-Neck Target Delineation Among Radiation Oncology Residents After a Teaching Intervention: A Prospective, Blinded Pilot Study

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

Bekelman, Justin E.; Wolden, Suzanne; Lee, Nancy

Purpose: We conducted this study to determine the feasibility of incorporating a teaching intervention on target delineation into the educational curriculum of a radiation oncology residency program and to assess the short-term effects on resident skills. Methods and Materials: The study schema consisted of a baseline evaluation, the teaching intervention, and a follow-up evaluation. At the baseline evaluation, the participants contoured three clinical tumor volumes (CTVs) (70 Gy, 59.4 Gy, and 54 Gy) on six contrast-enhanced axial computed tomography images of a de-identified patient with Stage T2N2bM0 squamous cell carcinoma of the right base of the tongue. The participants attendedmore » a series of head-and-neck oncology and anatomy seminars. The teaching intervention consisted of a didactic lecture and an interactive hands-on practical session designed to improve the knowledge and skills for target delineation in the head and neck. At the follow-up evaluation, the residents again contoured the CTVs. Results: Of the 14 eligible residents, 11 (79%) actually participated in the study. For all participants, but especially for those who had not had previous experience with head-and-neck target delineation, the teaching intervention was associated with improvement in the delineation of the node-negative neck (CTV 54 Gy contour). Regardless of clinical experience, participants had difficulty determining what should be included in the CTV 59.4 Gy contour to ensure adequate coverage of potential microscopic disease. Conclusion: Incorporating a teaching intervention into the education curriculum of a radiation oncology residency program is feasible and was associated with short-term improvements in target delineation skills. Subsequent interventions will require content refinement, additional validation, longer term follow-up, and multi-institutional collaboration.« less

Australia's TERN: Building, Sustaining and Advancing Collaborative Long Term Ecosystem Research Networks

NASA Astrophysics Data System (ADS)

HEld, A. A.; Phinn, S. R.

2012-12-01

TERN is Australia's Terrestrial Ecosystem Research Network (www.tern.org.au) is one of several environmental data collection, storage and sharing projects developed through the government's research infrastructure programs 2008-2014. This includes terrestrial and coastal ecosystem data collection infrastructure across multiple disciplines, hardware, software and processes used to store, analyse and integrate data sets. TERN's overall objective is to build the collaborations, infrastructure and programs to meet the needs of ecosystem science communities in Australia in the long term, through institutional frameworks necessary to establish a national terrestrial ecosystem site and observational network, coordinated networks enabling cooperation and operational experience; public access to quality assured and appropriately licensed data; and allowing the terrestrial ecosystem research community to define and sustain the terrestrial observing paradigm into the longer term. This paper explains how TERN was originally established, and now operates, along with plans to sustain itself in the future. TERN is implemented through discipline/technical groups referred to as "TERN Facilities". Combined, the facilities provide observations of surface mass and energy fluxes over key ecosystems, biophysical remote sensing data, ecological survey plots, soils information, and coastal ecosystems and associated water quality variables across Australia. Additional integrative facilities cover elements of ecoinformatics, data-scaling and modelling, and linking science to management. A central coordination and portal facility provides meta-data storage, data identification, legal and licensing support. Data access, uploading, meta-data generation, DOI attachment and licensing is completed at each facility's own portal level. TERN also acts as the open-data repository of choice for Australian scientists required to publish their data. Several key lessons we have learnt, will be presented during the talk.

24 CFR 578.51 - Rental assistance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

24 CFR 578.51 - Rental assistance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

TennCare and academic medical centers: the lessons from Tennessee.

PubMed

Meyer, G S; Blumenthal, D

1996-09-04

To ascertain the potential impact of public-sector-driven health system reform (Medicaid and Medicare programs) on academic medical centers (AMCs). A qualitative, case-study investigation of how 2 of Tennessee's 4 AMCs were affected by the TennCare program, which enrolled all of the state's Medicaid recipients and a sizable portion of its uninsured in managed care organizations (MCOs) in January 1994. We reviewed pertinent documents related to the AMCs, response to TennCare; interviewed AMC executives and staff, state officials, and representatives of MCOs serving TennCare beneficiaries; and conducted site visits at both AMCs. Changes in clinical revenues, clinical volume, patient selection, support for the AMCs, teaching and research missions, and the AMCs' response to these changes. Both AMCs studied experienced large revenue shortfalls, the closure of some specialty services, adverse patient selection, and loss of the patient volume needed to do clinical research, and had to reduce the number of training program positions. Longer-term consequences of TennCare for AMCs may include the integration of community-based services into academic missions, the acceleration of clinical diversification, and the attainment of experience in managed care, anticipating the evolution of the private-sector market. The consequences of public-sector health system reform for AMCs are similar to, and equally as challenging as, the effects of private-sector changes in health care delivery. Important differences include the rapidity with which public-sector reforms can transform the AMC market, the vulnerability of special payments to AMCs, such as graduate medical education funding, and the accountability of managers of public-sector initiatives to the political process. It remains to be seen whether public-sector reforms will afford some competitive advantage to AMCs over the long term.

Optimism and challenge for science-based conservation of migratory species in and out of U.S. National Parks.

PubMed

Berger, Joel; Cain, Steven L; Cheng, Ellen; Dratch, Peter; Ellison, Kevin; Francis, John; Frost, Herbert C; Gende, Scott; Groves, Craig; Karesh, William A; Leslie, Elaine; Machlis, Gary; Medellin, Rodrigo A; Noss, Reed F; Redford, Kent H; Soukup, Michael; Wilcove, David; Zack, Steve

2014-02-01

Public agencies sometimes seek outside guidance when capacity to achieve their mission is limited. Through a cooperative agreement and collaborations with the U.S. National Park Service (NPS), we developed recommendations for a conservation program for migratory species. Although NPS manages ∼ 36 million hectares of land and water in 401 units, there is no centralized program to conserve wild animals reliant on NPS units that also migrate hundreds to thousands of kilometers beyond parks. Migrations are imperiled by habitat destruction, unsustainable harvest, climate change, and other impediments. A successful program to counter these challenges requires public support, national and international outreach, and flourishing migrant populations. We recommended two initial steps. First, in the short term, launch or build on a suite of projects for high-profile migratory species that can serve as proof to demonstrate the centrality of NPS units to conservation at different scales. Second, over the longer term, build new capacity to conserve migratory species. Capacity building will entail increasing the limited knowledge among park staff about how and where species or populations migrate, conditions that enable migration, and identifying species' needs and resolving them both within and beyond parks. Building capacity will also require ensuring that park superintendents and staff at all levels support conservation beyond statutory borders. Until additional diverse stakeholders and a broader American public realize what can be lost and do more to protect it and engage more with land management agencies to implement actions that facilitate conservation, long distance migrations are increasingly likely to become phenomena of the past. © 2014 Society for Conservation Biology.

Effect of Upper Limb Rehabilitation Compared to No Upper Limb Rehabilitation in Lung Transplant Recipients: A Randomized Controlled Trial.

PubMed

Fuller, Louise M; El-Ansary, Doa; Button, Brenda M; Corbett, Monique; Snell, Greg; Marasco, Silvana; Holland, Anne E

2017-10-16

To investigate the effect of a supervised upper limb (UL) program (SULP) compared to no supervised UL program (NULP) after lung transplantation (LTx). Randomized controlled trial. Physiotherapy gym. Participants (N=80; mean age, 56±11y; 37 [46%] men) were recruited after LTx. All participants underwent lower limb strength thrice weekly and endurance training. Participants randomized to SULP completed progressive UL strength training program using handheld weights and adjustable pulley equipment. Overall bodily pain was rated on the visual analog scale. Shoulder flexion and abduction muscle strength were measured on a hand held dynamometer. Health related quality of life was measured with Medical Outcomes Study 36-item Short Form health Survey and the Quick Dash. Measurements were made at baseline, 6 weeks, 12 weeks, and 6 months by blinded assessors. After 6 weeks of training, participants in the SULP (n=41) had less overall bodily pain on the visual analog scale than did participants in the NULP (n=36) (mean VAS bodily pain score, 2.1±1.3cm vs 3.8±1.7cm; P<.001) as well as greater UL strength than did participants in the NULP (mean peak force, 8.4±4.0Nm vs 6.7±2.8Nm; P=.037). At 12 weeks, participants in the SULP better quality of life related to bodily pain (76±17 vs 66±26; P=.05), but at 6 months there were no differences between the groups in any outcome measures. No serious adverse events were reported. UL rehabilitation results in short-term improvements in pain and muscle strength after LTx, but no longer-term effects were evident. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

2017 Update on the WFC3/UVIS Stability and Contamination Monitor

NASA Astrophysics Data System (ADS)

Shanahan, C. E.; Gosmeyer, C. M.; Baggett, S.

2017-06-01

The photometric throughput of the UVIS detector on WFC3 is monitored each cycle for its stability as a function of time, wavelength, as well as to check for any evidence of contamination on the CCD windows, which would manifest as a decrease in throughput strongest in the bluest filters. This program has been in place since the installation of WFC3 in 2009, historically making periodic observations of the spectrophotometric standard GRW+70d5824 (GRW70) in several key filters from 200 nm to 600 nm, with red filters acting as a control. This is a follow up report to the last analysis of the temporal stability of UVIS (Gosmeyer et al., 2014), since which several major changes to the program and data analysis have been implemented. Due to recent work suggesting a low-level, long-term variability for GRW70, another spectrophotometric standard star - GD153 - has been added to the program and is now analyzed in conjunction with GRW70. Data are now processed with the latest version of the CALWF3 calibration pipeline (v. 3.4), which has several new features that represent a paradigm shift in calibration methodology. Finally, the data analysis software, which was previously entirely IRAF based, was re-written in Python. We find a steady decline in the count rate for most filters but no evidence for contamination, which would manifest as a wavelength-dependent effect, impacting bluer filters more strongly. These declines range from 0.01% to 0.3% per year, and are stronger in longer wavelength filters. Similar temporal changes are found for both stars, and the long-term trends in throughput agree with previous trends derived in 2014.

Forging T-Lymphocyte Identity: Intersecting Networks of Transcriptional Control.

PubMed

Rothenberg, Ellen V; Ungerbäck, Jonas; Champhekar, Ameya

2016-01-01

T-lymphocyte development branches off from other lymphoid developmental programs through its requirement for sustained environmental signals through the Notch pathway. In the thymus, Notch signaling induces a succession of T-lineage regulatory factors that collectively create the T-cell identity through distinct steps. This process involves both the staged activation of T-cell identity genes and the staged repression of progenitor-cell-inherited regulatory genes once their roles in self-renewal and population expansion are no longer needed. With the recent characterization of innate lymphoid cells (ILCs) that share transcriptional regulation programs extensively with T-cell subsets, T-cell identity can increasingly be seen as defined in modular terms, as the processes selecting and actuating effector function are potentially detachable from the processes generating and selecting clonally unique T-cell receptor structures. The developmental pathways of different classes of T cells and ILCs are distinguished by the numbers of prerequisites of gene rearrangement, selection, and antigen contact before the cells gain access to nearly common regulatory mechanisms for choosing effector function. Here, the major classes of transcription factors that interact with Notch signals during T-lineage specification are discussed in terms of their roles in these programs, the evidence for their spectra of target genes at different stages, and their cross-regulatory and cooperative actions with each other. Specific topics include Notch modulation of PU.1 and GATA-3, PU.1-Notch competition, the relationship between PU.1 and GATA-3, and the roles of E proteins, Bcl11b, and GATA-3 in guiding acquisition of T-cell identity while avoiding redirection to an ILC fate. © 2016 Elsevier Inc. All rights reserved.

Basic instincts

NASA Astrophysics Data System (ADS)

Hutson, Matthew

2018-05-01

In their adaptability, young children demonstrate common sense, a kind of intelligence that, so far, computer scientists have struggled to reproduce. Gary Marcus, a developmental cognitive scientist at New York University in New York City, believes the field of artificial intelligence (AI) would do well to learn lessons from young thinkers. Researchers in machine learning argue that computers trained on mountains of data can learn just about anything—including common sense—with few, if any, programmed rules. But Marcus says computer scientists are ignoring decades of work in the cognitive sciences and developmental psychology showing that humans have innate abilities—programmed instincts that appear at birth or in early childhood—that help us think abstractly and flexibly. He believes AI researchers ought to include such instincts in their programs. Yet many computer scientists, riding high on the successes of machine learning, are eagerly exploring the limits of what a naïve AI can do. Computer scientists appreciate simplicity and have an aversion to debugging complex code. Furthermore, big companies such as Facebook and Google are pushing AI in this direction. These companies are most interested in narrowly defined, near-term problems, such as web search and facial recognition, in which blank-slate AI systems can be trained on vast data sets and work remarkably well. But in the longer term, computer scientists expect AIs to take on much tougher tasks that require flexibility and common sense. They want to create chatbots that explain the news, autonomous taxis that can handle chaotic city traffic, and robots that nurse the elderly. Some computer scientists are already trying. Such efforts, researchers hope, will result in AIs that sit somewhere between pure machine learning and pure instinct. They will boot up following some embedded rules, but will also learn as they go.

Postgraduate training for young psychiatrists--experience of the Berlin Summer School.

PubMed

Mihai, A; Ströhle, A; Maric, N; Heinz, A; Helmchen, H; Sartorius, N

2006-12-01

Growing professional exchange between Eastern and Western European countries increases the possibilities for international postgraduate training courses and by that satisfying the need for rapid and facilitation of travel and migration in the enlarged European Union increase achieving high standards. The purpose of this study was to evaluate a summer school program that trained young Eastern European psychiatrists and to assess the impact of the program on their professional development and future activities. We evaluated the training effect of the first 3 years of the Berlin Summer School with respect to (1) the participants' satisfaction with the topics, quality and originality of the presentations, and (2) long-term effects and implications for their professional career. All participants (N=43) filled out anonymously the evaluation form at the end of each summer school. An evaluation of long-term effects was carried out 2 years later with a questionnaire that was sent via e-mail to all former participants. Participants were most satisfied with practical topics such as "how to prepare a paper", "how to evaluate a paper", or "how to participate in a congress." The appreciation of the presented topics and the appreciation of courses increased in each consecutive summer school. All summer school participants reported that the course had some influence on their future career, and one fifth of the participants felt that their professional development was influenced "a lot". Although limited to 1 week of intensive training, a summer school program can have a longer lasting positive influence on the professional development of the participants. Participants felt that particularly the training of practical skills improved their research performance. Former participants founded an independent multicentric and multinational research group and supported national courses that were organized similar to the Berlin Summer School.

Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

PubMed

Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

2015-11-01

NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. There were 202,804 cases included in secondary analysis and 3075 in the prospective study. A combination of behavioural support and stop smoking medication delivered by SSS practitioners. Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected. Stop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012-13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites. The National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

34 CFR 668.164 - Disbursing funds.

Code of Federal Regulations, 2010 CFR

2010-07-01

... policy, the institution must nevertheless disburse the funds to the student using a method described in..., and TEACH Grant programs, the student is no longer enrolled at the institution for the award year. (2...; or (C) For an award under the TEACH Grant program, the institution originates the award to the...

ENGLEWOOD PUBLIC SCHOOLS ELEMENTARY READING GUIDE.

ERIC Educational Resources Information Center

TROUT, JOHN; AND OTHERS

THE READING GUIDE OF THE ENGLEWOOD PUBLIC SCHOOLS, NEW JERSEY, EMPHASIZES INDIVIDUALIZED INSTRUCTION. TEACHERS ARE URGED TO BE LESS CONCERNED WITH TEXTBOOK MATERIAL AND MORE CONCERNED WITH PUPIL ABILITY. THE FOLLOWING THREE PREMISES GUIDE THE READING PROGRAM--(1) GRADE PLACEMENTS ARE NO LONGER AN ADEQUATE BASIS FOR STRUCTURING THE READING PROGRAM.…

Commercialization of the British Extension Service: An American View.

ERIC Educational Resources Information Center

Harter, Don

1993-01-01

Britain's decision to commercialize the Agricultural Development and Advisory Service has implications for extension programs in other countries. If programs now offered were commercialized, extension would no longer be an agency responsive to the public interest as a whole but would be driven by interests of paying clients. (JOW)

Leadership Development for Teachers: Models and Choices.

ERIC Educational Resources Information Center

Burgess, Wm. V.

Studies have shown that a commitment to any change, including curricular program, student policy, or educational innovation, is best obtained by involving those who are most affected by the change. Staff development and inservice education programs are longer-lasting and more positively received when the instructional staff are part of the…

Attitudes of Ohio Vocational Agriculture Teachers toward Summer Programs.

ERIC Educational Resources Information Center

Short, Gary E.; Miller, Larry E.

Because many experiences needed by vocational agriculture students typically occur during the summer, the contracts of Ohio vocational agriculture teachers have been longer than the typical 9-month academic school year. A study examined the attitudes of vocational agriculture instructors throughout Ohio toward summer programs so that policymakers…

StarBright Learning Exchange

ERIC Educational Resources Information Center

Kalinowski, Michael

2007-01-01

This article features StarBright Learning Exchange, a program that provides a cross-cultural exchange between Australian and South African early childhood educators. The program was originated when its president, Carol Allen, and her colleague, Karen Williams, decided that they could no longer sit by and watch the unfolding social catastrophe that…

Enhanced Preliminary Assessment Fort Devens, Massachusetts

DTIC Science & Technology

1992-04-30

remedial programs and RCRA corrective actions at Fort Devens . The areas regulated under RCRA will require closure when no longer in...under which the work in the MEP has been developed requires full integration of CERCLA remedial programs and RCRA corrective actions at Fort Devens ...AREEs 65 and 67, asbestos and radon, respectively. Fort Devens has ongoing programs that deal with these concerns. Any remedial action or disturbance

Facilitating longer working lives: international evidence on why and how.

PubMed

Wise, David A

2010-01-01

The article advances the view that social and economic choices in societies can reasonably adjust as the age structure of the population changes; in particular, some of the bounty of longer lives can reasonably be allocated to prolonging the labor force participation of older workers. Data on reductions in mortality and, in some countries, declines in disability are presented in ways that help to clarify that prolonged working lives may be a natural concomitant of living longer. The article reviews the problems inherent in the combination of living longer and reducing labor force participation at older ages. It discusses two ways to facilitate longer working lives: (1) eliminating penalties on work at older ages--inherent in the provisions of the social security programs in many countries--that induce older persons to leave the labor force at younger ages; and (2) correcting a false rationale--the "boxed economy" view of the labor market--that is often used to support retention of the provisions that induce older persons to leave the labor force.

Content and Evaluation of the Benefits of Effective Exercise for Older Adults With Knee Pain Trial Physiotherapist Training Program.

PubMed

Holden, Melanie A; Whittle, Rebecca; Healey, Emma L; Hill, Susan; Mullis, Ricky; Roddy, Edward; Sowden, Gail; Tooth, Stephanie; Foster, Nadine E

2017-05-01

To explore whether participating in the Benefits of Effective Exercise for knee Pain (BEEP) trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain in older adults. Before/after training program evaluation. Physiotherapists were asked to complete a questionnaire before the BEEP trial training program, immediately after, and 12 to 18 months later (postintervention delivery in the BEEP trial). The questionnaire included a case vignette and associated clinical management questions. Questionnaire responses were compared over time and between physiotherapists trained to deliver each intervention within the BEEP trial. Primary care. Physiotherapists (N=53) who completed the BEEP trial training program. Not applicable. Self-confidence in the diagnosis and management of knee pain in older adults; and intended clinical behavior measured by a case vignette and associated clinical management questions. Fifty-two physiotherapists (98%) returned the pretraining questionnaire, and 44 (85%) and 39 (74%) returned the posttraining and postintervention questionnaires, respectively. Posttraining, self-confidence in managing older adults with knee pain increased, and intended clinical behavior regarding exercise for knee pain in older adults appeared more in line with clinical guidelines. However, not all positive changes were maintained in the longer-term. Participating in the BEEP trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain, but by 12 to 18 months later, some of these positive changes were lost. This suggests that brief training programs are useful, but additional strategies are likely needed to successfully maintain changes in clinical behavior over time. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Army Logistician. Volume 41, Issue 4, July-August 2009

DTIC Science & Technology

2009-08-01

misuse the terms associated with targeting to fit sustainment, we run the risk of misusing the original term when it is used in the context of lethal...but as the term became a “catch- all” for Army operations, the original concept lost its intended purpose. We no longer use the term because of its...the detriment of its original purpose in Army plan- ning and operations. Rather than change terminology, the sustainment community needs to focus on

A prospective study of the severity of early respiratory distress in late preterms compared to term infants.

PubMed

Kitsommart, Ratchada; Phatihattakorn, Chayawat; Pornladnun, Pornpat; Paes, Bosco

2016-01-01

To compare the severity of early respiratory distress in late preterm (LPT) versus term infants. A prospective cohort study was conducted in a tertiary care neonatal unit in Thailand. Levels of respiratory support, duration of intubation, and short term morbidities were compared between LPT and term infants. Two-hundred nineteen LPT and 564 term infants were included over a period of 2 years (2009-2011). 106 (48.4%) LPTs versus 58 (10.3%) term infants received non-invasive ventilation or intubation [p < 0.001; OR (95% CI) 8.2 (5.6, 12.0)]. The intubation rate was 24.7% in LPTs versus 7.3% in term infants [p < 0.001; OR (95% CI) 4.18 (2.7, 6.5)]. The duration of intubation was longer in LPT infants (median 5.0 versus 2.0 days. p = 0.03). There was a non-significant trend towards a higher mortality rate in the LPT group [p = 0.14; OR (95% CI) 3.9 (0.7, 23.5)]. This is one of three published prospective studies on the topic. The study design lends more robust credence to the results previously identified only in retrospective and systematic reviews. LPT infants are more likely to require positive-pressure ventilation support and incur a longer duration of intubation. A trend towards greater mortality is prevalent compared to term infants.

Strange Words: Autistic Traits and the Processing of Non-Literal Language.

PubMed

McKenna, Peter E; Glass, Alexandra; Rajendran, Gnanathusharan; Corley, Martin

2015-11-01

Previous investigations into metonymy comprehension in ASD have confounded metonymy with anaphora, and outcome with process. Here we show how these confounds may be avoided, using data from non-diagnosed participants classified using Autism Quotient. Participants read sentences containing target words with novel or established metonymic senses (e.g., Finland, Vietnam) in literal- or figurative-supporting contexts. Participants took longer to read target words in figurative contexts, especially where the metonymic sense was novel. Importantly, participants with higher AQs took longer still to read novel metonyms. This suggests a focus for further exploration, in terms of potential differences between individuals diagnosed with ASD and their neurotypical counterparts, and more generally in terms of the processes by which comprehension is achieved.

California-Specific Power-to-Hydrogen and Power-to-Gas Business Case Evaluation

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

Eichman, Joshua D.; Flores-Espino, Francisco

Flexible operation of electrolysis systems represents an opportunity to reduce the cost of hydrogen for a variety of end-uses while also supporting grid operations and thereby enabling greater renewable penetration. California is an ideal location to realize that value on account of growing renewable capacity and markets for hydrogen as a fuel cell electric vehicle (FCEV) fuel, refineries, and other end-uses. Shifting the production of hydrogen to avoid high cost electricity and participation in utility and system operator markets along with installing renewable generation to avoid utility charges and increase revenue from the Low Carbon Fuel Standard (LCFS) program canmore » result in around $2.5/kg (21%) reduction in the production and delivery cost of hydrogen from electrolysis. This reduction can be achieved without impacting the consumers of hydrogen. Additionally, future strategies for reducing hydrogen cost were explored and include lower cost of capital, participation in the Renewable Fuel Standard program, capital cost reduction, and increased LCFS value. Each must be achieved independently and could each contribute to further reductions. Using the assumptions in this study found a 29% reduction in cost if all future strategies are realized. Flexible hydrogen production can simultaneously improve the performance and decarbonize multiple energy sectors. The lessons learned from this study should be used to understand near-term cost drivers and to support longer-term research activities to further improve cost effectiveness of grid integrated electrolysis systems.« less

Sustainability and integration of radioecology-position paper.

PubMed

Muikku, M; Beresford, N A; Garnier-Laplace, J; Real, A; Sirkka, L; Thorne, M; Vandenhove, H; Willrodt, C

2018-03-01

This position paper gives an overview of how the COMET project (COordination and iMplementation of a pan-European instrumenT for radioecology, a combined Collaborative Project and Coordination and Support Action under the EC/Euratom 7th Framework Programme) contributed to the integration and sustainability of radioecology in Europe via its support to and interaction with the European Radioecology ALLIANCE. COMET built upon the foundations laid by the FP7 project STAR (Strategic Network for Integrating Radioecology) Network of Excellence in radioecology. In close association with the ALLIANCE, and based on the Strategic Research Agenda (SRA), COMET developed innovative mechanisms for joint programming and implementation of radioecological research. To facilitate and foster future integration under a common federating structure, research activities developed within COMET were targeted at radioecological research needs identified in the SRA. Furthermore, COMET maintained and developed strong mechanisms for knowledge exchange, dissemination and training to enhance and maintain European capacity, competence and skills in radioecology. In the short term the work to promote radioecology will continue under the H2020 project EJP-CONCERT (European Joint Programme for the Integration of Radiation Protection Research). The EJP-CONCERT project (2015-2020) aims to develop a sustainable structure for promoting and administering joint programming and open research calls in the field of radiation protection research for Europe. In the longer term, radioecological research will be facilitated by the ALLIANCE. External funding is, however, required in order to be able to answer emerging research needs.

Spatial and temporal variations in landscape evolution: historic and longer-term sediment flux through global catchments

USGS Publications Warehouse

Covault, Jacob A.; Craddock, William H.; Romans, Brian W.; Fildani, Andrea; Gosai, Mayur

2013-01-01

Sediment generation and transport through terrestrial catchments influence soil distribution, geochemical cycling of particulate and dissolved loads, and the character of the stratigraphic record of Earth history. To assess the spatiotemporal variation in landscape evolution, we compare global compilations of stream gauge–derived () and cosmogenic radionuclide (CRN)–derived (predominantly 10Be; ) denudation of catchments (mm/yr) and sediment load of rivers (Mt/yr). Stream gauges measure suspended sediment loads of rivers during several to tens of years, whereas CRNs provide catchment-integrated denudation rates at 102–105-yr time scales. Stream gauge–derived and CRN-derived sediment loads in close proximity to one another (<500 km) exhibit broad similarity ( stream gauge samples; CRN samples). Nearly two-thirds of CRN-derived sediment loads exceed historic loads measured at the same locations (). Excessive longer-term sediment loads likely are a result of longer-term recurrence of large-magnitude sediment-transport events. Nearly 80% of sediment loads measured at approximately the same locations exhibit stream gauge loads that are within an order of magnitude of CRN loads, likely as a result of the buffering capacity of large flood plains. Catchments in which space for deposition exceeds sediment supply have greater buffering capacity. Superior locations in which to evaluate anthropogenic influences on landscape evolution might be buffered catchments, in which temporary storage of sediment in flood plains can provide stream gauge–based sediment loads and denudation rates that are applicable over longer periods than the durations of gauge measurements. The buffering capacity of catchments also has implications for interpreting the stratigraphic record; delayed sediment transfer might complicate the stratigraphic record of external forcings and catchment modification.

Intern Programs

Science.gov Websites

International Partnership) thumbnail For Italian physics & engineering grads PST - Pre-Service Teacher Internship (No longer active) thumbnail For STEM pre-service teachers Fermi National Accelerator Laboratory

Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults.

PubMed

Ybarra, Michele L; Holtrop, Jodi Summers; Prescott, Tonya L; Strong, David

2014-11-01

Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth smoking cessation program for young adult smokers. 164 18-24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of program messages was the most commonly noted program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and program features to be even more salient. Future young adult mHealth interventions could: Integrate models that are flexible to different "paths" of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Costs of day hospital and community residential chemical dependency treatment.

PubMed

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs at residential versus day hospital programs were similar for women and for Whites. For non-Whites, and marginally for men, a preference for residential care would appear to come at a higher cost. Lengths of stay in residential treatment were significantly longer than in day hospital, but costs per week were lower. Women and Whites appear to be equally well-served in residential and day hospital programs, with no significant cost differential. Provision of residential treatment for non-Whites may be more costly than day hospital, because their residential stays are likely to be 3 times longer than they would be if treated in day hospital. For men, residential care will be marginally more costly. IMPLICATIONS FOR HEALTH POLICY FORMULATION: Residential treatment appears to represent a cost-effective alternative to day hospital for female and White clients with severe alcohol and drug problems who are not at environmental risk. The much shorter stays in day hospital than at residential among non-Whites highlight the need for research to better understand how to best meet the needs and preferences of non-White clients when considering both costs and outcomes.

75 FR 58285 - Short-Term, Small Amount Loans

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... believed that a longer term was necessary to enable borrowers to pay back a loan in small, more manageable... drive borrowers back to payday lenders. After considering these comments the Board has determined to... for a higher number of loans, the Board disagrees that a limited number of loans will push borrowers...

An Assessment of the Effects of the Endocrine Disrupting Chemical 17ß-Trenbolone on Japanese Medaka Fish in a Multigenerational Exposure

EPA Science Inventory

Presently the research emphasis for endocrine disrupting chemicals has been on the development of short-term screening assays. However, assessing effect concentrations of the most sensitive developmental stages impacted in longer-term and multi-generation tests remains to be det...

Working Together Internationally

ERIC Educational Resources Information Center

Freedman, Terry

2009-01-01

To a large extent, schools encourage collaboration all the time, especially in countries such as the United States, Britain, and Australia. Much of what goes on in schools is fairly short-term. There are, however, an increasing number of teachers who are seeing the potential value in longer-term projects in which students have to work together.…

26 CFR 1.7702B-2 - Special rules for pre-1997 long-term care insurance contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... defined in section 4 of the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Model Act, as in effect on August 21, 1996), regardless of the terminology used by the State in... actually becomes effective is substantially longer than under the insurance company's usual business...

An Integrated Model of Choices and Response Times in Absolute Identification

ERIC Educational Resources Information Center

Brown, Scott D.; Marley, A. A. J.; Donkin, Christopher; Heathcote, Andrew

2008-01-01

Recent theoretical developments in the field of absolute identification have stressed differences between relative and absolute processes, that is, whether stimulus magnitudes are judged relative to a shorter term context provided by recently presented stimuli or a longer term context provided by the entire set of stimuli. The authors developed a…

Mining. Industry Training Monograph No. 2.

ERIC Educational Resources Information Center

Dumbrell, Tom

Mining is the second smallest industry division in terms both of employment and number of business units in Australia. Employment accounts for less than 1 percent of all jobs. The outlook for employment is clouded by continuing uncertainty in Australia's main Asian markets and by the longer-term impact of environmental concerns. Mining industry…

Impacts of insect biological control on soil N transformations in Tamarix-invaded ecosystems in the Great Basin, USA

USDA-ARS?s Scientific Manuscript database

Understanding the impacts of insect biological control of Tamarix spp. on soil nitrogen (N) transformations is important because changes to N supply could alter plant community succession. We investigated short-term and longer-term impacts of herbivory by the northern tamarisk beetle (Diorhabda cari...

Impacts of insect biological control on soil N transformations in Tamarix-invaded ecosystems in the Great Basin

USDA-ARS?s Scientific Manuscript database

Understanding the impacts of insect biological control of Tamarix spp. on soil nitrogen (N) transformations is important because changes to N supply could alter plant community succession. We investigated short-term and longer-term impacts of herbivory by the northern tamarisk beetle (Diorhabda cari...

Long-term outcomes of forest restoration in an urban park

Treesearch

Brady L. Simmons; Richard A. Hallett; Nancy Falxa Sonti; D. S. N. Auyeung; Jacqueline W. T. Lu

2016-01-01

Creating, restoring, and sustaining forests in urban areas are complicated by habitat fragmentation, invasive species, and degraded soils. Although there is some research on the outcomes of urban reforestation plantings during the first 5 years, there is little research on longer term outcomes. Here, we compare the successional trajectories of restored and unrestored...

Can Oregon marshes keep up with the rising tide? A study of short and long term marsh accretion - CERF 2015

EPA Science Inventory

More frequent inundation of Oregon coastal marshlands associated with rising sea level threatens these important and diverse habitats. Accretion rates determined by the marker horizon method and longer term peak Cs137 detection in nine marsh systems from Coquille to Tillamook we...

Can Oregon Marshes Keep Up With The Rising Tide? A Study of Short and Long Term Marsh Accretion.

EPA Science Inventory

More frequent inundation of Oregon coastal marshlands associated with rising sea level threatens these important and diverse habitats. Study plot accretion rates determined by the marker horizon method and longer term peak Cs137 detection in eight marsh systems from Coquille to ...

Involuntary Attention and Physiological Arousal Evoked by Structural Features and Emotional Content in TV Commercials.

ERIC Educational Resources Information Center

Lang, Annie

1990-01-01

Examines how emotional content in televised messages intensifies physiological attentional responses. Explains that heart rate data indicating both shorter-term responses and longer-term arousal were collected from 10 female and 4 male advertising students. Finds that emotional content increases physiological arousal in viewers and that heart…

76 FR 12648 - Lowering Miners' Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... be appropriate to use on a short-term basis. 13. The proposed rule addresses (1) which occupations... for respirable coal mine dust, provide for full- shift sampling, redefine the term ``normal production... respect to their availability. If shorter or longer timeframes are recommended, please provide the...