Systematic adaptation of data delivery

DOEpatents

Bakken, David Edward

2016-02-02

This disclosure describes, in part, a system management component for use in a power grid data network to systematically adjust the quality of service of data published by publishers and subscribed to by subscribers within the network. In one implementation, subscribers may identify a desired data rate, a minimum acceptable data rate, desired latency, minimum acceptable latency and a priority for each subscription and the system management component may adjust the data rates in real-time to ensure that the power grid data network does not become overloaded and/or fail. In one example, subscriptions with lower priorities may have their quality of service adjusted before subscriptions with higher priorities. In each instance, the quality of service may be maintained, even if reduced, to meet or exceed the minimum acceptable quality of service for the subscription.

46 CFR 164.013-5 - Acceptance tests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... described in UL 1191, as appropriate, are performed on a minimum of five samples in each of the lightest and darkest colors submitted for acceptance by a recognized laboratory accepted under § 164.019. ...

46 CFR 164.013-5 - Acceptance tests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... described in UL 1191, as appropriate, are performed on a minimum of five samples in each of the lightest and darkest colors submitted for acceptance by a recognized laboratory accepted under § 164.019. ...

46 CFR 164.013-5 - Acceptance tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... described in UL 1191, as appropriate, are performed on a minimum of five samples in each of the lightest and darkest colors submitted for acceptance by a recognized laboratory accepted under § 164.019. ...

14 CFR 1274.505 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... performance, financial and technical resources or accessibility to other necessary resources. In certain... or performance required, including the range of acceptable characteristics or minimum acceptable...

Determination of minimum suction level necessary for field dental units.

PubMed

Charlton, David G

2010-04-01

A significant problem with most field dental units is that their suction is too weak to effectively remove debris from the mouth. The purpose of this study was to determine the minimum clinically acceptable suction level for routine dentistry. A vacuum pump was connected to a high-volume dental evacuation line in a simulated clinical setting and different suction airflow rates were evaluated by nine evaluator dentists for their capability to effectively remove amalgam debris and water. Airflow levels were rated as "clinically acceptable" or "clinically unacceptable" by each evaluator. Data were analyzed using a chi2 test for trend. Analysis indicated a significant linear trend between airflow and ratings (p < 0.0001). The first airflow level considered by all evaluators as producing clinically acceptable suction was 4.5 standard cubic feet per minute (0.127 standard cubic meters per minute). This value should be the minimum level required for all military field dental units.

28 CFR 70.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Consideration must be given to such matters as contractor integrity, record of past performance, financial and... performed or performance required, including the range of acceptable characteristics or minimum acceptable...

43 CFR 12.944 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Consideration shall be given to such matters as contractor integrity, record of past performance, financial and... performed or performance required, including the range of acceptable characteristics or minimum acceptable...

A practical approach to determination of laboratory GC-MS limits of detection.

PubMed

Underwood, P J; Kananen, G E; Armitage, E K

1997-01-01

Determination of limit of detection (LOD) values in a forensic laboratory serves a fundamental forensic requirement for assay performance. In addition to demonstrating assay capability, LOD values can also be used to fulfill certification requirements of a high-volume forensic drug laboratory. The LOD was defined as the lowest concentration of drug that the laboratory can detect in a specimen with forensic certainty at a minimum of 85% of the time. Overall batch acceptance criteria included acceptable quantitation of control materials (within 20% of target), acceptable chromatography (symmetry, peak integration, peak shape, peak, and baseline resolution), retention time within +/-1% of the extracted standard, and mass ion ratios within +/-20% of the extracted standard mass ion ratios. Individual specimen acceptance criteria were the same as the batch acceptance criteria excluding the quantitation requirement. Data were collected from all instruments on different runs. A minimum of ten data points was required for each certified instrument, and a minimum of 85% of data points was acceptable. Quantitation within +/-20% of the LOD concentration was not required, but acceptable mass ratios were required. Data points with poor chromatography (internal standard failed mass ratios; interference of the baseline, for example, shoulders; asymmetry; and baseline resolution) was omitted from the acceptable rate calculation. Data points with good chromatography with failed mass ion ratios were included in the acceptable rate calculation. With these criteria, we established the following LODs: 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid, 2 ng/mL; benzoylecgonine, 5 ng/mL; phencyclidine, 2.5 ng/mL; amphetamine, 150 ng/mL; methamphetamine, 100 ng/mL; codeine, 500 ng/mL; and morphine, 1000 ng/mL.

Apollo experience report environmental acceptance testing

NASA Technical Reports Server (NTRS)

Laubach, C. H. M.

1976-01-01

Environmental acceptance testing was used extensively to screen selected spacecraft hardware for workmanship defects and manufacturing flaws. The minimum acceptance levels and durations and methods for their establishment are described. Component selection and test monitoring, as well as test implementation requirements, are included. Apollo spacecraft environmental acceptance test results are summarized, and recommendations for future programs are presented.

32 CFR 32.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... acceptable characteristics or minimum acceptable standards. (iv) The specific features of “brand name or... expected to exceed the simplified acquisition threshold, specifies a “brand name” product. (4) The proposed...

Minimum training criteria for police traffic accident reconstruction.

DOT National Transportation Integrated Search

1987-03-01

This report summarizes the development of a set of minimum training criteria for police accident reconstructionists. Prior to this effort, no nationally accepted standards or criteria were recognized for evaluating the qualifications of police engage...

Relaxing the rule of ten events per variable in logistic and Cox regression.

PubMed

Vittinghoff, Eric; McCulloch, Charles E

2007-03-15

The rule of thumb that logistic and Cox models should be used with a minimum of 10 outcome events per predictor variable (EPV), based on two simulation studies, may be too conservative. The authors conducted a large simulation study of other influences on confidence interval coverage, type I error, relative bias, and other model performance measures. They found a range of circumstances in which coverage and bias were within acceptable levels despite less than 10 EPV, as well as other factors that were as influential as or more influential than EPV. They conclude that this rule can be relaxed, in particular for sensitivity analyses undertaken to demonstrate adequate control of confounding.

Emergency Medical Technician: Basic Refresher Curriculum (Instructor Course Guide )

DOT National Transportation Integrated Search

1997-09-01

The EMT-Basic Refresher curriculum is the minimum acceptable content that must : be included in any EMT-Basic refresher educational program. This program should : consist of a minimum of 24 classroom hours. The refresher training program is : divided...

[Minimum Standards for the Spatial Accessibility of Primary Care: A Systematic Review].

PubMed

Voigtländer, S; Deiters, T

2015-12-01

Regional disparities of access to primary care are substantial in Germany, especially in terms of spatial accessibility. However, there is no legally or generally binding minimum standard for the spatial accessibility effort that is still acceptable. Our objective is to analyse existing minimum standards, the methods used as well as their empirical basis. A systematic literature review was undertaken of publications regarding minimum standards for the spatial accessibility of primary care based on a title word and keyword search using PubMed, SSCI/Web of Science, EMBASE and Cochrane Library. 8 minimum standards from the USA, Germany and Austria could be identified. All of them specify the acceptable spatial accessibility effort in terms of travel time; almost half include also distance(s). The travel time maximum, which is acceptable, is 30 min and it tends to be lower in urban areas. Primary care is, according to the identified minimum standards, part of the local area (Nahbereich) of so-called central places (Zentrale Orte) providing basic goods and services. The consideration of means of transport, e. g. public transport, is heterogeneous. The standards are based on empirical studies, consultation with service providers, practical experiences, and regional planning/central place theory as well as on legal or political regulations. The identified minimum standards provide important insights into the effort that is still acceptable regarding spatial accessibility, i. e. travel time, distance and means of transport. It seems reasonable to complement the current planning system for outpatient care, which is based on provider-to-population ratios, by a gravity-model method to identify places as well as populations with insufficient spatial accessibility. Due to a lack of a common minimum standard we propose - subject to further discussion - to begin with a threshold based on the spatial accessibility limit of the local area, i. e. 30 min to the next primary care provider for at least 90% of the regional population. The exceeding of the threshold would necessitate a discussion of a health care deficit and in line with this a potential need for intervention, e. g. in terms of alternative forms of health care provision. © Georg Thieme Verlag KG Stuttgart · New York.

Anesthesiologists' perceptions of minimum acceptable work habits of nurse anesthetists.

PubMed

Logvinov, Ilana I; Dexter, Franklin; Hindman, Bradley J; Brull, Sorin J

2017-05-01

Work habits are non-technical skills that are an important part of job performance. Although non-technical skills are usually evaluated on a relative basis (i.e., "grading on a curve"), validity of evaluation on an absolute basis (i.e., "minimum passing score") needs to be determined. Survey and observational study. None. None. The theme of "work habits" was assessed using a modification of Dannefer et al.'s 6-item scale, with scores ranging from 1 (lowest performance) to 5 (highest performance). E-mail invitations were sent to all consultant and fellow anesthesiologists at Mayo Clinic in Florida, Arizona, and Minnesota. Because work habits expectations can be generational, the survey was designed for adjustment based on all invited (responding or non-responding) anesthesiologists' year of graduation from residency. The overall mean±standard deviation of the score for anesthesiologists' minimum expectations of nurse anesthetists' work habits was 3.64±0.66 (N=48). Minimum acceptable scores were correlated with the year of graduation from anesthesia residency (linear regression P=0.004). Adjusting for survey non-response using all N=207 anesthesiologists, the mean of the minimum acceptable work habits adjusted for year of graduation was 3.69 (standard error 0.02). The minimum expectations for nurse anesthetists' work habits were compared with observational data obtained from the University of Iowa. Among 8940 individual nurse anesthetist work habits scores, only 2.6% were <3.69. All N=65 of the Iowa nurse anesthetists' mean work habits scores were significantly greater than the Mayo estimate (3.69) for the minimum expectations; all P<0.00024. Our results suggest that routinely evaluated work habits of nurse anesthetists within departments should not be compared with an appropriate minimum score (i.e., of 3.69). Instead, work habits scores should be analyzed based on relative reporting among anesthetists. Copyright © 2017 Elsevier Inc. All rights reserved.

Simulator study of minimum acceptable level of longitudinal stability for a representative STOL configuration during landing approach

NASA Technical Reports Server (NTRS)

Grantham, W. D.; Deal, P. L.

1974-01-01

A fixed-base simulator study was conducted to determine the minimum acceptable level of longitudinal stability for a representative turbofan STOL (short take-off and landing) transport airplane during the landing approach. Real-time digital simulation techniques were used. The computer was programed with equations of motion for six degrees of freedom, and the aerodynamic inputs were based on measured wind-tunnel data. The primary piloting task was an instrument approach to a breakout at a 60-m (200-ft) ceiling.

Beliefs and social behavior in a multi-period ultimatum game

PubMed Central

Azar, Ofer H.; Lahav, Yaron; Voslinsky, Alisa

2015-01-01

We conduct a multi-period ultimatum game in which we elicit players' beliefs. Responders do not predict accurately the amount that will be offered to them, and do not get better in their predictions over time. At the individual level we see some effect of the mistake in expectations in the previous period on the responder's expectation about the offer in the current period, but this effect is relatively small. The proposers' beliefs about the minimum amount that responders will accept is significantly higher than the minimum amount responders believe will be accepted by other responders. The proposer's belief about the minimal acceptable offer does not change following a rejection. Nevertheless, the proposer's offer in the next period does increase following a rejection. The probability of rejection increases when the responder has higher expectations about the amount that will be offered to him or higher beliefs about the minimal amount that other responders will accept. PMID:25762909

Feasibility of the Nintendo WiiFit™ for improving walking in individuals with a lower limb amputation

PubMed Central

Imam, Bita; McLaren, Linda; Chapman, Paul; Finlayson, Heather

2013-01-01

Objectives: To evaluate the feasibility of the Nintendo WiiFit™ as an adjunct to usual therapy in individuals with a lower limb amputation. Methods: The study was a Multiple Baseline (AB) Single Subject Research Design. Subjects were ≥19 years old, had their first unilateral transtibial or transfemoral amputation  ≤12 months ago, and were participating in prosthetic training. WiiFit training was provided for 30 min, 5 times a week, for a minimum of 2 and a maximum of 6 weeks in addition to usual therapy. Feasibility indicators were safety, post-intervention fatigue and pain levels, adherence, and subject’s acceptability of the program as measured by the Short Feedback Questionnaire–modified (SFQ-M). The primary clinical outcome was walking capacity assessed by the 2 Minute Walk Test (2MWT). The secondary clinical outcomes were the Short Physical Performance Battery, L-test, and Activities-Specific Balance Confidence. Results: Subjects (4 transtibial; 2 transfemoral) had a median age of 48.5 years (range = 45–59 years). No adverse events associated with the intervention occurred. Median pain and fatigue levels were 1.3 (range = 0.5–3.5) and 3.1 (range = 1.4–4.1), respectively. Median adherence was 80%. Subjects found the WiiFit enjoyable and acceptable (median SFQ-M = 35). Five subjects showed statistical improvement on the 2MWT and four on the secondary outcomes (p < 0.05). Conclusion: The WiiFit intervention was found to be feasible in individuals with unilateral lower limb amputation. This research provides the foundation for future clinical research investigating the use of the WiiFit as a viable adjunctive therapy to improve outcomes in individuals with unilateral lower limb amputation who are participating in prosthetic training. PMID:26770676

Feasibility of the Nintendo WiiFit™ for improving walking in individuals with a lower limb amputation.

PubMed

Imam, Bita; Miller, William C; McLaren, Linda; Chapman, Paul; Finlayson, Heather

2013-01-01

To evaluate the feasibility of the Nintendo WiiFit™ as an adjunct to usual therapy in individuals with a lower limb amputation. The study was a Multiple Baseline (AB) Single Subject Research Design. Subjects were ≥19 years old, had their first unilateral transtibial or transfemoral amputation  ≤12 months ago, and were participating in prosthetic training. WiiFit training was provided for 30 min, 5 times a week, for a minimum of 2 and a maximum of 6 weeks in addition to usual therapy. Feasibility indicators were safety, post-intervention fatigue and pain levels, adherence, and subject's acceptability of the program as measured by the Short Feedback Questionnaire-modified (SFQ-M). The primary clinical outcome was walking capacity assessed by the 2 Minute Walk Test (2MWT). The secondary clinical outcomes were the Short Physical Performance Battery, L-test, and Activities-Specific Balance Confidence. Subjects (4 transtibial; 2 transfemoral) had a median age of 48.5 years (range = 45-59 years). No adverse events associated with the intervention occurred. Median pain and fatigue levels were 1.3 (range = 0.5-3.5) and 3.1 (range = 1.4-4.1), respectively. Median adherence was 80%. Subjects found the WiiFit enjoyable and acceptable (median SFQ-M = 35). Five subjects showed statistical improvement on the 2MWT and four on the secondary outcomes (p < 0.05). The WiiFit intervention was found to be feasible in individuals with unilateral lower limb amputation. This research provides the foundation for future clinical research investigating the use of the WiiFit as a viable adjunctive therapy to improve outcomes in individuals with unilateral lower limb amputation who are participating in prosthetic training.

41 CFR 302-4.704 - Must we require a minimum driving distance per day?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal Travel Regulation System RELOCATION ALLOWANCES PERMANENT CHANGE OF STATION (PCS) ALLOWANCES FOR... driving distance not less than an average of 300 miles per day. However, an exception to the daily minimum... reasons acceptable to you. ...

24 CFR 200.926c - Model code provisions for use in partially accepted code jurisdictions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Minimum Property Standards § 200.926c Model code provisions for use in partially accepted code... partially accepted, then the properties eligible for HUD benefits in that jurisdiction shall be constructed..., those portions of one of the model codes with which the property must comply. Schedule for Model Code...

24 CFR 200.926c - Model code provisions for use in partially accepted code jurisdictions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Minimum Property Standards § 200.926c Model code provisions for use in partially accepted code... partially accepted, then the properties eligible for HUD benefits in that jurisdiction shall be constructed..., those portions of one of the model codes with which the property must comply. Schedule for Model Code...

Bosch osteotomy and scarf osteotomy for hallux valgus correction.

PubMed

Maffulli, Nicola; Longo, Umile Giuseppe; Oliva, Francesco; Denaro, Vincenzo; Coppola, Cristiano

2009-10-01

Minimally invasive distal metatarsal osteotomies are becoming broadly accepted for correction of hallux valgus. We compared the duration of surgery, the length of hospital stay, the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS) in 36 patients who underwent a minimal incision subcapital osteotomy of the first metatarsal with 36 matched patients who had hallux valgus corrected by a scarf technique. The minimum follow-up was 2.1 years (mean, 2.5 years; range, 2.1-3.2 years). Patients having the osteotomy had similar AOFAS and FAOS scores with less operating time and earlier discharge. Less operative time may benefit the patients, and earlier discharge has financial implications for the hospital.

Long-term Outcomes After Ulnar Collateral Ligament Reconstruction in Competitive Baseball Players: Minimum 10-Year Follow-up.

PubMed

Osbahr, Daryl C; Cain, E Lyle; Raines, B Todd; Fortenbaugh, Dave; Dugas, Jeffrey R; Andrews, James R

2014-06-01

Ulnar collateral ligament reconstruction (UCLR) has afforded baseball players with excellent results; however, previous studies have described only short-term outcomes. To evaluate long-term outcomes after UCLR in baseball players. Case series; Level of evidence, 4. All UCLRs performed on competitive baseball players with a minimum 10-year follow-up were identified. Surgical data were collected prospectively and patients were surveyed by telephone follow-up, during which scoring systems were used to assess baseball career and post-baseball career outcomes. Of 313 patients, 256 (82%) were contacted at an average of 12.6 years; 83% of these baseball players (90% pitchers) were able to return to the same or higher level of competition in less than 1 year, but results varied according to preoperative level of play. Baseball career longevity was 3.6 years in general and 2.9 years at the same or higher level of play, but major and minor league players returned for longer than did collegiate and high school players after surgery (P < .001). Baseball retirement typically occurred for reasons other than elbow problems (86%). Many players had shoulder problems (34%) or surgery (25%) during their baseball career, and these occurrences most often resulted in retirement attributable to shoulder problems (P < .001). For post-baseball career outcomes, 92% of patients were able to throw without pain, and 98% were still able to participate in throwing at least on a recreational level. The 10-year minimum follow-up scores (mean ± standard deviation) for the Disabilities of the Arm, Shoulder and Hand (DASH), DASH work module, and DASH sports module were 0.80 ± 4.43, 1.10 ± 6.90, and 2.88 ± 11.91, respectively. Overall, 93% of patients were satisfied, with few reports of persistent elbow pain (3%) or limitation of function (5%). Long-term follow-up of UCLRs in baseball players indicates that most patients were satisfied, with few reports of persistent elbow pain or limitation of function. During their baseball career, most of these athletes were able to return to the same or higher level of competition in less than 1 year, with acceptable career longevity and retirement typically for reasons other than the elbow. According to a standardized disability and outcome scale, patients also had excellent results after UCLR during daily, work, and sporting activities. © 2014 The Author(s).

78 FR 7314 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... accounting firm in accordance with generally accepted accounting principles the report of which is made... affordable coverage if the individual's required contribution (determined on an annual basis) for minimum... portion of the required contribution made through a salary reduction arrangement and excluded from gross...

30 CFR 7.308 - Lockwasher equivalency test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... hole and continuously and uniformly tightened at a speed not to exceed 30 rpm until the fastening's... cycles. (b) Acceptable performance. The minimum torque value required to start removal of the fastening from the installed position (minimum breakway torque) for any cycle of any test sample shall be greater...

30 CFR 7.308 - Lockwasher equivalency test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... hole and continuously and uniformly tightened at a speed not to exceed 30 rpm until the fastening's... cycles. (b) Acceptable performance. The minimum torque value required to start removal of the fastening from the installed position (minimum breakway torque) for any cycle of any test sample shall be greater...

30 CFR 7.308 - Lockwasher equivalency test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... hole and continuously and uniformly tightened at a speed not to exceed 30 rpm until the fastening's... cycles. (b) Acceptable performance. The minimum torque value required to start removal of the fastening from the installed position (minimum breakway torque) for any cycle of any test sample shall be greater...

30 CFR 7.308 - Lockwasher equivalency test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... hole and continuously and uniformly tightened at a speed not to exceed 30 rpm until the fastening's... cycles. (b) Acceptable performance. The minimum torque value required to start removal of the fastening from the installed position (minimum breakway torque) for any cycle of any test sample shall be greater...

30 CFR 7.308 - Lockwasher equivalency test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... hole and continuously and uniformly tightened at a speed not to exceed 30 rpm until the fastening's... cycles. (b) Acceptable performance. The minimum torque value required to start removal of the fastening from the installed position (minimum breakway torque) for any cycle of any test sample shall be greater...

21 CFR 123.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... acceptable levels. (c) Critical limit means the maximum or minimum value to which a physical, biological, or... acceptable level the occurrence of the identified food safety hazard. (d) Fish means fresh or saltwater... used to indicate conditions during processing at a critical control point. (k)(1) Processing means...

Reliability of risk-adjusted outcomes for profiling hospital surgical quality.

PubMed

Krell, Robert W; Hozain, Ahmed; Kao, Lillian S; Dimick, Justin B

2014-05-01

Quality improvement platforms commonly use risk-adjusted morbidity and mortality to profile hospital performance. However, given small hospital caseloads and low event rates for some procedures, it is unclear whether these outcomes reliably reflect hospital performance. To determine the reliability of risk-adjusted morbidity and mortality for hospital performance profiling using clinical registry data. A retrospective cohort study was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program, 2009. Participants included all patients (N = 55,466) who underwent colon resection, pancreatic resection, laparoscopic gastric bypass, ventral hernia repair, abdominal aortic aneurysm repair, and lower extremity bypass. Outcomes included risk-adjusted overall morbidity, severe morbidity, and mortality. We assessed reliability (0-1 scale: 0, completely unreliable; and 1, perfectly reliable) for all 3 outcomes. We also quantified the number of hospitals meeting minimum acceptable reliability thresholds (>0.70, good reliability; and >0.50, fair reliability) for each outcome. For overall morbidity, the most common outcome studied, the mean reliability depended on sample size (ie, how high the hospital caseload was) and the event rate (ie, how frequently the outcome occurred). For example, mean reliability for overall morbidity was low for abdominal aortic aneurysm repair (reliability, 0.29; sample size, 25 cases per year; and event rate, 18.3%). In contrast, mean reliability for overall morbidity was higher for colon resection (reliability, 0.61; sample size, 114 cases per year; and event rate, 26.8%). Colon resection (37.7% of hospitals), pancreatic resection (7.1% of hospitals), and laparoscopic gastric bypass (11.5% of hospitals) were the only procedures for which any hospitals met a reliability threshold of 0.70 for overall morbidity. Because severe morbidity and mortality are less frequent outcomes, their mean reliability was lower, and even fewer hospitals met the thresholds for minimum reliability. Most commonly reported outcome measures have low reliability for differentiating hospital performance. This is especially important for clinical registries that sample rather than collect 100% of cases, which can limit hospital case accrual. Eliminating sampling to achieve the highest possible caseloads, adjusting for reliability, and using advanced modeling strategies (eg, hierarchical modeling) are necessary for clinical registries to increase their benchmarking reliability.

Field testing the ENSEMBLE Minimum Dataset: performance of an instrument to address heterogeneity of treatment effects.

PubMed

Brenneman, Susan K; Shen, Wei; Brekke, Lee; Paczkowski, Rosirene; Bancroft, Tim; Kaplan, Sherrie H; Greenfield, Sheldon; Berger, Marc; Buesching, Don P

2014-09-01

To assess the ability of ENterprising SElective Multi-instrument BLend for hEterogeneity analysis (ENSEMBLE) Minimum Dataset instrument dimensions to discriminate among subgroups of patients expected to have differential outcomes. Patients with Type 2 diabetes, knee osteoarthritis, ischemic heart disease or heart failure completed a survey designed to represent three dimensions (health, personality and behavior). Health-related outcomes and utilization were investigated using claims data. Discriminant validity and associations between the dimensions and outcomes were assessed. A total of 2625 patients completed the survey. The dimensions discriminated 50-100% of the outcome levels across disease cohorts; behavior dimension scores did not differ significantly among the healthcare utilization level subgroups in any disease cohort. ENSEMBLE Minimum Dataset dimensions discriminated health-related outcome levels among patients with varied diseases.

Child Labour Remains "Massive Problem."

ERIC Educational Resources Information Center

World of Work, 2002

2002-01-01

Despite significant progress in efforts to abolish child labor, an alarming number of children are engaged in its worst forms. Although 106 million are engaged in acceptable labor (light work for those above the minimum age for employment), 246 million are involved in child labor that should be abolished (under minimum age, hazardous work). (JOW)

17 CFR 1.52 - Self-regulatory organization adoption and surveillance of minimum financial requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Self-regulatory organization... Miscellaneous § 1.52 Self-regulatory organization adoption and surveillance of minimum financial requirements... accounting and auditing firm that is acceptable to the Commission; and (2) Self-regulatory organization means...

49 CFR 180.411 - Acceptable results of tests and inspections.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Acceptable results of tests and inspections. 180.411 Section 180.411 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE... results of tests and inspections. (a) Corroded or abraded areas. The minimum thickness may not be less...

49 CFR 180.411 - Acceptable results of tests and inspections.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Acceptable results of tests and inspections. 180.411 Section 180.411 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE... results of tests and inspections. (a) Corroded or abraded areas. The minimum thickness may not be less...

49 CFR 180.411 - Acceptable results of tests and inspections.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Acceptable results of tests and inspections. 180.411 Section 180.411 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS... results of tests and inspections. (a) Corroded or abraded areas. The minimum thickness may not be less...

Are dental researchers asking patient-important questions? A scoping review.

PubMed

Fleming, Padhraig S; Koletsi, Despina; O'Brien, Kevin; Tsichlaki, Aliki; Pandis, Nikolaos

2016-06-01

There is an increasing recognition that research outcomes should resonate with patients rather than fixating on technical aspects of interventions. We aimed to assess the nature of outcomes within a representative subset of clinical trials published in leading dental journals. Randomized controlled trials published over a 3-year period up to December 31st, 2015 were identified in eight leading general and specialty dental journals: Journal of Dental Research, Journal of Dentistry, American Journal of Orthodontics and Dentofacial Orthopedics, Pediatric Dentistry, International Journal of Prosthodontics, Journal of Endodontics, International Journal of Oral and Maxillofacial Surgery and Journal of Clinical Periodontology. The number and nature of outcomes considered within these trials were assessed. Overall 220 RCTs involving 409 outcomes (257 primary and 152 secondary) were identified. Measures of disease activity were most commonly assessed as both primary (n=91, 35%) and secondary outcomes (n=59, 39%). Quality of life and functional measures were rarely considered as primary outcome domains. Overall, 182 (44%) outcomes were primarily clinician-focused, 140 (34%) were patient-centered, while 22% (n=87) were both patient- and clinician- focused. There is an undue emphasis on technical, clinician-centered outcomes within dental research common to all specialty areas. Development and adoption of core outcome sets representing the minimum set of data that should be obtained within a dental clinical trial would assist in addressing this issue. There is an acceptance that research outcomes should ultimately be of relevance and benefit to patients rather than focusing on technical aspects of interventions. This study points to an undue emphasis on technical, clinician-centered outcomes within dental research common to all specialty areas. Development and adoption of agreed dental core outcome sets would help to remedy this. Copyright © 2016 Elsevier Ltd. All rights reserved.

Femtosecond laser-assisted cataract surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery: Baseline characteristics, surgical procedure, and outcomes.

PubMed

Lundström, Mats; Dickman, Mor; Henry, Ype; Manning, Sonia; Rosen, Paul; Tassignon, Marie-José; Young, David; Stenevi, Ulf

2017-12-01

To describe a large cohort of femtosecond laser-assisted cataract surgeries in terms of baseline characteristics and the related outcomes. Eighteen cataract surgery clinics in 9 European countries and Australia. Prospective multicenter case series. Data on consecutive eyes having femtosecond laser-assisted cataract surgery in the participating clinics were entered in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). A trained registry manager in each clinic was responsible for valid reporting to the EUREQUO. Demographics, preoperative corrected distance visual acuity (CDVA), risk factors, type of surgery, type of intraocular lens, visual outcomes, refractive outcomes, and complications were reported. Complete data were available for 3379 cases. The mean age was 64.4 years ± 10.9 (SD) and 57.8% (95% confidence interval [CI], 56.1-59.5) of the patients were women. A surgical complication was reported in 2.9% of all cases (95% CI, 2.4-3.5). The mean postoperative CDVA was 0.04 ± 0.15. logarithm of the minimum angle of resolution. A biometry prediction error (spherical equivalent) was within ±0.5 diopter in 71.8% (95% CI, 70.3-73.3) of all surgeries. Postoperative complications were reported in 3.3% (95% CI, 2.7-4.0). Patients with good preoperative CDVA had the best visual and refractive outcomes; patients with poor preoperative visual acuity had poorer outcomes. The visual and refractive outcomes of femtosecond laser-assisted cataract surgery were favorable compared with manual phacoemulsification. The outcomes were highly influenced by the preoperative visual acuity, but all preoperative CDVA groups had acceptable outcomes. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative

PubMed Central

Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J; Dekker, Evelien; Hoff, Geir; Jover, Rodrigo; Suchanek, Stepan; Ferlitsch, Monika; Anderson, John; Roesch, Thomas; Hultcranz, Rolf; Racz, Istvan; Kuipers, Ernst J; Garborg, Kjetil; East, James E; Rupinski, Maciej; Seip, Birgitte; Bennett, Cathy; Senore, Carlo; Minozzi, Silvia; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Spada, Cristiano; Hassan, Cesare; Dinis-Ribeiro, Mario; Rutter, Matthew D

2017-01-01

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 rate of adequate bowel preparation (minimum standard 90%); 2 cecal intubation rate (minimum standard 90%); 3 adenoma detection rate (minimum standard 25%); 4 appropriate polypectomy technique (minimum standard 80%); 5 complication rate (minimum standard not set); 6 patient experience (minimum standard not set); 7 appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures. PMID:28507745

Minimum flow unit installation at the South Edwards Hydro Plant

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

Bernhardt, P.; Bates, D.

1995-12-31

Niagara Mohawk Power Corp. owns and operates the 3.3 MW South Edwards Hydro Plant in Northern New York. The FERC license for this plant requires a minimum flow release in the bypass region of the river. NMPC submitted a license amendment to the FERC to permit the addition of a minimum flow unit to take advantage of this flow. The amendment was accepted, permitting the installation of the 236 kw, 60 cfs unit to proceed. The unit was installed and commissioned in 1994.

Syllabus in Medical Assisting: Health Occupations Education Program.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.

The document presents a syllabus which would serve as a guideline for health occupations educators in establishing a course of study for training medical assistants which would meet New York State requirements and be acceptable for State credit. The syllabus is arranged in three columns: (1) minimum acceptable content of study which requires 80…

Association between household food security and infant feeding practices in urban informal settlements in Nairobi, Kenya.

PubMed

Macharia, T N; Ochola, S; Mutua, M K; Kimani-Murage, E W

2018-02-01

Studies in urban informal settlements show widespread inappropriate infant and young child feeding (IYCF) practices and high rates of food insecurity. This study assessed the association between household food security and IYCF practices in two urban informal settlements in Nairobi, Kenya. The study adopted a longitudinal design that involved a census sample of 1110 children less than 12 months of age and their mothers aged between 12 and 49 years. A questionnaire was used to collect information on: IYCF practices and household food security. Logistic regression was used to determine the association between food insecurity and IYFC practices. The findings showed high household food insecurity; only 19.5% of the households were food secure based on Household Insecurity Access Score. Infant feeding practices were inappropriate: 76% attained minimum meal frequency; 41% of the children attained a minimum dietary diversity; and 27% attained minimum acceptable diet. With the exception of the minimum meal frequency, infants living in food secure households were significantly more likely to achieve appropriate infant feeding practices than those in food insecure households: minimum meal frequency (adjusted odds ratio (AOR)=1.26, P=0.530); minimum dietary diversity (AOR=1.84, P=0.046) and minimum acceptable diet (AOR=2.35, P=0.008). The study adds to the existing body of knowledge by demonstrating an association between household food security and infant feeding practices in low-income settings. The findings imply that interventions aimed at improving infant feeding practices and ultimately nutritional status need to also focus on improving household food security.

Western Australian Public Opinions of a Minimum Pricing Policy for Alcohol: Study Protocol

PubMed Central

Keatley, David A; Daube, Mike; Hardcastle, Sarah J

2015-01-01

Background Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. Objective This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. Methods The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing. Results The study is expected to take approximately 14 months to complete. Conclusions The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations. PMID:26582408

Western Australian Public Opinions of a Minimum Pricing Policy for Alcohol: Study Protocol.

PubMed

Keatley, David A; Carragher, Natacha; Chikritzhs, Tanya; Daube, Mike; Hardcastle, Sarah J; Hagger, Martin S

2015-11-18

Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing. The study is expected to take approximately 14 months to complete. The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations.

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

Mendell, Mark J.; Fisk, William J.

Background - The goal of this project, with a focus on commercial buildings in California, was to develop a new framework for evidence-based minimum ventilation rate (MVR) standards that protect occupants in buildings while also considering energy use and cost. This was motivated by research findings suggesting that current prescriptive MVRs in commercial buildings do not provide occupants with fully safe and satisfactory indoor environments. Methods - The project began with a broad review in several areas ? the diverse strategies now used for standards or guidelines for MVRs or for environmental contaminant exposures, current knowledge about adverse human effectsmore » associated with VRs, and current knowledge about contaminants in commercial buildings, including their their presence, their adverse human effects, and their relationships with VRs. Based on a synthesis of the reviewed information, new principles and approaches are proposed for setting evidence-based VRs standards for commercial buildings, considering a range of human effects including health, performance, and acceptability of air. Results ? A review and evaluation is first presented of current approaches to setting prescriptive building ventilation standards and setting acceptable limits for human contaminant exposures in outdoor air and occupational settings. Recent research on approaches to setting acceptable levels of environmental exposures in evidence-based MVR standards is also described. From a synthesis and critique of these materials, a set of principles for setting MVRs is presented, along with an example approach based on these principles. The approach combines two sequential strategies. In a first step, an acceptable threshold is set for each adverse outcome that has a demonstrated relationship to VRs, as an increase from a (low) outcome level at a high reference ventilation rate (RVR, the VR needed to attain the best achievable levels of the adverse outcome); MVRs required to meet each specific outcome threshold are estimated; and the highest of these MVRs, which would then meet all outcome thresholds, is selected as the target MVR. In a second step, implemented only if the target MVR from step 1 is judged impractically high, costs and benefits are estimated and this information is used in a risk management process. Four human outcomes with substantial quantitative evidence of relationships to VRs are identified for initial consideration in setting MVR standards. These are: building-related symptoms (sometimes called sick building syndrome symptoms), poor perceived indoor air quality, and diminished work performance, all with data relating them directly to VRs; and cancer and non-cancer chronic outcomes, related indirectly to VRs through specific VR-influenced indoor contaminants. In an application of step 1 for offices using a set of example outcome thresholds, a target MVR of 9 L/s (19 cfm) per person was needed. Because this target MVR was close to MVRs in current standards, use of a cost/benefit process seemed unnecessary. Selection of more stringent thresholds for one or more human outcomes, however, could raise the target MVR to 14 L/s (30 cfm) per person or higher, triggering the step 2 risk management process. Consideration of outdoor air pollutant effects would add further complexity to the framework. For balancing the objective and subjective factors involved in setting MVRs in a cost-benefit process, it is suggested that a diverse group of stakeholders make the determination after assembling as much quantitative data as possible.« less

Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

PubMed Central

Grieve, Sharon; Perez, Roberto SGM; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden R, Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

2017-01-01

Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. ‘What is the clinical presentation and course of CRPS, and what factors influence it?’ was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally. PMID:28178071

Developing a Standard Set of Patient-Centred Outcomes for Inflammatory Bowel Disease-an International, Cross-disciplinary Consensus.

PubMed

Kim, Andrew H; Roberts, Charlotte; Feagan, Brian G; Banerjee, Rupa; Bemelman, Willem; Bodger, Keith; Derieppe, Marc; Dignass, Axel; Driscoll, Richard; Fitzpatrick, Ray; Gaarentstroom-Lunt, Janette; Higgins, Peter D; Kotze, Paulo Gustavo; Meissner, Jillian; O'Connor, Marian; Ran, Zhi-Hua; Siegel, Corey A; Terry, Helen; van Deen, Welmoed K; van der Woude, C Janneke; Weaver, Alandra; Yang, Suk-Kyun; Sands, Bruce E; Vermeire, Séverine; Travis, Simon Pl

2018-03-28

Success in delivering value-based healthcare involves measuring outcomes that matter most to patients. Our aim was to develop a minimum Standard Set of patient-centred outcome measures for inflammatory bowel disease [IBD], for use in different healthcare settings. An international working group [n = 25] representing patients, patient associations, gastroenterologists, surgeons, specialist nurses, IBD registries and patient-reported outcome measure [PROM] methodologists participated in a series of teleconferences incorporating a modified Delphi process. Systematic review of existing literature, registry data, patient focus groups and open review periods were used to reach consensus on a minimum set of standard outcome measures and risk adjustment variables. Similar methodology has been used in 21 other disease areas [www.ichom.org]. A minimum Standard Set of outcomes was developed for patients [aged ≥16] with IBD. Outcome domains included survival and disease control [survival, disease activity/remission, colorectal cancer, anaemia], disutility of care [treatment-related complications], healthcare utilization [IBD-related admissions, emergency room visits] and patient-reported outcomes [including quality of life, nutritional status and impact of fistulae] measured at baseline and at 6 or 12 month intervals. A single PROM [IBD-Control questionnaire] was recommended in the Standard Set and minimum risk adjustment data collected at baseline and annually were included: demographics, basic clinical information and treatment factors. A Standard Set of outcome measures for IBD has been developed based on evidence, patient input and specialist consensus. It provides an international template for meaningful, comparable and easy-to-interpret measures as a step towards achieving value-based healthcare in IBD.

The ability of land owners and their cooperatives to leverage payments greater than opportunity costs from conservation contracts.

PubMed

Lennox, Gareth D; Armsworth, Paul R

2013-06-01

In negotiations over land-right acquisitions, landowners have an informational advantage over conservation groups because they know more about the opportunity costs of conservation measures on their sites. This advantage creates the possibility that landowners will demand payments greater than the required minimum, where this minimum required payment is known as the landowner’s willingness to accept (WTA). However, in recent studies of conservation costs, researchers have assumed landowners will accept conservation with minimum payments. We investigated the ability of landowners to demand payments above their WTA when a conservation group has identified multiple sites for protection. First, we estimated the maximum payment landowners could potentially demand, which is set when groups of landowners act as a cooperative. Next, through the simulation of conservation auctions, we explored the amount of money above landowners’ WTA (i.e., surplus) that conservation groups could cede to secure conservation agreements, again investigating the influence of landowner cooperatives. The simulations showed the informational advantage landowners held could make conservation investments up to 42% more expensive than suggested by the site WTAs. Moreover, all auctions resulted in landowners obtaining payments greater than their WTA; thus, it may be unrealistic to assume landowners will accept conservation contracts with minimum payments. Of particular significance for species conservation, conservation objectives focused on overall species richness,which therefore recognize site complementarity, create an incentive for land owners to form cooperatives to capture surplus. To the contrary, objectives in which sites are substitutes, such as the maximization of species occurrences, create a disincentive for cooperative formation.

Carrying capacity as "informed judgment": The values of science and the science of values

Treesearch

Robert E. Manning

2001-01-01

Contemporary carrying capacity frameworks, such as Limits of Acceptable Change and Visitor Experience and Resource Protection, rely on formulation of standards of quality, which are defined as minimum acceptable resource and social conditions in parks and wilderness. Formulation of standards of quality involves elements of both science and values, and both of these...

Rate based failure detection

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

Johnson, Brett Emery Trabun; Gamage, Thoshitha Thanushka; Bakken, David Edward

This disclosure describes, in part, a system management component and failure detection component for use in a power grid data network to identify anomalies within the network and systematically adjust the quality of service of data published by publishers and subscribed to by subscribers within the network. In one implementation, subscribers may identify a desired data rate, a minimum acceptable data rate, desired latency, minimum acceptable latency and a priority for each subscription. The failure detection component may identify an anomaly within the network and a source of the anomaly. Based on the identified anomaly, data rates and or datamore » paths may be adjusted in real-time to ensure that the power grid data network does not become overloaded and/or fail.« less

Cost of and soil loss on "minimum-standard" forest truck roads constructed in the central Appalachians

Treesearch

J. N. Kochenderfer; G. W. Wendel; H. Clay Smith

1984-01-01

A "minimum-standard" forest truck road that provides efficient and environmentally acceptable access for several forest activities is described. Cost data are presented for eight of these roads constructed in the central Appalachians. The average cost per mile excluding gravel was $8,119. The range was $5,048 to $14,424. Soil loss was measured from several...

Association between women's empowerment and infant and child feeding practices in sub-Saharan Africa: an analysis of Demographic and Health Surveys.

PubMed

Na, Muzi; Jennings, Larissa; Talegawkar, Sameera A; Ahmed, Saifuddin

2015-12-01

To explore the relationship between women's empowerment and WHO recommended infant and young child feeding (IYCF) practices in sub-Saharan Africa. Analysis was conducted using data from ten Demographic and Health Surveys between 2010 and 2013. Women's empowerment was assessed by nine standard items covering three dimensions: economic, socio-familial and legal empowerment. Three core IYCF practices examined were minimum dietary diversity, minimum meal frequency and minimum acceptable diet. Separate multivariable logistic regression models were applied for the IYCF practices on dimensional and overall empowerment in each country. Benin, Burkina Faso, Ethiopia, Mali, Niger, Nigeria, Rwanda, Sierra Leone, Uganda and Zimbabwe. Youngest singleton children aged 6-23 months and their mothers (n 15 153). Less than 35 %, 60 % and 18 % of children 6-23 months of age met the criterion of minimum dietary diversity, minimum meal frequency and minimum acceptable diet, respectively. In general, likelihood of meeting the recommended IYCF criteria was positively associated with the economic dimension of women's empowerment. Socio-familial empowerment was negatively associated with the three feeding criteria, except in Zimbabwe. The legal dimension of empowerment did not show any clear pattern in the associations. Greater overall empowerment of women was consistently and positively associated with multiple IYCF practices in Mali, Rwanda and Sierra Leone. However, consistent negative relationships were found in Benin and Niger. Null or mixed results were observed in the remaining countries. The importance of women's empowerment for IYCF practices needs to be discussed by context and by dimension of empowerment.

Why Some Teachers Easily Learn to Use a New Virtual Learning Environment: A Technology Acceptance Perspective

ERIC Educational Resources Information Center

Rienties, Bart; Giesbers, Bas; Lygo-Baker, Simon; Ma, Hoi Wah Serena; Rees, Roger

2016-01-01

After a decade of virtual learning environments (VLEs) in higher education, many teachers still use only a minimum of its affordances. This study looked at how academic staff interacted with a new and unknown VLE in order to understand how technology acceptance and support materials influence (perceived and actual) task performance. In an…

Equal status in Ultimatum Games promotes rational sharing.

PubMed

Han, Xiao; Cao, Shinan; Bao, Jian-Zhang; Wang, Wen-Xu; Zhang, Boyu; Gao, Zi-You; Sánchez, Angel

2018-01-19

Experiments on the Ultimatum Game (UG) repeatedly show that people's behaviour is far from rational. In UG experiments, a subject proposes how to divide a pot and the other can accept or reject the proposal, in which case both lose everything. While rational people would offer and accept the minimum possible amount, in experiments low offers are often rejected and offers are typically larger than the minimum, and even fair. Several theoretical works have proposed that these results may arise evolutionarily when subjects act in both roles and there is a fixed interaction structure in the population specifying who plays with whom. We report the first experiments on structured UG with subjects playing simultaneously both roles. We observe that acceptance levels of responders approach rationality and proposers accommodate their offers to their environment. More precisely, subjects keep low acceptance levels all the time, but as proposers they follow a best-response-like approach to choose their offers. We thus find that status equality promotes rational sharing while the influence of structure leads to fairer offers compared to well-mixed populations. Our results are far from what is observed in single-role UG experiments and largely different from available predictions based on evolutionary game theory.

Casemix and process indicators of outcome in stroke. The Royal College of Physicians minimum data set for stroke.

PubMed

Irwin, P; Rudd, A

1998-01-01

The emphasis on outcomes measurement requires that casemix is considered in any comparative studies. In 1996 the Intercollegiate Working Party for Stroke agreed a minimum data set to measure the severity of casemix in stroke. The reasons for its development, the evidence base supporting the items included and the possible uses of the data set are described. It is currently being evaluated in national outcome and process audits to be reported at a later date.

The volume-outcome relationship and minimum volume standards--empirical evidence for Germany.

PubMed

Hentschker, Corinna; Mennicken, Roman

2015-06-01

For decades, there is an ongoing discussion about the quality of hospital care leading i.a. to the introduction of minimum volume standards in various countries. In this paper, we analyze the volume-outcome relationship for patients with intact abdominal aortic aneurysm and hip fracture. We define hypothetical minimum volume standards in both conditions and assess consequences for access to hospital services in Germany. The results show clearly that patients treated in hospitals with a higher case volume have on average a significant lower probability of death in both conditions. Furthermore, we show that the hypothetical minimum volume standards do not compromise overall access measured with changes in travel times. Copyright © 2014 John Wiley & Sons, Ltd.

Determination of Minimum Training Sample Size for Microarray-Based Cancer Outcome Prediction–An Empirical Assessment

PubMed Central

Cheng, Ningtao; Wu, Leihong; Cheng, Yiyu

2013-01-01

The promise of microarray technology in providing prediction classifiers for cancer outcome estimation has been confirmed by a number of demonstrable successes. However, the reliability of prediction results relies heavily on the accuracy of statistical parameters involved in classifiers. It cannot be reliably estimated with only a small number of training samples. Therefore, it is of vital importance to determine the minimum number of training samples and to ensure the clinical value of microarrays in cancer outcome prediction. We evaluated the impact of training sample size on model performance extensively based on 3 large-scale cancer microarray datasets provided by the second phase of MicroArray Quality Control project (MAQC-II). An SSNR-based (scale of signal-to-noise ratio) protocol was proposed in this study for minimum training sample size determination. External validation results based on another 3 cancer datasets confirmed that the SSNR-based approach could not only determine the minimum number of training samples efficiently, but also provide a valuable strategy for estimating the underlying performance of classifiers in advance. Once translated into clinical routine applications, the SSNR-based protocol would provide great convenience in microarray-based cancer outcome prediction in improving classifier reliability. PMID:23861920

Reliability and validity of the cross-culturally adapted Turkish version of the Core Outcome Measures Index for low back pain.

PubMed

Çetin, Engin; Çelik, Evrim Coşkun; Acaroğlu, Emre; Berk, Haluk

2018-01-01

To produce a cross-culturally adapted and validated Turkish version of The Core Outcome Measure Index (COMI) Back questionnaire. Ninety-six Turkish-speaking patients with non-specific low back pain (LBP) were recruited from orthopedic and physical therapy outpatient clinics in a public hospital. They completed a booklet of questionnaires containing Turkish version of COMI, adjectival pain scale, Roland Morris disability questionnaire, European 5 Dimension Questionnaire and brief version of World Health Organization Quality of Life Questionnaire. Within following 7-14 days, 67 patients, reported no or minimal changes in their back pain status, completed the Turkish COMI again to assess reproducibility. Data quality was good with very few missing answers. COMI summary index score displayed 3% floor effects and no ceiling effects. The correlations between the COMI summary index score and each of the full instrument whole scores were found to be excellent to very good (ρ = - 0.81 to 0.74). Reliability expressed as intraclass correlation coefficient (ICC) was 0.95 (95% CI 0.91-0.97). Standard error of measurement (SEM agreement ) was acceptable at 0.41 and the minimum detectable change (MDC 95% ) was 1.14. Turkish version of the COMI has acceptable psychometric properties. It is a valid and reliable instrument and cross-culturally adapted, in accordance with established guidelines, for the use by Turkish-speaking patients. It can be recommended for use in evaluation of patients with chronic LBP in daily practice, in international multicenter studies and in spine registry systems.

Outcome scores in spinal surgery quantified: excellent, good, fair and poor in terms of patient-completed tools.

PubMed

Tafazal, Suhayl I; Sell, Philip J

2006-11-01

Outcome scores are very useful tools in the field of spinal surgery as they allow us to assess a patient's progress and the effect of various treatments. The clinical importance of a score change is not so clear. Although previous studies have looked at the minimum clinically important score change, the degree of score change varies considerably. Our study is a prospective cohort study of 193 patients undergoing discectomy, decompression and fusion procedures with minimum 2-year follow-up. We have used three standard outcome measures in common usage, the oswestry disability index (ODI), the low back outcome score (LBOS) and the visual analogue score (VAS). We have defined each of these scores according to a global measure of outcome graded by the patient as excellent, good, fair or poor. We have also graded patient perception and classified excellent and good as success and fair and poor as failure. Our results suggest that a median 24-point change in the ODI equates with a good outcome or is the minimum change needed for success. We have also found that different surgical disorders have very different minimal clinically important differences as perceived by patient perception. We found that for a discectomy a minimum 27-point change in the ODI would be classed as a success, for a decompression the change in ODI needed to class it as a success would be 16 points, whereas for a fusion the change in the ODI would be only 13 points. We believe that patient-rated global measures of outcome are of value and we have quantified them in terms of the standard outcome measures used in spinal surgery.

Global measures of outcome in a controlled comparison of pharmacological and psychological treatment of panic disorder and agoraphobia in primary care.

PubMed Central

Sharp, D M; Power, K G; Simpson, R J; Swanson, V; Anstee, J A

1997-01-01

BACKGROUND: Panic disorder, with and without agoraphobia, is a prevalent condition which presents primarily in general practice. Previous clinical outcome studies have been conducted mainly in specialist university departments or hospital settings, and have tended to employ complex rating scales that are not well suited for use as outcome measures in primary care. AIM: To evaluate the outcome, in a primary care setting, of fluvoxamine versus cognitive behaviour therapy, each used alone and in combination in a double-blind placebo-controlled framework, balanced for therapist contact. METHOD: A total of 149 patients satisfying DSMIII-R criteria for panic disorder were randomly allocated to receive one of the following: fluvoxamine, placebo, fluvoxamine plus cognitive behaviour therapy, placebo plus cognitive behaviour therapy, and cognitive behaviour therapy alone. These five treatment groups represent the minimum number acceptable for such a comparison to be made. All patients received an identical schedule of contact over 13 weeks. Measures of symptom severity, general health and social disruption were taken at entry point and end point; measures of change in symptoms were taken at end point only. Outcome was reported in terms of brief global ratings of severity of illness and change in symptoms, and of ratings of general health and social disruption that are suitable for use in general practice. RESULTS: All active treatment groups showed statistically significant advantages over placebo over a range of outcome ratings. The groups employing cognitive behaviour therapy showed the most robust and consistent response. CONCLUSION: The brief global measures reported here proved adequate to the task of assessing treatment outcome. Results indicate that treatments including cognitive behaviour therapy can be effective in the treatment of panic disorder and agoraphobia in primary care. PMID:9167318

Endoscopic Gluteus Medius Repair With Concomitant Arthroscopy for Labral Tears: A Case Series With Minimum 5-Year Outcomes.

PubMed

Perets, Itay; Mansor, Yosif; Yuen, Leslie C; Chen, Austin W; Chaharbakhshi, Edwin O; Domb, Benjamin G

2017-12-01

To report the minimum 5-year outcomes of endoscopic gluteus medius repair for partial- and full-thickness tears with concomitant hip arthroscopy. Data for all patients who underwent hip arthroscopy between February 2009 and September 2011 were prospectively collected. We included patients who underwent endoscopic gluteus medius repair with concomitant arthroscopic labral treatment and for whom the following measures were obtained preoperatively and at a minimum of 5 years' follow-up: modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, and visual analog scale score for pain. For included patients, the International Hip Outcome Tool-12 (iHOT-12) score and satisfaction rating were also available at latest follow-up. Patients with at least 1 of the following criteria were excluded: preoperative Tönnis osteoarthritis grade of 2 or greater, previous hip conditions, severe dysplasia, and Workers' Compensation claims. There were 16 patients eligible for inclusion, 14 (87.5%) of whom had minimum 5-year follow-up, with a mean of 68.8 months (range, 60.1-79.6 months). The study group consisted of 13 women (92.9%) and 1 man (7.1%) with a mean age at surgery of 57.4 years (range, 46.3-74.8 years). Outcome scores improved as follows: modified Harris Hip Score, from 52.4 to 81.2 (P = .004); Non-Arthritic Hip Score, from 48.0 to 82.5 (P = .002); Hip Outcome Score-Sports Specific Subscale, from 30.1 to 66.4 (P < .001); and visual analog scale score, from 6.2 to 2.6 (P = .001). At minimum 5-year follow-up, the mean iHOT-12 score was 73.8 and the mean patient satisfaction rating was 8.4. Survivorship was 92.9%, with 1 patient who underwent conversion to total hip arthroplasty. There was no deterioration in patient outcomes and satisfaction between 2 and 5 years postoperatively. There were no clinical failures of gluteus medius repair and no complications. Endoscopic gluteus medius repair with concomitant hip arthroscopy for labral tears is safe and shows favorable outcomes at minimum 5-year follow-up. Patient outcomes were as favorable at 5 years as they were at 2 years postoperatively. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Three-day clotrimazole treatment in candidal vulvovaginitis.

PubMed Central

Masterton, G; Napier, I R; Henderson, J N; Roberts, J E

1977-01-01

The accepted modern practice is to treat each sexually transmitted disease with the shortest possible course of treatment consistent with success. In candidal vulvovaginitis, six days is the minimum period that has so far been found to be successful, but we report here a further reduction to three days. Patients were given two clotrimazole pessaries nightly for three consecutive nights; the overall success rate was 89-4% one month after treatment. This compares favourably with the 93% cure rate reported with the six-day course of clotrimazole. With both the long and short courses, patients having their first attack of genital candidosis responded better than those with a history of previous infection. Short courses of clotrimazole treatment are particularly valuable in dealing with uncooperative women who stop treatment at the earliest possible moment. Clinical and laboratory diagnostic pitfalls and their possible influence upon the therapeutic outcome are also discussed. PMID:870143

Adolescents' unconditional acceptance by parents and teachers and educational outcomes: A structural model of gender differences.

PubMed

Makri-Botsari, Evi

2015-08-01

The purpose of this study was to detect gender specific patterns in the network of relations between unconditionality of parental and teacher acceptance in the form of unconditional positive regard and a range of educational outcomes, as indexed by academic self-perception, academic intrinsic motivation, and academic achievement. To test the role of gender as a moderator, a multi-group analysis was employed within the framework of structural equation modelling with increasing restrictions placed on the structural paths across genders. The results on a sample of 427 adolescents in grades 7-9 showed that conditionality of acceptance undermined level of perceived acceptance for both social agents. Moreover, unconditionality of teacher acceptance exerted stronger influences on students' educational outcomes than unconditionality of parental acceptance, with effect sizes being larger for girls than for boys. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Relationships Between Minimum Alcohol Pricing and Crime During the Partial Privatization of a Canadian Government Alcohol Monopoly.

PubMed

Stockwell, Tim; Zhao, Jinhui; Marzell, Miesha; Gruenewald, Paul J; Macdonald, Scott; Ponicki, William R; Martin, Gina

2015-07-01

The purpose of this study was to estimate the independent effects of increases in minimum alcohol prices and densities of private liquor stores on crime outcomes in British Columbia, Canada, during a partial privatization of off-premise liquor sales. A time-series cross-sectional panel study was conducted using mixed model regression analysis to explore associations between minimum alcohol prices, densities of liquor outlets, and crime outcomes across 89 local health areas of British Columbia between 2002 and 2010. Archival data on minimum alcohol prices, per capita alcohol outlet densities, and ecological demographic characteristics were related to measures of crimes against persons, alcohol-related traffic violations, and non-alcohol-related traffic violations. Analyses were adjusted for temporal and regional autocorrelation. A 10% increase in provincial minimum alcohol prices was associated with an 18.81% (95% CI: ±17.99%, p < .05) reduction in alcohol-related traffic violations, a 9.17% (95% CI: ±5.95%, p < .01) reduction in crimes against persons, and a 9.39% (95% CI: ±3.80%, p < .001) reduction in total rates of crime outcomes examined. There was no significant association between minimum alcohol prices and non-alcohol-related traffic violations (p > .05). Densities of private liquor stores were not significantly associated with alcohol-involved traffic violations or crimes against persons, though they were with non-alcohol-related traffic violations. Reductions in crime events associated with minimum-alcohol-price changes were more substantial and specific to alcohol-related events than the countervailing increases in densities of private liquor stores. The findings lend further support to the application of minimum alcohol prices for public health and safety objectives.

Time-based partitioning model for predicting neurologically favorable outcome among adults with witnessed bystander out-of-hospital CPA.

PubMed

Abe, Toshikazu; Tokuda, Yasuharu; Cook, E Francis

2011-01-01

Optimal acceptable time intervals from collapse to bystander cardiopulmonary resuscitation (CPR) for neurologically favorable outcome among adults with witnessed out-of-hospital cardiopulmonary arrest (CPA) have been unclear. Our aim was to assess the optimal acceptable thresholds of the time intervals of CPR for neurologically favorable outcome and survival using a recursive partitioning model. From January 1, 2005 through December 31, 2009, we conducted a prospective population-based observational study across Japan involving consecutive out-of-hospital CPA patients (N = 69,648) who received a witnessed bystander CPR. Of 69,648 patients, 34,605 were assigned to the derivation data set and 35,043 to the validation data set. Time factors associated with better outcomes: the better outcomes were survival and neurologically favorable outcome at one month, defined as category one (good cerebral performance) or two (moderate cerebral disability) of the cerebral performance categories. Based on the recursive partitioning model from the derivation dataset (n = 34,605) to predict the neurologically favorable outcome at one month, 5 min threshold was the acceptable time interval from collapse to CPR initiation; 11 min from collapse to ambulance arrival; 18 min from collapse to return of spontaneous circulation (ROSC); and 19 min from collapse to hospital arrival. Among the validation dataset (n = 35,043), 209/2,292 (9.1%) in all patients with the acceptable time intervals and 1,388/2,706 (52.1%) in the subgroup with the acceptable time intervals and pre-hospital ROSC showed neurologically favorable outcome. Initiation of CPR should be within 5 min for obtaining neurologically favorable outcome among adults with witnessed out-of-hospital CPA. Patients with the acceptable time intervals of bystander CPR and pre-hospital ROSC within 18 min could have 50% chance of neurologically favorable outcome.

Fatigue acceptance test limit criterion for larger diameter rolled thread fasteners

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

Kephart, A.R.

1997-05-01

This document describes a fatigue lifetime acceptance test criterion by which studs having rolled threads, larger than 1.0 inches in diameter, can be assured to meet minimum quality attributes associated with a controlled rolling process. This criterion is derived from a stress dependent, room temperature air fatigue database for test studs having a 0.625 inch diameter threads of Alloys X-750 HTH and direct aged 625. Anticipated fatigue lives of larger threads are based on thread root elastic stress concentration factors which increase with increasing thread diameters. Over the thread size range of interest, a 30% increase in notch stress ismore » equivalent to a factor of five (5X) reduction in fatigue life. The resulting diameter dependent fatigue acceptance criterion is normalized to the aerospace rolled thread acceptance standards for a 1.0 inch diameter, 0.125 inch pitch, Unified National thread with a controlled Root radius (UNR). Testing was conducted at a stress of 50% of the minimum specified material ultimate strength, 80 Ksi, and at a stress ratio (R) of 0.10. Limited test data for fastener diameters of 1.00 to 2.25 inches are compared to the acceptance criterion. Sensitivity of fatigue life of threads to test nut geometry variables was also shown to be dependent on notch stress conditions. Bearing surface concavity of the compression nuts and thread flank contact mismatch conditions can significantly affect the fastener fatigue life. Without improved controls these conditions could potentially provide misleading acceptance data. Alternate test nut geometry features are described and implemented in the rolled thread stud specification, MIL-DTL-24789(SH), to mitigate the potential effects on fatigue acceptance data.« less

The impact of minimum wages on population health: evidence from 24 OECD countries.

PubMed

Lenhart, Otto

2017-11-01

This study examines the relationship between minimum wages and several measures of population health by analyzing data from 24 OECD countries for a time period of 31 years. Specifically, I test for health effects as a result of within-country variations in the generosity of minimum wages, which are measured by the Kaitz index. The paper finds that higher levels of minimum wages are associated with significant reductions of overall mortality rates as well as in the number of deaths due to outcomes that have been shown to be more prevalent among individuals with low socioeconomic status (e.g., diabetes, disease of the circulatory system, stroke). A 10% point increase of the Kaitz index is associated with significant declines in death rates and an increase in life expectancy of 0.44 years. Furthermore, I provide evidence for potential channels through which minimum wages impact population health by showing that more generous minimum wages impact outcomes such as poverty, the share of the population with unmet medical needs, the number of doctor consultations, tobacco consumption, calorie intake, and the likelihood of people being overweight.

The association of minimum wage change on child nutritional status in LMICs: A quasi-experimental multi-country study.

PubMed

Ponce, Ninez; Shimkhada, Riti; Raub, Amy; Daoud, Adel; Nandi, Arijit; Richter, Linda; Heymann, Jody

2017-08-02

There is recognition that social protection policies such as raising the minimum wage can favourably impact health, but little evidence links minimum wage increases to child health outcomes. We used multi-year data (2003-2012) on national minimum wages linked to individual-level data from the Demographic and Health Surveys (DHS) from 23 low- and middle-income countries (LMICs) that had least two DHS surveys to establish pre- and post-observation periods. Over a pre- and post-interval ranging from 4 to 8 years, we examined minimum wage growth and four nutritional status outcomes among children under 5 years: stunting, wasting, underweight, and anthropometric failure. Using a differences-in-differences framework with country and time-fixed effects, a 10% increase in minimum wage growth over time was associated with a 0.5 percentage point decline in stunting (-0.054, 95% CI (-0.084,-0.025)), and a 0.3 percentage point decline in failure (-0.031, 95% CI (-0.057,-0.005)). We did not observe statistically significant associations between minimum wage growth and underweight or wasting. We found similar results for the poorest households working in non-agricultural and non-professional jobs, where minimum wage growth may have the most leverage. Modest increases in minimum wage over a 4- to 8-year period might be effective in reducing child undernutrition in LMICs.

ORACLE Stroke Study: Opinion Regarding Acceptable Outcome Following Decompressive Hemicraniectomy for Ischemic Stroke.

PubMed

Honeybul, Stephen; Ho, Kwok M; Blacker, David W

2016-08-01

There continues to be considerable interest in the use of decompressive hemicraniectomy in the management of malignant cerebral artery infarction; however, concerns remain about long-term outcome. To assess opinion on consent and acceptable outcome among a wide range of healthcare workers. Seven hundred seventy-three healthcare workers at the 2 major public neurosurgical centers in Western Australia participated. Participants were asked to record their opinion on consent and acceptable outcome based on the modified Rankin Score (mRS). The evidence for clinical efficacy of the procedure was presented, and participants were then asked to reconsider their initial responses. Of the 773 participants included in the study, 407 (52.7%) initially felt that they would provide consent for a decompressive craniectomy as a lifesaving procedure, but only a minority of them considered an mRS score of 4 or 5 an acceptable outcome (for mRS score ≤4, n = 67, 8.7%; for mRS score = 4, n = 57, 7.4%). After the introduction of the concept of the disability paradox and the evidence for the clinical efficacy of decompressive craniectomy, more participants were unwilling to accept decompressive craniectomy (18.1% vs 37.8%), but at the same time, more were willing to accept an mRS score ≤4 as an acceptable outcome (for mRS score ≤4, n = 92, 11.9%; for mRS score = 4, n = 79, 10.2%). Most participants felt survival with dependency to be unacceptable. However, many would be willing to provide consent for surgery in the hopes that they may survive with some degree of independence. DESTINY, Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral ArterymRS, modified Rankin Scale.

Gender-based Outcomes and Acceptability of a Computer-assisted Psychosocial Intervention for Substance Use Disorders.

PubMed

Campbell, Aimee N C; Nunes, Edward V; Pavlicova, Martina; Hatch-Maillette, Mary; Hu, Mei-Chen; Bailey, Genie L; Sugarman, Dawn E; Miele, Gloria M; Rieckmann, Traci; Shores-Wilson, Kathy; Turrigiano, Eva; Greenfield, Shelly F

2015-06-01

Digital technologies show promise for increasing treatment accessibility and improving quality of care, but little is known about gender differences. This secondary analysis uses data from a multi-site effectiveness trial of a computer-assisted behavioral intervention, conducted within NIDA's National Drug Abuse Clinical Trials Network, to explore gender differences in intervention acceptability and treatment outcomes. Men (n=314) and women (n=192) were randomly assigned to 12-weeks of treatment-as-usual (TAU) or modified TAU+Therapeutic Education System (TES), whereby TES substituted for 2hours of TAU per week. TES is composed of 62 Web-delivered, multimedia modules, covering skills for achieving and maintaining abstinence plus prize-based incentives contingent on abstinence and treatment adherence. Outcomes were: (1) abstinence from drugs and heavy drinking in the last 4weeks of treatment, (2) retention, (3) social functioning, and (4) drug and alcohol craving. Acceptability was the mean score across five indicators (i.e., interesting, useful, novel, easy to understand, and satisfaction). Gender did not moderate the effect of treatment on any outcome. Women reported higher acceptability scores at week 4 (p=.02), but no gender differences were detected at weeks 8 or 12. Acceptability was positively associated with abstinence, but only among women (p=.01). Findings suggest that men and women derive similar benefits from participating in a computer-assisted intervention, a promising outcome as technology-based treatments expand. Acceptability was associated with abstinence outcomes among women. Future research should explore characteristics of women who report less satisfaction with this modality of treatment and ways to improve overall acceptability. Copyright © 2015 Elsevier Inc. All rights reserved.

How Does Definition of Minimum Break Length Affect Objective Measures of Sitting Outcomes Among Office Workers?

PubMed

Kloster, Stine; Danquah, Ida Høgstedt; Holtermann, Andreas; Aadahl, Mette; Tolstrup, Janne Schurmann

2017-01-01

Harmful health effects associated with sedentary behavior may be attenuated by breaking up long periods of sitting by standing or walking. However, studies assess interruptions in sitting time differently, making comparisons between studies difficult. It has not previously been described how the definition of minimum break duration affects sitting outcomes. Therefore, the aim was to address how definitions of break length affect total sitting time, number of sit-to-stand transitions, prolonged sitting periods and time accumulated in prolonged sitting periods among office workers. Data were collected from 317 office workers. Thigh position was assessed with an ActiGraph GT3X+ fixed on the right thigh. Data were exported with varying bout length of breaks. Afterward, sitting outcomes were calculated for the respective break lengths. Absolute numbers of sit-to-stand transitions decreased, and number of prolonged sitting periods and total time accumulated in prolonged sitting periods increased, with increasing minimum break length. Total sitting time was not influenced by varying break length. The definition of minimum break length influenced the sitting outcomes with the exception of total sitting time. A standard definition of break length is needed for comparison and interpretation of studies in the evolving research field of sedentary behavior.

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

Xu, H; Guerrero, M; Prado, K

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors,more » cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.« less

40 CFR 180.40 - Tolerances for crop groups.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TOLERANCES AND EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.40 Tolerances... representative crops are given as an indication of the minimum residue chemistry data base acceptable to the...

40 CFR 180.40 - Tolerances for crop groups.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TOLERANCES AND EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.40 Tolerances... representative crops are given as an indication of the minimum residue chemistry data base acceptable to the...

40 CFR 180.40 - Tolerances for crop groups.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TOLERANCES AND EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.40 Tolerances... representative crops are given as an indication of the minimum residue chemistry data base acceptable to the...

40 CFR 180.40 - Tolerances for crop groups.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TOLERANCES AND EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.40 Tolerances... representative crops are given as an indication of the minimum residue chemistry data base acceptable to the...

40 CFR 180.40 - Tolerances for crop groups.

Code of Federal Regulations, 2012 CFR

2012-07-01

... TOLERANCES AND EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.40 Tolerances... representative crops are given as an indication of the minimum residue chemistry data base acceptable to the...

40 CFR 30.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... characteristics or minimum acceptable standards. (iv) The specific features of “brand name or equal” descriptions..., specifies a “brand name” product. (4) The proposed award over the small purchase threshold is to be awarded...

22 CFR 145.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... characteristics or minimum acceptable standards. (iv) The specific features of “brand name or equal” descriptions... “brand name” product. (4) The proposed award over the small purchase limitation is to be awarded to other...

A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

PubMed

Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

2017-09-19

Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

Exposure to Large-Scale Social and Behavior Change Communication Interventions Is Associated with Improvements in Infant and Young Child Feeding Practices in Ethiopia

PubMed Central

Rawat, Rahul; Mwangi, Edina M.; Tesfaye, Roman; Abebe, Yewelsew; Baker, Jean; Frongillo, Edward A.; Ruel, Marie T.; Menon, Purnima

2016-01-01

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and with children aged 24–59.9 mo (n = 1481 and n = 1475) were conducted at baseline (2010) and endline (2014), respectively. Differences in outcomes over time were estimated using regression models, accounting for clustering and covariates. Plausibility analyses included tracing recall of key messages and promoted foods and dose-response analyses. We observed improvements in most WHO-recommended IYCF indicators. Early BF initiation and exclusive BF increased by 13.7 and 9.4 percentage points (pp), respectively. Differences for timely introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich foods were 22.2, 3.3, 26.2, 3.5, and 2.7 pp, respectively. Timely introduction and intake of foods promoted by the interventions improved significantly, but anthropometric outcomes did not. We also observed a dose-response association between health post visits and early initiation of BF (OR: 1.8); higher numbers of home visits by community volunteers and key messages recalled were associated with 1.8–4.4 times greater odds of achieving MDD, MMF, and MAD, and higher numbers of radio spots heard were associated with 3 times greater odds of achieving MDD and MAD. The interventions were associated with plausible improvements in IYCF practices, but large gaps in improving children’s diets in Ethiopia remain, particularly during complementary feeding. PMID:27755586

Determinants of inadequate complementary feeding practices among children aged 6-23 months in Ghana.

PubMed

Issaka, Abukari I; Agho, Kingsley E; Burns, Penelope; Page, Andrew; Dibley, Michael J

2015-03-01

To explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey. The source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling. Ghana. Children (n 822) aged 6-23 months. The prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6-8 months was 72.6 % (95 % CI 64.6 %, 79.3 %). The proportion of children aged 6-23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46.0 % (95 % CI 42.3 %, 49.9 %) and 51.4 % (95 % CI 47.4 %, 55.3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29.9 % (95 % CI 26.1 %, 34.1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3.55; 95 % CI 1.05, 12.02). The prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

Impact of performance goals on the needs of highway infrastructure maintenance.

DOT National Transportation Integrated Search

2011-07-01

Although it is widely accepted that establishing suitable performance goal is critical for system : maintenance and preservation, a framework that considers the inter-relationship between conflicting : objectives of minimum maintenance and rehabilita...

Outcomes of an Acceptance and Commitment Therapy-Based Skills Training Group for Students with High-Functioning Autism Spectrum Disorder: A Quasi-Experimental Pilot Study

ERIC Educational Resources Information Center

Pahnke, Johan; Lundgren, Tobias; Hursti, Timo; Hirvikoski, Tatja

2014-01-01

Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as…

Current trends and outcomes of breast reconstruction following nipple-sparing mastectomy: results from a national multicentric registry with 1006 cases over a 6-year period.

PubMed

Casella, Donato; Calabrese, Claudio; Orzalesi, Lorenzo; Gaggelli, Ilaria; Cecconi, Lorenzo; Santi, Caterina; Murgo, Roberto; Rinaldi, Stefano; Regolo, Lea; Amanti, Claudio; Roncella, Manuela; Serra, Margherita; Meneghini, Graziano; Bortolini, Massimiliano; Altomare, Vittorio; Cabula, Carlo; Catalano, Francesca; Cirilli, Alfredo; Caruso, Francesco; Lazzaretti, Maria Grazia; Meattini, Icro; Livi, Lorenzo; Cataliotti, Luigi; Bernini, Marco

2017-05-01

Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study. Data extraction from the National Database was performed restricting cases to the 2009-2014 period. Different reconstruction procedures were analyzed in terms of their distribution over time and with respect to specific indications. A 1-year minimum follow-up was conducted to assess reconstructive unsuccessful events. Univariate and multivariate analyses were performed to investigate the causes of both prosthetic and autologous failures. 913 patients, for a total of 1006 procedures, are included in the analysis. A prosthetic only reconstruction is accomplished in 92.2 % of cases, while pure autologous tissues are employed in 4.2 % and a hybrid (prosthetic plus autologous) in 3.6 %. Direct-to-implant (DTI) reaches 48.7 % of all reconstructions in the year 2014. Prophylactic NSMs have a DTI reconstruction in 35.6 % of cases and an autologous tissue flap in 12.9 % of cases. Failures are 2.7 % overall: 0 % in pure autologous flaps and 9.1 % in hybrid cases. Significant risk factors for failures are diabetes and the previous radiation therapy on the operated breast. Reconstruction following NSM is mostly prosthetic in Italy, with DTI gaining large acceptance over time. Failures are low and occurring in diabetic and irradiated patients at the multivariate analysis.

36 CFR 51.5 - What information will the prospectus include?

Code of Federal Regulations, 2012 CFR

2012-07-01

..., include, but are not limited to the following: (1) The minimum acceptable franchise fee or other forms of... out by department for the three most recent years; franchise fees charged under the current concession...

36 CFR 51.5 - What information will the prospectus include?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., include, but are not limited to the following: (1) The minimum acceptable franchise fee or other forms of... out by department for the three most recent years; franchise fees charged under the current concession...

36 CFR 51.5 - What information will the prospectus include?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., include, but are not limited to the following: (1) The minimum acceptable franchise fee or other forms of... out by department for the three most recent years; franchise fees charged under the current concession...

36 CFR 51.5 - What information will the prospectus include?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., include, but are not limited to the following: (1) The minimum acceptable franchise fee or other forms of... out by department for the three most recent years; franchise fees charged under the current concession...

36 CFR 51.5 - What information will the prospectus include?

Code of Federal Regulations, 2014 CFR

2014-07-01

..., include, but are not limited to the following: (1) The minimum acceptable franchise fee or other forms of... out by department for the three most recent years; franchise fees charged under the current concession...

Risk-adjusted clinical outcomes in patients enrolled in a bloodless program

PubMed Central

Frank, Steven M.; Wick, Elizabeth C.; Dezern, Amy E.; Ness, Paul M.; Wasey, Jack O.; Pippa, Andrew C.; Dackiw, Elizabeth; Resar, Linda M.S.

2014-01-01

BACKGROUND Although clinical outcomes have been reported for patients who do not accept allogeneic blood transfusion (ABT), many previous studies lack a control group, fail to use risk adjustment, and focus exclusively on cardiac surgery. STUDY DESIGN AND METHODS We report a risk-adjusted, propensity score–matched, retrospective case-control study of clinical outcomes for inpatients who did not accept ABT (bloodless, n = 294) and those who did accept ABT (control, n = 1157). Multidisciplinary specialized care was rendered to the bloodless patients to conserve blood and optimize clinical outcomes. Differences in hemoglobin (Hb), mortality, five morbid outcomes, and hospital charges and costs were compared. Subgroups of medical and surgical patients were analyzed, and independent predictors of outcome were determined by multivariate analysis. RESULTS Overall, mortality was lower in the bloodless group (0.7%) than in the control group (2.7%; p = 0.046), primarily attributed to the surgical subgroup. After risk adjustment, bloodless care was not an independent predictor of the composite adverse outcome (death or any morbid event; p = 0.91; odds ratio, 1.02; 95% confidence interval, 0.68–1.53). Discharge Hb concentrations were similar in the bloodless (10.8 ± 2.7 g/dL) and control (10.9 ± 2.3 g/dL) groups (p = 0.42). Total and direct hospital costs were 12% (p = 0.02) and 18% (p = 0.02) less, respectively, in the bloodless patients, a difference attributed to the surgical subgroup. CONCLUSIONS Using appropriate blood conservation measures for patients who do not accept ABT results in similar or better outcomes and is associated with equivalent or lower costs. This specialized care may be beneficial even for those patients who accept ABT. PMID:24942198

Accepting Lower Salaries for Meaningful Work

PubMed Central

Hu, Jing; Hirsh, Jacob B.

2017-01-01

A growing literature indicates that people are increasingly motivated to experience a sense of meaning in their work lives. Little is known, however, about how perceptions of work meaningfulness influence job choice decisions. Although much of the research on job choice has focused on the importance of financial compensation, the subjective meanings attached to a job should also play a role. The current set of studies explored the hypothesis that people are willing to accept lower salaries for more meaningful work. In Study 1, participants reported lower minimum acceptable salaries when comparing jobs that they considered to be personally meaningful with those that they considered to be meaningless. In Study 2, an experimental enhancement of a job’s apparent meaningfulness lowered the minimum acceptable salary that participants required for the position. In two large-scale cross-national samples of full-time employees in 2005 and 2015, Study 3 found that participants who experienced more meaningful work lives were more likely to turn down higher-paying job offers elsewhere. The strength of this effect also increased significantly over this time period. Study 4 replicated these findings in an online sample, such that participants who reported having more meaningful work were less willing to leave their current jobs and organizations for higher paying opportunities. These patterns of results remained significant when controlling for demographic factors and differences in job characteristics. PMID:29085310

Core Outcome Set-STAndards for Development: The COS-STAD recommendations.

PubMed

Kirkham, Jamie J; Davis, Katherine; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

2017-11-01

The use of core outcome sets (COS) ensures that researchers measure and report those outcomes that are most likely to be relevant to users of their research. Several hundred COS projects have been systematically identified to date, but there has been no formal quality assessment of these studies. The Core Outcome Set-STAndards for Development (COS-STAD) project aimed to identify minimum standards for the design of a COS study agreed upon by an international group, while other specific guidance exists for the final reporting of COS development studies (Core Outcome Set-STAndards for Reporting [COS-STAR]). An international group of experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives produced the COS-STAD recommendations to help improve the quality of COS development and support the assessment of whether a COS had been developed using a reasonable approach. An open survey of experts generated an initial list of items, which was refined by a 2-round Delphi survey involving nearly 250 participants representing key stakeholder groups. Participants assigned importance ratings for each item using a 1-9 scale. Consensus that an item should be included in the set of minimum standards was defined as at least 70% of the voting participants from each stakeholder group providing a score between 7 and 9. The Delphi survey was followed by a consensus discussion with the study management group representing multiple stakeholder groups. COS-STAD contains 11 minimum standards that are the minimum design recommendations for all COS development projects. The recommendations focus on 3 key domains: the scope, the stakeholders, and the consensus process. The COS-STAD project has established 11 minimum standards to be followed by COS developers when planning their projects and by users when deciding whether a COS has been developed using reasonable methods.

Compulsory Sterilization: The Change in India's Population Policy

ERIC Educational Resources Information Center

Gulhati, Kaval

1977-01-01

Reviews India's previous stand regarding family planning which favored the notion that economic development would provide the incentive for fertility control. Recent recommendations, however, include raising minimum marriage age for girls and increasing incentives for acceptance of sterilization. (CS)

36 CFR 254.41 - Public sale or exchange in absence of application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exchange in absence of application. (a) Mineral survey fractions or road rights-of-way which have not been.... (c) The public notice shall describe the lands to be sold, minimum acceptable price, conditions of...

Statewide test of construction quality index for pavement software : final report, October 2008.

DOT National Transportation Integrated Search

2008-10-01

All Florida Department of Transportation (FDOT) pavement projects are accepted in accordance with : one or more construction specifications. The purposes of these specifications are to provide guidance : and establish minimum requirements that enable...

Optimization of traffic data collection for specific pavement design applications.

DOT National Transportation Integrated Search

2006-05-01

The objective of this study is to establish the minimum traffic data collection effort required for pavement design applications satisfying a maximum acceptable error under a prescribed confidence level. The approach consists of simulating the traffi...

Minimum probe length for unique identification of all open reading frames in a microbial genome

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

Sokhansanj, B A; Ng, J; Fitch, J P

2000-03-05

In this paper, we determine the minimum hybridization probe length to uniquely identify at least 95% of the open reading frame (ORF) in an organism. We analyze the whole genome sequences of 17 species, 11 bacteria, 4 archaea, and 2 eukaryotes. We also present a mathematical model for minimum probe length based on assuming that all ORFs are random, of constant length, and contain an equal distribution of bases. The model accurately predicts the minimum probe length for all species, but it incorrectly predicts that all ORFs may be uniquely identified. However, a probe length of just 9 bases ismore » adequate to identify over 95% of the ORFs for all 15 prokaryotic species we studied. Using a minimum probe length, while accepting that some ORFs may not be identified and that data will be lost due to hybridization error, may result in significant savings in microarray and oligonucleotide probe design.« less

Fixation of Trochanteric Fragments in Cementless Bipolar Hemiarthroplasty of Unstable Intertrochanteric Fracture: Cerclage Wiring

PubMed Central

Lee, Young-Kyun; Koo, Kyung-Hoi

2017-01-01

Purpose Bipolar hemiarthroplasty (HA) is an option for the treatment of unstable intertrochanteric fracture in elderly patients. There is a raising concern regarding cable-grip related complications for the fixation of trochanteric fragments. Therefore, the aim of this study was to evaluate outcome of cementless HA with fixation for the trochanteric fragments using monofilament wires in unstable intertrochanteric fracture. Materials and Methods We reviewed 92 cementless bipolar HAs using a grit-blasted long stem design for unstable intertrochanteric fractures in 91 elderly patients with a mean age of 81.7 years. During the arthroplasty, trochanteric fracture fragments were fixed using 1 or 2 vertical wires and transverse wires. We evaluated the clinical outcomes such as abductor power, ambulatory ability and wire-related complications, and radiologic outcomes including the union of the trochanteric fragment and subsidence of stem. Results Sixty-two patients were followed for a minimum of 2 years (mean, 59 months) postoperatively. The mean abductor power and Koval category was 4.1 (range, 3 to 5) and 4.6 (range, 1 to 6). The wire was broken in 3 hips (4.8%) and the nonunion of the greater trochanter occurred in 1 hips (1.6%). Two stems subsided by 3 mm and 8 mm, respectively, during postoperative 6 weeks, after which the subsidence was not progressive. Conclusion Cerclage wiring of the trochanter using monofilament wire leads to acceptable outcome in cementless HA for senile patients with unstable intertrochanteric fracture. Cerclage wiring using a monofilament wire is recommended for the fixation of trochanteric fragments. PMID:29250501

Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT).

PubMed

Lindsay, Emily K; Creswell, J David

2017-02-01

Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one's experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one's relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mechanisms of Mindfulness Training: Monitor and Acceptance Theory (MAT)1

PubMed Central

Lindsay, Emily K.; Creswell, J. David

2016-01-01

Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one’s experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one’s relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research. PMID:27835764

Control/display trade-off study for single-pilot instrument flight rule operations

NASA Technical Reports Server (NTRS)

Hoh, R.

1983-01-01

The objectives were to determine minimum autopilot functions and displays required to keep pilot workload at an acceptable level; to determine what constitutes an acceptable level of workload; to identify critical tasks; and to suggest specific experiments required to refine conclusions. It was determined that workload relief is derived from basic stability augmentation; that complex autopilots can lead to serious blunders; and that displays need to enhance positional awareness and minimize the likelihood of false hypothesis.

40 CFR 265.1 - Purpose, scope, and applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

....1 Section 265.1 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND... establish minimum national standards that define the acceptable management of hazardous waste during the...

46 CFR 176.650 - Alternative Hull Examination Program options: Divers or underwater ROV.

Code of Federal Regulations, 2011 CFR

2011-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 176.650 - Alternative Hull Examination Program options: Divers or underwater ROV.

Code of Federal Regulations, 2014 CFR

2014-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 176.650 - Alternative Hull Examination Program options: Divers or underwater ROV.

Code of Federal Regulations, 2012 CFR

2012-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 176.650 - Alternative Hull Examination Program options: Divers or underwater ROV.

Code of Federal Regulations, 2013 CFR

2013-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

Surrogate outcomes: experiences at the Common Drug Review

PubMed Central

2013-01-01

Background Surrogate outcomes are a significant challenge in drug evaluation for health technology assessment (HTA) agencies. The research objectives were to: identify factors associated with surrogate use and acceptability in Canada’s Common Drug Review (CDR) recommendations, and compare the CDR with other HTA or regulatory agencies regarding surrogate concerns. Methods Final recommendations were identified from CDR inception (September 2003) to December 31, 2010. Recommendations were classified by type of outcome (surrogate, final, other) and acceptability of surrogates (determined by the presence/absence of statements of concern regarding surrogates). Descriptive and statistical analyses examined factors related to surrogate use and acceptability. For thirteen surrogate-based submissions, recommendations from international HTA and regulatory agencies were reviewed for statements about surrogate acceptability. Results Of 156 final recommendations, 68 (44%) involved surrogates. The overall ‘do not list’ (DNL) rate was 48%; the DNL rate for surrogates was 41% (p = 0.175). The DNL rate was 64% for non-accepted surrogates (n = 28) versus 25% for accepted surrogates (odds ratio 5.4, p = 0.002). Clinical uncertainty, use of economic evidence over price alone, and a premium price were significantly associated with non-accepted surrogates. Surrogates were used most commonly for HIV, diabetes, rare diseases, cardiovascular disease and cancer. For the subset of drugs studied, other HTA agencies did not express concerns for most recommendations, while regulatory agencies frequently stated surrogate acceptance. Conclusions The majority of surrogates were accepted at the CDR. Non-accepted surrogates were significantly associated with clinical uncertainty and a DNL recommendation. There was inconsistency of surrogate acceptability across several international agencies. Stakeholders should consider collaboratively establishing guidelines on the use, validation, and acceptability of surrogates. PMID:24341379

25 CFR 547.15 - What are the minimum technical standards for electronic data communications between system...

Code of Federal Regulations, 2010 CFR

2010-04-01

... WITH THE PLAY OF CLASS II GAMES § 547.15 What are the minimum technical standards for electronic data...) Player tracking information; (8) Download Packages; and (9) Any information that affects game outcome. (b...

25 CFR 547.15 - What are the minimum technical standards for electronic data communications between system...

Code of Federal Regulations, 2012 CFR

2012-04-01

... WITH THE PLAY OF CLASS II GAMES § 547.15 What are the minimum technical standards for electronic data...) Player tracking information; (8) Download Packages; and (9) Any information that affects game outcome. (b...

25 CFR 547.15 - What are the minimum technical standards for electronic data communications between system...

Code of Federal Regulations, 2011 CFR

2011-04-01

... WITH THE PLAY OF CLASS II GAMES § 547.15 What are the minimum technical standards for electronic data...) Player tracking information; (8) Download Packages; and (9) Any information that affects game outcome. (b...

Semi-Metallic Be5C2 Monolayer Global Minimum with Quasi-Planar Pentacoordinate Carbons and Negative Poissons Ratio (Open Access Publisher’s Version)

DTIC Science & Technology

2016-05-03

ARTICLE Received 25 Nov 2015 | Accepted 1 Apr 2016 | Published 3 May 2016 Semi-metallic Be5C2 monolayer global minimum with quasi -planar...forming a quasi -planar pentacoordinate carbon moiety. Be5C2 monolayer appears to have good stability as revealed by its moderate cohesive energy...some promise to be realized experimentally . Be5C2 monolayer is a gapless semiconductor with a Dirac-like point in the band structure and also has an

Spacecraft Minimum Allowable Concentrations: Determination, Application, and Contingency Situations

NASA Technical Reports Server (NTRS)

Marshburn, Thomas H.; Dawson, David L. (Technical Monitor)

1999-01-01

This document is an outline of a presentation about the determination of minimum allowable concentrations in spacecraft. The presentation reviews the type of toxins and mechanisms to determine the acceptable concentrations of these toxic substances. The considerations for the unique situation that spaceflight entails including zero gravity, and the intense scrutiny are reviewed. The current measurement hardware is reviewed. The spacecraft atmospheres on the Shuttle, airflow, the Space Station and the EMU in respect to airflow, pressure, constituents are also summarized. Contingency situations and potential hazards are also discussed.

Wise Investment? Modeling Industry Profitability and Risk of Targeted Chemotherapy for Incurable Solid Cancers

PubMed Central

Conter, Henry J.; Chu, Quincy S.C.

2012-01-01

Purpose: Pharmaceutical development involves substantial financial risk. This risk, rising development costs, and the promotion of continued research and development have been cited as major drivers in the progressive increase in drug prices. Currently, cost-effective analyses are being used to determine the value of treatment. However, cost-effective analyses practically function as a threshold for value and do not directly address the rationale for drug prices. We set out to create a functional model for industry price decisions and clarify the minimum acceptable profitability of new drugs. Methods: Assuming that industry should only invest in profitable ventures, we employed a linear cost-volume-profit breakeven analysis to equate initial capital investment and risk and post–drug-approval profits, where drug development represents the bulk of investment. A Markov decision analysis model was also used to define the relationships between investment events risk. A systematic literature search was performed to determine event probabilities, clinical trial costs, and total expenses as inputs into the model. Disease-specific inputs, current market size across regions, and lengths of treatment for cancer types were also included. Results: With development of single novel chemotherapies costing from $802 to $1,042 million (2002 US dollars), pharmaceutical profits should range from $4.3 to $5.2 billion, with an expected rate of return on investment of 11% annually. However, diversification across cancer types for chemotherapy can reduce the minimum required profit to less than $3 billion. For optimal diversification, industry should study four tumor types per drug; however, nonprofit organizations could tolerate eight parallel development tracks to minimize the risk of development failure. Assuming that pharmaceutical companies hold exclusive rights for drug sales for only 5 years after market approval, the minimum required profit per drug per month per patient ranges from $294 for end-stage lung cancer to $3,231 for end-stage renal cell carcinoma. Conclusion: Pharmaceutical development in oncology is costly, with substantial risk, but is also highly profitable. Minimum acceptable profits per drug per month of treatment per patient vary with prevalence of disease, but they should be less than $5,000 per month of treatment in the developed world. Minimum acceptable profits may be lower for treatments with additional efficacy in the earlier stages of a tumor type. However, this type of event could not be statistically modeled. PMID:29447097

Ultrasound and Functional Assessment of Transtendinous Repairs of Partial-Thickness Articular-Sided Rotator Cuff Tears.

PubMed

Ostrander, Roger V; Klauser, Jeffrey M; Menon, Sanjay; Hackel, Joshua G

2017-03-01

Partial-thickness articular-sided rotator cuff tears are a frequent source of shoulder pain. Despite conservative measures, some patients continue to be symptomatic and require surgical management. However, there is some controversy as to which surgical approach results in the best outcomes for grade 3 tears. The purpose of this study was to evaluate repair integrity and the clinical results of patients treated with transtendinous repair of high-grade partial-thickness articular-sided rotator cuff tears. Our hypothesis was that transtendinous repairs would result in reliable healing and acceptable functional outcomes. Case series; Level of evidence, 4. Twenty patients with a minimum follow-up of 2 years were included in the study. All patients underwent arthroscopic repair of high-grade partial-thickness rotator cuff tears utilizing a transtendinous technique by a single surgeon. At latest follow-up, the repair integrity was evaluated using ultrasound imaging, and functional scores were calculated. Ultrasound evaluation demonstrated that 18 of 20 patients had complete healing with a normal-appearing rotator cuff. Two patients had a minor residual partial tear. Sixteen of 20 patients had no pain on visual analog scale. Four patients complained of mild intermittent residual pain. All patients were rated as "excellent" by both the University of California at Los Angeles Shoulder Score and the Simple Shoulder Test. The transtendon technique for the repair of articular-sided high-grade partial rotator cuff tears results in reliable tendon healing and excellent functional outcomes.

How well do WHO complementary feeding indicators relate to nutritional status of children aged 6-23 months in rural Northern Ghana?

PubMed

Saaka, Mahama; Wemakor, Anthony; Abizari, Abdul-Razak; Aryee, Paul

2015-11-23

Though the World Health Organization (WHO) recommended Infant and Young Child Feeding (IYCF) indicators have been in use, little is known about their association with child nutritional status. The objective of this study was to explore the relationship between IYCF indicators (timing of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet) and child growth indicators. A community-based cross-sectional survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure. Of the 1984 children aged 6-23 months; 58.2 % met the minimum meal frequency, 34.8 % received minimum dietary diversity (≥4 food groups), 27.8 % had received minimum acceptable diet and only 15.7 % received appropriate complementary feeding. With respect to nutritional status, 20.5 %, 11.5 % and 21.1 % of the study population were stunted, wasted and underweight respectively. Multiple logistic regression analysis revealed that compared to children who were introduced to complementary feeding either late or early, children who started complementary feeding at six months of age were 25 % protected from chronic malnutrition (AOR = 0.75, CI = 0.50 - 0.95, P = 0.02). It was found that children whose mothers attended antenatal care (ANC) at least 4 times were 34 % protected [AOR 0.66; 95 % CI (0.50 - 0.88)] against stunted growth compared to children born to mothers who attended ANC less than 4 times. Children from households with high household wealth index were 51 % protected [AOR 0.49; 95 % CI (0.26 - 0.94)] against chronic malnutrition compared to children from households with low household wealth index. After adjusting for potential confounders, there was a significant positive association between appropriate complementary feeding index and mean WLZ (β = 0.10, p = 0.005) but was not associated with mean LAZ. The WHO IYCF indicators better explain weight-for-length Z-scores than length-for-age Z-scores of young children in rural Northern Ghana. Furthermore, a composite indicator comprising timely introduction of solid, semi-solid or soft foods at 6 months, minimum meal frequency, and minimum dietary diversity better explains weight-for-length Z-scores than each of the single indicators.

10 CFR 706.2 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ENERGY SECURITY POLICIES AND PRACTICES RELATING TO LABOR-MANAGEMENT RELATIONS General § 706.2 Basis and... objectives for labor-management relations in the DOE program, namely: (a) Wholehearted acceptance by... efficient management expected from DOE contractors; (e) Minimum interference with the traditional rights and...

Alternative Treatment Technologies – Working With the Pathogen Equivalency Committee

EPA Science Inventory

Under current Federal regulations (40 CFR 503), municipal sludge must be treated prior to land application. The regulations identify two classes of treatment with respect to pathogen reduction: Class B (three alternatives) which provides a minimum acceptable level of treatment;...

45 CFR 170.455 - Testing and certification to newer versions of certain standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification... Technology may be upgraded to comply with newer versions of an adopted minimum standard accepted by the...

45 CFR 170.455 - Testing and certification to newer versions of certain standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification... Technology may be upgraded to comply with newer versions of an adopted minimum standard accepted by the...

45 CFR 170.455 - Testing and certification to newer versions of certain standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification... Technology may be upgraded to comply with newer versions of an adopted minimum standard accepted by the...

45 CFR 170.455 - Testing and certification to newer versions of certain standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification... Technology may be upgraded to comply with newer versions of an adopted minimum standard accepted by the...

45 CFR 170.455 - Testing and certification to newer versions of certain standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification... Technology may be upgraded to comply with newer versions of an adopted minimum standard accepted by the...

49 CFR 175.78 - Stowage compatibility of cargo.

Code of Federal Regulations, 2010 CFR

2010-10-01

... leakage. (b) At a minimum, the segregation instructions prescribed in the following Segregation Table must be followed to maintain acceptable segregation between packages containing hazardous materials with different hazards. The Segregation Table instructions apply whether or not the class or division is the...

Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

PubMed

Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

2016-08-01

Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

Mathematics. Suggested Learner Outcomes: Grades 9-12.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Education, Oklahoma City.

This publication provides suggested learner outcomes for guiding instruction and evaluation of students in grades 9-12 in Oklahoma. The goals are intended to provide teachers, administrators, school boards, parents, and other concerned citizens with a clear understanding of expected minimum learner outcomes for each mathematics course. Teachers…

Minimum information about a single amplified genome (MISAG) and a metagenome-assembled genome (MIMAG) of bacteria and archaea

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

Bowers, Robert M.; Kyrpides, Nikos C.; Stepanauskas, Ramunas

The number of genomes from uncultivated microbes will soon surpass the number of isolate genomes in public databases (Hugenholtz, Skarshewski, & Parks, 2016). Technological advancements in high-throughput sequencing and assembly, including single-cell genomics and the computational extraction of genomes from metagenomes (GFMs), are largely responsible. Here we propose community standards for reporting the Minimum Information about a Single-Cell Genome (MIxS-SCG) and Minimum Information about Genomes extracted From Metagenomes (MIxS-GFM) specific for Bacteria and Archaea. The standards have been developed in the context of the International Genomics Standards Consortium (GSC) community (Field et al., 2014) and can be viewed as amore » supplement to other GSC checklists including the Minimum Information about a Genome Sequence (MIGS), Minimum information about a Metagenomic Sequence(s) (MIMS) (Field et al., 2008) and Minimum Information about a Marker Gene Sequence (MIMARKS) (P. Yilmaz et al., 2011). Community-wide acceptance of MIxS-SCG and MIxS-GFM for Bacteria and Archaea will enable broad comparative analyses of genomes from the majority of taxa that remain uncultivated, improving our understanding of microbial function, ecology, and evolution.« less

50 CFR 260.6 - Terms defined.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the processing, handling, transporting, and storage of fish and fishery products. Inspection... Secretary of the Department or any other officer or employee of the Department authorized to exercise the...” means the minimum basis of acceptability for human food purposes, of any fish or fishery product as...

46 CFR 71.50-27 - Alternative Hull Examination (AHE) program options: Divers or underwater remotely operated...

Code of Federal Regulations, 2011 CFR

2011-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 71.50-27 - Alternative Hull Examination (AHE) program options: Divers or underwater remotely operated...

Code of Federal Regulations, 2013 CFR

2013-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 71.50-27 - Alternative Hull Examination (AHE) program options: Divers or underwater remotely operated...

Code of Federal Regulations, 2012 CFR

2012-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

46 CFR 71.50-27 - Alternative Hull Examination (AHE) program options: Divers or underwater remotely operated...

Code of Federal Regulations, 2014 CFR

2014-10-01

... accuracy; (3) Take ultrasonic thickness gaugings at a minimum of 5 points on each plate, evenly spaced; (4... must be accepted by the Officer in Charge, Marine Inspection (OCMI) prior to the survey. If you choose...

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs...

Salt content and minimum acceptable levels in whole-muscle cured meat products.

PubMed

Delgado-Pando, Gonzalo; Fischer, Estelle; Allen, Paul; Kerry, Joe P; O'Sullivan, Maurice G; Hamill, Ruth M

2018-05-01

Reported salt levels in whole-muscle cured meat products differ substantially within and among European countries, providing substantial scope for salt reduction across this sector. The objective of this study was to identify the minimum acceptable salt levels in typical whole-muscle cured products in terms of physicochemical, microbial and sensorial properties. Salt levels in a small selection of commercial Irish meat products were determined to establish a baseline for reduction. Subsequently, eight different back bacon rasher and cooked ham products were produced with varying levels of salt: 2.9%, 2.5%, 2% and 1.5% for bacon, and 2%, 1.6%, 1.0% and 0.8% for ham. Salt reduction produced products with significantly harder texture and higher microbial counts, with no difference in the colour and affecting the sensory properties. Nonetheless, salt reduction proved to be feasible to levels of 34% and 19% in bacon and ham products, respectively, compared to baseline. Copyright © 2018 Elsevier Ltd. All rights reserved.

Minimum Age of Sale for Tobacco Products and Electronic Cigarettes: Ethical Acceptability of US "Tobacco 21 Laws".

PubMed

Morain, Stephanie Rubino; Malek, Janet

2017-09-01

Several US jurisdictions have recently passed laws that raise the minimum age of sale for tobacco products and electronic cigarettes to 21 years (Tobacco 21 laws). Although these laws have been demonstrated to be an effective means to reduce youth smoking initiation, their passage and potential expansion have provoked controversy. Critics have objected to these laws, claiming that they unduly intrude on individual freedom and that they irrationally and paternalistically restrict the freedom of those aged 18 to 20 years, who were previously able to legally purchase tobacco products. We have examined the ethical acceptability of Tobacco 21 laws. First, we have described ethical support for such a restriction grounded in its public health benefit. We have then offered arguments that raise doubts about the soundness of critics' objections to these regulations and described an additional ethical justification arising from concern about preventing harm to others. On the basis of this analysis, we conclude that Tobacco 21 laws are ethically justifiable.

Recent Immigrants as Labor Market Arbitrageurs: Evidence from the Minimum Wage.

PubMed

Cadena, Brian C

2014-03-01

This paper investigates the local labor supply effects of changes to the minimum wage by examining the response of low-skilled immigrants' location decisions. Canonical models emphasize the importance of labor mobility when evaluating the employment effects of the minimum wage; yet few studies address this outcome directly. Low-skilled immigrant populations shift toward labor markets with stagnant minimum wages, and this result is robust to a number of alternative interpretations. This mobility provides behavior-based evidence in favor of a non-trivial negative employment effect of the minimum wage. Further, it reduces the estimated demand elasticity using teens; employment losses among native teens are substantially larger in states that have historically attracted few immigrant residents.

Quality improvement in neurology residency programs. Report of the Quality Improvement Committee of the Association of University Professors of Neurology.

PubMed

Bradley, W G; Daube, J; Mendell, J R; Posner, J; Richman, D; Troost, B T; Swift, T R

1997-11-01

The neurology residency programs in the United States are facing a crisis of quality. The Association of University Professors of Neurology (AUPN) approved the Quality Improvement Committee to examine this situation and make recommendations, which have been accepted by the AUPN. The recommendations are (1) that the educational goals of neurology residency training be dissociated from patient-care needs in academic medical centers and (2) that minimum levels of quality be applied to residents in neurology residency programs and to these programs themselves. These minimum criteria should include minimum educational criteria for entry into the program, minimum criteria for advancement from one year to the next in the program, and minimum criteria for performance of the graduates of neurology residency programs for program accreditation. The implementation of these recommendations will require a shift of funding of the care of indigent patients from the graduate medical education budget to direct patient-care sources. These recommendations will significantly improve the quality of neurologists and neurologic care in the United States.

Tablet splitting: a review of the clinical and economic outcomes and patient acceptance. Second of a 2-part series. Part 1 was published in May 2012 (Consult Pharm 2012;27:239-53).

PubMed

Freeman, Maisha Kelly; White, Whitney; Iranikhah, Maryam

2012-06-01

To describe the clinical outcomes, patient acceptance, and economic effect associated with tablet splitting. PubMed (1966-June 2011) and International Pharmaceutical Abstract (1975-June 2011) searches were conducted using tablet splitting as the search terms. All studies that evaluated the clinical outcome (n = 4), patient acceptance (n = 5), and economic effects (n = 8) of tablet splitting were included. The American Pharmacists Association guidelines, recommendations from the Food and Drug Administration, and clinical trial data were evaluated. The majority of trials conducted evaluating clinical outcomes associated with tablet splitting were evaluated in patients receiving statins and antihypertensives. Clinical outcomes associated with risperidone were assessed. No adverse clinical outcomes were observed with therapy. Most studies evaluating the economic effects of tablet splitting have revealed a cost savings associated with this process; however, many studies were subject to limitations. The first part of this two-part series reviewed the weight and content uniformity in tablet splitting. Tablet splitting does not seem to significantly affect clinical outcomes related to management of hypertension, cholesterol, or psychiatric disorders, nor influence overall patient adherence.

REAL-PANLAR Project for the Implementation and Accreditation of Centers of Excellence in Rheumatoid Arthritis Throughout Latin America

PubMed Central

Santos-Moreno, Pedro; Galarza-Maldonado, Claudio; Caballero-Uribe, Carlo V.; Cardiel, Mario H.; Massardo, Loreto; Soriano, Enrique R.; Olano, José Aguilar; Díaz Coto, José F.; Durán Pozo, Gabriel R.; da Silveira, Inês Guimarães; de Castrejón, Vianna J. Khoury; Pérez, Leticia Lino; Méndez Justo, Carlos A.; Montufar Guardado, Rubén A.; Muños, Rafael; Elvir, Sergio Murillo; Paredes Domínguez, Ernesto R.; Pons-Estel, Bernardo; Ríos Acosta, Carlos R.; Sandino, Sayonara; Toro Gutiérrez, Carlos E.; Villegas de Morales, Sol María; Pineda, Carlos

2015-01-01

Objective A consensus meeting of representatives of 16 Latin American and Caribbean countries and the REAL-PANLAR group met in the city of Bogota to provide recommendations for improving quality of care of patients with rheumatoid arthritis (RA) in Latin America, defining a minimum standards of care and the concept of center of excellence in RA. Methods Twenty-two rheumatologists from 16 Latin American countries with a special interest in quality of care in RA participated in the consensus meeting. Two RA Colombian patients and 2 health care excellence advisors were also invited to the meeting. A RAND-modified Delphi procedure of 5 steps was applied to define categories of centers of excellence. During a 1-day meeting, working groups were created in order to discuss and validate the minimum quality-of-care standards for the 3 proposed types of centers of excellence in RA. Positive votes from at least 60% of the attending leaders were required for the approval of each standard. Results Twenty-two opinion leaders from the PANLAR countries and the REAL-PANLAR group participated in the discussion and definition of the standards. One hundred percent of the participants agreed with setting up centers of excellence in RA throughout Latin America. Three types of centers of excellence and its criteria were defined, according to indicators of structure, processes, and outcomes: standard, optimal, and model. The standard level should have basic structure and process indicators, the intermediate or optimal level should accomplish more structure and process indicators, and model level should also fulfill outcome indicators and patient experience. Conclusions This is the first Latin American effort to standardize and harmonize the treatment provided to RA patients and to establish centers of excellence that would offer to RA patients acceptable clinical results and high levels of safety. PMID:26010179

REAL-PANLAR Project for the Implementation and Accreditation of Centers of Excellence in Rheumatoid Arthritis Throughout Latin America: A Consensus Position Paper From REAL-PANLAR Group on Improvement of Rheumatoid Arthritis Care in Latin America Establishing Centers of Excellence.

PubMed

Santos-Moreno, Pedro; Galarza-Maldonado, Claudio; Caballero-Uribe, Carlo V; Cardiel, Mario H; Massardo, Loreto; Soriano, Enrique R; Olano, José Aguilar; Díaz Coto, José F; Durán Pozo, Gabriel R; da Silveira, Inês Guimarães; de Castrejón, Vianna J Khoury; Pérez, Leticia Lino; Méndez Justo, Carlos A; Montufar Guardado, Rubén A; Muños, Rafael; Elvir, Sergio Murillo; Paredes Domínguez, Ernesto R; Pons-Estel, Bernardo; Ríos Acosta, Carlos R; Sandino, Sayonara; Toro Gutiérrez, Carlos E; Villegas de Morales, Sol María; Pineda, Carlos

2015-06-01

A consensus meeting of representatives of 16 Latin American and Caribbean countries and the REAL-PANLAR group met in the city of Bogota to provide recommendations for improving quality of care of patients with rheumatoid arthritis (RA) in Latin America, defining a minimum standards of care and the concept of center of excellence in RA. Twenty-two rheumatologists from 16 Latin American countries with a special interest in quality of care in RA participated in the consensus meeting. Two RA Colombian patients and 2 health care excellence advisors were also invited to the meeting. A RAND-modified Delphi procedure of 5 steps was applied to define categories of centers of excellence. During a 1-day meeting, working groups were created in order to discuss and validate the minimum quality-of-care standards for the 3 proposed types of centers of excellence in RA. Positive votes from at least 60% of the attending leaders were required for the approval of each standard. Twenty-two opinion leaders from the PANLAR countries and the REAL-PANLAR group participated in the discussion and definition of the standards. One hundred percent of the participants agreed with setting up centers of excellence in RA throughout Latin America. Three types of centers of excellence and its criteria were defined, according to indicators of structure, processes, and outcomes: standard, optimal, and model. The standard level should have basic structure and process indicators, the intermediate or optimal level should accomplish more structure and process indicators, and model level should also fulfill outcome indicators and patient experience. This is the first Latin American effort to standardize and harmonize the treatment provided to RA patients and to establish centers of excellence that would offer to RA patients acceptable clinical results and high levels of safety.

Septic single-stage knee arthrodesis after failed total knee arthroplasty using a cemented coupled nail.

PubMed

Hawi, N; Kendoff, D; Citak, M; Gehrke, T; Haasper, C

2015-05-01

Knee arthrodesis is a potential salvage procedure for limb preservation after failure of total knee arthroplasty (TKA) due to infection. In this study, we evaluated the outcome of single-stage knee arthrodesis using an intramedullary cemented coupled nail without bone-on-bone fusion after failed and infected TKA with extensor mechanism deficiency. Between 2002 and 2012, 27 patients (ten female, 17 male; mean age 68.8 years; 52 to 87) were treated with septic single-stage exchange. Mean follow-up duration was 67.1months (24 to 143, n = 27) (minimum follow-up 24 months) and for patients with a minimum follow-up of five years 104.9 (65 to 143,; n = 13). A subjective patient evaluation (Short Form (SF)-36) was obtained, in addition to the Visual Analogue Scale (VAS). The mean VAS score was 1.44 (SD 1.48). At final follow-up, four patients had recurrent infections after arthrodesis (14.8%). Of these, three patients were treated with a one-stage arthrodesis nail exchange; one of the three patients had an aseptic loosening with a third single-stage exchange, and one patient underwent knee amputation for uncontrolled sepsis at 108 months. All patients, including the amputee, indicated that they would choose arthrodesis again. Data indicate that a single-stage knee arthrodesis offers an acceptable salvage procedure after failed and infected TKA. ©2015 The British Editorial Society of Bone & Joint Surgery.

49 CFR 192.327 - Cover.

Code of Federal Regulations, 2012 CFR

2012-10-01

... State or municipality: (1) Establishes a minimum cover of less than 24 inches (610 millimeters); (2... accepted practices). (f) All pipe installed offshore, except in the Gulf of Mexico and its inlets, under... concrete coating, or protected by an equivalent means. (g) All pipelines installed under water in the Gulf...

49 CFR 192.327 - Cover.

Code of Federal Regulations, 2011 CFR

2011-10-01

... State or municipality: (1) Establishes a minimum cover of less than 24 inches (610 millimeters); (2... accepted practices). (f) All pipe installed offshore, except in the Gulf of Mexico and its inlets, under... concrete coating, or protected by an equivalent means. (g) All pipelines installed under water in the Gulf...

36 CFR 223.229 - Contents of prospectus.

Code of Federal Regulations, 2011 CFR

2011-07-01

....229 Section 223.229 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE... sale of special forest products shall include the following: (a) The minimum acceptable value or unit... downpayment; (d) The location and area of the sale, including acreage; (e) The estimated volumes, quality...

40 CFR 63.843 - Emission limits for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The emission capture system shall be installed and operated to meet the generally accepted engineering standards for minimum exhaust rates as published by the American Conference of Governmental Industrial Hygienists in Chapters 3 and 5 of “Industrial Ventilation: A Handbook of Recommended Practice” (incorporated...

40 CFR 63.843 - Emission limits for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The emission capture system shall be installed and operated to meet the generally accepted engineering standards for minimum exhaust rates as published by the American Conference of Governmental Industrial Hygienists in Chapters 3 and 5 of “Industrial Ventilation: A Handbook of Recommended Practice” (incorporated...

40 CFR 63.843 - Emission limits for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The emission capture system shall be installed and operated to meet the generally accepted engineering standards for minimum exhaust rates as published by the American Conference of Governmental Industrial Hygienists in Chapters 3 and 5 of “Industrial Ventilation: A Handbook of Recommended Practice” (incorporated...

40 CFR 63.843 - Emission limits for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The emission capture system shall be installed and operated to meet the generally accepted engineering standards for minimum exhaust rates as published by the American Conference of Governmental Industrial Hygienists in Chapters 3 and 5 of “Industrial Ventilation: A Handbook of Recommended Practice” (incorporated...

40 CFR 63.843 - Emission limits for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) The emission capture system shall be installed and operated to meet the generally accepted engineering standards for minimum exhaust rates as published by the American Conference of Governmental Industrial Hygienists in Chapters 3 and 5 of “Industrial Ventilation: A Handbook of Recommended Practice” (incorporated...

Automatic, nondestructive test monitors in-process weld quality

NASA Technical Reports Server (NTRS)

Deal, F. C.

1968-01-01

Instrument automatically and nondestructively monitors the quality of welds produced in microresistance welding. It measures the infrared energy generated in the weld as the weld is made and compares this energy with maximum and minimum limits of infrared energy values previously correlated with acceptable weld-strength tolerances.

76 FR 25413 - Supplemental Nutrition Assistance Program (SNAP): Eligibility, Certification, and Employment and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... inflation; exclude retirement and education accounts from countable resources; permit States to expand the...)--Excluding education accounts from resources; Section 4107--Increasing the minimum benefit for small... accept or continue employment, or to participate in training or education in preparation for employment...

Preschool Regulations.

ERIC Educational Resources Information Center

Nebraska State Dept. of Health and Human Services, Lincoln.

Published by the Department of Health and Human Services, as required by Nebraska law, this guide details regulations for the physical well-being, safety, and protection of children and defines the minimum levels of acceptable services to be provided in Nebraska preschools. The first section of the guide lists specific preschool regulations,…

Cosmetic Outcomes for Accelerated Partial Breast Irradiation Before Surgical Excision of Early-Stage Breast Cancer Using Single-Dose Intraoperative Radiotherapy

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

Kimple, Randall J.; Klauber-DeMore, Nancy; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC

2011-02-01

Purpose: Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered before tumor excision for patients with early-stage breast cancer. Methods and Materials: Patients age 48 or older with ultrasound-visible invasive ductal cancers <3 cm and clinically negative lymph nodes were eligible for treatment on this institutional review board-approved Phase II clinical trial. Treatment planning ultrasound was used to select an electron energy and cone size sufficient to cover the tumor plus a 1.5- to 2.0-cm circumferential margin laterally and a 1-cm-deep margin with the 90% isodose line. The dose was prescribed to a nominal 15 Gy and delivered usingmore » a Mobetron electron irradiator before tumor excision by segmental mastectomy. Physician- and patient-assessed cosmetic outcome and patient satisfaction were determined by questionnaire. Results: From March 2003 to July 2007, 71 patients were treated with intraoperative radiation therapy. Of those, 56 patients were evaluable, with a median follow-up of 3.1 years (minimum 1 year). Physician and patient assessment of cosmesis was 'good or excellent' (Radiation Therapy Oncology Group cosmesis scale) in 45/56 (80%) and 32/42 (76%) of all patients, respectively. Eleven patients who received additional whole breast radiation had similar rates of good or excellent cosmesis: 40/48 (83%) and 29/36 (81%), respectively). Grade 1 or 2 acute toxicities were seen in 4/71 (6%) patients. No Grade 3 or 4 toxicities or serious adverse events have been seen. Conclusion: Intraoperative radiotherapy delivered to an in situ tumor is feasible with acceptable acute tolerance. Patient and physician assessment of the cosmetic outcome is good to excellent.« less

Establishment of an effective acute stroke telemedicine program for Australia: protocol for the Victorian Stroke Telemedicine project.

PubMed

Cadilhac, Dominique A; Moloczij, Natasha; Denisenko, Sonia; Dewey, Helen; Disler, Peter; Winzar, Bruce; Mosley, Ian; Donnan, Geoffrey A; Bladin, Christopher

2014-02-01

Urgent treatment of acute stroke in rural Australia is problematic partly because of limited access to medical specialists. Utilization of telemedicine could improve delivery of acute stroke treatments in rural communities. The study aims to demonstrate enhanced clinical decision making for use of thrombolysis within 4·5 h of ischemic stroke symptom onset in a rural setting using a telemedicine specialist support model. A formative program evaluation research design was used. The Victorian Stroke Telemedicine program was developed and will be evaluated over five stages to ensure successful implementation. The phases include: (a) preimplementation phase to establish the Victorian Stroke Telemedicine program including the clinical pathway, data collection tools, and technology processes; (b) pilot clinical application phase to test the pathway in up to 10 patients; (c) modification phase to refine the program; (d) full clinical implementation phase where the program is maintained for one-year; and (e) a sustainability phase to assess project outcomes over five-years. Qualitative (clinician interviews) and quantitative data (patient, clinician, costs, and technology processes) are collected in each phase. The primary outcome is to achieve a minimum 10% absolute increase in eligible patients treated with thrombolysis. Secondary outcomes are utilization of the telestroke pathway and improvements in processes of stroke care (e.g., time to brain scan). We will report door to telemedicine consultation time, length of telemedicine consultation, clinical utility and acceptability from the perspective of clinicians, and 90-day patient outcomes. This research will provide evidence for an effective telestroke program for use in regional Australian hospitals. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Future trends which will influence waste disposal.

PubMed Central

Wolman, A

1978-01-01

The disposal and management of solid wastes are ancient problems. The evolution of practices naturally changed as populations grew and sites for disposal became less acceptable. The central search was for easy disposal at minimum costs. The methods changed from indiscriminate dumping to sanitary landfill, feeding to swine, reduction, incineration, and various forms of re-use and recycling. Virtually all procedures have disabilities and rising costs. Many methods once abandoned are being rediscovered. Promises for so-called innovations outstrip accomplishments. Markets for salvage vary widely or disappear completely. The search for conserving materials and energy at minimum cost must go on forever. PMID:570105

Protocol for the development of a Core Outcome Set (COS) for hemorrhoidal disease: an international Delphi study.

PubMed

van Tol, R R; Melenhorst, J; Dirksen, C D; Stassen, L P S; Breukink, S O

2017-07-01

Over the last decade, many studies were performed regarding treatment options for hemorrhoidal disease. Randomised controlled trials (RCTs) should have well-defined primary and secondary outcomes. However, the reported outcome measures are numerous and diverse. The heterogeneity of outcome definition in clinical trials limits transparency and paves the way for bias. The development of a core outcome set (COS) helps minimizing this problem. A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease. The aim of this project is to generate a COS regarding the outcome of treatment after hemorrhoidal disease. A Delphi study will be performed by an international steering group healthcare professionals and patients with the intention to create a standard outcome set for future clinical trials for the treatment of hemorrhoidal disease. First, a literature review will be conducted to establish which outcomes are used in clinical trials for hemorrhoidal disease. Secondly, both healthcare professionals and patients will participate in several consecutive rounds of online questionnaires and a face-to-face meeting to refine the content of the COS. Development of a COS for hemorrhoidal disease defines a minimum outcome-reporting standard and will improve the quality of research in the future.

Malnutrition in Hospitalized Pediatric Patients: Assessment, Prevalence, and Association to Adverse Outcomes.

PubMed

Daskalou, Efstratia; Galli-Tsinopoulou, Assimina; Karagiozoglou-Lampoudi, Thomais; Augoustides-Savvopoulou, Persefone

2016-01-01

Malnutrition is a frequent finding in pediatric health care settings in the form of undernutrition or excess body weight. Its increasing prevalence and impact on overall health status, which is reflected in the adverse outcomes, renders imperative the application of commonly accepted and evidence-based practices and tools by health care providers. Nutrition risk screening on admission and nutrition status evaluation are key points during clinical management of hospitalized pediatric patients, in order to prevent health deterioration that can lead to serious complications and growth consequences. In addition, anthropometric data based on commonly accepted universal growth standards can give accurate results for nutrition status. Both nutrition risk screening and nutrition status assessment are techniques that should be routinely implemented, based on commonly accepted growth standards and methodology, and linked to clinical outcomes. The aim of the present review was to address the issue of hospital malnutrition in pediatric settings in terms of prevalence, outline nutrition status evaluation and nutrition screening process using different criteria and available tools, and present its relationship with outcome measures. Key teaching points • Malnutrition-underweight or excess body weight-is a frequent imbalance in pediatric settings that affects physical growth and results in undesirable clinical outcomes. • Anthropometry interpretation through growth charts and nutrition screening are cornerstones for the assessment of malnutrition.To date no commonly accepted anthropometric criteria or nutrition screening tools are used in hospitalized pediatric patients. • Commonly accepted nutrition status and screening processes based on the World Health Organization's growth standards can contribute to the overall hospital nutrition care of pediatric patients.

Technology as a Double-Edged Sword: From Behavior Prediction with UTAUT to Students' Outcomes Considering Personal Characteristics

ERIC Educational Resources Information Center

Khechine, Hager; Lakhal, Sawsen

2018-01-01

Aim/Purpose: We aim to bring a better understanding of technology use in the educational context. More specifically, we investigate the determinants of webinar acceptance by university students and the effects of this acceptance on students' outcomes in the presence of personal characteristics such as anxiety, attitude, computer self-efficacy, and…

Acceptability and Preliminary Outcomes of a Peer-Led Depression Prevention Intervention for African American Adolescents and Young Adults in Employment Training Programs

ERIC Educational Resources Information Center

Tandon, Darius; Mendelson, Tamar; Mance, GiShawn

2011-01-01

This study examines the acceptability and preliminary outcomes from an open trial of a depression prevention intervention for low-income African American adolescents and young adults in employment training programs. The sample (N=42) consisted of predominately African American adolescents and young adults (mean age=19.1) exhibiting subclinical…

The Labor Market for PhDs in Science and Engineering: Career Outcomes.

ERIC Educational Resources Information Center

Solmon, Lewis C.; Hurwicz, Margo-Lea

The outcomes of the employment situation for science and engineering PhDs were assessed through a survey of college and university departments and faculty members who had accepted new academic jobs or who had left academic jobs for other positions within the last three years. Faculty members who had accepted their first job after receiving the…

Acceptance and relationship context: a model of substance use disorder treatment outcome.

PubMed

Gifford, Elizabeth V; Ritsher, Jennifer B; McKellar, John D; Moos, Rudolf H

2006-08-01

This study presented and tested a model of behavior change in long-term substance use disorder recovery, the acceptance and relationship context (ARC) model. The model specifies that acceptance-based behavior and constructive social relationships lead to recovery, and that treatment programs with supportive, involved relationships facilitate the development of these factors. This study used a prospective longitudinal naturalistic design and controlled for baseline levels of study variables. The model was tested on a sample of 2549 patients in 15 residential substance use disorder treatment programs. Acceptance-based responding (ABR), social relationship quality (SRQ), treatment program alliance (TPA) and substance use-related impairment were assessed using interviews and self-report questionnaires. TPA predicted ABR and SRQ and, in turn, ABR predicted better 2-year and 5-year treatment outcomes. The baseline-controlled model accounted for 41% of the variance in outcome at 2-year follow-up and 28% of the variance in outcome at 5-year follow-up. CONCLUSIONS Patients from treatment programs with an affiliative relationship network are more likely to respond adaptively to internal states associated previously with substance use, develop constructive social relationships and achieve long-term treatment benefits.

Minimum visual requirements in different occupations in Finland.

PubMed

Aine, E

1984-01-01

In Finland the employers can individually fix the minimum visual requirements for their personnel in almost every occupation. In transportation, in police and national defence proper eyesight is regarded so important that strict visual requirements for these have been fixed by the Government. The regulations are often more close when accepting the person to the occupation than later on when working. The minimum requirements are mostly stated for visual acuity, colour perception and visual fields. In some occupations the regulations concern also the refractive error of the eyes and possible eye diseases. In aviation the regulations have been stated by the International Civil Aviation Organization ( ICAO ). The minimum visual requirements for a driving license in highway traffic are classed according to the types of motor vehicles. In railways , maritime commerce and national defence the task of the worker determines the specified regulations. The policeman must have a distant visual acuity of 0.5 without eyeglasses in both eyes and nearly normal colour perception when starting the training course.

Associations between relational sexual behaviour, pornography use, and pornography acceptance among US college students.

PubMed

Willoughby, Brian J; Carroll, Jason S; Nelson, Larry J; Padilla-Walker, Laura M

2014-01-01

Pornography use among emerging adults in the USA has increased in recent decades, as has the acceptance of such consumption. While previous research has linked pornography use to both positive and negative outcomes in emerging adult populations, few studies have investigated how attitudes toward pornography may alter these associations, or how examining pornography use together with other sexual behaviours may offer unique insights into the outcomes associated with pornography use. Using a sample of 792 emerging adults, the present study explored how the combined examination of pornography use, acceptance, and sexual behaviour within a relationship might offer insight into emerging adults' development. Results suggested clear gender differences in both pornography use and acceptance patterns. High male pornography use tended to be associated with high engagement in sex within a relationship and was associated with elevated risk-taking behaviours. High female pornography use was not associated with engagement in sexual behaviours within a relationship and was general associated with negative mental health outcomes.

Equity through Accountability? Mandating Minimum Competency Exit Examinations for Secondary Students with Learning Disabilities.

ERIC Educational Resources Information Center

Manset, Genevieve; Washburn, Sandra J.

2000-01-01

This article reviews the research related to minimum competency testing (MCT) as a requirement for high school graduation for students with learning disabilities. It examines whether inclusive MCT requirements lead to positive educational outcomes, raises issues of accommodations and alternative diplomas, possible increased dropout rates, and…

Minimum Wages and Teenagers' Enrollment--Employment Outcomes: A Multinominal Logit Model.

ERIC Educational Resources Information Center

Ehrenberg, Ronald G.; Marcus, Alan J.

1982-01-01

This paper tests the hypothesis that the effect of minimum wage legislation on teenagers' education decisions is asymmetrical across family income classes, with the legislation inducing children from low-income families to reduce their levels of schooling and children from higher-income families to increase their educational attainment. (Author)

When Do Laws Matter? National Minimum-Age-of-Marriage Laws, Child Rights, and Adolescent Fertility, 1989–2007

PubMed Central

Kim, Minzee; Longhofer, Wesley; Boyle, Elizabeth Heger; Nyseth, Hollie

2014-01-01

Using the case of adolescent fertility, we ask the questions of whether and when national laws have an effect on outcomes above and beyond the effects of international law and global organizing. To answer these questions, we utilize a fixed-effect time-series regression model to analyze the impact of minimum-age-of-marriage laws in 115 poor- and middle-income countries from 1989 to 2007. We find that countries with strict laws setting the minimum age of marriage at 18 experienced the most dramatic decline in rates of adolescent fertility. Trends in countries that set this age at 18 but allowed exceptions (for example, marriage with parental consent) were indistinguishable from countries that had no such minimum-age-of-marriage law. Thus, policies that adhere strictly to global norms are more likely to elicit desired outcomes. The article concludes with a discussion of what national law means in a diffuse global system where multiple actors and institutions make the independent effect of law difficult to identify. PMID:25525281

Impact of study outcome on submission and acceptance metrics for peer reviewed medical journals: six year retrospective review of all completed GlaxoSmithKline human drug research studies.

PubMed

Evoniuk, Gary; Mansi, Bernadette; DeCastro, Barbara; Sykes, Jennie

2017-04-21

Objectives  To determine whether the outcome of drug studies influenced submission and/or acceptance rates for publication in peer reviewed medical journals. Design  A six year retrospective review of publication status by study outcome for all human drug research studies conducted by a single industry sponsor (GlaxoSmithKline) that completed from 1 January 2009 to 30 June 2014 and were therefore due for manuscript submission (per the sponsor's policy) to peer reviewed journals within 18 months of study completion-that is, 31 December 2015. In addition, manuscripts from studies completing after 30 June 2014 were included irrespective of outcome if they were submitted before 31 December 2015. Setting  Studies conducted by a single industry sponsor (GlaxoSmithKline) Studies reviewed  1064 human drug research studies. Main outcome measures  All studies were assigned a publication status at 26 February 2016 including (as applicable): study completion date, date of first primary manuscript submission, number of submissions, journal decision(s), and publication date. All studies were also classified with assessors blinded to publication status as "positive" (perceived favorable outcome for the drug under study), "negative" (perceived unfavorable outcome for the drug under study), mixed, or non-comparative based on the presence and outcome of the primary outcome measure(s) for each study. "Negative" studies included safety studies in which the primary outcome was achieved but was adverse for the drug under study. For the total cohort and each of the four study outcomes, measures included descriptive statistics for study phase, time from study completion to submission and publication, and number and outcome (accepted/rejected) of publication submissions. Results  Of the 1064 studies (phase I-IV, interventional and non-interventional) included, 321 had study outcomes classified as positive, 155 as negative, 52 as mixed, and 536 as non-comparative. At the time of publication cut-off date (26 February 2016), 904 (85%) studies had been submitted for publication as full manuscripts and 751 (71%) had been successfully published or accepted, with 100 (9%) still under journal review. An additional 77 (7%) studies were conference abstracts and were not included in submission or publication rates. Submission rates by study outcome were 79% for the 321 studies with positive outcomes, 92% for the 155 with negative outcomes, 94% for the 52 with mixed outcomes, and 85% for the 536 non-comparative studies; while rates of publication at the cut-off date were 66%, 77%, 77%, and 71%, respectively. Median time from study completion to submission was 537 days (interquartile range 396-638 days) and 823 days (650-1063 days) from completion to publication, with similar times observed across study outcomes. First time acceptance rates were 56% for studies with positive outcomes and 48% for studies with negative outcomes. Over 10% of studies across all categories required three or more submissions to achieve successful publication. At the time of analysis, 83 studies had not been submitted for publication, including 49 bioequivalence studies with positive outcomes and 33 non-comparative studies. Most studies (98%, 1041/1064) had results posted to one or more public registers, including all studies subject to FDAAA (Food and Drug Administration Amendments Act) requirements for posting to www.clinicaltrials.gov Conclusions  Over the period studied, there was no evidence of submission or publication bias: 92% of studies with negative outcomes were submitted for publication by the cut-off date versus 79% of those with positive outcomes. Publication rates were slightly higher for studies with a negative (that is, unfavorable) outcome compared with a positive outcome, despite a slightly lower rate of acceptance at first submission. Many studies required multiple submission attempts before they were accepted for publication. Analyses focusing solely on publication rates do not take into account unsuccessful efforts to publish. Sponsors and journal editors should share similar information to contribute to better understanding of issues and barriers to full transparency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

20 CFR 404.1641 - Standards of performance.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... (a) General. The performance standards include both a target level of performance and a threshold level of performance for the State agency. The target level represents a level of performance that we and the States will work to attain in the future. The threshold level is the minimum acceptable level...

20 CFR 416.1041 - Standards of performance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance. (a) General. The performance standards include both a target level of performance and a threshold level of performance for the State agency. The target level represents a level of performance that we and the States will work to attain in the future. The threshold level is the minimum acceptable level...

75 FR 15484 - Railroad Safety Technology Program Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... governments for projects that have a public benefit of improved railroad safety and efficiency. The program... State and local governments for projects * * * that have a public benefit of improved safety and network... minimum 20 percent grantee cost share (cash or in-kind) match requirement. DATES: FRA will begin accepting...

Syllabus in Dental Assisting.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

The syllabus, part of the New York Health Occupations Education Program, is a statement of the minimum course content acceptable for State credit, requiring two and one-half hours each day of 160 teaching days in each of two academic years. The Introduction to the syllabus contains recommendations regarding selection of teachers and students,…

31 CFR 321.25 - Payment and retention of definitive securities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... prohibited from accepting an image, or other copy or reproduction of the definitive security, for redemption or processing. To ensure that all transactions processed by agents are properly validated, agents... converted to an electronic image. At a minimum, the agent must retain such securities for a period of thirty...

31 CFR 321.25 - Payment and retention of definitive securities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... agent is prohibited from accepting an image, or other copy or reproduction of the definitive security, for redemption or processing. To ensure that all transactions processed by agents are properly... truncated and converted to an electronic image. At a minimum, the agent must retain such securities for a...

31 CFR 321.25 - Payment and retention of definitive securities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... prohibited from accepting an image, or other copy or reproduction of the definitive security, for redemption or processing. To ensure that all transactions processed by agents are properly validated, agents... converted to an electronic image. At a minimum, the agent must retain such securities for a period of thirty...

28 CFR 79.40 - Scope of subpart.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ACT Eligibility Criteria for Claims by Uranium Miners § 79.40 Scope of subpart. The regulations in... miners, i.e., uranium mine workers, and the nature of the evidence that will be accepted as proof of the... exposure to a defined minimum level of radiation during employment in aboveground or underground uranium...

28 CFR 79.40 - Scope of subpart.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACT Eligibility Criteria for Claims by Uranium Miners § 79.40 Scope of subpart. The regulations in... miners, i.e., uranium mine workers, and the nature of the evidence that will be accepted as proof of the... exposure to a defined minimum level of radiation during employment in aboveground or underground uranium...

28 CFR 79.40 - Scope of subpart.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACT Eligibility Criteria for Claims by Uranium Miners § 79.40 Scope of subpart. The regulations in... miners, i.e., uranium mine workers, and the nature of the evidence that will be accepted as proof of the... exposure to a defined minimum level of radiation during employment in aboveground or underground uranium...

29 CFR 570.121 - Age certificates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... certificate furnishes protection to the employer as provided by the act only if it shows the minor to be above the minimum age applicable thereunder to the occupation in which he is employed. Thus, a State.... Pursuant to the regulations of the Secretary, State employment or age certificates are accepted as proof of...

Essentials of an Acceptable School for Certified Laboratory Assistants.

ERIC Educational Resources Information Center

American Medical Association, Chicago, IL. Council on Medical Education.

These guidelines outline administration, organization, faculty, admission prerequisites, curriculum, clinical material, ethics, student health and procedure for attaining approval. The course must be at least 12 months in duration and include a minimum of 100 hours of didactic instruction. An initial period should include orientation in (1)…

76 FR 35363 - Proposed Amendment to Class B Airspace; Seattle, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

...: This action proposes to modify Class B airspace in Seattle, WA to contain aircraft conducting... surrounding airports with high density air traffic operations by providing an area, in which all aircraft are... in higher airport arrival acceptance rates during IFR minimums, but requires aircraft to be...

Delivering Telecourses: Procedural Issues.

ERIC Educational Resources Information Center

Rothstein, Bette M.

The logistics for college adaptation of telecourses entail certain procedures which, though they differ from one school to another, still encompass a basic minimum of steps that need to be taken: (1) the decision to investigate; (2) the ascertainment of interest within the relevant disciplines; (3) the evaluation and acceptance of an available…

49 CFR 180.411 - Acceptable results of tests and inspections.

Code of Federal Regulations, 2011 CFR

2011-10-01

... than that prescribed in the applicable specification. (b) Dents, cuts, digs and gouges. For evaluation... minimum thickness remaining beneath a cut, dig, or gouge may not be less than that prescribed in the... to hazardous materials service. (e) Relief valves. Any pressure relief valve that fails to open and...

28 CFR 79.40 - Scope of subpart.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ACT Eligibility Criteria for Claims by Uranium Miners § 79.40 Scope of subpart. The regulations in... miners, i.e., uranium mine workers, and the nature of the evidence that will be accepted as proof of the... exposure to a defined minimum level of radiation during employment in aboveground or underground uranium...

The Costs and Benefits of Increasing the Minimum Service Requirement for NROTC Graduates

DTIC Science & Technology

2008-12-01

3. Cost Analysis ......................................................................................14 B. WOMEN AND MINORITIES IN THE NAVY...16 1. Motivations for Women and Minorities ..........................................16 2. The Present and...Another adverse effect of the MSR extension might be to change the propensity for women and minorities to accept NROTC scholarships. The history

Irrigation and Fertilization Type, Rate, and Frequency of Application

Treesearch

Thomas E. Starkey

2002-01-01

There is no "cookbook" formula for growing longleaf pine (Pinus palustris Mill.). However, some very definite minimum guidelines must be followed to successfully produce an acceptable crop of trees. Irrigation and fertilization are the two most important management practices in the growth of the seedlings. Specific guidelines and...

A New "Idea of Nature" for Chemical Education

ERIC Educational Resources Information Center

Earley, Joseph E., Sr.

2013-01-01

"The idea of nature" (general model of how things work) that is accepted in a society strongly influences that group's social and technological progress. Currently, science education concentrates on "analysis" of stable pre-existing items to minimum constituents. This emphasis is consistent with an outlook that has been…

Recent Immigrants as Labor Market Arbitrageurs: Evidence from the Minimum Wage*

PubMed Central

Cadena, Brian C.

2014-01-01

This paper investigates the local labor supply effects of changes to the minimum wage by examining the response of low-skilled immigrants’ location decisions. Canonical models emphasize the importance of labor mobility when evaluating the employment effects of the minimum wage; yet few studies address this outcome directly. Low-skilled immigrant populations shift toward labor markets with stagnant minimum wages, and this result is robust to a number of alternative interpretations. This mobility provides behavior-based evidence in favor of a non-trivial negative employment effect of the minimum wage. Further, it reduces the estimated demand elasticity using teens; employment losses among native teens are substantially larger in states that have historically attracted few immigrant residents. PMID:24999288

The influence of intention, outcome and question-wording on children's and adults' moral judgments.

PubMed

Nobes, Gavin; Panagiotaki, Georgia; Bartholomew, Kimberley J

2016-12-01

The influence of intention and outcome information on moral judgments was investigated by telling children aged 4-8yearsandadults (N=169) stories involving accidental harms (positive intention, negative outcome) or attempted harms (negative intention, positive outcome) from two studies (Helwig, Zelazo, & Wilson, 2001; Zelazo, Helwig, & Lau, 1996). When the original acceptability (wrongness) question was asked, the original findings were closely replicated: children's and adults' acceptability judgments were based almost exclusively on outcome, and children's punishment judgments were also primarily outcome-based. However, when this question was rephrased, 4-5-year-olds' judgments were approximately equally influenced by intention and outcome, and from 5-6years they were based considerably more on intention than outcome. These findings indicate that, for methodological reasons, children's (and adults') ability to make intention-based judgment has often been substantially underestimated. Copyright © 2016 Elsevier B.V. All rights reserved.

The clinical utility of lung clearance index in early cystic fibrosis lung disease is not impacted by the number of multiple-breath washout trials

PubMed Central

Foong, Rachel E.; Harper, Alana J.; King, Louise; Turkovic, Lidija; Davis, Miriam; Clem, Charles C.; Davis, Stephanie D.; Ranganathan, Sarath; Hall, Graham L.

2018-01-01

The lung clearance index (LCI) from the multiple-breath washout (MBW) test is a promising surveillance tool for pre-school children with cystic fibrosis (CF). Current guidelines for MBW testing recommend that three acceptable trials are required. However, success rates to achieve these criteria are low in children aged <7 years and feasibility may improve with modified pre-school criteria that accepts tests with two acceptable trials. This study aimed to determine if relationships between LCI and clinical outcomes of CF lung disease differ when only two acceptable MBW trials are assessed. Healthy children and children with CF aged 3–6 years were recruited for MBW testing. Children with CF also underwent bronchoalveolar lavage fluid collection and a chest computed tomography scan. MBW feasibility increased from 46% to 75% when tests with two trials were deemed acceptable compared with tests where three acceptable trials were required. Relationships between MBW outcomes and markers of pulmonary inflammation, infection and structural lung disease were not different between tests with three acceptable trials compared with tests with two acceptable trials. This study indicates that pre-school MBW data from two acceptable trials may provide sufficient information on ventilation distribution if three acceptable trials are not possible. PMID:29707562

Sensory acceptance and survival of probiotic bacteria in ice cream produced with different overrun levels.

PubMed

Ferraz, Juliana L; Cruz, Adriano G; Cadena, Rafael S; Freitas, Monica Q; Pinto, Uelinton M; Carvalho, Celio C; Faria, Jose A F; Bolini, Helena M A

2012-01-01

The effect of different overrun levels on the sensory acceptance and survival of probiotic bacteria in ice cream was investigated. Vanilla ice creams supplemented with Lactobacillus acidophilus were processed with overruns of 45%, 60%, and 90%. Viable probiotic bacterial counts and sensory acceptance were assessed. All the ice creams presented a minimum count of 6 log CFU/g at the end of 60 d of frozen storage. However, higher overrun levels negatively influenced cell viability, being reported a decrease of 2 log CFU/g for the 90% overrun treatment. In addition, it was not reported an influence about acceptability with respect to appearance, aroma, and taste of the ice creams (P > 0.05). Overall, the results suggest that lower overrun levels should be adopted during the manufacture of ice cream in order to maintain its probiotic status through the shelf life. © 2012 Institute of Food Technologists®

Outcomes of high-dose levofloxacin therapy remain bound to the levofloxacin minimum inhibitory concentration in complicated urinary tract infections.

PubMed

Armstrong, Eliana S; Mikulca, Janelle A; Cloutier, Daniel J; Bliss, Caleb A; Steenbergen, Judith N

2016-11-25

Fluoroquinolones are a guideline-recommended therapy for complicated urinary tract infections, including pyelonephritis. Elevated drug concentrations of fluoroquinolones in the urine and therapy with high-dose levofloxacin are believed to overcome resistance and effectively treat infections caused by resistant bacteria. The ASPECT-cUTI phase 3 clinical trial (ClinicalTrials.gov, NCT01345929 and NCT01345955 , both registered April 28, 2011) provided an opportunity to test this hypothesis by examining the clinical and microbiological outcomes of high-dose levofloxacin treatment by levofloxacin minimum inhibitory concentration. Patients were randomly assigned 1:1 to ceftolozane/tazobactam (1.5 g intravenous every 8 h) or levofloxacin (750 mg intravenous once daily) for 7 days of therapy. The ASPECT-cUTI study provided data on 370 patients with at least one isolate of Enterobacteriaceae at baseline who were treated with levofloxacin. Outcomes were assessed at the test-of-cure (5-9 days after treatment) and late follow-up (21-42 days after treatment) visits in the microbiologically evaluable population (N = 327). Test-of-cure clinical cure rates above 90% were observed at minimum inhibitory concentrations ≤4 μg/mL. Microbiological eradication rates were consistently >90% at levofloxacin minimum inhibitory concentrations ≤0.06 μg/mL. Lack of eradication of causative pathogens at the test-of-cure visit increased the likelihood of relapse by the late follow-up visit. Results from this study do not support levofloxacin therapy for complicated urinary tract infections caused by organisms with levofloxacin minimum inhibitory concentrations ≥4 μg/mL. ClinicalTrials.gov, NCT01345929 and NCT01345955.

Outcomes of Hip Arthroscopy in Competitive Athletes.

PubMed

Perets, Itay; Hartigan, David E; Chaharbakhshi, Edwin O; Ashberg, Lyall; Ortiz-Declet, Victor; Domb, Benjamin G

2017-08-01

To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology. Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome scores including modified Harris hip score (mHHS), nonarthritic athletic hip score (NAHS), hip outcome score-sports-specific subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were as follows: <16 years old, preoperative Tönnis grade >1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of 2 years postoperatively. Fifty-one hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum 2-year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (P < .0001). Mean NAHS increased from 66.8 to 88.8 (P < .0001). Mean HOS-SSS improved from 46.8 to 80.1 (P < .0001). Mean VAS decreased from 5.1 to 1.7 (P < .0001). Thirty-five (85.4%) hip arthroscopies allowed the patients to return to sports at follow-up. Thirty-four (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Space Life Sciences at NASA: Spaceflight Health Policy and Standards

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.; House, Nancy G.

2006-01-01

In January 2005, the President proposed a new initiative, the Vision for Space Exploration. To accomplish the goals within the vision for space exploration, physicians and researchers at Johnson Space Center are establishing spaceflight health standards. These standards include fitness for duty criteria (FFD), permissible exposure limits (PELs), and permissible outcome limits (POLs). POLs delineate an acceptable maximum decrement or change in a physiological or behavioral parameter, as the result of exposure to the space environment. For example cardiovascular fitness for duty standards might be a measurable clinical parameter minimum that allows successful performance of all required duties. An example of a permissible exposure limit for radiation might be the quantifiable limit of exposure over a given length of time (e.g. life time radiation exposure). An example of a permissible outcome limit might be the length of microgravity exposure that would minimize bone loss. The purpose of spaceflight health standards is to promote operational and vehicle design requirements, aid in medical decision making during space missions, and guide the development of countermeasures. Standards will be based on scientific and clinical evidence including research findings, lessons learned from previous space missions, studies conducted in space analog environments, current standards of medical practices, risk management data, and expert recommendations. To focus the research community on the needs for exploration missions, NASA has developed the Bioastronautics Roadmap. The Bioastronautics Roadmap, NASA's approach to identification of risks to human space flight, revised baseline was released in February 2005. This document was reviewed by the Institute of Medicine in November 2004 and the final report was received in October 2005. The roadmap defines the most important research and operational needs that will be used to set policy, standards (define acceptable risk), and implement an overall Risk Management and Analysis process. Currently NASA is drafting spaceflight health standards for neurosensory alterations, space radiation exposure, behavioral health, muscle atrophy, cardiovascular fitness, immunological compromise, bone demineralization, and nutrition.

Treating amblyopia in adults with prosthetic occluding contact lenses.

PubMed

Garcia-Romo, Esperanza; Perez-Rico, Consuelo; Roldán-Díaz, Isabel; Arévalo-Serrano, Juan; Blanco, Román

2018-05-01

To investigate the feasibility, effectiveness and acceptability of using prosthetic occluding contact lenses (OCLs) to treat moderate amblyopia in adults and of the role of the multifocal visual evoked potential (mfVEP) as a predictor of postamblyopic therapy. A comparative, prospective, interventional, case series pilot study with amblyopic adults (mean age: 40 years, range 20-50 years) allocated into two intervention groups: eye patching and OCL. The primary outcome variable was logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and secondary outcomes were mfVEP amplitude and latency and patients' health-related quality of life National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Significant improvements in pre- to postamblyopic therapy BCVA were seen at 1.5 months in the OCL group [0.29 logMAR, 95% confidence interval (CI): 0.10-0.47 versus 0.11 logMAR, 95% CI: 0.02-0.19; p < 0.001] and eye patching group (0.29 logMAR, 95% CI: 0.17-0.40 versus 0.18 logMAR, 95% CI: 0.12-0.23; p < 0.01). Post-treatment BCVA was inversely related to age (R: 0.009, 95% CI: -0.02 to -0.001; p = 0.04) and the presence of strabismus (R: -0.3, 95% CI: -0.434 to -0.17; p = 0.001). No significant changes in the number and size of the abnormal mfVEP amplitude and latency defects were observed after occlusion. The NEI VFQ-25 composite score showed significant improvement in the OCL users at 12 months compared to eye patching. Significant vision improvement can be achieved, making occlusion with OCLs an effective and more acceptable therapy for adults with amblyopia. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center.

PubMed

Alvi, Rashid; Memon, Muhammad Saleh; Shera, Samad; Mumtaz, Seema N; Shaikh, Sikander Ali; Fahim, Muhammad Faisal

2016-01-01

To determine the visual outcome of laser treatment in clinically significant macular edema. This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan (DAP) during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with "Clinical Significant macular edema" (CSME), treated with laser photocoagulation were analyzed. Best-corrected visual acuity (BCVA) at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data. Diabetic retinopathy was found in 20.3% (1777) of 8742 diabetic attending DAP Hospital" amongst whom 39.6% (705) had Sight threatening diabetic retinopathy. Laser was advised in 96.4% (680) individuals, accepted by 70.5% (480) individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes (99%) and focal laser was done in 12 eyes (1%). After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% (22) eyes, stabilized in 67% (619) eyes and improved in 30.7% (284) eyes. One line improvement on Snellen's chart was fond in 21.3% (197) eyes, 2 lines in 8% (74) eyes, 3 lines in 1.2% (12) eyes and 4 lines in one (0.1%) eye with p-value of 0.000. Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist.

Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center

PubMed Central

Alvi, Rashid; Memon, Muhammad Saleh; Shera, Samad; Mumtaz, Seema N.; Shaikh, Sikander Ali; Fahim, Muhammad Faisal

2016-01-01

Objective: To determine the visual outcome of laser treatment in clinically significant macular edema. Methods: This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan (DAP) during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with “Clinical Significant macular edema” (CSME), treated with laser photocoagulation were analyzed. Best-corrected visual acuity (BCVA) at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data. Results: Diabetic retinopathy was found in 20.3% (1777) of 8742 diabetic attending DAP Hospital” amongst whom 39.6% (705) had Sight threatening diabetic retinopathy. Laser was advised in 96.4% (680) individuals, accepted by 70.5% (480) individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes (99%) and focal laser was done in 12 eyes (1%). After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% (22) eyes, stabilized in 67% (619) eyes and improved in 30.7% (284) eyes. One line improvement on Snellen’s chart was fond in 21.3% (197) eyes, 2 lines in 8% (74) eyes, 3 lines in 1.2% (12) eyes and 4 lines in one (0.1%) eye with p-value of 0.000. Conclusion: Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist. PMID:27882027

The Use of Osteochondral Allograft Transplantation for Primary Treatment of Cartilage Lesions in the Knee.

PubMed

Briggs, Dustin T; Sadr, Kamran N; Pulido, Pamela A; Bugbee, William D

2015-10-01

To assess the outcome of osteochondral allograft (OCA) transplantation as the primary treatment for cartilage injury in patients with no previous surgical treatment. Case series. Patients were identified in our outcomes database. Patients undergoing primary OCA transplantation with no prior surgical treatment and a minimum of 2 years follow-up were selected. Pain and function were evaluated preoperatively and postoperatively. Patient satisfaction was assessed. Reoperations following OCA transplantation were captured. Failure was defined as revision OCA or conversion to arthroplasty. Fifty-five patients (61 knees) were included in the analysis. The study consisted of 30 males and 25 females (mean age = 32.9 years; range = 15.7-67.8 years). The most common diagnoses for the OCA transplantation were osteochondritis dissecans (44.3%) and avascular necrosis (31.1%). Pain and function improved preoperatively to postoperatively on all outcome scales (P < 0.01). The majority of patients (86%) were "extremely satisfied" or "satisfied." OCA survivorship was 89.5% at 5 years and 74.7% at 10 years. At latest follow-up (mean = 7.6 years; range = 1.9-22.6 years), OCA remained in situ in 50 knees (82%). Eighteen knees (29.5%) had further surgery; 11 OCA failures and 7 other surgical procedure(s). Of the failed knees (mean time to failure = 3.5 years; range = 0.5-13.7 years), 8 were converted to arthroplasty, 2 had OCA revisions, and 1 had a patellectomy. OCA transplantation is an acceptable primary treatment method for some chondral and osteochondral defects of the knee. Failure of previous treatment(s) is not a prerequisite for OCA transplantation.

Extending the Technology Acceptance Model to Explore the Intention to Use Second Life for Enhancing Healthcare Education

ERIC Educational Resources Information Center

Chow, Meyrick; Herold, David Kurt; Choo, Tat-Ming; Chan, Kitty

2012-01-01

Learners need to have good reasons to engage and accept e-learning. They need to understand that unless they do, the outcomes will be less favourable. The technology acceptance model (TAM) is the most widely recognized model addressing why users accept or reject technology. This study describes the development and evaluation of a virtual…

25 CFR 547.14 - What are the minimum technical standards for electronic random number generation?

Code of Federal Regulations, 2011 CFR

2011-04-01

... CLASS II GAMES § 547.14 What are the minimum technical standards for electronic random number generation... rules of the game. For example, if a bingo game with 75 objects with numbers or other designations has a... serial correlation (outcomes shall be independent from the previous game); and (x) Test on subsequences...

25 CFR 547.7 - What are the minimum technical hardware standards applicable to Class II gaming systems?

Code of Federal Regulations, 2011 CFR

2011-04-01

... OF CLASS II GAMES § 547.7 What are the minimum technical hardware standards applicable to Class II... the game, and are specially manufactured or proprietary and not off-the-shelf, shall display a unique... outcome or integrity of any game, progressive award, financial instrument, cashless transaction, voucher...

25 CFR 547.7 - What are the minimum technical hardware standards applicable to Class II gaming systems?

Code of Federal Regulations, 2012 CFR

2012-04-01

... OF CLASS II GAMES § 547.7 What are the minimum technical hardware standards applicable to Class II... the game, and are specially manufactured or proprietary and not off-the-shelf, shall display a unique... outcome or integrity of any game, progressive award, financial instrument, cashless transaction, voucher...

25 CFR 547.14 - What are the minimum technical standards for electronic random number generation?

Code of Federal Regulations, 2012 CFR

2012-04-01

... CLASS II GAMES § 547.14 What are the minimum technical standards for electronic random number generation... rules of the game. For example, if a bingo game with 75 objects with numbers or other designations has a... serial correlation (outcomes shall be independent from the previous game); and (x) Test on subsequences...

25 CFR 547.14 - What are the minimum technical standards for electronic random number generation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... CLASS II GAMES § 547.14 What are the minimum technical standards for electronic random number generation... rules of the game. For example, if a bingo game with 75 objects with numbers or other designations has a... serial correlation (outcomes shall be independent from the previous game); and (x) Test on subsequences...

25 CFR 547.7 - What are the minimum technical hardware standards applicable to Class II gaming systems?

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF CLASS II GAMES § 547.7 What are the minimum technical hardware standards applicable to Class II... the game, and are specially manufactured or proprietary and not off-the-shelf, shall display a unique... outcome or integrity of any game, progressive award, financial instrument, cashless transaction, voucher...

A flight investigation with a STOL airplane flying curved, descending instrument approach paths

NASA Technical Reports Server (NTRS)

Benner, M. S.; Mclaughlin, M. D.; Sawyer, R. H.; Vangunst, R.; Ryan, J. L.

1974-01-01

A flight investigation using a De Havilland Twin Otter airplane was conducted to determine the configurations of curved, 6 deg descending approach paths which would provide minimum airspace usage within the requirements for acceptable commercial STOL airplane operations. Path configurations with turns of 90 deg, 135 deg, and 180 deg were studied; the approach airspeed was 75 knots. The length of the segment prior to turn, the turn radius, and the length of the final approach segment were varied. The relationship of the acceptable path configurations to the proposed microwave landing system azimuth coverage requirements was examined.

Scholarly publishing depends on peer reviewers.

PubMed

Fernandez-Llimos, Fernando

2018-01-01

The peer-review crisis is posing a risk to the scholarly peer-reviewed journal system. Journals have to ask many potential peer reviewers to obtain a minimum acceptable number of peers accepting reviewing a manuscript. Several solutions have been suggested to overcome this shortage. From reimbursing for the job, to eliminating pre-publication reviews, one cannot predict which is more dangerous for the future of scholarly publishing. And, why not acknowledging their contribution to the final version of the article published? PubMed created two categories of contributors: authors [AU] and collaborators [IR]. Why not a third category for the peer-reviewer?

Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.

PubMed

Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A

2016-01-08

The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable.

Accuracy of SOFA score in prediction of 30-day outcome of critically ill patients.

PubMed

Safari, Saeed; Shojaee, Majid; Rahmati, Farhad; Barartloo, Alireza; Hahshemi, Behrooz; Forouzanfar, Mohammad Mehdi; Mohammadi, Elham

2016-12-01

Researchers have attempted to design various scoring systems to determine the severity and predict the outcome of critically ill patients. The present study aimed to evaluate the accuracy of SOFA score in predicting 1-month outcome of these patients in emergency department. The present study is a prospective cross-sectional study of >18 year old non-trauma critically ill patients presented to EDs of 3 hospitals, Tehran, Iran, during October 2014 to October 2015. Baseline characteristics, SOFA score variables, and 1-month outcome of patients were recorded and screening performance characteristics of the score were calculated using STATA 11 software. 140 patients with the mean age of 68.36 ± 18.62 years (18-95) were included (53.5% male). The most common complaints were decrease in level of consciousness (76.43%) and sepsis (60.0%), were the most frequent final diagnoses. Mean SOFA score of the patients was 7.13 ± 2.36 (minimum 2 and maximum 16). 72 (51.43%) patients died during the following 30 days and 16 (11.43%) patients were affected with multiple organ failure. Area under the ROC curve of SOFA score in predicting mortality of studied patients was 0.73 (95%CI: 0.65-0.81) (Fig. 2). Table 2 depicts screening performance characteristics of this scale in prediction of 1-month mortality in the best cut-off point of ≥7. At this cut-off point, sensitivity and specificity of SOFA in predicting 1-month mortality were 75% and 63.23%, respectively. Findings of the present study showed that SOFA scoring system has fair accuracy in predicting 1-month mortality of critically ill patients. However, until a more reliable scoring system is developed, SOFA might be useful for narrative prediction of patient outcome considering its acceptable likelihood ratios.

Measuring treatment outcomes in gambling disorders: a systematic review.

PubMed

Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

2018-03-01

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

47 CFR 73.623 - DTV applications and changes to DTV allotments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of land mobile operations on channels 14-20. The Commission will not accept petitions to amend the... co-channel land mobile operation or 176 km from the city center of an adjacent channel land mobile... DTV Table that do not meet the minimum DTV-to-land mobile spacing standards will, however, be...

47 CFR 73.623 - DTV applications and changes to DTV allotments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of land mobile operations on channels 14-20. The Commission will not accept petitions to amend the... co-channel land mobile operation or 176 km from the city center of an adjacent channel land mobile... DTV Table that do not meet the minimum DTV-to-land mobile spacing standards will, however, be...

47 CFR 73.623 - DTV applications and changes to DTV allotments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of land mobile operations on channels 14-20. The Commission will not accept petitions to amend the... co-channel land mobile operation or 176 km from the city center of an adjacent channel land mobile... DTV Table that do not meet the minimum DTV-to-land mobile spacing standards will, however, be...

47 CFR 73.623 - DTV applications and changes to DTV allotments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of land mobile operations on channels 14-20. The Commission will not accept petitions to amend the... co-channel land mobile operation or 176 km from the city center of an adjacent channel land mobile... DTV Table that do not meet the minimum DTV-to-land mobile spacing standards will, however, be...

47 CFR 73.623 - DTV applications and changes to DTV allotments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of land mobile operations on channels 14-20. The Commission will not accept petitions to amend the... co-channel land mobile operation or 176 km from the city center of an adjacent channel land mobile... DTV Table that do not meet the minimum DTV-to-land mobile spacing standards will, however, be...

Community Support for Basic Education in Sub-Saharan Africa. Africa Region Human Development Working Paper Series.

ERIC Educational Resources Information Center

Watt, Patrick

Currently, Africa stands out as the world's poorest and most educationally deprived region. Where communities are empowered to identify their own needs and priorities, participate in decisions about resource allocation, and hold education providers accountable for ensuring that children receive a minimum acceptable standard of education, schooling…

BMPs for silvicultural chemicals

Treesearch

J. L. Michael

2002-01-01

Silvicultural chemicals include fertilizers and pesticides applied for forest management. All states East of the Rockies have at least some form of voluntary silvicultural chemical BMPs (SCBMPs) and it is widely accepted that these BMPs effect some protection of water quality. All SCBWs recommend a minimum width zone (streamside management zone or SMZ) on each side of...

38 CFR 36.4362 - Rights and restrictions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... parking areas or facilities. (ii) Any contract or lease, including franchises and licenses, to which a declarant is a party. (iii) The requirements of paragraphs (a)(2)(i) and (ii) of this section do not apply... restrictions are acceptable: (i) A requirement that leases have a minimum initial term of up to 1 year; or (ii...

AP, Dual Enrollment, and the Survival of Honors Education

ERIC Educational Resources Information Center

Guzy, Annmarie

2016-01-01

A new admissions crisis has begun to emerge in the honors community. In an increasing number of states, legislatures are mandating uniform minimum AP and dual enrollment credits that public colleges and universities must accept, and consequently the honors students that have been admitted based in part on their willingness to take on challenging…

Syllabus for a Course of Instruction, Preparing the Nurse's Assistant.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

The rapidly increasing need for persons trained to assist the nursing staff of health facilities presents occupational education programs with both an opportunity and a duty. This course syllabus is designed for the instruction of nurse's assistants and is the minimum course content acceptable for State credit. A program of supervised experience…

Best Management Practices for Silvicultural Chemicals and the Science Behind Them

Treesearch

Jerry L. Michael

2004-01-01

Silvicultural chemicals include fertilizers and pesticides applied for forest management. All states east of the Rockies have at least some form of silvicultural chemical best management practices (SCBMPs) and it is widely accepted that SCBMPs effect someprotection of water quality. All SCBMPs recommend handling and application precautions and a minimum width...

46 CFR 164.023-13 - Production tests and inspections.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Constant Rate of Traverse tensile testing machine, capable of initial clamp separation of ten inches and a... production testing on a lot must meet the following criteria for the lot to be shipped as Coast Guard... the acceptance testing values but not less than the performance minimums. (2) Length/weight values...

17 CFR 1.17 - Minimum financial requirements for futures commission merchants and introducing brokers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... internal risk management control system of the futures commission merchant; a description of how the... section; and (ii)(A) The readily marketable collateral is in the possession or control of the applicant or... accepted accounting principles. For the purposes of computing “net capital”, the term “liabilities”: (i...

36 CFR 222.54 - Grazing fees in the East-competitive bidding.

Code of Federal Regulations, 2010 CFR

2010-07-01

... permit to be issued, as well as document existing improvements and their condition. The prospectus shall...; (ii) The minimum bid price the agency will accept; (iii) Any required range improvements; and (iv) The... improvements. This hay price index shall be based on 3-year average hay prices and annually reflect the percent...

36 CFR 222.54 - Grazing fees in the East-competitive bidding.

Code of Federal Regulations, 2011 CFR

2011-07-01

... permit to be issued, as well as document existing improvements and their condition. The prospectus shall...; (ii) The minimum bid price the agency will accept; (iii) Any required range improvements; and (iv) The... improvements. This hay price index shall be based on 3-year average hay prices and annually reflect the percent...

Study of etchants for corrosion-resistant metals, space shuttle external tank

NASA Technical Reports Server (NTRS)

Simmons, J. R.

1980-01-01

Acceptable etchant concentrations and application and removal procedures for etching austenitic stainless steel, nickel base alloys, and titanium alloys (annealed) employed on the external tank were formulated. The etchant solutions were to be capable of removing a minimum of 0.4 mils of surface material in less than one hour.

75 FR 48370 - Biweekly Notice Applications and Amendments to Facility Operating Licenses Involving No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-10

... revise the minimum Emergency Diesel Generator (EDG) output voltage acceptance criterion in Surveillance... ensures the timely transfer of plant safety system loads to the Emergency Diesel Generators in the event a... from the emergency diesel generators in a timely manner. This change is needed to bring Fermi 2 into...

75 FR 11433 - Airworthiness Directives; Hawker Beechcraft Corporation Model G58 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-11

... brake reservoir tubing and the heater fuel pump wiring for minimum clearance and installing acceptable... of a power wire shorting out on the brake reservoir tube. We are issuing this AD to detect and correct inadequate clearance of the brake reservoir tubing and the heater fuel pump wiring, which could...

Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

ERIC Educational Resources Information Center

Garwe, Evelyn Chiyevo

2014-01-01

The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

45 CFR 2400.43 - Required courses of graduate study.

Code of Federal Regulations, 2012 CFR

2012-10-01

... study. (a) To be acceptable to the Foundation, those courses related to the Constitution referred to in... study of topics directly related to the United States Constitution. More than 12 semester hours or their... minimum of 12 semester hours or their credit hour equivalent of study of the United States Constitution...

25 CFR 542.14 - What are the minimum internal control standards for the cage?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., collecting and recording checks returned to the gaming operation after deposit, re-deposit, and write-off... person approving the counter check transaction. (4) When traveler's checks or other guaranteed drafts... identity, including photo identification. (8) A file for customers shall be prepared prior to acceptance of...

Swimming Pool Water Treatment Chemicals and/or Processes. Standard No. 22.

ERIC Educational Resources Information Center

National Sanitation Foundation, Ann Arbor, MI.

Chemicals or processes used or intended for use, in the treatment of swimming pool water are covered. Minimum public health limits or acceptability in regard to toxicity, biocidal effectiveness, and chemical behavior and analysis are presented. The appendices give guidelines to the scientific and statistically sound evaluations to determine the…

Access to prenatal care: inequalities in a region with high maternal mortality in southeastern Brazil.

PubMed

Martinelli, Katrini Guidolini; Santos Neto, Edson Theodoro Dos; Gama, Silvana Granado Nogueira da; Oliveira, Adauto Emmerich

2016-05-01

Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman's test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.

Environment-friendly cycle time optimization and quality improvisation using Six Sigma.

PubMed

Deshpande, V S; Mungle, N P

2008-07-01

Healthy environment in any organization can make a difference in improving productivity and quality with low defect, lack of concentration, willingness to work, minimum accidental problems etc. Six Sigma is one of the more recent quality improvement initiatives to gain popularity and acceptance in many industries across the globe. It is an alternative to TQM to obtain minimum manufacturing defect, cycle time reduction, cost reduction, inventory reduction etc. Its use is increasingly widespread in many industries, in both manufacturing and service industries with many proponents of the approach claiming that it has developed beyond a quality control approach into a broader process improvement concept.

Design for Minimum Risk

NASA Technical Reports Server (NTRS)

Wetherholt, Jon; Heimann, Timothy J.

2010-01-01

Design for Minimum Risk (DFMR) is a term used by NASA programs as an expansion of the general hazard reduction process where if an identified hazard cannot be eliminated, the design is modified to reduce the associated mishap risk to an acceptable level. DFMR is a set of specific requirements to minimize risk. DFMR is not well understood and there are many misconceptions concerning the meaning and use. This paper will provide insight into the use of DFMR for space applications; it s comparison to other hazard mitigation strategies and examples of how the approach has been used in the past. It will also highlight documents used by NASA on various programs to determine DFMR.

A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

PubMed

Strayhorn, G

2000-04-01

To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.

Midterm Outcomes of Revision Total Hip Arthroplasty With the Use of a Multihole Highly-Porous Titanium Shell.

PubMed

Delanois, Ronald E; Gwam, Chukwuweike U; Mohamed, Nequesha; Khlopas, Anton; Chughtai, Morad; Malkani, Arthur L; Mont, Michael A

2017-09-01

We are reporting on the minimum 5-year outcomes of patients who underwent revision total hip arthroplasty (THA) using a specific highly-porous titanium shell. We assessed (1) aseptic and all-cause survivorship; (2) functional outcomes; (3) complications; and (4) radiographic outcomes. Two hospital databases were evaluated for patients who underwent revision THA due to component instability or aseptic loosening using a cementless highly-porous titanium shell between September 2006 and December 2011. This yielded 35 patients who had a mean age of 61 years (range 14-88 years). Patients had a mean follow-up of 6 years (minimum 5 years). All-cause and aseptic survivorship of the shell was calculated. Functional outcomes were assessed using the Harris Hip Score. We determined the incidence of postoperative complications and performed radiographic evaluation of pelvic radiographs from regular office visits. The aseptic survivorship of the acetabular component was 97% (95% confidence interval; 8.1-9.5). The all-cause survivorship of the acetabular component was 91% (95% confidence interval; 7.3-8.1). One patient had an aseptic failure and 2 patients had septic failures. The mean postoperative Harris Hip Score was 76 points (range, 61-91 points). Excluding the aseptic and septic failures, there was no osteolysis or progressive radiolucencies present on radiographic evaluation at final follow-up. At a minimum of 5-year follow-up, the highly-porous titanium acetabular revision shell has excellent survivorship and functional outcomes. Although long-term follow-up is needed to further monitor these implants, the results are promising and demonstrate that this prosthesis may be an excellent option for patients undergoing revision THA. Copyright © 2017 Elsevier Inc. All rights reserved.

Functional Outcome and Healing of Large and Massive Rotator Cuff Tears Repaired With a Load-Sharing Rip-Stop Construct.

PubMed

Noyes, Matthew P; Ladermann, Alexandre; Denard, Patrick J

2017-09-01

To prospectively review functional outcomes and healing rates of large and massive rotator cuff tears repaired with a load-sharing rip-stop (LSRS) technique. Twenty-one consecutive patients underwent arthroscopic rotator cuff repair with an LSRS construct between January and December 2014. Seventeen patients with a minimum of 2 years' follow-up were included. Four patients did not complete clinical evaluations and functional outcome scores at a minimum of 2 years' follow-up and were lost to follow-up. Ultrasound imaging was used to assess for rotator cuff healing at a minimum of 6 months postoperatively. Range of motion, strength, and functional outcome scores were evaluated at final follow-up. Mean active forward elevation improved from 109° preoperatively to 153° postoperatively, and mean supraspinatus strength improved by 1 strength grade, from 3.5 preoperatively to 4.4 postoperatively. When we compared preoperative and postoperative values, the American Shoulder and Elbow Surgeons score improved from 40.8 to 89.5, the Single Assessment Numeric Evaluation score improved from 32.8 to 83.1, the Simple Shoulder Test score improved from 3.8 to 10.3, and the pain score on a visual analog scale decreased from 4.8 to 0.8 (P < .001). Of 17 patients, 13 (82%) were satisfied with their outcomes. Ultrasound evaluation 6 months after surgery showed complete healing in 53%, partial healing in 29%, and no healing in 18%. The LSRS construct showed satisfactory functional outcomes with reasonable healing rates in an otherwise challenging subset of rotator cuff tears. This construct may be an alternative for tears not amenable to double-row repair. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Does Acceptance and Relationship Focused Behavior Therapy Contribute to Bupropion Outcomes? A Randomized Controlled Trial of Functional Analytic Psychotherapy and Acceptance and Commitment Therapy for Smoking Cessation

ERIC Educational Resources Information Center

Gifford, Elizabeth V.; Kohlenberg, Barbara S.; Hayes, Steven C.; Pierson, Heather M.; Piasecki, Melissa P.; Antonuccio, David O.; Palm, Kathleen M.

2011-01-01

This study evaluated a treatment combining bupropion with a novel acceptance and relationship focused behavioral intervention based on the acceptance and relationship context (ARC) model. Three hundred and three smokers from a community sample were randomly assigned to bupropion, a widely used smoking cessation medication, or bupropion plus…

A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 1: Surgical Treatment of Acute Injuries.

PubMed

Geeslin, Andrew G; Moulton, Samuel G; LaPrade, Robert F

2016-05-01

There is a paucity of outcome data to guide the surgical treatment of acute grade III posterolateral corner (PLC) knee injuries. To systematically review the literature to compare clinical outcomes of the treatment for acute grade III PLC injuries. Systematic review; Level of evidence, 4. A systematic review of the literature including Cochrane, PubMed, Medline, and Embase was performed. The following search terms were used: posterolateral corner knee, posterolateral knee, posterolateral instability, multiligament knee, and knee dislocation. Inclusion criteria were outcome studies of surgically treated acute PLC injuries with a minimum 2-year follow-up, subjective outcomes, objective outcomes including varus stability, and subgroup data on PLC injuries. Two investigators independently reviewed all abstracts. Accepted definitions of varus stability on examination or stress radiographs and the need for revision surgery were used to categorically define success and failure. Eight studies with a total of 134 patients were included. The mean patient age was reported in 7 studies (range, 21-31.5 years). The mean time to surgery was reported in 5 studies (range, 15-24.3 days); surgery was performed within 3 weeks in the other 3 studies. Four studies reported International Knee Documentation Committee scores (range, 78.1-91.3); 5 studies reported Lysholm scores (range, 87.5-90.3). Only 3 studies obtained bilateral varus stress radiographs. Based on an objective evaluation with varus stress examinations or radiographs, there was an overall success rate of 81% and failure rate of 19%. In 2 studies, the fibular collateral ligament and popliteus tendon were repaired and staged cruciate reconstruction performed in most patients; there were 17 failures of 45 patients (38%). In the remainder of the studies, patients were treated with local tissue transfer, hybrid repair for amenable structures or reconstruction for midsubstance tears, or reconstruction of all torn structures; the failure rate was 9%. The repair of acute grade III PLC injuries and staged treatment of combined cruciate injuries were associated with a substantially higher postoperative PLC failure rate. Further research is required to identify the reconstruction technique that provides optimal subjective and objective outcomes. © 2015 The Author(s).

Surgical outcomes and nipple projection using the modified skate flap for nipple-areolar reconstruction in a series of 422 implant reconstructions.

PubMed

Zhong, Toni; Antony, Anu; Cordeiro, Peter

2009-05-01

Numerous techniques have been used in an attempt to achieve long-term nipple projection following nipple-areolar reconstruction (NAR). A common setback, however, is the diminution of projection over time; this phenomenon is particularly evident following implant based breast reconstruction. The purpose of this report was thus to evaluate surgical outcomes and long-term nipple projection with the use of "modified skate flap" technique in exclusively implant based postmastectomy reconstructions. A retrospective review was performed for the period between 1993 and 2007. All consecutive patients with 2-staged tissue expander/implant reconstructions followed by NAR using the modified skate flap technique performed by the senior author (P.C.) were identified in a prospectively maintained breast reconstruction database. Only patients with a minimum of 1-year follow-up were included in the study. Patients with a history of irradiation to the breast were excluded from nipple projection assessment. Clinical outcome measurements included long-term nipple projection as well as incidence of complications from the NAR procedure using the modified skate flap technique. Over the 15-year study period, 475 patients underwent 2-staged tissue expander/implant reconstruction followed by NAR using the modified skate flap technique. Of these, there was a total of 292 patients with the minimum requirement of 1-year follow-up post NAR (61% follow-up rate). The total number of reconstructed nipple areolar complexes evaluated in this series was 422 (130 bilateral and 162 unilateral NAR). Forty patients (28 unilateral and 12 bilateral NAR) who received radiation to their breasts were excluded from nipple projection assessment. At a median follow-up of 44 months (range: 12-84 months), mean nipple projection was 2.5 mm (range: 1-4 mm). Minor complications occurred in 7.2% of the patients (n = 292). Skin graft donor site dehiscence was the most common complication (3.1%) followed by partial skin graft nontake of the areola (2.1%). This report documents the largest series of NAR using a single technique in the setting of postmastectomy reconstructions. This technique can be safely performed over breast implants with acceptably low rates of complications and predictable results. Long-term nipple projection over implant reconstructions using this technique is modest and this must be forewarned to patients completing the final stage of their implant reconstruction.

Self-acceptance of stuttering: A preliminary study.

PubMed

De Nardo, Thales; Gabel, Rodney M; Tetnowski, John A; Swartz, Eric R

2016-01-01

This study explored the relationship between self-acceptance of stuttering and (1) psychosocial factors (self-esteem, hostility towards others, emotional support, and perceived discrimination); (2) treatment history (support group participation, therapy duration, and perceived therapy success); and (3) previously reported variables in self-acceptance of stuttering, which include age and stuttering severity. Participants were 80 adults who stutter who were recruited with assistance from the National Stuttering Association and Board Certified Specialists in Fluency Disorders. Participants completed an electronic survey composed of an acceptance of stuttering scale, psychosocial scales, and a participant information questionnaire. Statistical analysis identified significant correlations between participants' reports of self-acceptance of stuttering and self-esteem, perceived discrimination, hostility towards others, and perceived therapy outcome. Self-esteem was positively correlated with self-acceptance, while hostility towards others and perceived discrimination was negatively correlated with self-acceptance. Participants who perceived their therapy outcome to be successful were significantly more likely to report higher levels of self-acceptance. No significant relationships were found between self-acceptance of stuttering and support group participation, emotional support, stuttering severity, and participant age. This exploratory investigation has provided a foundation for future studies on the self-acceptance of stuttering. The findings indicate common psychosocial variables in self-acceptance of stuttering and of other disabilities. The significant relationships between self-acceptance of stuttering and psychosocial and therapeutic variables found need to be further explored to identify its causalities and clinical implications. The reader will be able to (1) discuss the importance of assessing self-acceptance of stuttering, (2) summarize the literature on self-acceptance of disability, and (3) describe the significant findings related to self-acceptance of stuttering and psychosocial, therapeutic variables. Copyright © 2016 Elsevier Inc. All rights reserved.

Mental health measures in predicting outcomes for the selection and training of navy divers.

PubMed

van Wijk, Charles H

2011-03-01

Two models have previously been enlisted to predict success in training using psychological markers. Both the Mental Health Model and Trait Anxiety Model have shown some success in predicting behaviours associated with arousal among student divers. This study investigated the potential of these two models to predict outcome in naval diving selection and training. Navy diving candidates (n = 137) completed the Brunel Mood Scale and the State-Trait Personality Inventory (trait-anxiety scale) prior to selection. The mean scores of the candidates accepted for training were compared to those who were not accepted. The mean scores of the candidates who passed training were then compared to those who failed. A number of trainees withdrew from training due to injury, and their scores were also compared to those who completed the training. Candidates who were not accepted were more depressed, fatigued and confused than those who were accepted for training, and reported higher trait anxiety. There were no significant differences between the candidates who passed training and those who did not. However, injured trainees were tenser, more fatigued and reported higher trait anxiety than the rest. Age, gender, home language, geographical region of origin and race had no significant interaction with outcome results. While the models could partially discriminate between the mean scores of different outcome groups, none of them contributed meaningfully to predicting individual outcome in diving training. Both models may have potential in identifying proneness to injury, and this requires further study.

SU-F-T-18: The Importance of Immobilization Devices in Brachytherapy Treatments of Vaginal Cuff

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

Shojaei, M; Dumitru, N; Pella, S

2016-06-15

Purpose: High dose rate brachytherapy is a highly localized radiation therapy that has a very high dose gradient. Thus one of the most important parts of the treatment is the immobilization. The smallest movement of the patient or applicator can result in dose variation to the surrounding tissues as well as to the tumor to be treated. We will revise the ML Cylinder treatments and their localization challenges. Methods: A retrospective study of 25 patients with 5 treatments each looking into the applicator’s placement in regard to the organs at risk. Motion possibilities for each applicator intra and inter fractionationmore » with their dosimetric implications were covered and measured in regard with their dose variance. The localization immobilization devices used were assessed for the capability to prevent motion before and during the treatment delivery. Results: We focused on the 100% isodose on central axis and a 15 degree displacement due to possible rotation analyzing the dose variations to the bladder and rectum walls. The average dose variation for bladder was 15% of the accepted tolerance, with a minimum variance of 11.1% and a maximum one of 23.14% on the central axis. For the off axis measurements we found an average variation of 16.84% of the accepted tolerance, with a minimum variance of 11.47% and a maximum one of 27.69%. For the rectum we focused on the rectum wall closest to the 120% isodose line. The average dose variation was 19.4%, minimum 11.3% and a maximum of 34.02% from the accepted tolerance values Conclusion: Improved immobilization devices are recommended. For inter-fractionation, localization devices are recommended in place with consistent planning in regards with the initial fraction. Many of the present immobilization devices produced for external radiotherapy can be used to improve the localization of HDR applicators during transportation of the patient and during treatment.« less

Constructing, Quantifying, and Validating an Adverse Outcome Pathway for Vascular Developmental Toxicity

EPA Science Inventory

Constructing, Quantifying, and Validating an Adverse Outcome Pathway for Vascular Developmental Toxicity The adverse outcome pathway (AOP) for embryonic vascular disruption1 leading to a range of adverse prenatal outcomes was recently entered into the AOP wiki and accepted as par...

Living life with my child’s pain: The Parent Pain Acceptance Questionnaire (PPAQ)

PubMed Central

Smith, Allison M.; Sieberg, Christine B.; Odell, Shannon; Randall, Edin; Simons, Laura E.

2014-01-01

Objective Parents’ emotional, cognitive, and behavioral responses are highly influential upon children’s pain and functional outcomes. One important response to pediatric pain is acceptance: the degree to which an individual participates in routine daily activities in the presence of pain and is willing to let pain be a part of their life without efforts to control or avoid it. However, no tool currently exists to assess parents’ own acceptance of their child’s pain. The aim of this study was to validate the Parent Pain Acceptance Questionnaire (PPAQ). Method The PPAQ was administered to 310 parents of youth with chronic pain in an outpatient pediatric headache program and a day hospital pain rehabilitation program. An exploratory factor analysis revealed two factors for the PPAQ: an 11-item Activity Engagement scale and a 4-item Acceptance of Pain-Related Thoughts & Feelings scale. Results The PPAQ total score and subscales demonstrated strong internal consistency. Greater parent pain acceptance was positively associated with child pain acceptance, and was negatively correlated with parent protective behaviors, parent minimizing behaviors, parent and child pain catastrophizing, and child fear of pain. Parent protective behaviors and child pain acceptance both served as mediators of the relationship between parent pain acceptance and child functional disability. Conclusions The PPAQ is a valid measure of parent pain acceptance and may provide valuable insights into parent responses to child pain and the ways in which parent acceptance influences child outcomes. Clinical implications and suggestions for future research are discussed. PMID:25119514

Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. Clinical Outcomes in Routine Evaluation-Outcome Measures.

PubMed

Barkham, M; Margison, F; Leach, C; Lucock, M; Mellor-Clark, J; Evans, C; Benson, L; Connell, J; Audin, K; McGrath, G

2001-04-01

To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.

Validation and testing of the Acceptability E-scale for Web-based patient-reported outcomes in cancer care

PubMed Central

Tariman, Joseph D.; Berry, Donna L.; Halpenny, Barbara; Wolpin, Seth; Schepp, Karen

2010-01-01

The performance of the Acceptability E-scale was tested in a sample of 627 adult and older adult patients from various oncology clinics who completed an electronic symptoms survey. The revised Acceptability E-scale has strong psychometric properties and can be useful in assessing the acceptability and usability of computerized health-related programs in oncology and other health population. PMID:20974066

The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.

PubMed

Day, Melissa A; Thorn, Beverly E

2016-04-01

This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy). A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N=24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted. Pain acceptance emerged as a significant mediator of the group-interference relation (p<.05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p<.05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference. Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study.

PubMed

Pahnke, Johan; Lundgren, Tobias; Hursti, Timo; Hirvikoski, Tatja

2014-11-01

Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13-21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder. © The Author(s) 2013.

25 CFR 542.7 - What are the minimum internal control standards for bingo?

Code of Federal Regulations, 2014 CFR

2014-04-01

... by the Tribal gaming regulatory authority, will be acceptable. (b) Game play standards. (1) The... procedures that ensure the correct calling of numbers selected in the bingo game. (5) Each ball shall be.... For speed bingo games not verified by camera equipment, each ball drawn shall be verified by a person...

25 CFR 542.7 - What are the minimum internal control standards for bingo?

Code of Federal Regulations, 2010 CFR

2010-04-01

... acceptable. (b) Game play standards. (1) The functions of seller and payout verifier shall be segregated... selected in the bingo game. (5) Each ball shall be shown to a camera immediately before it is called so that it is individually displayed to all customers. For speed bingo games not verified by camera...

25 CFR 542.7 - What are the minimum internal control standards for bingo?

Code of Federal Regulations, 2012 CFR

2012-04-01

... section, as approved by the Tribal gaming regulatory authority, will be acceptable. (b) Game play... bingo game. (5) Each ball shall be shown to a camera immediately before it is called so that it is individually displayed to all customers. For speed bingo games not verified by camera equipment, each ball...

25 CFR 542.7 - What are the minimum internal control standards for bingo?

Code of Federal Regulations, 2013 CFR

2013-04-01

... by the Tribal gaming regulatory authority, will be acceptable. (b) Game play standards. (1) The... procedures that ensure the correct calling of numbers selected in the bingo game. (5) Each ball shall be.... For speed bingo games not verified by camera equipment, each ball drawn shall be verified by a person...

76 FR 76155 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... annual minimum generation of 3,504,000 kilowatt-hours with the installation of 10 units. Applicant... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study the feasibility of the Maurice River Tidal Energy Project, which would be located on the Maurice River...

76 FR 70720 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

... annual minimum generation of 3,504,000 kilowatt-hours with the installation of 10 units. Applicant... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study the feasibility of the Avalon Tidal Energy Project, which would be located on the Ingram Thoroughfare...

Bricklayer: Apprenticeship Course Outline. Apprenticeship and Industry Training. 0110

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2010

2010-01-01

The graduate of the Bricklayer apprenticeship training is a journeyperson who will be able to: (1) responsibly do all work tasks expected of a journeyperson; (2) supervise, train and coach apprentices; (3) produce a better quality product than the minimum acceptable by industry standard; (4) use and maintain tools and equipment to the standards of…

Bricklayer: Apprenticeship Course Outline. Apprenticeship and Industry Training. 0110.1

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2010

2010-01-01

The graduate of the Bricklayer apprenticeship training is a journeyperson who will be able to: (1) responsibly do all work tasks expected of a journeyperson; (2) supervise, train and coach apprentices; (3) produce a better quality product than the minimum acceptable by industry standard; (4) use and maintain tools and equipment to the standards of…

78 FR 47471 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... Permit the Nullification of Trades Involving Catastrophic Errors July 30, 2013 Pursuant to Section 19(b.... Specifically, BX proposes to amend Section 6(f)(iii) to permit the nullification of trades involving... of the proposed adjusted price to accept it or else the trade will be nullified: Minimum Theoretical...

17 CFR Appendix B to Part 38 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2013 CFR

2013-04-01

... decision-making and implementation of emergency intervention in the market. At a minimum, the DCM must have... COMMODITY FUTURES TRADING COMMISSION DESIGNATED CONTRACT MARKETS Pt. 38, App. B Appendix B to Part 38... the core principle is illustrative only of the types of matters a designated contract market may...

17 CFR Appendix B to Part 38 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2014 CFR

2014-04-01

.... The designated contract market must demonstrate that it is making a good-faith effort to resolve... decision-making and implementation of emergency intervention in the market. At a minimum, the DCM must have... COMMODITY FUTURES TRADING COMMISSION DESIGNATED CONTRACT MARKETS Pt. 38, App. B Appendix B to Part 38...

Obtaining Your License: Careers in Real Estate.

ERIC Educational Resources Information Center

Lyon, Robert

Two steps are required to obtain a real estate salesperson's license in Texas: (1) selecting a broker to serve as an advisor, and (2) meeting personal requirements (at least 18 years old, a Texas resident, completion of a minimum of 12 semester hours of real estate and related courses, application, acceptable score on state exam, and payment of…

25 CFR 542.14 - What are the minimum internal control standards for the cage?

Code of Federal Regulations, 2012 CFR

2012-04-01

... deposit (cash, check, chips); however, (vi) Provided all of the information in paragraph (c)(2)(i) through... equivalents, chips, and tokens shall be accepted from customers for the purpose of a customer deposit. (7) The... Commission upon request. (e) Chip and token standards. The Tribal gaming regulatory authority, or the gaming...

25 CFR 542.14 - What are the minimum internal control standards for the cage?

Code of Federal Regulations, 2013 CFR

2013-04-01

... deposit (cash, check, chips); however, (vi) Provided all of the information in paragraph (c)(2)(i) through... equivalents, chips, and tokens shall be accepted from customers for the purpose of a customer deposit. (7) The... Commission upon request. (e) Chip and token standards. The Tribal gaming regulatory authority, or the gaming...

38 CFR 36.4361 - Acceptable ownership arrangements and documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... condominium, including building types, architectural style and the size of the units for those phases of the..., building types, architectural style and size of the units, etc. of these phases. However, the minimum... elements. (See § 36.4864(a)(6).) (Authority: 38 U.S.C. 3703(c)(1), 3710(a)(6)) (The Office of Management...

Minimum activation martensitic alloys for surface disposal after exposure to neutron flux

DOEpatents

Lechtenberg, Thomas

1985-01-01

Steel alloys for long-term exposure to neutron flux have a martensitic microstructure and contain chromium, carbon, tungsten, vanadium and preferably titanium. Activation of the steel is held to within acceptable limits for eventual surface disposal by stringently controlling the impurity levels of Ni, Mo, Cu, N, Co, Nb, Al and Mn.

78 FR 37212 - Portland General Electric Company; Notice of Application Accepted for Filing, Soliciting Motions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... install minimum flow turbine generating units. b. Project No.: 2195-088. c. Date Filed: April 10, 2013. d..., Director of Hydro Licensing and Water Rights, Portland General Electric Company, 121 SW Salmon Street... turbine facilities at four locations: 1) a powerhouse at the base of Timothy Lake Dam housing two...

Single-row, double-row, and transosseous equivalent techniques for isolated supraspinatus tendon tears with minimal atrophy: A retrospective comparative outcome and radiographic analysis at minimum 2-year followup

PubMed Central

McCormick, Frank; Gupta, Anil; Bruce, Ben; Harris, Josh; Abrams, Geoff; Wilson, Hillary; Hussey, Kristen; Cole, Brian J.

2014-01-01

Purpose: The purpose of this study was to measure and compare the subjective, objective, and radiographic healing outcomes of single-row (SR), double-row (DR), and transosseous equivalent (TOE) suture techniques for arthroscopic rotator cuff repair. Materials and Methods: A retrospective comparative analysis of arthroscopic rotator cuff repairs by one surgeon from 2004 to 2010 at minimum 2-year followup was performed. Cohorts were matched for age, sex, and tear size. Subjective outcome variables included ASES, Constant, SST, UCLA, and SF-12 scores. Objective outcome variables included strength, active range of motion (ROM). Radiographic healing was assessed by magnetic resonance imaging (MRI). Statistical analysis was performed using analysis of variance (ANOVA), Mann — Whitney and Kruskal — Wallis tests with significance, and the Fisher exact probability test <0.05. Results: Sixty-three patients completed the study requirements (20 SR, 21 DR, 22 TOE). There was a clinically and statistically significant improvement in outcomes with all repair techniques (ASES mean improvement P = <0.0001). The mean final ASES scores were: SR 83; (SD 21.4); DR 87 (SD 18.2); TOE 87 (SD 13.2); (P = 0.73). There was a statistically significant improvement in strength for each repair technique (P < 0.001). There was no significant difference between techniques across all secondary outcome assessments: ASES improvement, Constant, SST, UCLA, SF-12, ROM, Strength, and MRI re-tear rates. There was a decrease in re-tear rates from single row (22%) to double-row (18%) to transosseous equivalent (11%); however, this difference was not statistically significant (P = 0.6). Conclusions: Compared to preoperatively, arthroscopic rotator cuff repair, using SR, DR, or TOE techniques, yielded a clinically and statistically significant improvement in subjective and objective outcomes at a minimum 2-year follow-up. Level of Evidence: Therapeutic level 3. PMID:24926159

Social Competence in Childhood Brain Tumor Survivors: Feasibility and Preliminary Outcomes of a Peer-Mediated Intervention

PubMed Central

Devine, Katie A.; Bukowski, William M.; Sahler, Olle Jane Z.; Ohman-Strickland, Pamela; Smith, Tristram H.; Lown, E. Anne; Patenaude, Andrea Farkas; Korones, David N.; Noll, Robert B.

2016-01-01

Objective Evaluate the acceptability, feasibility, and preliminary outcomes of a peer-mediated intervention to improve social competence of brain tumor survivors and classmates. Methods Twelve childhood brain tumor survivors and 217 classroom peers in intervention (n = 8) or comparison (n = 4) classrooms completed measures of social acceptance and reputation at two time points in the year. The intervention (5–8 sessions over 4–6 weeks) taught peer leaders skills for engaging classmates. Individual and classroom outcomes were analyzed with ANCOVA. Results Recruitment rates of families of brain tumor survivors (81%) and schools (100%) were adequate. Peer leaders reported satisfaction with the intervention. Preliminary outcome data trended toward some benefit in increasing the number of friend nominations for survivors of brain tumors but no changes in other peer-reported metrics. Preliminary results also suggested some positive effects on classroom levels of victimization and rejection. Conclusions A peer-mediated intervention was acceptable to families of brain tumor survivors and feasible to implement in schools. Findings warrant a larger trial to evaluate improvements for children with brain tumors and their peers. PMID:27355881

Feasibility of group intervention for bereaved siblings after pediatric cancer death.

PubMed

Greenwald, Naomi; Barrera, Maru; Neville, Alexandra; Hancock, Kelly

2017-01-01

This study evaluated the feasibility (acceptability, recruitment, retention rates, treatment fidelity, and outcome measures) of implementing a manualized group intervention for bereaved siblings after pediatric cancer death. A convenience sample of 10 siblings participated. The intervention consisted of eight 2-hour sessions that focused on strategies for coping with grief, relationships, and emotional growth. Positive outcomes were obtained with respect to acceptability, recruitment, retention rates, and treatment fidelity. Preliminary outcomes were mixed. Parent pre- and post-intervention outcomes suggested improvements in siblings' overall emotional and social quality of life. Siblings' self-reports reflected no improvements. These data support the feasibility of conducting this intervention and suggest beneficial outcomes based on parental reports. Further research is recommended to evaluate the group intervention efficacy with a large sample using a randomized controlled trial to address the needs of bereaved siblings.

Development of the Austrian Nursing Minimum Data Set (NMDS-AT): the third Delphi Round, a quantitative online survey.

PubMed

Ranegger, Renate; Hackl, Werner O; Ammenwerth, Elske

2015-01-01

A Nursing Minimum Data Set (NMDS) aims at systematically describing nursing care in terms of patient problems, nursing activities, and patient outcomes. In an earlier Delphi study, 56 data elements were proposed to be included in an Austrian Nursing Minimum Data Set (NMDS-AT). To identify the most important data elements of this list, and to identify appropriate coding systems. Online Delphi-based survey with 88 experts. 43 data elements were rated as relevant for an NMDS-AT (strong agreement of more than half of the experts): nine data elements concerning the institution, patient demographics, and medical condition; 18 data elements concerning patient problems by using nursing diagnosis; seven data elements concerning nursing outcomes, and nine data elements concerning nursing interventions. As classification systems, national classification systems were proposed besides ICNP, NNN, and nursing-sensitive indicators. The resulting proposal for an NMDS-AT will now be tested with routine data.

Predictive value of magnetic resonance for identifying neurovascular compressions in trigeminal neuralgia.

PubMed

Ruiz-Juretschke, F; Guzmán-de-Villoria, J G; García-Leal, R; Sañudo, J R

2017-05-23

Microvascular decompression (MVD) is accepted as the only aetiological surgical treatment for refractory classic trigeminal neuralgia (TN). There is therefore increasing interest in establishing the diagnostic and prognostic value of identifying neurovascular compressions (NVC) using preoperative high-resolution three-dimensional magnetic resonance (MRI) in patients with classic TN who are candidates for surgery. This observational study includes a series of 74 consecutive patients with classic TN treated with MVD. All patients underwent a preoperative three-dimensional high-resolution MRI with DRIVE sequences to diagnose presence of NVC, as well as the degree, cause, and location of compressions. MRI results were analysed by doctors blinded to surgical findings and subsequently compared to those findings. After a minimum follow-up time of six months, we assessed the surgical outcome and graded it on the Barrow Neurological Institute pain intensity score (BNI score). The prognostic value of the preoperative MRI was estimated using binary logistic regression. Preoperative DRIVE MRI sequences showed a sensitivity of 95% and a specificity of 87%, with a 98% positive predictive value and a 70% negative predictive value. Moreover, Cohen's kappa (CK) indicated a good level of agreement between radiological and surgical findings regarding presence of NVC (CK 0.75), type of compression (CK 0.74) and the site of compression (CK 0.72), with only moderate agreement as to the degree of compression (CK 0.48). After a mean follow-up of 29 months (range 6-100 months), 81% of the patients reported pain control with or without medication (BNI score i-iiiI). Patients with an excellent surgical outcome, i.e. without pain and off medication (BNI score i), made up 66% of the total at the end of follow-up. Univariate analysis using binary logistic regression showed that a diagnosis of NVC on the preoperative MRI was a favorable prognostic factor that significantly increased the odds of obtaining an excellent outcome (OR 0.17, 95% CI 0.04-0.72; P=.02) or an acceptable outcome (OR 0.16, 95% CI 0.04-0.68; P=.01) after MVD. DRIVE MRI shows high sensitivity and specificity for diagnosing NVC in patients with refractory classic TN and who are candidates for MVD. The finding of NVC on preoperative MRI is a good prognostic factor for long-term pain relief with MVD. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Toxicity and repellency to rats of actidione

USGS Publications Warehouse

Traub, R.; DeWitt, J.B.; Welch, J.F.; Newman, D.

1950-01-01

The antibiotic actidione was found to be highly repellent to laboratory rats and to significantly reduce gnawing attacks upon treated paperboards. Rats refused to accept food or water containing this material even under conditions of acute starvation and died of starvation and thirst,rather than accept water containing l.0 mg. of actidione per liter. The compound is highly toxic to .rats with the minimum .lethal dose by oral administration being approximately l.0 mg./Kg body weight. Paperboard treated with the compound resisted gnawing attacks by specially trained and motivated rats for periods of two hundred hours, although similar .untreated boards were pierced within thirty-to sixty minutes.

World Trade Organization, ILO conventions, and workers' compensation.

PubMed

LaDou, Joseph

2005-01-01

The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PubMed

O'Connor, Martin; Munnelly, Anita; Whelan, Robert; McHugh, Louise

2018-05-01

eHealth is an innovative method of delivering therapeutic content with the potential to improve access to third-wave behaviural and cognitive therapies. This systematic review and meta-analysis aimed to determine the efficacy and acceptability of third-wave eHealth treatments in improving mental health outcomes. A comprehensive search of electronic bibliographic databases including PubMed, PsycINFO, Web of Science, and CENTRAL was conducted to identify randomized controlled trials of third-wave treatments in which eHealth was the main component. Twenty-one studies were included in the review. Meta-analyses revealed that third-wave eHealth significantly outperformed inactive control conditions in improving anxiety, depression, and quality-of-life outcomes and active control conditions in alleviating anxiety and depression with small to medium effect sizes. No statistically significant differences were found relative to comparison interventions. Findings from a narrative synthesis of participant evaluation outcomes and meta-analysis of participant attrition rates provided preliminary support for the acceptability of third-wave eHealth. Third-wave eHealth treatments are efficacious in improving mental health outcomes including anxiety, depression, and quality of life, but not more so than comparison interventions. Preliminary evidence from indices of participant evaluation and attrition rates supports the acceptability of these treatments. Copyright © 2017. Published by Elsevier Ltd.

The Relative Importance of Psychological Acceptance and Emotional Intelligence to Workplace Well-Being

ERIC Educational Resources Information Center

Donaldson-Feilder, Emma J.; Bond, Frank W.

2004-01-01

Psychological acceptance (acceptance) and emotional intelligence (EI) are two relatively new individual characteristics that are hypothesised to affect well-being and performance at work. This study compares both of them, in terms of their ability to predict various well-being outcomes (i.e. general mental health, physical well-being, and job…

Evaluating the Acceptability and Feasibility of Project ACCEPT: An Intervention for Youth Newly Diagnosed with HIV

ERIC Educational Resources Information Center

Hosek, Sybil G.; Lemos, Diana; Harper, Gary W.; Telander, Kyle

2011-01-01

Given the potential for negative psychosocial and medical outcomes following an HIV diagnosis, Project ACCEPT, a 12-session behavioral intervention, was developed and pilot-tested for youth (aged 16-24) newly diagnosed with HIV. Fifty participants recently diagnosed with HIV were enrolled from 4 sites selected through the Adolescent Medicine…

The Impact of Multimedia Education on Uptake of Comprehensive Eye Examinations in Rural China: A Randomized, Controlled Trial.

PubMed

Dan, Aihua; Raubvogel, Graham; Chen, Tingting; Ye, Tiantian; Jin, Ling; Xiao, Baixiang; Sanchez, Ana; Congdon, Nathan

2015-01-01

To study the effect of multimedia education on acceptance of comprehensive eye examinations (CEEs), critical for detecting glaucoma and diabetic eye disease, among rural Chinese patients using a randomized, controlled design. Patients aged ≥40 years were recruited from 52 routine clinic sessions (26 intervention, 26 control) conducted at seven rural hospitals in Guangdong, China. Subjects answered demographic questionnaires, were tested on knowledge about CEEs and chronic eye disease, and were told the cost of examination (range US$0-8). At intervention sessions, subjects were cluster-randomized to view a 10-minute video on the value of CEEs and retested. Control subjects were not retested. Trial outcomes were acceptance of CEEs (primary outcome) and final knowledge scores (secondary outcome). At baseline, >70% (p = 0.70) of both intervention (n = 241, 61.2 ± 12.3 years) and control (n = 218, 58.4 ± 11.7 years) subjects answered no knowledge questions correctly, but mean scores on the test (maximum 5 points) increased by 1.39 (standard deviation 0.12) points (p < 0.001) after viewing the video. Intervention (73.0%) and control (72.9%) subjects did not differ in acceptance of CEEs (p > 0.50). In mixed-effect logistic regression models, acceptance of CEEs was associated with availability of free CEEs (odds ratio 18.3, 95% confidence interval 1.32-253.0), but not group assignment or knowledge score. Acceptance was 97.5% (79/81) when free exams were offered. Education increased knowledge about but not acceptance of CEEs, which was generally high. Making CEEs free could further increase acceptance.

Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus.

PubMed

Mohammadinia, M; Rahmani, S; Eslami, G; Ghassemi-Broumand, M; Aghazadh Amiri, M; Aghaie, Gh; Tabatabaee, S M; Taheri, S; Behgozin, A

2012-02-01

To evaluate the disinfectant properties of the three multipurpose contact lens disinfecting solutions available in Iran, against clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus, based on the international organization for standardization (ISO) 14729 guidelines. Three multipurpose solutions that were tested were ReNu Multiplus, Solo Care Aqua and All-Clean Soft. The test solutions were challenged with clinical isolates and the standard strains of P. aeruginosa(ATCC 9027) and S. aureus(ATCC 6538), based on the ISO Stand-alone procedure for disinfecting products. Solutions were sampled for surviving microorganisms at manufacturer's minimum recommended disinfection time. The number of viable organisms was determined and log reductions calculated. All of the three test solutions in this study provided a reduction greater than the required mean 3.0 logarithmic reduction against the recommended standard ATCC strains of P. aeruginosa and S. aureus. Antibacterial effectiveness of Solo Care Aqua and All-Clean Soft against clinical isolates of P. aeruginosa and S. aureus were acceptable based on ISO 14729 Stand-alone test. ReNu MultiPlus showed a minimum acceptable efficacy against the clinical isolate of S. aureus, but did not reduce the clinical isolate by the same amount. Although the contact lens disinfecting solutions meet/exceed the ISO 14729 Stand-alone primary acceptance criteria for standard strains of P. aeruginosa and S. aureus, their efficacy may be insufficient against clinical isolates of these organisms.

Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus

PubMed Central

Mohammadinia, M; Rahmani, S; Eslami, G; Ghassemi-Broumand, M; Aghazadh Amiri, M; Aghaie, Gh; Tabatabaee, S M; Taheri, S; Behgozin, A

2012-01-01

Purpose To evaluate the disinfectant properties of the three multipurpose contact lens disinfecting solutions available in Iran, against clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosaand Staphylococcus aureus, based on the international organization for standardization (ISO) 14729 guidelines. Methods Three multipurpose solutions that were tested were ReNu Multiplus, Solo Care Aqua and All-Clean Soft. The test solutions were challenged with clinical isolates and the standard strains of P. aeruginosa(ATCC 9027) and S. aureus(ATCC 6538), based on the ISO Stand-alone procedure for disinfecting products. Solutions were sampled for surviving microorganisms at manufacturer's minimum recommended disinfection time. The number of viable organisms was determined and log reductions calculated. Results All of the three test solutions in this study provided a reduction greater than the required mean 3.0 logarithmic reduction against the recommended standard ATCC strains of P. aeruginosaand S. aureus. Antibacterial effectiveness of Solo Care Aqua and All-Clean Soft against clinical isolates of P. aeruginosaand S. aureuswere acceptable based on ISO 14729 Stand-alone test. ReNu MultiPlus showed a minimum acceptable efficacy against the clinical isolate of S. aureus, but did not reduce the clinical isolate by the same amount. Conclusions Although the contact lens disinfecting solutions meet/exceed the ISO 14729 Stand-alone primary acceptance criteria for standard strains of P. aeruginosaand S. aureus, their efficacy may be insufficient against clinical isolates of these organisms. PMID:22094301

Mars Observer trajectory and orbit design

NASA Technical Reports Server (NTRS)

Beerer, Joseph G.; Roncoli, Ralph B.

1991-01-01

The Mars Observer launch, interplanetary, Mars orbit insertion, and mapping orbit designs are described. The design objective is to enable a near-maximum spacecraft mass to be placed in orbit about Mars. This is accomplished by keeping spacecraft propellant requirements to a minimum, selecting a minimum acceptable launch period, equalizing the spacecraft velocity change requirement at the beginning and end of the launch period, and constraining the orbit insertion maneuvers to be coplanar. The mapping orbit design objective is to provide the opportunity for global observation of the planet by the science instruments while facilitating the spacecraft design. This is realized with a sun-synchronous near-polar orbit whose ground-track pattern covers the planet at progressively finer resolution.

Application of trajectory optimization techniques to upper atmosphere sampling flights using the F4-C Phantom aircraft

NASA Technical Reports Server (NTRS)

Hague, D. S.; Merz, A. W.

1975-01-01

Altitude potential of an off-the-shelf F4-C aircraft is examined. It is shown that the standard F4-C has a maximum altitude capability in the region from 85000 to 95000 ft, depending on the minimum dynamic pressures deemed acceptable for adequate flight control. By using engine overspeed capability and by making use of prevailing winds in the stratosphere, it is suggested that the maximum altitude achievable by an F4-C should be in the vicinity of 95000 ft for routine flight operation. This altitude is well in excess of the minimum altitudes which must be achieved for monitoring the possible growth of suspected aerosol contaminants.

Systematic review of social media interventions for smoking cessation.

PubMed

Naslund, John A; Kim, Sunny Jung; Aschbrenner, Kelly A; McCulloch, Laura J; Brunette, Mary F; Dallery, Jesse; Bartels, Stephen J; Marsch, Lisa A

2017-10-01

Popular social media could extend the reach of smoking cessation efforts. In this systematic review, our objectives were: 1) to determine whether social media interventions for smoking cessation are feasible, acceptable, and potentially effective; 2) to identify approaches for recruiting subjects; and 3) to examine the specific intervention design components and strategies employed to promote user engagement and retention. We searched Scopus, Medline, EMBASE, Cochrane Central, PsychINFO, CINAHL, and Web of Science through July 2016 and reference lists of relevant articles. Included studies described social media interventions for smoking cessation and must have reported outcomes related to feasibility, acceptability, usability, or smoking-related outcomes. We identified 7 studies (all were published since 2014) that enrolled 9755 participants (median=136 [range 40 to 9042]). Studies mainly used Facebook (n=4) or Twitter (n=2), and emerged as feasible and acceptable. Five studies reported smoking-related outcomes such as greater abstinence, reduction in relapse, and an increase in quit attempts. Most studies (n=6) recruited participants using online or Facebook advertisements. Tailored content, targeted reminders, and moderated discussions were used to promote participant engagement. Three studies found that active participation through posting comments or liking content may be associated with improved outcomes. Retention ranged from 35% to 84% (median=70%) across the included studies. Our review highlights the feasibility, acceptability and preliminary effectiveness of social media interventions for smoking cessation. Future research should continue to explore approaches for promoting user engagement and retention, and whether sustained engagement translates to clinically meaningful smoking cessation outcomes. Copyright © 2017. Published by Elsevier Ltd.

Required Area for a Crew Person in a Space Vehicle

NASA Technical Reports Server (NTRS)

Mount, Frances E.

1998-01-01

This 176 page report was written in circa 1966 to examine the effects of confmement during space flight. One of the topics covered was the required size of a space vehicle for extended missions. Analysis was done using size of crew and length of time in a confmed space. The report was based on all information available at that time. The data collected and analyzed included both NASA and (when possible) Russian missions flown to date, analogs (such as submarines), and ground studies. Both psychological and physiological responses to confmement were examined. Factors evaluated in estimating the degree of impairment included the level of performance of intellectual, perceptual, manual and co-ordinated tasks, response to psychological testing, subjective comments of the participants, nature and extent of physiological change, and the nature and extent of behavioral change and the nature and extent of somatic complaints. Information was not included from studies where elements of perceptual isolation were more than mildly incidental - water immersion studies, studies in darkened and acoustically insulated rooms, studies with distorted environmental inputs - unpattemed light and white noise. Using the graph from the document, the upper line provides a threshold of minimum acceptable volumeall points above the line may be considered acceptable. The lower line provides a threshold of unacceptable volume - all points below the line are unacceptable. The area in between the two lines is the area of doubtful acceptability where impairment tends to increase with reduction in volume and increased duration of exposure. Reference is made of the Gemini VII, 14-day duration mission which had detectable impairment with a combination of 40 cubic feet per man for 14 days. In line with all other data this point should be in the 'marked impairment' zone. It is assumed that the state of fitness, dedication and experience influenced this outcome.

Perspectives on high-intensity interval exercise for health promotion in children and adolescents

PubMed Central

Bond, Bert; Weston, Kathryn L; Williams, Craig A; Barker, Alan R

2017-01-01

Physical activity lowers future cardiovascular disease (CVD) risk; however, few children and adolescents achieve the recommended minimum amount of daily activity. Accordingly, there is virtue in identifying the efficacy of small volumes of high-intensity exercise for health benefits in children and adolescents for the primary prevention of CVD risk. The purpose of this narrative review is to provide a novel overview of the available literature concerning high-intensity interval-exercise (HIIE) interventions in children and adolescents. Specifically, the following areas are addressed: 1) outlining the health benefits observed following a single bout of HIIE, 2) reviewing the role of HIIE training in the management of pediatric obesity, and 3) discussing the effectiveness of school-based HIIE training. In total, 39 HIIE intervention studies were included in this review. Based upon the available data, a single bout of high-intensity exercise provides a potent stimulus for favorable, acute changes across a range of cardiometabolic outcomes that are often superior to a comparative bout of moderate-intensity exercise (14 studies reviewed). HIIE also promotes improvements in cardiorespiratory fitness and cardiometabolic health status in overweight and obese children and adolescents (10 studies reviewed) and when delivered in the school setting (15 studies reviewed). We thus conclude that high-intensity exercise is a feasible and potent method of improving a range of cardiometabolic outcomes in children and adolescents. However, further work is needed to optimize the delivery of HIIE interventions in terms of participant enjoyment and acceptability, to include a wider range of health outcomes, and to control for important confounding variables (eg, changes in diet and habitual physical activity). Finally, research into the application of HIIE training interventions to children and adolescents of different ages, sexes, pubertal status, and sociocultural backgrounds is required. PMID:29225481

Mid-Term Clinical Outcome and Reconstruction of Posterior Tibial Slope after UKA.

PubMed

Franz, Alois; Boese, Christoph Kolja; Matthies, Andrej; Leffler, Jörg; Ries, Christian

2018-05-21

Unicompartmental knee arthroplasty (UKA) has gained growing popularity over the last decades. The posterior tibial slope (PTS) has been shown to play a significant role for knee biomechanics and is thought to be crucial for clinical function of the UKA. We evaluated the clinical outcome at mid-term follow-up after UKA. Furthermore, the reconstruction of the individual PTS was analyzed. A total of 91 consecutive patients undergoing medial UKA for osteoarthritis were included. Patients were contacted by telephone for a survival analysis at a minimum of 30 months after surgery. Patient-oriented questionnaires and Knee Osteoarthritis Outcome Score (KOOS) were obtained. A retrospective chart review and radiological analysis of component alignment were performed for all patients before and at 6 weeks after surgery. Of 91 patients (93 knees) undergoing UKA, 69 patients (70 knees) were available for clinical follow-up after a mean of 56.0 (range 31-81) months post-surgery. The clinical results of the examined patients in the present study showed mean subscale scores of the KOOS and Western Ontario and McMaster Universities Osteoarthritis Index between 71 and 91%. Overall 7 of 91 patients were revised during the course of follow-up period and underwent total knee arthroplasty. A Kaplan-Meier analysis showed a survival rate for UKA of 90.5% after 48 months. Calculated implant survival was 75.9 months (95% confidence interval 72.3-79.6) at the mean. The radiographic analysis of pre- and postoperative PTS showed no differences ( p  = 0.113).UKA for osteoarthritis of the medial knee compartment shows encouraging clinical results at mid-term follow-up. The individual PTS could be reconstructed within acceptable ranges. This is a retrospective therapeutic study with Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Methods, metrics and research gaps around minimum data sets for nursing practice and fundamental care: A scoping literature review.

PubMed

Muntlin Athlin, Åsa

2018-06-01

To examine and map research on minimum data sets linked to nursing practice and the fundamentals of care. Another aim was to identify gaps in the evidence to suggest future research questions to highlight the need for standardisation of terminology around nursing practice and fundamental care. Addressing fundamental care has been highlighted internationally as a response to missed nursing care. Systematic performance measurements are needed to capture nursing practice outcomes. Overview of the literature framed by the scoping study methodology. PubMed and CINAHL were searched using the following inclusion criteria: peer-reviewed empirical quantitative and qualitative studies related to minimum data sets and nursing practice published in English. No time restrictions were set. Exclusion criteria were as follows: no available full text, reviews and methodological and discursive studies. Data were categorised into one of the fundamentals of care elements. The review included 20 studies published in 1999-2016. Settings were mainly nursing homes or hospitals. Of 14 elements of the fundamentals of care, 11 were identified as measures in the included studies, but their frequency varied. The most commonly identified elements concerned safety, prevention and medication (n = 11), comfort (n = 6) and eating and drinking (n = 5). Studies have used minimum data sets and included variables linked to nursing practices and fundamentals of care. However, the relations of these variables to nursing practice were not always clearly described and the main purpose of the studies was seldom to measure the outcomes of nursing interventions. More robust studies focusing on nursing practice and patient outcomes are warranted. Using minimum data sets can highlight the nurses' work and what impact it has on direct patient care. Appropriate models, systems and standardised terminology are needed to facilitate the documentation of nursing activities. © 2017 John Wiley & Sons Ltd.

Minimum reporting standards for clinical research on groin pain in athletes

PubMed Central

Delahunt, Eamonn; Thorborg, Kristian; Khan, Karim M; Robinson, Philip; Hölmich, Per; Weir, Adam

2015-01-01

Groin pain in athletes is a priority area for sports physiotherapy and sports medicine research. Heterogeneous studies with low methodological quality dominate research related to groin pain in athletes. Low-quality studies undermine the external validity of research findings and limit the ability to generalise findings to the target patient population. Minimum reporting standards for research on groin pain in athletes are overdue. We propose a set of minimum reporting standards based on best available evidence to be utilised in future research on groin pain in athletes. Minimum reporting standards are provided in relation to: (1) study methodology, (2) study participants and injury history, (3) clinical examination, (4) clinical assessment and (5) radiology. Adherence to these minimum reporting standards will strengthen the quality and transparency of research conducted on groin pain in athletes. This will allow an easier comparison of outcomes across studies in the future. PMID:26031644

Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes.

PubMed

Domb, Benjamin G; Yuen, Leslie C; Ortiz-Declet, Victor; Litrenta, Jody; Perets, Itay; Chen, Austin W

2017-10-01

Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes. Case series; Level of evidence, 4. Data for patients undergoing primary hip arthroscopic surgery with LBR from February 2008 to May 2011 with a minimum 5-year follow-up were prospectively collected and retrospectively reviewed. Patients with preoperative Tonnis osteoarthritis grade ≥2, previous hip conditions (slipped capital femoral epiphysis, avascular necrosis, Legg-Calv-Perthes disease), severe dysplasia (lateral center-edge angle <18°), or previous ipsilateral hip surgery were excluded. Statistical equivalence tests evaluated patient-reported outcomes (PROs) including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and patient satisfaction (0-10 scale; 10 = very satisfied). Of the 70 patients (74 hips) who met inclusion and exclusion criteria, 60 (85.7%) patients (64 hips) were available at a minimum 5-year follow-up. All PRO scores significantly improved from preoperative values with a mean follow-up of 67.8 ± 7.4 months (range, 60.0-89.7 months). The mean mHHS increased from 64.4 ±13.8 to 85.3 ± 17.7 ( P < .001), the mean NAHS from 63.7 ± 17.0 to 87.0 ± 14.7 ( P < .001), and the mean HOS-SSS from 47.1 ± 23.2 to 76.5 ± 25.9 ( P < .001). The mean VAS score decreased from 5.9 ± 2.4 to 2.0 ± 2.1 ( P < .001). The mean patient satisfaction score was 8.1 ± 2.0. The improvement in PRO scores was sustained from 2- to 5-year follow-up. At 2 and 5 years, survivorship rates were 96.9% and 90.6%, respectively, and the respective secondary arthroscopic surgery rates were 10.9% (7/64) and 17.2% (11/64). At a minimum 5-year follow-up, arthroscopic LBR continued to be a successful procedure and valid technique based on 3 PROs, the VAS, patient satisfaction, and survivorship. Significantly improved outcome scores were maintained compared with preoperative values and showed no signs of deterioration from the 2-year scores. The long-term survivorship of hip arthroscopic surgery has yet to be determined; however, these midterm results demonstrate the rates of additional procedures (both secondary arthroscopic surgery and conversion to total hip arthroplasty), that may be necessary after 2 years.

Acceptability of a Web-based Community Reinforcement Approach for Substance Use Disorders with Treatment-seeking American Indians/Alaska Natives

PubMed Central

Campbell, Aimee N. C.; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M.; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V.

2014-01-01

Longstanding disparities in substance use disorders and treatment access exist among American Indian/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version (Therapeutic Education System [TES]) of the Community Reinforcement Approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N=40) show that TES was acceptable across seven indices (range=7.8 to 9.4 on 0 to 10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted. PMID:25022913

Acceptability of a web-based community reinforcement approach for substance use disorders with treatment-seeking American Indians/Alaska Natives.

PubMed

Campbell, Aimee N C; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V

2015-05-01

Longstanding disparities in substance use disorders and treatment access exist among American Indians/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version [therapeutic education system (TES)] of the community reinforcement approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N = 40) show that TES was acceptable across seven indices (range 7.8-9.4 on 0-10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted.

Safety and acceptability of transcranial direct current stimulation for the acute treatment of major depressive episodes: Analysis of individual patient data.

PubMed

Moffa, Adriano H; Brunoni, André R; Fregni, Felipe; Palm, Ulrich; Padberg, Frank; Blumberger, Daniel M; Daskalakis, Zafiris J; Bennabi, Djamila; Haffen, Emmanuel; Alonzo, Angelo; Loo, Colleen K

2017-10-15

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that has been increasingly used for major depressive disorder (MDD) treatment. Although studies in healthy volunteers showed that the technique is well-tolerated, tDCS safety and acceptability have not been sufficiently explored in patients with MDD. We collected individual patient data from 6 randomized clinical trials that had been previously identified in a systematic review and meta-analysis. Primary outcomes were safety (rate of adverse events) and acceptability (rate of dropouts). Secondary outcomes were clinical, demographic and treatment predictors of the primary outcomes. Dropout rates between active (8.8%) and sham (12%) groups were not significantly different (OR= 0.7, p=0.38). Adverse event rates between active (73.5%) and sham (68.3%) groups were not significantly different (OR= 1.4, p= 0.23). Higher current densities were associated with lower adverse event rates. Dropout reasons were not systematically reported and adverse events were not collected using questionnaires standardized across studies. Active tDCS is as acceptable and safe as sham tDCS, as found in randomized clinical trials of MDD. Copyright © 2017. Published by Elsevier B.V.

Clearfell controversies and alternative timber harvest designs: how acceptability perceptions vary between Tasmania and the U.S. Pacific Northwest.

PubMed

Ribe, Robert G; Ford, Rebecca M; Williams, Kathryn J H

2013-01-15

Perceptions of the acceptability of alternative "variable retention" timber harvests, that keep trees standing in harvested areas, were compared between regions beset by major forestry conflicts. Data from similar studies of similar harvest systems were compared between Oregon and Tasmania. These comparisons were related to attitudes and to differences in ecosystems, silvicultural prescriptions, forestry outcomes, aesthetics, and social-political context. Findings showed that perceptions measured in one region cannot be assumed valid in another. Substantial regional differences arose not from general sociological differences but from differences in local forestry outcomes. These largely arose from different regeneration requirements of commercial tree species and consequent differences in the design of otherwise analogous harvests. Comparisons of perceptions by people with similar attitudes yielded substantial regional differences. Those prioritizing ecological conservation were mainly influenced by habitat outcomes, and consequently preferred harvests with aggregated tree retention patterns in Tasmania but not in Oregon. People sympathetic to timber industry interests in both regions showed little association between forestry outcomes and acceptability and favoured more intensive harvests. Tasmanian harvest advocates perceived harvests that keep more standing trees as less acceptable than those in Oregon. This may be due to sampling differences or to greater risk perceptions towards new harvest designs in Tasmania. Tasmanians generally disliked clearfelling more than Oregonians, likely due to different political narratives framing these perceptions or to higher aesthetic impacts in Tasmania due to burning. Dispersed retention was perceived as more acceptable in Oregon than in Tasmania, likely because Oregon had much higher post-harvest tree densities. Regional differences in wildfire-risk and logger-safety were not strongly associated with different acceptability perceptions because these were confounded by other more influential concerns. More and better cross-regional studies of environmental perceptions are needed and would benefit from more standardized or coordinated methods. Copyright © 2012 Elsevier Ltd. All rights reserved.

Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo

PubMed Central

Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

2015-01-01

Objectives Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Design Participants were recruited using respondent-driven sampling. Setting Bukavu, Democratic Republic of Congo in 2012. Participants 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Intervention Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Outcome measures Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. Results 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Conclusions Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may improve mental health outcomes in this population. PMID:25854968

Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

PubMed

Solomon, Dagmawit; Aderaw, Zewdie; Tegegne, Teketo Kassaw

2017-10-12

Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia. A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6-23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity. In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother's educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers' knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11-3.53). In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.

Current Status of Robot-Assisted Radical Cystectomy: What is the Real Benefit?

PubMed

Takenaka, Atsushi

2015-09-01

In recent years, robot-assisted radical cystectomy has received attention worldwide as a useful procedure that helps to overcome the limitations of open radical cystectomy. We compared the surgical technique, perioperative and oncological outcomes, and learning curve of robot-assisted radical cystectomy with those of open radical cystectomy. The indications for robot-assisted radical cystectomy are identical to those of open radical cystectomy. Relative contraindications are due to patient positioning in the Trendelenburg position for long periods. Urinary diversion is performed either extracorporeally with a small skin incision or intracorporeally with a totally robotic-assisted maneuver. Accordingly, robot-assisted radical cystectomy can be performed safely with an acceptable operative time, little blood loss, and low transfusion rates. The lymph node yield and positive surgical margin rate were not significantly different between robot-assisted radical cystectomy and open radical cystectomy. The survival rates after robot-assisted radical cystectomy are estimated to be similar to that after open radical cystectomy. However, the recurrence pattern is different between robot-assisted radical cystectomy and open radical cystectomy, i.e., extrapelvic lymph node recurrence and peritoneal carcinomatosis were more frequently found in patients who underwent robot-assisted radical cystectomy than in those who underwent open radical cystectomy. Further validation is necessary to prove the feasibility of oncological control. A steep learning curve is one of the benefits of the new technique. The experience of only 50 robot-assisted radical prostatectomies is a minimum requirement for performing feasible robot-assisted radical cystectomy, and surgeons who have performed only 30 surgeries can reach an acceptable level of quality for robot-assisted radical cystectomy.

External quality assessment of urine particle identification: a Northern European experience.

PubMed

Kouri, Timo T; Makkonen, Pirjo

2015-11-01

External quality assessment (EQA) schemes for urinalysis have been provided by Labquality Ltd, the publicly owned EQA service provider in Finland, since the 1980s. In 2014, the scheme on urine particle identification had 329 participating laboratories, out of which 60% from 19 countries were outside Finland. Each of the four annual web-based rounds were distributed with four Sternheimer-stained images from a single patient sample, as viewed both by bright-field and phase-contrast optics. Participants reported classified categories either at the basic or at the advanced level. Participating laboratories received assessment of their analytical performance as compared to their peers, including reflections from clinical data and preanalytical detail of the specimen. In general, reporting of basic urine particles succeeded in the eight schemes during the years 2013-2014 as follows: red blood cells 82%-92%, white blood cells 82%-97%, squamous epithelial cells 92%-98%, casts 84%-94%, and small epithelial cells 73%-83% (minimum and maximum of expected or accepted reports). This basic level of differentiation is used in routine laboratory reports, or as verification of results produced by automated instruments. Considerable effort is needed to standardise national procedures and reporting formats, in order to improve the shown figures internationally. Future technologies may help to alleviate limitations created by single digital images. Despite improvements, degenerating cells and casts always exhibit intermediate forms creating disputable classifications. That is why assessment of performance should encompass justified acceptable categories into the assessed outcomes. Preanalytical and clinical detail provide essential added value to morphological findings.

Individuals' Perspectives on Coping with Vision Loss from Diabetic Retinopathy.

PubMed

Sturrock, Bonnie A; Rees, Gwyneth; Lamoureux, Ecosse L; Wong, Tien Y; Holloway, Edith; Fenwick, Eva K

2018-04-01

People with vision loss from diabetic retinopathy (DR) and diabetic macular edema (DME) use problem-focused and emotion-regulation strategies that may influence their short- and longer-term adaptation and psychological outcomes. Our findings can assist the development of models of adjustment to DR/DME-related vision loss and treatments focused on adaptation. To qualitatively determine the coping strategies used by participants with vision loss resulting from DR/DME. Fifty-seven participants with DR/DME engaged in one of eight focus groups or one of 18 semistructured interviews. Participants were mostly older than 55 years (mean, 58.7 years) and male (68%) and had type 2 diabetes (74%; median duration, 17 years). Almost 50% had proliferative DR, 95% had undergone laser treatment, and 42% had DME; 68%, 14% and 14% had none, mild (<0.3 logarithm of the minimum angle of resolution ≤ 0.48), and moderate-severe vision impairment (>0.48 logarithm of the minimum angle of resolution) in the better eye. Focus groups/interviews were transcribed verbatim and iteratively analyzed using the constant comparative method. Qualitative software NVivo 2008 was used to sort/store the data. Our top-down and bottom-up approach to conceptualize the data was informed by the Transactional Model of Stress and Coping. Coping efforts were mostly problem focused (64%) with seven subthemes: problem solving, passive coping, changing activities to suit a new ability level, active coping, rehearsing alternative outcomes, maintaining independence, and information seeking. Emotion-regulation strategies were distraction, acceptance, alternative adaptive thinking, avoidance, expressing emotions, denial, and changing emotions. Meaning-based coping strategies included mindfulness and engaging in meaningful activities. Themes relating to adaptation and moderators to coping (e.g., dispositional optimism) are outlined. Participants described a variety of ways to cope. Some strategies are likely to improve functioning and decrease distress, whereas others are expected to reduce immediate distress while perpetuating this in the longer term. Our findings may assist researchers to develop models of adjustment to DR/DME-related vision loss and psychosocial/educational interventions focused on adaptation.

Psychometric properties including reliability, validity and responsiveness of the Majeed pelvic score in patients with chronic sacroiliac joint pain.

PubMed

Bajada, Stefan; Mohanty, Khitish

2016-06-01

The Majeed scoring system is a disease-specific outcome measure that was originally designed to assess pelvic injuries. The aim of this study was to determine the psychometric properties of the Majeed scoring system for chronic sacroiliac joint pain. Internal consistency, content validity, criterion validity, construct validity and responsiveness to change was assessed prospectively for the Majeed scoring system in a cohort of 60 patients diagnosed with sacroiliac joint pain. This diagnosis was confirmed with CT-guided sacroiliac joint anaesthetic block. The overall Majeed score showed acceptable internal consistency (Cronbach alpha = 0.63). Similarly, it showed acceptable floor (0 %) and ceiling (0 %) effects. On the other hand, the domains of pain, work, sitting and sexual intercourse had high (>30 %) floor effects. Significant correlation with the physical component of the Short Form-36 (p = 0.005) and Oswestry disability index (p ≤ 0.001) was found indicating acceptable criterion validity. The overall Majeed score showed acceptable construct validity with all five developed hypotheses showing significance (p ≤ 0.05). The overall Majeed score showed acceptable responsiveness to change with a large (≥0.80) effect size and standardized response mean. Overall the Majeed scoring system demonstrated acceptable psychometric properties for outcome assessment in chronic sacroiliac joint pain. Thus, its use in this condition is adequate. However, some domains demonstrated suboptimal performance indicating that improvement might be achieved with the development of an outcome measure specific for sacroiliac joint dysfunction and degeneration.

Social network influences on initiation and maintenance of reduced drinking among college students.

PubMed

Reid, Allecia E; Carey, Kate B; Merrill, Jennifer E; Carey, Michael P

2015-02-01

To determine whether (a) social networks influence the extent to which college students initiate and/or maintain reductions in drinking following an alcohol intervention and (b) students with riskier networks respond better to a counselor-delivered, vs. a computer-delivered, intervention. Mandated students (N = 316; 63% male) provided their perceptions of peer network members' drinking statuses (e.g., heavy drinker) and how accepting each friend would be if the participant reduced his or her drinking. Next, they were randomized to receive a brief motivational intervention (BMI) or Alcohol Edu for Sanctions (EDU). In latent growth models controlling for baseline levels on outcomes, influences of social networks on 2 phases of intervention response were examined: initiation of reductions in drinks per heaviest week, peak blood alcohol content (BAC), and consequences at 1 month (model intercepts) and maintenance of reductions between 1 and 12 months (model slopes). Peer drinking status predicted initiation of reductions in drinks per heaviest week and peak BAC; peer acceptability predicted initial reductions in consequences. Peer Acceptability × Condition interactions were significant or marginal for all outcomes in the maintenance phase. In networks with higher perceived acceptability of decreasing use, BMI and EDU exhibited similar growth rates. In less accepting networks, growth rates were significantly steeper among EDU than BMI participants. For consumption outcomes, lower perceived peer acceptability predicted steeper rates of growth in drinking among EDU but not BMI participants. Understanding how social networks influence behavior change and how interventions mitigate their influence is important for optimizing efficacy of alcohol interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Acceptance and Continuance Factors Associated with Mobile Medical App Use: A Qualitative Case Study of Diabetes Apps

ERIC Educational Resources Information Center

MacDonald, Amy Joy

2017-01-01

Despite advances in smartphone technologies and development of myriad apps that can support self-management efforts for chronic disease like diabetes, initial acceptance of such apps by actual users was characterized by low consistent use by these users. Few studies conducted by researchers on acceptance and use outcomes of mobile apps focused on…

The role of maternal acceptance in the relation between community violence exposure and child functioning.

PubMed

Bailey, Beth Nordstrom; Hannigan, John H; Delaney-Black, Virginia; Covington, Chandice; Sokol, Robert J

2006-02-01

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that "buffer" or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.

A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 2: Surgical Treatment of Chronic Injuries.

PubMed

Moulton, Samuel G; Geeslin, Andrew G; LaPrade, Robert F

2016-06-01

There are a variety of reported surgical techniques outcomes of chronic grade III posterolateral corner (PLC) knee injuries. It is unknown if outcomes differ among the various surgical treatments. To systematically review the literature and report subjective and objective outcomes for surgical treatment strategies for chronic grade III PLC injuries to determine the optimal surgical technique. Systematic review; Level of evidence, 4. A systematic review of the literature including Cochrane, PubMed, Medline, and Embase was performed. The following search terms were used: posterolateral corner knee, posterolateral knee, posterolateral instability, multiligament knee, and knee dislocation. Inclusion criteria were outcome studies of surgical treatment for chronic PLC knee injuries with a minimum 2-year follow-up, subjective outcomes, objective outcomes including varus stability, and subgroup data on PLC injuries. Two investigators independently reviewed all abstracts. Accepted definitions of varus stability on examination or stress radiographs, and the need for revision surgery, were used to categorically define success and failure. Fifteen studies with a total of 456 patients were included in this study. The 15 studies included 5 with level 3 evidence and 10 with level 4 evidence. The mean age of the patients in each study ranged from 25.2 to 40 years, the reported mean time to surgery ranged from 5.5 to 52.8 months, and the mean follow-up duration ranged from 2 to 16.3 years. Mean postoperative Lysholm scores ranged from 65.5 to 91.8; mean postoperative International Knee Documentation Committee (IKDC) scores ranged from 62.6 to 86.0. Based on objective stability, there was an overall success rate of 90% and a 10% failure rate of PLC reconstruction. A variety of surgical techniques were reported. Chronic PLC injuries were reconstructed in all studies, and while techniques varied, the surgical management of chronic PLC injuries had a 90% success rate and a 10% failure rate according to the individual investigators' examination or stress radiographic assessment of objective outcomes. More than half of the 456 patients had a combined posterior cruciate ligament-PLC injury. Surgical techniques included variations of fibular slings, capsular shifts, and anatomic-based techniques (fibular tunnel and tibial tunnel). Further research is needed to determine the optimal surgical technique for treating chronic grade III PLC injuries. © 2015 The Author(s).

76 FR 37806 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... 10 to 30 NC Sea Dragon or Red Hawk tidal turbines at a rated capacity of 100 kilowatts, (2) an... Federal Power Act, proposing to study the feasibility of the Cohansey River Energy Project, which would be.... The project is estimated to have an annual minimum generation of 3,504,000 kilowatt-hours with the...

77 FR 61598 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study... tidal turbines at a rated capacity of 100 kilowatts, (2) an estimated 2.5 kilometers in length of... a minimum of 17,520 megawatt hours per year with the installation of 50 units. Applicant Contact: Mr...

76 FR 71004 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... estimated to have an annual minimum generation of 3,504,000 kilowatt-hours with the installation of 10 units... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study the feasibility of the Margate Tidal Energy Project, which would be located on the Beach Thoroughfare...

76 FR 67726 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... estimated to have an annual minimum generation of 3,504,000 kilowatt-hours with the installation of 10 units... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study the feasibility of the Dorchester--Maurice Tidal Energy Project, which would be located on the Maurice...

76 FR 76154 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... annual minimum generation of 3,504,000 kilowatt-hours with the installation of 10 units. Applicant... Services, LLC filed an application, pursuant to section 4(f) of the Federal Power Act, proposing to study the feasibility of the Cape May Tidal Energy Project, which would be located on the Cape May Canal in...

78 FR 20842 - Energy Conservation Program: Energy Conservation Standards for Residential Clothes Dryers and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

...,999 British thermal units per hour (Btu/h), and the minimum cooling capacity for product class 5b for room air conditioners without reverse cycle and with louvered sides as 25,000 Btu/h, rather than 27,999 Btu/h and 28,000 Btu/h, respectively. DATES: DOE will accept comments, data, and information regarding...

25 CFR 542.14 - What are the minimum internal control standards for the cage?

Code of Federal Regulations, 2010 CFR

2010-04-01

... the cage shall be recorded on a cage accountability form on a per-shift basis. (6) Only cash, cash... identity, including photo identification. (8) A file for customers shall be prepared prior to acceptance of... cage shall be summarized on a cage accountability form on a per shift basis and shall be supported by...

78 FR 77114 - Pacific Gas and Electric Company: Notice of Application Accepted for Filing, Soliciting Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... ``exceptionally low inflow'' minimum flow releases outlined in the January 28, 2004. Due to the urgent nature of this request and the potential immediate impacts to fishery resources, the Commission took action on... applicable; (2) set forth in the heading the name of the applicant and the project number of the application...

76 FR 12269 - Minimum Standards for Driver's Licenses and Identification Cards Acceptable by Federal Agencies...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

... compliant on or before May 11, 2011. Id. At the time DHS promulgated the REAL ID final rule, DHS recognized... time to ensure that the documents they issue meet the security requirements of the REAL ID Act. Without.... SUMMARY: Pursuant to the Department of Homeland Security's REAL ID regulations, States must be in full...

Qualification of an Acceptable Alternative to Halon 1211 DOD Flightline Extinguishers

DTIC Science & Technology

2008-09-01

Minimum Performance Standard MSDS Material Safety Data Sheet NATO North Atlantic Treaty Organization NAWCAD Naval Air Warfare Center Aircraft...included chronic and acute occupational exposure limits and cardiotoxicity. Alternatives that were carcinogens or that had any adverse developmental...gear to fight the fires Does not exceed pain threshold for exposed skin Each unit tested met this performance objective 2. Firefighting

40 CFR 141.131 - Analytical requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... chromatography 300.1 D 6581-00 Ion chromatography & post column reaction 317.0 Rev 2.0 6, 326.0 6 IC/ICP-MS 321.8... sample collection. 6 Ion chromatography & post column reaction or IC/ICP-MS must be used for monitoring... study between a maximum and minimum acceptance limit of ±50% and ±15% of the study mean. (iii) Beginning...

24 CFR 200.926 - Minimum property standards for one and two family dwellings.

Code of Federal Regulations, 2012 CFR

2012-04-01

... property is to be located. (c) Standard for evaluating local or state building codes. The Secretary shall compare a local building code submitted under paragraph (d) of this section or a State code to the list of... each area and subarea on the list. (2) A State or local building code will be partially accepted if it...

24 CFR 200.926 - Minimum property standards for one and two family dwellings.

Code of Federal Regulations, 2014 CFR

2014-04-01

... property is to be located. (c) Standard for evaluating local or state building codes. The Secretary shall compare a local building code submitted under paragraph (d) of this section or a State code to the list of... each area and subarea on the list. (2) A State or local building code will be partially accepted if it...

24 CFR 200.926 - Minimum property standards for one and two family dwellings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... property is to be located. (c) Standard for evaluating local or state building codes. The Secretary shall compare a local building code submitted under paragraph (d) of this section or a State code to the list of... each area and subarea on the list. (2) A State or local building code will be partially accepted if it...

5 CFR 843.410 - Annuity for a child age 18 to 22 during full-time school attendance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... accepted as minimum for completion, by a full-time day student, of the academic or training program... student, and whose parent dies after the child's 22nd birthday but before the date the annuity terminates... to receive an annuity as a full-time student, the child must also meet all other requirements...

Low-flow profiles of the Tennessee River tributaries in Georgia

USGS Publications Warehouse

Carter, R.F.; Hopkins, E.H.; Perlman, H.A.

1988-01-01

Low flow information is provided for use in an evaluation of the capacity of streams to permit withdrawals or to accept waste loads without exceeding the limits of State water quality standards. The purpose of this report is to present the results of a compilation of available low flow data in the form of tables and ' 7Q10 flow profiles ' (minimum average flow for 7 consecutive days with a 10-yr recurrence interval) (7Q10 flow plotted against distance along a stream channel) for all stream reaches of the Tennessee River tributaries where sufficient data of acceptable accuracy are available. Drainage area profiles are included for all stream basins larger than 5 sq mi, except for those in a few remote areas. This report is the fifth in a series of reports that will cover all stream basins north of the Fall Line in Georgia. It includes the parts of the Tennessee River basin in Georgia. Flow records were not adjusted for diversions or other factors that cause measured flows to represent other than natural flow conditions. The 7-day minimum flow profile was omitted for stream reaches where natural flow was known to be altered significantly. (Lantz-PTT)

Introduction of a new mobile-bearing total knee prosthesis: minimum three year follow-up of an RCT comparing it with a fixed-bearing device.

PubMed

Beard, D J; Pandit, H; Price, A J; Butler-Manuel, P A; Dodd, C A F; Murray, D W; Goodfellow, J W

2007-12-01

As part of the step-wise validation of a new prosthesis (TMK), we previously published the 1 year results of a randomised controlled trial in patients undergoing bilateral knee replacement [Price A., Rees J., Beard D., Juszczak E. et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. JBJS B 2003;85-B-1:62-7.]. Forty patients had the new mobile-bearing prosthesis implanted in one knee and an established fixed-bearing device in the other (AGC). We now report the 3 year status of these patients and, in addition, review a separate multi-centre cohort of 172 patients who had undergone unilateral arthroplasty with the TMK. No significant differences were found in outcome (American Knee Society Score and Oxford Knee Score) between the two prostheses. The greater incidence of "clicking" in the mobile-bearing knee, reported in the previous review, persisted (TMK=48%, AGC=30%). The presence of this mechanical noise was found to have no relationship with outcome in either of the prostheses. The unilateral cohort study showed an acceptable complication rate for the new prosthesis, although some patients reported subjective instability. The method of controlled introduction of the TMK, of which this constitutes a further step, has allowed us to assess the significance of a reported problem (clicking) and to provide scientific data from which other surgeons can decide about use of the implant.

Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues.

PubMed

Kocur, Damian; Zbroszczyk, Miłosz; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Baron, Jan; Bażowski, Piotr; Kwiek, Stanisław

2016-10-01

We report our experience with endovascular coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes and periprocedural complications. The analysis included treatment results of 28 patients with ruptured and unruptured aneurysms. The aneurysm size ranged from 1.8 to 9.8 mm (mean 5.2, SD 1.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of six months. Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 27 (96%) cases and incomplete occlusion in one (4%) case. Imaging follow-up, performed in 15 (53.6%) patients, showed no change in the degree of occlusion in 11 (73%), coil compaction in one (7%) and progressive occlusion in three (20%) patients. Three (20%) patients underwent a second coil embolization. The procedure-related severe morbidity and mortality rate was 6.4% (2/31). Coil prolapse was present in one (3.2%) case and intraprocedural aneurysm rupture in three (9.6%) cases. The clinical follow-up evaluation achieved in 19 (67.9%) patients showed no change in 17 (89.5%) patients and improvement in two (10.5%) patients. Although the efficacy of coil embolization of anterior communicating artery aneurysms is unquestionable and the procedure-related complications are acceptable, they should not be neglected. Further investigations are needed to better understand protective factors, as well as to establish unequivocally appropriate management strategy of these complications. © The Author(s) 2016.

SU-E-I-65: The Joint Commission's Requirements for Annual Diagnostic Physics Testing of Nuclear Medicine Equipment, and a Clinically Relevant Methodology for Testing Low-Contrast Resolution

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

West, W. Geoffrey; Gray, David Clinton

Purpose: To introduce the Joint Commission's requirements for annual diagnostic physics testing of all nuclear medicine equipment, effective 7/1/2014, and to highlight an acceptable methodology for testing lowcontrast resolution of the nuclear medicine imaging system. Methods: The Joint Commission's required diagnostic physics evaluations are to be conducted for all of the image types produced clinically by each scanner. Other accrediting bodies, such as the ACR and the IAC, have similar imaging metrics, but do not emphasize testing low-contrast resolution as it relates clinically. The proposed method for testing low contrast resolution introduces quantitative metrics that are clinically relevant. The acquisitionmore » protocol and calculation of contrast levels will utilize a modified version of the protocol defined in AAPM Report #52. Results: Using the Rose criterion for lesion detection with a SNRpixel = 4.335 and a CNRlesion = 4, the minimum contrast levels for 25.4 mm and 31.8 mm cold spheres were calculated to be 0.317 and 0.283, respectively. These contrast levels are the minimum threshold that must be attained to guard against false positive lesion detection. Conclusion: Low contrast resolution, or detectability, can be properly tested in a manner that is clinically relevant by measuring the contrast level of cold spheres within a Jaszczak phantom using pixel values within ROI's placed in the background and cold sphere regions. The measured contrast levels are then compared to a minimum threshold calculated using the Rose criterion and a CNRlesion = 4. The measured contrast levels must either meet or exceed this minimum threshold to prove acceptable lesion detectability. This research and development activity was performed by the authors while employed at West Physics Consulting, LLC. It is presented with the consent of West Physics, which has authorized the dissemination of the information and/or techniques described in the work.« less

Simulating future uncertainty to guide the selection of survey designs for long-term monitoring

USGS Publications Warehouse

Garman, Steven L.; Schweiger, E. William; Manier, Daniel J.; Gitzen, Robert A.; Millspaugh, Joshua J.; Cooper, Andrew B.; Licht, Daniel S.

2012-01-01

A goal of environmental monitoring is to provide sound information on the status and trends of natural resources (Messer et al. 1991, Theobald et al. 2007, Fancy et al. 2009). When monitoring observations are acquired by measuring a subset of the population of interest, probability sampling as part of a well-constructed survey design provides the most reliable and legally defensible approach to achieve this goal (Cochran 1977, Olsen et al. 1999, Schreuder et al. 2004; see Chapters 2, 5, 6, 7). Previous works have described the fundamentals of sample surveys (e.g. Hansen et al. 1953, Kish 1965). Interest in survey designs and monitoring over the past 15 years has led to extensive evaluations and new developments of sample selection methods (Stevens and Olsen 2004), of strategies for allocating sample units in space and time (Urquhart et al. 1993, Overton and Stehman 1996, Urquhart and Kincaid 1999), and of estimation (Lesser and Overton 1994, Overton and Stehman 1995) and variance properties (Larsen et al. 1995, Stevens and Olsen 2003) of survey designs. Carefully planned, “scientific” (Chapter 5) survey designs have become a standard in contemporary monitoring of natural resources. Based on our experience with the long-term monitoring program of the US National Park Service (NPS; Fancy et al. 2009; Chapters 16, 22), operational survey designs tend to be selected using the following procedures. For a monitoring indicator (i.e. variable or response), a minimum detectable trend requirement is specified, based on the minimum level of change that would result in meaningful change (e.g. degradation). A probability of detecting this trend (statistical power) and an acceptable level of uncertainty (Type I error; see Chapter 2) within a specified time frame (e.g. 10 years) are specified to ensure timely detection. Explicit statements of the minimum detectable trend, the time frame for detecting the minimum trend, power, and acceptable probability of Type I error (α) collectively form the quantitative sampling objective.

Understanding the impact of simulated patients on health care learners' communication skills: a systematic review.

PubMed

Kaplonyi, Jessica; Bowles, Kelly-Ann; Nestel, Debra; Kiegaldie, Debra; Maloney, Stephen; Haines, Terry; Williams, Cylie

2017-12-01

Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap exists in the body of research on the effectiveness of SP-based education to teach communication skills that impact patient outcomes. The aim of this systematic review was to critically analyse the existing research, investigating whether SP-based communication skills training improves learner-patient communication, how communication skill improvement is measured, and who measures these improvements. The databases Medline, ProQuest (Health & Medical Complete, Nursing and Allied Health Source) and CINAHL (EBSCOhost) Education Resources Information Centre (ERIC) were searched for articles that investigated the effects of SP-based education on the communication skills of medical, nursing and allied health learners. There were 60 studies included in the review. Only two studies reported direct patient outcomes, one reporting some negative impact, and no studies included an economic analysis. Many studies reported statistically significant third-party ratings of improved communication effectiveness following SP-based education; however, studies were unable to be pooled for meta-analysis because of the outcome collection methods. There were a small number of studies comparing SP with no training at all and there were no differences between communication skills, contradicting the results from studies reporting benefits. Of the 60 studies included for analysis, 54 (90%) met the minimum quality score of 7/11, with four articles (7%) scoring 11/11. SP-based education is widely accepted as a valuable and effective means of teaching communication skills but there is limited evidence of how this translates to patient outcomes and no indication of economic benefit for this type of training over another method. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Experiences and Acceptance of Intimate Partner Violence: Associations with STI Symptoms and Ability to Negotiate Sexual Safety among Young Liberian Women

PubMed Central

Callands, Tamora A.; Sipsma, Heather L.; Betancourt, Theresa S.; Hansen, Nathan B.

2013-01-01

Women who experience intimate partner violence may be at elevated risk for poor sexual health outcomes including sexual transmitted infections (STIs). This association however, has not been consistently demonstrated in low-income or post-conflict countries; furthermore, the role that attitudes towards intimate partner violence play in sexual health outcomes and behaviour has rarely been examined. We examined associations between intimate partner violence experiences, accepting attitudes towards physical intimate partner violence, and sexual health and behavioural outcomes among 592 young women in post-conflict Liberia. Participants’ experiences with either moderate or severe physical violence or sexual violence were common. Additionally, accepting attitudes towards physical intimate partner violence were positively associated with reporting STI symptoms, intimate partner violence experiences and the ability to negotiate safe sex. Findings suggest that for sexual health promotion and risk reduction intervention efforts to achieve full impact, interventions must address the contextual influence of violence, including individual attitudes toward intimate partner violence. PMID:23586393

Experiences and acceptance of intimate partner violence: associations with sexually transmitted infection symptoms and ability to negotiate sexual safety among young Liberian women.

PubMed

Callands, Tamora A; Sipsma, Heather L; Betancourt, Theresa S; Hansen, Nathan B

2013-01-01

Women who experience intimate partner violence (IPV) may be at elevated risk for poor sexual health outcomes, including sexually transmitted infections (STIs). This association, however, has not been consistently demonstrated in low-income or post-conflict countries. Furthermore, the role that attitudes towards IPV play in sexual-health outcomes and behaviour has rarely been examined. We examined associations between IPV experiences, accepting attitudes towards physical IPV, and sexual-health and behavioural outcomes among 592 young women in post-conflict Liberia. Participants' experiences with either moderate or severe physical violence or sexual violence were common. Additionally, accepting attitudes towards physical IPV were positively associated with reporting STI symptoms, IPV experiences and the ability to negotiate safe sex. Findings suggest that for sexual-health-promotion and risk-reduction-intervention efforts to achieve full impact, interventions must address the contextual influence of violence, including individual attitudes toward IPV.

Theory development in health care informatics: Information and communication technology acceptance model (ICTAM) improves the explanatory and predictive power of technology acceptance models.

PubMed

An, Ji-Young

2006-01-01

The purpose of this web-based study was to explain and predict consumers' acceptance and usage behavior of Internet health information and services. Toward this goal, the Information and Communication Technology Acceptance Model (ICTAM) was developed and tested. Individuals who received a flyer through the LISTSERV of HealthGuide were eligible to participate. The study population was eighteen years old and older who had used Internet health information and services for a minimum of 6 months. For the analyses, SPSS (version 13.0) and AMOS (version 5.0) were employed. More than half of the respondents were women (n = 110, 55%). The average age of the respondents was 35.16 years (S.D. = 10.07). A majority reported at least some college education (n = 126, 63%). All of the observed factors accounted for 75.53% of the total variance explained. The fit indices of the structural model were within an acceptable range: chi2/df = 2.38 (chi2 = 1786.31, df = 752); GFI = .71; RMSEA = .08; CFI = .86; NFI = .78. The results of this study provide empirical support for the continued development of ICTAM in the area of health consumers' information and communication technology acceptance.

Acceptable range of speech level in noisy sound fields for young adults and elderly persons.

PubMed

Sato, Hayato; Morimoto, Masayuki; Ota, Ryo

2011-09-01

The acceptable range of speech level as a function of background noise level was investigated on the basis of word intelligibility scores and listening difficulty ratings. In the present study, the acceptable range is defined as the range that maximizes word intelligibility scores and simultaneously does not cause a significant increase in listening difficulty ratings from the minimum ratings. Listening tests with young adult and elderly listeners demonstrated the following. (1) The acceptable range of speech level for elderly listeners overlapped that for young listeners. (2) The lower limit of the acceptable speech level for both young and elderly listeners was 65 dB (A-weighted) for noise levels of 40 and 45 dB (A-weighted), a level with a speech-to-noise ratio of +15 dB for noise levels of 50 and 55 dB, and a level with a speech-to-noise ratio of +10 dB for noise levels from 60 to 70 dB. (3) The upper limit of the acceptable speech level for both young and elderly listeners was 80 dB for noise levels from 40 to 55 dB and 85 dB or above for noise levels from 55 to 70 dB. © 2011 Acoustical Society of America

Acceptability and characterization of extruded pinto, navy and black beans.

PubMed

Simons, Courtney W; Hall, Clifford; Tulbek, Mehmet; Mendis, Mihiri; Heck, Taylor; Ogunyemi, Samuel

2015-08-30

Consumption of dry beans has been relatively flat over the last decade. Creating new bean products may increase the consumption of beans and allow more consumers to obtain the health benefits of beans. In this study, pinto, navy and black beans were milled and the resulting flours extruded into puffs. Unflavored extruded puffs were evaluated by untrained panelists using a hedonic scale for appearance, flavor, texture and overall acceptability. The compositions of raw flours and extrudates were characterized. Sensory results indicated that all beans met or exceeded the minimum requirement for acceptability. Overall acceptability of navy and pinto beans was not significantly different, while acceptability of black bean puffs was significantly lower. Total protein (198-217 g kg(-1)) in extrudates was significantly different among the three beans. Total starch ranged from 398 to 406 g kg(-1) and was not significantly different. Resistant starch, total extractable lipid and raffinose contents were significantly reduced by extrusion. Extrusion did not affect crude fiber and phytic acid contents. The minimal effects on protein and fiber contents, the significant reduction in raffinose content and the acceptability of the unflavored extruded puffs support using various bean flours as ingredients in extruded puffed products. © 2014 Society of Chemical Industry.

Publication Bias in Kienbock's Disease: A Systematic Review

PubMed Central

Squitieri, Lee; Petruska, Elizabeth; Chung, Kevin C

2015-01-01

Purpose Kienbock's disease is considered a “rare disease” and currently affects less than 200,000 people in the U.S. Given the inherent challenges associated with researching rare diseases, the intense effort in hand surgery to treat this uncommon disorder may be susceptible to publication bias in which positive outcomes are preferentially published. The specific aim of this project is to conduct a systematic review of the literature with the hypothesis that publication bias is present for the treatment of Kienbock's disease. Methods We conducted a systematic review of all available abstracts associated with published manuscripts (English and non-English) and abstracts accepted to the 1992-2004 American Society for Surgery of the Hand (ASSH) annual meetings. Data collection included various study characteristics, direction of outcome (positive, neutral/negative), complication rates, mean follow-up time, time to publication, and length of patient enrollment. Results Our study included 175 (124 English, 51 non-English) published Kienbock's manuscripts and 14 Kienbock's abstracts from the 1992-2004 annual ASSH meetings. Abstracts from published manuscripts were associated with a 53% positive outcome rate, which is lower than the 74% positive outcome rate found among other surgical disorders. Over the past 40 years, studies have become more positive (36% to 68%, p = 0.007) and are more likely to incorporate statistical analysis testing (0% to 55%, p <0.001). Of the 14 abstracts accepted to ASSH, 11 (79%) were published in peer-reviewed journals. Ten of the 14 accepted abstracts (71%) were considered positive, and there was no significant difference in publication rate between studies with positive (n = 10) and non-positive (n = 4) outcomes (p = 1.000). Conclusions The acceptance rate for negative outcomes studies regarding Kienbock's disease is higher than for other surgical disorders. This may indicate a relative decrease in positive outcome bias among published Kienbock's studies compared to other surgical disorders. However, the increasing positive outcome rate for published Kienbock's studies over time may suggest a trend of increasing publication bias among journals toward Kienbock's studies. PMID:20193856

TESTING AND ACCEPTANCE OF FUEL PLATES FOR RERTR FUEL DEVELOPMENT EXPERIMENTS

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

J.M. Wight; G.A. Moore; S.C. Taylor

2008-10-01

This paper discusses how candidate fuel plates for RERTR Fuel Development experiments are examined and tested for acceptance prior to reactor insertion. These tests include destructive and nondestructive examinations (DE and NDE). The DE includes blister annealing for dispersion fuel plates, bend testing of adjacent cladding, and microscopic examination of archive fuel plates. The NDE includes Ultrasonic (UT) scanning and radiography. UT tests include an ultrasonic scan for areas of “debonds” and a high frequency ultrasonic scan to determine the "minimum cladding" over the fuel. Radiography inspections include identifying fuel outside of the maximum fuel zone and measurements and calculationsmore » for fuel density. Details of each test are provided and acceptance criteria are defined. These tests help to provide a high level of confidence the fuel plate will perform in the reactor without a breach in the cladding.« less

Do Higher Minimum Wages Benefit Health? Evidence From the UK.

PubMed

Lenhart, Otto

This study examines the link between minimum wages and health outcomes by using the introduction of the National Minimum Wage (NMW) in the United Kingdom in 1999 as an exogenous variation of earned income. A test for health effects by using longitudinal data from the British Household Panel Survey for a period of ten years was conducted. It was found that the NMW significantly improved several measures of health, including self-reported health status and the presence of health conditions. When examining potential mechanisms, it was shown that changes in health behaviors, leisure expenditures, and financial stress can explain the observed improvements in health.

Antibacterial, antifungal and cytotoxic evaluation of some new quinazolinone derivatives

PubMed Central

Hassanzadeh, F.; Jafari, E.; Hakimelahi, G.H.; Khajouei, M. Rahmani; Jalali, M.; Khodarahmi, G.A.

2012-01-01

Quinazolinone ring system is renown because of its wide spectrum of pharmacological activities due to various substitutions on this ring system. In this study, the minimum inhibitory concentration of the synthesized compounds in our laboratory was determined by micro dilution Alamar Blue® Assay against six strains of bacteria (three Gram-positive and three Gram-negative) and three strains of fungi. Following a broth micro dilution minimum inhibitory concentration (MIC) test, Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) tests were performed. Cytotoxic effects of the compounds were measured using the MTT colorimetric assay on HeLa cell line. Results of antimicrobial screening showed that compounds had better bacteriostatic activity against Gram-negative bacteria. Results from MBC revealed that these compounds had more significant bacteriostatic than bactericidal activities. Nearly all screened compounds showed good activity against C. albicans and A. niger. Results from MFC indicated that these compounds had better fungistatic rather than fungicidal activities. The synthesized target molecules were found to exhibit different cytotoxicity in the range of 10 to 100 μM on HeLa cell line. Compounds 6 and 7 exhibited acceptable cytotoxicity approximately 50% at 10 μM concentration. PMID:23181085

Acceptance of Spousal Death: The Factor of Time in Bereaved Older Adults' Search for Meaning

ERIC Educational Resources Information Center

Chan, Wallace Chi Ho; Chan, Cecilia L. W.

2011-01-01

Response to the death of a spouse was examined by focusing on acceptance, which was conceptualized as both a process and an outcome. Grounded theory was applied to analyze the experience of 15 bereaved Hong Kong Chinese older adults. The main theme that emerged was time. Acceptance of spousal death was found to be related to the search for meaning…

LPTA Versus Tradeoff: Analysis of Contract Source Selection Strategies and Performance Outcomes

DTIC Science & Technology

2016-06-01

methodologies contracting professionals employ to acquire what the DOD needs. Contracting professionals may use lowest price technically acceptable (LPTA) and...contract management process, source selection, lowest price technically acceptable, tradeoff 15. NUMBER OF PAGES 69 16. PRICE CODE 17. SECURITY...use lowest price technically acceptable (LPTA) and tradeoff strategies to procure requirements to maximize the overall best value to the government

Model of Information and Communication Technology (ICT) Acceptance and Use for Teaching Staff in Sub-Saharan Africa Public Higher Education Institutions

ERIC Educational Resources Information Center

Ouedraogo, Boukary

2017-01-01

This article uses data survey on 82 teachers from the University of Ouagadougou and the model of unified theory of acceptance and use of technology (UTAUT) to assess the determinants of acceptance and educational use of ICT by teachers. The paper's outcomes show that the construct "performance expectancy" of ICT (expected utility and…

Optimization of HTST process parameters for production of ready-to-eat potato-soy snack.

PubMed

Nath, A; Chattopadhyay, P K; Majumdar, G C

2012-08-01

Ready-to-eat (RTE) potato-soy snacks were developed using high temperature short time (HTST) air puffing process and the process was found to be very useful for production of highly porous and light texture snack. The process parameters considered viz. puffing temperature (185-255 °C) and puffing time (20-60 s) with constant initial moisture content of 36.74% and air velocity of 3.99 m.s(-1) for potato-soy blend with varying soy flour content from 5% to 25% were investigated using response surface methodology following central composite rotatable design (CCRD). The optimum product in terms of minimum moisture content (11.03% db), maximum expansion ratio (3.71), minimum hardness (2,749.4 g), minimum ascorbic acid loss (9.24% db) and maximum overall acceptability (7.35) were obtained with 10.0% soy flour blend in potato flour at the process conditions of puffing temperature (231.0 °C) and puffing time (25.0 s).

The influence of pedagogical content knowledge (PCK) for teaching macroevolution on student outcomes in a general education biology course

NASA Astrophysics Data System (ADS)

Walter, Emily Marie

This study investigated the influence of pedagogical content knowledge (PCK) for teaching macroevolution on non-science majors' knowledge of macroevolution and evolution acceptance. The nature and sources of an experienced faculty member's PCK and instruction as enacted PCK (Park & Oliver, 2008) were examined to consider the influence of these components on students' knowledge of macroevolution and evolution acceptance. The study used a mixed methods approach to understand how PCK influences student outcomes, and is one of the first to examine the influence of PCK on student outcomes at the post-secondary level. In addition, the study is one of few to document a significant relationship between knowledge of evolution and evolution acceptance, including how instruction influenced these outcomes. The case selected for study was a general education biology class: 270 students and their instructor. To examine the nature and sources of the instructor's PCK for teaching macroevolution, the course was observed in its entirety, the instructor was interviewed before, during, and after the evolution unit, and artifacts were collected from the evolution unit. Interview and observational protocols for the instructor were developed based on the Magnussson, Kracjik, & Borko (1999) model of PCK. The instructor was found to have deep knowledge of learners, and this knowledge in turn informed the other components of her PCK. Her knowledge of learners was built through reflecting on student exam outcomes, referencing the pedagogical literature, interactions with students, and discussions with colleagues. These findings have implications for faculty professional development. The influence of the course was examined both quantitatively and qualitatively. Students were surveyed using the Measure of Understanding of Macroevolution (Nadelson & Southerland, 2010a) the Measure of Acceptance of the Theory of Evolution (Rutledge & Warden, 1999, 2007). From pre- to post-test, students became significantly more accepting of evolution (p < .0001) and made significant gains in understanding macroevolution ( p < .0001). Knowledge of macroevolution and evolution acceptance were also significantly correlated (r[268] = .47, p < .01). Twelve students initially scoring low on both instruments also interviewed to examine how the instruction influenced their responses on the instruments. Nine of the students became more accepting of evolution, which they attributed to learning about the volume of evidence for evolution (especially transitional fossils) and learning about the history of life. These findings have important implications for evolution education policy and practice at the post-secondary level.

Acceptability of Home-Assessment Post Medical Abortion and Medical Abortion in a Low-Resource Setting in Rajasthan, India. Secondary Outcome Analysis of a Non-Inferiority Randomized Controlled Trial

PubMed Central

Paul, Mandira; Iyengar, Kirti; Essén, Birgitta; Gemzell-Danielsson, Kristina; Iyengar, Sharad D.; Bring, Johan; Soni, Sunita; Klingberg-Allvin, Marie

2015-01-01

Background Studies evaluating acceptability of simplified follow-up after medical abortion have focused on high-resource or urban settings where telephones, road connections, and modes of transport are available and where women have formal education. Objective To investigate women’s acceptability of home-assessment of abortion and whether acceptability of medical abortion differs by in-clinic or home-assessment of abortion outcome in a low-resource setting in India. Design Secondary outcome of a randomised, controlled, non-inferiority trial. Setting Outpatient primary health care clinics in rural and urban Rajasthan, India. Population Women were eligible if they sought abortion with a gestation up to 9 weeks, lived within defined study area and agreed to follow-up. Women were ineligible if they had known contraindications to medical abortion, haemoglobin < 85mg/l and were below 18 years. Methods Abortion outcome assessment through routine clinic follow-up by a doctor was compared with home-assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet. A computerized random number generator generated the randomisation sequence (1:1) in blocks of six. Research assistants randomly allocated eligible women who opted for medical abortion (mifepristone and misoprostol), using opaque sealed envelopes. Blinding during outcome assessment was not possible. Main Outcome Measures Women’s acceptability of home-assessment was measured as future preference of follow-up. Overall satisfaction, expectations, and comparison with previous abortion experiences were compared between study groups. Results 731 women were randomized to the clinic follow-up group (n = 353) or home-assessment group (n = 378). 623 (85%) women were successfully followed up, of those 597 (96%) were satisfied and 592 (95%) found the abortion better or as expected, with no difference between study groups. The majority, 355 (57%) women, preferred home-assessment in the event of a future abortion. Significantly more women, 284 (82%), in the home-assessment group preferred home-assessment in the future, as compared with 188 (70%) of women in the clinic follow-up group, who preferred clinic follow-up in the future (p < 0.001). Conclusion Home-assessment is highly acceptable among women in low-resource, and rural, settings. The choice to follow-up an early medical abortion according to women’s preference should be offered to foster women’s reproductive autonomy. Trial Registration ClinicalTrials.gov NCT01827995 PMID:26327217

25 CFR 547.14 - What are the minimum technical standards for electronic random number generation?

Code of Federal Regulations, 2013 CFR

2013-04-01

... the application under the rules of the game. For example, if a bingo game with 75 objects with numbers... test potency and degree of serial correlation (outcomes must be independent from the previous game...) General requirements. (1) Software that calls an RNG to derive game outcome events must immediately use...

25 CFR 547.14 - What are the minimum technical standards for electronic random number generation?

Code of Federal Regulations, 2014 CFR

2014-04-01

... the application under the rules of the game. For example, if a bingo game with 75 objects with numbers... test potency and degree of serial correlation (outcomes must be independent from the previous game...) General requirements. (1) Software that calls an RNG to derive game outcome events must immediately use...

An Empirical System for Assessing the Impact of Aptitude Requirement Adjustments on Air Force Initial Skills Training.

ERIC Educational Resources Information Center

Mumford, Michael D.; And Others

A multivariate modeling approach was developed to assess the impact of changes in aptitude requirement minimums on U.S. Air Force technical training outcomes. Initially, interviews were conducted with technical training personnel to identify significant student inputs, course content, and training outcome variables. Measures of these variables…

The Effectiveness and Cost-Effectiveness of Spinal Cord Stimulation for Refractory Angina (RASCAL Study): A Pilot Randomized Controlled Trial.

PubMed

Eldabe, Sam; Thomson, Simon; Duarte, Rui; Brookes, Morag; deBelder, Mark; Raphael, Jon; Davies, Ed; Taylor, Rod

2016-01-01

Patients with "refractory angina" (RA) unsuitable for coronary revascularization experience high levels of hospitalization and poor health-related quality of life. Randomized trials have shown spinal cord stimulation (SCS) to be a promising treatment for chronic stable angina and RA; however, none has compared SCS with usual care (UC). The aim of this pilot study was to address the key uncertainties of conducting a definitive multicenter trial to assess the clinical and cost-effectiveness of SCS in RA patients, i.e., recruitment and retention of patients, burden of outcome measures, our ability to standardize UC in a UK NHS setting. RA patients deemed suitable were randomized in a 1:1 ratio to SCS plus UC (SCS group) or UC alone (UC group). We sought to assess: recruitment, uptake, and retention of patients; feasibility and acceptability of SCS treatment; the feasibility and acceptability of standardizing UC; and the feasibility and acceptability of the proposed trial outcome measures. Patient outcomes were assessed at baseline (prerandomization) and three and six months postrandomization. We failed to meet our planned recruitment target (45 patients) and randomized 29 patients (15 SCS group, 14 UC group) over a 42-month period across four sites. None of the study participants chose to withdraw following consent and randomization. With exception of two deaths, all completed evaluation at baseline and follow-up. Although the study was not formally powered to compare outcomes between groups, we saw a trend toward larger improvements in both primary and secondary outcomes in the SCS group. While patient recruitment was found to be challenging, levels of participant retention, outcome completion, and acceptability of SCS therapy were high. A number of lessons are presented in order to take forward a future definitive pragmatic randomized trial. © 2015 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals, Inc. on behalf of International Neuromodulation Society.

Simultaneous development of laparoscopy and robotics provides acceptable perioperative outcomes and shows robotics to have a faster learning curve and to be overall faster in rectal cancer surgery: analysis of novice MIS surgeon learning curves.

PubMed

Melich, George; Hong, Young Ki; Kim, Jieun; Hur, Hyuk; Baik, Seung Hyuk; Kim, Nam Kyu; Sender Liberman, A; Min, Byung Soh

2015-03-01

Laparoscopy offers some evidence of benefit compared to open rectal surgery. Robotic rectal surgery is evolving into an accepted approach. The objective was to analyze and compare laparoscopic and robotic rectal surgery learning curves with respect to operative times and perioperative outcomes for a novice minimally invasive colorectal surgeon. One hundred and six laparoscopic and 92 robotic LAR rectal surgery cases were analyzed. All surgeries were performed by a surgeon who was primarily trained in open rectal surgery. Patient characteristics and perioperative outcomes were analyzed. Operative time and CUSUM plots were used for evaluating the learning curve for laparoscopic versus robotic LAR. Laparoscopic versus robotic LAR outcomes feature initial group operative times of 308 (291-325) min versus 397 (373-420) min and last group times of 220 (212-229) min versus 204 (196-211) min-reversed in favor of robotics; major complications of 4.7 versus 6.5 % (NS), resection margin involvement of 2.8 versus 4.4 % (NS), conversion rate of 3.8 versus 1.1 (NS), lymph node harvest of 16.3 versus 17.2 (NS), and estimated blood loss of 231 versus 201 cc (NS). Due to faster learning curves for extracorporeal phase and total mesorectal excision phase, the robotic surgery was observed to be faster than laparoscopic surgery after the initial 41 cases. CUSUM plots demonstrate acceptable perioperative surgical outcomes from the beginning of the study. Initial robotic operative times improved with practice rapidly and eventually became faster than those for laparoscopy. Developing both laparoscopic and robotic skills simultaneously can provide acceptable perioperative outcomes in rectal surgery. It might be suggested that in the current milieu of clashing interests between evolving technology and economic constrains, there might be advantages in embracing both approaches.

Racial Variation in Vocational Rehabilitation Outcomes: A Structural Equation Modeling Approach

ERIC Educational Resources Information Center

Martin, Frank H.

2010-01-01

Numerous studies have indicated racial and ethnic disparities in the vocational rehabilitation (VR) system, including differences in acceptance, services provided, closure types, and employment outcomes. Few of these studies, however, have used advanced multivariate techniques or latent constructs to measure quality of employment outcomes (QEO) or…

Recent Internet Use and Associations with Clinical Outcomes among Patients Entering Addiction Treatment Involved in a Web-Delivered Psychosocial Intervention Study.

PubMed

Tofighi, B; Campbell, A N C; Pavlicova, M; Hu, M C; Lee, J D; Nunes, E V

2016-10-01

The acceptability and clinical impact of a web-based intervention among patients entering addiction treatment who lack recent internet access are unclear. This secondary analysis of a national multisite treatment study (NIDA Clinical Trials Network-0044) assessed for acceptability and clinical impact of a web-based psychosocial intervention among participants enrolling in community-based, outpatient addiction treatment programs. Participants were randomly assigned to 12 weeks of a web-based therapeutic education system (TES) based on the community reinforcement approach plus contingency management versus treatment as usual (TAU). Demographic and clinical characteristics, and treatment outcomes were compared among participants with recent internet access in the 90 days preceding enrollment (N = 374) and without internet access (N = 133). Primary outcome variables included (1) acceptability of TES (i.e., module completion; acceptability of web-based intervention) and (2) clinical impact (i.e., self-reported abstinence confirmed by urine drug/breath alcohol tests; retention measured as time to dropout). Internet use was common (74 %) and was more likely among younger (18-49 years old) participants and those who completed high school (p < .001). Participants randomized to TES (n = 255) without baseline internet access rated the acceptability of TES modules significantly higher than those with internet access (t = 2.49, df = 218, p = .01). There was a near significant interaction between treatment, baseline abstinence, and internet access on time to dropout (χ 2 (1) = 3.8089, p = .051). TES was associated with better retention among participants not abstinent at baseline who had internet access (X 2 (1) = 6.69, p = .01). These findings demonstrate high acceptability of this web-based intervention among participants that lacked recent internet access.

Feasibility, acceptability, and preliminary outcomes of the Fortalezas Familiares intervention for Latino families facing maternal depression

PubMed Central

Valdez, Carmen R.; Padilla, Brian; Moore, Sarah; Magaña, Sandra

2014-01-01

This pilot study examined the feasibility, acceptability, and preliminary outcomes of a linguistically- and culturally-adapted intervention for immigrant Latina mothers with depression and their families. Fortalezas Familiares (Family Strengths) is a community-based, 12-week, multi-family group intervention that aims to increase communication about family processes leading up to and affected by the mother’s depression, build child coping and efficacy, enhance parenting competence and skills, and promote cultural and social assets within the family. In terms of feasibility, of 16 families who enrolled and participated in the intervention, 13 families attended more than 90% of meetings and completed the intervention. Post-tests reported positive changes following the intervention, including improved psychological functioning, increased family and marital support, and enhanced family functioning, as reported by mothers and other caregivers. Mothers also reported decreased conduct and hyperactivity problems among their children. Children reported positive changes in their psychological functioning and coping, peer relations, parenting warmth and acceptance, and overall family functioning. Post-intervention focus groups and surveys measuring acceptability revealed families’ satisfaction with the intervention and suggested areas of improvement. We discuss similarities and differences in outcomes between the adapted intervention, Fortalezas Familiares, and the original intervention, Keeping Families Strong, and propose future areas of intervention adaptation and development. PMID:24033238

TextTB: A Mixed Method Pilot Study Evaluating Acceptance, Feasibility, and Exploring Initial Efficacy of a Text Messaging Intervention to Support TB Treatment Adherence

PubMed Central

Pearce, Patricia F.; Chirico, Cristina; Etchevarria, Mirta; Cardinale, Daniel; Rubinstein, Fernando

2013-01-01

Objective. To assess a text messaging intervention to promote tuberculosis (TB) treatment adherence. Methods. A mixed-methods pilot study was conducted within a public pulmonary-specialized hospital in Argentina. Patients newly diagnosed with TB who were 18 or older, and had mobile phone access were recruited and randomized to usual care plus either medication calendar (n = 19) or text messaging intervention (n = 18) for the first two months of treatment. Primary outcomes were feasibility and acceptability; secondary outcomes explored initial efficacy. Results. Feasibility was evidenced by high access to mobile phones, familiarity with texting, most phones limited to basic features, a low rate of participant refusal, and many describing suboptimal TB understanding. Acceptability was evidenced by participants indicating feeling cared for, supported, responsible for their treatment, and many self-reporting adherence without a reminder. Participants in the texting group self-reported adherence on average 77% of the days whereas only 53% in calendar group returned diaries. Exploring initial efficacy, microscopy testing was low and treatment outcomes were similar in both groups. Conclusion. The texting intervention was well accepted and feasible with greater reporting of adherence using text messaging than the diary. Further evaluation of the texting intervention is warranted. PMID:24455238

Multi-Family Pediatric Pain Group Therapy: Capturing Acceptance and Cultivating Change.

PubMed

Huestis, Samantha E; Kao, Grace; Dunn, Ashley; Hilliard, Austin T; Yoon, Isabel A; Golianu, Brenda; Bhandari, Rashmi P

2017-12-07

Behavioral health interventions for pediatric chronic pain include cognitive-behavioral (CBT), acceptance and commitment (ACT), and family-based therapies, though literature regarding multi-family therapy (MFT) is sparse. This investigation examined the utility and outcomes of the Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE) program, which included all three modalities (CBT, ACT, MFT) for youth with chronic pain and their parents. Program utility, engagement, and satisfaction were evaluated via quantitative and qualitative feedback. Pain-specific psychological, behavioral, and interpersonal processes were examined along with outcomes related to disability, quality of life, pain interference, fatigue, anxiety, and depressive symptoms. Participants indicated that CAPTIVATE was constructive, engaging, and helpful for social and family systems. Clinical and statistical improvements with large effect sizes were captured for pain catastrophizing, acceptance, and protective parenting but not family functioning. Similar effects were found for functional disability, pain interference, fatigue, anxiety, and depression. Given the importance of targeting multiple systems in the management of pediatric chronic pain, preliminary findings suggest a potential new group-based treatment option for youth and families. Next steps involve evaluating the differential effect of the program over treatment as usual, as well as specific CBT, ACT, and MFT components and processes that may affect outcomes.

Psychological and educational interventions for subfertile men and women.

PubMed

Verkuijlen, Jolijn; Verhaak, Christianne; Nelen, Willianne L D M; Wilkinson, Jack; Farquhar, Cindy

2016-03-31

Approximately one-fifth of all subfertile couples seeking fertility treatment show clinically relevant levels of anxiety, depression, or distress. Psychological and educational interventions are frequently offered to subfertile couples, but their effectiveness, both in improving mental health and pregnancy rates, is unclear. To assess the effectiveness of psychological and educational interventions for subfertile couples on psychological and fertility treatment outcomes. We searched (from inception to 2 April 2015) the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 2, 2015), MEDLINE, EMBASE, PsycINFO, EBSCO CINAHL, DARE, Web of Science, OpenGrey, LILACS, PubMed, and ongoing trials registers. We handsearched reference lists and contacted experts in the field. We included published and unpublished randomised controlled trials (RCTs), cluster randomised trials, and cross-over trials (first phase) evaluating the effectiveness of psychological and educational interventions on psychological and fertility treatment outcomes in subfertile couples. Two review authors independently assessed trial risk of bias and extracted data. We contacted study authors for additional information. Our primary outcomes were psychological measures (anxiety and depression) and fertility rates (live birth or ongoing pregnancy). We assessed the overall quality of the evidence using GRADE criteria.As we did not consider the included studies to be sufficiently similar to permit meaningful pooling, we summarised the results of the individual studies by presenting the median and interquartile range (IQR) of effects as well as the minimum and maximum values. We calculated standardised mean differences (SMDs) for continuous variables and odds ratios (ORs) for dichotomous outcomes. We included 39 studies involving 4925 participants undergoing assisted reproductive technology. Studies were heterogeneous with respect to a number of factors, including nature and duration of interventions, participants, and comparator groups. As a result, we judged that pooling results would not result in a clinically meaningful estimate of a treatment effect. There were substantial methodological weaknesses in the studies, all of which were judged to be at high risk of bias for one or more quality assessment domains. There was concern about attrition bias (24 studies), performance bias for psychological outcomes (27 studies) and fertility outcomes (18 studies), and detection bias for psychological outcomes (26 studies). We therefore considered study-specific estimates of intervention effects to be unreliable. Thirty-three studies reported the outcome mental health. Only two studies reported the outcome live birth, and both of these had substantial attrition. One study reported ongoing pregnancy, again with substantial attrition. We have combined live birth and ongoing pregnancy in one outcome. Psychological outcomesStudies utilised a variety of measures of anxiety and depression. In all cases a low score denoted benefit from the intervention.SMDs for anxiety were as follows: psychological interventions versus attentional control or usual care: median (IQR) = -0.30 (-0.84 to 0.00), minimum value -5.13; maximum value 0.84, 17 RCTs, 2042 participants; educational interventions versus attentional control or usual care: median = 0.03, minimum value -0.38; maximum value 0.23, 4 RCTs, 330 participants.SMDs for depression were as follows: psychological interventions versus attentional control or usual care: median (IQR) = -0.45 (-0.68 to -0.08), minimum value -3.01; maximum value 1.23, 12 RCTs, 1160 participants; educational interventions versus attentional control or usual care: median = -0.33, minimum value -0.46; maximum value 0.17, 3 RCTs, 304 participants. Fertility outcomesWhen psychological interventions were compared with attentional control or usual care, ORs for live birth or ongoing pregnancy ranged from minimum value 1.13 to maximum value 10.05. No studies of educational interventions reported this outcome. The effects of psychological and educational interventions on mental health including distress, and live birth or ongoing pregnancy rates is uncertain due to the very low quality of the evidence. Existing trials of psychological and educational interventions for subfertility were generally poorly designed and executed, resulting in very serious risk of bias and serious inconsistency in study findings. There is a need for studies employing appropriate methodological techniques to investigate the benefits of these treatments for this population. In particular, attentional control groups should be employed, that is groups receiving a treatment that mimics the amount of time and attention received by the treatment group but is not thought to have a specific effect upon the participants, in order to distinguish between therapeutic and non-specific effects of interventions. Where attrition cannot be minimised, appropriate statistical techniques for handling drop-out must be applied. Failure to address these issues in study design has resulted in studies that do not provide a valid basis for answering questions about the effectiveness of these interventions.

AN INFERENTIAL INDEX OF SWIMMING POOL PURITY

PubMed Central

Fair, Gordon M.

1920-01-01

Score cards for swimming pools is the suggestion of this paper. Figures about these establishments are today in the class with crude statistics, and may lead to unreliable conclusions. Here are suggested various indexes which may be of service in framing minimum requirements for these pools. This article is an effort to clear up a complicated matter for which there are not now accepted standards. PMID:18010324

75 FR 70730 - Natural Currents Energy Services, LLC; Notice of Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

...(f) of the Federal Power Act, proposing to study the feasibility of the Salem Tidal Energy Project... Atlantic Port Terminal to the south. The project proposes between 10 and 30 NC Sea Dragon or Red Hawk tidal... minimum of 3,504,000 kW hours per year with the installation of 10 units. Applicant Contact: Mr. Roger...

76 FR 71959 - KC Hydro LLC of New Hampshire; Notice of Preliminary Permit Application Accepted for Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-21

... shaft Kaplan turbine-generating unit with a total installed capacity of 0.84 MW; (5) a new 135-foot-long... outlet works; (4) a minimum flow turbine generator and a new 2,000-square-foot powerhouse containing one or two submersible or tubular-type turbine generators with a total installed capacity of 0.36 MW; (5...

Weightbearing Versus Nonweightbearing After Meniscus Repair.

PubMed

VanderHave, Kelly L; Perkins, Crystal; Le, Michael

2015-01-01

Optimal rehabilitation after meniscal repair remains controversial. To review the current literature on weightbearing status after meniscal repairs and to provide evidence-based recommendations for postoperative rehabilitation. MEDLINE (January 1, 1993 to July 1, 2014) and Embase (January 1, 1993 to July 1, 2014) were queried with use of the terms meniscus OR/AND repair AND rehabilitation. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. Systematic review. Level 4. Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years follow-up were extracted. Successful clinical outcomes ranged from 70% to 94% with conservative rehabilitation. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. Outcomes after both conservative (restricted weightbearing) protocols and accelerated rehabilitation (immediate weightbearing) yielded similar good to excellent results; however, lack of similar objective criteria and consistency among surgical techniques and existing studies makes direct comparison difficult. © 2015 The Author(s).

Changes, trends and challenges of medical education in Latin America.

PubMed

Pulido M, Pablo A; Cravioto, Alejandro; Pereda, Ana; Rondón, Roberto; Pereira, Gloria

2006-02-01

This paper briefly reviews the current situation of Latin American medical schools and the search to improve the quality and professionalism of medical education through the region. Institutional evaluation and accreditation programs based on nationally ongoing developing standards have been accepted, now optimized and complemented by the framework of the Global & International Standards of Medical Education working jointly with the WFME. More recently, the process has evolved to look into the quality of the outcomes of the medicals as seen by examinations implemented at the end of medical studies and the initiation of medical practice. In addition, there is vision for the application of new programs such as the global minimum essential requirements advanced by the Institute for International Medical Education (IIME). The PanAmerican Federation of Associations of Medical Schools (PAFAMS), an academic, non-governmental organization, is fostering the exchange of ideas and experiences among members, associations and affiliated medical schools geared to focus on the quality and professionalism of the graduates of medical schools in Latin America. These actions also aim to consolidate databases of information on medical education and innovative endeavors in continuing professional education and development through e-learning projects in the region.

Reliability of 3D laser-based anthropometry and comparison with classical anthropometry.

PubMed

Kuehnapfel, Andreas; Ahnert, Peter; Loeffler, Markus; Broda, Anja; Scholz, Markus

2016-05-26

Anthropometric quantities are widely used in epidemiologic research as possible confounders, risk factors, or outcomes. 3D laser-based body scans (BS) allow evaluation of dozens of quantities in short time with minimal physical contact between observers and probands. The aim of this study was to compare BS with classical manual anthropometric (CA) assessments with respect to feasibility, reliability, and validity. We performed a study on 108 individuals with multiple measurements of BS and CA to estimate intra- and inter-rater reliabilities for both. We suggested BS equivalents of CA measurements and determined validity of BS considering CA the gold standard. Throughout the study, the overall concordance correlation coefficient (OCCC) was chosen as indicator of agreement. BS was slightly more time consuming but better accepted than CA. For CA, OCCCs for intra- and inter-rater reliability were greater than 0.8 for all nine quantities studied. For BS, 9 of 154 quantities showed reliabilities below 0.7. BS proxies for CA measurements showed good agreement (minimum OCCC > 0.77) after offset correction. Thigh length showed higher reliability in BS while upper arm length showed higher reliability in CA. Except for these issues, reliabilities of CA measurements and their BS equivalents were comparable.

Paraspinal Transposition Flap for Reconstruction of Sacral Soft Tissue Defects: A Series of 53 Cases from a Single Institute

PubMed Central

Chattopadhyay, Debarati; Agarwal, Akhilesh Kumar; Guha, Goutam; Bhattacharya, Nirjhar; Chumbale, Pawan K; Gupta, Souradip; Murmu, Marang Buru

2014-01-01

Study Design Case series. Purpose To describe paraspinal transposition flap for coverage of sacral soft tissue defects. Overview of Literature Soft tissue defects in the sacral region pose a major challenge to the reconstructive surgeon. Goals of sacral wound reconstruction are to provide a durable skin and soft tissue cover adequate for even large sacral defects; minimize recurrence; and minimize donor site morbidity. Various musculocutaneous and fasciocutanous flaps have been described in the literature. Methods The flap was applied in 53 patients with sacral soft tissue defects of diverse etiology. Defects ranged in size from small (6 cm×5 cm) to extensive (21 cm×10 cm). The median age of the patients was 58 years (range, 16-78 years). Results There was no flap necrosis. Primary closure of donor sites was possible in all the cases. The median follow up of the patients was 33 months (range, 4-84 months). The aesthetic outcomes were acceptable. There has been no recurrence of pressure sores. Conclusions The authors conclude that paraspinal transposition flap is suitable for reconstruction of large sacral soft tissue defects with minimum morbidity and excellent long term results. PMID:24967044

What is the emotional acceptance after limb salvage with an expandable prosthesis?

PubMed

Henderson, Eric R; Pepper, Andrew M; Marulanda, German A; Millard, Justin D; Letson, G Douglas

2010-11-01

Limb preservation surgery for extremity sarcomas offers the promise of improved function and cosmesis over amputation. Application of limb salvage surgery for pediatric patients with expandable metallic endoprostheses is gaining acceptance. The few studies reporting these devices have focused on functional outcomes; one has addressed quality of life. We asked the following questions: (1) how happy are these patients; (2) how do these patients perceive their bodies; (3) do these children have difficulty with social interactions; and (4) how satisfied are patients and their parents with their outcomes? We retrospectively identified and contacted 26 living patients who underwent limb salvage with an expandable device. The Pediatric Outcomes Data Collection Instrument was administered to 15 of the 26 families. Attention was paid to the happiness domain of the Pediatric Outcomes Data Collection Instrument and specific answers within this domain were reported. Children who received limb salvage with an expandable endoprosthesis showed high emotional satisfaction with their outcome. Overall patients reported excellent perceptions of body image and physical attractiveness. Most patients reported frequent social interactions with their peers and no difficulty with making new friends. Although this study has a limited number of subjects and no control group, the data correlate with previously scores and indicate a high degree of emotional acceptance after limb salvage with an expandable endoprosthesis in a pediatric population.

Evaluating outcomes of palliative photodynamic therapy: instrument development and preliminary results

NASA Astrophysics Data System (ADS)

Goodell, Teresa T.; Bargo, Paulo R.; Jacques, Steven L.

2002-06-01

Background: Subjective measures are considered the gold standard in palliative care evaluation, but no studies have evaluated palliative photodynamic therapy (PDT) subjectively. If PDT is to be accepted as a palliative therapy for later-stage obstructing esophageal and lung cancer, evidence of its effectiveness and acceptability to patients must be made known. Study Design/Materials and Methods: This ongoing study's major aim is to evaluate subjective outcomes of PDT in patients with obstructing esophageal and lung cancer. Existing measures of health status, dysphagia and performance status were supplemented with an instrument developed to evaluate PDT symptom relief and side effect burden, the PDT Side Effects Survey (PSES). Results: PDT patients treated with porfimer sodium (Photofrin) and 630-nm light experienced reduced dysphagia grade and stable performance status for at least one month after PDT (N= 10-17), but these effects did not necessarily persist at three months. Fatigue, appetite and quality of life may be the most burdensome issues for these patients. Conclusions: Preliminary data suggest that the PSES is an acceptable and valid tool for measuring subjective outcomes of palliative PDT. This study is the first attempt to systematically evaluate subjective outcomes of palliative PDT. Multi-center outcomes research is needed to draw generalizable conclusions that will establish PDT's effectiveness in actual clinical practice and enhance the wider adoption of PDT as a cancer symptom relief modality.

Increasing the acceptance of internet-based mental health interventions in primary care patients with depressive symptoms. A randomized controlled trial.

PubMed

Ebert, D D; Berking, M; Cuijpers, P; Lehr, D; Pörtner, M; Baumeister, H

2015-05-01

Internet-based interventions (IBI) are effective in treating depression. However, uptake rates in routine care are still limited. Hence, this study aimed to (1) assess the acceptance of IBIs in primary care patients with depressive symptoms and to (2) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients' acceptance of IBIs. Primary care patients (N=128) with Minor or Major Depression were randomly assigned to an intervention (IG) or control group (CG). Patients in the IG were shown a brief informational video about IBIs before receiving a questionnaire that assessed their acceptance of IBIs and other secondary outcomes. Patients of the CG filled out the questionnaire immediately. Baseline acceptance of IBIs in the CG was high for 6.3%, moderate for 53.1% and low for 40.6% of patients. Acceptance of IBIs was significantly higher in the IG when compared to the CG (d=.71, 95%-CI:.09-2.91). Except for social influence and the general attitude towards psychological treatment, all secondary outcomes were also significantly improved (e.g. effort- (d=.40) and performance-expectancy: d=.65; knowledge about Internet interventions d=.35). Depression of the participants was only assessed using a self-report measure (PHQ-9). Primary care patients' acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video. Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs. Copyright © 2015 Elsevier B.V. All rights reserved.

Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers' Acceptance in the United States.

PubMed

Habibi, Mona F; Springer, Cary M; Spence, Marsha L; Hansen-Petrik, Melissa B; Kavanagh, Katherine F

2018-05-01

Suboptimal breastfeeding duration and exclusivity rates are a public health concern. Therefore, there is a need for identifying effective tools for use in interventions targeting specific barriers to optimal breastfeeding outcomes. Research aim: This study aimed to assess the relationship between acceptance of remote lactation consultation using videoconferencing and (a) maternal demographic factors, (b) technology acceptance subscales, (c) maternal learning style preferences, and (d) other potentially explanatory maternal factors. This was a cross-sectional, online study. English-speaking mothers of at least 18 years of age, with an infant age 4 months or younger, and who reported initiating breastfeeding were eligible to participate. Mothers were recruited from 27 randomly selected states. One hundred one mothers completed the survey, resulting in a response rate of 71%. The main outcome was acceptance of videoconferencing use for lactation consultation. No significant differences were found in acceptance by maternal demographic factors or learning style preferences. Acceptance was significantly related to perceived ease of use ( r = .680, p < .001), perceived usefulness/extrinsic motivation ( r = .774, p < .001), intrinsic motivation ( r = .689, p < .001), desire for control of privacy ( r = -.293, p < .01), and mother's perception of the infant father's/maternal partner's acceptance of videoconferencing for lactation consultation ( r = .432, p < .001). Only perceived usefulness/extrinsic motivation and maternal age remained in the final regression model ( R 2 = .616, p < .001). Although perceived usefulness/extrinsic motivation was positively associated with acceptance, maternal age was inversely related. This sample of mothers indicated general acceptance of videoconferencing for lactation consultation, with younger mothers and those perceiving it to be more useful demonstrating greater acceptance.

Behavior change communication activities improve infant and young child nutrition knowledge and practice of neighboring non-participants in a cluster-randomized trial in rural Bangladesh.

PubMed

Hoddinott, John; Ahmed, Ishita; Ahmed, Akhter; Roy, Shalini

2017-01-01

To examine the impact on infant and young child nutrition knowledge and practice of mothers who were neighbors of mothers participating in a nutrition Behavior Change Communication (BCC) intervention in rural Bangladesh. We analyzed data from 300 mothers whose neighbor participated in a nutrition BCC intervention and 600 mothers whose neighbor participated in an intervention that did not include BCC. We constructed measures capturing mothers' knowledge of infant and young child nutrition (IYCN) and measures of food consumption by children 6-24m. The effect on these outcomes of exposure to a neighbor receiving a nutrition BCC intervention was estimated using ordinary least squares and probit regressions. The study was registered with ClinicalTrials.gov (Study ID: NCT02237144). Having a neighboring mother participate in a nutrition BCC intervention increased non-participant mothers' IYCN knowledge by 0.17 SD (translating to 0.3 more correct answers). They were 14.1 percentage points more likely to feed their 6-24m children legumes and nuts; 11.6 percentage points more likely to feed these children vitamin A rich fruits and vegetables; and 10.0 percentage points more likely to feed these children eggs. Children of non-participant mothers who had a neighboring mother participate in a nutrition BCC intervention were 13.8 percentage points more likely to meet World Health Organization (WHO) guidelines for minimum diet diversity, 11.9 percentage points more likely to meet WHO guidelines for minimum acceptable diet, and 10.3 percentage points more likely to meet WHO guidelines for minimum meal frequency for children who continue to be breastfed after age 6m. Children aged 0-6m of non-participant mothers who are neighbors of mothers receiving BCC were 7.1 percentage points less likely to have ever consumed water-based liquids. Studies of nutrition BCC that do not account for information spillovers to non-participants may underestimate its benefits in terms of IYCN knowledge and practice.

Behavior change communication activities improve infant and young child nutrition knowledge and practice of neighboring non-participants in a cluster-randomized trial in rural Bangladesh

PubMed Central

Ahmed, Ishita; Ahmed, Akhter; Roy, Shalini

2017-01-01

Objective To examine the impact on infant and young child nutrition knowledge and practice of mothers who were neighbors of mothers participating in a nutrition Behavior Change Communication (BCC) intervention in rural Bangladesh. Methods We analyzed data from 300 mothers whose neighbor participated in a nutrition BCC intervention and 600 mothers whose neighbor participated in an intervention that did not include BCC. We constructed measures capturing mothers’ knowledge of infant and young child nutrition (IYCN) and measures of food consumption by children 6-24m. The effect on these outcomes of exposure to a neighbor receiving a nutrition BCC intervention was estimated using ordinary least squares and probit regressions. The study was registered with ClinicalTrials.gov (Study ID: NCT02237144). Results Having a neighboring mother participate in a nutrition BCC intervention increased non-participant mothers’ IYCN knowledge by 0.17 SD (translating to 0.3 more correct answers). They were 14.1 percentage points more likely to feed their 6-24m children legumes and nuts; 11.6 percentage points more likely to feed these children vitamin A rich fruits and vegetables; and 10.0 percentage points more likely to feed these children eggs. Children of non-participant mothers who had a neighboring mother participate in a nutrition BCC intervention were 13.8 percentage points more likely to meet World Health Organization (WHO) guidelines for minimum diet diversity, 11.9 percentage points more likely to meet WHO guidelines for minimum acceptable diet, and 10.3 percentage points more likely to meet WHO guidelines for minimum meal frequency for children who continue to be breastfed after age 6m. Children aged 0-6m of non-participant mothers who are neighbors of mothers receiving BCC were 7.1 percentage points less likely to have ever consumed water-based liquids. Conclusions Studies of nutrition BCC that do not account for information spillovers to non-participants may underestimate its benefits in terms of IYCN knowledge and practice. PMID:28636674

A psychological flexibility conceptualisation of the experience of injustice among individuals with chronic pain

PubMed Central

McCracken, Lance M; Trost, Zina

2014-01-01

Accumulating evidence suggests that the experience of injustice in patients with chronic pain is associated with poorer pain-related outcomes. Despite this evidence, a theoretical framework to understand this relationship is presently lacking. This review is the first to propose that the psychological flexibility model underlying Acceptance and Commitment Therapy (ACT) may provide a clinically useful conceptual framework to understand the association between the experience of injustice and chronic pain outcomes. A literature review was conducted to identify research and theory on the injustice experience in chronic pain, chronic pain acceptance, and ACT. Research relating injustice to chronic pain outcomes is summarised, the relevance of psychological flexibility to the injustice experience is discussed, and the subprocesses of psychological flexibility are proposed as potential mediating factors in the relationship between injustice and pain outcomes. Application of the psychological flexibility model to the experience of pain-related injustice may provide new avenues for future research and clinical interventions for patients with pain. Summary points • Emerging research links the experience of pain-related injustice to problematic pain outcomes. • A clinically relevant theoretical framework is currently lacking to guide future research and intervention on pain-related injustice. • The psychological flexibility model would suggest that the overarching process of psychological inflexibility mediates between the experience of injustice and adverse chronic pain outcomes. • Insofar as the processes of psychological inflexibility account for the association between injustice experiences and pain outcomes, methods of Acceptance and Commitment Therapy (ACT) may reduce the impact of injustice of pain outcomes. • Future research is needed to empirically test the proposed associations between the experience of pain-related injustice, psychological flexibility and pain outcomes, and whether ACT interventions mitigate the impact of pain-related injustice on pain outcomes. PMID:26516537

LPTA versus Tradeoff: Analysis of Contract Source Selection Strategies and Performance Outcomes

DTIC Science & Technology

2016-06-15

methodologies contracting professionals employ to acquire what the DOD needs. Contracting professionals may use lowest price technically acceptable...17 1. 2. Lowest Price Technically Acceptable...Acquisition Streamlining Act Government Accountability Office highest technically rated offeror independent variable lowest price technically

Does Technology Acceptance Affect E-Learning in a Non-Technology-Intensive Course?

ERIC Educational Resources Information Center

Buche, Mari W.; Davis, Larry R.; Vician, Chelley

2012-01-01

Prior research suggests that individuals' technology acceptance levels may affect their work and learning performance outcomes when activities are conducted through information technology usage. Most previous research investigating the relationship between individual attitudes towards technology and learning has been conducted in…

Assessment of swallowability and palatability of oral dosage forms in children: Report from an M-CERSI pediatric formulation workshop.

PubMed

Ternik, Robert; Liu, Fang; Bartlett, Jeremy A; Khong, Yuet Mei; Thiam Tan, David Cheng; Dixit, Trupti; Wang, Siri; Galella, Elizabeth A; Gao, Zhihui; Klein, Sandra

2018-02-05

The acceptability of pediatric pharmaceutical products to patients and their caregivers can have a profound impact on the resulting therapeutic outcome. However, existing methodology and approaches used for acceptability assessments for pediatric products is fragmented, making robust and consistent product evaluations difficult. A pediatric formulation development workshop took place in Washington, DC in June 2016 through the University of Maryland's Center of Excellence in Regulatory Science and Innovation (M-CERSI). A session at the workshop was dedicated to acceptability assessments and focused on two major elements that affect the overall acceptability of oral medicines, namely swallowability and palatability. The session started with presentations to provide an overview of literature, background and current state on swallowability and palatability assessments. Five parallel breakout discussions followed the presentations on each element, focusing on three overarching themes, risk-based approaches, methodology and product factors. This article reports the key outcomes of the workshop related to swallowability and palatability assessments. Copyright © 2017 Elsevier B.V. All rights reserved.

Air versus ground transport of the major trauma patient: a natural experiment.

PubMed

McVey, Jennifer; Petrie, David A; Tallon, John M

2010-01-01

1) To compare the outcomes of adult trauma patients transported to a level I trauma center by helicopter vs. ground ambulance. 2) To determine whether using a unique "natural experiment" design to obtain the ground comparison group will reduce potential confounders. Outcomes in adult trauma patients transported to a tertiary care trauma center by air were compared with outcomes in a group of patients who were accepted by the online medical control physician for air transport, but whose air missions were aborted for aviation reasons (weather, maintenance, out on a mission); these patients were subsequently transported by ground ambulance instead. Outcomes were also analyzed for a third ground control group composed of all other adult trauma patients transported by ground during this time period. Data were collected by retrospective database review of trauma patients transferred between July 1, 1997, and June 30, 2003. Outcomes were measured by Trauma Injury Severity Score (TRISS) analysis. Z and W scores were calculated. Three hundred ninety-seven missions were flown by LifeFlight during the study period vs. 57 in the clinical accept-aviation abort ground transport group. The mean ages, gender distributions, mechanisms of injury, and Injury Severity Scores (ISSs) were similar in the two groups. Per 100 patients transported, 5.61 more lives were saved in the air group vs. the clinical accept-aviation abort ground transport group (Z = 3.37). As per TRISS analysis, this is relative to the expected mortality seen with a similar group in the Major Trauma Outcomes Study (MTOS). The Z score for the clinical accept-aviation abort ground transport group was 0.4. The 1,195 patients in the third all-other ground control group had a higher mean age, lower mean ISS, and worse outcomes according to TRISS analysis (W = -2.02). This unique natural experiment led to better matched air vs. ground cohorts for comparison. As per TRISS analysis, air transport of the adult major trauma patient is associated with significantly improved survival as compared with ground transport.

Self-Concept of Children with Intellectual Disability in Mainstream Settings

ERIC Educational Resources Information Center

Huck, Sally; Kemp, Coral; Carter, Mark

2010-01-01

Background: Positive self-concept is an important educational outcome for individuals with disability. Method: Perceived competence and acceptance of 17 children with intellectual disability, included in mainstream classes, were assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA) and…

Parents Taking Action: A Psycho-Educational Intervention for Latino Parents of Children With Autism Spectrum Disorder.

PubMed

Magaña, Sandra; Lopez, Kristina; Machalicek, Wendy

2017-03-01

The increased prevalence of autism spectrum disorder (ASD) among Latino children, later diagnosis, limited access to bicultural specialist support, and worsened health outcomes when compared to non-Latinos points to the need for a culturally relevant parent education intervention. This pilot study examined the feasibility, acceptability, and preliminary outcomes of a culturally derived intervention, Parents Taking Action, for 19 Spanish-speaking mothers of children with ASD. This study introduces the Promotora de Salud Model of intervention delivery to the autism field. A mixed-methods design including one group pre- and posttest design and focus groups was used to evaluate the outcomes of PTA. We found that the intervention was both feasible to implement and acceptable to participants. We also found significant increases in empowerment oriented outcomes for parents between pre- and posttest suggesting that the intervention is promising. Suggestions for future research and practice are offered. © 2015 Family Process Institute.

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders

PubMed Central

Espel, Hallie M.; Goldstein, Stephanie P.; Manasse, Stephanie M.; Juarascio, Adrienne S.

2016-01-01

Purpose This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Methods Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Results Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Conclusions Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted. PMID:26511501

The development of an outcome measure for liaison mental health services.

PubMed

Guthrie, Else; Harrison, Mathew; Brown, Richard; Sandhu, Rajdeep; Trigwell, Peter; Abraham, Seri; Nawaz, Shazada; Kelsall, Peter; Thomasson, Rachel

2018-06-01

Aims and methodTo develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind-body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe). The liaison outcome measure was acceptable and easy to use. All subscales showed acceptable interrater reliability, with the exception of the mind-body subscale. Overall, the measure appears to show stability and sensitivity to change.Clinical implicationsThe measure provides a useful and robust way to determine symptomatic change in a liaison mental health setting, although the mind-body subscale requires modification.Declaration of interestNone.

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

PubMed

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

PROMIS Peer Relationships Short Form: How Well Does Self-Report Correlate With Data From Peers?

PubMed

Devine, Katie A; Willard, Victoria W; Hocking, Matthew C; Stapleton, Jerod L; Rotter, David; Bukowski, William M; Noll, Robert B

2018-05-24

To examine the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS®) peer relationships short form (PR-SF), including association with peer-reported friendships, likeability, and social reputation. 203 children (Mage = 10.12 years, SD = 2.37, range = 6-14) in Grades 1-8 completed the 8-item PR-SF and friendship nominations, like ratings, and social reputation measures about their peers during 2 classroom visits approximately 4 months apart, as part of a larger study. A confirmatory factor analysis, followed by an exploratory factor analysis, was conducted to examine the factor structure of the PR-SF. Spearman correlations between the PR-SF and peer-reported outcomes evaluated construct validity. For the PR-SF, a 2-factor solution demonstrated better fit than a 1-factor solution. The 2 factors appear to assess friendship quality (3 items) and peer acceptance (5 items). Reliability was marginal for the friendship quality factor (.66) but adequate for the acceptance factor (.85); stability was .34 for the PR-SF over 4 months. The PR-SF (8 items) and acceptance factor (5 items) both had modest but significant correlations with measures of friendship (rs = .25-.27), likeability (rs = .21-.22), and social reputation (rs = .29-.44). The PR-SF appears to be measuring two distinct aspects of social functioning. The 5-item peer acceptance scale is modestly associated with peer-reported friendship, likeability, and social reputation. Although not a replacement for peer-reported outcomes, the PR-SF is a promising patient-reported outcome for peer relationships in youth.

Children and adolescent acceptability of a new device system to administer human growth hormone--a pilot study.

PubMed

Kappelgaard, Anne-Marie; Mikkelsen, Søren; Bagger, Claus; Fuchs, Gitte Schøning

2012-01-01

Growth hormone (GH) is used to treat growth failure in children and metabolic impairments in adults with GH deficiency (GHD). Treatment requires daily subcutaneous injections that may affect treatment outcomes, and subsequently efficacy outcomes. To enhance potential adherence, improved GH delivery device systems are being developed. To compare patient acceptability and usability of Norditropin FlexPro/FlexPro PenMate with Norditropin NordiFlex/NordiFlex PenMate for GH administration in children/adolescents with GHD. A multinational, open-label, uncontrolled study. Patients (n = 50; 4-18 years) currently on GH therapy injected test medium into a foam pad. Ease-of-use and patient device preference were recorded by questionnaire. The majority (80%) of patients preferred FlexPro PenMate over NordiFlex PenMate with 96% and 84%, respectively, reporting that they found the FlexPro PenMate system user-friendly and that they were highly confident using it. The FlexPro system was well accepted by patients. This may facilitate greater adherence to treatment and improve patient outcomes.

Risk measures for power failures in transmission systems

NASA Astrophysics Data System (ADS)

Cassidy, Alex; Feinstein, Zachary; Nehorai, Arye

2016-11-01

We present a novel framework for evaluating the risk of failures in power transmission systems. We use the concept of systemic risk measures from the financial mathematics literature with models of power system failures in order to quantify the risk of the entire power system for design and comparative purposes. The proposed risk measures provide the collection of capacity vectors for the components in the system that lead to acceptable outcomes. Keys to the formulation of our measures of risk are two elements: a model of system behavior that provides the (distribution of) outcomes based on component capacities and an acceptability criterion that determines whether a (random) outcome is acceptable from an aggregated point of view. We examine the effects of altering the line capacities on energy not served under a variety of networks, flow manipulation methods, load shedding schemes, and load profiles using Monte Carlo simulations. Our results provide a quantitative comparison of the performance of these schemes, measured by the required line capacity. These results provide more complete descriptions of the risks of power failures than the previous, one-dimensional metrics.

Apparatus and method for classifying fuel pellets for nuclear reactor

DOEpatents

Wilks, Robert S.; Sternheim, Eliezer; Breakey, Gerald A.; Sturges, Jr., Robert H.; Taleff, Alexander; Castner, Raymond P.

1984-01-01

Control for the operation of a mechanical handling and gauging system for nuclear fuel pellets. The pellets are inspected for diameters, lengths, surface flaws and weights in successive stations. The control includes, a computer for commanding the operation of the system and its electronics and for storing and processing the complex data derived at the required high rate. In measuring the diameter, the computer enables the measurement of a calibration pellet, stores that calibration data and computes and stores diameter-correction factors and their addresses along a pellet. To each diameter measurement a correction factor is applied at the appropriate address. The computer commands verification that all critical parts of the system and control are set for inspection and that each pellet is positioned for inspection. During each cycle of inspection, the measurement operation proceeds normally irrespective of whether or not a pellet is present in each station. If a pellet is not positioned in a station, a measurement is recorded, but the recorded measurement indicates maloperation. In measuring diameter and length a light pattern including successive shadows of slices transverse for diameter or longitudinal for length are projected on a photodiode array. The light pattern is scanned electronically by a train of pulses. The pulses are counted during the scan of the lighted diodes. For evaluation of diameter the maximum diameter count and the number of slices for which the diameter exceeds a predetermined minimum is determined. For acceptance, the maximum must be less than a maximum level and the minimum must exceed a set number. For evaluation of length, the maximum length is determined. For acceptance, the length must be within maximum and minimum limits.

The impact of registration accuracy on imaging validation study design: A novel statistical power calculation.

PubMed

Gibson, Eli; Fenster, Aaron; Ward, Aaron D

2013-10-01

Novel imaging modalities are pushing the boundaries of what is possible in medical imaging, but their signal properties are not always well understood. The evaluation of these novel imaging modalities is critical to achieving their research and clinical potential. Image registration of novel modalities to accepted reference standard modalities is an important part of characterizing the modalities and elucidating the effect of underlying focal disease on the imaging signal. The strengths of the conclusions drawn from these analyses are limited by statistical power. Based on the observation that in this context, statistical power depends in part on uncertainty arising from registration error, we derive a power calculation formula relating registration error, number of subjects, and the minimum detectable difference between normal and pathologic regions on imaging, for an imaging validation study design that accommodates signal correlations within image regions. Monte Carlo simulations were used to evaluate the derived models and test the strength of their assumptions, showing that the model yielded predictions of the power, the number of subjects, and the minimum detectable difference of simulated experiments accurate to within a maximum error of 1% when the assumptions of the derivation were met, and characterizing sensitivities of the model to violations of the assumptions. The use of these formulae is illustrated through a calculation of the number of subjects required for a case study, modeled closely after a prostate cancer imaging validation study currently taking place at our institution. The power calculation formulae address three central questions in the design of imaging validation studies: (1) What is the maximum acceptable registration error? (2) How many subjects are needed? (3) What is the minimum detectable difference between normal and pathologic image regions? Copyright © 2013 Elsevier B.V. All rights reserved.

[Problems of implementing integration management at company level in small and medium-sized enterprises].

PubMed

Hetzel, C; Flach, T; Weber, A; Schian, H-M

2006-05-01

At company level responsibility increases for the employment of workers with health-related problems or disabilities, but realisation in small and medium-sized enterprises (SME) is lacking. Therefore a model is developed based on theory and a survey. Minimum requirements for "betriebliches Eingliederungsmanagement" (integration management at company level) according to section 84 (2) SGB IX Book 9 of the German Social Code, the main products of the international movement "disability management", a description of roles for realisation and the main sources of employers' support are described. Although external supporting of SMEs is unquestioned, it is expensive and retards own initiative and own activity counting solely on this. Only by developing a minimum of SME's awareness, acceptance and competence, this will open up to (currently suboptimal) external support. Goal is identifying SME managers' attitudes, activities, proposals and expectations referring integration management at company level to derive concepts of SME's support. 13 interviews are analysed by qualitative content analysis identifying the following barriers: information deficit, absence of priority, limited possibilities for transitional work, cost, partially limited workers' self-responsibility, illness as a "tabes" subject. Possibilities overcoming these barriers are delineated. On that basis a model is presented: pragmatically for realisation, a company contact person with minimum competence, uniform external support, institutional partners' integration and quality assurance according to disability management. Interlocking SME world and social insurance world means first to support SME's awareness, acceptance and competence, second to create for SME a central contact in the "rehabilitation jungle" and third to develop SME-suitable premiums according to section 84 (3) SGB IX, Book 9 of the German social code.

Does press-fit technique reduce tunnel volume enlargement after anterior cruciate ligament reconstruction with autologous hamstring tendons? A prospective randomized computed tomography study.

PubMed

Hwang, Dae-Hee; Shetty, Gautam M; Kim, Jong In; Kwon, Jae Ho; Song, Jae-Kwang; Muñoz, Michael; Lee, Jun Seop; Nha, Kyung-Wook

2013-01-01

The purpose of this prospective, randomized, computed tomography-based study was to investigate whether the press-fit technique reduces tunnel volume enlargement (TVE) and improves the clinical outcome after anterior cruciate ligament reconstruction at a minimum follow-up of 1 year compared with conventional technique. Sixty-nine patients undergoing primary ACL reconstruction using hamstring autografts were randomly allocated to either the press-fit technique group (group A) or conventional technique group (group B). All patients were evaluated for TVE and tunnel widening using computed tomography scanning, for functional outcome using International Knee Documentation Committee and Lysholm scores, for rotational stability using the pivot-shift test, and for anterior laxity using the KT-2000 arthrometer at a minimum of 1-year follow-up. There were no significant differences in TVE between the 2 groups. In group A, in which the press-fit technique was used, mean volume enlargement in the femoral tunnel was 65% compared with 71.5% in group B (P = .84). In group A, 57% (20 of 35) of patients developed femoral TVE compared with 67% (23 of 34) of patients in group B (P = .27). Both groups showed no significant difference for functional outcome (mean Lysholm score P = .73, International Knee Documentation Committee score P = .15), or knee laxity (anterior P = .78, rotational P = .22) at a minimum follow-up of 1 year. In a comparison of press-fit and conventional techniques, there were no significant differences in TVE and clinical outcome at short-term follow-up. Level II, therapeutic study, prospective randomized clinical trial. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Patellofemoral arthritis treated with resurfacing implant: Clinical outcome and complications at a minimum two-year follow-up.

PubMed

Zicaro, Juan Pablo; Yacuzzi, Carlos; Astoul Bonorino, Juan; Carbo, Lisandro; Costa-Paz, Matias

2017-12-01

This study evaluated the clinical and radiographic outcomes of a series of patients treated with an anatomic inlay resurfacing implant, with a minimum two-year follow-up. Fifteen patients underwent patellofemoral-resurfacing procedures using a HemiCAP Wave Patellofemoral Inlay Resurfacing implant from 2010 to 2013. Clinical outcomes included: Visual Analog Scale (VAS), Lysholm score, Knee Society Score (KSS), and evaluation of Kujala, and Hospital for Special Surgery Patellofemoral score (HSS-PF). The postoperative complications were analyzed. Nineteen knees were evaluated; the average follow-up was 35.2months. Fourteen were women, with an average age of 54years. The pre-operative/postoperative clinical results presented a significant improvement: VAS 8/2.5, Lysholm 31.9/85.8, KSS 39.8/82.5, Kujala 32.1/79.3 and Hospital for Special Surgery Patellofemoral score (HSS-PF) 15.9/90.6. A total of 87% of patients were either satisfied or very satisfied with the overall outcome. There were no radiographic signs of loosening. Seven postoperative complications were recorded: two presented ongoing knee pain, one postoperative stiffness, one patellar bounce due to maltracking, two ilio-tibial band syndrome, and one tibial anterior tuberosity osteotomy nonunion. Two patients underwent a total knee arthroplasty conversion and were considered a failure. None of these complications were implant related. Patellofemoral inlay resurfacing for isolated patellofemoral arthritis was an effective and safe procedure with high levels of patient satisfaction. No mechanical implant failure was seen at a minimum two-year follow-up. This implant design appeared to be an alternative to the traditional patellofemoral prostheses. Concomitant osteochondral lesions, patellofemoral dysplasia or patellar maltracking might be poor prognostic factors for this type of implant. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring psychological mechanisms of clinical response to an internet-delivered psychological pain management program.

PubMed

Gandy, M; Karin, E; Jones, M P; McDonald, S; Sharpe, L; Titov, N; Dear, B F

2018-05-13

The evidence for Internet-delivered pain management programs for chronic pain is growing, but there is little empirical understanding of how they effect change. Understanding mechanisms of clinical response to these programs could inform their effective development and delivery. A large sample (n = 396) from a previous randomized controlled trial of a validated internet-delivered psychological pain management program, the Pain Course, was used to examine the influence of three potential psychological mechanisms (pain acceptance, pain self-efficacy, fear of movement/re-injury) on treatment-related change in disability, depression, anxiety and average pain. Analyses involved generalized estimating equation models for clinical outcomes that adjusted for co-occurring change in psychological variables. This was paired with cross-lagged analysis to assess for evidence of causality. Analyses involved two time points, pre-treatment and post-treatment. Changes in pain-acceptance were strongly associated with changes in three (depression, anxiety and average pain) of the four clinical outcomes. Changes in self-efficacy were also strongly associated with two (anxiety and average pain) clinical outcomes. These findings suggest that participants were unlikely to improve in these clinical outcomes without also experiencing increases in their pain self-efficacy and pain acceptance. However, there was no clear evidence from cross-lagged analyses to currently support these psychological variables as direct mechanisms of clinical improvements. There was only statistical evidence to suggest higher levels of self-efficacy moderated improvements in depression. The findings suggest that, while clinical improvements are closely associated with improvements in pain acceptance and self-efficacy, these psychological variables may not drive the treatment effects observed. This study employed robust statistical techniques to assess the psychological mechanisms of an established internet-delivered pain management program. While clinical improvements (e.g. depression, anxiety, pain) were closely associated with improvements in psychological variables (e.g. pain self-efficacy and pain acceptance), these variables do not appear to be treatment mechanisms. © 2018 European Pain Federation - EFIC®.

Factors Influencing Acceptability and Perceived Impacts of a Mandatory ePortfolio Implemented by an Occupational Therapy Regulatory Organization.

PubMed

Vachon, Brigitte; Foucault, Marie-Lyse; Giguère, Charles-Édouard; Rochette, Annie; Thomas, Aliki; Morel, Martine

2018-01-01

The use of ePortfolios has been implemented in several regulatory organizations to encourage clinicians' engagement in continuing professional development (CPD). However, their use has achieved mixed success, and multiple personal and contextual factors can influence their impacts on practice change. The aim of this study was to identify which factors influence the acceptability and perceived impacts of an ePortfolio implemented by an occupational therapy regulatory organization in one Canadian province. A cross-sectional online survey design was used. The survey was sent to registered occupational therapists in Quebec. Multiple regression analyses were conducted to identify factors influencing acceptability and outcomes: ease of use, satisfaction, impact on implementation of the CPD plan, and competence improvement. The survey was fully completed by 546 participants. Factors significantly influencing the ePortfolio acceptability and perceived impacts were attitude toward and familiarity with the portfolio, confidence in reflective skills, engagement in the CPD plan, and desire for feedback. Time spent completing the ePortfolio and the fact of completing it in teams were negatively associated with the outcomes. Shaping more favorable user attitudes, helping users recognize and experience the tool's benefits for their practice, and fostering confidence in their reflective skills are important factors that can be addressed to improve ePortfolio acceptability and outcomes. Contextual factors, such as time spent completing the ePortfolio and completing it in teams, seem to reflect greater difficulty with using the tool. Study findings can contribute to improving ePortfolio implementation in the CPD context.

Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years.

PubMed

Millett, Peter J; Espinoza, Chris; Horan, Marilee P; Ho, Charles P; Warth, Ryan J; Dornan, Grant J; Christoph Katthagen, J

2017-10-01

To evaluate the outcomes of two commonly used transosseous-equivalent (TOE) arthroscopic rotator cuff repair (RCR) techniques for full-thickness supraspinatus tendon tears (FTST) using a robust multi-predictor model. 155 shoulders in 151 patients (109 men, 42 women; mean age 59 ± 10 years) who underwent arthroscopic RCR of FTST, using either a knotted suture bridging (KSB) or a knotless tape bridging (KTB) TOE technique were included. ASES and SF-12 PCS scores assessed at a minimum of 2 years postoperatively were modeled using propensity score weighting in a multiple linear regression model. Patients able to return to the study center underwent a follow-up MRI for evaluation of rotator cuff integrity. The outcome data were available for 137 shoulders (88%; n = 35/41 KSB; n = 102/114 KTB). Seven patients (5.1%) that underwent revision rotator cuff surgery were considered failures. The median postoperative ASES score of the remaining 130 shoulders was 98 at a mean follow-up of 2.9 years (range 2.0-5.4 years). A higher preoperative baseline outcome score and a longer follow-up had a positive effect, whereas a previous RCR and workers' compensation claims (WCC) had a negative effect on final ASES or SF 12 PCS scores. The repair technique, age, gender and the number of anchors used for the RCR had no significant influence. Fifty-two patients returned for a follow-up MRI at a mean of 4.4 years postoperatively. Patients with a KSB RCR were significantly more likely to have an MRI-diagnosed full-thickness rotator cuff re-tear (p < 0.05). Excellent outcomes can be achieved at a minimum of 2 years following arthroscopic KSB or KTB TOE RCR of FTST. The preoperative baseline outcome score, a prior RCR, WCC and the length of follow-up significantly influenced the outcome scores. The repair technique did not affect the final functional outcomes, but patients with KTB TOE RCR were less likely to have a full-thickness rotator cuff re-tear. Level III, Retrospective Comparative Study.

Development of Test Items Related to Selected Concepts Within the Scheme the Particle Nature of Matter.

ERIC Educational Resources Information Center

Doran, Rodney L.; Pella, Milton O.

The purpose of this study was to develop tests items with a minimum reading demand for use with pupils at grade levels two through six. An item was judged to be acceptable if the item satisfied at least four of six criteria. Approximately 250 students in grades 2-6 participated in the study. Half of the students were given instruction to develop…

Measuring Microaggression and Organizational Climate Factors in Military Units

DTIC Science & Technology

2011-04-01

i.e., items) to accurately assess what we intend for them to measure. To assess construct and convergent validity, the author assessed the statistical ...sample indicated both convergent and construct validity of the microaggression scale. Table 5 presents these statistics . Measuring Microaggressions...models. As shown in Table 7, the measurement models had acceptable fit indices. That is, the Chi-square statistics were at their minimum; although the

Space Station crew safety alternatives study. Volume 5: Space Station safety plan

NASA Technical Reports Server (NTRS)

Mead, G. H.; Peercy, R. L., Jr.; Raasch, R. F.

1985-01-01

The Space Station Safety Plan has been prepared as an adjunct to the subject contract final report, suggesting the tasks and implementation procedures to ensure that threats are addressed and resolution strategy options identified and incorporated into the space station program. The safety program's approach is to realize minimum risk exposure without levying undue design and operational constraints. Safety objectives and risk acceptances are discussed.

7 CFR 52.3755 - Minimum drained weights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Canned Ripe Olives 1 Product Description....5 64.0 1814.4 Super colossal 4.0 113.4 7.25 205.5 64.0 1814.4 Table II—Acceptance Values for Drained... 3.25 92.1 5.75 163.0 49.0 1389.1 Super colossal 3.25 92.1 5.75 163.0 49.0 1389.1 Table III...

7 CFR 52.3755 - Minimum drained weights.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Canned Ripe Olives 1 Product Description....5 64.0 1814.4 Super colossal 4.0 113.4 7.25 205.5 64.0 1814.4 Table II—Acceptance Values for Drained... 3.25 92.1 5.75 163.0 49.0 1389.1 Super colossal 3.25 92.1 5.75 163.0 49.0 1389.1 Table III...

7 CFR 52.3755 - Minimum drained weights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Canned Ripe Olives 1 Product Description....5 64.0 1814.4 Super colossal 4.0 113.4 7.25 205.5 64.0 1814.4 Table II—Acceptance Values for Drained... 3.25 92.1 5.75 163.0 49.0 1389.1 Super colossal 3.25 92.1 5.75 163.0 49.0 1389.1 Table III...

Treatment Acceptability of Interventions Published in Six School Psychology Journals

ERIC Educational Resources Information Center

Villarreal, Victor; Ponce, Christopher; Gutierrez, Heveli

2015-01-01

Treatment acceptability (TA) is critical when selecting and implementing an intervention, as TA is associated with treatment outcomes. The significance of TA is reflected in school psychology models for services that state that school psychologists should address TA during development, implementation, and evaluation of interventions. However, the…

Ambiguities and conflicting results: the limitations of the kappa statistic in establishing the interrater reliability of the Irish nursing minimum data set for mental health: a discussion paper.

PubMed

Morris, Roisin; MacNeela, Padraig; Scott, Anne; Treacy, Pearl; Hyde, Abbey; O'Brien, Julian; Lehwaldt, Daniella; Byrne, Anne; Drennan, Jonathan

2008-04-01

In a study to establish the interrater reliability of the Irish Nursing Minimum Data Set (I-NMDS) for mental health difficulties relating to the choice of reliability test statistic were encountered. The objective of this paper is to highlight the difficulties associated with testing interrater reliability for an ordinal scale using a relatively homogenous sample and the recommended kw statistic. One pair of mental health nurses completed the I-NMDS for mental health for a total of 30 clients attending a mental health day centre over a two-week period. Data was analysed using the kw and percentage agreement statistics. A total of 34 of the 38 I-NMDS for mental health variables with lower than acceptable levels of kw reliability scores achieved acceptable levels of reliability according to their percentage agreement scores. The study findings implied that, due to the homogeneity of the sample, low variability within the data resulted in the 'base rate problem' associated with the use of kw statistic. Conclusions point to the interpretation of kw in tandem with percentage agreement scores. Suggestions that kw scores were low due to chance agreement and that one should strive to use a study sample with known variability are queried.

The scavenging of volatile anesthetic agents in the cardiovascular intensive care unit environment: a technical report.

PubMed

Pickworth, Thomas; Jerath, Angela; DeVine, Rita; Kherani, Nazmin; Wąsowicz, Marcin

2013-01-01

The use of volatile-based sedation within critical care environments has been limited by difficulties of drug administration and safety concerns over environment pollution and staff exposure in an intensive care unit (ICU) with no scavenging. The aim of this study was to develop a simple scavenging system to be used with the Anesthesia Conserving Device (AnaConDa(®)) and to determine whether or not ambient concentrations of residual anesthetic are within current acceptable limits. The scavenging system consists of two Deltasorb(®) canisters attached to the ICU ventilator in series. AnaConDa is a miniature vaporizer designed to provide volatile-based sedation within an ICU. The first ten patients recruited into a larger randomized trial assessing outcomes after elective coronary graft bypass surgery were sedated within the cardiac ICU using either isoflurane or sevoflurane. Sedation was guided by the Sedation Agitation Scale, resulting in an end-tidal minimum anesthetic concentration of volatile agent ranging from 0.1-0.3. At one hour post ICU admission, infrared photometric analysis was used to assess environmental contamination at four points along the ventilator circuit and scavenging system and around the patient's head. All measurements taken within the patient's room were below 1 part per million, which satisfies criteria for occupational exposure. This study shows that volatile agents can be administered safely within critical care settings using a simple scavenging system. Our scavenging system used in conjunction with the AnaConDa device reduced the concentration of environmental contamination to a level that is acceptable to Canadian standards and standards in most Western countries and thus conforms to international safety standards. The related clinical trial was registered at www.clinicaltrials.gov (NCT01151254).

Anatomical Society core regional anatomy syllabus for undergraduate medicine: the Delphi process.

PubMed

Smith, C F; Finn, G M; Stewart, J; McHanwell, S

2016-01-01

A modified Delphi method was employed to seek consensus when revising the UK and Ireland's core syllabus for regional anatomy in undergraduate medicine. A Delphi panel was constructed involving 'expert' (individuals with at least 5 years' experience in teaching medical students anatomy at the level required for graduation). The panel (n = 39) was selected and nominated by members of Council and/or the Education Committee of the Anatomical Society and included a range of specialists including surgeons, radiologists and anatomists. The experts were asked in two stages to 'accept', 'reject' or 'modify' (first stage only) each learning outcome. A third stage, which was not part of the Delphi method, then allowed the original authors of the syllabus to make changes either to correct any anatomical errors or to make minor syntax changes. From the original syllabus of 182 learning outcomes, removing the neuroanatomy component (163), 23 learning outcomes (15%) remained unchanged, seven learning outcomes were removed and two new learning outcomes added. The remaining 133 learning outcomes were modified. All learning outcomes on the new core syllabus achieved over 90% acceptance by the panel. © 2015 Anatomical Society.

Cost-oriented evaluation of ecosystem services under consideration of income risks and risk attitudes of farmers.

PubMed

Dörschner, T; Musshoff, O

2013-09-30

Agri-environmental measures are often not as accepted among farmers as is expected. The present study investigates whether changes in income risks and the individual risk attitudes of farmers may constitute an explanatory approach for the low acceptance of the measures. For this purpose, a normative model is developed that calculates the premia claimed by the farmers for adopting environmental measures under the consideration of income risks and different risk attitudes. We apply this model to environmental measures aiming at an increase of the faunistic diversity of species on grassland and showing that changes in income risks and the decision makers' risk attitudes can significantly influence farmers' minimum compensation claims. Copyright © 2013 Elsevier Ltd. All rights reserved.

The research subject as wage earner.

PubMed

Anderson, James A; Weijer, Charles

2002-01-01

The practice of paying research subjects for participating in clinical trials has yet to receive an adequate moral analysis. Dickert and Grady argue for a wage payment model in which research subjects are paid an hourly wage based on that of unskilled laborers. If we accept this approach, what follows? Norms for just working conditions emerge from workplace legislation and political theory. All workers, including paid research subjects under Dickert and Grady's analysis, have a right to at least minimum wage, a standard work week, extra pay for overtime hours, a safe workplace, no fault compensation for work-related injury, and union organization. If we accept that paid research subjects are wage earners like any other, then the implications for changes to current practice are substantial.

System design of the Pioneer Venus spacecraft. Volume 7: Communication subsystem studies

NASA Technical Reports Server (NTRS)

Newlands, D. M.

1973-01-01

Communications subsystem tradeoffs were undertaken to establish a low cost and low weight design consistent with the mission requirements. Because of the weight constraint of the Thor/Delta launched configuration, minimum weight was emphasized in determining the Thor/Delta design. In contrast, because of the greatly relaxed weight constraint of the Atlas/Centaur launched configuration, minimum cost and off the shelf hardware were emphasized and the attendant weight penalities accepted. Communication subsystem hardware elements identified for study included probe and bus antennas (CM-6, CM-17), power amplifiers (CM-10), and the large probe transponder and small probe stable oscillator required for doppler tracking (CM-11, CM-16). In addition, particular hardware problems associated with the probe high temperature and high-g environment were investigated (CM-7).

Compliance with minimum information guidelines in public metabolomics repositories

PubMed Central

Spicer, Rachel A.; Salek, Reza; Steinbeck, Christoph

2017-01-01

The Metabolomics Standards Initiative (MSI) guidelines were first published in 2007. These guidelines provided reporting standards for all stages of metabolomics analysis: experimental design, biological context, chemical analysis and data processing. Since 2012, a series of public metabolomics databases and repositories, which accept the deposition of metabolomic datasets, have arisen. In this study, the compliance of 399 public data sets, from four major metabolomics data repositories, to the biological context MSI reporting standards was evaluated. None of the reporting standards were complied with in every publicly available study, although adherence rates varied greatly, from 0 to 97%. The plant minimum reporting standards were the most complied with and the microbial and in vitro were the least. Our results indicate the need for reassessment and revision of the existing MSI reporting standards. PMID:28949328

Compliance with minimum information guidelines in public metabolomics repositories.

PubMed

Spicer, Rachel A; Salek, Reza; Steinbeck, Christoph

2017-09-26

The Metabolomics Standards Initiative (MSI) guidelines were first published in 2007. These guidelines provided reporting standards for all stages of metabolomics analysis: experimental design, biological context, chemical analysis and data processing. Since 2012, a series of public metabolomics databases and repositories, which accept the deposition of metabolomic datasets, have arisen. In this study, the compliance of 399 public data sets, from four major metabolomics data repositories, to the biological context MSI reporting standards was evaluated. None of the reporting standards were complied with in every publicly available study, although adherence rates varied greatly, from 0 to 97%. The plant minimum reporting standards were the most complied with and the microbial and in vitro were the least. Our results indicate the need for reassessment and revision of the existing MSI reporting standards.

The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer.

PubMed

Waters, Aoife Mi; Tudur Smith, Catrin; Young, Bridget; Jones, Terry M

2014-05-13

The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be 'cherry-picked', such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent implementation in oropharyngeal cancer clinical trials will improve the quality and relevance of research. This study is registered at the National Institute for Health Research (NIHR) Clinical Research Network (CRN) portfolio, ID 13823 (17 January 2013).

The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer

PubMed Central

2014-01-01

Background The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be ‘cherry-picked’, such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. Methods/Design This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. Discussion A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent implementation in oropharyngeal cancer clinical trials will improve the quality and relevance of research. Trials and registration This study is registered at the National Institute for Health Research (NIHR) Clinical Research Network (CRN) portfolio, ID 13823 (17 January 2013). PMID:24885068

Group acceptance and commitment therapy (ACT) for bipolar disorder and co-existing anxiety - an open pilot study.

PubMed

Pankowski, Sara; Adler, Mats; Andersson, Gerhard; Lindefors, Nils; Svanborg, Cecilia

2017-03-01

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen's d between 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted.

Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention.

PubMed

Mustanski, Brian; Greene, George J; Ryan, Daniel; Whitton, Sarah W

2015-01-01

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.

Blood pressure levels post mechanical thrombectomy and outcomes in non-recanalized large vessel occlusion patients.

PubMed

Goyal, Nitin; Tsivgoulis, Georgios; Pandhi, Abhi; Dillard, Kira; Alsbrook, Diana; Chang, Jason J; Krishnaiah, Balaji; Nickele, Christopher; Hoit, Daniel; Alsherbini, Khalid; Alexandrov, Andrei V; Arthur, Adam S; Elijovich, Lucas

2018-01-11

Permissive hypertension may benefit patients with non-recanalized large vessel occlusion (nrLVO) post mechanical thrombectomy (MT) by maintaining brain perfusion. Data evaluating the impact of post-MT blood pressure (BP) levels on outcomes in nrLVO patients are scarce. We investigated the association of the post-MT BP course with safety and efficacy outcomes in nrLVO. Hourly systolic BP (SBP) and diastolic BP (DBP) values were prospectively recorded for 24 hours following MT in consecutive nrLVO patients. Maximum, minimum, and mean BP levels were documented. Three-month functional independence (FI) was defined as modified Rankin Scale (mRS) scores of 0-2. A total of 88 nrLVO patients were evaluated post MT. Patients with FI had lower maximum SBP (160±19 mmHg vs 179±23 mmHg; P=0.001) and higher minimum SBP levels (119±12 mmHg vs 108±25 mmHg; P=0.008). Maximum SBP (183±20 mmHg vs 169±23 mmHg; P=0.008) and DBP levels (105±20 mmHg vs 89±18 mmHg; P=0.001) were higher in patients who died at 3 months while minimum SBP values were lower (102±28 mmHg vs 115±16 mmHg; P=0.007). On multivariable analyses, both maximum SBP (OR per 10 mmHg increase: 0.55, 95% CI 0.39 to 0.79; P=0.001) and minimum SBP (OR per 10 mmHg increase: 1.64, 95% CI 1.04 to 2.60; P=0.033) levels were independently associated with the odds of FI. Maximum DBP (OR per 10 mmHg increase: 1.61; 95% CI 1.10 to 2.36; P=0.014) and minimum SBP (OR per 10 mmHg increase: 0.65, 95% CI 0.47 to 0.90; P=0.009) values were independent predictors of 3-month mortality. Our study demonstrates that wide BP excursions from the mean during the first 24 hours post MT are associated with worse outcomes in patients with nrLVO. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables.

PubMed

Rafiei, Sima; Pourreza, Abolghasem

2013-06-01

Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities.

Shoulder Arthroplasty for Sequelae of Obstetrical Brachial Plexus Injury.

PubMed

Werthel, Jean-David; Schoch, Bradley; Frankle, Mark; Cofield, Robert; Elhassan, Bassem T

2018-03-29

Shoulder arthroplasty following obstetrical brachial plexus injury (OBPI) is technically challenging because glenoid morphology, muscle balance, and humeral version are substantially altered compared with the neurologically intact shoulder. The purpose of this study is to report the outcome of shoulder arthroplasty in a group of patients with end-stage arthritis secondary to OBPI. Seven patients with OBPI and secondary glenohumeral arthritis were treated with shoulder arthroplasty between 1976 and 2014. Two underwent hemiarthroplasty (HA), 2 underwent total shoulder arthroplasty (TSA), and 3 underwent reverse shoulder arthroplasty (RSA). One HA was lost to follow-up and was excluded. The remaining 6 patients (mean age, 62.5 years old at the time of surgery) were followed for a minimum of 2 years (mean, 7.5 years; range, 2-13 years) Outcome measures included pain, range of motion, and postoperative modified Neer ratings. Pain improved in all shoulders. Mean forward flexion was unchanged. No shoulders treated with HA/TSA regained forward elevation above 90°, compared with 1 out of the 3 RSAs. External rotation improved from a mean of -10° to 20°. Active internal rotation decreased from L1 to L5. Immediate postoperative radiographs showed either severe posterior or posterosuperior subluxation in all 3 patients treated with nonconstrained implants. Shoulder arthroplasty is an acceptable option to relieve pain in patients with symptomatic shoulder arthritis as a sequel of OBPI. However, range of motion improvements are not expected. Therapeutic V. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Feasibility and Efficacy of the Nintendo Wii Gaming System to Improve Balance Performance Post-Stroke: Protocol of a Phase II Randomized Controlled Trial in an Inpatient Rehabilitation Setting.

PubMed

Bower, Kelly J; Clark, Ross A; McGinley, Jennifer L; Martin, Clarissa L; Miller, Kimberly J

2013-04-01

Balance deficits following stroke are common and debilitating. Commercially available gaming systems, such as the Nintendo(®) (Kyoto, Japan) Wii™, have been widely adopted clinically; however, there is limited evidence supporting their feasibility and efficacy for improving balance performance following stroke. The aim of this trial is to investigate the clinical feasibility and efficacy of using the Nintendo Wii gaming system as an adjunct to standard care to improve balance performance following stroke in an inpatient rehabilitation setting. Thirty participants undergoing inpatient stroke rehabilitation will be recruited into this Phase II, single-blind, randomized controlled trial. Participants will be allocated into a Balance or Upper Limb Group, and both groups will perform activities using the Nintendo Wii in addition to their standard care. Participants will attend three 45-minute sessions per week, for a minimum of 2 and a maximum of 4 weeks. The main focus of the study is to investigate the feasibility of the intervention protocol. This will be evaluated through recruitment, retention, adherence, acceptability, and safety. The Step Test and Functional Reach Test will be the primary efficacy outcomes. Secondary outcomes will include force platform, mobility, and upper limb measures. Assessments will occur at baseline, 2 weeks, and 4 weeks after study entry. To the authors' knowledge, this will be the largest randomized clinical trial to investigate the feasibility and efficacy of the Nintendo Wii gaming system for improving balance performance in a stroke population. The results will inform the design of a Phase III multicenter trial.

Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues

PubMed Central

Zbroszczyk, Miłosz; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Baron, Jan; Bażowski, Piotr; Kwiek, Stanisław

2016-01-01

Objective We report our experience with endovascular coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes and periprocedural complications. Materials and methods The analysis included treatment results of 28 patients with ruptured and unruptured aneurysms. The aneurysm size ranged from 1.8 to 9.8 mm (mean 5.2, SD 1.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of six months. Results Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 27 (96%) cases and incomplete occlusion in one (4%) case. Imaging follow-up, performed in 15 (53.6%) patients, showed no change in the degree of occlusion in 11 (73%), coil compaction in one (7%) and progressive occlusion in three (20%) patients. Three (20%) patients underwent a second coil embolization. The procedure-related severe morbidity and mortality rate was 6.4% (2/31). Coil prolapse was present in one (3.2%) case and intraprocedural aneurysm rupture in three (9.6%) cases. The clinical follow-up evaluation achieved in 19 (67.9%) patients showed no change in 17 (89.5%) patients and improvement in two (10.5%) patients. Conclusions Although the efficacy of coil embolization of anterior communicating artery aneurysms is unquestionable and the procedure-related complications are acceptable, they should not be neglected. Further investigations are needed to better understand protective factors, as well as to establish unequivocally appropriate management strategy of these complications. PMID:27531863

Long-term outcome of primary endoscopic realignment for bulbous urethral injuries: risk factors of urethral stricture.

PubMed

Seo, Ill Young; Lee, Jea Whan; Park, Seung Chol; Rim, Joung Sik

2012-12-01

Although endoscopic realignment has been accepted as a standard treatment for urethral injuries, the long-term follow-up data on this procedure are not sufficient. We report the long-term outcome of primary endoscopic realignment in bulbous urethral injuries. Patients with bulbous urethral injuries were treated by primary endoscopic realignment between 1991 and 2005. The operative procedure included suprapubic cystostomy and transurethral catheterization using a guide wire, within 72 hours of injury. The study population included 51 patients with a minimum follow-up duration of 5 years. The most common causes of the injuries were straddle injury from falling down (74.5%), and pelvic bone fracture (7.8%). Gross hematuria was the most common complaint (92.2%). Twenty-three patients (45.1%) had complete urethral injuries. The mean time to operation after the injury was 38.8±43.2 hours. The mean operation time and mean indwelling time of a urethral Foley catheter were 55.5±37.6 minutes and 22.0±11.9 days, respectively. Twenty out of 51 patients (39.2%) were diagnosed with urethral stricture in 89.1±36.6 months after surgery. A multivariate analysis revealed that young age and operation time were independent risk factors for strictures as a complication of urethral realignment (hazard ratio [HR], 6.554, P=0.032; HR, 6.206, P=0.035). Urethral stricture commonly developed as a postoperative complication of primary endoscopic urethral realignment for bulbous urethral injury, especially in young age and long operation time.

Outcome Measures Used in Clinical Trials for Behçet Syndrome: A Systematic Review

PubMed Central

Hatemi, Gulen; Merkel, Peter A.; Hamuryudan, Vedat; Boers, Maarten; Direskeneli, Haner; Aydin, Sibel Z.; Yazici, Hasan

2015-01-01

Behçet syndrome (BS) is a multisystem vasculitis that is most active during young adulthood, causing serious disability and significant impairment in quality of life. Differences in the disease course, severity, and organ involvement between patients, depending on the age at presentation and sex, makes it impossible to determine a single management strategy. The diversity and variability in the outcome measures used in clinical trials in BS makes it difficult to compare the results or inform physicians about the best management strategy for individual patients. There is a large unmet need to determine or develop validated outcome measures for use in clinical trials in BS that are acceptable to researchers and regulatory agencies. We conducted a systematic review to describe the outcomes and outcome measures that have been used in clinical trials in BS. This review revealed the diversity and variability in the outcomes and outcome measures and the lack of standard definitions for most outcomes and rarity of validated outcome tools for disease assessment in BS. This systematic literature review will identify domains and candidate instruments for use in a Delphi exercise, the next step in the development of a core set of outcome measures that are properly validated and widely accepted by the collaboration of researchers from many different regions of the world and from different specialties, including rheumatology, ophthalmology, dermatology, gastroenterology, and neurology. PMID:24488418

Outcome measures used in clinical trials for Behçet syndrome: a systematic review.

PubMed

Hatemi, Gulen; Merkel, Peter A; Hamuryudan, Vedat; Boers, Maarten; Direskeneli, Haner; Aydin, Sibel Z; Yazici, Hasan

2014-03-01

Behçet syndrome (BS) is a multisystem vasculitis that is most active during young adulthood, causing serious disability and significant impairment in quality of life. Differences in the disease course, severity, and organ involvement between patients, depending on the age at presentation and sex, makes it impossible to determine a single management strategy. The diversity and variability in the outcome measures used in clinical trials in BS makes it difficult to compare the results or inform physicians about the best management strategy for individual patients. There is a large unmet need to determine or develop validated outcome measures for use in clinical trials in BS that are acceptable to researchers and regulatory agencies. We conducted a systematic review to describe the outcomes and outcome measures that have been used in clinical trials in BS. This review revealed the diversity and variability in the outcomes and outcome measures and the lack of standard definitions for most outcomes and rarity of validated outcome tools for disease assessment in BS. This systematic literature review will identify domains and candidate instruments for use in a Delphi exercise, the next step in the development of a core set of outcome measures that are properly validated and widely accepted by the collaboration of researchers from many different regions of the world and from different specialties, including rheumatology, ophthalmology, dermatology, gastroenterology, and neurology.

Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era.

PubMed

Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L

2016-01-01

There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

Altering impulsive decision making with an acceptance-based procedure.

PubMed

Morrison, Kate L; Madden, Gregory J; Odum, Amy L; Friedel, Jonathan E; Twohig, Michael P

2014-09-01

Delay discounting is one facet of impulsive decision making and involves subjectively devaluing a delayed outcome. Steeply discounting delayed rewards is correlated with substance abuse and other problematic behaviors. To the extent that steep delay discounting underlies these clinical disorders, it would be advantageous to find psychosocial avenues for reducing delay discounting. Acceptance-based interventions may prove useful as they may help to decrease the distress that arises while waiting for a delayed outcome. The current study was conducted to determine if a 60-90 minute acceptance-based training would change delay discounting rates among 30 undergraduate university students in comparison to a waitlist control. Measures given at pre- and posttraining included a hypothetical monetary delay discounting task, the Acceptance and Action Questionnaire-II (AAQ-II), and the Distress Tolerance Scale. Those assigned to the treatment group decreased their discounting of delayed money, but not distress intolerance or psychological inflexibility when compared to the waitlist control group. After the waiting period, the control group received the intervention. Combining all participants' pre- to posttreatment data, the acceptance-based treatment significantly decreased discounting of monetary rewards and increased distress tolerance. The difference in AAQ-II approached significance. Acceptance-based treatments may be a worthwhile option for decreasing delay discounting rates and, consequently, affecting the choices that underlie addiction and other problematic behaviors. Copyright © 2014. Published by Elsevier Ltd.

Comparison of the complementary feeding practices between mothers with twins and mothers with singletons.

PubMed

Bentil, Helena Joycelyn; Steiner-Asiedu, Matilda; Lartey, Anna

2016-01-01

Several studies have been done on infant feeding practices but few have focused on twins. The aim of this study was to compare the complementary feeding practices between mothers with twins and mothers with singletons. Mother-infant pairs (50 mother-twin pairs and 50 mother-singleton pairs) with children aged 6 to 23 months were recruited from two public health clinics and communities in Tema and Ashaiman. Information was collected on the background characteristics of the mothers. Recumbent length and weight of the children were measured. Dietary information on the infants was collected using 24 hour recall. The differences between two groups were tested using independent t-student test for continuous variables and chi-square test for categorical variables. The minimum dietary diversity (4+ food groups) was met by only 32% of the twins and 40% of the singletons, and 28% of the twins and 38% of the singletons met the requirement for minimum acceptable diet (minimum dietary diversity and the minimum meal frequency). Minimum meal frequency was met by 78% of the twins and 76% of the singletons. There were no significant differences between the two groups of infants. Prevalence of undernutrition was not significantly different among the two groups (twins versus singletons: underweight-26% versus 24%, stunting-20% versus 24% and wasting-14% versus 10%. Complementary feeding practices were suboptimal in both groups of mothers requiring interventions to improve infant feeding practices.

Impact of individual clinical outcomes on trial participants' perspectives on enrollment in emergency research without consent.

PubMed

Whitesides, Louisa W; Baren, Jill M; Biros, Michelle H; Fleischman, Ross J; Govindarajan, Prasanthi R; Jones, Elizabeth B; Pancioli, Arthur M; Pentz, Rebecca D; Scicluna, Victoria M; Wright, David W; Dickert, Neal W

2017-04-01

Evidence suggests that patients are generally accepting of their enrollment in trials for emergency care conducted under exception from informed consent. It is unknown whether individuals with more severe initial injuries or worse clinical outcomes have different perspectives. Determining whether these differences exist may help to structure post-enrollment interactions. Primary clinical data from the Progesterone for the Treatment of Traumatic Brain Injury trial were matched to interview data from the Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study. Answers to three key questions from Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study were analyzed in the context of enrolled patients' initial injury severity (initial Glasgow Coma Scale and Injury Severity Score) and principal clinical outcomes (Extended Glasgow Outcome Scale and Extended Glasgow Outcome Scale relative to initial injury severity). The three key questions from Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study addressed participants' general attitude toward inclusion in the Progesterone for the Treatment of Traumatic Brain Injury trial (general trial inclusion), their specific attitude toward being included in Progesterone for the Treatment of Traumatic Brain Injury trial under the exception from informed consent (personal exception from informed consent enrollment), and their attitude toward the use of exception from informed consent in the Progesterone for the Treatment of Traumatic Brain Injury trial in general (general exception from informed consent enrollment). Qualitative analysis of interview transcripts was performed to provide contextualization and to determine the extent to which respondents framed their attitudes in terms of clinical experience. Clinical data from Progesterone for the Treatment of Traumatic Brain Injury trial were available for all 74 patients represented in the Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study (including 46 patients for whom the surrogate was interviewed due to the patient's cognitive status or death). No significant difference was observed regarding acceptance of general trial inclusion or acceptance of general exception from informed consent enrollment between participants with favorable neurological outcomes and those with unfavorable outcomes relative to initial injury. Agreement with personal enrollment in Progesterone for the Treatment of Traumatic Brain Injury trial under exception from informed consent, however, was significantly higher among participants with favorable outcomes compared to those with unfavorable outcomes (89% vs 59%, p = 0.003). There was also a statistically significant relationship between more severe initial injury and increased acceptance of personal exception from informed consent enrollment ( p = 0.040) or general exception from informed consent use ( p = 0.034) in Progesterone for the Treatment of Traumatic Brain Injury trial. Many individuals referenced personal experience as a basis for their attitudes, but these references were not used to support negative views. Patients and surrogates of patients with unfavorable clinical outcomes were somewhat less accepting of their own inclusion in the Progesterone for the Treatment of Traumatic Brain Injury trial under exception from informed consent than were patients or surrogates of patients with favorable clinical outcomes. These findings suggest a need to identify optimal strategies for communicating with patients and their surrogates regarding exception from informed consent enrollment when clinical outcomes are poor.

Development of cookies made with cocoyam, fermented sorghum and germinated pigeon pea flour blends using response surface methodology.

PubMed

Okpala, Laura C; Okoli, Eric C

2014-10-01

Cookies were produced from blends of cocoyam, fermented sorghum and germinated pigeon pea flours. The study was carried out to evaluate the effects of varying the proportions of these components on the sensory and protein quality of the cookies. The sensory attributes studied were colour, taste, texture, crispness and general acceptability while the protein quality indices were biological value (BV) and net protein utilization (NPU). Mixture response surface methodology was used to model the sensory and protein quality with single, binary and ternary combinations of germinated pigeon pea, fermented sorghum and cocoyam flours. Results showed that BV and NPU of most of the cookies were above minimum acceptable levels. With the exception of cookies containing high levels of pigeon pea flour, cookies had acceptable sensory scores. Increase in pigeon pea flour resulted in increase in the BV and NPU. Regression equations suggested that the ternary blends produced the highest increase in all the sensory attributes (with the exception of colour).

Development of an International Prostate Cancer Outcomes Registry.

PubMed

Evans, Sue M; Nag, Nupur; Roder, David; Brooks, Andrew; Millar, Jeremy L; Moretti, Kim L; Pryor, David; Skala, Marketa; McNeil, John J

2016-04-01

To establish a Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ) for monitoring outcomes of prostate cancer treatment and care, in a cost-effective manner. Stakeholders were recruited based on their interest, importance in achieving the monitoring and reporting of clinical practice and patient outcomes, and in amalgamation of existing registries. Each participating jurisdiction is responsible for local governance, site recruitment, data collection, and data transfer into the PCOR-ANZ. To establish each local registry, hospitals and clinicians within a jurisdiction were approached to voluntarily contribute to the registry following relevant ethical approval. Patient contact occurs following notification of prostate cancer through a hospital or pathology report, or from a cancer registry. Patient registration is based on an opt-out model. The PCOR-ANZ is a secure web-based registry adhering to ISO 27001 standards. Based on a standardised minimum data set, information on demographics, diagnosis, treatment, outcomes, and patient reported quality of life, are collected. Eight of nine jurisdictions have agreed to contribute to the PCOR-ANZ. Each jurisdiction has commenced implementation of necessary infrastructure to support rapid rollout. PCOR-ANZ has defined a minimum data set for collection, to enable analysis of key quality indicators that will aid in assessing clinical practice and patient focused outcomes. PCOR-ANZ will provide a useful resource of risk-adjusted evidence-based data to clinicians, hospitals, and decision makers on prostate cancer clinical practice. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Cassini RTG acceptance test results and RTG performance on Galileo and Ulysses

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

Kelly, C.E.; Klee, P.M.

Flight acceptance testing has been completed for the RTGs to be used on the Cassini spacecraft which is scheduled for an October 6, 1997 launch to Saturn. The acceptance test program includes vibration tests, magnetic field measurements, mass properties (weight and c.g.) and thermal vacuum test. This paper presents the thermal vacuum test results. Three RTGs are to be used, F-2, F-6, and F-7. F-5 is the backup RTG, as it was for the Galileo and Ulysses missions launched in 1989 and 1990, respectively. RTG performance measured during the thermal vacuum tests carried out at the Mound Laboratory facility metmore » all specification requirements. Beginning of mission (BOM) and end of mission (EOM) power predictions have been made based on these tests results. BOM power is predicted to be 888 watts compared to the minimum requirement of 826 watts. Degradation models predict the EOM power after 16 years is to be 640 watts compared to a minimum requirement of 596 watts. Results of small scale module tests are also shown. The modules contain couples from the qualification and flight production runs. The tests have exceeded 28,000 hours (3.2 years) and are continuing to provide increased confidence in the predicted long term performance of the Cassini RTGs. All test results indicate that the power requirements of the Cassini spacecraft will be met. BOM and EOM power margins of over 5% are predicted. Power output from telemetry for the two Galileo RTGs are shown from the 1989 launch to the recent Jupiter encounter. Comparisons of predicted, measured and required performance are shown. Telemetry data are also shown for the RTG on the Ulysses spacecraft which completed its planned mission in 1995 and is now in the extended mission.« less

Cassini RTG acceptance test results and RTG performance on Galileo and Ulysses

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

Kelly, C.E.; Klee, P.M.

Flight acceptance testing has been completed for the RTGs to be used on the Cassini spacecraft which is scheduled for an October 6, 1997 launch to Saturn. The acceptance test program includes vibration tests, magnetic field measurements, properties (weight and c.g.) and thermal vacuum test. This paper presents The thermal vacuum test results. Three RTGs are to be used, F-2, F-6, and F-7. F-5 is tile back-up RTG, as it was for the Galileo and Ulysses missions launched in 1989 and 1990, respectively. RTG performance measured during the thermal vacuum tests carried out at die Mound Laboratory facility met allmore » specification requirements. Beginning of mission (BOM) and end of mission (EOM) power predictions have been made based on than tests results. BOM power is predicted to be 888 watts compared to the minimum requirement of 826 watts. Degradation models predict the EOM power after 16 years is to be 640 watts compared to a minimum requirement of 596 watts. Results of small scale module tests are also showing. The modules contain couples from the qualification and flight production runs. The tests have exceeded 28,000 hours (3.2 years) and are continuing to provide increased confidence in the predicted long term performance of the Cassini RTGs. All test results indicate that the power requirements of the Cassini spacecraft will be met. BOM and EOM power margins of over five percent are predicted. Power output from telemetry for the two Galileo RTGs are shown from the 1989 launch to the recent Jupiter encounter. Comparisons of predicted, measured and required performance are shown. Telemetry data are also shown for the RTG on the Ulysses spacecraft which completed its planned mission in 1995 and is now in the extended mission.« less

Space Radiation Risks for Astronauts on Multiple International Space Station Missions

PubMed Central

Cucinotta, Francis A.

2014-01-01

Mortality and morbidity risks from space radiation exposure are an important concern for astronauts participating in International Space Station (ISS) missions. NASA’s radiation limits set a 3% cancer fatality probability as the upper bound of acceptable risk and considers uncertainties in risk predictions using the upper 95% confidence level (CL) of the assessment. In addition to risk limitation, an important question arises as to the likelihood of a causal association between a crew-members’ radiation exposure in the past and a diagnosis of cancer. For the first time, we report on predictions of age and sex specific cancer risks, expected years of life-loss for specific diseases, and probability of causation (PC) at different post-mission times for participants in 1-year or multiple ISS missions. Risk projections with uncertainty estimates are within NASA acceptable radiation standards for mission lengths of 1-year or less for likely crew demographics. However, for solar minimum conditions upper 95% CL exceed 3% risk of exposure induced death (REID) by 18 months or 24 months for females and males, respectively. Median PC and upper 95%-confidence intervals are found to exceed 50% for several cancers for participation in two or more ISS missions of 18 months or longer total duration near solar minimum, or for longer ISS missions at other phases of the solar cycle. However, current risk models only consider estimates of quantitative differences between high and low linear energy transfer (LET) radiation. We also make predictions of risk and uncertainties that would result from an increase in tumor lethality for highly ionizing radiation reported in animal studies, and the additional risks from circulatory diseases. These additional concerns could further reduce the maximum duration of ISS missions within acceptable risk levels, and will require new knowledge to properly evaluate. PMID:24759903

Spacecraft Parachute Recovery System Testing from a Failure Rate Perspective

NASA Technical Reports Server (NTRS)

Stewart, Christine E.

2013-01-01

Spacecraft parachute recovery systems, especially those with a parachute cluster, require testing to identify and reduce failures. This is especially important when the spacecraft in question is human-rated. Due to the recent effort to make spaceflight affordable, the importance of determining a minimum requirement for testing has increased. The number of tests required to achieve a mature design, with a relatively constant failure rate, can be estimated from a review of previous complex spacecraft recovery systems. Examination of the Apollo parachute testing and the Shuttle Solid Rocket Booster recovery chute system operation will clarify at which point in those programs the system reached maturity. This examination will also clarify the risks inherent in not performing a sufficient number of tests prior to operation with humans on-board. When looking at complex parachute systems used in spaceflight landing systems, a pattern begins to emerge regarding the need for a minimum amount of testing required to wring out the failure modes and reduce the failure rate of the parachute system to an acceptable level for human spaceflight. Not only a sufficient number of system level testing, but also the ability to update the design as failure modes are found is required to drive the failure rate of the system down to an acceptable level. In addition, sufficient data and images are necessary to identify incipient failure modes or to identify failure causes when a system failure occurs. In order to demonstrate the need for sufficient system level testing prior to an acceptable failure rate, the Apollo Earth Landing System (ELS) test program and the Shuttle Solid Rocket Booster Recovery System failure history will be examined, as well as some experiences in the Orion Capsule Parachute Assembly System will be noted.

Optimizing probability of detection point estimate demonstration

NASA Astrophysics Data System (ADS)

Koshti, Ajay M.

2017-04-01

The paper provides discussion on optimizing probability of detection (POD) demonstration experiments using point estimate method. The optimization is performed to provide acceptable value for probability of passing demonstration (PPD) and achieving acceptable value for probability of false (POF) calls while keeping the flaw sizes in the set as small as possible. POD Point estimate method is used by NASA for qualifying special NDE procedures. The point estimate method uses binomial distribution for probability density. Normally, a set of 29 flaws of same size within some tolerance are used in the demonstration. Traditionally largest flaw size in the set is considered to be a conservative estimate of the flaw size with minimum 90% probability and 95% confidence. The flaw size is denoted as α90/95PE. The paper investigates relationship between range of flaw sizes in relation to α90, i.e. 90% probability flaw size, to provide a desired PPD. The range of flaw sizes is expressed as a proportion of the standard deviation of the probability density distribution. Difference between median or average of the 29 flaws and α90 is also expressed as a proportion of standard deviation of the probability density distribution. In general, it is concluded that, if probability of detection increases with flaw size, average of 29 flaw sizes would always be larger than or equal to α90 and is an acceptable measure of α90/95PE. If NDE technique has sufficient sensitivity and signal-to-noise ratio, then the 29 flaw-set can be optimized to meet requirements of minimum required PPD, maximum allowable POF, requirements on flaw size tolerance about mean flaw size and flaw size detectability requirements. The paper provides procedure for optimizing flaw sizes in the point estimate demonstration flaw-set.

Space radiation risks for astronauts on multiple International Space Station missions.

PubMed

Cucinotta, Francis A

2014-01-01

Mortality and morbidity risks from space radiation exposure are an important concern for astronauts participating in International Space Station (ISS) missions. NASA's radiation limits set a 3% cancer fatality probability as the upper bound of acceptable risk and considers uncertainties in risk predictions using the upper 95% confidence level (CL) of the assessment. In addition to risk limitation, an important question arises as to the likelihood of a causal association between a crew-members' radiation exposure in the past and a diagnosis of cancer. For the first time, we report on predictions of age and sex specific cancer risks, expected years of life-loss for specific diseases, and probability of causation (PC) at different post-mission times for participants in 1-year or multiple ISS missions. Risk projections with uncertainty estimates are within NASA acceptable radiation standards for mission lengths of 1-year or less for likely crew demographics. However, for solar minimum conditions upper 95% CL exceed 3% risk of exposure induced death (REID) by 18 months or 24 months for females and males, respectively. Median PC and upper 95%-confidence intervals are found to exceed 50% for several cancers for participation in two or more ISS missions of 18 months or longer total duration near solar minimum, or for longer ISS missions at other phases of the solar cycle. However, current risk models only consider estimates of quantitative differences between high and low linear energy transfer (LET) radiation. We also make predictions of risk and uncertainties that would result from an increase in tumor lethality for highly ionizing radiation reported in animal studies, and the additional risks from circulatory diseases. These additional concerns could further reduce the maximum duration of ISS missions within acceptable risk levels, and will require new knowledge to properly evaluate.

Technical note: Alternatives to reduce adipose tissue sampling bias.

PubMed

Cruz, G D; Wang, Y; Fadel, J G

2014-10-01

Understanding the mechanisms by which nutritional and pharmaceutical factors can manipulate adipose tissue growth and development in production animals has direct and indirect effects in the profitability of an enterprise. Adipocyte cellularity (number and size) is a key biological response that is commonly measured in animal science research. The variability and sampling of adipocyte cellularity within a muscle has been addressed in previous studies, but no attempt to critically investigate these issues has been proposed in the literature. The present study evaluated 2 sampling techniques (random and systematic) in an attempt to minimize sampling bias and to determine the minimum number of samples from 1 to 15 needed to represent the overall adipose tissue in the muscle. Both sampling procedures were applied on adipose tissue samples dissected from 30 longissimus muscles from cattle finished either on grass or grain. Briefly, adipose tissue samples were fixed with osmium tetroxide, and size and number of adipocytes were determined by a Coulter Counter. These results were then fit in a finite mixture model to obtain distribution parameters of each sample. To evaluate the benefits of increasing number of samples and the advantage of the new sampling technique, the concept of acceptance ratio was used; simply stated, the higher the acceptance ratio, the better the representation of the overall population. As expected, a great improvement on the estimation of the overall adipocyte cellularity parameters was observed using both sampling techniques when sample size number increased from 1 to 15 samples, considering both techniques' acceptance ratio increased from approximately 3 to 25%. When comparing sampling techniques, the systematic procedure slightly improved parameters estimation. The results suggest that more detailed research using other sampling techniques may provide better estimates for minimum sampling.

Cassini RTG Acceptance Test Results and RTG Performance on Galileo and Ulysses

DOE R&D Accomplishments Database

Kelly, C. E.; Klee, P. M.

1997-06-01

Flight acceptance testing has been completed for the RTGs to be used on the Cassini spacecraft which is scheduled for an October 6, 1997 launch to Saturn. The acceptance test program includes vibration tests, magnetic field measurements, properties (weight and c.g.) and thermal vacuum test. This paper presents The thermal vacuum test results. Three RTGs are to be used, F 2, F 6, and F 7. F 5 is tile back up RTG, as it was for the Galileo and Ulysses missions launched in 1989 and 1990, respectively. RTG performance measured during the thermal vacuum tests carried out at die Mound Laboratory facility met all specification requirements. Beginning of mission (BOM) and end of mission (EOM) power predictions have been made based on than tests results. BOM power is predicted to be 888 watts compared to the minimum requirement of 826 watts. Degradation models predict the EOM power after 16 years is to be 640 watts compared to a minimum requirement of 596 watts. Results of small scale module tests are also showing. The modules contain couples from the qualification and flight production runs. The tests have exceeded 28,000 hours (3.2 years) and are continuing to provide increased confidence in the predicted long term performance of the Cassini RTGs. All test results indicate that the power requirements of the Cassini spacecraft will be met. BOM and EOM power margins of over five percent are predicted. Power output from telemetry for the two Galileo RTGs are shown from the 1989 launch to the recent Jupiter encounter. Comparisons of predicted, measured and required performance are shown. Telemetry data are also shown for the RTG on the Ulysses spacecraft which completed its planned mission in 1995 and is now in the extended mission.

Minimum weight design of rectangular and tapered helicopter rotor blades with frequency constraints

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Walsh, Joanne L.

1988-01-01

The minimum weight design of a helicopter rotor blade subject to constraints on coupled flap-lag natural frequencies has been studied. A constraint has also been imposed on the minimum value of the autorotational inertia of the blade in order to ensure that it has sufficient inertia to autorotate in the case of engine failure. The program CAMRAD is used for the blade modal analysis and CONMIN is used for the optimization. In addition, a linear approximation analysis involving Taylor series expansion has been used to reduce the analysis effort. The procedure contains a sensitivity analysis which consists of analytical derivatives of the objective function and the autorotational inertia constraint and central finite difference derivatives of the frequency constraints. Optimum designs have been obtained for both rectangular and tapered blades. Design variables include taper ratio, segment weights, and box beam dimensions. It is shown that even when starting with an acceptable baseline design, a significant amount of weight reduction is possible while satisfying all the constraints for both rectangular and tapered blades.

Minimum weight design of rectangular and tapered helicopter rotor blades with frequency constraints

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Walsh, Joanne L.

1988-01-01

The minimum weight design of a helicopter rotor blade subject to constraints on coupled flap-lag natural frequencies has been studied. A constraint has also been imposed on the minimum value of the autorotational inertia of the blade in order to ensure that it has sufficient inertia to aurorotate in the case of engine failure. The program CAMRAD is used for the blade modal analysis and CONMIN is used for the optimization. In addition, a linear approximation analysis involving Taylor series expansion has been used to reduce the analysis effort. The procedure contains a sensitivity analysis which consists of analytical derivatives of the objective function and the autorotational inertia constraint and central finite difference derivatives of the frequency constraints. Optimum designs have been obtained for both rectangular and tapered blades. Design variables include taper ratio, segment weights, and box beam dimensions. It is shown that even when starting with an acceptable baseline design, a significant amount of weight reduction is possible while satisfying all the constraints for both rectangular and tapered blades.

Minimum weight design of helicopter rotor blades with frequency constraints

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Walsh, Joanne L.

1989-01-01

The minimum weight design of helicopter rotor blades subject to constraints on fundamental coupled flap-lag natural frequencies has been studied in this paper. A constraint has also been imposed on the minimum value of the blade autorotational inertia to ensure that the blade has sufficient inertia to autorotate in case of an engine failure. The program CAMRAD has been used for the blade modal analysis and the program CONMIN has been used for the optimization. In addition, a linear approximation analysis involving Taylor series expansion has been used to reduce the analysis effort. The procedure contains a sensitivity analysis which consists of analytical derivatives of the objective function and the autorotational inertia constraint and central finite difference derivatives of the frequency constraints. Optimum designs have been obtained for blades in vacuum with both rectangular and tapered box beam structures. Design variables include taper ratio, nonstructural segment weights and box beam dimensions. The paper shows that even when starting with an acceptable baseline design, a significant amount of weight reduction is possible while satisfying all the constraints for blades with rectangular and tapered box beams.

The dynamics of financial stability in complex networks

NASA Astrophysics Data System (ADS)

da Cruz, J. P.; Lind, P. G.

2012-08-01

We address the problem of banking system resilience by applying off-equilibrium statistical physics to a system of particles, representing the economic agents, modelled according to the theoretical foundation of the current banking regulation, the so called Merton-Vasicek model. Economic agents are attracted to each other to exchange `economic energy', forming a network of trades. When the capital level of one economic agent drops below a minimum, the economic agent becomes insolvent. The insolvency of one single economic agent affects the economic energy of all its neighbours which thus become susceptible to insolvency, being able to trigger a chain of insolvencies (avalanche). We show that the distribution of avalanche sizes follows a power-law whose exponent depends on the minimum capital level. Furthermore, we present evidence that under an increase in the minimum capital level, large crashes will be avoided only if one assumes that agents will accept a drop in business levels, while keeping their trading attitudes and policies unchanged. The alternative assumption, that agents will try to restore their business levels, may lead to the unexpected consequence that large crises occur with higher probability.

Using Acceptance and Commitment Therapy during Methadone Dose Reduction: Rationale, Treatment Description, and a Case Report

ERIC Educational Resources Information Center

Stotts, Angela L.; Masuda, Akihiko; Wilson, Kelly

2009-01-01

Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from an MM client who voluntarily participated in an Acceptance and…

Integrating Telemedicine for Disaster Response: Testing the Emergency Telemedicine Technology Acceptance Model

ERIC Educational Resources Information Center

Davis, Theresa M.

2013-01-01

Background: There is little evidence that technology acceptance is well understood in healthcare. The hospital environment is complex and dynamic creating a challenge when new technology is introduced because it impacts current processes and workflows which can significantly affect patient care delivery and outcomes. This study tested the effect…

Methodological issues in the design and evaluation of supported communication for aphasia training: a cluster-controlled feasibility study

PubMed Central

Horton, Simon; Clark, Allan; Barton, Garry; Lane, Kathleen; Pomeroy, Valerie M

2016-01-01

Objective To assess the feasibility and acceptability of training stroke service staff to provide supported communication for people with moderate–severe aphasia in the acute phase; assess the suitability of outcome measures; collect data to inform sample size and Health Economic evaluation in a definitive trial. Design Phase II cluster-controlled, observer-blinded feasibility study. Settings In-patient stroke rehabilitation units in the UK matched for bed numbers and staffing were assigned to control and intervention conditions. Participants 70 stroke rehabilitation staff from all professional groups, excluding doctors, were recruited. 20 patients with moderate-severe aphasia were recruited. Intervention Supported communication for aphasia training, adapted to the stroke unit context versus usual care. Training was supplemented by a staff learning log, refresher sessions and provision of communication resources. Main outcome measures Feasibility of recruitment and acceptability of the intervention and of measures required to assess outcomes and Health Economic evaluation in a definitive trial. Staff outcomes: Measure of Support in Conversation; patient outcomes: Stroke and Aphasia Quality of Life Scale; Communicative Access Measure for Stroke; Therapy Outcome Measures for aphasia; EQ-5D-3L was used to assess health outcomes. Results Feasibility of staff recruitment was demonstrated. Training in the intervention was carried out with 28 staff and was found to be acceptable in qualitative reports. 20 patients consented to take part, 6 withdrew. 18 underwent all measures at baseline; 16 at discharge; and 14 at 6-month follow-up. Of 175 patients screened 71% were deemed to be ineligible, either lacking capacity or too unwell to participate. Poor completion rates impacted on assessment of patient outcomes. We were able to collect sufficient data at baseline, discharge and follow-up for economic evaluation. Conclusions The feasibility study informed components of the intervention and implementation in day-to-day practice. Modifications to the design are needed before a definitive cluster-randomised trial can be undertaken. Trial registration number ISRCTN37002304; Results. PMID:27091825

Problem Solving Skills Training for Parents of Children with Chronic Pain: A Pilot Randomized Controlled Trial

PubMed Central

Palermo, Tonya M.; Law, Emily F.; Bromberg, Maggie; Fales, Jessica; Eccleston, Christopher; Wilson, Anna C.

2016-01-01

This pilot randomized controlled trial aimed to determine the feasibility, acceptability, and preliminary efficacy of parental problem solving skills training (PSST) compared to treatment as usual (TAU) on improving parental mental health symptoms, physical health and well-being, and parenting behaviors. Effects of parent PSST on child outcomes (pain, emotional and physical functioning) were also examined. Participants included 61 parents of children aged 10–17 years with chronic pain randomized to PSST (n = 31) or TAU (n = 30). Parents receiving PSST participated in 4–6 individual sessions of training in problem solving skills. Outcomes were assessed at pre-treatment, immediately post-treatment, and at 3-month follow up. Feasibility was determined by therapy session attendance, therapist ratings, and parent treatment acceptability ratings. Feasibility of PSST delivery in this population was demonstrated by high compliance with therapy attendance, excellent retention, high therapist ratings of treatment engagement, and high parent ratings of treatment acceptability. PSST was associated with post-treatment improvements in parental depression (d = −0.68), general mental health (d = 0.64), and pain catastrophizing (d = −0.48), as well as in child depression (d = −0.49), child general anxiety (d = −0.56), and child pain-specific anxiety (d = −0.82). Several effects were maintained at 3-month follow-up. Findings demonstrate that PSST is feasible and acceptable to parents of youth with chronic pain. Treatment outcome analyses show promising but mixed patterns of effects of PSST on parent and child mental health outcomes. Further rigorous trials of PSST are needed to extend these pilot results. PMID:26845525

The Empirical Foundations of Telemedicine Interventions in Primary Care.

PubMed

Bashshur, Rashid L; Howell, Joel D; Krupinski, Elizabeth A; Harms, Kathryn M; Bashshur, Noura; Doarn, Charles R

2016-05-01

This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world.

The Empirical Foundations of Telemedicine Interventions in Primary Care

PubMed Central

Howell, Joel D.; Krupinski, Elizabeth A.; Harms, Kathryn M.; Bashshur, Noura; Doarn, Charles R.

2016-01-01

Abstract Introduction: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. Materials and Methods: The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. Results: The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Conclusions: Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world. PMID:27128779

Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome.

PubMed

de Graaf, L Esther; Huibers, Marcus J H; Riper, Heleen; Gerhards, Sylvia A H; Arntz, Arnoud

2009-08-01

In a recent randomized trial, we were unable to confirm the previously reported high effectiveness of CCBT. Therefore, the aim of the current study was to have a closer look at usage and acceptability (i.e. expectancy, credibility, and satisfaction) of the intervention. Depressed participants (N=200) were given login codes for unsupported online CCBT. A track-and-trace system tracked which components were used. We used a 9-month follow-up period. Uptake was sufficient, but dropout was high. Many usage indices were positively associated with short-term depressive improvement, whereas only homework was related to long-term improvement. Acceptability was good and expectancy could predict long-term, but not short-term outcome. Associations between use of CCBT and improvement are merely correlational. Our sample was too depressed in relation to the scope of the intervention. We relied on online self-report measures. Analyses were exploratory in nature. Although CCBT might be a feasible and acceptable treatment for depression, means to improve treatment adherence are needed for moderately to severely depressed individuals.

Elevated Patient Body Mass Index Does Not Negatively Affect Self-Reported Outcomes of Thoracolumbar Surgery: Results of a Comparative Observational Study with Minimum 1-Year Follow-Up

PubMed Central

Manson, Neil A.; Green, Alana J.; Abraham, Edward P.

2015-01-01

Study Design Retrospective study. Objective Quantify the effect of obesity on elective thoracolumbar spine surgery patients. Methods Five hundred consecutive adult patients undergoing thoracolumbar spine surgery to treat degenerative pathologies with minimum follow-up of at least 1 year were included. Primary outcome measures included Numerical Rating Scales for back and leg pain, the Short Form 36 Physical Component Summary and Mental Component Summary, the modified Oswestry Disability Index, and patient satisfaction scores collected preoperatively and at 3, 6, 12, and 24 months postoperatively. Secondary outcome measures included perioperative and postoperative adverse events, postoperative emergency department presentation, hospital readmission, and revision surgeries. Patients were grouped according to World Health Organization body mass index (BMI) guidelines to isolate the effect of obesity on primary and secondary outcome measures. Results Mean BMI was 30 kg/m2, reflecting a significantly overweight population. Each BMI group reported statistically significant improvement on all self-reported outcome measures. Contrary to our hypothesis, however, there was no association between BMI group and primary outcome measures. Patients with BMI of 35 to 39.99 visited the emergency department with complaints of pain significantly more often than the other groups. Otherwise, we did not detect any differences in the secondary outcome measures between BMI groups. Conclusions Patients of all levels of obesity experienced significant improvement following elective thoracolumbar spine surgery. These outcomes were achieved without increased risk of postoperative complications such as infection and reoperation. A risk–benefit algorithm to assist with surgical decision making for obese patients would be valuable to surgeons and patients alike. PMID:26933611

Consolidating DoD Housing and Allowance Data Collection

DTIC Science & Technology

1991-01-01

data . In addition, the military staff chains of command, unit chains of command, DMDC, and the Navy’s Facilities Support Office (FACSO) become...non-pay section of the form if the Finance Office abandons it. However, the current methods of collecting data are equally risky, and statistical ...minimum standards are rescored as acceptable. The survey data sheets are then mailed to the Navy’s Facility Support Office (FACSO) at Port Hueneme, CA

Plasma Thruster Development: Magnetoplasmadynamic Propulsion, Status and Basic Problems.

DTIC Science & Technology

1986-02-01

34 9 Sublimation Rates vs. Temperature for Typical Electrode Materials 65 10 Time to Reach Melting vs. Surface Heat Load (One-Dimensional, Large Area...Approx.) for Different Electrode Materials and Initial Temperatures 75 V LIST OF TABLES TABLE PAGE I Models of Thruster Types (with approximation (1...much higher specific impulse values than the minimum must be achieved in order to obtain acceptable effi- Sciencies , e.g. for 30% efficiency with argon

A Multi-Week Behavioral Sampling Tag for Sound Effects Studies: Design Trade-Offs and Prototype Evaluation

DTIC Science & Technology

2013-09-30

performance of algorithms detecting dives, strokes , clicks, respiration and gait changes. (ii) Calibration errors: Size and power constraints in...acceptance parameters used to detect and classify events. For example, swim stroke detection requires parameters defining the minimum magnitude and the min...and max duration of a stroke . Species dependent parameters can be selected from existing DTAG data but other parameters depend on the size of the

Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya.

PubMed

Briesen, Sebastian; Roberts, Helen; Ilako, Dunera; Karimurio, Jefitha; Courtright, Paul

2010-01-01

To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery. Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL. A standardized questionnaire asked for socio-demographic data and prior cataract surgery in one eye. After interview, patients were offered free surgery. Primary outcome was the mean QoL-score between acceptors and non-acceptors. Secondary outcomes were visual acuity and socio-demographic factors and their contribution to QoL-scores and the decision on acceptance or refusal. Fifty nine people (16.5%) refused and 298 accepted cataract surgery. Vision-related QoL was poorer in people accepting than in those refusing (mean score 51.54 and 43.12 respectively). People with poor visual acuity were only slightly more likely to accept surgery than people with better vision; the strongest predictors of acceptance were the QoL-score and gender. Men were twice as likely to accept compared to women. Of people who accepted surgery, 73.8% had best eye vision of 20/200 or better. In this population, visual acuity was of limited use to predict a person's decision to accept or refuse cataract surgery. QoL-scores provide further insight into which individuals will agree to surgery and it might be useful to adapt the QoL-questions for field use. Gender inequities remain a matter of concern with men being more likely to get sight-restoring surgery.

Optimizing longwall mine layouts

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

Minkel, M.J.

1996-12-31

Before spending the time to design an underground mine in detail, the mining engineer should be assured of the economic viability of the location of the layout. This has historically been a trial-and-error, iterative process. Traditional underground mine planning usually bases the layout on the geological characteristics of a deposit such as minimum seam height, quality, and the absence of faults. Whether one attempts to make a decision manually. or use traditional mine planning software, the process works something like this: First you build geological model. Then you impose a {open_quotes}best guess{close_quotes} as to which geological layers will become partmore » of the mined product, or will influence mining. Next you place your design where you believe is the best location to make a mine. Then you select equipment which you believe will cost-effectively mine the area. Finally, you schedule your equipment selection through the design over the mine life, run financial analyses and see if the rate of return is acceptable. If the NPV is acceptable, the design is accepted. If the NPV is not acceptable, the engineer has to restart the cycle of redesigning the layout, rescheduling the equipment, and restudying the economics again.« less

Cost justification of clinical pharmacy services on a general surgery team: focus on diagnosis-related group cases.

PubMed

Bertch, K E; Hatoum, H T; Willett, M S; Witte, K W

1988-11-01

We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical predictors of facial nerve outcome after translabyrinthine resection of acoustic neuromas.

PubMed

Shamji, Mohammed F; Schramm, David R; Benoit, Brien G

2007-01-01

The translabyrinthine approach to acoustic neuroma resection offers excellent exposure for facial nerve dissection with 95% preservation of anatomic continuity. Acceptable outcome in facial asymptomatic patients is reported at 64-90%, but transient postoperative deterioration often occurs. The objective of this study was to identify preoperative clinical presentation and intraoperative surgical findings that predispose patients to facial nerve dysfunction after acoustic neuroma surgery. The charts of 128 consecutive translabyrinthine patients were examined retrospectively to identify new clinical and intraoperative predictors of facial nerve outcome. Postoperative evaluation of patients to normal function or mild asymmetry upon close inspection (House-Brackmann grades of I or II) was defined as an acceptable outcome, with obvious asymmetry to no movement (grades III to VI) defined as unacceptable. Intraoperative nerve stimulation was performed in all cases, and clinical grading was performed by a single neurosurgeon in all cases. Among patients with no preoperative facial nerve deficit, 87% had an acceptable result. Small size (P < 0.01) and low intraoperative nerve stimulation of < 0.10 mA (P< 0.01) were reaffirmed as predictive of functional nerve preservation. Additionally, preoperative tinnitus (P = 0.03), short duration of hearing loss (P< 0. 01), and lack of subjective tumour adherence to the facial nerve (P = 0.02) were independently correlated with positive outcome. Our experience with the translabyrinthine approach reveals the previously unestablished associations of facial nerve outcome to include presence of tinnitus and duration of hypoacusis. Independent predictors of tumour size and nerve stimulation thresholds were reaffirmed, and the subjective description of tumour adherence to the facial nerve making dissection more difficult appears to be important.

The feasibility and acceptability of conducting a trial of specialist medical care and the Lightning Process in children with chronic fatigue syndrome: feasibility randomized controlled trial (SMILE study)

PubMed Central

2013-01-01

Background Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is relatively common in children with limited evidence for treatment. The Phil Parker Lightning Process (LP) is a trademarked intervention, which >250 children use annually. There are no reported studies investigating the effectiveness or possible side effects of LP. Methods The trial population was drawn from the Bath and Bristol NHS specialist paediatric CFS or ME service. The study was designed as a pilot randomized trial with children (aged 12 to 18 years) comparing specialist medical care with specialist medical care plus the Lightning Process. Integrated qualitative methodology was used to explore the feasibility and acceptability of the recruitment, randomization and interventions. Results A total of 56 children were recruited from 156 eligible children (1 October 2010 to 16 June 2012). Recruitment, randomization and both interventions were feasible and acceptable. Participants suggested changes to improve feasibility and acceptability and we incorporated the following in the trial protocol: stopped collecting 6-week outcomes; introduced a second reminder letter; used phone calls to collect primary outcomes from nonresponders; informed participants about different approaches of each intervention and changed our recommendation for the primary outcome for the full study from school attendance to disability (SF-36 physical function subscale) and fatigue (Chalder Fatigue Scale). Conclusions Conducting randomized controlled trials (RCTs) to investigate an alternative treatment such as LP is feasible and acceptable for children with CFS or ME. Feasibility studies that incorporate qualitative methodology enable changes to be made to trial protocols to improve acceptability to participants. This is likely to improve recruitment rate and trial retention. Trial registration Feasibility study first randomization: 29 September 2010. Trial registration: Current Controlled Trials ISRCTN81456207 (31 July 2012). Full trial first randomization: 19 September 2012. PMID:24304689

Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Derivations and Verification of Plans. Volume 1

NASA Technical Reports Server (NTRS)

Johnson, Kenneth L.; White, K, Preston, Jr.

2012-01-01

The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques. This recommended procedure would be used as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. This document contains the outcome of the assessment.

Feasibility and Acceptability of Internet-delivered Cognitive Behavioral Therapy for Chronic Pain in Adolescents With Sickle Cell Disease and Their Parents.

PubMed

Palermo, Tonya M; Dudeney, Joanne; Santanelli, James P; Carletti, Alexie; Zempsky, William T

2018-03-01

Pain is a clinical hallmark of sickle cell disease (SCD), and is rarely optimally managed. Cognitive-behavioral therapy (CBT) for pain has been effectively delivered through the Internet in other pediatric populations. We tested feasibility and acceptability of an Internet-delivered CBT intervention in 25 adolescents with SCD (64% female, mean age=14.8 y) and their parents randomized to Internet CBT (n=15) or Internet Pain Education (n=10). Participants completed pretreatment/posttreatment measures. Eight dyads completed semistructured interviews to evaluate treatment acceptability. Feasibility indicators included recruitment and participation rates, engagement and adherence to intervention, and completion of outcome measures. In total, 87 referrals were received from 9 study sites; our recruitment rate was 60% from those families approached for screening. Among participants, high levels of initial intervention engagement (>90%), and adherence (>70%) were demonstrated. Most participants completed posttreatment outcome and diary measures (>75%). Retention at posttreatment was 80%. High treatment acceptability was reported in interviews. Our findings suggest that Internet-delivered CBT for SCD pain is feasible and acceptable to adolescents with SCD and their parents. Engagement and adherence were good. Next steps are to modify recruitment plans to enhance enrollment and determine efficacy of Internet CBT for SCD pain in a large multisite randomized controlled trial.

[Acceptance of lot sampling: its applicability to the evaluation of the primary care services portfolio].

PubMed

López-Picazo Ferrer, J

2001-05-15

To determine the applicability of the acceptance of lot quality assurance sampling (LQAS) in the primary care service portfolio, comparing its results with those given by classic evaluation. Compliance with the minimum technical norms (MTN) of the service of diabetic care was evaluated through the classic methodology (confidence 95%, accuracy 5%, representativeness of area, sample of 376 histories) and by LQAS (confidence 95%, power 80%, representativeness of primary care team (PCT), defining a lot by MTN and PCT, sample of 13 histories/PCT). Effort, information obtained and its operative nature were assessed. 44 PCTs from Murcia Primary Care Region. Classic methodology: compliance with MTN ranged between 91.1% (diagnosis, 95% CI, 84.2-94.0) and 30% (repercussion in viscera, 95% CI, 25.4-34.6). Objectives in three MTN were reached (diagnosis, history and EKG). LQAS: no MTN was accepted in all the PCTs, <01-diagnosis> being the most accepted (42 PCT, 95.6%) and <07-Funduscopy> the least accepted (24 PCT, 55.6%). In 9 PCT all were accepted (20.4%), and in 2 none were accepted (4.5%). Data were analysed through Pareto charts. Classic methodology offered accurate results, but did not identify which centres were those that did not comply (general focus). LQAS was preferable for evaluating MTN and probably coverage because: 1) it uses small samples, which foment internal quality-improvement initiatives; 2) it is easy and rapid to execute; 3) it identifies the PCT and criteria where there is an opportunity for improvement (specific focus), and 4) it can be used operatively for monitoring.

Positive teacher and peer relations combine to predict primary school students' academic skill development.

PubMed

Kiuru, Noona; Aunola, Kaisa; Lerkkanen, Marja-Kristiina; Pakarinen, Eija; Poskiparta, Elisa; Ahonen, Timo; Poikkeus, Anna-Maija; Nurmi, Jari-Erik

2015-04-01

This study examined cross-lagged associations between positive teacher and peer relations and academic skill development. Reading and math skills were tested among 625 students in kindergarten and Grade 4. Teacher reports of positive affect toward each student and classmate reports of peer acceptance were gathered in Grades 1-3. The results showed, first, that positive teacher affect toward the student and peer acceptance were reciprocally associated: Positive teacher affect predicted higher peer acceptance, and higher peer acceptance predicted a higher level of positive teacher affect. Second, the effect of positive teacher affect on academic skill development was partly mediated via peer acceptance, while the effect of early academic skills on peer acceptance was partly mediated via positive teacher affect. The results suggest that a warm and supportive teacher can increase a student's peer acceptance, which, in turn, is positively associated with learning outcomes. (c) 2015 APA, all rights reserved).

Direct and Indirect Psychosocial Outcomes for Children with Autism Spectrum Disorder and their Parents Following a Parent-involved Social Skills Group Intervention.

PubMed

Weiss, Jonathan A; Viecili, Michelle A; Sloman, Leon; Lunsky, Yona

2013-11-01

This study examined the direct and indirect outcomes of a social skills group intervention for children with high functioning autism spectrum disorders and their parents. Thirty-five children and their parents participated in the program evaluation. Children and parents completed measures of child social skills and problem behaviors. Children reported on their self-concept, and parents reported on their psychological acceptance and empowerment. Results indicate significant increases in overall child social skills according to parent and child report, in child general self-worth, and in parent service empowerment and psychological acceptance. While past program evaluations of social skills groups highlight changes in social competence, taking a broader perspective on the types of positive outcomes suggests potential benefits for both child and parent.

The number of lung transplants can be safely doubled using extended criteria donors; a single-center review.

PubMed

Meers, Caroline; Van Raemdonck, Dirk; Verleden, Geert M; Coosemans, Willy; Decaluwe, Herbert; De Leyn, Paul; Nafteux, Philippe; Lerut, Toni

2010-06-01

Relaxing the standard lung donor criteria may significantly increase the reported 15% organ yield but post-transplant recipient outcome should be carefully monitored. Charts from all consecutive deceased organ donors within our hospital network were reviewed over a 2-year period. Reasons for lung refusals and number of lungs transplanted were analysed. Hospital outcome including early recipient survival was compared between standard- and extended criteria donors. Out of 283 referrals, 164 (58%) qualified as donor of any organ. The majority (65.9%) of these effective donors were declined for lung donation because of chest X-ray abnormalities (20%), age >70 years (13%), poor oxygenation (10%), or aspiration (9%). Out of 56 (34.1%) accepted lung donors, 50 transplants were performed at our center, 23 from standard criteria donors versus 27 from extended criteria donors. There were no significant differences in hospital outcome and in early survival between lung recipients from both donor groups. Lung acceptance rate (34.1%) in our donor network is 10-20% higher than reported figures. The number of lung transplants in our center doubled by accepting extended criteria donors. This policy did not negatively influence our results after lung transplantation.

A study of video frame rate on the perception of moving imagery detail

NASA Technical Reports Server (NTRS)

Haines, Richard F.; Chuang, Sherry L.

1993-01-01

The rate at which each frame of color moving video imagery is displayed was varied in small steps to determine what is the minimal acceptable frame rate for life scientists viewing white rats within a small enclosure. Two, twenty five second-long scenes (slow and fast animal motions) were evaluated by nine NASA principal investigators and animal care technicians. The mean minimum acceptable frame rate across these subjects was 3.9 fps both for the slow and fast moving animal scenes. The highest single trial frame rate averaged across all subjects for the slow and the fast scene was 6.2 and 4.8, respectively. Further research is called for in which frame rate, image size, and color/gray scale depth are covaried during the same observation period.

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

Bouzaki, Mohammed Moustafa, E-mail: bouzaki-physique1@yahoo.fr; Chadel, Meriem; Université de Lorraine, LMOPS, EA 4423, 57070 Metz

This contribution analyzes the energy provided by a solar kit dedicated to autonomous usage and installed in Central Europe (Longitude 6.10°; Latitude 49.21° and Altitude 160 m) by using the simulation software PVSYST. We focused the analysis on the effect of temperature and solar irradiation on the I-V characteristic of a commercial PV panel. We also consider in this study the influence of charging and discharging the battery on the generator efficiency. Meteorological data are integrated into the simulation software. As expected, the solar kit provides an energy varying all along the year with a minimum in December. In themore » proposed approach, we consider this minimum as the lowest acceptable energy level to satisfy the use. Thus for the other months, a lost in the available renewable energy exists if no storage system is associated.« less

Conceptualising and managing trade-offs in sustainability assessment

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

Morrison-Saunders, Angus, E-mail: A.Morrison-Saunders@murdoch.edu.au; School of Environmental Science, Murdoch University; Pope, Jenny

One of the defining characteristics of sustainability assessment as a form of impact assessment is that it provides a forum for the explicit consideration of the trade-offs that are inherent in complex decision-making processes. Few sustainability assessments have achieved this goal though, and none has considered trade-offs in a holistic fashion throughout the process. Recent contributions such as the Gibson trade-off rules have significantly progressed thinking in this area by suggesting appropriate acceptability criteria for evaluating substantive trade-offs arising from proposed development, as well as process rules for how evaluations of acceptability should occur. However, there has been negligible uptakemore » of these rules in practice. Overall, we argue that there is inadequate consideration of trade-offs, both process and substantive, throughout the sustainability assessment process, and insufficient considerations of how process decisions and compromises influence substantive outcomes. This paper presents a framework for understanding and managing both process and substantive trade-offs within each step of a typical sustainability assessment process. The framework draws together previously published literature and offers case studies that illustrate aspects of the practical application of the framework. The framing and design of sustainability assessment are vitally important, as process compromises or trade-offs can have substantive consequences in terms of sustainability outcomes delivered, with the choice of alternatives considered being a particularly significant determinant of substantive outcomes. The demarcation of acceptable from unacceptable impacts is a key aspect of managing trade-offs. Offsets can be considered as a form of trade-off within a category of sustainability that are utilised to enhance preferred alternatives once conditions of impact acceptability have been met. In this way they may enable net gains to be delivered; another imperative for progress to sustainability. Understanding the nature and implications of trade-offs within sustainability assessment is essential to improving practice. - Highlights: Black-Right-Pointing-Pointer A framework for understanding trade-offs in sustainability assessment is presented. Black-Right-Pointing-Pointer Trade-offs should be considered as early as possible in any sustainability assessment process. Black-Right-Pointing-Pointer Demarcation of acceptable from unacceptable impacts is needed for effective trade-off management. Black-Right-Pointing-Pointer Offsets in place, time or kind can ensure and attain a net benefit outcome overall. Black-Right-Pointing-Pointer Gibson's trade-off rules provide useful acceptability criteria and process guidance.« less

Relations of children's proactive and reactive assertiveness to peer acceptance: moderating effects of social interest.

PubMed

Lee, Han-Jong

2014-06-01

Previous studies on the social outcome of assertiveness reported mixed findings, failing to support the assumption that assertiveness promotes peer acceptance. In an attempt to provide explanations for the inconsistencies in prior findings, this study proposed making a distinction between proactive and reactive assertiveness and examined the moderating effects of social interest. A total of 441 fifth and sixth graders (232 boys, 209 girls; M age = 10.6 yr., SD = 0.6) participated in the study. Results indicated that proactive assertiveness was positively related to peer acceptance regardless of social interest. By contrast, reactive assertiveness was positively related to peer acceptance but only when social interest is high. When social interest is low, it was negatively associated with peer acceptance.

Survival of primary condylar-constrained total knee arthroplasty at a minimum of 7 years.

PubMed

Maynard, Lance M; Sauber, Timothy J; Kostopoulos, Vasileios K; Lavigne, Gregory S; Sewecke, Jeffrey J; Sotereanos, Nicholas G

2014-06-01

The purpose of the present study is to retrospectively analyze clinical and radiographic outcomes in primary constrained condylar knee arthroplasty at a minimum follow-up of 7 years. Given the concern for early aseptic loosening in constrained implants, we focused on this outcome. Our cohort consists of 127 constrained condylar knees. The mean age of patients in the study was 68.3 years, with a mean follow-up of 110.7 months. The diagnosis was primary osteoarthritis in 92%. There were four periprosthetic distal femur fractures, with a rate of revision of 0.8%. No implants were revised for aseptic loosening. Kaplan-Meier survivorship analysis with removal of any component as the end point revealed that the 10-year rate of survival of the primary CCK was 97.6% (95% CI, 94%-100%). Copyright © 2014. Published by Elsevier Inc.

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

PubMed Central

Santosa, Katherine B.; Fattah, Adel; Gavilán, Javier; Hadlock, Tessa A.; Snyder-Warwick, Alison K.

2017-01-01

IMPORTANCE There is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population. OBJECTIVES To review the literature to evaluate the use of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society—a group of medical professionals dedicated to care of patients with facial palsy. DESIGN, SETTING, AND PARTICIPANTS A literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography in documenting facial nerve function. The literature search and analysis was performed in August and September 2015, and the survey was conducted in August and September 2013. MAIN OUTCOMES AND MEASURES The literature review searched EMBASE, CINAHL, and MEDLINE databases from inception of each database through September 2015. Additional studies were identified by scanning references from relevant studies. Only English-language articles were eligible for inclusion. Articles that discussed patients with facial palsy and outlined photographic guidelines for this patient population were included in the study. The survey was disseminated to the Sir Charles Bell Society members in electronic form. It consisted of 10 questions related to facial grading scales, patient-reported outcome measures, other psychological assessment tools, and photographic and videographic recordings. RESULTS In total, 393 articles were identified in the literature search, 7 of which fit the inclusion criteria. Six of the 7 articles discussed or proposed views specific to patients with facial palsy. However, none of the articles specifically focused on photographic standards for the population with facial palsy. Eighty-three of 151 members (55%) of the Sir Charles Bell Society responded to the survey. All survey respondents used photographic documentation, but there was variability in which facial expressions were used. Eighty-two percent (68 of 83) used some form of videography. From these data, we propose a set of minimum photographic standards for patients with facial palsy, including the following 10 static views: at rest or repose, small closed-mouth smile, large smile showing teeth, elevation of eyebrows, closure of eyes gently, closure of eyes tightly, puckering of lips, showing bottom teeth, snarling or wrinkling of the nose, and nasal base view. CONCLUSIONS AND RELEVANCE There is no consensus on photographic standardization to report outcomes for patients with facial palsy. Minimum photographic standards for facial paralysis publications are proposed. Videography of the dynamic movements of these views should also be recorded. LEVEL OF EVIDENCE NA. PMID:28125753

Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol.

PubMed

Hocking, Jane S; Temple-Smith, Meredith; van Driel, Mieke; Law, Matthew; Guy, Rebecca; Bulfone, Liliana; Wood, Anna; Low, Nicola; Donovan, Basil; Fairley, Christopher K; Kaldor, John; Gunn, Jane

2016-09-13

Financial incentives and audit plus feedback on performance are two strategies commonly used by governments to motivate general practitioners (GP) to undertake specific healthcare activities. However, in recent years, governments have reduced or removed incentive payments without evidence of the potential impact on GP behaviour and patient outcomes. This trial (known as ACCEPt-able) aims to determine whether preventive care activities in general practice are sustained when financial incentives and/or external audit plus feedback on preventive care activities are removed. The activity investigated is annual chlamydia testing for 16- to 29-year-old adults, a key preventive health strategy within this age group. ACCEPt-able builds on a large cluster randomised controlled trial (RCT) that evaluated a 3-year chlamydia testing intervention in general practice. GPs were provided with a support package to facilitate annual chlamydia testing of all sexually active 16- to 29-year-old patients. This package included financial incentive payments to the GP for each chlamydia test conducted and external audit plus feedback on each GP's chlamydia testing rates. ACCEPt-able is a factorial cluster RCT in which general practices are randomised to one of four groups: (i) removal of audit plus feedback-continue to receive financial incentive payments for each chlamydia test; (ii) removal of financial incentive payments-continue to receive audit plus feedback; (iii) removal of financial incentive payments and audit plus feedback; and (iv) continue financial incentive payments and audit plus feedback. The primary outcome is chlamydia testing rate measured as the proportion of sexually active 16- to 29-year-olds who have a GP consultation within a 12-month period and at least one chlamydia test. This will be the first RCT to examine the impact of removal of financial incentive payments and audit plus feedback on the chlamydia testing behaviour of GPs. This trial is particularly timely and will increase our understanding about the impact of financial incentives and audit plus feedback on GP behaviour when governments are looking for opportunities to control healthcare budgets and maximise clinical outcomes for money spent. The results of this trial will have implications for supporting preventive health measures beyond the content area of chlamydia. The trial has been registered on the Australian and New Zealand Clinical Trials Registry ( ACTRN12614000595617 ).

The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables

PubMed Central

Rafiei, Sima; Pourreza, Abolghasem

2013-01-01

Background: Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. Methods: This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Results: Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Conclusion: Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities. PMID:24596840

Values and Psychological Acceptance as Correlates of Burnout in Support Staff Working with Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Noone, Stephen J.; Hastings, Richard P.

2011-01-01

There is growing evidence that acceptance and mindfulness interventions for support staff in intellectual disability (ID) services can have beneficial mental health outcomes for staff themselves and individuals with ID. However, there are few data focusing on the relevance of related psychological processes for support staff well-being. The…

The Relationship between Teacher Orientation and Consultation Terminology, Intervention Acceptability, Evaluation of Effectiveness, and Willingness to Implement

ERIC Educational Resources Information Center

Heuser, Robin Rachelle

2012-01-01

The current study was designed to expand on previous research examining the effect of terminology on ratings of intervention acceptability and to investigate the effects of terminology on judgments of outcome data and willingness to implement. Secondarily, this study explored teacher beliefs and instructional style. The sample for this study…

Trust, confidence, procedural fairness, outcome fairness, moral conviction, and the acceptance of GM field experiments.

PubMed

Siegrist, Michael; Connor, Melanie; Keller, Carmen

2012-08-01

In 2005, Swiss citizens endorsed a moratorium on gene technology, resulting in the prohibition of the commercial cultivation of genetically modified crops and the growth of genetically modified animals until 2013. However, scientific research was not affected by this moratorium, and in 2008, GMO field experiments were conducted that allowed us to examine the factors that influence their acceptance by the public. In this study, trust and confidence items were analyzed using principal component analysis. The analysis revealed the following three factors: "economy/health and environment" (value similarity based trust), "trust and honesty of industry and scientists" (value similarity based trust), and "competence" (confidence). The results of a regression analysis showed that all the three factors significantly influenced the acceptance of GM field experiments. Furthermore, risk communication scholars have suggested that fairness also plays an important role in the acceptance of environmental hazards. We, therefore, included measures for outcome fairness and procedural fairness in our model. However, the impact of fairness may be moderated by moral conviction. That is, fairness may be significant for people for whom GMO is not an important issue, but not for people for whom GMO is an important issue. The regression analysis showed that, in addition to the trust and confidence factors, moral conviction, outcome fairness, and procedural fairness were significant predictors. The results suggest that the influence of procedural fairness is even stronger for persons having high moral convictions compared with persons having low moral convictions. © 2012 Society for Risk Analysis.

Understanding stakeholder important outcomes and perceptions of equity, acceptability and feasibility of a care model for haemophilia management in the US: a qualitative study.

PubMed

Lane, S J; Sholapur, N S; Yeung, C H T; Iorio, A; Heddle, N M; Sholzberg, M; Pai, M

2016-07-01

Care for persons with haemophilia (PWH) is most commonly delivered through the integrated care model used by Hemophilia Treatment Centers (HTCs). Although this model is widely accepted as the gold standard for the management of haemophilia; there is little evidence comparing different care models. We performed a qualitative study to gain insight into issues related to outcomes, acceptability, equity and feasibility of different care models operating in the US. We used a qualitative descriptive approach with semi-structured interviews. Purposive sampling was used to recruit individuals with experience providing or receiving care for haemophilia in the US through either an integrated care centre, a specialty pharmacy or homecare company, or by a specialist in a non-specialized centre. Persons with haemophilia, parents of PWH aged ≤18, healthcare providers, insurance company representatives and policy developers were invited to participate. Twenty-nine interviews were conducted with participants representing 18 US states. Participants in the study sample had experience receiving or providing care predominantly within an HTC setting. Integrated care at HTCs was highly acceptable to participants, who appreciated the value of specialized, expert care in a multidisciplinary team setting. Equity and feasibility issues were primarily related to health insurance and funding limitations. Additional research is required to document the impact of care on health and psychosocial outcomes and identify effective ways to facilitate equitable access to haemophilia treatment and care. © 2016 John Wiley & Sons Ltd.

Increased minimum legal age for the sale of alcohol in the Netherlands as of 2014: The effect on alcohol sellers' compliance after one and two years.

PubMed

Schelleman-Offermans, Karen; Roodbeen, Ruud T J; Lemmens, Paul H H M

2017-11-01

As of January 2014, the Dutch minimum legal age for the sale and purchase of all alcoholic beverages has increased from 16 to 18 years of age. The effectiveness of a minimum legal age policy in controlling the availability of alcohol for adolescents depends on the extent to which this minimum legal age is complied with in the field. The main aim of the current study is to investigate, for a country with a West-European drinking culture, whether raising the minimum legal age for the sale of alcohol has influenced compliance rates among Dutch alcohol vendors. A total of 1770 alcohol purchase attempts by 15-year-old mystery shoppers were conducted in three independent Dutch representative samples of on- and off-premise alcohol outlets in 2013 (T0), 2014 (T1), and 2016 (T2). The effect of the policy change was estimated controlling for gender and age of the vendor. Mean alcohol sellers' compliance rates significantly increased for 15-year-olds from 46.5% before to 55.7% one year and to 73.9% two years after the policy change. Two years after the policy change, alcohol vendors were up to 3 times more likely to comply with the alcohol age limit policy. After the policy change, mean alcohol compliance rates significantly increased when 15-year-olds attempted to purchase alcohol, an effect which seems to increase over time. Nevertheless, a rise in the compliance rate was already present in the years preceding the introduction of the new minimum legal age. This perhaps signifies a process in which a lowering in the general acceptability of juvenile drinking already started before the increased minimum legal age was introduced and alcohol vendors might have been anticipating this formal legal change. Copyright © 2017 Elsevier B.V. All rights reserved.

77 FR 4807 - Revised Fee Policy for Acceptance of Foreign Research Reactor Spent Nuclear Fuel From High-Income...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

...This notice announces a change in the fee policy by the Department of Energy (DOE) for receipt and management of spent nuclear fuel (SNF) from foreign research reactors (FRR) containing uranium enriched in the U.S. in countries with high-income economies, as identified in the World Bank Development Report. The fee will increase in three phases (See Table 1) for all future SNF shipments (including Training, Research, Isotopes, General Atomics (TRIGA) from high-income economy countries. The first phase will take effect immediately and the fee will increase from no higher than $3,750 per kg total mass (not heavy metal mass) to $5,625 per kg total mass for SNF containing low enriched uranium (LEU). The second phase will be implemented automatically on January 1, 2014, and the fees will increase from $5,625 per kg total mass to $7,500 per kg total mass for shipments of SNF containing LEU and from no higher than $4,500 per kg total mass to $6,750 per kg total mass for SNF containing highly enriched uranium (HEU). The third phase will be implemented automatically on January 1, 2016, and the fee will increase from $6,750 per kg total mass to $9,000 per kg total mass for shipments of SNF containing HEU. DOE is also implementing a new minimum fee of $200,000 per shipment of any type and amount of eligible SNF to reflect a minimum cost of providing acceptance services. This minimum fee will take effect immediately. In the case where a reactor operator already has a signed and executed contract with DOE, DOE intends to negotiate an equitable adjustment to the fee in accordance with this revised fee policy. Under this revised fee policy, the fee for return of TRIGA fuel will be the same as that of aluminum based fuel. All other aspects of the fee policy are unaffected by this Notice. This is the first fee increase since the fee policy was established in 1996, and will help DOE offset a portion of the increase in operation costs of managing SNF. DOE will continue to pay the costs for shipping, receipt and management of SNF from other than high-income economy countries. All other conditions and policies as previously established for acceptance of FRR SNF will continue to apply. DOE reserves the right to revise the fee policy at any time to respond to changed circumstances. DOE also reserves the right to adjust the fee set in an acceptance contract if there are unique and compelling circumstances that make it in DOE's best interest to do so.

DESTINY-S: attitudes of physicians toward disability and treatment in malignant MCA infarction.

PubMed

Neugebauer, Hermann; Creutzfeldt, Claire J; Hemphill, J Claude; Heuschmann, Peter U; Jüttler, Eric

2014-08-01

Decompressive hemicraniectomy (DHC) reduces mortality and improves outcome after malignant middle cerebral artery (MCA) infarction but leaves a high number of survivors severely disabled. Attitudes among physicians toward the degree of disability that is considered acceptable and the impact of aphasia may play a major role in treatment decisions. DESTINY-S is a multicenter, international, cross-sectional survey among 1,860 physicians potentially involved in the treatment of malignant MCA infarction. Questions concerned the grade of disability, the hemisphere of the stroke, and the preferred treatment for malignant MCA infarction. mRS scores of 3 or better were considered acceptable by the majority of respondents (79.3%). Only few considered a mRS score of 5 still acceptable (5.8%). A mRS score of 4 was considered acceptable by 38.0%. Involved hemisphere (dominant vs. non-dominant) was considered a major clinical symptom influencing treatment decisions in 47.7% of respondents, also reflected by significantly different rates for DHC as preferred treatment in dominant versus non-dominant hemispheric infarction (46.9 vs. 72.9%). Significant differences in acceptable disability and treatment decisions were found among geographic regions, medical specialties, and respondents with different work experiences. Little consensus exists among physicians regarding acceptable outcome and therapeutic management after malignant MCA infarction, and physician's recommendations do not correlate with available evidence. We advocate for a decision-making process that balances scientific evidence, patient preference, and clinical expertise.

A Five-Phase Model for Clinical-Outcome Research

ERIC Educational Resources Information Center

Robey, Randall R.

2004-01-01

Through a variety of approaches, speech-language pathologists and audiologists have produced strong evidence that treatments are generally potent. However, we have largely ignored the accepted standards for clinical-outcome testing used throughout the broader research community (e.g., by other clinical disciplines, federal regulators, and…

Updating the OMERACT filter: core areas as a basis for defining core outcome sets.

PubMed

Kirwan, John R; Boers, Maarten; Hewlett, Sarah; Beaton, Dorcas; Bingham, Clifton O; Choy, Ernest; Conaghan, Philip G; D'Agostino, Maria-Antonietta; Dougados, Maxime; Furst, Daniel E; Guillemin, Francis; Gossec, Laure; van der Heijde, Désirée M; Kloppenburg, Margreet; Kvien, Tore K; Landewé, Robert B M; Mackie, Sarah L; Matteson, Eric L; Mease, Philip J; Merkel, Peter A; Ostergaard, Mikkel; Saketkoo, Lesley Ann; Simon, Lee; Singh, Jasvinder A; Strand, Vibeke; Tugwell, Peter

2014-05-01

The Outcome Measures in Rheumatology (OMERACT) Filter provides guidelines for the development and validation of outcome measures for use in clinical research. The "Truth" section of the OMERACT Filter presupposes an explicit framework for identifying the relevant core outcomes that are universal to all studies of the effects of intervention effects. There is no published outline for instrument choice or development that is aimed at measuring outcome, was derived from broad consensus over its underlying philosophy, or includes a structured and documented critique. Therefore, a new proposal for defining core areas of measurement ("Filter 2.0 Core Areas of Measurement") was presented at OMERACT 11 to explore areas of consensus and to consider whether already endorsed core outcome sets fit into this newly proposed framework. Discussion groups critically reviewed the extent to which case studies of current OMERACT Working Groups complied with or negated the proposed framework, whether these observations had a more general application, and what issues remained to be resolved. Although there was broad acceptance of the framework in general, several important areas of construction, presentation, and clarity of the framework were questioned. The discussion groups and subsequent feedback highlighted 20 such issues. These issues will require resolution to reach consensus on accepting the proposed Filter 2.0 framework of Core Areas as the basis for the selection of Core Outcome Domains and hence appropriate Core Outcome Sets for clinical trials.

Minimum Alcohol Prices and Outlet Densities in British Columbia, Canada: Estimated Impacts on Alcohol-Attributable Hospital Admissions

PubMed Central

Zhao, Jinhui; Martin, Gina; Macdonald, Scott; Vallance, Kate; Treno, Andrew; Ponicki, William; Tu, Andrew; Buxton, Jane

2013-01-01

Objectives. We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia. Methods. The longitudinal panel study (2002–2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables. Results. A 10% increase in the average minimum price of all alcoholic beverages was associated with an 8.95% decrease in acute alcohol-attributable admissions and a 9.22% reduction in chronic alcohol-attributable admissions 2 years later. A Can$ 0.10 increase in average minimum price would prevent 166 acute admissions in the 1st year and 275 chronic admissions 2 years later. We also estimated significant, though smaller, adverse impacts of increased private liquor store density on hospital admission rates for all types of alcohol-attributable admissions. Conclusions. Significant health benefits were observed when minimum alcohol prices in British Columbia were increased. By contrast, adverse health outcomes were associated with an expansion of private liquor stores. PMID:23597383

Dose-Escalated Stereotactic Body Radiation Therapy for Patients With Intermediate- and High-Risk Prostate Cancer: Initial Dosimetry Analysis and Patient Outcomes

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

Kotecha, Rupesh; Djemil, Toufik; Tendulkar, Rahul D.

Purpose: To report the short-term clinical outcomes and acute and late treatment-related genitourinary (GU) and gastrointestinal (GI) toxicities in patients with intermediate- and high-risk prostate cancer treated with dose-escalated stereotactic body radiation therapy (SBRT). Methods and Materials: Between 2011 and 2014, 24 patients with prostate cancer were treated with SBRT to the prostate gland and proximal seminal vesicles. A high-dose avoidance zone (HDAZ) was created by a 3-mm expansion around the rectum, urethra, and bladder. Patients were treated to a minimum dose of 36.25 Gy in 5 fractions, with a simultaneous dose escalation to a dose of 50 Gy to the targetmore » volume away from the HDAZ. Acute and late GU and GI toxicity outcomes were measured according to the National Cancer Institute Common Terminology Criteria for Adverse Events toxicity scale, version 4. Results: The median follow-up was 25 months (range, 18-45 months). Nine patients (38%) experienced an acute grade 2 GU toxicity, which was medically managed, and no patients experienced an acute grade 2 GI toxicity. Two patients (8%) experienced late grade 2 GU toxicity, and 2 patients (8%) experienced late grade 2 GI toxicity. No acute or late grade ≥3 GU or GI toxicities were observed. The 24-month prostate-specific antigen relapse-free survival outcome for all patients was 95.8% (95% confidence interval 75.6%-99.4%), and both biochemical failures occurred in patients with high-risk disease. All patients are currently alive at the time of this analysis and continue to be followed. Conclusions: A heterogeneous prostate SBRT planning technique with differential treatment volumes (low dose: 36.25 Gy; and high dose: 50 Gy) with an HDAZ provides a safe method of dose escalation. Favorable rates of biochemical control and acceptably low rates of acute and long-term GU and GI toxicity can be achieved in patients with intermediate- and high-risk prostate cancer treated with SBRT.« less

Kinematic alignment is a possible alternative to mechanical alignment in total knee arthroplasty.

PubMed

Lee, Yong Seuk; Howell, Stephen M; Won, Ye-Yeon; Lee, O-Sung; Lee, Seung Hoon; Vahedi, Hamed; Teo, Seow Hui

2017-11-01

A systematic review was conducted to answer the following questions: (1) Does kinematically aligned (KA) total knee arthroplasty (TKA) achieve clinical outcomes comparable to those of mechanically aligned (MA) TKA? (2) How do the limb, knee, and component alignments differ between KA and MA TKA? (3) How is joint line orientation angle (JLOA) changed from the native knee in KA TKA compared to that in MA TKA? Nine full-text articles in English that reported the clinical and radiological outcomes of KA TKA were included. Five studies had a control group of patients who underwent MA TKA. Data on patient demographics, clinical scores, and radiological results were extracted. There were two level I, one level II, three level III, and three level IV studies. Six of the nine studies used patient-specific instrumentation, one study used computer navigation, and two studies used manual instrumentation. The clinical outcomes of KA TKA were comparable or superior to those of MA TKA with a minimum 2-year follow-up. Limb and knee alignment in KA TKA was similar to those in MA TKA, and component alignment showed slightly more varus in the tibial component and slightly more valgus in the femoral component. The JLOA in KA TKA was relatively parallel to the floor compared to that in the native knee and not oblique (medial side up and lateral side down) compared to that in MA TKA. The implant survivorship and complication rate of the KA TKA were similar to those of the MA TKA. Similar or better clinical outcomes were produced by using a KA TKA at early-term follow-up and the component alignment differed from that of MA TKA. KA TKA seemed to restore function without catastrophic failure regardless of the alignment category up to midterm follow-up. The JLOA in KA TKA was relatively parallel to the floor similar to the native knee compared to that in MA TKA. The present review of nine published studies suggests that relatively new kinematic alignment is an acceptable and alternative alignment to mechanical alignment, which is better understood. Further validation of these findings requires more randomized clinical trials with longer follow-up. Level II.

General deterrence effects of U.S. statutory DUI fine and jail penalties: long-term follow-up in 32 states.

PubMed

Wagenaar, Alexander C; Maldonado-Molina, Mildred M; Erickson, Darin J; Ma, Linan; Tobler, Amy L; Komro, Kelli A

2007-09-01

We examined effects of state statutory changes in DUI fine or jail penalties for firsttime offenders from 1976 to 2002. A quasi-experimental time-series design was used (n=324 monthly observations). Four outcome measures of drivers involved in alcohol-related fatal crashes are: single-vehicle nighttime, low BAC (0.01-0.07g/dl), medium BAC (0.08-0.14g/dl), high BAC (>/=0.15g/dl). All analyses of BAC outcomes included multiple imputation procedures for cases with missing data. Comparison series of non-alcohol-related crashes were included to efficiently control for effects of other factors. Statistical models include state-specific Box-Jenkins ARIMA models, and pooled general linear mixed models. Twenty-six states implemented mandatory minimum fine policies and 18 states implemented mandatory minimum jail penalties. Estimated effects varied widely from state to state. Using variance weighted meta-analysis methods to aggregate results across states, mandatory fine policies are associated with an average reduction in fatal crash involvement by drivers with BAC>/=0.08g/dl of 8% (averaging 13 per state per year). Mandatory minimum jail policies are associated with a decline in single-vehicle nighttime fatal crash involvement of 6% (averaging 5 per state per year), and a decline in low-BAC cases of 9% (averaging 3 per state per year). No significant effects were observed for the other outcome measures. The overall pattern of results suggests a possible effect of mandatory fine policies in some states, but little effect of mandatory jail policies.

Physical activity is associated with the physical, psychological, social and environmental quality of life in people with mental health problems in a low resource setting.

PubMed

Vancampfort, Davy; Van Damme, Tine; Probst, Michel; Firth, Joseph; Stubbs, Brendon; Basangwa, David; Mugisha, James

2017-12-01

There is a growing recognition of the importance of encouraging patients with mental health problems to become more active as an efficacious strategy to reduce the disability-associated burden. The aim of the current study was to investigate if there are differences in quality of life (QoL) outcomes between people with mental health problems that do and do not meet the recommendations of 150min per week of physical activity. 109 (36♀) Ugandan in- and outpatients (mean age = 34.2 ± 10.2 years) (depression = 7, bipolar disorder = 31, schizophrenia = 21, alcohol use disorder = 50) completed the Physical Activity Vital Sign (PAVS) method and World Health Organization Quality of Life Assessment brief version. Those who did not achieve the minimum physical activity recommendations as assessed by the PAVS (n = 63) had a lower physical, psychological, social and environmental QoL. The current data offer further evidence that the PAVS method might be an important risk identification tool in people with mental health problems. The feasibility and acceptability of the PAVS may help promote the importance of physical activity assessment and prescription as a core part of the treatment of mental health problems in LMICs. Copyright © 2017 Elsevier B.V. All rights reserved.

Optimal subsystem approach to multi-qubit quantum state discrimination and experimental investigation

NASA Astrophysics Data System (ADS)

Xue, ShiChuan; Wu, JunJie; Xu, Ping; Yang, XueJun

2018-02-01

Quantum computing is a significant computing capability which is superior to classical computing because of its superposition feature. Distinguishing several quantum states from quantum algorithm outputs is often a vital computational task. In most cases, the quantum states tend to be non-orthogonal due to superposition; quantum mechanics has proved that perfect outcomes could not be achieved by measurements, forcing repetitive measurement. Hence, it is important to determine the optimum measuring method which requires fewer repetitions and a lower error rate. However, extending current measurement approaches mainly aiming at quantum cryptography to multi-qubit situations for quantum computing confronts challenges, such as conducting global operations which has considerable costs in the experimental realm. Therefore, in this study, we have proposed an optimum subsystem method to avoid these difficulties. We have provided an analysis of the comparison between the reduced subsystem method and the global minimum error method for two-qubit problems; the conclusions have been verified experimentally. The results showed that the subsystem method could effectively discriminate non-orthogonal two-qubit states, such as separable states, entangled pure states, and mixed states; the cost of the experimental process had been significantly reduced, in most circumstances, with acceptable error rate. We believe the optimal subsystem method is the most valuable and promising approach for multi-qubit quantum computing applications.

Outcome assessment of patients undergoing maxillofacial procedures for the treatment of sleep apnea: comparison of subjective and objective results.

PubMed

Dattilo, David J; Drooger, Scott A

2004-02-01

The purpose of this study was to compare the subjective findings of the Epworth Sleepiness Scale (ESS) to the objective findings of the overnight sleep study (OSS) in 57 patients who underwent phase I and phase II surgery for the correction of obstructive sleep apnea (OSA). Forty-two patients in phase I category (hyoid suspension, palatal surgery, and/or genioglossus advancement) and 15 patients in phase II category (maxillomandibular advancement) were examined. All patients had an OSS and completion of an ESS preoperatively and at a minimum of 8 weeks postoperatively. The results of each test were evaluated to examine any relationship between the improvements of the findings of the OSS to the changes in the ESS. Using accepted criteria, phase I surgery produced an 80% success rate and phase II surgery produced a greater than 95% success rate in both the respiratory disturbance index and the ESS. 1) Both phase I and phase II procedures are effective in treating OSA. 2) Phase II appears to be more effective in treating OSA using both objective and subjective evaluations. 3) Improvement in ESS scores and excessive daytime sleepiness seems to parallel the improvement in OSS scores in patients undergoing surgical correction of OSA.

People with learning disabilities in 'out-of-area' residential placements: 2. Reasons for and effects of placement.

PubMed

Beadle-Brown, J; Mansell, J L; Whelton, B; Hutchinson, A; Skidmore, C

2006-11-01

Official guidance on out-of-area placements creates incentives that could lead to people being placed against their own best interests, with negative consequences for them and for the 'receiving' authorities. Information was collected for 30 people through interviews with them, their families, home managers and care managers. Interviews concerned resident needs, reasons for placement, the homes, care management arrangements, resident quality of life and social inclusion. Information on care standards was abstracted from official records. The main reasons for out-of-area placement were insufficient local services of acceptable quality, financial incentives and loss of family contact through prior institutionalization. The effects varied, with the most disabled people experiencing worst outcomes. Some aspects were worse than comparison studies (choice, community involvement, number of homes meeting all the national minimum standards), some were the same (participation, family visiting and other contact), and one was better (visits to families). Variation was also evident in the involvement of social services staff from the placing authority and in ease of access to local healthcare resources. Social services and health authorities should develop services locally that can support people with the full range of individual needs. Perverse incentives should be removed, perhaps by increasing the application of direct payments and personalized budgets.

Seeking Global Minima

NASA Astrophysics Data System (ADS)

Tajuddin, Wan Ahmad

1994-02-01

Ease in finding the configuration at the global energy minimum in a symmetric neural network is important for combinatorial optimization problems. We carry out a comprehensive survey of available strategies for seeking global minima by comparing their performances in the binary representation problem. We recall our previous comparison of steepest descent with analog dynamics, genetic hill-climbing, simulated diffusion, simulated annealing, threshold accepting and simulated tunneling. To this, we add comparisons to other strategies including taboo search and one with field-ordered updating.

Transient Pressure Measurements in the Vaneless Space of a Francis Turbine during Load Acceptances from Minimum Load

NASA Astrophysics Data System (ADS)

Goyal, R.; Gandhi, B. K.; Cervantes, M. J.

2018-06-01

Increased penetration of solar and the wind impels the designers of the hydroelectric power generation unit to provide more flexibility in operation for the stability of the grid. The power generating unit includes turbine which needs to sustain sudden change in its operating conditions. Thus, the hydraulic turbine experiences more transients per day which result in chronic problems such as fatigue to the runner, instrument malfunctioning, vibrations, wear and tear etc. This paper describes experiments performed on a high model (1.5:1) Francis turbine for load acceptances from the minimum load. The experiments presented in the paper are the part of Francis-99 workshop which aims to determine the performance of numerical models in simulations of model Francis turbine under steady and transient operating conditions. The aim of the paper is to present the transient pressure variation in the vaneless space of a Francis turbine where high-frequency pulsations are normally expected. For this, two pressure sensors, VL1 and VL2, are mounted at the vaneless space, one near the beginning of the spiral casing and the other before the end of the spiral casing. Both are used to capture the unsteady pressure field developed in the space between guide vanes and runner inlet. The time-resolved pressure signals are analyzed and presented during the transient to observe the pressure variation and dominant frequencies of pulsations.