Needed: A Fresh Perspective on Campus Violence
ERIC Educational Resources Information Center
Bernier, Anthony; Males, Mike
2017-01-01
That campuses suffer unacceptable levels of violence is undisputable; they are part of a larger American society in which family, community, and institutional violence far exceed levels found in comparable Western nations. And yet, amid the finger-pointing and scapegoating of students as violent, we note a critical lack of evidence-based analysis,…
Making Training More Cognitively Effective: Making Videos Interactive
ERIC Educational Resources Information Center
Cherrett, Tom; Wills, Gary; Price, Joe; Maynard, Sarah; Dror, Itiel E.
2009-01-01
The cost of health and safety (H&S) failures to the UK industry is currently estimated at up to 6.5 billion British Pounds per annum, with the construction sector suffering unacceptably high levels of work-related incidents. Better H&S education across all skill levels in the industry is seen as an integral part of any solution.…
Atypical Opioid Mechanisms of Control of Injury-Induced Cutaneous Pain by Delta Receptors
2016-07-01
treat, and current opioids (i.e. mu opioid receptor agonists such as morphine) cause unacceptable side effects including addiction . Injuries suffered...treat, and current opioids that act on mu opioid receptors such as morphine generate significant side effects including addiction . War-related...slides. Slides were then processed for fluorescent in situ hybridization with RNAscope technology (ACD Biosystems) to detect Oprd1 mRNA, as described
Bentley, Walter J
2009-12-01
The foundation of an integrated pest management program involves valid treatment thresholds, accurate and simple monitoring methods, effective natural controls, selective pesticides and trained individuals who can implement the concept. The Integrated Control Concept written by Stern, Smith, van den Bosch and Hagen elucidated each of these points in an alfalfa ecosystem. Alfalfa hay (Medicago sativa L.) has a low per acre value, requires little hand labor and is primarily marketed in the USA. In contrast, fresh market table grape (Vitis vinifera L.) has a high per acre value, requires frequent hand labor operations, suffers unacceptable cosmetic damage and is marketed throughout both the USA and the world. Each of the components of a working IPM program is present in table grape production. Marketing grapes to foreign countries presents special problems with pests considered invasive and where residue tolerances for some selective insecticides are lacking. However, fresh market grape farmers are still able to deal with these special problems and utilize an IPM program that has resulted in a 42% reduction in broad-spectrum insecticide use from 1995 to 2007. (c) 2009 Society of Chemical Industry.
ERIC Educational Resources Information Center
Levine-Brown, Linda S.
This report describes the implementation of a data-based program to reduce unacceptable student behaviors and decrease the number of administrative interventions with 21 students with severe emotional disturbances. A computerized database was developed to track classroom and transportation discipline infractions. Students met monthly to review…
Khosravani, Vahid; Sharifi Bastan, Farangis; Samimi Ardestani, Mehdi; Jamaati Ardakani, Razieh
2017-09-01
There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Long Duration Space Missions: Human Subsystem Risks and Requirements
NASA Technical Reports Server (NTRS)
Kundrot, Criag E.
2011-01-01
This viewgraph presentation reviews the human health and performance risks associated with long duration space flight beyond low earth orbit. The contents include: 1) Human Research Program; 2) Human Subsystem Risks; 3) Human Exploration Framework Team (HEFT) Architecture Elements; 4) Potentially Unacceptable Risks -1; 5) Potentially Unacceptable Risks-2; and 6) Major Mission Drivers of Risk.
Living to the bitter end? A personalist approach to euthanasia in persons with severe dementia.
Gastmans, Chris; De Lepeleire, Jan
2010-02-01
The number of people suffering from dementia will rise considerably in the years to come. This will have important implications for society. People suffering from dementia have to rely on relatives and professional caregivers when their disorder progresses. Some people want to determine for themselves their moment of death, if they should become demented. They think that the decline in personality caused by severe dementia is shocking and unacceptable. In this context, some people consider euthanasia as a way to avoid total deterioration. In this article, we discuss some practical and ethical dilemmas regarding euthanasia in persons with severe dementia based on an advance euthanasia directive. We are using a personalist approach in dealing with these ethical dilemmas.
Spherical shock waves in general relativity
NASA Astrophysics Data System (ADS)
Nutku, Y.
1991-11-01
We present the metric appropriate to a spherical shock wave in the framework of general relativity. This is a Petrov type-N vacuum solution of the Einstein field equations where the metric is continuous across the shock and the Riemann tensor suffers a step-function discontinuity. Spherical gravitational waves are described by type-N Robinson-Trautman metrics. However, for shock waves the Robinson-Trautman solutions are unacceptable because the metric becomes discontinuous in the Robinson-Trautman coordinate system. Other coordinate systems that have so far been introduced for describing Robinson-Trautman solutions also suffer from the same defect. We shall present the C0-form of the metric appropriate to spherical shock waves using Penrose's approach of identification with warp. Further extensions of Penrose's method yield accelerating, as well as coupled electromagnetic-gravitational shock-wave solutions.
Skid correction program : user's manual.
DOT National Transportation Integrated Search
2012-06-01
This document outlines methods for use by UDOT personnel to address pavements with unacceptable skid numbers. The program involves coordination between Safety, Pavement Management, Region, and Maintenance managers. A process has been recommended usin...
DOT National Transportation Integrated Search
2000-05-01
The current safety and loss control program for the South Dakota Department of Transportation is not reaching its full potential and does not adequately prevent accidents and injuries. The Department has experienced an unacceptably high number of acc...
Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi
2017-09-01
The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Spherical shock waves in general relativity
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nutku, Y.
1991-11-15
We present the metric appropriate to a spherical shock wave in the framework of general relativity. This is a Petrov type-{ital N} vacuum solution of the Einstein field equations where the metric is continuous across the shock and the Riemann tensor suffers a step-function discontinuity. Spherical gravitational waves are described by type-{ital N} Robinson-Trautman metrics. However, for shock waves the Robinson-Trautman solutions are unacceptable because the metric becomes discontinuous in the Robinson-Trautman coordinate system. Other coordinate systems that have so far been introduced for describing Robinson-Trautman solutions also suffer from the same defect. We shall present the {ital C}{sup 0}-formmore » of the metric appropriate to spherical shock waves using Penrose's approach of identification with warp. Further extensions of Penrose's method yield accelerating, as well as coupled electromagnetic-gravitational shock-wave solutions.« less
Obstetric fistula: what about gender power?
Roush, Karen; Kurth, Ann; Hutchinson, M Katherine; Van Devanter, Nancy
2012-01-01
Despite over 40 years of research there has been little progress in the prevention of obstetric fistula and women continue to suffer in unacceptable numbers. Gender power imbalance has consistently been shown to have serious implications for women's reproductive health and is known to persist in regions where obstetric fistula occurs. Yet, there is limited research about the role gender power imbalance plays in childbirth practices that put women at risk for obstetric fistula. This information is vital for developing effective maternal health interventions in regions affected by obstetric fistula.
NASA Astrophysics Data System (ADS)
Tomarov, G. V.; Shipkov, A. A.; Lovchev, V. N.; Gutsev, D. F.
2016-10-01
Problems of metal flow-accelerated corrosion (FAC) in the pipelines and equipment of the condensate- feeding and wet-steam paths of NPP power-generating units (PGU) are examined. Goals, objectives, and main principles of the methodology for the implementation of an integrated program of AO Concern Rosenergoatom for the prevention of unacceptable FAC thinning and for increasing operational flow-accelerated corrosion resistance of NPP EaP are worded (further the Program). A role is determined and potentialities are shown for the use of Russian software packages in the evaluation and prediction of FAC rate upon solving practical problems for the timely detection of unacceptable FAC thinning in the elements of pipelines and equipment (EaP) of the secondary circuit of NPP PGU. Information is given concerning the structure, properties, and functions of the software systems for plant personnel support in the monitoring and planning of the inservice inspection of FAC thinning elements of pipelines and equipment of the secondary circuit of NPP PGUs, which are created and implemented at some Russian NPPs equipped with VVER-1000, VVER-440, and BN-600 reactors. It is noted that one of the most important practical results of software packages for supporting NPP personnel concerning the issue of flow-accelerated corrosion consists in revealing elements under a hazard of intense local FAC thinning. Examples are given for successful practice at some Russian NPP concerning the use of software systems for supporting the personnel in early detection of secondary-circuit pipeline elements with FAC thinning close to an unacceptable level. Intermediate results of working on the Program are presented and new tasks set in 2012 as a part of the updated program are denoted. The prospects of the developed methods and tools in the scope of the Program measures at the stages of design and construction of NPP PGU are discussed. The main directions of the work on solving the problems of flow-accelerated corrosion of pipelines and equipment in Russian NPP PGU are defined.
Intensive Time Out Program Evaluation.
ERIC Educational Resources Information Center
Burton, Mary; Parks, Stephen
The New Brunswick (Canada) Youth Treatment Program is a community-based intervention strategy for conduct disordered youth in New Brunswick. The Program's Intensive Time Out (ITO) is a strategy to eliminate unacceptable behaviors. It is recommended within the school setting for children from 6 to 11 years of age, and is designed to reverse the…
Implementation and Impact of the Check & Connect Mentoring Program
ERIC Educational Resources Information Center
Heppen, Jessica; O'Cummings, Mindee; Poland, Lindsay; Zeiser, Krissy; Mills, Nicholas
2015-01-01
High school graduation rates remain unacceptably low in the U.S., especially among disadvantaged youth (Chapman, Laird, Ifill, & KelalRamani, 2011; Stillwell, 2010), with troubling implications for future earnings and employment status (Bureau of Labor Statistics, 2012). Check & Connect (C&C) is an individualized program that pairs…
Gynecologic Oncology Group quality assurance audits: analysis and initiatives for improvement.
Blessing, John A; Bialy, Sally A; Whitney, Charles W; Stonebraker, Bette L; Stehman, Frederick B
2010-08-01
The Gynecologic Oncology Group (GOG) is a multi-institution, multi-discipline Cooperative Group funded by the National Cancer Institute (NCI) to conduct clinical trials which investigate the treatment, prevention, control, quality of survivorship, and translational science of gynecologic malignancies. In 1982, the NCI initiated a program of on-site quality assurance audits of participating institutions. Each is required to be audited at least once every 3 years. In GOG, the audit mandate is the responsibility of the GOG Quality Assurance Audit Committee and it is centralized in the Statistical and Data Center (SDC). Each component (Regulatory, Investigational Drug Pharmacy, Patient Case Review) is classified as Acceptable, Acceptable, follow-up required, or Unacceptable. To determine frequently occurring deviations and develop focused innovative solutions to address them. A database was created to examine the deviations noted at the most recent audit conducted at 57 GOG parent institutions during 2004-2007. Cumulatively, this involved 687 patients and 306 protocols. The results documented commendable performance: Regulatory (39 Acceptable, 17 Acceptable, follow-up, 1 Unacceptable); Pharmacy (41 Acceptable, 3 Acceptable, follow-up, 1 Unacceptable, 12 N/A): Patient Case Review (31 Acceptable, 22 Acceptable, follow-up, 4 Unacceptable). The nature of major and lesser deviations was analyzed to create and enhance initiatives for improvement of the quality of clinical research. As a result, Group-wide proactive initiatives were undertaken, audit training sessions have emphasized recurring issues, and GOG Data Management Subcommittee agendas have provided targeted instruction and training. The analysis was based upon parent institutions only; affiliate institutions and Community Clinical Oncology Program participants were not included, although it is assumed their areas of difficulty are similar. The coordination of the GOG Quality Assurance Audit program in the SDC has improved data quality by enhancing our ability to identify frequently occurring deviations and develop innovative solutions to avoid or minimize their occurrence in the future.
Final Rule (signed September 26, 2016)
New Listings of Substitutes; Changes of Listing Status; and Reinterpretation of Unacceptability for Closed Cell Foam Products under the SNAP Program; and Revision of Clean Air Act Section 608 Venting Prohibition for Propane.
Superfund: Contaminated Sediments
Contaminated sediments are a significant environmental problem and contribute to the over 3,200 fish consumption advisories nationwide. The Superfund program cleans up sediment sites that present an unacceptable risk to human health or the environment.
Proposed Rule (April 18, 2016)
Proposed Rule - Protection of Stratospheric Ozone: New Listings of Substitutes; Changes of Listing Status; Reinterpretation of Unacceptability for Closed Cell Foam Products under the Significant New Alternatives Policy Program; and Revision of Clean Air Ac
The Efficacy of a Multifaceted Weight Management Program for Children and Young Adolescents
ERIC Educational Resources Information Center
Kihm, Holly Spencer
2014-01-01
The incidence of overweight and obesity among children and young adolescents remains unacceptably high and places our youth at risk for several negative outcomes. Recognizing the need for a youth-focused weight management program in our community, the researcher developed, implemented, and evaluated a small pilot study, FitKids. The aims of…
Section 612(c) of the Clean Air Act (CAA) requires the Agency to publish a list of acceptable and unacceptable substitutes for ozone-depleting substances (ODS). The SNAP program does not require that substitutes be risk- free to be found acceptable.
Karadeniz, S T; Akgul, S U; Ogret, Y; Ciftci, H S; Bayraktar, A; Bakkaloglu, H; Caliskan, Y; Yelekci, K; Turkmen, A; Aydin, A E; Oguz, F S; Carin, M; Aydin, F
2017-04-01
High rates of panel-reactive antibody (PRA) may decrease the chance of kidney transplantation and may result in long waiting periods before transplantation. The calculated PRA (cPRA) is performed based on unacceptable HLA antigens. These antigens are identified by a program that was created based on the antibodies that developed against the HLA antigens circulating in serum and on the risk of binding of these antibodies to antigens. The antigen profile of the population and antigen frequencies can be measured, and more realistic cPRA positivity rates may be obtained using this method. We developed a program based on the HLA antigens of 494 blood donors in 2 European Federation for Immunogenetics-accredited Tissue Typing Laboratories in Turkey. Next-generation sequencing-based tissue typing (HLA-A, -B, -C, -DR, -DQ, 4 digits) of the samples was performed. The PRA screening test was performed on 380 patients who were waiting for organ transplant from a cadaver in Istanbul Faculty of Medicine. The single antigen bead assay testing was performed to identify the antibody profiles on 48 hypersensitized patients. The PRA testing results using the current methods were 44.6% ± 18.5%, and the cPRA rate was 86.2% ± 5.1%. The mean PRA positivity of the sensitized patients using the current methods was 44.6%; however, the rate was 86.2% using the cPRA. cPRA shows the rate of the rejected donors according to all unacceptable antigens. The need for a list of unacceptable antigens in place of the PRA positivity rate is a real change in the sensitization-dependent calculation as cPRA positivity rate. In principal, implementation of cPRA will encourage many centers and laboratories to adopt a standard measurement of sensitization in Turkey. It will increase the chances of better donor match, particularly for hypersensitized patients, by the creation of an unacceptable mismatch program using cPRA software. Copyright © 2017 Elsevier Inc. All rights reserved.
New Bedford Harbor Long Term Monitoring Program
New Bedford Harbor (NBH), located in southeastern Massachusetts, was designated as a Superfund site in 1983 due to unacceptably high levels of sediment contamination by polychlorinated biphenyls (PCBs). Based on human health and environmental concerns, the decision was made to d...
ERIC Educational Resources Information Center
Vallejo, M. Edmund
1987-01-01
Although the Pueblo (Colorado) School District's student dropout rate compares favorably with national and state data, the community found the disproportionate number of Hispanic dropouts unacceptable. This article describes the district's efforts to reorganize staff, strengthen existing programs, and institute teen mother, inhouse suspension,…
48 CFR 25.504 - Evaluation Examples.
Code of Federal Regulations, 2011 CFR
2011-10-01
... PROGRAMS FOREIGN ACQUISITION Evaluating Foreign Offers-Supply Contracts 25.504 Evaluation Examples. The... examples assume that the contracting officer has eliminated all offers that are unacceptable for reasons... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Evaluation Examples. 25...
42 CFR 493.1445 - Standard; Laboratory director responsibilities.
Code of Federal Regulations, 2010 CFR
2010-10-01
... quality laboratory services for all aspects of test performance, which includes the preanalytic, analytic... result is found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...
Even minimally or moderately corrosive water can cause unacceptable and dangerous lead contamination to be released from common plumbing materials and devices into drinking water. Designing sampling programs to uncover the potential for ingestion of lead in water and to protect ...
5 CFR 432.105 - Proposing and taking action based on unacceptable performance.
Code of Federal Regulations, 2010 CFR
2010-01-01
... unacceptable performance. 432.105 Section 432.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERFORMANCE BASED REDUCTION IN GRADE AND REMOVAL ACTIONS § 432.105 Proposing and taking action based on unacceptable performance. (a) Proposing action based on unacceptable performance...
Backcountry impact management: Lessons from research
David N. Cole
1994-01-01
Recreational use of backcountry inevitably impacts environments intended for preservation. Where use is light or where management programs provide adequate protection, impacts need not be unacceptably severe. However, where use is heavy and protective actions are inadequate, impacts may be severe and widespread. Trails may become deeply eroded trenches or mudholes and...
42 CFR 493.1407 - Standard; Laboratory director responsibilities.
Code of Federal Regulations, 2010 CFR
2010-10-01
... developed and used for each of the tests performed in the laboratory provide quality laboratory services for... results are found to be unacceptable or unsatisfactory; (5) Ensure that the quality control and quality assessment programs are established and maintained to assure the quality of laboratory services provided and...
Code of Federal Regulations, 2010 CFR
2010-07-01
... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...
Code of Federal Regulations, 2012 CFR
2012-07-01
... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...
Code of Federal Regulations, 2011 CFR
2011-07-01
... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...
Eliminating the Use of Behavioral Techniques that are Cruel and Dehumanizing
ERIC Educational Resources Information Center
Weiss, Nancy R.
2005-01-01
In schools and residential programs across the country, individuals with disabilities are victims of "aversive interventions" which are used to control challenging behaviors. This means that painful or dehumanizing procedures are used in response to behaviors that are judged to be unacceptable. Aversive procedures include the use of electric…
Comparison of Selected Bale Moisture Measurements in a Commercial Gin
USDA-ARS?s Scientific Manuscript database
Proper measurement of bale moisture content (mc) is crucial to proper management of a cotton gin. One issue would be to avoid producing wet cotton, unacceptable for Commodity Credit Corporation Marketing Assistance Loan Program, which is defined to be a bale of cotton which is at or above 7.5% wet ...
An Investigation of the Teacher Advancement Program and Student Performance in Urban Schools
ERIC Educational Resources Information Center
Grant, Ginger Madonna
2010-01-01
In 2005, the achievement gap between African-American and Caucasian students doubled in the state of Louisiana. Sixty-three percent of the public schools in an urban school district in southeastern Louisiana received an Academically Unacceptable Status (AUS) rating according to Louisiana accountability standards. In 2006, the Louisiana Board of…
NASA Technical Reports Server (NTRS)
Dupnick, E.; Wiggins, D.
1980-01-01
The functional specifications, functional design and flow, and the program logic of the GREEDY computer program are described. The GREEDY program is a submodule of the Scheduling Algorithm for Mission Planning and Logistics Evaluation (SAMPLE) program and has been designed as a continuation of the shuttle Mission Payloads (MPLS) program. The MPLS uses input payload data to form a set of feasible payload combinations; from these, GREEDY selects a subset of combinations (a traffic model) so all payloads can be included without redundancy. The program also provides the user a tutorial option so that he can choose an alternate traffic model in case a particular traffic model is unacceptable.
[Futile medical care and euthanasia in the opinion of professional nurses].
Renn-Zurek, Agnieszka
2014-03-01
Futile medical care and euthanasia are hard to assess unequivocally and are becoming a frequent topic of social discussion. The problem requires both ethical and moral consideration as well as legal regulations. As a medical issue it has got both its supporters and opponents. The aim of the study was to evaluate of nurses' attitudes and knowledge concerning euthanasia and persistend therapy. The survey group included 183 nurses aged 30-58. The diagnostic method poll was applied, the technique used was a questionnaire. Among the nurses participating in the survey, 83% is against providing futile medical care when it is known that it will not bring any effect, while increasing the suffering and prolonging dying. 45% of the respondents consider euthanasia unacceptable, 41% think that euthanasia could be performed in cases in which patient's suffering cannot be relieved. 49% of the surveyed think that euthanasia should remain strictly prohibited by the Polish law, while 31% think that Polish legal system should legalize euthanasia. The nurses are aware that futile medical care for terminally ill and dying patients does not lead to successful treatment but instead it prolongs dying and suffering, at the same time resulting in extremely high financial costs. In most cases they are advocates of its discontinuing. The surveyed nurses differ in their approach towards euthanasia, some of them supporting the idea, the other--opposing it. Most of them express the opinion that euthanasia should be forbidden in the Polish law and their personal approach towards euthanasia is negative.
1979-01-01
syn- thesis proceed s by ignoring unacceptable syntax or other errors , pro- tection against subsequent execution of a faulty reaction scheme can be...resulting TAPE9 . During subroutine syn thesis and reaction processing, a search is made (fo r each secondary electron collision encountered) to...program library, which can be cat- alogued and saved if any future specialized modifications (beyond the scope of the syn thesis capability of LASER
ERIC Educational Resources Information Center
Ableidinger, Joe; Kowal, Julie
2010-01-01
As the United States continues to grapple with unacceptable education results, "a great teacher for every student" has risen to a national imperative. In response, many districts have increased retention efforts through teacher induction programs, professional development, mentoring, and other strategies. But education actually has lower…
Behavior Management Guide for Parents of Children with Dual Sensory Impairments. Bulletin No. 9129.
ERIC Educational Resources Information Center
Papineau, Andrew
This guide describes methods to help parents and others reduce the unacceptable behaviors of children with multiple sensory impairments and replace those behaviors with acceptable ones. The guide recommends that the behavior change program begin with simple changes so that both the parents and the child gain experience in changing behavior. The…
USDA-ARS?s Scientific Manuscript database
Proper measurement of bale moisture content (mc) is crucial to proper management of a cotton gin. It is important to avoid producing wet cotton both for the benefit of the mills and because wet cotton is unacceptable for Commodity Credit Corporation Marketing Assistance Loan Program. Wet cotton is...
Proposed New Listings of Substitutes; Changes of Listing Status; and Reinterpretation of Unacceptability for Closed Cell Foam Products Under the Significant New Alternatives Policy Program; and Revision of Clean Air Act Section 608 Venting Prohibition for
Code of Federal Regulations, 2011 CFR
2011-07-01
... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...
Code of Federal Regulations, 2010 CFR
2010-07-01
... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...
Code of Federal Regulations, 2010 CFR
2010-07-01
... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...
Code of Federal Regulations, 2011 CFR
2011-07-01
... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...
A fully analytic treatment of resonant inductive coupling in the far field
NASA Astrophysics Data System (ADS)
Sedwick, Raymond J.
2012-02-01
For the application of resonant inductive coupling for wireless power transfer, fabrication of flat spiral coils using ribbon wire allows for analytic expressions of the capacitance and inductance of the coils and therefore the resonant frequency. The expressions can also be used in an approximate way for the analysis of coils constructed from cylindrical wire. Ribbon wire constructed from both standard metals as well as high temperature superconducting material is commercially available, so using these derived expressions as a basis, a fully analytic treatment is presented that allows for design trades to be made for hybrid designs incorporating either technology. The model is then extended to analyze the performance of the technology as applied to inductively coupled communications, which has been demonstrated as having an advantage in circumstances where radiated signals would suffer unacceptable levels of attenuation.
A robust probabilistic collaborative representation based classification for multimodal biometrics
NASA Astrophysics Data System (ADS)
Zhang, Jing; Liu, Huanxi; Ding, Derui; Xiao, Jianli
2018-04-01
Most of the traditional biometric recognition systems perform recognition with a single biometric indicator. These systems have suffered noisy data, interclass variations, unacceptable error rates, forged identity, and so on. Due to these inherent problems, it is not valid that many researchers attempt to enhance the performance of unimodal biometric systems with single features. Thus, multimodal biometrics is investigated to reduce some of these defects. This paper proposes a new multimodal biometric recognition approach by fused faces and fingerprints. For more recognizable features, the proposed method extracts block local binary pattern features for all modalities, and then combines them into a single framework. For better classification, it employs the robust probabilistic collaborative representation based classifier to recognize individuals. Experimental results indicate that the proposed method has improved the recognition accuracy compared to the unimodal biometrics.
Healthcare: affordable quality coverage for all.
Lee, Keat Jin
2009-06-01
The quality of medical care available in the United States is the best in the world. However, today's American healthcare delivery system is unacceptable. It is too expensive, disjointed, and wasteful. The amount spent on healthcare in the United States is sufficient to meet everyone's needs; the reason it does not is that the money is misspent. Healthcare makes up 16 percent of the gross domestic product, or $2.3 trillion, yet 46 million people are uninsured, the majority of people are underinsured, and even those with insurance suffer significant hassles in receiving healthcare. Medical errors occur at alarming rates. The lack of quality measures to define best practices leads to a wide variation of practices and costs. Fragmented healthcare leads to errors. The goal of this paper is to explore a set of 20 comprehensive steps to begin reform of healthcare in this country.
ERIC Educational Resources Information Center
Gray, Jennifer; Garner, Linda; Snow, Diane; Wright, Kathy
2004-01-01
To care for the whole person, nurses must provide spiritual care (Narayanasamy, 1995; Wright, 1998). The inability to consistently and effectively provide spiritual care has been linked to the lack of educational preparation in our basic nursing programs (Govier, 2000; Piles, 1990). This lack of preparation is unacceptable because patients…
USDA-ARS?s Scientific Manuscript database
Proper measurement of bale moisture content (mc) is crucial to proper management of a cotton gin. It is important to avoid producing wet cotton, unacceptable for Commodity Credit Corporation Marketing Assistance Loan Program, which is defined to be a bale of cotton which is at or above 7.5% wet bas...
All Stars Plus: A Competence and Motivation Enhancement Approach to Prevention
ERIC Educational Resources Information Center
Hansen, William B.; Dusenbury, Linda
2004-01-01
All Stars Core is a school-based drug abuse prevention program for 11 to 14 year olds from the United States. It focuses on five qualities that protect children from drug use: viewing drug use as uncommon and unacceptable to the peer group (norms); viewing drug use as interfering with future goals; commitment to avoid drug use; positive attention…
19 CFR 152.108 - Unacceptable bases of appraisement.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 19 Customs Duties 2 2013-04-01 2013-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...
19 CFR 152.108 - Unacceptable bases of appraisement.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 19 Customs Duties 2 2011-04-01 2011-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...
19 CFR 152.108 - Unacceptable bases of appraisement.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 19 Customs Duties 2 2012-04-01 2012-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...
19 CFR 152.108 - Unacceptable bases of appraisement.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 19 Customs Duties 2 2010-04-01 2010-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...
The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder.
Brakoulias, Vlasios; Starcevic, Vladan; Berle, David; Milicevic, Denise; Moses, Karen; Hannan, Anthony; Sammut, Peter; Martin, Andrew
2013-10-01
In the quest to unravel the heterogeneity of obsessive-compulsive disorder (OCD), an increasing number of factor analytic studies are recognising unacceptable/taboo thoughts as one of the symptom dimensions of OCD. This study aims to examine the characteristics associated with unacceptable/taboo thoughts. Using the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC) with 154 individuals with OCD, obsessive-compulsive symptoms were subjected to principal components analysis. The characteristics associated with the resulting symptom dimensions were then assessed using logistic and linear regression techniques. Unacceptable/taboo thoughts comprised of sexual, religious and impulsive aggressive obsessions, and mental rituals. Higher scores on an unacceptable/taboo thoughts symptom dimension were predicted by higher Y-BOCS obsession subscores, Y-BOCS time preoccupied by obsessions scores, Y-BOCS distress due to obsessions scores, importance of control of thought ratings, male gender, and having had treatment prior to entering into the study. Unacceptable/taboo thoughts were also predicted by greater levels of hostility, and a past history of non-alcohol substance dependence. An unacceptable/taboo thought symptom dimension of OCD is supported by a unique set of associated characteristics that should be considered in the assessment and treatment of individuals with these symptoms. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.
Englisch, Susanne; Fritzinger, Michael; Zink, Mathias
2008-01-01
Duloxetine, a dual-reuptake inhibitor of serotonin and norepinephrine, has been approved for the treatment of major depressive episodes and for female stress urinary incontinence. At present, only sparse experiences are available regarding antidepressive treatment in patients with a psychotic lifetime diagnose, whereas this group of patients often suffer from major depressive episodes. Here, we describe the first case of a male patient with postpsychotic depression who developed the severe side effect of urinary retention during antidepressive treatment with duloxetine combined with olanzapine. After remission of his psychotic episode, the patient presented with depressed mood, psychomotor inhibition, sleep disturbance, and suicidal ideas. Without changing the antipsychotic therapy, we implemented duloxetine (60 mg/d) and the patient significantly improved. However, he increasingly suffered from obstructive voiding difficulties and complained about a weak urinary stream and incomplete voiding leading to unacceptable dribbling. The urinary retention disappeared completely within 1 week after discontinuation of duloxetine. We switched to venlafaxine (150 mg/d) and were able to keep the depression in remission. This case report demonstrates for the first time the onset of urinary retention in postpsychotic depression and during combined treatment with duloxetine and olanzapine. We therefore suggest increased attention on voiding function in particular if several pharmacological agents are combined.
21 CFR 1305.25 - Unaccepted and defective electronic orders.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...
21 CFR 1305.25 - Unaccepted and defective electronic orders.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...
ERIC Educational Resources Information Center
Scroggins, Ruby C.
2012-01-01
The purpose of this study was to examine the degree of academic growth of Academically Unacceptable schools in Louisiana which have been assigned a Distinguished Educator. Distinguished Educators are external change agents who are placed in Academically Unacceptable schools in Louisiana. The data were generated from the Louisiana Department of…
Successful African-American Mathematics Students in Academically Unacceptable High Schools
ERIC Educational Resources Information Center
Sheppard, Peter A., IV
2005-01-01
The objectives of this study were to determine (1) the reasons why successful mathematics students have been able to thrive in schools labeled academically unacceptable and (2) why they have chosen to stay in these academically unacceptable schools despite having the option to leave for a better performing school. Qualitative methods including…
In Situ Wetland Restoration Demonstration
2014-07-01
Program (ESTCP) has funded the Naval Facilities Engineering and Expeditionary Warfare Center (NAVFAC EXWC) and its DoD partners: U.S. Army Public Health ...Command Engineering Service Center [NAVFAC ESC]) and its DoD partners U.S. Army Public Health Command, Naval Facilities Engineering Command Atlantic...made that unacceptable risks to human health or the environment may be present in portions of the Canal Creek system. Innovative technologies
Nuclear Weapon Accident Response Procedures (NARP) Manual
1990-09-01
5-E-13 5-E-5 Field M onitoring Data Log ................................................ 5-E-15 5-E-6 TLD Measurement Collection... Dosimetry Program and the USAF Master Radiation Exposure Registery, Oct 73. (u) OPNAVINST 3440.15, Minimum Criteria and Standards for Navy and Marine...ordnance to prevent an unacceptable detonation. Dosimetry . The measurement of radiation doses as it applies to both the devices used idosimeters) and to the
Code of Federal Regulations, 2010 CFR
2010-07-01
... STRATOSPHERIC OZONE Significant New Alternatives Policy Program Pt. 82, Subpt. G, App. H Appendix H to Subpart G..., 1999 CFC-12 Automobile and Non-automobile Motor Vehicle Air Conditioners, Retrofit and New Criteria for... inch or the thread direction must be reversed (i.e. right-handed vs. left-handed). Simply changing the...
McEachern, Kathryn; Semenoff-Irving, Marcia; van der Leeden, Pamela
2000-01-01
The monitoring program for elk effects on Tomales Point vegetation is designed to provide information on how tule elk grazing affects plant communities and rare species. The basic objective of the program is to show whether the elk are driving the vegetation into an unacceptable state by their grazing. The expectation is that as elk numbers increase, grazing pressure will increase too, resulting in unacceptable levels of any or all of the following: low vegetation ground cover, poor nutritional quality for the elk, undesirable increases in weedy species, unacceptable loss of native plant biodiversity, population declines in rare plants, population declines in plants used for food and nectar by the endangered silverspot butterfly, and increased erosion.The monitoring program has 3 basic components designed to provide complementary information on different aspects of the elk-vegetation system. Long-term plant community monitoring along permanent transects will show how plant species composition and cover are changing since cattle removal in 1979, and it will show whether any of he undesirable traits listed above are developing in the vegetation. However, monitoring these transects alone will not tell us what the effects of continued grazing by elk are apart from changes the vegetation would be undergoing anyway. In order to tease apart the elk effects from change that is happening because of cattle removal, elk exclosures are needed. By sampling inside and outside exclosures, we will be able to see how elk are modifying the rates and directions of change in the vegetation that would be happening in their absence. In a sense, the exclosures serve as a “check” on elk effects. They will allow us to interpret how much of the change is due to elk and how much can be attributed to other processes such as natural succession or weather patterns. This information will allow us to analyze whether changing elk management will have a desirable effect on the vegetation. Finally, periodic mapping and counting of plants in rare plant populations will show whether plant population ranges are expanding and populations are stable or growing. If not, then management actions can be taken to improve habitat conditions for the plants.A general summary of the rationale and sample design for each of the 3 components of the elk-effects monitoring program follows. Field sampling for the entire program should require about 15 weeks for a 2 to 3- person team, and data processing, analysis, and report writing should require about 9 weeks. Time and labor estimates for this program are given in Table A-1. In addition to elk-effects monitoring, Point Reyes staff periodically monitor fire transects and residual dry matter plots on Tomales Point. They are not included as part of the elk-effects monitoring program and they are described elsewhere. Protocols for fire and residual dry matter sampling are not included in the time estimate for the elk- effects monitoring program.
Code of Federal Regulations, 2014 CFR
2014-07-01
... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...
Code of Federal Regulations, 2013 CFR
2013-07-01
... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...
The need for an intermediate mass scale in GUTs
NASA Technical Reports Server (NTRS)
Shafi, Q.
1983-01-01
The minimal SU(5) grand unified field theory (GUT) model fails to resolve the strong charge parity (CP) problem, suffers from the cosmological monopole problem, sheds no light on the nature of the 'dark' mass in the universe, and predicts an unacceptably low value for the baryon asymmetry. All these problems can be overcome in suitable grand unified axion models with an intermediate mass scale of about 10 to the 11th power to 10 to the 12th power GeV. An example based on the gauge group SO(10) is presented. Among other things, it predicts that the axions comprise the 'dark' mass in the universe, and that there exists a galactic monopole flux of 10 to the -8th power to 10 to the -7th power/sq cm/yr. Other topics that are briefly discussed include proton decay, family symmetry, neutrino masses and the gauge hierarchy problem.
Hinrichsen, D
1989-01-01
A brief update on the destruction of the environment is given. The concern is for the coastal waters and rivers which are polluted daily by raw sewage, industrial waste, and sedimentation, e.g., the Juru in Malaysia, the Pasig in the Philippines, and the Chao Phraya in Thailand are open sewers by the time the rivers reach the sea or bay. Metropolitan Manila's river is said to be biologically dead from pollution, and the bays of Manila and Jakarta suffer from oxygen depletion. Unfortunately, the coastal area maintains population as well as the wealth of marine life. In the US in 1990, 75% of the population will live within 50 miles of a shore including the Great Lakes. 30 southeast Asia's 50 largest cities are located on or near a coast. Over fishing, over population, over developing, and over exploitation are unacceptable; the alternative is for man to correct his mistakes.
Procreative beneficence and the prospective parent
Herissone‐Kelly, P
2006-01-01
Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence (PPB) holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering. PMID:16507665
Procreative beneficence and the prospective parent.
Herissone-Kelly, P
2006-03-01
Julian Savulescu has given clear expression to a principle-that of "procreative beneficence"-which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence (PPB) holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering.
Kim, Heeyeon; Seo, Jiwoo; Namkoong, Kee; Hwang, Eun Hee; Sohn, Sung Yun; Kim, Se Joo; Kang, Jee In
2016-03-01
There is limited evidence on suicidality and its associated factors in patients with obsessive-compulsive disorder (OCD). The present study investigated the potential contributing traits such as alexithymia and perfectionism and clinical risk factors including symptom dimensions associated with high suicidality in OCD patients. A total of 81 patients with OCD were included (mean age: 28.89 years, SD=7.95 years, 62% men). Suicidal risk was assessed using the Scale for Suicide Ideation and history taking. To assess alexithymia and perfectionism, the Toronto Alexithymia Scale-20 and the Measure of Constructs Underlying Perfectionism were applied. Clinical characteristics of OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Obsessive-Compulsive Scale, and the Montgomery-Asberg Depression Rating Scale. Among OCD patients, 37% had a history of previous suicidal attempt, and 56.8% had current suicidal ideation. Those with lifetime suicide attempts scored significantly higher for alexithymia and ego-dystonic perfectionism than those without such history. In the binary logistic regression analysis, high score for alexithymia and the responsibility for harm, injury, or bad luck were significant determinants for lifetime suicide attempts. As for current suicide ideation, ego-dystonic perfectionism and the dimension of unacceptable thought were significant predictors of suicidal risk. The classification of suicidal risk and personality traits relied on self-report measures. The present findings indicate that personality traits such as alexithymia and perfectionism may contribute to high suicidality in patients with OCD, and patients suffering with unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2015 Elsevier B.V. All rights reserved.
21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...
21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...
Brian Roy Lockhart; Ralph D. Nyland
2004-01-01
Professional ethics involve statements by a professional organization to guide the behavior of its members, and to help them determine acceptable and unacceptable behavior in a given situation. Most, if not all, natural resource organizations have Code of Ethics. How to incorporate them across the curriculum and in individual courses of a natural resources program is a...
Chen, Gila
2010-09-01
The aim of the current article was to examine the meaning of suffering in drug addiction and in the recovery process. Negative emotions may cause primary suffering that can drive an individual toward substance abuse. At the same time, drugs only provide temporary relief, and over time, the pathological effects of the addiction worsen causing secondary suffering, which is a motivation for treatment. The 12-Step program offers a practical way to cope with suffering through a process of surrender. The act of surrender sets in motion a conversion experience, which involves a self-change including reorganization of one's identity and meaning in life. This article is another step toward understanding one of the several factors that contribute to the addict's motivation for treatment. This knowledge may be helpful for tailoring treatment that addresses suffering as a factor that initiates treatment motivation and, in turn, treatment success.
Akbas, Mert; Gunduz, Emel; Sanli, Suat; Yegin, Arif
2016-01-01
There are various facial pain syndromes including trigeminal neuralgia, trigeminal neuropathic pain and atypical facial pain syndromes. Effectiveness of the pulsed radiofrequency in managing various pain syndromes has been clearly demonstrated. There are a limited number of studies on the pulsed radiofrequency treatment for sphenopalatine ganglion in patients suffering from face and head pain. The purpose of this study is to evaluate the satisfaction of pulsed radiofrequency treatment at our patients retrospectively. Infrazygomatic approach was used for the pulsed radiofrequency of the sphenopalatine ganglion under fluoroscopic guidance. After the tip of the needle reached the target point, 0.25-0.5ms pulse width was applied for sensory stimulation at frequencies from 50Hz to 1V. Paraesthesias were exposed at the roof of the nose at 0.5-0.7V. To rule out trigeminal contact that led to rhythmic mandibular contraction, motor stimulation at a frequency of 2Hz was applied. Then, four cycles of pulsed radiofrequency lesioning were performed for 120s at a temperature of 42°C. Pain relief could not be achieved in 23% of the patients (unacceptable), whereas pain was completely relieved in 35% of the patients (excellent) and mild to moderate pain relief could be achieved in 42% of the patients (good) through sphenopalatine ganglion-pulsed radiofrequency treatment. Pulsed radiofrequency of the sphenopalatine ganglion is effective in treating the patients suffering from intractable chronic facial and head pain as shown by our findings. There is a need for prospective, randomized, controlled trials in order to confirm the efficacy and safety of this new treatment modality in chronic head and face pain. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.
Akbas, Mert; Gunduz, Emel; Sanli, Suat; Yegin, Arif
2016-01-01
There are various facial pain syndromes including trigeminal neuralgia, trigeminal neuropathic pain and atypical facial pain syndromes. Effectiveness of the pulsed radiofrequency in managing various pain syndromes has been clearly demonstrated. There are a limited number of studies on the pulsed radiofrequency treatment for sphenopalatine ganglion in patients suffering from face and head pain. The purpose of this study is to evaluate the satisfaction of pulsed radiofrequency treatment at our patients retrospectively. Infrazygomatic approach was used for the pulsed radiofrequency of the sphenopalatine ganglion under fluoroscopic guidance. After the tip of the needle reached the target point, 0.25-0.5 ms pulse width was applied for sensory stimulation at frequencies from 50 Hz to 1 V. Paraesthesias were exposed at the roof of the nose at 0.5-0.7 V. To rule out trigeminal contact that led to rhythmic mandibular contraction, motor stimulation at a frequency of 2 Hz was applied. Then, four cycles of pulsed radiofrequency lesioning were performed for 120 s at a temperature of 42°C. Pain relief could not be achieved in 23% of the patients (unacceptable), whereas pain was completely relieved in 35% of the patients (excellent) and mild to moderate pain relief could be achieved in 42% of the patients (good) through sphenopalatine ganglion-pulsed radiofrequency treatment. Pulsed radiofrequency of the sphenopalatine ganglion is effective in treating the patients suffering from intractable chronic facial and head pain as shown by our findings. There is a need for prospective, randomized, controlled trials in order to confirm the efficacy and safety of this new treatment modality in chronic head and face pain. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
Linking Logistics and Operations: A Case Study of World War II Air Power
1991-01-01
Weapon System Evaluation Group, 1951, p. 30). The logistic innovation greatly extended the time that combat ships could remain on station and...presented. This Note was produced under the Project AIR FORCE Resource Management and System Acquisition Program in the project "Combat Support C3 Needs...maintenance workload data suggest either unacceptable system performance or excessive costs. The predictive power of these models is so poor as to
Army Air Commandos: A New Organization for Army Special Operations Aviation Foreign Internal Defense
2014-06-13
AFSOC-managed AvFID program? How can USASOAC assimilate the RWAvFID mission into its portfolio without unacceptable decrement to its other core...was exploring options to strengthen its FID portfolio .2 USSOCOM’s focus shift combined with the AvFID capability gap would begin a process that would...security environment, US national strategy, and present capabilities. For the joint force this has meant investment, divestment, and rebalancing across
Wijma, Barbro; Zbikowski, Anke; Brüggemann, A Jelmer
2016-02-27
As health care exists to alleviate patients' suffering it is unacceptable that it inflicts unnecessary suffering on patients. We therefore have developed and evaluated a drama pedagogical model for staff interventions using Forum Play, focusing on staff's experiences of failed encounters where they have perceived that the patient felt abused. In the current paper we present how our preliminary theoretical framework of intervening against abuse in health care developed and was revised during this intervention. During and after the intervention, five important lessons were learned and incorporated in our present theoretical framework. First, a Forum Play intervention may break the silence culture that surrounds abuse in health care. Second, organizing staff training in groups was essential and transformed abuse from being an individual problem inflicting shame into a collective responsibility. Third, initial theoretical concepts "moral resources" and "the vicious violence triangle" proved valuable and became useful pedagogical tools during the intervention. Four, the intervention can be understood as having strengthened staff's moral resources. Five, regret appeared to be an underexplored resource in medical training and clinical work.The occurrence of abuse in health care is a complex phenomenon and the research area is in need of theoretical understanding. We hope this paper can inspire others to further develop theories and interventions in order to counteract abuse in health care.
Ifesanya, Adeleke O; Afuwape, Dolapo; Okoje, Victoria N; Agunloye, Atinuke; Odole, Olusola; Okolo, Clement A; Alonge, Temitope O
2009-01-01
An environment in which traffic regulations are not strictly enforced often is characterized by carnage from motor vehicular crashes resulting in severe injuries with unacceptably high mortality. The descriptive demographics and injury characteristics of pedestrian road crash victims presenting to a tertiary medical center in southwestern Nigeria are presented in order to provide baseline epidemiology as a first step in determining areas of potential mitigation for care of unintentional injuries. Consecutive pedestrian road traffic crash patients treated in the Accident and Emergency Department of a tertiary hospital were prospectively reviewed from March 2007 to February 2008 to determine baseline demographics and clinical outcomes. A total of 184 patients with a mean value of the ages of 31.4 years were studied; 27% of the patients were <11 years of age. The male to female ratio was 1.6:1. Fifty-four percent of the victims were struck by automobiles and 29% were struck by motorcycles. Sixty-five percent were struck while crossing common thoroughfares. Head injury was sustained in 61% of patients. The mortality rate was 31.0% (n = 57). The clinical course leading to death showed 22.8% of the patients who died initially experienced hemorrhagic shock, 17.5% suffered a severe head injury, and 17.5% suffered aspiration. Autopsy confirmed brainstem herniation in 28.1% of the patients who died. The average interval between injury and death was 5.5 +/-13.6 days (range: 0-77 days). In this setting, three out of every ten patients experiencing pedestrian vehicular trauma will die before leaving the hospital. The elderly are most at risk, with two-thirds of victims dying from injuries sustained. This raises serious questions about the prehospital- and hospital-based emergency services for vehicular road crash victims in this environment, and confirms the World Health Organization findings that Africa has the highest rate overall for unintentional injury deaths. A system-wide program must be put in place that addresses proven prevention measures across all sectors of the community.
Ground hardness and injury in community level Australian football.
Twomey, Dara M; Finch, Caroline F; Lloyd, David G; Elliott, Bruce C; Doyle, Tim L A
2012-07-01
To describe the risk and details of injuries associated with ground hardness in community level Australian football (AF). Prospective injury surveillance with periodic objective ground hardness measurement. 112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g). Clegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06-1.62) times higher and 1.82 (95%CI: 1.17-2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness. Despite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Naturalness and Animal Welfare
Yeates, James
2018-01-01
Simple Summary Many people feel that we should ensure that animals have natural lives and can perform natural behaviours. However, it is unclear what exactly we mean by ‘natural’ and how we can assess it scientifically. We might use naturalness to highlight possible suffering that needs looking into, as a rule of thumb about what is good for animals, and to establish a threshold for what is acceptable or unacceptable in how we affect animals. We can assess animals’ naturalness in terms of how similar they are to their closest wild counterparts, both in scientific assessments and in decisions about how we care for animals. Abstract Naturalness is considered important for animals, and is one criterion for assessing how we care for them. However, it is a vague and ambiguous term, which needs definition and assessments suitable for scientific and ethical questions. This paper makes a start on that aim. This paper differentiates the term from other related concepts, such as species-typical behaviour and wellbeing. It identifies contingent ways in which naturalness might be used, as: (i) prompts for further welfare assessment; (ii) a plausible hypothesis for what safeguards wellbeing; (iii) a threshold for what is acceptable; (iv) constraints on what improvements are unacceptable; and (v) demarcating what is not morally wrong, because of a lack of human agency. It then suggests an approach to evaluating animals’ behaviour that is quantitative, is based on reality, and which assesses naturalness by degrees. It proposes classing unaffected wild populations as natural by definition. Where animals might have been affected by humans, they should be compared to the closest population(s) of unaffected animals. This approach could allow us both to assess naturalness scientifically, and to make practical decisions about the behaviour of domestic animals. PMID:29621140
Johns, Jennifer L.; Moorhead, Kaitlin A.; Hu, Jing; Moorhead, Roberta C.
2018-01-01
Clinical pathology testing of rodents is often challenging due to insufficient sample volume. One solution in clinical veterinary and exploratory research environments is dilution of samples prior to analysis. However, published information on the impact of preanalytical sample dilution on rodent biochemical data is incomplete. The objective of this study was to evaluate the effects of preanalytical sample dilution on biochemical analysis of mouse and rat serum samples utilizing the Siemens Dimension Xpand Plus. Rats were obtained from end of study research projects. Mice were obtained from sentinel testing programs. For both, whole blood was collected via terminal cardiocentesis into empty tubes and serum was harvested. Biochemical parameters were measured on fresh and thawed frozen samples run straight and at dilution factors 2–10. Dilutions were performed manually, utilizing either ultrapure water or enzyme diluent per manufacturer recommendations. All diluted samples were generated directly from the undiluted sample. Preanalytical dilution caused clinically unacceptable bias in most analytes at dilution factors four and above. Dilution-induced bias in total calcium, creatinine, total bilirubin, and uric acid was considered unacceptable with any degree of dilution, based on the more conservative of two definitions of acceptability. Dilution often caused electrolyte values to fall below assay range precluding evaluation of bias. Dilution-induced bias occurred in most biochemical parameters to varying degrees and may render dilution unacceptable in the exploratory research and clinical veterinary environments. Additionally, differences between results obtained at different dilution factors may confound statistical comparisons in research settings. Comparison of data obtained at a single dilution factor is highly recommended. PMID:29497614
Code of Federal Regulations, 2010 CFR
2010-07-01
... Use Conditions Substitutes Application Substitute Decision Conditions Comments Electronics Cleaning w.... Electronics cleaning w/CFC-113 Dibromomethane Unacceptable High ODP; other alternatives exist. Electronics...
Description of an Audio-Based Paced Respiration Intervention for Vasomotor Symptoms
Burns, Debra S.; Drews, Michael R.; Carpenter, Janet S.
2013-01-01
Millions of women experience menopause-related hot flashes or flushes that may have a negative effect on their quality of life. Hormone therapy is an effective treatment, however, it may be contraindicated or unacceptable for some women based on previous health complications or an undesirable risk–benefit ratio. Side effects and the unacceptability of hormone therapy have created a need for behavioral interventions to reduce hot flashes. A variety of complex, multimodal behavioral, relaxation-based interventions have been studied with women (n = 88) and showed generally favorable results. However, currently extensive resource commitments reduce the translation of these interventions into standard care. Slow, deep breathing is a common component in most interventions and may be the active ingredient leading to reduced hot flashes. This article describes the content of an audio-based program designed to teach paced breathing to reduce hot flashes. Intervention content was based on skills training theory and music entrainment. The audio intervention provides an efficient way to deliver a breathing intervention that may be beneficial to other clinical populations. PMID:23914283
Human System Drivers for Exploration Missions
NASA Technical Reports Server (NTRS)
Kundrot, Craig E.; Steinberg, Susan; Charles, John B.
2010-01-01
Evaluation of DRM4 in terms of the human system includes the ability to meet NASA standards, the inclusion of the human system in the design trade space, preparation for future missions and consideration of a robotic precursor mission. Ensuring both the safety and the performance capability of the human system depends upon satisfying NASA Space Flight Human System Standards.1 These standards in turn drive the development of program-specific requirements for Near-earth Object (NEO) missions. In evaluating DRM4 in terms of these human system standards, the currently existing risk models, technologies and biological countermeasures were used. A summary of this evaluation is provided below in a structure that supports a mission architecture planning activities. 1. Unacceptable Level of Risk The duration of the DRM4 mission leads to an unacceptable level of risk for two aspects of human system health: A. The permissible exposure limit for space flight radiation exposure (a human system standard) would be exceeded by DRM4. B. The risk of visual alterations and abnormally high intracranial pressure would be too high. 1
Zimmerman, Karen; Jinadasa, Deepani; Maegga, Bertha; Guerrero, Alejandro
2015-01-01
Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs. Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected. The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after). The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.
Huet, Olivier; Ramsey, Debbie; Miljavec, Sandra; Jenney, Adam; Aubron, Cecile; Aprico, Andrea; Stefanovic, Nada; Balkau, Beverley; Head, Geoff A; de Haan, Judy B; Chin-Dusting, Jaye P F
2013-06-01
With animal models, death as an intentional end point is ethically unacceptable. However, in the study of septic shock, death is still considered the only relevant end point. We defined eight humane end points into four stages of severity (from healthy to moribund) and used to design a clinically relevant scoring tool, termed "the mouse clinical assessment score for sepsis" (M-CASS). The M-CASS was used to enable a consistent approach to the assessment of disease severity. This allowed an ethical and objective assessment of disease after which euthanasia was performed, instead of worsening suffering. The M-CASS displayed a high internal consistency (Cronbach α = 0.97) with a high level of agreement and an intraclass correlation coefficient equal to 0.91. The plasma levels of cytokines and markers of oxidative stress were all associated with the M-CASS score (Kruskal-Wallis test, P < 0.05). The M-CASS allows tracking of disease progression and animal welfare requirements.
Recent developments in the reform of English law on assisted suicide.
Shaw, Julia J A
2009-12-01
Assisted suicide remains a deeply contested issue in the U.K. Recently three Assisted Dying for the Terminally Ill Bills were introduced in a three year period, all of which failed. Despite the provision of clear and precise safeguards, at each reading the House of Lords fixed largely on the traditional slippery slope and sanctity of life positions; a disproportionate reliance on theological determinism in particular prevented informed rational debate. People are living longer often with chronic, incurable diseases and palliative care is frequently of poor quality or even unavailable in the U.K. and it is unacceptable that individuals 'suffering unbearably' in their final days have no available domestic alternative. Yet the courts have consistently declined to prosecute in cases where friends and relatives have accompanied terminally ill persons abroad to die, against the provisions of the 1961 Suicide Act s2(1). This article critically assesses recent developments in English law on assisted dying and considers the implications for a more inclusive and reasoned debate in the future.
Huan, Zhibo; Xu, Zhi; Luo, Jinhui; Xie, Defang
2016-11-01
Residues of 14 pesticides were determined in 150 cowpea samples collected in five southern Chinese provinces in 2013 and 2014.70% samples were detected one or more residues. 61.3% samples were illegal mainly because of detection of unauthorized pesticides. 14.0% samples contained more than three pesticides. Deterministic and probabilistic methods were used to assess the chronic and acute risk of pesticides in cowpea to eight subgroups of people. Deterministic assessment showed that the estimated short-term intakes (ESTIs) of carbofuran were 1199.4%-2621.9% of the acute reference doses (ARfD) while the rates were 985.9%-4114.7% using probabilistic assessment. Probabilistic assessment showed 4.2%-7.8% subjects may suffer from unacceptable acute risk from carbofuran contaminated cowpeas from the five provinces (especially children). But undue concern is not necessary, because all the estimations are based on conservative assumption. Copyright © 2016 Elsevier Inc. All rights reserved.
Evidence of photo manipulation in a delusional parasitosis paper.
Shelomi, Matan
2013-06-01
In 2004, an article in the Journal of the New York Entomological Society claimed that individuals with delusory parasitosis actually suffer from collembola infestations. The article has been critiqued for poor methodology and results that contradict all knowledge about collembolans. Less easily accounted for has been a figure in the article purporting to show a collembolan in a skin scraping. The image appears to have been altered using photo manipulation software to an unacceptable degree, and this paper demonstrates that to be the case. The altered figure represents creation of nonexistent data, a form of scientific misconduct. Whether the deception is deliberate or a product of an otherwise well-meaning author ignorant of the limits of acceptable image manipulation is unknown, but the result is peer-reviewed support for a conclusion that complicates patient treatment. In the current era of computers, even regional entomology journals must have detailed standards for what kind of images and image manipulations are acceptable for publication.
Solovey, Mark
2012-03-01
During the 1960s, a growing contingent of left-leaning voices claimed that the social sciences suffered mistreatment and undue constraints within the natural science-dominated federal science establishment. According to these critics, the entrenched scientific pecking order in Washington had an unreasonable commitment to the unity of the sciences, which reinforced unacceptable inequalities between the social and the natural sciences. The most important political figure who advanced this critique, together with a substantial legislative proposal for reform, was the Oklahoma Democratic Senator Fred Harris. Yet histories of science and social science have told us surprisingly little about Harris. Moreover, existing accounts of his effort to create a National Social Science Foundation have misunderstood crucial features of this story. This essay argues that Harris's NSSF proposal developed into a robust, historically unique, and increasingly critical liberal challenge to the post-World War II federal science establishment's treatment of the social sciences as "second-class citizens."
2003-06-01
prosocial actions. Recognition for Positive Behavior 88% (22) Reinforcement or acknowledgement for positive behavior . Bonding 76% (19) A youth’s...danger of acquiring, or already have, unacceptable habits and attitudes, as well as those who already have outstanding character and behavior .31...adult and peer mentors), and 3) care-centered (providing family-like environments where youth can feel safe and build trusting relationships). Youth
1993-08-01
Military Health Services System (MHSS), continue to rise at an unacceptable rate. In an effort to curb rising costs, the Department of Defense has...Currently we spend $23,000 a second, more than $2 billion a day, and $733 billion a year on medical care (Castro, 1991). The cost of medical care in the...mandated that DoD pursue cost containment initiatives. Demonstration projects such as the Civilian Health and Medical Program of the Uniformed Services
Failure analysis of blistered gold plating on spot welded electrical relays
NASA Technical Reports Server (NTRS)
Sokolowski, Witold; O'Donnell, Tim
1989-01-01
Gold-plated stainless-steel sideplates, part of a JPL Galileo spacecraft electronic-relay assembly, exhibited blistering after resistance spot welding. Unacceptable relays had heavy nonuniform gold electrodeposited layers with thicknesses 4.5-11.5 microns. SEM and metallographic investigations indicated much higher heat input generated during the resistance spot welding in unacceptable relays. The attributes of acceptable welded relays are contrasted with unacceptable relays; the possible mechanism of laminar formation of polymeric material in the gold plating is discussed; and some recommendations are provided to prevent similar problems.
Proulx, Gilbert; Rodtka, Dwight
2015-01-01
Although predation bounty programs (rewards offered for capturing or killing an animal) ended more than 40 years ago in Canada, they were reintroduced in Alberta in 2007 by hunting, trapping, and farming organizations, municipalities and counties, and in 2009 in Saskatchewan, by municipal and provincial governments and the Saskatchewan Cattlemen’s Association. Bounty hunters use inhumane and non-selective killing methods such as shooting animals in non-vital regions, and killing neck snares and strychnine poisoning, which cause suffering and delayed deaths. They are unselective, and kill many non-target species, some of them at risk. Predator bounty programs have been found to be ineffective by wildlife professionals, and they use killing methods that cause needless suffering and jeopardize wildlife conservation programs. Our analysis therefore indicates that government agencies should not permit the implementation of bounty programs. Accordingly, they must develop conservation programs that will minimize wildlife-human conflicts, prevent the unnecessary and inhumane killing of animals, and ensure the persistence of all wildlife species. PMID:26479482
Proulx, Gilbert; Rodtka, Dwight
2015-10-19
Although predation bounty programs (rewards offered for capturing or killing an animal) ended more than 40 years ago in Canada, they were reintroduced in Alberta in 2007 by hunting, trapping, and farming organizations, municipalities and counties, and in 2009 in Saskatchewan, by municipal and provincial governments and the Saskatchewan Cattlemen's Association. Bounty hunters use inhumane and non-selective killing methods such as shooting animals in non-vital regions, and killing neck snares and strychnine poisoning, which cause suffering and delayed deaths. They are unselective, and kill many non-target species, some of them at risk. Predator bounty programs have been found to be ineffective by wildlife professionals, and they use killing methods that cause needless suffering and jeopardize wildlife conservation programs. Our analysis therefore indicates that government agencies should not permit the implementation of bounty programs. Accordingly, they must develop conservation programs that will minimize wildlife-human conflicts, prevent the unnecessary and inhumane killing of animals, and ensure the persistence of all wildlife species.
13 CFR 123.506 - How much can you borrow under the Military Reservist EIDL Program?
Code of Federal Regulations, 2010 CFR
2010-01-01
... ADMINISTRATION DISASTER LOAN PROGRAM Military Reservist Economic Injury Disaster Loans § 123.506 How much can you... economic injury you have suffered or are likely to suffer until normal operations resume as a result of the absence of one or more essential employees called to active duty, up to a maximum of $2 million. [73 FR...
Anshel, Mark H; Brinthaupt, Thomas M; Kang, Minsoo
2010-01-01
This study examined the effect of a 10-week wellness program on changes in physical fitness and mental well-being. The conceptual framework for this study was the Disconnected Values Model (DVM). According to the DVM, detecting the inconsistencies between negative habits and values (e.g., health, family, faith, character) and concluding that these "disconnects" are unacceptable promotes the need for health behavior change. Participants were 164 full-time employees at a university in the southeastern U.S. The program included fitness coaching and a 90-minute orientation based on the DVM. Multivariate Mixed Model analyses indicated significantly improved scores from pre- to post-intervention on selected measures of physical fitness and mental well-being. The results suggest that the Disconnected Values Model provides an effective cognitive-behavioral approach to generating health behavior change in a 10-week workplace wellness program.
47 CFR 22.878 - Obligation to abate unacceptable interference.
Code of Federal Regulations, 2010 CFR
2010-10-01
.... 22.878 Section 22.878 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.878 Obligation to abate unacceptable interference. This section applies only to commercial...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...
Code of Federal Regulations, 2010 CFR
2010-07-01
.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...
Code of Federal Regulations, 2011 CFR
2011-07-01
.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...
Measuring Attitudes toward Acceptable and Unacceptable Parenting Practices
ERIC Educational Resources Information Center
Budd, Karen S.; Behling, Steven; Li, Yan; Parikshak, Sangeeta; Gershenson, Rachel A.; Feuer, Rachel; Danko, Christina M.
2012-01-01
This study investigated the properties of a new rating instrument, the Parenting Questionnaire (PQ), designed to measure attitudes about acceptable and unacceptable parenting practices. In Study 1, subject matter experts representing culturally diverse psychologists, parents, and college students were consulted to identify 110 items receiving high…
NASA Technical Reports Server (NTRS)
Trenkle, Timothy; Driggers, Phillip
2011-01-01
The Joint Polar Satellite System (JPSS) is a joint NOAA/NASA mission comprised of a series of polar orbiting weather and climate monitoring satellites which will fly in a sun-synchronous orbit, with a 1330 equatorial crossing time. JPSS resulted from the decision to reconstitute the National Polar-orbiting Operational Environmental Satellite System (NPOESS) into two separate programs, one to be run by the Department of Defense (DOD) and the other by NOAA. This decision was reached in early 2010, after numerous development issues caused a series of unacceptable delays in launching the NPOESS system.
Clinical Outcome Metrics for Optimization of Robust Training
NASA Technical Reports Server (NTRS)
Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M,; Foy, M. H.; Dulchavsky, S. A.;
2015-01-01
The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capabilities (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-flight Medical Capabilities". Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes.
Prioritizing Medical Resources for Exploration Missions
NASA Technical Reports Server (NTRS)
Shah, R. V.; Kerstman, E. L.
2015-01-01
Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In-flight Medical Capabilities."
McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.
2014-01-01
Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans. PMID:25471949
McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F
2014-12-01
The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.
Suffering: toward a contextual praxis.
Georges, Jane M
2002-09-01
Janice M. Morse's article in Advances in Nursing Science (24:1) revised and summarized the major findings of a research program exploring the behavioral-experiential nature of suffering. Using a feminist critical theory stance, this article addresses Morse's conceptualization of a praxis of suffering. First, it identifies the strengths and contributions of Morse's body of research to nursing science. Next, it undertakes a critique situated in feminist critical theory in which the limitations of Morse's work are explored using exemplars from the Western literary tradition. Finally, the article proposes a new conceptualization of an alternative contextual praxis of suffering in which nurses' responses to suffering are situated in an emancipatory paradigm of authentic presence.
Code of Federal Regulations, 2010 CFR
2010-10-01
...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference...
Code of Federal Regulations, 2014 CFR
2014-10-01
...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...
Code of Federal Regulations, 2012 CFR
2012-10-01
...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...
Code of Federal Regulations, 2011 CFR
2011-10-01
...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...
Code of Federal Regulations, 2013 CFR
2013-10-01
...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...
30 CFR 250.136 - How will MMS determine if my operating performance is unacceptable?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How will MMS determine if my operating performance is unacceptable? 250.136 Section 250.136 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT...) Accidents and their nature; (b) Pollution events, environmental damages and their nature; (c) Incidents of...
Kersten, Paula; Vandal, Alain C; Elder, Hinemoa; McPherson, Kathryn M
2018-04-21
This observational study examines the internal construct validity, internal consistency and cross-informant reliability of the Strengths and Difficulties Questionnaire (SDQ) in a New Zealand preschool population across four ethnicity strata (New Zealand European, Māori, Pasifika, Asian). Rasch analysis was employed to examine internal validity on a subsample of 1000 children. Internal consistency (n=29 075) and cross-informant reliability (n=17 006) were examined using correlations, intraclass correlation coefficients and Cronbach's alpha on the sample available for such analyses. Data were used from a national SDQ database provided by the funder, pertaining to New Zealand domiciled children aged 4 and 5 and scored by their parents and teachers. The five subscales do not fit the Rasch model (as indicated by the overall fit statistics), contain items that are biased (differential item functioning (DIF)) by key variables, suffer from a floor and ceiling effect and have unacceptable internal consistency. After dealing with DIF, the Total Difficulty scale does fit the Rasch model and has good internal consistency. Parent/teacher inter-rater reliability was unacceptably low for all subscales. The five SDQ subscales are not valid and not suitable for use in their own right in New Zealand. We have provided a conversion table for the Total Difficulty scale, which takes account of bias by ethnic group. Clinicians should use this conversion table in order to reconcile DIF by culture in final scores. It is advisable to use both parents and teachers' feedback when considering children's needs for referral of further assessment. Future work should examine whether validity is impacted by different language versions used in the same country. © 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.
NASA Technical Reports Server (NTRS)
Mankins, John C.; Mazanek, Daniel D.
2001-01-01
The safe, affordable and effective transfer of ever-larger payloads and eventually personnel beyond Low Earth Orbit (LEO) is a major challenge facing future commercial development and human exploration of space. Without reusable systems, sustained exploration or large scale development beyond LEO appears to be economically non-viable. However, reusable systems must be capable of both good fuel efficiency and "high utilization of capacity", or else economic costs will remain unacceptably high. Various options exist that can provide high fuel efficiency - for example, Solar Electric Propulsion Systems (SEPS) - but only at the cost of low thrust and concomitant long transit times. Chemical propulsion systems offer the potential for high thrust and short transit times - including both cryogenic and non-cryogenic options - but only at the cost of relatively low specific impulse (Isp). Nuclear thermal propulsion systems offer relatively good thrust-to-weight and Isp - but involve public concerns that may be insurmountable for all except the most-critical of public purposes. Fixed infrastructures have been suggested as one approach to solving this challenge; for example, rotating tether approaches. However, these systems tend to suffer from high initial costs or unacceptable operational constraints. A new concept has been identified - the Hybrid Propellant Module (HPM) - that integrates the best features of both chemical and solar electric transportation architectures. The HPM approach appears to hold promise of solving the issues associated with other approaches, opening a new family of capabilities for future space exploration and development of near-Earth space and beyond. This paper provides a summary overview of the challenge of Earth neighborhood transportation and discusses how various systems concepts might be applied to meet the needs of these architectures. The paper describes a new approach, the HPM, and illustrates the application of the concept for a typical mission concept. The paper concludes with a discussion of needed technologies and a possible timeline for the development and evolution of this class of systems concepts.
Performance of life support breathing apparatus for under-ice diving operations.
Lang, Michael A; Clarke, John R
2017-01-01
Single-hose scuba regulators dived in very cold water may suffer first- or second-stage malfunction, yielding complete occlusion of air flow or massive freeflow that rapidly expends a diver's air supply. This study, conducted in Antarctica, evaluated the under-ice performance of a sampling of commercially available regulators. Seventeen science divers logged a total of 305 dives in -1.86°C seawater under 6-meter-thick Antarctic fast-ice over two field seasons in 2008 and 2009. Dive profiles had an average depth of 30 msw and dive time of 29 minutes, including a mandatory three-minute safety stop at 6 msw. Sixty-nine unmodified regulator units (17 models) from 12 different manufacturers underwent standardized pre-dive regulator care and were randomly assigned to divers. Depths and times of onset of second-stage regulator freeflow were recorded. In 305 dives, there were 65 freeflows. The freeflows were not evenly distributed across the regulator brands. Regulator failure rates fell into two categories (⟨ 11% and ⟩ 26%). The regulators classified for the purpose of the test as "acceptable" (⟨ 11% failure rate: Dive-Rite Jetstream, Sherwood Maximus SRB3600, Poseidon Xstream Deep, Poseidon Jetstream, Sherwood Maximus SRB7600, Poseidon Cyklon, Mares USN22 Abyss) experienced only nine freeflows out of 146 exposures for a 6% overall freeflow incidence. Those classified as "unacceptable" (⟨ 26% failure rate) suffered 56 freeflows out of 159 exposures (35% freeflow incidence.). Contrary to expectations, the pooled incidences for the seven best performing regulators was significantly different by Chi-square test from the 10 remaining regulators (P ⟨ 0.001).
Policy Implications of Air Quality Research
NASA Astrophysics Data System (ADS)
Sheinbaum, C.
2004-12-01
While an integrated assessment approach will be required to achieve and sustain improvements in the air quality of Mexico City Metropolitan Area's (MCMA), policy strategies must be based on a solid understanding of the pollutant emissions and atmospheric processes that lead to unacceptable levels of air pollution. The required level of understanding can only be achieved by comprehensive atmospheric measurements followed by a coordinated atmospheric modeling program. The innovative, two-phase atmospheric measurement program, which was a collaborative effort between Massachusetts Institute of Technology and the Mexican Metropolitan Environmental Commission, with exploratory measurements in February 2002 and extensive measurements from late March through early May of 2003, was an important step towards meeting these requirements. Although the extensive data sets from the two measurement programs are still being analyzed by the investigators, their preliminary analysis efforts have yielded important insights into the nature and extent of air pollution problem in the MCMA, which in turn will have important policy implications.
Christensen, Jeanne G; Henrik, Permin
2007-01-01
Scabies and syphilis was very common but social unaccepted diseases in the later part of the 19th century. In 1892, 1,210 patients with syphilis and 106 children suffering from scabies were treated at the Kommunehospital in Copenhagen. Case records from patients admitted March 19th and September 19th, form the study basis of different aspects of scabies and syphilis treatment in the period. In the mid 19th century different soap treatments were the common cure for scabies. In the 1880s the cure became napthollinement, powdering with flour followed by rapping the patient in a sheet. Throughout the whole period experiments with medicine and thereby the patients was the norm. The treatment of syphilis consisted of different forms of mercury cures combined with bathes. Admission time was long and the patient was rarely cured. Progress in the treatments of both diseases was made in the daily work with patients. Access to knowledge, economy, the effort of the physician and the relationship between the different professions and groups in the hospital influenced and formed the process.
The future of hemodialysis membranes.
Humes, H D; Fissell, W H; Tiranathanagul, K
2006-04-01
Hemodialytic treatment of patients with either acute or chronic renal failure has had a dramatic impact on the mortality rates of these patients. Unfortunately, this membrane-based therapy is still incomplete renal replacement, as the mortality and morbidity of these patients remain unacceptably high. Much progress must be made to improve the biocompatibility of hemodialysis membranes as well as their hydraulic and permselective properties to remove small solutes and 'middle molecules' in compact cartridges. The next directions of development will leverage materials and mechanical engineering technology, including microfluidics and nanofabrication, to further improve the clearance functions of the kidney to replicate glomerular permselectivity while retaining high rates of hydraulic permeability. The extension of membrane technology to biohybrid devices utilizing progenitor/stem cells will be another substantive advance for renal replacement therapy. The ability to not only replace solute and water clearance but also active reabsorptive transport and metabolic activity will add additional benefit to the therapy of patients suffering from renal failure. This area of translational research is rich in creative opportunities to improve the unmet medical needs of patients with either chronic or acute renal failure.
An exploration of negative thoughts as a normal phenomenon after childbirth.
Hall, Pauline L; Wittkowski, Anja
2006-01-01
The period following the birth of a child brings many transitions into a woman's life, which can effect major psychological and social changes, including feelings of loss. If new mothers experience negative thoughts at this time, when societal expectations are of happiness, this may lead to feelings of unacceptability and guilt. This study aimed to investigate the prevalence of negative thoughts after childbirth in nondepressed mothers. Following the identification of negative thoughts experienced by women who had suffered postnatal depression, a quantitative survey was conducted, which asked nondepressed mothers to indicate how often they experienced the negative thoughts or images identified by depressed mothers. One hundred and fifty-eight returned questionnaire packs were included in the analyses. The 158 nondepressed mothers acknowledged experiencing all but one of the 54 negative cognitions. Negative cognitions usually associated with postnatal depression are also experienced by mothers who are not considered depressed. This information provides evidence for reassuring new mothers that negative thoughts after childbirth are common. This, in turn, may help to reduce feelings of guilt associated with experiencing negative thoughts in the postpartum period.
Incentives for organ donation in the United States: feasible alternative or forthcoming apocalypse?
Hippen, Benjamin; Matas, Arthur
2009-04-01
Several factors have generated interest in proposals to offer incentives in exchange for kidneys from living donors, including the growing shortage of available organs, the apparent asymptote of traditional means of organ procurement, and the intimate link between the inadequacies of organ procurement policies in developed countries with the flourishing of underground organ trafficking in developing countries. Herein, we review the scope and dimensions of the growing shortage of organs in the United States, with attention to how each of the proposed solutions to same has proven insufficient. With special attention to the concerns leveled by Gabriel Danovitch in his 'Open Letter,' we conclude that each of his concerns are unfounded, and offer a prospectus on how a trial of such systems might be pursued in the United States. The failure of current approaches to organ procurement in the United States and other developed countries has led to unnecessary suffering and death, with morally unacceptable consequences for developing countries. For these reasons, a structured trial of incentives for organ procurement in the United States is a moral imperative.
Extension of the shelf life of guava by individual packaging with cling and shrink films.
Rana, Seema; Siddiqui, Saleem; Goyal, Ankit
2015-12-01
Guava is a climacteric fruit so physico-chemical changes continuously occur after harvest till fruit become unfit for consumption and suffers from post harvest losses. The main objective of this work was to assess the effectiveness of individual film in form of Shrink and Cling wrap on shelf life of guava. Fruits were individually packed in polythene bags (LDPE) of 200 gauge thickness by Shrink and Cling wrapping and stored at 7 ± 3 °C. Individual wrapping reduced the magnitude of changes during storage i.e., ripening process drastically as evident from lower total soluble solids, higher ascorbic acid, polyphenol content with lower polyphenol oxidase activity and physiological loss of weight (PLW) was less than 3.5 %. Film wrapping preserved freshness of wrapped fruits as they remained acceptable for whole storage time in contrast to control fruits which turned unacceptable by 15(th) day of storage. Control fruits showed significant compositional changes as well as in polyphenol content, ascorbic acid and reduced number of marketable fruits while Cling and Shrink wrapping enhanced the shelf life by 10 days.
[Ethical and legal issues concerning renal replacement therapy withdrawal or withholding].
Radziszewski, Andrzej; Stompór, Tomasz; Gajda, Mariusz; Sułowicz, Władysław
2006-01-01
Rapid and dynamic increase of the number of patients that need different forms of renal replacement therapy can be noticed in the developed countries. This increase is associated with increased number of patients with 'diseases of modern civilization', such as diabetes and hypertension, which lead to kidney complications (e.g. diabetic and hypertensive nephropathy). Improved long-term care (especially diabetic and cardiologic) allows these patients to survive longer and to reach the stage of end-stage renal disease. This leads to increasing age and morbidity of patients treated with dialysis. In many cases, due to extremely advanced level of co-morbidity patients on dialysis are exposed to extreme level of suffering and unacceptably low quality of life. Persistent continuing of renal replacement therapy under such circumstances (with no hope for recovery or improvement) raises also some economical issues, especially in the context of permanent crisis and shortage of resources in health systems of most countries in the world. In this review the current practice concerning withdrawal or withholding of renal replacement therapy as well as some legal and ethical issues of this practice are discussed.
Verification of Dose Distribution in Carbon Ion Radiation Therapy for Stage I Lung Cancer
DOE Office of Scientific and Technical Information (OSTI.GOV)
Irie, Daisuke; Saitoh, Jun-ichi, E-mail: junsaito@gunma-u.ac.jp; Shirai, Katsuyuki
Purpose: To evaluate robustness of dose distribution of carbon-ion radiation therapy (C-ion RT) in non-small cell lung cancer (NSCLC) and to identify factors affecting the dose distribution by simulated dose distribution. Methods and Materials: Eighty irradiation fields for delivery of C-ion RT were analyzed in 20 patients with stage I NSCLC. Computed tomography images were obtained twice before treatment initiation. Simulated dose distribution was reconstructed on computed tomography for confirmation under the same settings as actual treatment with respiratory gating and bony structure matching. Dose-volume histogram parameters, such as %D95 (percentage of D95 relative to the prescribed dose), were calculated.more » Patients with any field for which the %D95 of gross tumor volume (GTV) was below 90% were classified as unacceptable for treatment, and the optimal target margin for such cases was examined. Results: Five patients with a total of 8 fields (10% of total number of fields analyzed) were classified as unacceptable according to %D95 of GTV, although most patients showed no remarkable change in the dose-volume histogram parameters. Receiver operating characteristic curve analysis showed that tumor displacement and change in water-equivalent pathlength were significant predictive factors of unacceptable cases (P<.001 and P=.002, respectively). The main cause of degradation of the dose distribution was tumor displacement in 7 of the 8 unacceptable fields. A 6-mm planning target volume margin ensured a GTV %D95 of >90%, except in 1 extremely unacceptable field. Conclusions: According to this simulation analysis of C-ion RT for stage I NSCLC, a few fields were reported as unacceptable and required resetting of body position and reconfirmation. In addition, tumor displacement and change in water-equivalent pathlength (bone shift and/or chest wall thickness) were identified as factors influencing the robustness of dose distribution. Such uncertainties should be regarded in planning.« less
Experiences of employees with arm, neck or shoulder complaints: a focus group study
2014-01-01
Background Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. Methods A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Results Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Conclusions Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS. PMID:24779360
Experiences of employees with arm, neck or shoulder complaints: a focus group study.
Hutting, Nathan; Heerkens, Yvonne F; Engels, Josephine A; Staal, J Bart; Nijhuis-van der Sanden, Maria W G
2014-04-29
Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS.
[Ethical behavioral standards of medical students on examinations and studies].
Tolkin, Lior; Glick, Shimon
2007-06-01
In recent years the medical literature has reflected an increasing interest in the medical ethics of physicians and medical students. Studies have shown that cheating in medical school is frequent enough to cause concern, that there is a positive correlation between students' ethical attitude and their ethical behavior and between cheating in school and cheating in patient care. This study aims to examine student attitudes towards cheating, their self-reported behavior, analyze cultural and sub-cultural differences, and to reach practical conclusions that might be incorporated into the teaching of ethics in medical schools. Anonymous questionnaires were distributed to 193 first and second year students of the Israeli and American programs at Ben-Gurion University. The questionnaire consisted of fifty three multiple choice questions. The students were asked to state their opinion on various cheating practices at medical school and dishonesty in patient care, to estimate how they would resolve various ethical dilemmas and to provide some demographic information. The results were analyzed using SPSS. T-tests, Chi-Square tests, one-way analysis of variance, and Pearson and Spearman's coefficients, all used as appropriate. Completed questionnaires were returned by 141 students (73%). The majority of the students regard cheating in an exam (93%) or on a final paper (85%) to be morally unacceptable behavior. Copying during an exam is regarded as more morally unacceptable than copying a homework exercise. The majority of the students consider faking a patient's laboratory results to be morally unacceptable behavior (98%). American students regard copying a homework exercise, reconstructing exam questions for the benefit of next year students and giving answers to a fellow student during an exam to be more morally unacceptable in comparison to the Israeli students. Married students consider cheating to be more morally unacceptable than unmarried students. A positive correlation was found between religiosity and the position that cheating is a morally negative practice. There is a positive correlation between cheating in high school and the position that cheating is morally acceptable. In addition, the more often a student cheated in high school the more that student claims that he or she would cheat if they were sure that they would not be caught. Amongst Israeli students, there was a correlation between the view that the faculty did not treat them well, and the position that cheating is morally acceptable, No correlation was found between cheating and gender, age, birth country of parents, army service, or type of high school. Students' attitude toward cheating is significantly determined by the cultural and sub-cultural characteristics of each student's background. Ethical discussions in which an ethical code would be formed, moral dilemmas analyzed and cultural differences addressed, may help improve the ethical behavior of students in medical school, and thus improve their ethical practice in patient care.
Jaffré, Yannick; Suh, Siri
2016-05-01
Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs' goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health. Copyright © 2016 Elsevier Ltd. All rights reserved.
LANL Safeguards and Security Assurance Program. Revision 6
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1995-04-03
The Safeguards and Security (S and S) Assurance Program provides a continuous quality improvement approach to ensure effective, compliant S and S program implementation throughout the Los Alamos National Laboratory. Any issues identified through the various internal and external assessments are documented, tracked and closed using the Safeguards and Security Issue Management Program. The Laboratory utilizes an integrated S and S systems approach to protect US Department of Energy (DOE) interests from theft or diversion of special nuclear material (SNM), sabotage, espionage, loss or theft of classified/controlled matter or government property, and other hostile acts that may cause unacceptable impactsmore » on national security, health and safety of employees and the public, and the environment. This document explains the basis, scope, and conduct of the S and S process to include: self-assessments, issue management, risk assessment, and root cause analysis. It also provides a discussion of S and S topical areas, roles and responsibilities, process flow charts, minimum requirements, methodology, terms, and forms.« less
The Contributions of the American Military Working Dog in Vietnam.
1998-06-05
program. Due to limited resources, the ARVN forces could not and would not provide a nutritious diet to the dogs and many suffered and even died of...Vietnam War the U.S. would continue to support the ARVN dog program. Due to inadequate diet and medical care the dogs suffered a high mortality rate...would become instructors when the U.S. Army established its own training school in the U.S.. The British- Malaysian -American agreement was to expire in
Fuel cell flooding detection and correction
DiPierno Bosco, Andrew; Fronk, Matthew Howard
2000-08-15
Method and apparatus for monitoring an H.sub.2 -O.sub.2 PEM fuel cells to detect and correct flooding. The pressure drop across a given H.sub.2 or O.sub.2 flow field is monitored and compared to predetermined thresholds of unacceptability. If the pressure drop exists a threshold of unacceptability corrective measures are automatically initiated.
Code of Federal Regulations, 2011 CFR
2011-10-01
...-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. 22.970 Section... MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. (a) Definition...
The Perfect Place to Work? Australian Academic Libraries and Unacceptable Behaviour
ERIC Educational Resources Information Center
Moorcroft, Heather
2009-01-01
Despite the stereotype of libraries as peaceful retreats, unacceptable behaviour is a reality that desk staff have to deal with. This paper outlines the results of two surveys conducted at Charles Darwin University Library to investigate the extent to which this is a problem in Australian academic libraries. The first survey went to CAUL (Council…
Code of Federal Regulations, 2010 CFR
2010-10-01
... 22.970 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non... −104 dBm or higher, as measured at the R.F. input of the receiver of a mobile unit; or (B) A median...
NATIONAL ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM (NELAP) SUPPORT
The nation has long suffered from the inefficiencies and inconsistencies of the current multiple environmental laboratory accreditation programs. In the 1970's, EPA set minimum standards for a drinking water certification program. The drinking water program was adopted by the s...
Thermal Modeling and Testing of the Edison Demonstration of Smallsat Networks Project
NASA Technical Reports Server (NTRS)
Coker, Robert
2014-01-01
NASA's Edison program is intending to launch the Edison Demonstration of Smallsat Networks (EDSN) project, a swarm of 8 1.5U cubesats in the fall of 2014 to demonstrate intra-swarm communications and multi-point in situ space physics data acquisition. Due to late changes in the duty cycles of various components, potential overheating issues appeared. In addition, it was determined that capacity loss due to the coldness of the batteries was unacceptable, so mitigation was required. This paper will discuss the thermal modeling, testing, and results of the EDSN mission.
Damping Goes the Distance in Golf
NASA Technical Reports Server (NTRS)
2004-01-01
In the late 1980s, Dr. Benjamin Dolgin of NASA s Jet Propulsion Laboratory developed a concept for a high-damping graphite/viscoelastic material for the Strategic Defense Initiative (popularly referred to as "Star Wars"), as part of a space-based laser anti-missile program called "Asterix." Dolgin drummed up this concept with the intention of stabilizing weapons launch platforms in space, where there is no solid ground to firmly support these structures. Without the inclusion of high-damping material, the orbital platforms were said to vibrate for 20 minutes after force was applied - a rate deemed "unacceptable" by leaders of the Strategic Defense Initiative.
Steroids in bacterial meningitis: yes.
Benninger, Felix; Steiner, Israel
2013-02-01
Bacterial meningitis is an infectious condition associated with severe morbidity and mortality, even with rapid diagnosis and appropriate antibiotic therapy. Despite decrease in the rate of bacterial meningitis brought about by vaccination programs against Haemophilus influenzae type-B and Streptococcus pneumonia, the incidence of meningitis is still unacceptably high and acute treatment remains the mainstay of therapy. The infection is accompanied by intense inflammatory response, which may carry deleterious effects upon the tissue. This led to the possibility of adjuvant corticosteroid therapy, as an anti-inflammatory agent, in bacterial meningitis. The debate focuses on the rational and evidence supporting and refuting such an approach.
Structural tailoring of counter rotation propfans
NASA Technical Reports Server (NTRS)
Brown, Kenneth W.; Hopkins, D. A.
1989-01-01
The STAT program was designed for the optimization of single rotation, tractor propfan designs. New propfan designs, however, generally consist of two counter rotating propfan rotors. STAT is constructed to contain two levels of analysis. An interior loop, consisting of accurate, efficient approximate analyses, is used to perform the primary propfan optimization. Once an optimum design has been obtained, a series of refined analyses are conducted. These analyses, while too computer time expensive for the optimization loop, are of sufficient accuracy to validate the optimized design. Should the design prove to be unacceptable, provisions are made for recalibration of the approximate analyses, for subsequent reoptimization.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Clayton, Christopher; Kothari, Vijendra; Starr, Ken
2012-02-26
The U. S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collectionmore » adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS&M) program: Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. DOE must continue to maintain constructive relationships with the U.S. Army Corps of Engineers and state and federal regulators.« less
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Unacceptable interference to non-cellular 800 MHz licensees from 800 MHz cellular systems or part 22 Cellular Radiotelephone systems, and within the 900 MHz Business/Industrial Land Transportation Pool. 90.672 Section 90.672 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...
Relating (Un)acceptability to Interpretation. Experimental Investigations on Negation
Etxeberria, Urtzi; Tubau, Susagna; Deprez, Viviane; Borràs-Comes, Joan; Espinal, M. Teresa
2018-01-01
Although contemporary linguistic studies routinely use unacceptable sentences to determine the boundary of what falls outside the scope of grammar, investigations far more rarely take into consideration the possible interpretations of such sentences, perhaps because these interpretations are commonly prejudged as irrelevant or unreliable across speakers. In this paper we provide the results of two experiments in which participants had to make parallel acceptability and interpretation judgments of sentences presenting various types of negative dependencies in Basque and in two varieties of Spanish (Castilian Spanish and Basque Country Spanish). Our results show that acceptable sentences are uniformly assigned a single negation reading in the two languages. However, while unacceptable sentences consistently convey single negation in Basque, they are interpreted at chance in both varieties of Spanish. These results confirm that judgment data that distinguish between acceptable and unacceptable negative utterances can inform us not only about an adult’s grammar of his/her particular language but also about interesting cross-linguistic differences. We conclude that the acceptability and interpretation of (un)grammatical negative sentences can serve linguistic theory construction by helping to disentangle basic assumptions about the nature of various negative dependencies. PMID:29456515
Nuclear war between Israel and Iran: lethality beyond the pale
2013-01-01
Background The proliferation of nuclear technology in the politically volatile Middle East greatly increases the likelihood of a catastrophic nuclear war. It is widely accepted, while not openly declared, that Israel has nuclear weapons, and that Iran has enriched enough nuclear material to build them. The medical consequences of a nuclear exchange between Iran and Israel in the near future are envisioned, with a focus on the distribution of casualties in urban environments. Methods Model estimates of nuclear war casualties employed ESRI's ArcGIS 9.3, blast and prompt radiation were calculated using the Defense Nuclear Agency's WE program, and fallout radiation was calculated using the Defense Threat Reduction Agency's (DTRA's) Hazard Prediction and Assessment Capability (HPAC) V404SP4, as well as custom GIS and database software applications. Further development for thermal burn casualties was based on Brode, as modified by Binninger, to calculate thermal fluence. ESRI ArcGISTM programs were used to calculate affected populations from the Oak Ridge National Laboratory's LandScanTM 2007 Global Population Dataset for areas affected by thermal, blast and radiation data. Results Trauma, thermal burn, and radiation casualties were thus estimated on a geographic basis for three Israeli and eighteen Iranian cities. Nuclear weapon detonations in the densely populated cities of Iran and Israel will result in an unprecedented millions of numbers of dead, with millions of injured suffering without adequate medical care, a broad base of lingering mental health issues, a devastating loss of municipal infrastructure, long-term disruption of economic, educational, and other essential social activity, and a breakdown in law and order. Conclusions This will cause a very limited medical response initially for survivors in Iran and Israel. Strategic use of surviving medical response and collaboration with international relief could be expedited by the predicted casualty distributions and locations. The consequences for health management of thermal burn and radiation patients is the worst, as burn patients require enormous resources to treat, and there will be little to no familiarity with the treatment of radiation victims. Any rational analysis of a nuclear war between Iran and Israel reveals the utterly unacceptable outcomes for either nation. PMID:23663406
Burgess, Diana J; Mock, Jeremiah; Schillo, Barbara A; Saul, Jessie E; Phan, Tam; Chhith, Yanat; Alesci, Nina; Foldes, Steven S
2014-08-04
Southeast Asian communities in the United States have suffered from high rates of tobacco use and high rates of chronic diseases associated with firsthand and secondhand smoking. Research is needed on how best to reduce and prevent tobacco use and exposure to secondhand smoke in these communities. The objective of this study was to examine how tobacco use patterns in Minnesota's Southeast Asian communities have been shaped by culture, immigration, and adjustment to life in America in order to inform future tobacco control strategies. The study consisted of semi-structured interviews with 60 formal and informal leaders from Minnesota's Hmong, Khmer (Cambodian), Lao, and Vietnamese communities and incorporated principles of community-based participatory research. Among Khmer, Lao and Vietnamese, tobacco in the homeland was a valued part of material culture and was used to signify social status, convey respect, and support social rituals among adult men (the only group for whom smoking was acceptable). Among the Hmong, regular consumption of tobacco was unacceptable and rarely seen until the civil war in Laos when a number of Hmong soldiers became smokers. In Minnesota, social norms have begun to shift, with smoking becoming less acceptable. Although older male smokers felt social pressure to quit, smoking functioned to reduce the stress of social isolation, economic hardship, prior trauma, and the loss of power and status. Youth and younger women no longer felt as constrained by culturally-rooted social prohibitions to smoke. Leaders from Minnesota's Southeast Asian communities perceived key changes in tobacco-related attitudes, beliefs, and behaviors which were embedded in the context of shifting power, status, and gender roles within their communities. This has practical implications for developing policy and interventions. Older Southeast Asians are likely to benefit from culturally-tailored programs (e.g., that value politeness and the importance of acting in ways that benefit the family, community, and clan) and programs that work with existing social structures, as well as initiatives that address smokers' psychological distress and social isolation. Leaders remained uncertain about how to address smoking uptake among youth, pointing to a need for additional research.
Code of Federal Regulations, 2012 CFR
2012-01-01
... SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.1 Introduction. This part contains the terms and conditions for loans made under the Special Apple Loan Program. These regulations are applicable to... program objective is to assist producers of apples suffering from economic loss as a result of low apple...
Code of Federal Regulations, 2010 CFR
2010-01-01
... SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.1 Introduction. This part contains the terms and conditions for loans made under the Special Apple Loan Program. These regulations are applicable to... program objective is to assist producers of apples suffering from economic loss as a result of low apple...
Code of Federal Regulations, 2014 CFR
2014-01-01
... SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.1 Introduction. This part contains the terms and conditions for loans made under the Special Apple Loan Program. These regulations are applicable to... program objective is to assist producers of apples suffering from economic loss as a result of low apple...
Code of Federal Regulations, 2011 CFR
2011-01-01
... SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.1 Introduction. This part contains the terms and conditions for loans made under the Special Apple Loan Program. These regulations are applicable to... program objective is to assist producers of apples suffering from economic loss as a result of low apple...
Code of Federal Regulations, 2013 CFR
2013-01-01
... SPECIAL PROGRAMS SPECIAL APPLE LOAN PROGRAM § 773.1 Introduction. This part contains the terms and conditions for loans made under the Special Apple Loan Program. These regulations are applicable to... program objective is to assist producers of apples suffering from economic loss as a result of low apple...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2010 CFR
2010-07-01
... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2013 CFR
2013-07-01
... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2011 CFR
2011-07-01
... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2012 CFR
2012-07-01
... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2014 CFR
2014-07-01
... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
Code of Federal Regulations, 2010 CFR
2010-07-01
... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gondi, Vinai, E-mail: vgondi@chicagocancer.org; University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin; Cui, Yunfeng
2015-03-01
Purpose: RTOG 0933 was a phase II trial of hippocampal avoidance during whole brain radiation therapy for patients with brain metastases. The results demonstrated improvement in short-term memory decline, as compared with historical control individuals, and preservation of quality of life. Integral to the conduct of this trial were quality assurance processes inclusive of pre-enrollment credentialing and pretreatment centralized review of enrolled patients. Methods and Materials: Before enrolling patients, all treating physicians and sites were required to successfully complete a “dry-run” credentialing test. The treating physicians were credentialed based on accuracy of magnetic resonance imaging–computed tomography image fusion and hippocampal andmore » normal tissue contouring, and the sites were credentialed based on protocol-specified dosimetric criteria. Using the same criteria, pretreatment centralized review of enrolled patients was conducted. Physicians enrolling 3 consecutive patients without unacceptable deviations were permitted to enroll further patients without pretreatment review, although their cases were reviewed after treatment. Results: In all, 113 physicians and 84 sites were credentialed. Eight physicians (6.8%) failed hippocampal contouring on the first attempt; 3 were approved on the second attempt. Eight sites (9.5%) failed intensity modulated radiation therapy planning on the first attempt; all were approved on the second attempt. One hundred thirteen patients were enrolled in RTOG 0933; 100 were analyzable. Eighty-seven cases were reviewed before treatment; 5 (5.7%) violated the eligibility criteria, and 21 (24%) had unacceptable deviations. With feedback, 18 cases were approved on the second attempt and 2 cases on the third attempt. One patient was treated off protocol. Twenty-two cases were reviewed after treatment; 1 (4.5%) violated the eligibility criteria, and 5 (23%) had unacceptable deviations. Conclusions: Although >95% of the cases passed the pre-enrollment credentialing, the pretreatment centralized review disqualified 5.7% of reviewed cases, prevented unacceptable deviations in 24% of reviewed cases, and limited the final unacceptable deviation rate to 5%. Thus, pretreatment review is deemed necessary in future hippocampal avoidance trials and is potentially useful in other similarly challenging radiation therapy technique trials.« less
Seismic performance assessment of base-isolated safety-related nuclear structures
Huang, Y.-N.; Whittaker, A.S.; Luco, N.
2010-01-01
Seismic or base isolation is a proven technology for reducing the effects of earthquake shaking on buildings, bridges and infrastructure. The benefit of base isolation has been presented in terms of reduced accelerations and drifts on superstructure components but never quantified in terms of either a percentage reduction in seismic loss (or percentage increase in safety) or the probability of an unacceptable performance. Herein, we quantify the benefits of base isolation in terms of increased safety (or smaller loss) by comparing the safety of a sample conventional and base-isolated nuclear power plant (NPP) located in the Eastern U.S. Scenario- and time-based assessments are performed using a new methodology. Three base isolation systems are considered, namely, (1) Friction Pendulum??? bearings, (2) lead-rubber bearings and (3) low-damping rubber bearings together with linear viscous dampers. Unacceptable performance is defined by the failure of key secondary systems because these systems represent much of the investment in a new build power plant and ensure the safe operation of the plant. For the scenario-based assessments, the probability of unacceptable performance is computed for an earthquake with a magnitude of 5.3 at a distance 7.5 km from the plant. For the time-based assessments, the annual frequency of unacceptable performance is computed considering all potential earthquakes that may occur. For both assessments, the implementation of base isolation reduces the probability of unacceptable performance by approximately four orders of magnitude for the same NPP superstructure and secondary systems. The increase in NPP construction cost associated with the installation of seismic isolators can be offset by substantially reducing the required seismic strength of secondary components and systems and potentially eliminating the need to seismically qualify many secondary components and systems. ?? 2010 John Wiley & Sons, Ltd.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
Ten witnesses from the Environmental Protection Agency (EPA), state and local environmental agencies, teachers, health providers, and others testified on the risks and possible control measures of radon gas emissions in homes. Home tests are finding as many as 40% to have unacceptable levels, but EPA and other government agencies have waited for the media to alert the population. The witnesses were asked to suggest ways in which EPA can initiate assistance in this area in order to protect public health. EPA spokesmen reviewed their programs, including the Radon Action Program, which began operating in 1985. Material submitted for themore » record by EPA follows the testimony.« less
Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme
2014-01-01
Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953
An evaluation of flight path management automation in transport category aircraft
NASA Technical Reports Server (NTRS)
Chandra, D.; Bussolari, S. R.
1991-01-01
A desk-top simulation of a Boeing 757/767 Electronic Flight Instrumentation System (EFIS) and Control Display Unit (CDU) was used in an experiment to compare three modes of communication for the clearance amendment process: standard voice procedures, a textual delivery method, and a graphical delivery method. Eight qualified Boeing 757/767 pilots served as subjects. Each flew nine landing scenarios with three amendments given in each scenario. Both acceptable and unacceptable clearance amendments were presented in order to assess situational awareness. Times for comprehension and execution of the amendment were recorded along with workload ratings, responses to unacceptable amendments, and subjective impressions. The graphical mode was found to be superior in terms of the time measures and subjective ratings. No difference was found between the modes in the ability to detect unacceptable clearances.
Installation Tobacco Control Programs in the U.S. Military
Smith, Elizabeth A.; Poston, Walker S. C.; Haddock, Christopher K.; Malone, Ruth E.
2016-01-01
Tobacco use prevalence is unacceptably high in the U.S. military, and the Department of Defense and service branches have implemented tobacco control policies and cessation programs. To explore aspects of programs regarded as exemplary by their services, we visited four installations, nominated by their service's health promotion leaders, and conducted interviews, observations, and focus groups. Installations included Naval Hospital Guam, Tripler Army Medical Center, MacDill Air Force Base, and the Naval Hospital at Marine Corps Air Ground Combat Center Twentynine Palms. The tobacco control managers (TCMs) at the programs studied were all civilian employees, highly motivated and enthusiastic, and had remained in their positions for approximately a decade. Other commonalities included support from command, a “culture” of health, and location in warm climates. Programs varied in their involvement in establishing designated tobacco use areas, and length and requirement of attending cessation classes; however, no evaluation of cessation programs is currently underway. TCMs should be more engaged in policy discussions for the larger installations they serve. A strong policy framework and command support for TCMs will be necessary to achieve the goal of a tobacco-free military. PMID:27244072
Brohet, C R; Richman, H G
1979-06-01
Automated processing of electrocardiograms by the Veterans Administration program was evaluated for both agreement with physician interpretation and interpretative accuracy as assessed with nonelectrocardiographic criteria. One thousand unselected electrocardiograms were analyzed by two reviewer groups, one familiar and the other unfamiliar with the computer program. A significant number of measurement errors involving repolarization changes and left axis deviation occurred; however, interpretative disagreements related to statistical decision were largely language-related. Use of a printout with a more traditional format resulted in agreement with physician interpretation by both reviewer groups in more than 80 percent of cases. Overall sensitivity based on agreement with nonelectrocardiographic criteria was significantly greater with use of the computer program than with use of the conventional criteria utilized by the reviewers. This difference was particularly evident in the subgroup analysis of myocardial infarction and left ventricular hypertrophy. The degree of overdiagnosis of left ventricular hypertrophy and posteroinferior infarction was initially unacceptable, but this difficulty was corrected by adjustment of probabilities. Clinical acceptability of the Veterans Administration program appears to require greater physician education than that needed for other computer programs of electrocardiographic analysis; the flexibility of interpretation by statistical decision offers the potential for better diagnostic accuracy.
Behavioral Contributions to Rehabilitation and Childhood Asthma
ERIC Educational Resources Information Center
Creer, Thomas L.; And Others
1976-01-01
Described is the 12- to 18-month residential treatment program at the Children's Asthma Research Institute and Hospital, a behaviorally oriented rehabilitation program for children who suffer from chronic bronchial asthma. (IM)
NASA Technical Reports Server (NTRS)
Phillips, Warren F.
1989-01-01
The results obtained show that it is possible to control light-weight robots with flexible links in a manner that produces good response time and does not induce unacceptable link vibrations. However, deflections induced by gravity cause large static position errors with such a control system. For this reason, it is not possible to use this control system for controlling motion in the direction of gravity. The control system does, on the other hand, have potential for use in space. However, in-space experiments will be needed to verify its applicability to robots moving in three dimensions.
The elimination of scabies: a task for our generation.
McLean, Florence E
2013-10-01
Scabies prevalence remains unacceptably high in many regions throughout the world. Infestation with scabies significantly impacts quality of life and is linked to pyoderma and consequently to severe long-term sequelae such as post-streptococcal glomerulonephritis. In the past, control programs using topical treatments have met with poor compliance; however, the highly effective oral agent ivermectin may offer a new paradigm in scabies management. Problems still exist with insensitive diagnostic tests, questions concerning mite reservoirs, and restrictions on who can receive ivermectin. Despite these difficulties, the elimination of scabies in communities worst affected may soon be possible. © 2013 The International Society of Dermatology.
McKenna, J; Gutierrez, K; McCall, K
2000-05-01
Intensive and sustained efforts to "counter-market" tobacco among teenagers are necessary to negate the "friendly familiarity" created by tobacco advertising and to communicate the true health and social costs of tobacco use. Counter-marketing campaigns should: highlight a tobacco-free lifestyle as the majority lifestyle of diverse and interesting individuals; explain the dangers of tobacco in a personal, emotional way; offer youth empowerment and control; use multiple voices, strategies, and executions; offer constructive alternatives to tobacco use; and portray smoking as unacceptable and undesirable for everyone. Counter-marketing activities should work in concert with other interventions to alter social norms regarding tobacco.
NASA Astrophysics Data System (ADS)
Pochampally, Kishore K.; Gupta, Surendra M.; Kamarthi, Sagar V.
2004-02-01
Although there are many quantitative models in the literature to design a reverse supply chain, every model assumes that all the recovery facilities that are engaged in the supply chain have enough potential to efficiently re-process the incoming used products. Motivated by the risk of re-processing used products in facilities of insufficient potentiality, this paper proposes a method to identify potential facilities in a set of candidate recovery facilities operating in a region where a reverse supply chain is to be established. In this paper, the problem is solved using a newly developed method called physical programming. The most significant advantage of using physical programming is that it allows a decision maker to express his preferences for values of criteria (for comparing the alternatives), not in the traditional form of weights but in terms of ranges of different degrees of desirability, such as ideal range, desirable range, highly desirable range, undesirable range, and unacceptable range. A numerical example is considered to illustrate the proposed method.
Code of Federal Regulations, 2012 CFR
2012-01-01
... PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.51 General. (a) DSA is available to borrowers with program loans who suffered losses as a result of a natural disaster. (b) DSA is not intended...
Code of Federal Regulations, 2013 CFR
2013-01-01
... PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.51 General. (a) DSA is available to borrowers with program loans who suffered losses as a result of a natural disaster. (b) DSA is not intended...
Code of Federal Regulations, 2011 CFR
2011-01-01
... PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.51 General. (a) DSA is available to borrowers with program loans who suffered losses as a result of a natural disaster. (b) DSA is not intended...
Code of Federal Regulations, 2014 CFR
2014-01-01
... PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.51 General. (a) DSA is available to borrowers with program loans who suffered losses as a result of a natural disaster. (b) DSA is not intended...
Code of Federal Regulations, 2010 CFR
2010-01-01
... PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.51 General. (a) DSA is available to borrowers with program loans who suffered losses as a result of a natural disaster. (b) DSA is not intended...
Repercussions of violence on the mental health of workers of the Family Health Program.
Lancman, Selma; Ghirardi, Maria Isabel Garcez; Castro, Eliane Dias de; Tuacek, Tatiana Amodeo
2009-08-01
To describe forms of external and indirect violence that affect the mental health of workers of the Programa Saúde da Família (Family Health Program), as well as the strategies developed by these workers to enable their work and to be psychologically protected. Qualitative study on the Programa Saúde da Família work process, performed in the cities of São Paulo, Ribeirão Preto and Embu (Southeastern Brazil) in 2005. Theoretical approach of psychodynamics of work, which proposes the formation of reflection groups with workers, was employed. Subjective aspects of work, situations of psychological suffering and strategies used by workers to deal with suffering and continue to work were sought to be identified. The Program's work organization exposed workers to the following: situations of violence, invisible at times; feeling of impotence in the face of precarious situations; lack of acknowledgement of efforts made; lack of borders between professional and personal aspects; intense experiences of social and domestic violence; fear of risk of exposure; feeling of moral and physical integrity being threatened; and fear of reprisal. Situations of psychological suffering resulting from violence in the workplace were observed. These became more intense in the Programa Saúde da Família due to regular contact with situations of violence that cause fear and a feeling of vulnerability. Psychological repercussions caused by violence in the workplace, not always expressed in the form of psychological disorders, were observed in situations of intense suffering. Workers develop strategies to minimize suffering, protect themselves psychologically and continue to work; and seek to create solidarity and protection networks with the population, aiming to reduce vulnerability. With the experience gained, they learn to detect high-risk situations, avoiding those they believe to be threatening.
Spildooren, Joke; Speetjens, Ite; Abrahams, Johan; Feys, Peter; Timmermans, Annick
2018-04-28
Motivation towards an exercise program is higher in a small group setting in comparison to individual therapy. Due to attentional problems, group exercises are difficult for people with Alzheimer disease (AD). This study evaluates the feasibility of a music-supported video-based group exercise program in older adults suffering from AD. Five participants with moderate AD were recruited from a nursing home. A progressive physical exercise program using a video-based training with musical accompaniment was performed and digitally recorded to investigate the adherence and performed accuracy of the exercises. The overall participation during the exercises was 84.1%. The quality of the performance was for all exercises above the cut-off scores. A music-supported video-based group exercise program is feasible in persons with AD. The participants were motivated and the expectations towards the program increased over time. Music seemed an important factor for attention in participants with AD.
Beyond Job Search or Basic Education: Rethinking the Role of Skills in Welfare Reform.
ERIC Educational Resources Information Center
Strawn, Julie
Most welfare-to-work programs may be classified as quick employment programs emphasizing individual or group job searches or skill-building programs emphasizing basic education. Although both types of programs offer benefits, they also suffer from significant limitations. To be more effective than their predecessors, current-generation…
Deferred Capital Renewal as a Spoiler for Campus Programs
ERIC Educational Resources Information Center
Whitefield, Joe
2010-01-01
For facilities managers, deferred capital renewal (DCR) is the issue that, in many ways, can play the role of spoiler for other programs and initiatives are that important to their campuses. In particular, operations and maintenance programs, campus growth strategies, and even sustainability programs can suffer setbacks caused by the unplanned…
NASA Technical Reports Server (NTRS)
Hahn, Edward C.; Hansman, R. J., Jr.
1992-01-01
An experiment to study how automation, when used in conjunction with datalink for the delivery of ATC clearance amendments, affects the situational awareness of aircrews was conducted. The study was focused on the relationship of situational awareness to automated Flight Management System (FMS) programming of datalinked clearances and the readback of ATC clearances. Situational awareness was tested by issuing nominally unacceptable ATC clearances and measuring whether the error was detected by the subject pilots. The experiment also varied the mode of clearance delivery: Verbal, Textual, and Graphical. The error detection performance and pilot preference results indicate that the automated programming of the FMS may be superior to manual programming. It is believed that automated FMS programming may relieve some of the cognitive load, allowing pilots to concentrate on the strategic implications of a clearance amendment. Also, readback appears to have value, but the small sample size precludes a definite conclusion. Furthermore, because textual and graphical modes of delivery offer different but complementary advantages for cognitive processing, a combination of these modes of delivery may be advantageous in a datalink presentation.
So, You Want to be a Science Communicator?
NASA Astrophysics Data System (ADS)
Radzilowicz, John G.
2009-03-01
The late Carl Sagan opined that somehow we have managed to create a global civilization dependant on science and technology in which almost no one understands science and technology. This is an unacceptable recipe for disaster with social, political and financial implications for the future of scientific research. And so, like it or not, popular science communication, more than ever before, is an important and necessary part of the scientific enterprise. Public outreach programs, media interviews, and popular articles have become required parts of the scientist's professional repertoire. But, what does it take to be a good science communicator? What is needed to develop and deliver meaningful public outreach programs? How do you handle non-technical presentations? And, what help is available in developing the necessary skills for good popular science communication? This presentation will look at the essential components of effective science communication aimed at a broad public audience. The components of successful science communication in programs, presentations and articles will be discussed. Specific attention will be given to how university-museum partnerships can expand the reach and enhance the quality of public outreach programs.
NASA Technical Reports Server (NTRS)
Hahn, Edward C.; Hansman, R. John, Jr.
1992-01-01
An experiment to study how automation, when used in conjunction with datalink for the delivery of air traffic control (ATC) clearance amendments, affects the situational awareness of aircrews was conducted. The study was focused on the relationship of situational awareness to automated Flight Management System (FMS) programming and the readback of ATC clearances. Situational awareness was tested by issuing nominally unacceptable ATC clearances and measuring whether the error was detected by the subject pilots. The experiment also varied the mode of clearance delivery: Verbal, Textual, and Graphical. The error detection performance and pilot preference results indicate that the automated programming of the FMS may be superior to manual programming. It is believed that automated FMS programming may relieve some of the cognitive load, allowing pilots to concentrate on the strategic implications of a clearance amendment. Also, readback appears to have value, but the small sample size precludes a definite conclusion. Furthermore, because textual and graphical modes of delivery offer different but complementary advantages for cognitive processing, a combination of these modes of delivery may be advantageous in a datalink presentation.
U. S. fusion programs: Struggling to stay in the game
DOE Office of Scientific and Technical Information (OSTI.GOV)
Crawford, M.
Funding for the US fusion energy program has suffered and will probably continue to suffer major cuts. A committee hand-picked by Energy Secretary James Watkins urged the Department of Energy to mount an aggressive program to develop fusion power, but congress cut funding from $323 million in 1990 to $275 million in 1991. This portends dire conditions for fusion research and development. Projects to receive top priority are concerned with the tokamaks and to keep the next big machine, the Burning Plasma Experiment, scheduled for beginning of construction in 1993 on schedule. Secretary Watkins is said to want to keepmore » the International Thermonuclear Energy Reactor (ITER) on schedule. ITER would follow the Burning Plasma Experiment.« less
The medical ethics of Dr J Marion Sims: a fresh look at the historical record
Wall, L L
2006-01-01
Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims's modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time. PMID:16731734
Heitzig, Jobst; Lessmann, Kai; Zou, Yong
2011-01-01
As the Copenhagen Accord indicates, most of the international community agrees that global mean temperature should not be allowed to rise more than two degrees Celsius above preindustrial levels to avoid unacceptable damages from climate change. The scientific evidence distilled in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change and recent reports by the US National Academies shows that this can only be achieved by vast reductions of greenhouse gas emissions. Still, international cooperation on greenhouse gas emissions reductions suffers from incentives to free-ride and to renegotiate agreements in case of noncompliance, and the same is true for other so-called “public good games.” Using game theory, we show how one might overcome these problems with a simple dynamic strategy of linear compensation when the parameters of the problem fulfill some general conditions and players can be considered to be sufficiently rational. The proposed strategy redistributes liabilities according to past compliance levels in a proportionate and timely way. It can be used to implement any given allocation of target contributions, and we prove that it has several strong stability properties. PMID:21903930
Correlation-based pattern recognition for implantable defibrillators.
Wilkins, J.
1996-01-01
An estimated 300,000 Americans die each year from cardiac arrhythmias. Historically, drug therapy or surgery were the only treatment options available for patients suffering from arrhythmias. Recently, implantable arrhythmia management devices have been developed. These devices allow abnormal cardiac rhythms to be sensed and corrected in vivo. Proper arrhythmia classification is critical to selecting the appropriate therapeutic intervention. The classification problem is made more challenging by the power/computation constraints imposed by the short battery life of implantable devices. Current devices utilize heart rate-based classification algorithms. Although easy to implement, rate-based approaches have unacceptably high error rates in distinguishing supraventricular tachycardia (SVT) from ventricular tachycardia (VT). Conventional morphology assessment techniques used in ECG analysis often require too much computation to be practical for implantable devices. In this paper, a computationally-efficient, arrhythmia classification architecture using correlation-based morphology assessment is presented. The architecture classifies individuals heart beats by assessing similarity between an incoming cardiac signal vector and a series of prestored class templates. A series of these beat classifications are used to make an overall rhythm assessment. The system makes use of several new results in the field of pattern recognition. The resulting system achieved excellent accuracy in discriminating SVT and VT. PMID:8947674
Fan, Yuchen; Moon, James J.
2016-01-01
Bioterrorism agents that can be easily transmitted with high mortality rates and cause debilitating diseases pose major threats to national security and public health. The recent Ebola virus outbreak in West Africa and ongoing Zika virus outbreak in Brazil, now spreading throughout Latin America, are case examples of emerging infectious pathogens that have incited widespread fear and economic and social disruption on a global scale. Prophylactic vaccines would provide effective countermeasures against infectious pathogens and biological warfare agents. However, traditional approaches relying on attenuated or inactivated vaccines have been hampered by their unacceptable levels of reactogenicity and safety issues, whereas subunit antigen-based vaccines suffer from suboptimal immunogenicity and efficacy. In contrast, particulate vaccine delivery systems offer key advantages, including efficient and stable delivery of subunit antigens, co-delivery of adjuvant molecules to bolster immune responses, low reactogenicity due to the use of biocompatible biomaterials, and robust efficiency to elicit humoral and cellular immunity in systemic and mucosal tissues. Thus, vaccine nanoparticles and microparticles are promising platforms for clinical development of biodefense vaccines. In this review, we summarize the current status of research efforts to develop particulate vaccine delivery systems against bioterrorism agents and emerging infectious pathogens. PMID:27038091
Irreversible electroporation and the pancreas: What we know and where we are going?
Young, Shamar J
2015-08-27
Pancreatic adenocarcinoma continues to have a poor prognosis with 1 and 5 years survival rates of 27% and 6% respectively. The gold standard of treatment is resection, however, only approximately 10% of patients present with resectable disease. Approximately 40% of patients present with disease that is too locally advanced to resect. There is great interest in improving outcomes in this patient population and ablation techniques have been investigated as a potential solution. Unfortunately early investigations into thermal ablation techniques, particularly radiofrequency ablation, resulted in unacceptably high morbidity rates. Irreversible electroporation (IRE) has been introduced and is promising as it does not rely on thermal energy and has shown an ability to leave structural cells such as blood vessels and bile ducts intact during animal studies. IRE also does not suffer from heat sink effect, a concern given the large number of blood vessels surrounding the pancreas. IRE showed significant promise during preclinical animal trials and as such has moved on to clinical testing. There are as of yet only a few studies which look at the applications of IRE within humans in the setting of pancreatic adenocarcinoma. This paper reviews the basic principles, techniques, and current clinical data available on IRE.
Belić, Domagoj; Shawrav, Mostafa M; Bertagnolli, Emmerich
2017-01-01
This work presents a highly effective approach for the chemical purification of directly written 2D and 3D gold nanostructures suitable for plasmonics, biomolecule immobilisation, and nanoelectronics. Gold nano- and microstructures can be fabricated by one-step direct-write lithography process using focused electron beam induced deposition (FEBID). Typically, as-deposited gold nanostructures suffer from a low Au content and unacceptably high carbon contamination. We show that the undesirable carbon contamination can be diminished using a two-step process – a combination of optimized deposition followed by appropriate postdeposition cleaning. Starting from the common metal-organic precursor Me2-Au-tfac, it is demonstrated that the Au content in pristine FEBID nanostructures can be increased from 30 atom % to as much as 72 atom %, depending on the sustained electron beam dose. As a second step, oxygen-plasma treatment is established to further enhance the Au content in the structures, while preserving their morphology to a high degree. This two-step process represents a simple, feasible and high-throughput method for direct writing of purer gold nanostructures that can enable their future use for demanding applications. PMID:29259868
The medical ethics of Dr J Marion Sims: a fresh look at the historical record.
Wall, L L
2006-06-01
Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims's modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a "vulnerable population" in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction-a condition for which no other viable therapy existed at that time.
Aidar, Felipe J; Jacó de Oliveira, Ricardo; Gama de Matos, Dihogo; Chilibeck, Philip D; de Souza, Raphael F; Carneiro, André L; Machado Reis, Victor
2017-05-09
Aquatic exercise programs are used in rehabilitation and might help to reduce disability after stroke. This was a randomized intervention trial to assess the influence of an aquatic exercise program on people suffering from depression and anxiety after ischemic stroke. Participants were randomized to an experimental group (EG) composed of 19 individuals (51.8 ± 8.5 years; ten males and nine females), and a control group (CG) composed of 17 people (52.7 ± 6.7 years; nine males and eight females). The aquatic exercise program consisted of two sessions per week, each lasting between 45 and 60 minutes and divided into 5 to 10 minutes exercise sections during 12 weeks. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety levels while the Beck Depression Inventory was used as a self-assessment of depression. EG improved measures of depression, anxiety trait and anxiety state between pre- and post-treatment, with no changes in CG. EG improved in all tests related to functional capacity compared to CG. The practice of aquatic exercises promotes improvements in the levels of depression and anxiety in people who suffered an ischemic stroke.
The antecedents and prevention of unwanted pregnancy.
Gerrard, M; McCann, L; Geis, B D
1983-01-01
Much of the research on the antecedents and consequences of birth control has focused on teenagers and members of racial minority groups, but the trends in contraceptive use indicate that the danger of unwanted pregnancy exists for most women throughout the childbearing ages of 14-45, for white and middle class women as well as minority women and women from the lower socioeconomic status levels. There are basically 4 choices open to the unmarried woman who conceives: giving the child up for adoption, keeping the child without marrying, and marriage. There are little data on the mental health consequences of giving a child up for adoption, but there is no question that the experience at the very least upsetting and may cause longterm trauma. Induced abortion is less traumatic, both physically and psychologically, than carrying a pregnancy to term, however, many women suffer from longterm depression following the procedure. The social, economic, and psychological consequences of single motherhood are clearly documented for both teenagers and older women. The most frequently cited problems are delayed or truncated emotional and social activities, unemployment, and role overload resulting from the responsibility of caring for a child without the support of a spouse. The pregnant teenager who does marry has a 50% probability of divorce within 4 years, and even if the couple does stay married they suffer some adverse consequences. In 1978 Zelnick and Kantner estimated that it would be possible to reduce the number of premarital pregnancies and presumably their psychological and economic consequences by at least 40% if all sexually active young women were to use a contraceptive method and to use it consistently. If the majority of all sexually active women were to use the most reliable methods of contraception, the unwanted pregnancy rate would be reduced even more markedly. Yet, reliable contraceptive behavior involves a complex sequence of psychological and behavioral events including awareness of the risk of becoming pregnant, obtaining adequate information about contraception, making decisions about contraceptive use, acquiring contraception, and regular and consistent use of a reliable contraceptive method. The literature on the psychological antecedents of contraceptive behavior clearly characterize ineffective female contraceptors as being unaccepting of their own sexuality and having negative attitudes toward most matters pertaining to sex. Their attitudes and emotions include irrational fears about specific contraceptives, conflicting attitude and belief systems about birth control in general, and guilt. Implicit in this profile is an inability to think rationally about the high probability that unprotected sex will result in conception and an inability to engage in rational decision making about birth control. Yet, review of the prevention programs currently available reveals that the vast majority are designed to serve the self-motivated women. Given that these programs already have been demonstrated to be effective, it is time to direct attention to exploring ways to reach those women who will not adequate precautions without first experiencing changes in their attitudinal and emotional responses to sex.
The School-Based Violence Prevention Planning Program: A Pilot Test
ERIC Educational Resources Information Center
Armstrong, Todd A.; Webb, Vincent
2006-01-01
Despite a growing research literature identifying evidence-based prevention strategies, schools often adopt programs lacking evidentiary support (Gottfredson and Gottfredson, 2002; Ringwalt et al., 2002). Further, when evidence-based programs are adopted they often suffer from poor implementation (Gottfredson and Gottfredson, 2002). This gap…
Code of Federal Regulations, 2012 CFR
2012-01-01
... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...
Code of Federal Regulations, 2014 CFR
2014-01-01
... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...
Code of Federal Regulations, 2011 CFR
2011-01-01
... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...
Code of Federal Regulations, 2013 CFR
2013-01-01
... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...
Yang, Yali; Huang, Lihui; Cheng, Xiaohua; Fu, Xinxing; Liu, Jiaxing; Ni, Tingting
2014-11-01
To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss. Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic. Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients in unaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss. There are 84 cases (68.85%) accepting UNHS, the average age of first diagnosis was (17.24 ± 17.08) months; 37 cases (31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92 ± 18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group. The difference was statistically signif- icant (P < 0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%) single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group (P < 0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69 ± 11.16 months) was more earlier than words dysplasia group (37.13 ± 15.62 months) and sudden hearing loss group (47.40 ± 24.70 months) (P < 0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P > 0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P < 0.01). Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS. But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.
[Pleasure-suffering indicators of nursing work in a hemodialysis nursing service].
Prestes, Francine Cassol; Beck, Carmem Lúcia Colomé; Magnago, Tânia Solange Bosi de Souza; Silva, Rosângela Marion da
2015-06-01
To measure the pleasure and suffering indicators at work and relate them to the socio-demographic and employment characteristics of the nursing staff in a hemodialysis center in southern Brazil. Quantitative research, with 46 workers. We used a self-completed form with demographic and labor data and the Pleasure and Suffering Indicators at Work Scale (PSIWS). We conducted a bivariate and correlation descriptive analysis with significance levels of 5% using the Epi-Info® and PredictiveAnalytics Software programs. Freedom of Speech was considered critical; other factors were evaluated as satisfactory. The results revealed a possible association between sociodemographic characteristics and work, and pleasure and suffering indicators. There was a correlation between the factors evaluated. Despite the satisfactory evaluation, suffering is present in the studied context, expressed mainly by a lack of Freedom of Speech, with the need for interventions to prevent injury to the health of workers.
ERIC Educational Resources Information Center
Wolter, Bjorn H. K.; Millenbah, Kelly F.; Montgomery, Robert A.; Schneider, James W.
2011-01-01
Transfer students are of recognized importance to postsecondary education and every year feed thousands of students into natural resources programs across America. This influx of students can have a sustaining effect on many academic programs, including fisheries and wildlife programs, which are suffering from a nation-wide decrease in interest…
A Program Evaluation of a Seminar Program
ERIC Educational Resources Information Center
Lyons, Robert Dale, Jr.
2013-01-01
When students do not score well on standardized tests, their school can suffer. In an attempt to improve standardized test scores, a district placed students into a program called Seminar to help them work on weak areas of content through personalized instruction. The purpose of this project study was to assess if the Seminar program had a…
Between suffering and hope: rehabilitation from urinary incontinence as an intervening component.
Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini
2013-07-01
This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI) and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope--rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS) in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.
Code of Federal Regulations, 2010 CFR
2010-04-01
... DEPARTMENT OF STATE MISCELLANEOUS IRISH PEACE PROCESS CULTURAL AND TRAINING PROGRAM § 139.1 Purpose. (a) The regulations set forth in this Part implement, in part, the “Irish Peace Process Cultural and Training Program... establish a program to “allow young people from disadvantaged areas of designated counties suffering from...
Code of Federal Regulations, 2011 CFR
2011-04-01
... DEPARTMENT OF STATE MISCELLANEOUS IRISH PEACE PROCESS CULTURAL AND TRAINING PROGRAM § 139.1 Purpose. (a) The regulations set forth in this part implement, in part, the “Irish Peace Process Cultural and Training Program... establish a program to “allow young people from disadvantaged areas of designated counties suffering from...
Supervision and Evaluation of Paraprofessionals.
ERIC Educational Resources Information Center
Thomas, Lucinda E.
At a time when many agencies are suffering a cutback in funds, and money for new and innovative programs is limited, the use of more paraprofessionals in the helping professions can be very important. Professionals and administrators involved in program planning should carefully assess the contribution of paraprofessionals to the program. By using…
Evaluation Strategies in Financial Education: Evaluation with Imperfect Instruments
ERIC Educational Resources Information Center
Robinson, Lauren; Dudensing, Rebekka; Granovsky, Nancy L.
2016-01-01
Program evaluation often suffers due to time constraints, imperfect instruments, incomplete data, and the need to report standardized metrics. This article about the evaluation process for the Wi$eUp financial education program showcases the difficulties inherent in evaluation and suggests best practices for assessing program effectiveness. We…
The Comprehensive Project for Deprived Communitites in Israel.
ERIC Educational Resources Information Center
Goldstein, Joseph
A large-scale educational program, involving 30 settlements and neighborhoods that had been defined as suffering from deprivation, this project included a variety of reinforcement and enrichment programs. Information for a case study of the program was collected through interviews. Findings indicated that the guiding principles of the program…
Mentoring for Professional Geropsychology within a Doctoral Program
ERIC Educational Resources Information Center
Knight, Bob G.
2011-01-01
Mentoring in doctoral programs in professional psychology has its roots in mentoring in science programs of all types. Professional psychology in general may suffer from conflating mentoring with clinical supervision. Using the Pikes Peak Model competencies as a framework, mentoring in attitudes, knowledge, and skills related to professional…
Krefeld-Schwalb, Antonia; Witte, Erich H.; Zenker, Frank
2018-01-01
In psychology as elsewhere, the main statistical inference strategy to establish empirical effects is null-hypothesis significance testing (NHST). The recent failure to replicate allegedly well-established NHST-results, however, implies that such results lack sufficient statistical power, and thus feature unacceptably high error-rates. Using data-simulation to estimate the error-rates of NHST-results, we advocate the research program strategy (RPS) as a superior methodology. RPS integrates Frequentist with Bayesian inference elements, and leads from a preliminary discovery against a (random) H0-hypothesis to a statistical H1-verification. Not only do RPS-results feature significantly lower error-rates than NHST-results, RPS also addresses key-deficits of a “pure” Frequentist and a standard Bayesian approach. In particular, RPS aggregates underpowered results safely. RPS therefore provides a tool to regain the trust the discipline had lost during the ongoing replicability-crisis. PMID:29740363
Radiation risk and human space exploration.
Schimmerling, W; Cucinotta, F A; Wilson, J W
2003-01-01
Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.
Radiation risk and human space exploration
NASA Technical Reports Server (NTRS)
Schimmerling, W.; Cucinotta, F. A.; Wilson, J. W.
2003-01-01
Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.
Scattering of cylindrical electric field waves from an elliptical dielectric cylindrical shell
NASA Astrophysics Data System (ADS)
Urbanik, E. A.
1982-12-01
This thesis examines the scattering of cylindrical waves by large dielectric scatterers of elliptic cross section. The solution method was the method of moments using a Galerkin approach. Sinusoidal basis and testing functions were used resulting in a higher convergence rate. The higher rate of convergence made it possible for the program to run on the Aeronautical Systems Division's CYBER computers without any special storage methods. This report includes discussion on moment methods, solution of integral equations, and the relationship between the electric field and the source region or self cell singularity. Since the program produced unacceptable run times, no results are contained herein. The importance of this work is the evaluation of the practicality of moment methods using standard techniques. The long run times for a mid-sized scatterer demonstrate the impracticality of moment methods for dielectrics using standard techniques.
Krefeld-Schwalb, Antonia; Witte, Erich H; Zenker, Frank
2018-01-01
In psychology as elsewhere, the main statistical inference strategy to establish empirical effects is null-hypothesis significance testing (NHST). The recent failure to replicate allegedly well-established NHST-results, however, implies that such results lack sufficient statistical power, and thus feature unacceptably high error-rates. Using data-simulation to estimate the error-rates of NHST-results, we advocate the research program strategy (RPS) as a superior methodology. RPS integrates Frequentist with Bayesian inference elements, and leads from a preliminary discovery against a (random) H 0 -hypothesis to a statistical H 1 -verification. Not only do RPS-results feature significantly lower error-rates than NHST-results, RPS also addresses key-deficits of a "pure" Frequentist and a standard Bayesian approach. In particular, RPS aggregates underpowered results safely. RPS therefore provides a tool to regain the trust the discipline had lost during the ongoing replicability-crisis.
Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme
2014-09-01
Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.
1985-04-24
reliability/ downtime/ communication lines/ man-machine interface/ other: 2. A noticeable (to the user) failure happens about and that number has been...improving/ steady/ getting.worse. 3. The number of failures /errors for NOHIMS is acceptable/ somewhat acceptable/ somewhat unacceptable/ unacceptable...somewhat fast/ somewhat slow/ slow. 7. When a NWHIMS failure occurs, it affects the day-to-day provision of medical care because work procedures must
2005-01-01
previously detected high nitrate concen- trations. (Phenol and d- limonene , detected in equipment blanks at unacceptably high concentrations, are not...both tables, were not counted twice. (Phenol and d- limonene , detected in equipment blanks at unaccept- ably high concentrations, are not included in...The surrogate recoveries (not included in table 2) for the PPCP method were 101 and 102 percent. Three compounds, d- limonene , phenol, and
Beliefs about Emotions, Depression, Anxiety and Fatigue: A Mediational Analysis.
Sydenham, Mia; Beardwood, Jennifer; Rimes, Katharine A
2017-01-01
Beliefs that it is unacceptable to experience or express negative emotions have been found to be associated with various clinical problems. It is unclear how such beliefs, which could be viewed as a form of unhelpful perfectionism about emotions, may contribute to symptomatology. This study investigated two hypotheses: a) greater endorsement of beliefs about the unacceptability of negative emotions will be associated with greater emotional avoidance and lower levels of support-seeking and self-compassion; b) these beliefs about emotions will be associated with higher levels of symptoms of depression, anxiety and fatigue and that this relationship will be mediated by social support-seeking, emotional avoidance and self-compassion. Online questionnaires were completed by 451 community participants. Mediational analyses were undertaken to investigate emotional avoidance, social support-seeking and self-compassion as mediators of the relationship between beliefs about emotions and symptoms of depression, anxiety and fatigue. Beliefs about the unacceptability of negative emotions were significantly associated with more emotional avoidance and less self-compassion and support-seeking. The relationships between beliefs about emotions and depression, anxiety and fatigue were significantly mediated by self-compassion and emotional avoidance but not social support-seeking. Future research should investigate whether interventions that pay particular attention to emotional avoidance and self-compassion, such as mindfulness-based therapy or modified forms of CBT, may be beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.
Sisson, K; Newton, J
2007-08-01
To explore the attitudes of undergraduate dental students towards academically unacceptable behaviour. Three sets of vignettes were designed exploring; attitudes towards sharing essays which students present as their own work (set 1), attitudes towards purchasing an essay from a commercial website (set 2), and attitudes towards working in a group (set 3). Eighty-nine dental students read the vignettes, then indicated whether they felt the student depicted should engage in the behaviour, and whether any assessment of the work would be a fair assessment of the student's ability. In addition for the group working vignette, respondents were asked to indicate whether in that situation they would speak to the tutor about their own contribution to the group product. Twenty-one respondents (24%) reported that students should share essays, 11 (12%) felt that the essay would be a fair assessment; 13 (15%) felt that students should buy commercially produced essays, five (6%) felt it would be a fair assessment. For the vignettes involving group work, 31 (35%) respondents felt that group-based assessments were fair, 65 (73%) of respondents felt it unlikely that they would speak to the tutor about their individual contribution. A disturbing proportion of dental students report that cheating is acceptable, the majority feel that unacceptable academic practices are not a fair indication of students' ability. The respondents reported that they were unlikely to report the unacceptable working practices of fellow students.
Ho, Grace W K; Gross, Deborah A
2015-01-01
Nurses are mandated to report suspected cases of child maltreatment. However, it is unclear how nurses decide what constitutes child abuse or evidence for reporting. It is crucial to examine how nurses define various forms of child maltreatment, including child abuse and its differentiation from physical discipline, to enhance our services to families with young children. The present study examined pediatric nurses' views on acceptable versus unacceptable discipline behaviors to better understand parent behaviors that nurses are likely to deem reportable to child protective services. Using Q methodology, a convenience sample of 48 pediatric nurses from one urban medical center sorted 71 statements related to the behavior or outcome of punishing a child via the Internet application FlashQ. The statements were sorted on a predefined continuum ranging from "Most Unacceptable" to "Most Acceptable." By-person factor analysis was used to uncover groups of nurses with similar sorts and to generate a unique sort that represented the viewpoint of nurses in that group. Two distinct viewpoints were uncovered. Although there was consensus on what constitutes most acceptable and most unacceptable parent behaviors, nurses varied on their endorsement of using physical force as a form of discipline, suggesting a potential for discrepant tendencies to identify and report child abuse. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
A model of nonparticipation in alcohol treatment programs.
Burton, T L; Williamson, D L
1997-01-01
Why do the vast majority of those who suffer harm from drinking fail to obtain treatment? Based on a review of research literature and educational and treatment program materials, a model of nonparticipation in treatment is proposed whereby particular population groups are separated out according to whether or not they exhibit specified characteristics related to both harm from drinking and attitudes towards treatment. Eleven groups have been identified in the model, each of which has different reasons for failing to seek and/or obtain treatment. It is suggested that differing educational program messages should be sent to each group. While the model does not purport to be wholly inclusive of all nonparticipation, it offers a basis for addressing the variety of disparate groups that suffer harm from drinking but do not obtain treatment.
Challenges associated with the behaviour of radioactive particles in the environment.
Salbu, Brit; Kashparov, Valery; Lind, Ole Christian; Garcia-Tenorio, Rafael; Johansen, Mathew P; Child, David P; Roos, Per; Sancho, Carlos
2018-06-01
A series of different nuclear sources associated with the nuclear weapon and fuel cycles have contributed to the release of radioactive particles to the environment. Following nuclear weapon tests, safety tests, conventional destruction of weapons, reactor explosions and fires, a major fraction of released refractory radionuclides such as uranium (U) and plutonium (Pu) were present as entities ranging from sub microns to fragments. Furthermore, radioactive particles and colloids have been released from reprocessing facilities and civil reactors, from radioactive waste dumped at sea, and from NORM sites. Thus, whenever refractory radionuclides are released to the environment following nuclear events, radioactive particles should be expected. Results from many years of research have shown that particle characteristics such as elemental composition depend on the source, while characteristics such as particle size distribution, structure, and oxidation state influencing ecosystem transfer depend also on the release scenarios. When radioactive particles are deposited in the environment, weathering processes occur and associated radionuclides are subsequently mobilized, changing the apparent K d . Thus, particles retained in soils or sediments are unevenly distributed, and dissolution of radionuclides from particles may be partial. For areas affected by particle contamination, the inventories can therefore be underestimated, and impact and risk assessments may suffer from unacceptable large uncertainties if radioactive particles are ignored. To integrate radioactive particles into environmental impact assessments, key challenges include the linking of particle characteristics to specific sources, to ecosystem transfer, and to uptake and retention in biological systems. To elucidate these issues, the EC-funded COMET and RATE projects and the IAEA Coordinated Research Program on particles have revisited selected contaminated sites and archive samples. This COMET position paper summarizes new knowledge on key sources that have contributed to particle releases, including particle characteristics based on advanced techniques, with emphasis on particle weathering processes as well as on heterogeneities in biological samples to evaluate potential uptake and retention of radioactive particles. Copyright © 2017 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Lifer, J. David; Parsons, Kristine; Miller, Robert E.
2009-01-01
Given the downturn in Information Systems (IS) program enrollments, IS departments housed within schools of business are justifiably concerned about attracting more students into their programs. While some reasons for the downturn may be beyond the control of the academic community, it has been argued that IS programs are suffering, in part,…
Pakistan's maternal and child health policy: analysis, lessons and the way forward.
Siddiqi, S; Haq, I U; Ghaffar, A; Akhtar, T; Mahaini, R
2004-07-01
An estimated 400,000 infant and 16,500 maternal deaths occur annually in Pakistan. These translate into an infant mortality rate and maternal mortality ratio that should be unacceptable to any state. Disease states including communicable diseases and reproductive health (RH) problems, which are largely preventable account for over 50% of the disease burden. The analysis of Pakistan's maternal and child health (MCH) and family planning (FP) policy covers the period 1990-2002, and focuses on macroeconomic influences, priority programs and gaps, adequacy of resources, equity and organizational aspects, and the process of policy formulation. The overall MCH/FP policy is well directed. MCH/FP has been a priority in all policies; resource allocation, although unacceptably low, has substantially increased during the last decade; and there is a progressive shift from MCH to the reproductive health (RH) agenda. Areas in need of improvement include greater use of evidence as a basis for policy; increased priority to nutrition programs, measures to reduce neonatal and perinatal mortality, provision of emergency obstetric care, availability of skilled birth attendants, and a clear policy on integrated management of childhood illnesses. Enhanced planning capacity, development of a balanced human resource, improved governance to reduce staff absenteeism and frequent transfers, and a greater role of the private sector in the provision of services are some organizational aspects that need the governments' consideration. There are several lessons to be learnt: (i) Ministries of Health need sustained stewardship and well-documented evidence to protect cuts in resource allocation; (ii) frequent policy announcement sends inappropriate signals to managers and weakens on-going implementation; (iii) MCH/FP policies unless informed by evidence and participation of interest groups are unlikely to address gaps in programs; (iv) distributional and equity objectives of MCH/FP be addressed while setting overall national goals; (v) institutional capacity is a vital ingredient in translating MCH/FP policies into effective services. The suggested strategic directions emphasize, among others, the need for a comprehensive MCH/FP framework; strengthened stewardship in ministry of health, cost-effective strategies to address the gaps identified and doubling of the public sector resource allocation to MCH/FP over the next 5 years. The ability to ensure delivery of quality health services remains the biggest challenge in the Pakistani health sector. Unless sound policies are backed by well-functioning programs they are likely to become a victim of poor implementation.
Implementing embedded artificial intelligence rules within algorithmic programming languages
NASA Technical Reports Server (NTRS)
Feyock, Stefan
1988-01-01
Most integrations of artificial intelligence (AI) capabilities with non-AI (usually FORTRAN-based) application programs require the latter to execute separately to run as a subprogram or, at best, as a coroutine, of the AI system. In many cases, this organization is unacceptable; instead, the requirement is for an AI facility that runs in embedded mode; i.e., is called as subprogram by the application program. The design and implementation of a Prolog-based AI capability that can be invoked in embedded mode are described. The significance of this system is twofold: Provision of Prolog-based symbol-manipulation and deduction facilities makes a powerful symbolic reasoning mechanism available to applications programs written in non-AI languages. The power of the deductive and non-procedural descriptive capabilities of Prolog, which allow the user to describe the problem to be solved, rather than the solution, is to a large extent vitiated by the absence of the standard control structures provided by other languages. Embedding invocations of Prolog rule bases in programs written in non-AI languages makes it possible to put Prolog calls inside DO loops and similar control constructs. The resulting merger of non-AI and AI languages thus results in a symbiotic system in which the advantages of both programming systems are retained, and their deficiencies largely remedied.
Serving the Needs of At-Risk Refugee Youth: A Program Evaluation
ERIC Educational Resources Information Center
McBrien, J. Lynn
2006-01-01
Refugee students, although frequently subsumed under the "immigrant" heading, often suffer from effects of significant trauma that can make them more vulnerable than children of voluntary immigrant families. This study evaluated a program created specifically for refugee youth at-risk for academic failure and "social death." The program goals…
An outdoor challenge program as a means of enhancing mental health
Robert A. Hanson
1977-01-01
Modern life fosters confusion and encourages passivity, and youth suffer most from this pattern. The Outdoor Challenge Program enables young people to experience the active roles and the clarity of purpose called forth by a wilderness opportunity. The experience appears to enhance their mental health during and after the program.
Regional Medical Program; Guidelines for Evaluation.
ERIC Educational Resources Information Center
Dean, Gary S., And Others
This set of guidelines was written to provide a systematic explanation of the process of evaluation applied to Regional Medical Programs, as required by Public Law 89-239. Goals of the programs are the improvement of health care of patients suffering from heart disease, cancer, stroke and related diseases and improvement in the practice of health…
Oldridge, N B; Wicks, J R; Hanley, C; Sutton, J R; Jones, N L
1978-02-18
A group of 163 men in the Hamilton, Ont. region who had suffered a myocardial infarction were enrolled in a rehabilitation program of physical activity. These men constituted one cohort of a multicentre collaborative study designed to determine the effects of regular exercise of differing intensity on morbidity and mortality over a 4-year period.The noncompliance rate was 43% for the men who could have participated for 1 year, 46% of whom were classified as noncompliers within 1 month of entry into the program. There was no difference in overall compliance between the men exercising at high intensity and those exercising at low intensity; lack of motivation or interest was the most common reason for their leaving the program. Those leaving the program early tended to have a type A behaviour pattern (they were aggressive, ambitious and competitive, with a chronic sense of time urgency), were inactive during their leisure time, had had at least two previous infarctions and smoked. These characteristics suggest that the men leaving the program early may have been those at greatest risk for a further myocardial infarction.
Oldridge, N.B.; Wicks, J.R.; Hanley, C.; Sutton, J.R.; Jones, N.L.
1978-01-01
A group of 163 men in the Hamilton, Ont. region who had suffered a myocardial infarction were enrolled in a rehabilitation program of physical activity. These men constituted one cohort of a multicentre collaborative study designed to determine the effects of regular exercise of differing intensity on morbidity and mortality over a 4-year period. The noncompliance rate was 43% for the men who could have participated for 1 year, 46% of whom were classified as noncompliers within 1 month of entry into the program. There was no difference in overall compliance between the men exercising at high intensity and those exercising at low intensity; lack of motivation or interest was the most common reason for their leaving the program. Those leaving the program early tended to have a type A behaviour pattern (they were aggressive, ambitious and competitive, with a chronic sense of time urgency), were inactive during their leisure time, had had at least two previous infarctions and smoked. These characteristics suggest that the men leaving the program early may have been those at greatest risk for a further myocardial infarction. PMID:630495
Specification Section 01065S ES&H for Service Contracts
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kirsch, Greg C.
2014-07-01
Section Includes: Requirements and guidelines in performance of work concerning protection of environment and property, and the safety and health of Contractors, Sandia National Laboratories (SNL) and Department of Energy (DOE) employees, visitors to SNL, and members of the public. This Section is applicable only to Service Contracts that do not involve construction or construction-like activities. Construction and construction-like activities are covered by Section 01065, Environment, Safety and Health (ES&H) for Construction Contracts. The entire ES&H program shall focus on safe-by-design intent, understanding the technical basis for the work, identifying and controlling energy sources, unacceptable consequences, risk assessments, and positivemore » verification.« less
Screening for Inhibitors of Essential Leishmania Glucose Transporters
2013-07-01
stationed in that region (see reports in DoD – GEISWeb: www.geis.fhp.osd.mil/GEIS/IDTopics/ Leishmaniasis /LeishNavyPolicy.asp, entitled ‘ Leishmaniasis ...Troops Being Treated For Leishmaniasis ’). Drugs for treatment of leishmaniasis are generally expensive, toxic, and suffer from increasing occurrence of...this research program. Indeed current pharmacological treatments for leishmaniasis suffer from use of a limited number of compounds that were often
2003-04-07
prevention and education programs. This increase in migrant workers is transforming local HIV epidemics and spreading the virus throughout the country.41...consumers, represents a huge, untapped market that would otherwise be promising for U.S. trade growth, but for the instability in the region, fueled...in states that are suffering from increasing HIV infection rates than waiting until those states fail and we suffer loss of trade or we are forced to
Linton, Steven J; Flink, Ida K; Nilsson, Emma; Edlund, Sara
2017-05-01
Patient-centered, empathetic communication has been recommended as a means for improving the health care of patients suffering pain. However, a problem has been training health care providers since programs may be time-consuming and difficult to learn. Validation, a form of empathetic response that communicates that what a patient experiences is accepted as true, has been suggested as an appropriate method for improving communication with patients suffering pain. We study the immediate effects of providing medical students with a 2-session (45-minute duration each) program in validation skills on communication. A one group, pretest vs posttest design was employed with 22 volunteer medical students. To control patient variables, actors simulated 1 of 2 patient scenarios (randomly provided at pretest and posttest). Video recordings were blindly evaluated. Self-ratings of validation and satisfaction were also employed. Observed validation responses increased significantly after training and corresponded to significant reductions in invalidating responses. Both the patient simulators and the medical students were significantly more satisfied after the training. We demonstrated that training empathetic validation results in improved communication thus extending previous findings to a medical setting with patients suffering pain. Our results suggest that it would be feasible to provide validation training for health care providers and this warrants further investigation in controlled studies.
Weingarten, Christine; Rabago, Jina; Reynolds, Jasmine; Gates, Kalani; Yanagida, Evie; Baker, Charlene
2018-06-01
Rates of childhood sexual abuse are unacceptably high, with potentially long-lasting consequences for those who have been victimized. Currently, there are a number of sexual violence prevention programs that have been developed to lower rates of victimization, increase awareness, and connect victims with resources. Within this area of research, there has been less focus on effective methods of program dissemination. For example, school-based sexual violence prevention programs have had positive outcomes; however, little is known about how these programs are disseminated. The train-the-trainer model of dissemination utilizes master trainers to equip others to implement programs, thereby allowing more adults to teach and subsequently more children to receive the program. This study used survey data from teachers and other school personnel (n = 127) to analyze the utility of a train-the-trainer model of dissemination for a sexual violence prevention program in the state of Hawai'i. Through responses of people who were trained to implement the program (59.8% of whom did implement), aspects of the training, the program itself, and factors affecting whether a person implemented the program were explored. Results suggest that time spent in training, job position, and time in that position predicted whether a person trained to implement the sexual violence prevention program followed through with teaching the program to students. Additionally, 54.7% of people who did implement the program had at least one student disclose sexual violence to them, indicating the importance of sexual violence prevention programming and dissemination of these programs. Copyright © 2018 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Birk, Tanja; Hickl, Susanne; Wahl, Hans-Werner; Miller, Daniel; Kammerer, Annette; Holz, Frank; Becker, Stefanie; Volcker, Hans E.
2004-01-01
Purpose: The psychosocial needs of patients suffering from severe visual loss associated with advanced age-related macular degeneration (ARMD) are generally ignored in the clinical routine. The aim of this study was to develop and evaluate a psychosocial intervention program for ARMD patients. This intervention program was based on six modules…
ERIC Educational Resources Information Center
Hanish, Christine; And Others
1995-01-01
Previous attempts to rank doctoral programs in counseling psychology suffered from methodological flaws, such as the "Matthew effect." To offset such defects, this study examines citations in two data bases for 488 counseling psychology faculty. The authors list leading programs on the basis of 11 adjusted and unadjusted measures of scientific…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bolisetti, Chandrakanth; Yu, Chingching; Coleman, Justin
This report provides a framework for assessing the benefits of seismic isolation and exercises the framework on a Generic Department of Energy Nuclear Facility (GDNF). These benefits are (1) reduction in the risk of unacceptable seismic performance and a dramatic reduction in the probability of unacceptable performance at beyond-design basis shaking, and (2) a reduction in capital cost at sites with moderate to high seismic hazard. The framework includes probabilistic risk assessment and estimates of overnight capital cost for the GDNF.
Harper, Joann; Hinds, Pamela S; Baker, Justin N; Hicks, Judy; Spunt, Sheri L; Razzouk, Bassem I
2007-01-01
Children living with and dying of advanced-stage cancer suffer physically, emotionally, and spiritually. Relief of their suffering requires comprehensive, compassionate palliative and end-of-life (EoL) care.However, an EoL care program might appear inconsistent with the mission of a pediatric oncology research center committed to seeking cures. Here the authors describe the methods used to achieve full institutional commitment to their EoL care program and those used to build the program's philosophical, research, and educational foundations after they received approval. The authors convened 10 focus groups to solicit staff perceptions of the hospital's current palliative and EoL care. They also completed baseline medical record reviews of 145 patient records to identify key EoL characteristics. The authors then crafted a vision statement and a strategic plan, implemented new research protocols,and established publication and funding trajectories. They conclude that establishing a state-of-the-art palliative and EoL program in a cure-oriented pediatric setting is achievable via consensus building and recruitment of diverse institutional resources.
McClafferty, Hilary; Brooks, Audrey J; Chen, Mei-Kuang; Brenner, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Mark, John; Weydert, Joy; Yeh, Ann Ming; Maizes, Victoria
2018-04-23
It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents ( N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.
Effects of an Individualized Activity Program on Elderly Patients
ERIC Educational Resources Information Center
Salter, Carlota de Lerma; Salter, Charles A.
1975-01-01
A combined program of Reality Orientation, Activities of Daily Living, and Recreational Activities, together with environmental stimulation, was applied on an individualized basis to 21 elderly patients suffering from both psychological disorders and long-term physical illness. The motivation to participate in the available activities increased…
ERIC Educational Resources Information Center
Barkley, Russell A.
2006-01-01
From leading ADHD authority Dr. Russell A. Barkley, this instructive program integrates information about ADHD with the experiences of adults from different walks of life who suffer from the disorder. Including interviews with these individuals, their family members, and the clinicians who treat them, the program addresses such important topics as…
44 CFR 206.361 - Loan program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Loan program. 206.361 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Community Disaster Loans § 206.361 Loan... Community Disaster Loan to any local government which has suffered a substantial loss of tax and other...
44 CFR 206.371 - Loan program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Loan program. 206.371 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Community Disaster Loans § 206.371 Loan... Special Community Disaster Loan to any local government which has suffered a substantial loss of tax and...
Editorial: emerging issues in sociotechnical systems thinking and workplace safety.
Noy, Y Ian; Hettinger, Lawrence J; Dainoff, Marvin J; Carayon, Pascale; Leveson, Nancy G; Robertson, Michelle M; Courtney, Theodore K
2015-01-01
The burden of on-the-job accidents and fatalities and the harm of associated human suffering continue to present an important challenge for safety researchers and practitioners. While significant improvements have been achieved in recent decades, the workplace accident rate remains unacceptably high. This has spurred interest in the development of novel research approaches, with particular interest in the systemic influences of social/organisational and technological factors. In response, the Hopkinton Conference on Sociotechnical Systems and Safety was organised to assess the current state of knowledge in the area and to identify research priorities. Over the course of several months prior to the conference, leading international experts drafted collaborative, state-of-the-art reviews covering various aspects of sociotechnical systems and safety. These papers, presented in this special issue, cover topics ranging from the identification of key concepts and definitions to sociotechnical characteristics of safe and unsafe organisations. This paper provides an overview of the conference and introduces key themes and topics. Sociotechnical approaches to workplace safety are intended to draw practitioners' attention to the critical influence that systemic social/organisational and technological factors exert on safety-relevant outcomes. This paper introduces major themes addressed in the Hopkinton Conference within the context of current workplace safety research and practice challenges.
Editorial: emerging issues in sociotechnical systems thinking and workplace safety
Noy, Y. Ian; Hettinger, Lawrence J.; Dainoff, Marvin J.; Carayon, Pascale; Leveson, Nancy G.; Robertson, Michelle M.; Courtney, Theodore K.
2015-01-01
The burden of on-the-job accidents and fatalities and the harm of associated human suffering continue to present an important challenge for safety researchers and practitioners. While significant improvements have been achieved in recent decades, the workplace accident rate remains unacceptably high. This has spurred interest in the development of novel research approaches, with particular interest in the systemic influences of social/organisational and technological factors. In response, the Hopkinton Conference on Sociotechnical Systems and Safety was organised to assess the current state of knowledge in the area and to identify research priorities. Over the course of several months prior to the conference, leading international experts drafted collaborative, state-of-the-art reviews covering various aspects of sociotechnical systems and safety. These papers, presented in this special issue, cover topics ranging from the identification of key concepts and definitions to sociotechnical characteristics of safe and unsafe organisations. This paper provides an overview of the conference and introduces key themes and topics. Practitioner Summary: Sociotechnical approaches to workplace safety are intended to draw practitioners' attention to the critical influence that systemic social/organisational and technological factors exert on safety-relevant outcomes. This paper introduces major themes addressed in the Hopkinton Conference within the context of current workplace safety research and practice challenges. PMID:25819595
NASA Astrophysics Data System (ADS)
du Plessis, Adre J.; Volpe, Joseph J.
1996-10-01
Despite dramatic advances in the survival rate among infants undergoing cardiac surgery for congenital heart disease, the incidence of brain injury suffered by survivors remains unacceptably high. This is largely due to our limited understanding of the complex changes in cerebral oxygen utilization and supply occurring during the intraoperative period as a result of hypothermia, neuroactive drugs, and profound circulatory changes. Current techniques for monitoring the adequacy of cerebral oxygen supply and utilization during hypothermic cardiac surgery are inadequate to address this complex problem and consequently to identify the infant at risk for such brain injury. Furthermore, this inability to detect imminent hypoxic- ischemic brain injury is likely to become all the more conspicuous as new neuroprotective strategies, capable of salvaging 'insulated' neuronal tissue form cell death, enter the clinical arena. Near infrared spectroscopy is a relatively new, noninvasive, and portable technique capable of interrogating the oxygenation and hemodynamics of tissue in vivo. These characteristics of the technique have generated enormous interest among clinicians in the ability of near infrared spectroscopy to elucidate the mechanisms of intraoperative brain injury and ultimately to identify infants oat risk for such injury. This paper reviews the experience with this technique to date during infant cardiac surgery.
A Cost-Benefit Analysis of the National Guard Youth ChalleNGe Program. Technical Report
ERIC Educational Resources Information Center
Perez-Arce, Francisco; Constant, Louay; Loughran, David S.; Karoly, Lynn A.
2012-01-01
Decades of research show that high school dropouts are more likely than graduates to commit crimes, abuse drugs and alcohol, have children out of wedlock, earn low wages, be unemployed, and suffer from poor health. The ChalleNGe program, currently operating in 27 states, is a residential program coupled with post-residential mentoring that seeks…
ERIC Educational Resources Information Center
Anderson, James C., II.; Thorson, Candi J.; Kelinsky, Lia R.
2016-01-01
This case study outlines an appreciative inquiry approach to program reform using an agricultural teacher education program at a land-grant university that had begun to suffer from a large decline in student enrollment. Documents were analyzed that provided recommendations toward a master plan for reform made by 23 key agents based on their…
ERIC Educational Resources Information Center
Stake, Jayne E.; Mares, Kenneth R.
2005-01-01
The benefits of enrichment programs for the enhancement of students' science achievement are well established. However, little evidence is available on the value of these programs for increasing students' confidence and motivation for science. One problem in measuring changes in students' science attitudes is that students may suffer from a…
Invited Reaction: Protecting the Birds' Feathers--Keeping Ideology out of MBA and HRD Programs
ERIC Educational Resources Information Center
Bowman, Jeffry S.
2007-01-01
In reference to Peter Kuchinke's manuscript, the author points out that current MBA programs suffer from a myriad of ills that are somehow detrimental to organizations and that there is a similar problem with human resource development (HRD) programs (hence the reference in the title to "birds of a feather"). In this article, he shares his…
Mismatch or cumulative stress: toward an integrated hypothesis of programming effects.
Nederhof, Esther; Schmidt, Mathias V
2012-07-16
This paper integrates the cumulative stress hypothesis with the mismatch hypothesis, taking into account individual differences in sensitivity to programming. According to the cumulative stress hypothesis, individuals are more likely to suffer from disease as adversity accumulates. According to the mismatch hypothesis, individuals are more likely to suffer from disease if a mismatch occurs between the early programming environment and the later adult environment. These seemingly contradicting hypotheses are integrated into a new model proposing that the cumulative stress hypothesis applies to individuals who were not or only to a small extent programmed by their early environment, while the mismatch hypothesis applies to individuals who experienced strong programming effects. Evidence for the main effects of adversity as well as evidence for the interaction between adversity in early and later life is presented from human observational studies and animal models. Next, convincing evidence for individual differences in sensitivity to programming is presented. We extensively discuss how our integrated model can be tested empirically in animal models and human studies, inviting researchers to test this model. Furthermore, this integrated model should tempt clinicians and other intervenors to interpret symptoms as possible adaptations from an evolutionary biology perspective. Copyright © 2011 Elsevier Inc. All rights reserved.
Defining acceptable levels for ecological indicators: an approach for considering social values.
Smyth, Robyn L; Watzin, Mary C; Manning, Robert E
2007-03-01
Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.
Defining Acceptable Levels for Ecological Indicators: An Approach for Considering Social Values
NASA Astrophysics Data System (ADS)
Smyth, Robyn L.; Watzin, Mary C.; Manning, Robert E.
2007-03-01
Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.
Long term exposure of metals to hydrazine nitrate blend
NASA Technical Reports Server (NTRS)
Moran, Clifford M.; Blue, Gary D.
1986-01-01
A long term testing program is being conducted to determine the effects of materials in contact with a hydrazine nitrate blend for the purpose of designing chemical propulsion systems which can be used for current as well as future planetary spacecraft. Analysis of this data indicates that some aluminum alloys are acceptable for use with the particular blend of fuel used. Titanium alloy was identified as being acceptable for 10-year applications. Corrosion resistant steels, however, were found to have excessive corrosion rates and are therefore considered unacceptable for long-term use. There is also some evidence that the propellant decomposed at a rate far in excess of the acceptable rate of 0.1 percent per year when in contact with stainless steel.
Acceptance criteria for welds in ASTM A106 grade B steel pipe and plate
NASA Technical Reports Server (NTRS)
Hudson, C. M.; Wright, D. B., Jr.; Leis, B. N.
1986-01-01
Based on the RECERT Program findings, NASA-Langley funded a fatigue study of code-unacceptable welds. Usage curves were developed which were based on the structural integrity of the welds. The details of this study are presented in NASA CR-178114. The information presented is a condensation and reinterpretation of the information in NASA CR-178114. This condensation and reinterpretation generated usage curves for welds having: (1) indications 0.20 -inch deep by 0.40-inch long, and (2) indications 0.195-inch deep by 8.4-inches long. These curves were developed using the procedures used in formulating the design curves in Section VIII, Division 2 of the American Society of Mechanical Engineers Boiler and Pressure Vessel Code.
A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation.
Dubois, Sara; Fraser, David
2013-10-11
Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable.
Programs Suffer Cuts in Funding
ERIC Educational Resources Information Center
Klein, Alyson
2011-01-01
More than a dozen education programs--including high-profile efforts focused on literacy, teaching, and learning--face the prospect of a permanent federal funding loss after they were chopped from a stopgap spending measure signed into law by President Barack Obama last week. The temporary spending law, intended to keep the government running…
NASA Technical Reports Server (NTRS)
Bovell-Benjamin, Adelia C.; Guinard, Jean-Xavier
2003-01-01
Iron deficiency is the leading nutritional deficiency in the U.S. and the rest of the world, with its highest prevalences in the developing world. Iron fortification of food has been proposed as a strategy to reduce the high prevalence of iron deficiency. Poor consumer acceptance, unacceptable taste, and discoloration of the iron-fortified foods have been frequently listed as causes of unsuccessful iron fortification programs. An excellent prospect for improving consumer acceptance of iron-fortified foods is the incorporation of a thorough, organized, and unified approach to sensory evaluation practices into iron fortification programs for product optimization. The information gained from systematic sensory evaluation allows for the manipulation of the sensory attributes, and thus improvement of the sensory properties of the fortified food. However, iron fortification programs have not systematically measured the effect of fortification on the sensory quality of the food. Because sensory evaluation is an important criterion in successful iron fortification, an integrated approach is necessary. Therefore, nutritionists and sensory scientists should work closely with each other to select the most suitable sensory tests and methods. The objectives of this article are to: (1) critically review and discuss some traditional and contemporary approaches and applications of sensory evaluation practices in iron fortification programs, and (2) demonstrate the importance of incorporating a multidisciplinary, systematic sensory evaluation approach in iron fortification programs.
The United States Humanitarian Demining Program: Civil-Military Relations in Humanitarian Demining
2015-05-23
human suffering. The result was ‘humanitarian demining’, a new term which involves the removal of emplaced mines and provides information and education ...determine whether to approve the request. If approved, the HDP would design a demining/land mine education program to meet the requesting nation’s needs.31...11 Secretary of Defense establish a program to educate , train, and advise other nations on the establishment of humanitarian demining programs
The Medicaid personal care services program: implications for social work practice.
Oktay, J S; Palley, H A
1991-05-01
Results of a survey of Medicaid personal care programs in 15 states and the District of Columbia in 1987 show that these programs suffer from many problems. Low wages and slow payment make recruitment and retention of qualified workers difficult. Other problems include lack of coordination among agencies, lack of adequate standards for training or supervision of workers, unequal access to programs, and inequities among states. Implications for social workers are discussed.
The End-Stage Renal Disease Program: Basis for the Army Organ Transplant Program
1985-07-19
gradually lost, the condition is known as chronic renal failure . End-stage renal disease (ESRD) is the late and terminal phase of chronic renal ...extended Medicare coverage to persons suffering from kidney ( renal ) failure who either were currently or fully insured under the Social Security Act or...NO.NO. 11. TITLE (Include Security Classification) THE END-STAGE RENAL DISEASE PROGRAM: BASIS FOR THE ARMY ORGAN TRANSPLANT PROGRAM 12. PERSONAL
Performance Evaluation Tests for Environmental Research (PETER): evaluation of 114 measures
NASA Technical Reports Server (NTRS)
Bittner, A. C. Jr; Carter, R. C.; Kennedy, R. S.; Harbeson, M. M.; Krause, M.
1986-01-01
The goal of the Performance Evaluation Tests for Environmental Research (PETER) Program was to identify a set of measures of human capabilities for use in the study of environmental and other time-course effects. 114 measures studied in the PETER Program were evaluated and categorized into four groups based upon task stability and task definition. The Recommended category contained 30 measures that clearly obtained total stabilization and had an acceptable level of reliability efficiency. The Acceptable-But-Redundant category contained 15 measures. The 37 measures in the Marginal category, which included an inordinate number of slope and other derived measures, usually had desirable features which were outweighed by faults. The 32 measures in the Unacceptable category had either differential instability or weak reliability efficiency. It is our opinion that the 30 measures in the Recommended category should be given first consideration for environmental research applications. Further, it is recommended that information pertaining to preexperimental practice requirements and stabilized reliabilities should be utilized in repeated-measures environmental studies.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The worldwide semisubmersible drilling rig fleet is approaching retirement. But replacement is not an attractive option even though dayrates are reaching record highs. In 1991, Schlumberger Sedco Forex managers decided that an alternative might exist if regulators and insurers could be convinced to extend rig life expectancy through restoration. Sedco Forex chose their No. 704 semisubmersible, an 18-year North Sea veteran, to test their process. The first step was to determine what required restoration, meaning fatigue life analysis of each weld on the huge vessel. If inspected, the task would be unacceptably time-consuming and of questionable accuracy. Instead a suitemore » of computer programs modeled the stress seen by each weld, statistically estimated the sea states seen by the rig throughout its North Sea service and calibrated a beam-element model on which to run their computer simulations. The elastic stiffness of the structure and detailed stress analysis of each weld was performed with ANSYS, a commercially available finite-element analysis program. The use of computer codes to evaluate service life extension is described.« less
NASA Astrophysics Data System (ADS)
Conallin, John; Wilson, Emma; Campbell, Josh
2018-03-01
Anthropogenic pressure on freshwater ecosystems is increasing, and often leading to unacceptable social-ecological outcomes. This is even more prevalent in intermittent river systems where many are already heavily modified, or human encroachment is increasing. Although adaptive management approaches have the potential to aid in providing the framework to consider the complexities of intermittent river systems and improve utility within the management of these systems, success has been variable. This paper looks at the application of an adaptive management pilot project within an environmental flows program in an intermittent stream (Tuppal Creek) in the Murray Darling Basin, Australia. The program focused on stakeholder involvement, participatory decision-making, and simple monitoring as the basis of an adaptive management approach. The approach found that by building trust and ownership through concentrating on inclusiveness and transparency, partnerships between government agencies and landholders were developed. This facilitated a willingness to accept greater risks and unintended consequences allowing implementation to occur.
Reis, Andreas A
2016-06-07
This article provides a commentary to Ole Norheim' s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). © 2016 by Kerman University of Medical Sciences.
ERIC Educational Resources Information Center
Reusch, A.; Weiland, R.; Gerlich, C.; Dreger, K.; Derra, C.; Mainos, D.; Tuschhoff, T.; Berding, A.; Witte, C.; Kaltz, B.; Faller, H.
2016-01-01
Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management…
Across the Country, Youth Programs Bring the Issue of Brownfields Home
ERIC Educational Resources Information Center
US Environmental Protection Agency, 2007
2007-01-01
In the more than 10 years since the inception of EPA's (Environmental Protection Agency) Brownfields Program, brownfields have been redefined. Properties that were shunned or eyed warily by those with the resources to transform them are now viewed as dormant opportunities for economic and environmental rebirth. Communities that suffered aesthetic…
Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients
ERIC Educational Resources Information Center
Drapeau, Marie-Celine; Kronish, Neomi
2007-01-01
This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is…
USDA-ARS?s Scientific Manuscript database
Ready-to-use therapeutic food (RUTF) is the standard of care for children suffering from noncomplicated severe acute malnutrition (SAM). The objective was to develop a comprehensive linear programming (LP) tool to create novel RUTF formulations for Ethiopia. A systematic approach that surveyed inter...
2015-06-12
development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT eras...the development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT...Army began to acknowledge the effects that PTSD has on the force, and implemented programs and procedures, medicinal and psychological, in order to
Lucy, Malcolm J; Gamble, Jonathan J; Daku, Brian L; Bryce, Rhonda D; Rana, Masud
2014-12-01
Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. To evaluate the hypothesis that transport ventilation goals of intubated pediatric patients are better achieved using an FIR compared to an SIR. This randomized crossover simulation study compared the performance of SIR and FIR among anesthesia providers in a pediatric transport scenario. Subjects hand-ventilated a test lung while simultaneously maneuvering a stretcher bed to simulate patient transport. Hand ventilation was carried out using a Jackson-Rees circuit (FIR) and a Laerdal pediatric silicone resuscitator (SIR). The primary outcome was the proportion of total breaths delivered within the predefined target PIP/PEEP range (30+/- 3, 10+/- 3 cm H2O). Secondary outcomes included proportion of total breaths delivered with operationally defined unacceptable breath variables (PIP > 35 cm H2O or PEEP < 5 cm H2O). Overall, participants were four times more likely to deliver target breaths and one-third less likely to deliver unacceptable breaths using the FIR compared to the SIR. When comparing device performance, a 44% increase in the proportions of target breaths and a 40.4% decrease in unacceptable breaths using the FIR were observed (P < 0.0001 for both). Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles. © 2014 John Wiley & Sons Ltd.
Vucetich, John A; Nelson, Michael P; Phillips, Michael K
2006-10-01
The ethical, legal, and social significance of the U.S. Endangered Species Act of 1973 (ESA) is widely appreciated. Much of the significance of the act arises from the legal definitions that the act provides for the terms threatened species and endangered species. The meanings of these terms are important because they give legal meaning to the concept of a recovered species. Unfortunately, the meanings of these terms are often misapprehended and rarely subjected to formal analysis. We analyzed the legal meaning of recovered species and illustrate key points with details from "recovery" efforts for the gray wolf (Canis lupus). We focused on interpreting the phrase "significant portion of its range," which is part of the legal definition of endangered species. We argue that recovery and endangerment entail a fundamentally normative dimension (i.e., specifying conditions of endangerment) and a fundamentally scientific dimension (i.e., determining whether a species meets the conditions of endangerment). Specifying conditions for endangerment is largely normative because it judges risks of extinction to be either acceptable or unacceptable. Like many other laws that specify what is unacceptable, the ESA largely specifies the conditions that constitute unacceptable extinction risk. The ESA specifies unacceptable risks of extinction by defining endangered species in terms of the portion of a species' range over which a species is "in danger of extinction." Our analysis indicated that (1) legal recovery entails much more than the scientific notion of population viability, (2) most efforts to recover endangered species are grossly inadequate, and (3) many unlisted species meet the legal definition of an endangered or threatened species.
Rodriguez-Ruiz, A; Etxebarria, J; Boatti, L; Marigómez, I
2015-09-01
Lanestosa is a chronically polluted site (derelict mine) where the soil (Lanestosa (LA) soil) exceeds screening values (SVs) of regulatory policies in force (Basque Country; Europe) for Zn, Pb and Cd. A scenario-targeted toxicity assessment was carried out on the basis of a multi-endpoint bioassay approach. Acute and chronic toxicity bioassays were conducted with selected test species (Vibrio fischeri, Dictyostelium discoideum, Lactuca sativa, Raphanus sativus and Eisenia fetida) in combination with chemical analysis of soils and elutriates and with bioaccumulation studies in earthworms. Besides, the toxicity profile was compared with that of the mine runoff (RO) soil and of a fresh artificially polluted soil (LAAPS) resembling LA soil pollutant profile. Extractability studies in LA soil revealed that Pb, Zn and Cd were highly available for exchange and/or release into the environment. Indeed, Pb and Zn were accumulated in earthworms and LA soil resulted to be toxic. Soil respiration, V. fischeri, vegetative and developmental cycles of D. discoideum and survival and juvenile production of E. fetida were severely affected. These results confirmed that LA soil had unacceptable environmental risk and demanded intervention. In contrast, although Pb and Zn concentrations in RO soil revealed also unacceptable risk, both metal extractability and toxicity were much lower than in LA soil. Thus, within the polluted site, the need for intervention varied between areas that posed dissimilar risk. Besides, since LAAPS, with a high exchangeable metal fraction, was the most toxic, ageing under in situ natural conditions seemingly contributed to attenuate LA soil risk. As a whole, combining multi-endpoint bioassays with scenario-targeted analysis (including leaching and ageing) provides reliable risk assessment in soils posing unacceptable environmental risk according to SVs, which is useful to optimise the required intervention measures.
Juhl, David; Marget, Matthias; Hallensleben, Michael; Görg, Siegfried; Ziemann, Malte
2017-03-01
Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation. Copyright © 2017 Elsevier B.V. All rights reserved.
Bryan, Angela D; Gillman, Arielle S; Hansen, Natasha S
2016-07-01
Starting school later, keeping adolescents busy with structured programming, and making free condoms available, as Steinberg (2015) suggests, are important and necessary steps, but they are simply not sufficient if the goal is reducing sexually transmitted infections and unplanned pregnancy. We agree that the current state of affairs, which in many schools involves sexuality education using programs that are not empirically supported, is unacceptable. However, abandoning sexuality education entirely would leave adolescents ill equipped to protect themselves. Despite the fact that current intervention technology is neither perfect nor optimally effective, there are empirically supported, school-based sexual risk reduction interventions that teach these skills and are readily available. In addition, even though we agree that structured afternoon programs for school-aged adolescents would reduce the opportunity for sexual risk behavior during the school years, such programs would not address the demographic reality of sexual risk that continues for adolescents and emerging adults far past the end of traditional secondary education. We believe Steinberg's suggestions are an excellent start and ought to be implemented. But complementary to this approach should be the use of existing empirically supported sexual risk reduction interventions and research into the development of even more effective interventions. © The Author(s) 2016.
Human Research Program Integrated Research Plan. Revision C
NASA Technical Reports Server (NTRS)
Steinberg, Susan
2011-01-01
Crew health and performance are critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes (1) HRP's approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and (2) the method of integration for risk mitigation. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.
Ajjarapu, Aparna Sai; Broderick, Ann
2018-06-14
An estimated 1.5 billion people across the globe live with chronic pain, and an estimated 61 million people worldwide experience unrelieved serious health-related suffering. One-sixth of the global population lives in India, where approximately 10 million people endure unrelieved serious health-related suffering. The state of Kerala is home to Pallium India, one of the most sophisticated palliative care programs in the country. This private organization in Trivandrum provides palliative and hospice care to underresourced populations and emphasizes holistic pain treatment. The current project features the pain stories of six patients who received treatment from Pallium India. Basic patient demographic information was collected, and a Pallium India staff member who was fluent in Malayalam and English asked questions about each patient's pain experience. Pain narratives illustrate the substantial impact of Pallium India's home visit program and the role of total pain assessment in delivering high-quality palliative care.
Low immunisation uptake: Is the process the problem?
Harrington, P.; Woodman, C.; Shannon, W.
2000-01-01
OBJECTIVE—To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake. DESIGN—In depth interviews with mothers. SETTING—Two Community Care Areas, Dublin city, Ireland. PARTICIPANTS—In depth interviews of 23 mothers of children 1-2 years old, recruited purposively from a birth cohort born in 1994. MAIN RESULTS—Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour. CONCLUSIONS—Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics. Keywords: immunisation; health behaviour; immunisation uptake PMID:10814662
Swelum, Ayman Abdel-Aziz; Saadeldin, Islam M; Zaher, Hany A; Alsharifi, Sawsan A M; Alowaimer, Abdullah N
2017-06-01
We studied the effect of sexual excitation on serum testosterone and nitric oxide (NO) levels in water buffalo bulls with different categories of sexual behavior and their correlation with each other. Buffalo bulls were classified according to their sexual behavior (including reaction time, sexual aggressiveness and mating ability): acceptable (good to excellent) (n=5), fair (n=5), and unacceptable (poor) (n=5) sexual behavior. Blood samples were collected from all animals immediately before and after sexual teasing and/or mounting to estimate the testosterone and NO levels using a commercial radioimmunoassay kit and Griess reaction test, respectively. Comparisons among groups were evaluated using a mixed-design analysis of variance. Pearson's correlation coefficients were calculated to determine the relationship between testosterone and NO levels before and after sexual excitation besides sexual behavior. The level of testosterone before sexual excitation was higher (p≤0.05) in bulls with acceptable and fair sexual behavior than in bulls with unacceptable sexual behavior (0.86±0.01, 0.69±0.02, and 0.29±0.02ng/mL, respectively). The level of NO was higher (p≤0.05) in bulls with acceptable and fair sexual behavior than in bulls with unacceptable sexual behavior (8.00±0.03, 7.66±0.19, and 6.29±0.33μM, respectively). Sexual excitation significantly (p<0.05) increase testosterone and NO levels in bulls with acceptable (1.45±0.01ng/mL and 19.04±0.32μM, respectively) or fair (0.92±0.02ng/mL and 14.95±0.34μM, respectively) sexual behavior, but not in bulls with unacceptable sexual behavior. The unacceptable sexual behavior bulls had significantly lower testosterone and NO levels than the other bulls. There was a strong correlation and association between serum testosterone and NO levels besides sexual behavior of buffalo bulls. In conclusion, the alteration in the testosterone and NO levels after sexual excitation depends on the sexual behavior category of buffalo-bull. Testosterone and NO can be used to create a sexual behavior score. The testosterone and NO levels of can be predicted via evaluation of sexual behavior of buffalo bull. Copyright © 2017 Elsevier B.V. All rights reserved.
Ruffolo, Daria C; Andresen, Pamela A; Winn, Keith L
2013-01-01
Youth violence is among the most serious health threats in the nation today. Violence disproportionately affects young people and people of color. Although the national rates of violent injury and homicide have shown a decline in most regions of the United States over the past 15 years, the rates of violence and related injuries among youth remain unacceptably high. The prevention of youth violence has been a priority of health departments nationwide, including the Cook County Department of Public Health. The goal of this project was to provide key community leaders, social service workers, and nurses within suburban Cook County with educational sessions on Blueprints for Violence Prevention, an initiative to promote evidence-based youth violence prevention programs.
Public, animal, and environmental health implications of aquaculture.
Garrett, E. S.; dos Santos, C. L.; Jahncke, M. L.
1997-01-01
Aquaculture is important to the United States and the world's fishery system. Both import and export markets for aquaculture products will expand and increase as research begins to remove physiologic and other animal husbandry barriers. Overfishing of wild stock will necessitate supplementation and replenishment through aquaculture. The aquaculture industry must have a better understanding of the impact of the "shrouded" public and animal health issues: technology ignorance, abuse, and neglect. Cross-pollination and cross-training of public health and aquaculture personnel in the effect of public health, animal health, and environmental health on aquaculture are also needed. Future aquaculture development programs require an integrated Gestalt public health approach to ensure that aquaculture does not cause unacceptable risks to public or environmental health and negate the potential economic and nutritional benefits of aquaculture. PMID:9366596
NASA Technical Reports Server (NTRS)
Romine, G. L.; Reisert, T. D.; Gliozzi, J.
1973-01-01
A potential interference problem for the Viking '75 scientific investigation of the Martian surface resulting from retrorocket exhaust plume impingement of the surface was investigated experimentally and analytically. It was discovered that the conventional bell nozzle originally planned for the Viking Lander retrorockets would produce an unacceptably large amount of physical disturbance to the landing site. An experimental program was subsequently undertaken to find and/or develop a nozzle configuration which would significantly reduce the site alteration. A multiple nozzle configuration, consisting of 18 small bell nozzles, was shown to produce a level of disturbance that was considered by the Viking Lander Science Teams to be acceptable on the basis of results from full-scale tests on simulated Martian soils.
Reduction of earthquake risk in the united states: Bridging the gap between research and practice
Hays, W.W.
1998-01-01
Continuing efforts under the auspices of the National Earthquake Hazards Reduction Program are under way to improve earthquake risk assessment and risk management in earthquake-prone regions of Alaska, California, Nevada, Washington, Oregon, Arizona, Utah, Wyoming, and Idaho, the New Madrid and Wabash Valley seismic zones in the central United States, the southeastern and northeastern United States, Puerto Rico, Virgin Islands, Guam, and Hawaii. Geologists, geophysicists, seismologists, architects, engineers, urban planners, emergency managers, health care specialists, and policymakers are having to work at the margins of their disciplines to bridge the gap between research and practice and to provide a social, technical, administrative, political, legal, and economic basis for changing public policies and professional practices in communities where the earthquake risk is unacceptable. ?? 1998 IEEE.
Future challenges in the elimination of bacterial meningitis.
Bottomley, Matthew J; Serruto, Davide; Sáfadi, Marco Aurélio Palazzi; Klugman, Keith P
2012-05-30
Despite the widespread implementation of several effective vaccines over the past few decades, bacterial meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis and Group B Streptococcus (GBS) still results in unacceptably high levels of human mortality and morbidity. A residual disease burden due to bacterial meningitis is also apparent due to a number of persistent or emerging pathogens, including Mycobacterium tuberculosis, Escherichia coli, Staphylococcus aureus, Salmonella spp. and Streptococcus suis. Here, we review the current status of bacterial meningitis caused by these pathogens, highlighting how past and present vaccination programs have attempted to counter these pathogens. We discuss how improved pathogen surveillance, implementation of current vaccines, and development of novel vaccines may be expected to further reduce bacterial meningitis and related diseases in the future. Copyright © 2011 Elsevier Ltd. All rights reserved.
Lightweight causal and atomic group multicast
NASA Technical Reports Server (NTRS)
Birman, Kenneth P.; Schiper, Andre; Stephenson, Pat
1991-01-01
The ISIS toolkit is a distributed programming environment based on support for virtually synchronous process groups and group communication. A suite of protocols is presented to support this model. The approach revolves around a multicast primitive, called CBCAST, which implements a fault-tolerant, causally ordered message delivery. This primitive can be used directly or extended into a totally ordered multicast primitive, called ABCAST. It normally delivers messages immediately upon reception, and imposes a space overhead proportional to the size of the groups to which the sender belongs, usually a small number. It is concluded that process groups and group communication can achieve performance and scaling comparable to that of a raw message transport layer. This finding contradicts the widespread concern that this style of distributed computing may be unacceptably costly.
Space ten-meter telescope (STMT) - Structural and thermal feasibility study of the primary mirror
NASA Technical Reports Server (NTRS)
Bely, Pierre Y.; Bolton, John F.; Neeck, Steven P.; Tulkoff, Philip J.
1987-01-01
The structural and thermal behavior of a ten-meter primary mirror for a space optical/near-IR telescope in geosynchronous orbit is studied. The glass-type lightweighted mirror is monolithic, of the double arch type, and is supported at only three points. The computer programs SSPTA (thermal), NASTRAN (finite element), and ACCOS V (optical) are used in sequence to determine the temperature, deformation, and optical performance of the mirror. A mirror temperature of 130 K or less appears to be obtainable by purely passive means. With a fused silica or standard Zerodur blank, thermally-induced deformation is unacceptable and cannot be fully corrected by an active secondary mirror over the desired field. Either active thermal control or a blank of lower thermal expansion coefficient would be required.
Discovering New Hope through ABE: A Program for Kidney Dialysis Patients.
ERIC Educational Resources Information Center
Amonette, Linda M.
1984-01-01
Kidney dialysis patients often suffer emotional problems and face life adjustment problems. Adult basic education can be a useful tool to address these and to make positive use of idle time during dialysis. This article describes such a program, emphasizes the self-concept gain for students, and highlights the critical role of the understanding…
Connecting Incoming Freshmen with Engineering through Hands-On Projects
ERIC Educational Resources Information Center
Cui, Suxia; Wang, Younhui; Yang, Yonggao; Nave, Felecia M.; Harris, Kendall T.
2011-01-01
Engineering programs suffer a high attrition rate, which causes the nation to graduate much less engineers. A survey of the literature reveals that the high attrition rate is due mainly to the fact that the first year of an engineering program is all fundamental theory and students don't see the connection to their future engineering careers. To…
ERIC Educational Resources Information Center
Oumano, Elena
2005-01-01
This study was designed to examine the effectiveness of the "Fear and Loathing of Speaking Out in Public" program. The program, a personal initiative, adapts primary features of the treatment offered by Cognitive Behavioral Therapy (CBT) for clients suffering from fears and phobias. CBT strategies include progressive desensitization, identifying…
Extended School Year. AZ-TAS Themes & Issues: A Series of Topical Papers on Special Education.
ERIC Educational Resources Information Center
Arizona State Dept. of Education, Phoenix. Div. of Special Education.
Some children with disabilities suffer losses of social, behavioral, communication, or academic skills during breaks in instruction and may need an extended school year (ESY) program in order to ensure that they receive the "appropriate public education" that is federally mandated. This guide addresses the legal basis for ESY programs, court…
Differential Response: What to Make of the Existing Research? A Response to Hughes et al.
ERIC Educational Resources Information Center
Drake, Brett
2013-01-01
This article is a response to "Issues in Differential Response", a review of the current evidence pertaining to differential response (DR) programs in child protective services (CPS). In my view, the Hughes, Rycus, Saunders-Adams, Hughes, and Hughes article suffers from several weaknesses. First, DR programs are critiqued as if they were…
Promises to keep. An evaluator's perspective on employee assistance programs.
Albert, W C; Smythe, P C; Brook, R C
1985-01-01
This paper presents a critical review of the rapidly expanding literature concerning employee assistance programs (EAPs). Several essential features of EAPs are identified and the assumptions underlying these components are examined. The latter section of this report offers some tentative suggestions for correcting this situation so that the EAP movement will no longer suffer from the lack of a firm database upon which to build more coherent and defensible theories and programs.
Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review
Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E.; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C.; Roy, Jean-Sébastien
2016-01-01
Objective: To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. Methods: A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. Results: The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. Conclusion: There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers. PMID:27488037
Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review.
Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C; Roy, Jean-Sébastien
2016-09-30
To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers.
Develop an Indoor Air Quality Program in Your School
Effective cleaning and maintenance procedures are critical to protecting building systems and building occupants. Student, teacher and staff health and productivity can suffer when school building systems fail to operate as designed
Assessment of pediatric residents burnout in a tertiary academic centre
Jamjoom, Roaa S.; Park, Yoon S.
2018-01-01
Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4) in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital). The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally. PMID:29543309
[REHABILITATION OF MOBILITY AND MOTOR FUNCTION IN NURSING HOME RESIDENTS WITH DEMENTIA].
Aizen, Efraim; Lubosky, Enna; Sobeh, Saleh; Ibrahim, Rasha; Pressburger, Dina; Oliven, Roni
2018-04-01
Few clinical trials have evaluated exercise programs developed specifically for patients with dementia in nursing home settings. To determine if a training program tailored for demented patients, can be implemented in a nursing home setting in order to improve motor performances in patients with dementia who suffered functional decline. The present intervention was conducted in wards of patients suffering from dementia in three nursing homes. Patients suffering from dementia and hospitalized in a rehabilitation hospital were the control arm. Eligible patients in the wards assigned to the intervention group (NH; n = 24) received exercise training specifically designed for patients with dementia. Patients in the rehabilitation hospital were observed as a control group (RH; n = 50) and received usual care treatment. Primary endpoints were changes in Functional Independence Measure (FIM), 5X Sit-to-Stand Test, Timed up and go test and ADL. Basic parameters were examined as predictors of positive training response. Both the nursing home residents and rehabilitation hospital patients improved significantly in both primary endpoints (change: in Functional Independence Measure, NH: +119.2 ± 30.8 % versus RH: +83.3 ± 41.9%, p < 0.001; ADL, NH: +143.5 ± 102.6% versus RH: +59.0 ± 90.2%, p < 0.001). Age was found to be a predictor of positive training response. This functional training program tailored for demented patients can be implemented in a nursing home setting to improve motor performances in patients with dementia. Such interventions should be further evaluated in larger randomized controlled trials.
Effects of health care provider work hours and sleep deprivation on safety and performance.
Lockley, Steven W; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Czeisler, Charles A; Landrigan, Christopher P
2007-11-01
There has been increasing interest in the impact of resident-physician and nurse work hours on patient safety. The evidence demonstrates that work schedules have a profound effect on providers' sleep and performance, as well as on their safety and that of their patients. Nurses working shifts greater than 12.5 hours are at significantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. Physicians-in-training working traditional > 24-hour on-call shifts are at greatly increased risk of experiencing an occupational sharps injury or a motor vehicle crash on the drive home from work and of making a serious or even fatal medical error. As compared to when working 16-hours shifts, on-call residents have twice as many attentional failures when working overnight and commit 36% more serious medical errors. They also report making 300% more fatigue-related medical errors that lead to a patient's death. The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours routinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of preventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits.
"Social marketing" for early neonatal care: saving newborn lives in Pakistan.
Ejaz, Iram; Shaikh, Babar Tasneem
2010-01-01
According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care.
Gisslén, Magnus; Price, Richard W; Nilsson, Staffan
2011-12-28
A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART). This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI). ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without associated symptoms or evident functional impairment in daily living. While two tests are recommended to assess each domain, only one is required to fulfill this diagnostic criterion. Unfortunately, this definition necessitates that about 20% of the cognitively normal HIV-infected population is classified as suffering ANI. This liberal definition raises important ethical concerns and has as well diagnostic and therapeutic implications. Since neither its biological substrate, prognostic significance nor therapeutic implications are clearly established, we recommend that this diagnosis be modified or applied cautiously. The diagnoses of less severe forms of neurocognitive disorders in HIV relies on the outcomes of neuropsychological testing, and a high proportion of HIV-infected patients with effective cART may be classified as neurocognitively abnormal using the current criteria. The definition of ANI is not stringent, and results in approximately 20% of the population being classified as abnormal. To us this seems an unacceptable false-positive rate.
ERIC Educational Resources Information Center
Jones, Gary; Creighton, Theodore B.
With approximately 50 percent of school administrators retiring over the next 10 years, school leader preparation programs are under pressure to admit adequate numbers of candidates to justify their costs and continued existence. Candidate recruitment and selection suffer, however, from ongoing practical problems including the use of grade-point…
ERIC Educational Resources Information Center
Martin, Laurie; Milot, Alyssa
2007-01-01
This brief discusses diet, exercise, body image, and weight and also provides information for practitioners on how to measure these factors among youth in their program. It summarizes (1) what it means to be overweight; (2) what are body image and eating disorders; (3) what to do if you suspect that someone in your program is suffering from an…
Monzani, D; Genovese, E; Marrara, A; Gherpelli, C; Pingani, L; Forghieri, M; Rigatelli, M; Guadagnin, T; Arslan, E
2008-06-01
The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress.
Monzani, D; Genovese, E; Marrara, A; Gherpelli, C; Pingani, L; Forghieri, M; Rigatelli, M; Guadagnin, T; Arslan, E
2008-01-01
Summary The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach’s alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach’s alpha = 0.93) and its Danish (Cronbach’s alpha = 0.93) and Portuguese (Cronbach’s alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach’s alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress. PMID:18646574
Fight Fire Without Fire Fighters!
ERIC Educational Resources Information Center
Peacock, Richard D.
1977-01-01
There is a role for the classroom teacher in teaching fire safety. Discusses the inadequacies of present fire prevention programs and provides ten specific steps teachers can take to avoid suffering and death from fire. (Author/RK)
Reliability, Validity, and Usability of Data Extraction Programs for Single-Case Research Designs.
Moeyaert, Mariola; Maggin, Daniel; Verkuilen, Jay
2016-11-01
Single-case experimental designs (SCEDs) have been increasingly used in recent years to inform the development and validation of effective interventions in the behavioral sciences. An important aspect of this work has been the extension of meta-analytic and other statistical innovations to SCED data. Standard practice within SCED methods is to display data graphically, which requires subsequent users to extract the data, either manually or using data extraction programs. Previous research has examined issues of reliability and validity of data extraction programs in the past, but typically at an aggregate level. Little is known, however, about the coding of individual data points. We focused on four different software programs that can be used for this purpose (i.e., Ungraph, DataThief, WebPlotDigitizer, and XYit), and examined the reliability of numeric coding, the validity compared with real data, and overall program usability. This study indicates that the reliability and validity of the retrieved data are independent of the specific software program, but are dependent on the individual single-case study graphs. Differences were found in program usability in terms of user friendliness, data retrieval time, and license costs. Ungraph and WebPlotDigitizer received the highest usability scores. DataThief was perceived as unacceptable and the time needed to retrieve the data was double that of the other three programs. WebPlotDigitizer was the only program free to use. As a consequence, WebPlotDigitizer turned out to be the best option in terms of usability, time to retrieve the data, and costs, although the usability scores of Ungraph were also strong. © The Author(s) 2016.
Risk management for the Space Exploration Initiative
NASA Technical Reports Server (NTRS)
Buchbinder, Ben
1993-01-01
Probabilistic Risk Assessment (PRA) is a quantitative engineering process that provides the analytic structure and decision-making framework for total programmatic risk management. Ideally, it is initiated in the conceptual design phase and used throughout the program life cycle. Although PRA was developed for assessment of safety, reliability, and availability risk, it has far greater application. Throughout the design phase, PRA can guide trade-off studies among system performance, safety, reliability, cost, and schedule. These studies are based on the assessment of the risk of meeting each parameter goal, with full consideration of the uncertainties. Quantitative trade-off studies are essential, but without full identification, propagation, and display of uncertainties, poor decisions may result. PRA also can focus attention on risk drivers in situations where risk is too high. For example, if safety risk is unacceptable, the PRA prioritizes the risk contributors to guide the use of resources for risk mitigation. PRA is used in the Space Exploration Initiative (SEI) Program. To meet the stringent requirements of the SEI mission, within strict budgetary constraints, the PRA structure supports informed and traceable decision-making. This paper briefly describes the SEI PRA process.
Rennen, Els; Nagelhout, Gera E; van den Putte, Bas; Janssen, Eva; Mons, Ute; Guignard, Romain; Beck, François; de Vries, Hein; Thrasher, James F; Willemsen, Marc C
2014-02-01
This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking.
Rennen, Els; Nagelhout, Gera E.; van den Putte, Bas; Janssen, Eva; Mons, Ute; Guignard, Romain; Beck, François; de Vries, Hein; Thrasher, James F.; Willemsen, Marc C.
2014-01-01
This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking. PMID:23861478
Assessment of variations in control of asthma over time.
Combescure, C; Chanez, P; Saint-Pierre, P; Daurès, J P; Proudhon, H; Godard, P
2003-08-01
Control and severity of asthma are two different but complementary concepts. The severity of asthma could influence the control over time. The aim of this study was to demonstrate this relationship. A total 365 patients with persistent asthma (severity) were enrolled and followed-up prospectively. Data were analysed using a continuous time homogeneous Markov model of the natural history of asthma. Control of asthma was defined according to three health states which were qualified: optimal, suboptimal and unacceptable control (states 1, 2 and 3). Transition forces (denoted lambda(ij) from state i to state j) and transition probabilities between control states were assessed and the results stratified by asthma severity were compared. Models were validated by comparing expected and observed numbers of patients in the different states. Transition probabilities stabilised between 100-250 days and more rapidly in patients with mild-to-moderate asthma. Patients with mild-to-moderate asthma in suboptimal or unacceptable control had a high probability of transition directly to optimal control. Patients with severe asthma had a tendency to remain in unacceptable control. A Markov model is a useful tool to model the control of asthma over time. Severity modified clearly the health states. It could be used to compare the performance of different approaches to asthma management.
Pedestrian traffic injuries among school children in Kawempe, Uganda.
Nakitto, Mable T; Mutto, Milton; Howard, Andrew; Lett, Ronald
2008-09-01
Traffic injuries are an important problem in low income countries. In Uganda road traffic is the largest single cause of injury in Kampala; pedestrians, and children are most affected. Pedestrian injury affects school children in Uganda. To determine the overall risk of pedestrian traffic injury among school children in Kawempe, Uganda. A cohort was assembled at 35 primary schools and followed for 3 terms. Ten of the schools had participated in previous injury programs, others were systematically selected. Injuries were recorded by teachers using a questionnaire. Data collected included ID, school, age, grade, gender, incident date, vehicle type, and injury outcome. Demographic characteristics are described and cumulative incidences calculated. The cohort included 8,165 children (49% male) from 35 primary schools. The mean age was 9 years (Sd=2.78). Of the 35 schools, 92% were day; the others mixed day and boarding. 53 children (27 girls) were involved in a traffic incident. 25% of the injuries reported were serious and warranted care in a health facility. No deaths occurred. Forty % of incidents involved commercial motorcycles, 41% bicycles, 9% cars, 8% taxis, and 2% trucks. The cumulative incidence was 0.168% each term. Over the 3 terms of the year the cumulative incidence was 0.5 +/- 0.02. There were no gender differences in the cumulative incidence. Each school year about 1/2 % of Kawempe school children are involved in a traffic incident. Interventions are necessary to reduce the unacceptably high incidents of pedestrian traffic. Interventions to alleviate this situation including safer routes, teaching skills of road crossing to children as well as better regulation and road safety education to two wheelers could reduce the unacceptably high incidents of pedestrian traffic injury.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Peterson, M.J.
2005-10-31
An evaluation of the human and ecological risks associated with the P1 Pond and surrounding environs was conducted as part of the ETTP Site-Wide Remedial Investigation. The RI provides the basis for the focus on PCBs as the most important unacceptable risk to human and ecological health in the pond. Other P1 contaminants, media, or pathways of risk to receptors are identified in the RI, but are not addressed as a major risk reduction goal for the ETTP Site-Wide Feasibility Study. Therefore, the goal of the Ecological Management alternative is to reduce unacceptable risks associated with PCBs in fish. Manymore » of the actions proposed for this alternative, however, are likely to reduce risks associated with other contaminants and their pathways. The high PCB concentrations in fish from the P1 Pond are most certainly due in part to the current ecological condition of the pond that maximizes PCB biomagnification. This basic assumption and the factors contributing to it were evaluated by conducting an intensive field study of the P1 Pond in the summer of 2004 (for a thorough presentation of current P1 Pond biological conditions, see Peterson et al. 2005). Major hypotheses regarding the P1 Pond's current fish community, PCB fate and transport processes, pond vegetation, and limnological conditions that contribute to the high PCB levels in fish were validated by the study (Appendix A), The results of the 2004 ecological assessment, in concert with long-term datasets obtained as part of the ETTP Biological Monitoring and Abatement Program (BMAP) and recent abiotic sampling for the RI, provide the basis for the assessment of current conditions.« less
Cenozoic Motion of Greenland - Overlaps and Seaways
NASA Astrophysics Data System (ADS)
Lawver, L. A.; Norton, I. O.; Gahagan, L.
2014-12-01
Using the seafloor magnetic anomalies found in the Labrador Sea, North Atlantic and Eurasian basin to constrain the Cenozoic motion of Greenland, we have produced a new model for the tectonic evolution of the region. The aeromagnetic data collected by the Naval Research Lab [Brozena et al., 2003] in the Eurasian Basin and Canadian data from the Labrador Sea have been re-evaluated using new gridding algorithms and profile modeling using ModMag (Mendel et al., 2005). As a consequence, we have changed the published correlations, mostly prior to Chron C6 [19.05 Ma]. Presently published seafloor magnetic anomalies from the Labrador Sea assume that seafloor spreading ceased at C13 [33.06 Ma] but such an assumption produces an unacceptable overlap of Kronprins Christian Land of northeast Greenland with Svalbard, up to 140 km of overlap in some models. Our new model does not need any "unacceptable" overlap but does produce a slight amount of Eocene compression on Svalbard as is found on land there. Our model allows for an Early Eocene seaway between Ellesmere Island and northwest Greenland that may have connected the Labrador Sea through Baffin Bay and ultimately to the nascent Eurasian Basin, although its depth or even its essential existence is unknowable. During the Miocene, there is no room for a deepwater seaway in Fram Strait until at least the very end of the Early Miocene and perhaps not until Middle Miocene. Brozena, J. and six others, 2003. New aerogeophysical study of the Eurasia Basin and Lomonosov Ridge: Implications for basin development. Geology 31, 825-828. Mendel, V., M. Munschy and D.Sauter, 2005, MODMAG, a MATLAB program to model marine magnetic anomalies, Comp. Geosci., 31, .589-597
Gude, T; Grimstad, H; Holen, A; Anvik, T; Baerheim, A; Fasmer, O B; Hjortdahl, P; Vaglum, P
2015-12-18
In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills. This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence. The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26% of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment. Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.
Combustion of coal gas fuels in a staged combustor
NASA Technical Reports Server (NTRS)
Rosfjord, T. J.; Mcvey, J. B.; Sederquist, R. A.; Schultz, D. F.
1982-01-01
Gaseous fuels produced from coal resources generally have heating values much lower than natural gas; the low heating value could result in unstable or inefficient combustion. Coal gas fuels may contain ammonia which if oxidized in an uncontrolled manner could result in unacceptable nitrogen oxide exhaust emission levels. Previous investigations indicate that staged, rich-lean combustion represents a desirable approach to achieve stable, efficient, low nitrogen oxide emission operation for coal-derived liquid fuels contaning up to 0.8-wt pct nitrogen. An experimental program was conducted to determine whether this fuel tolerance can be extended to include coal-derived gaseous fuels. The results of tests with three nitrogen-free fuels having heating values of 100, 250, and 350 Btu/scf and a 250 Btu/scf heating value doped to contain 0.7 pct ammonia are presented.
The APGAR rubric for scoring online discussion boards.
Phillippi, Julia C; Schorn, Mavis N; Moore-Davis, Tonia
2015-05-01
The World Health Organization has called for a dramatic increase in the number of midwives and supports the use of innovative programs to assist students in achieving midwifery competencies. Online discussion boards are excellent educational tools for stimulating in-depth student engagement. However, complex discussions can be difficult to grade without a well-constructed rubric. The 'discussion-board APGAR' provides clear scoring criteria for discussions of midwifery care. The discussion-board APGAR has 5 components: Application, Professionalism, Group work, Analysis, and Rationale and provides scoring criteria for unacceptable, marginal, and proficient performance. The discussion-board APGAR is based on the Core Competencies for Basic Midwifery Practice in the United States (US), consistent with the International Confederation of Midwives Essential Competencies for Basic Midwifery Practice, and can be adjusted to be congruent with other midwifery standards. Copyright © 2014 Elsevier Ltd. All rights reserved.
Understanding adolescent development: implications for driving safety.
Keating, Daniel P
2007-01-01
The implementation of Graduated Driver Licensing (GDL) programs has significantly improved the crash and fatality rates of novice teen drivers, but these rates remain unacceptably high. A review of adolescent development research was undertaken to identify potential areas of improvement. Research support for GDL was found to be strong, particularly regarding early acquisition of expertise in driving safety (beyond driving skill), and to limitations that reduce opportunities for distraction. GDL regimes are highly variable, and no US jurisdictions have implemented optimal regimes. Expanding and improving GDL to enhance acquisition of expertise and self-regulation are indicated for implementation and for applied research. Driver training that effectively incorporates safety goals along with driving skill is another target. The insurance industry will benefit from further GDL enhancements. Benefits may accrue to improved driver training, improved simulation devices during training, and automated safety feedback instrumentation.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1983-01-01
Status of the Basalt Waste Isolation Project is given. Three key concerns have been identified that need to be resolved to either confirm or eliminate the basalts as a potential nuclear waste repository host medium. They are: A thorough understanding of the groundwater hydrology beneath the Hanford Site is needed to assure that a repository in basalt will not contribute unacceptable amounts of contaminants to the accessible environment. Our ability to construct a repository shaft and a network of underground tunnels needs to be fully demonstrated through an exploratory shaft program. Our ability to ultimately seal a repository, such thatmore » its integrity and the isolation of the waste are guaranteed, needs to be demonstrated.« less
NASA - easyJet Collaboration on the Human Factors Monitoring Program (HFMP) Study
NASA Technical Reports Server (NTRS)
Srivistava, Ashok N.; Barton, Phil
2012-01-01
This is the first annual report jointly prepared by NASA and easyJet on the work performed under the agreement to collaborate on a study of the many factors entailed in flight - and cabin-crew fatigue and documenting the decreases in performance associated with fatigue. The objective of this Agreement is to generate reliable, automated procedures that improve understanding of the levels and characteristics of flight - and cabin-crew fatigue factors, both latent and proximate, whose confluence will likely result in unacceptable flight crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and easyJet are both interested in assessing and testing NASA s automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases, much larger than can be handled practically by human experts.
NASA Technical Reports Server (NTRS)
Srivistava, Ashok N.; Barton, Phil
2012-01-01
This is the second interim report jointly prepared by NASA and easyJet on the work performed under the agreement to collaborate on a study of the factors entailed in flight and cabin-crew fatigue, and decreases in performance associated with fatigue. The objective of this Agreement is to generate reliable procedures that aid in understanding the levels and characteristics of flight and cabin-crew fatigue factors, both latent and proximate, whose confluence will likely result in unacceptable crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and easyJet are both interested in assessing and testing NASA s automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases; much larger than can be handled practically by human experts.
Using human rights in maternal mortality programs: from analysis to strategy.
Freedman, L P
2001-10-01
This article describes an approach to maternal mortality reduction that uses human rights not simply to denounce the injustice of death in pregnancy and childbirth, but also to guide the design and implementation of maternal mortality policies and programs. As a first principle, programs and policies need to prioritize measures that promote universal access to high quality emergency obstetric care services, which we know from health research are essential to saving women's lives. With that priority, human rights principles can be integrated into programs at the clinical, facility management, and national policy levels. For example, a human rights 'audit' can help identify ways to encourage respectful, non-discriminatory treatment of patients, providers and staff in the clinical setting. Human rights principles of entitlement and accountability can inform mechanisms of community participation designed to improve responsiveness and functioning of health facilities. Human rights principles can inform analysis of health sector reform and its impact on access to emergency obstetric care. Whether applied to the intricacies of human relationships within a facility or to the impact of international financial institutions on health systems, the ultimate role of human rights is to identify the workings of power that keep unacceptable levels of maternal morality as they are and to use the human rights vision of dignity and social justice to work for the re-arrangements of power necessary for change.
Primary zinc-air batteries for space power
NASA Technical Reports Server (NTRS)
Bragg, Bobby J.; Bourland, Deborah S.; Merry, Glenn; Putt, Ron
1992-01-01
Prismatic HR and LC cells and batteries were built and tested, and they performed well with respect to the program goals of high capacity and high rate capability at specific energies. The HR batteries suffered reduced utilizations owing to dryout at the 2 and 3 A rates for the 50 C tests owing to the requirement for forced convection. The LC batteries suffered reduced utilizations under all conditions owing to the chimney effect at 1 G, although this effect would not occur at 0 G. An empirical model was developed which accurately predicted utilizations and average voltages for single cells, although thermal effects encountered during battery testing caused significant deviations, both positive and negative, from the model. Based on the encouraging results of the test program, we believe that the zinc-air primary battery of a flat, stackable configuration can serve as a high performance and safe power source for a range of space applications.
Fine, Jared I; Isman, Robert E; Grant, Catherine B
2012-03-01
California children suffer more from dental disease than any other chronic childhood disease. Disparities in access and oral health are disproportionately represented among children from minority and low-income families. A comprehensive school-based/linked dental program is one essential ingredient in addressing these problems. Described here are the goals, program elements, and challenges of building a seamless dental services system that could reduce barriers care, maximize resources, and employ best practices to improve oral health.
Rehabilitation of Ankle and Foot Injuries in Athletes
Chinn, Lisa; Hertel, Jay
2009-01-01
Foot and ankle injuries are extremely common among athletes and other physically active individuals. Rehabilitation programs that emphasize the use of therapeutic exercise to restore joint range of motion, muscle strength, neuromuscular coordination, and gait mechanics have been shown to have clinical success for patients suffering various foot and ankle pathologies. Rehabilitation programs are discussed for ankle sprains, plantar fasciitis, Achilles tendonitis, and turf toe. PMID:19945591
Human Research Program Integrated Research Plan. Revision A January 2009
NASA Technical Reports Server (NTRS)
2009-01-01
The Integrated Research Plan (IRP) describes the portfolio of Human Research Program (HRP) research and technology tasks. The IRP is the HRP strategic and tactical plan for research necessary to meet HRP requirements. The need to produce an IRP is established in HRP-47052, Human Research Program - Program Plan, and is under configuration management control of the Human Research Program Control Board (HRPCB). Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological and behavioral effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes HRP s approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and how they are integrated to provide a risk mitigation tool. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.
National Space Transportation System (NSTS) technology needs
NASA Technical Reports Server (NTRS)
Winterhalter, David L.; Ulrich, Kimberly K.
1990-01-01
The National Space Transportation System (NSTS) is one of the Nation's most valuable resources, providing manned transportation to and from space in support of payloads and scientific research. The NSTS program is currently faced with the problem of hardware obsolescence, which could result in unacceptable schedule and cost impacts to the flight program. Obsolescence problems occur because certain components are no longer being manufactured or repair turnaround time is excessive. In order to achieve a long-term, reliable transportation system that can support manned access to space through 2010 and beyond, NASA must develop a strategic plan for a phased implementation of enhancements which will satisfy this long-term goal. The NSTS program has initiated the Assured Shuttle Availability (ASA) project with the following objectives: eliminate hardware obsolescence in critical areas, increase reliability and safety of the vehicle, decrease operational costs and turnaround time, and improve operational capability. The strategy for ASA will be to first meet the mandatory needs - keep the Shuttle flying. Non-mandatory changes that will improve operational capability and enhance performance will then be considered if funding is adequate. Upgrade packages should be developed to install within designated inspection periods, grouped in a systematic approach to reduce cost and schedule impacts, and allow the capability to provide a Block 2 Shuttle (Phase 3).
Gonzalez, Laura; Negrón, Rosalyn; Berry, Donna L.
2014-01-01
Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable (x¯=3.0) for audiovisual material and acceptable (x¯=3.0) for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer. PMID:25045535
Command and Control Software Development Memory Management
NASA Technical Reports Server (NTRS)
Joseph, Austin Pope
2017-01-01
This internship was initially meant to cover the implementation of unit test automation for a NASA ground control project. As is often the case with large development projects, the scope and breadth of the internship changed. Instead, the internship focused on finding and correcting memory leaks and errors as reported by a COTS software product meant to track such issues. Memory leaks come in many different flavors and some of them are more benign than others. On the extreme end a program might be dynamically allocating memory and not correctly deallocating it when it is no longer in use. This is called a direct memory leak and in the worst case can use all the available memory and crash the program. If the leaks are small they may simply slow the program down which, in a safety critical system (a system for which a failure or design error can cause a risk to human life), is still unacceptable. The ground control system is managed in smaller sub-teams, referred to as CSCIs. The CSCI that this internship focused on is responsible for monitoring the health and status of the system. This team's software had several methods/modules that were leaking significant amounts of memory. Since most of the code in this system is safety-critical, correcting memory leaks is a necessity.
Gillespie, I; Little, C; Mitchell, R
2000-03-01
A microbiological study of cold, ready-to-eat sliced meats from 2579 catering establishments (public houses, hotels, cafés, restaurants, residential homes and other catering premises) found that 2587 of 3494 samples (74%) were of acceptable quality, 892 (26%) were of unsatisfactory quality and 15 (<1%) were of unacceptable quality. Unacceptable results were due to high levels of Escherichia coli, Staphylococcus aureus, Listeria species and/or Clostridium perfringens. Unsatisfactory results were mostly due to high Aerobic Plate Counts. The microbiological quality of cold, ready-to-eat meats was associated with meat type, premises type, management training, hygienic practices, meat supplier and length of storage. The relationship between food hygiene training and microbiological quality is discussed.
The Boston Health Care for the Homeless Program: a public health framework.
O'Connell, James J; Oppenheimer, Sarah C; Judge, Christine M; Taube, Robert L; Blanchfield, Bonnie B; Swain, Stacy E; Koh, Howard K
2010-08-01
During the past 25 years, the Boston Health Care for the Homeless Program has evolved into a service model embodying the core functions and essential services of public health. Each year the program provides integrated medical, behavioral, and oral health care, as well as preventive services, to more than 11 000 homeless people. Services are delivered in clinics located in 2 teaching hospitals, 80 shelters and soup kitchens, and an innovative 104-bed medical respite unit. We explain the program's principles of care, describe the public health framework that undergirds the program, and offer lessons for the elimination of health disparities suffered by this vulnerable population.
Romero, Daniela C; Sauris, Aileen; Rodriguez, Fátima; Delgado, Daniela; Reddy, Ankita; Foody, JoAnne M
2016-03-01
Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.
14 CFR 33.25 - Accessory attachments.
Code of Federal Regulations, 2010 CFR
2010-01-01
... mounting attachment must include provisions for sealing to prevent contamination of, or unacceptable... loss of oil and to prevent contamination from sources outside the chamber enclosing the drive...
Code of Federal Regulations, 2013 CFR
2013-07-01
... DEFENSE (DOD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...
Code of Federal Regulations, 2012 CFR
2012-07-01
... DEFENSE (DOD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...
75 FR 6539 - Healthy Forests Reserve Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-10
... species, sustains biodiversity, protects watersheds, sequesters carbon, and helps purify the air. However... fragmentation, reduction in periodic fires, lack of proper management, or invasive species. Habitat loss has... for species that have suffered significant population declines. Active management and protection of...
Haidari, Ameneh; Moeini, Mahin; Khosravi, Alireza
2017-01-01
High blood pressure is the greatest risk factor of death, and patients should manage to control it. Peer support program is used to control chronic diseases. This study aims to determine the effect of peer support program on adherence to the regimen in patients suffering from hypertension. This study is a clinical trial conducted among 64 patients with hypertension referring to the Hypertension Research Center (Isfahan. Iran). The information was collected in three stages - before the start of intervention, immediately after, and 1 month after the intervention using a questionnaire of adherence to the treatment regimen for high blood pressure. The questionnaires were filled using a questioning method by patients who were not aware of the study. The experimental group attended 6 sessions of the peer support program (1 hour), and the control group attended two sessions held by the researcher. Data were analyzed using the Statistical Package for the Social Sciences version 18 software, and statistical tests were analyzed using independent t -test and analysis of variance with repeated measures. Before the intervention, there was no significant difference in adherence to the treatment regimen score between the two groups regarding the three aspects of medication regimen, diet, and activity program. Increase in scores of control group immediately after and 1 month after peer support program was higher ( p < 0.001) compared to before the intervention. This study showed that peer support programs had a positive impact on adherence to the treatment regimen in patients suffering from hypertension.
Williams, Monnica T.; Farris, Samantha G.; Turkheimer, Eric N.; Franklin, Martin E.; Simpson, H. Blair; Liebowitz, Michael; Foa, Edna B.
2014-01-01
Objective Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. Method The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n = 87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. Results The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β = .27, p = .02) and hoarding dimensions (β = .23, p = .04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. Conclusions EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. PMID:24983796
Meldrum, R J; Little, C L; Sagoo, S; Mithani, V; McLauchlin, J; de Pinna, E
2009-09-01
The purpose of this study was to establish the microbiological safety of salad vegetables and sauces served in kebab take-away restaurants. Comparison with published microbiological guidelines revealed that 4.7% of 1213 salad vegetable samples were of unsatisfactory microbiological quality due to Escherichia coli and/or Staphylococcus aureus levels at > or =10(2) cfu g(-1). Another 0.3% of salad samples were of unacceptable quality due to S. aureus at > or =10(4) cfu g(-1) (2 samples) or the presence of Salmonella Kentucky (1 sample). Cucumber was the most contaminated salad vegetable with regards to unsatisfactory levels of E. coli (6.0%) or S. aureus (4.5%). Five percent of 1208 sauce samples were of unsatisfactory microbiological quality due to E. coli, S. aureus at > or =10(2) cfu g(-1) and/or Bacillus cereus and other Bacillus spp. at > or =10(4) cfu g(-1). A further 0.6% of sauce samples were of unacceptable quality due to Bacillus spp. (Bacillus subtilis, Bacillus pumilus, Bacillus licheniformis) at > or =10(5) cfu g(-1) or the presence of Salmonella Agbeni (1 sample). More samples of chili sauce (8.7%) were of unsatisfactory or unacceptable microbiological quality than any other sauce types. The results emphasize the need for good hygiene practices in kebab take-away restaurants handling these types of ready-to-eat products.
Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric N; Franklin, Martin E; Simpson, H Blair; Liebowitz, Michael; Foa, Edna B
2014-08-01
Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n=87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β=.27, p=.02) and hoarding dimensions (β=.23, p=.04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
77 FR 20823 - Jyotin Parikh: Debarment Order
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-06
... failing to properly investigate, log and archive questionable, aberrant, and unacceptable laboratory... market new product lines. In furtherance of the conspiracy, in or around March 2003, Mr. Parikh...
Code of Federal Regulations, 2014 CFR
2014-07-01
... DEFENSE (DoD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...
47 CFR 22.971 - Obligation to abate unacceptable interference.
Code of Federal Regulations, 2010 CFR
2010-10-01
... interference, with full cooperation and utmost diligence, in the shortest time practicable. Interfering... severally responsible for abating interference, with full cooperation and utmost diligence, in the shortest...
Student Classroom Misbehavior: An Exploratory Study Based on Teachers' Perceptions
Sun, Rachel C. F.; Shek, Daniel T. L.
2012-01-01
This study aimed to examine the conceptions of junior secondary school student misbehaviors in classroom, and to identify the most common, disruptive, and unacceptable student problem behaviors from teachers' perspective. Twelve individual interviews with teachers were conducted. A list of 17 student problem behaviors was generated. Results showed that the most common and disruptive problem behavior was talking out of turn, followed by nonattentiveness, daydreaming, and idleness. The most unacceptable problem behavior was disrespecting teachers in terms of disobedience and rudeness, followed by talking out of turn and verbal aggression. The findings revealed that teachers perceived student problem behaviors as those behaviors involving rule-breaking, violating the implicit norms or expectations, being inappropriate in the classroom settings and upsetting teaching and learning, which mainly required intervention from teachers. PMID:22919297
Fuel processor temperature monitoring and control
Keskula, Donald H.; Doan, Tien M.; Clingerman, Bruce J.
2002-01-01
In one embodiment, the method of the invention monitors one or more of the following conditions: a relatively low temperature value of the gas stream; a relatively high temperature value of the gas stream; and a rate-of-change of monitored temperature. In a preferred embodiment, the rate of temperature change is monitored to prevent the occurrence of an unacceptably high or low temperature condition. Here, at least two temperatures of the recirculating gas stream are monitored over a period of time. The rate-of-change of temperature versus time is determined. Then the monitored rate-of-change of temperature is compared to a preselected rate-of-change of value. The monitoring of rate-of-change of temperature provides proactive means for preventing occurrence of an unacceptably high temperature in the catalytic reactor.
Threats to information security of real-time disease surveillance systems.
Henriksen, Eva; Johansen, Monika A; Baardsgaard, Anders; Bellika, Johan G
2009-01-01
This paper presents the main results from a qualitative risk assessment of information security aspects for a new real-time disease surveillance approach in general, and for the Snow surveillance system in particular. All possible security threats and acceptable solutions, and the implications these solutions had to the design of the system, were discussed. Approximately 30 threats were identified. None of these got an unacceptable high risk level originally, but two got medium risk level, of which one was concluded to be unacceptable after further investigation. Of the remaining low risk threats, some have severe consequence, thus requiring particular assessment. Since it is very important to identify and solve all security threats before real-time solutions can be used in a wide scale, additional investigations are needed.
Plant photonics: application of optical coherence tomography to monitor defects and rots in onion
NASA Astrophysics Data System (ADS)
Meglinski, I. V.; Buranachai, C.; Terry, L. A.
2010-04-01
The incidence of physiological and/or pathological defects in many fresh produce types is still unacceptably high and accounts for a large proportion of waste. With increasing interest in food security their remains strong demand in developing reliable and cost effective technologies for non-destructive screening of internal defects and rots, these being deemed unacceptable by consumers. It is well recognized that the internal defects and structure of turbid scattering media can be effectively visualized by using optical coherence tomography (OCT). In the present study, the high spatial resolution and advantages of OCT have been demonstrated for imaging the skins and outer laminae (concentric tissue layers) of intact whole onion bulbs with a view to non-invasively visualizing potential incidence/severity of internal defects.
Rajan, Hamsa
2016-11-20
This article describes the views of Tibetan women who have experienced physical violence from male intimate partners. How they conceptualise abuse, their views on acceptable versus unacceptable hitting, and the acts besides hitting which they felt to be unacceptable or abusive, are explored. Views of survivors' relatives/friends and men who have hit their wives are also included. Western-based domestic violence theory is shown to be incommensurate with abuse in particular socio-cultural settings. As feminist scholars emphasize listening deeply to voices of women in the global South, this article demonstrates how such listening might be undertaken when the views expressed by women diverge from feminism. © The Author(s) 2016.
NASA Technical Reports Server (NTRS)
Bailey, R. E.; Smith, R. E.
1982-01-01
An investigation of pilot-induced oscillation suppression (PIOS) filters was performed using the USAF/Flight Dynamics Laboratory variable stability NT-33 aircraft, modified and operated by Calspan. This program examined the effects of PIOS filtering on the longitudinal flying qualities of fighter aircraft during the visual approach and landing task. Forty evaluations were flown to test the effects of different PIOS filters. Although detailed analyses were not undertaken, the results indicate that PIOS filtering can improve the flying qualities of an otherwise unacceptable aircraft configuration (Level 3 flying qualities). However, the ability of the filters to suppress pilot-induced oscillations appears to be dependent upon the aircraft configuration characteristics. Further, the data show that the filters can adversely affect landing flying qualities if improperly designed. The data provide an excellent foundation from which detail analyses can be performed.
A survey of manufacturers of solar thermal energy systems
NASA Technical Reports Server (NTRS)
Levine, N.; Slonski, M. L.
1982-01-01
Sixty-seven firms that had received funding for development of solar thermal energy systems (STES) were surveyed. The effect of the solar thermal technology systems program in accelerating (STES) were assessed. The 54 firms still developing STES were grouped into a production typology comparing the three major technologies with three basic functions. It was discovered that large and small firms were developing primarily central receiver systems, but also typically worked on more than one technology. Most medium-sized firms worked only on distributed systems. Federal support of STES was perceived as necessary to allow producers to take otherwise unacceptable risks. Approximately half of the respondents would drop out of STES if support were terminated, including a disproportionate number of medium-sized firms. A differentiated view of the technology, taking into account differing firm sizes and the various stages of technology development, was suggested for policy and planning purposes.
A survey of manufacturers of solar thermal energy systems
NASA Astrophysics Data System (ADS)
Levine, N.; Slonski, M. L.
1982-08-01
Sixty-seven firms that had received funding for development of solar thermal energy systems (STES) were surveyed. The effect of the solar thermal technology systems program in accelerating (STES) were assessed. The 54 firms still developing STES were grouped into a production typology comparing the three major technologies with three basic functions. It was discovered that large and small firms were developing primarily central receiver systems, but also typically worked on more than one technology. Most medium-sized firms worked only on distributed systems. Federal support of STES was perceived as necessary to allow producers to take otherwise unacceptable risks. Approximately half of the respondents would drop out of STES if support were terminated, including a disproportionate number of medium-sized firms. A differentiated view of the technology, taking into account differing firm sizes and the various stages of technology development, was suggested for policy and planning purposes.
Multicriteria mapping of stakeholder preferences in regulating nanotechnology
NASA Astrophysics Data System (ADS)
Hansen, Steffen Foss
2010-08-01
In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework.
Hunger in legal immigrants in California, Texas, and Illinois.
Kasper, J; Gupta, S K; Tran, P; Cook, J T; Meyers, A F
2000-10-01
This study determined the prevalence of food insecurity and hunger in low-income legal immigrants. We conducted a cross-sectional survey of Latino and Asian legal immigrants attending urban clinics and community centers in California, Texas, and Illinois with a food security questionnaire. Among 630 respondents, 40% of the households were food insecure without hunger and 41% were food insecure with hunger. Independent predictors of hunger were income below federal poverty level (odds ratio [OR] = 2.72, 95% confidence interval [CI] = 1.72, 4.30), receipt of food stamps (OR = 2.53, 95% CI = 1.57, 4.09), Latino ethnicity (OR = 2.39, 95% CI = 1.49, 3.82), and poor English (OR = 1.76, 95% CI = 1.10, 2.82). The prevalence of hunger among low-income legal immigrants is unacceptably high. Access to food assistance programs is important for the health and well-being of this population.
Status and Needs of Power Electronics for Photovoltaic Inverters
NASA Astrophysics Data System (ADS)
Qin, Y. C.; Mohan, N.; West, R.; Bonn, R.
2002-06-01
Photovoltaics is the utility connected distributed energy resource (DER) that is in widespread use today. It has one element, the inverter, which is common with all DER sources except rotating generators. The inverter is required to transfer dc energy to ac energy. With all the DER technologies, (solar, wind, fuel cells, and microturbines) the inverter is still an immature product that will result in reliability problems in fielded systems. Today, the PV inverter is a costly and complex component of PV systems that produce ac power. Inverter MTFF (mean time to first failure) is currently unacceptable. Low inverter reliability contributes to unreliable fielded systems and a loss of confidence in renewable technology. The low volume of PV inverters produced restricts the manufacturing to small suppliers without sophisticated research and reliability programs or manufacturing methods. Thus, the present approach to PV inverter supply has low probability of meeting DOE reliability goals.
Results of the harmonics measurement program at the John F. Long photovoltaic house
NASA Astrophysics Data System (ADS)
Campen, G. L.
1982-03-01
Photovoltaic (PV) systems used in single-family dwellings require an inverter to act as an interface between the direct-current (dc) power output of the PV unit and the alternating-current (ac) power needed by house loads. A type of inverter known as line commutated injects harmonic currents on the ac side and requires large amounts of reactive power. Large numbers of such PV installations could lead to unacceptable levels of harmonic voltages on the utility system, and the need to increase the utility's deliver of reactive power could result in significant cost increases. The harmonics and power-factor effects are examined for a single PV installation using a line-commutated inverter. The magnitude and phase of various currents and voltages from the fundamental to the 13th harmonic were recorded both with and without the operation of the PV system.
CKD in disadvantaged populations.
Garcia-Garcia, Guillermo; Jha, Vivekanand
2015-02-01
The increased burden of CKD in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health-care disparities and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expansion of the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expansion of deceased-donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increased community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.
Chronic kidney disease in disadvantaged populations.
Garcia-Garcia, Guillermo; Jha, Vivekanand
2015-01-01
The increased burden of CKD in disadavantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities, and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.
Gielen, Joris; Gupta, Harmala; Rajvanshi, Ambika; Bhatnagar, Sushma; Mishra, Seema; Chaturvedi, Arvind K; den Branden, Stef Van; Broeckaert, Bert
2011-01-01
We wanted to assess Indian palliative-care nurses and physicians' attitudes toward pain control and palliative sedation. From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programs in New Delhi, using a semi-structured questionnaire, and following grounded-theory methodology (Glaser and Strauss). The interviewees did not consider administration of painkillers in large doses an ethical problem, provided the pain killers are properly titrated. Mild palliative sedation was considered acceptable. The interviewees disagreed whether palliative sedation can also be deep and continuous. Arguments mentioned against deep continuous palliative sedation were the conviction that it may cause unacceptable side effects, and impedes basic daily activities and social contacts. A few interviewees said that palliative sedation may hasten death. Due to fears and doubts regarding deep continuous palliative sedation, it may sometimes be too easily discarded as a treatment option for refractory symptoms.
Effects of mass on aircraft sidearm controller characteristics
NASA Technical Reports Server (NTRS)
Wagner, Charles A.
1994-01-01
When designing a flight simulator, providing a set of low mass variable-characteristic pilot controls can be very difficult. Thus, a strong incentive exists to identify the highest possible mass that will not degrade the validity of a simulation. The NASA Dryden Flight Research Center has conducted a brief flight program to determine the maximum acceptable mass (system inertia) of an aircraft sidearm controller as a function of force gradient. This information is useful for control system design in aircraft as well as development of suitable flight simulator controls. A modified Learjet with a variable-characteristic sidearm controller was used to obtain data. A boundary was defined between mass considered acceptable and mass considered unacceptable to the pilot. This boundary is defined as a function of force gradient over a range of natural frequencies. This investigation is limited to a study of mass-frequency characteristics only. Results of this investigation are presented in this paper.
Sound Nutrition Suffers When Salt and Fat Dominate the Lunch Tray.
ERIC Educational Resources Information Center
Montgomery, Anne
1988-01-01
Lunches served in many school cafeterias are low in fiber and high in fat and salt. Some food service directors are willing to transform standard programs into models of healthful eating. School lunches teach children what is nutritionally desirable. (MLF)
Alaofé, Halimatou; Zee, John; Dossa, Romain; O'Brien, Huguette Turgeon
2009-01-01
A 26-week nutrition intervention, including 4 weeks of nutrition education, combined with an increase in the content and bioavailability of dietary iron for 22 weeks was carried out in 34 intervention and 34 control adolescent girls suffering from mild iron deficiency anemia (IDA). In post-intervention, hemoglobin and serum ferritin were significantly higher in the intervention group, whereas the incidence of IDA was significantly lower in the intervention group compared to the control group. Nutrition knowledge scores were significantly higher in intervention girls compared to control girls. Dietary changes to improve available dietary iron can reduce iron deficiency anemia.
[Minimally invasive surgical therapy of gynecomastia: liposuction and exeresis technique].
Voigt, M; Walgenbach, K J; Andree, C; Bannasch, H; Looden, Z; Stark, G B
2001-10-01
A number of techniques are available for the correction of gynecomastia. Nonscarring sparing methods are preferred, and the minimally invasive technique is to use liposuction for the gland and the fatty tissue exclusively. In this retrospective study we present our experience with a combination of liposuction and subsequent resection of the remaining gland. Sixty-two patients (112 breasts) were surgically treated for gynecomastia from January 1996 and September 2000. From 1996 to 1997 all patients suffering from gynecomastia grade Simon I-II were treated by the method described by Rosenberg and Stark, which is exclusively suction of the fatty and glandular tissue. In a retrospective chart study a high recurrence rate was found in these patients. Subsequently we changed our technique to liposuction of the fatty tissue followed by sharp excision of the glandular tissue through the incision made for the liposuction cannula in the submammary fold. Suction alone was not sufficient to remove the glandular tissue; the rate of recurrence after suction was 35%. When sharp resection of the glandular tissue was carried out after the liposuction the recurrence rate dropped to under 10%. In total our complication rate was 50% including minor sequelae. The most frequent complication was unacceptable scarring of the nipple-areola complex. Hypesthesia of the nipple-areola occurred in 13.4% of the patients. The combination of liposuction and resection of the glandular tissue is a minimally invasive correction that can be used in all cases of gynecomastia grade Simon I-II.
Secondary stroke prevention: challenges and solutions.
Esenwa, Charles; Gutierrez, Jose
2015-01-01
Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.
Patients' beliefs: do they affect tuberculosis control? A study in a rural district of South Africa.
Edginton, M E; Sekatane, C S; Goldstein, S J
2002-12-01
A rural district of South Africa. To describe the beliefs and experiences about tuberculosis of patients and community members and to suggest how these affect presentation to health services and treatment adherence. A descriptive study using structured interviews with individual patients, and focus group interviews with patients and community groups. There is a strong belief in this community that tuberculosis is the result of breaking cultural rules that demand abstinence from sex after the death of a family member and after a woman has a spontaneous abortion. People believe that the resulting disease can only be treated by traditional healers. This delays presentation to hospitals or clinics. There is also a belief in a 'western' type TB that can spread from sufferers or is due to environmental pollution or to smoking or alcohol excesses. A number of factors were cited that influenced adherence to treatment. These included the stigma of TB, the belief that there should be abstinence from sex while on treatment, difficulties accessing health services, long waits and unacceptable health worker attitudes. With the increasing rates of tuberculosis in South Africa, strenuous measures are needed to implement a good control programme that will increase the cure rate of tuberculosis patients. The results of this study suggest the need for health workers to learn about local beliefs that may influence presentation and adherence, and for traditional and western health workers to collaborate.
Illumination modelling of a mobile device environment for effective use in driving mobile apps
NASA Astrophysics Data System (ADS)
Marhoubi, Asmaa H.; Saravi, Sara; Edirisinghe, Eran A.; Bez, Helmut E.
2015-05-01
The present generation of Ambient Light Sensors (ALS) of a mobile handheld device suffer from two practical shortcomings. The ALSs are narrow angle, i.e. they respond effectively only within a narrow angle of operation and there is a latency of operation. As a result mobile applications that operate based on the ALS readings could perform sub-optimally especially when operated in environments with non-uniform illumination. The applications will either adopt with unacceptable levels of latency or/and may demonstrate a discrete nature of operation. In this paper we propose a framework to predict the ambient illumination of an environment in which a mobile device is present. The predictions are based on an illumination model that is developed based on a small number of readings taken during an application calibration stage. We use a machine learning based approach in developing the models. Five different regression models were developed, implemented and compared based on Polynomial, Gaussian, Sum of Sine, Fourier and Smoothing Spline functions. Approaches to remove noisy data, missing values and outliers were used prior to the modelling stage to remove their negative effects on modelling. The prediction accuracy for all models were found to be above 0.99 when measured using R-Squared test with the best performance being from Smoothing Spline. In this paper we will discuss mathematical complexity of each model and investigate how to make compromises in finding the best model.
Watanabe, Norio; Horikoshi, Masaru; Yamada, Mitsuhiko; Shimodera, Shinji; Akechi, Tatsuo; Miki, Kazuhira; Inagaki, Masatoshi; Yonemoto, Naohiro; Imai, Hissei; Tajika, Aran; Ogawa, Yusuke; Takeshima, Nozomi; Hayasaka, Yu; Furukawa, Toshi A
2015-07-07
Major depression is one of the most debilitating diseases in terms of quality of life. Less than half of patients suffering from depression can achieve remission after adequate antidepressant treatment. Another promising treatment option is cognitive-behavior therapy (CBT). However, the need for experienced therapists and substantive dedicated time prevent CBT from being widely disseminated. In the present study, we aim to examine the effectiveness of switching antidepressants and starting a smartphone-based CBT program at the same time, in comparison to switching antidepressants only, among patients still suffering from depression after adequate antidepressant treatment. A multi-center randomized trial is currently being conducted since September 2014. The smartphone-based CBT program, named the "Kokoro-App," for major depression has been developed and its feasibility has been confirmed in a previous open study. The program consists of an introduction, 6 sessions and an epilogue, and is expected to be completed within 9 weeks by patients. In the present trial, 164 patients with DSM-5 major depressive disorder and still suffering from depressive symptoms after adequate antidepressant treatment for more than 4 weeks will be allocated to the Kokoro-App plus switching antidepressant group or the switching antidepressant alone group. The participants allocated to the latter group will receive full components of the Kokoro-App after 9 weeks. The primary outcome is the change in the total score on the Patient Health Questionnaire through the 9 weeks of the program, as assessed at week 0, 1, 5 and 9 via telephone by blinded raters. The secondary outcomes include the change in the total score of the Beck Depression Inventory-II, change in side effects as assessed by the Frequency, Intensity and Burden of Side Effects Rating, and treatment satisfaction. An effective and reachable intervention may not only lead to healthier mental status among depressed patients, but also to reduced social burden from this illness. This paper outlines the background and methods of a trial that evaluates the possible additive value of a smartphone-based CBT program for treatment-resistant depression. UMIN-CTR: UMIN000013693 (registered on 1 June 2014).
Lee, Young-Mee; Sohng, Kyeong-Yae
2005-12-01
The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.
ERIC Educational Resources Information Center
Stokes, Laura
2009-01-01
In 2007, the United Animal Nations (UAN) launched the Humane Education Ambassador Readers (HEAR), an innovation that focused on mitigation of animal suffering through education. In the HEAR program, adult volunteers read carefully selected story books to children in grades 3-6 in schools or other educational settings, and hold discussions with the…
77 FR 20639 - Shashikant Shah: Debarment Order
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-05
... investigate, log, and archive questionable, aberrant, and unacceptable laboratory results so that Able could... maintaining false, fraudulent, and inaccurate data and records to obtain FDA approval to market new product...
77 FR 20641 - Jose Concepcion: Debarment Order
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-05
... investigate, log, and archive questionable, aberrant, and unacceptable laboratory results so that Able could... maintaining false, fraudulent, and inaccurate data and records to obtain FDA approval to market new product...
32 CFR 154.13 - Sensitive positions.
Code of Federal Regulations, 2013 CFR
2013-07-01
... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...
32 CFR 154.13 - Sensitive positions.
Code of Federal Regulations, 2010 CFR
2010-07-01
... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...
32 CFR 154.13 - Sensitive positions.
Code of Federal Regulations, 2012 CFR
2012-07-01
... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...
32 CFR 154.13 - Sensitive positions.
Code of Federal Regulations, 2011 CFR
2011-07-01
... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...
32 CFR 154.13 - Sensitive positions.
Code of Federal Regulations, 2014 CFR
2014-07-01
... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...
Verhelst, Helena; Vander Linden, Catharine; Vingerhoets, Guy; Caeyenberghs, Karen
2017-02-01
Computerized cognitive training programs have previously shown to be effective in improving cognitive abilities in patients suffering from traumatic brain injury (TBI). These studies often focused on a single cognitive function or required expensive hardware, making it difficult to be used in a home-based environment. This pilot feasibility study aimed to evaluate the feasibility of a newly developed, home-based, computerized cognitive training program for adolescents who suffered from TBI. Additionally, feasibility of study design, procedures, and measurements were examined. Case series, longitudinal, pilot, feasibility intervention study with one baseline and two follow-up assessments. Nine feasibility outcome measures and criteria for success were defined, including accessibility, training motivation/user experience, technical smoothness, training compliance, participation willingness, participation rates, loss to follow-up, assessment timescale, and assessment procedures. Five adolescent patients (four boys, mean age = 16 years 7 months, standard deviation = 9 months) with moderate to severe TBI in the chronic stage were recruited and received 8 weeks of cognitive training with BrainGames. Effect sizes (Cohen's d) were calculated to determine possible training-related effects. The new cognitive training intervention, BrainGames, and study design and procedures proved to be feasible; all nine feasibility outcome criteria were met during this pilot feasibility study. Estimates of effect sizes showed small to very large effects on cognitive measures and questionnaires, which were retained after 6 months. Our pilot study shows that a longitudinal intervention study comprising our novel, computerized cognitive training program and two follow-up assessments is feasible in adolescents suffering from TBI in the chronic stage. Future studies with larger sample sizes will evaluate training-related effects on cognitive functions and underlying brain structures.
Effectiveness of a social inclusion program in people with non-affective psychosis.
Mazzi, Fausto; Baccari, Flavia; Mungai, Francesco; Ciambellini, Manuela; Brescancin, Lisa; Starace, Fabrizio
2018-06-07
People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. To date, only a minority of social interventions in psychosis have been investigated. Since 2011, the Department of Mental Health and Substance Abuse in Modena introduced the "Social Point" program, which provides social inclusion interventions to promote active social participation for patients suffering from severe mental illness. The aim of this study was to assess whether a social inclusion intervention is associated with better outcomes in terms of personal and social recovery, with particular reference to the areas of social functioning and activity, and subjective dimensions such as self-esteem, self-stigma and perceived quality of life. A cross-sectional design was adopted to compare 30 subjects, selected at the completion of "Social Point" program, with a group of subjects, matched for socio-demographic and clinical features, selected from a wait list for "Social Point". All subjects were evaluated by means of instruments assessing: level of disability, level of functioning, severity of psychopathology, self-esteem, internalised stigma and quality of life. Overall, the results of the study suggest that social inclusion interventions may be effective in people suffering from non-affective psychosis. A dose-effect relationship was also found between higher number of activities per patient and better outcomes within both social and psychopathological domains. However, due to the cross-sectional design of the study no definitive causality can be inferred. Psychosocial interventions promoting social inclusion are likely to represent an effective approach to improve personal and social recovery.
Metikaridis, T Damianos; Hadjipavlou, Alexander; Artemiadis, Artemios; Chrousos, George; Darviri, Christina
2016-05-20
Studies have shown that stress is implicated in the cause of neck pain (NP). The purpose of this study is to examine the effect of a simple, zero cost stress management program on patients suffering from NP. This study is a parallel-type randomized clinical study. People suffering from chronic non-specific NP were chosen randomly to participate in an eight week duration program of stress management (N= 28) (including diaphragmatic breathing, progressive muscle relaxation) or in a no intervention control condition (N= 25). Self-report measures were used for the evaluation of various variables at the beginning and at the end of the eight-week monitoring period. Descriptive and inferential statistic methods were used for the statistical analysis. At the end of the monitoring period, the intervention group showed a statistically significant reduction of stress and anxiety (p= 0.03, p= 0.01), report of stress related symptoms (p= 0.003), percentage of disability due to NP (p= 0.000) and NP intensity (p= 0.002). At the same time, daily routine satisfaction levels were elevated (p= 0.019). No statistically significant difference was observed in cortisol measurements. Stress management has positive effects on NP patients.
The Boston Health Care for the Homeless Program: A Public Health Framework
Oppenheimer, Sarah C.; Judge, Christine M.; Taube, Robert L.; Blanchfield, Bonnie B.; Swain, Stacy E.; Koh, Howard K.
2010-01-01
During the past 25 years, the Boston Health Care for the Homeless Program has evolved into a service model embodying the core functions and essential services of public health. Each year the program provides integrated medical, behavioral, and oral health care, as well as preventive services, to more than 11 000 homeless people. Services are delivered in clinics located in 2 teaching hospitals, 80 shelters and soup kitchens, and an innovative 104-bed medical respite unit. We explain the program's principles of care, describe the public health framework that undergirds the program, and offer lessons for the elimination of health disparities suffered by this vulnerable population. PMID:20558804
The Philippine Population Program strategic plan (1981-1985).
1980-01-01
The challenge of the population problem is to effectively mobilize the country's population for productive activity. Rather than simply concern with controlling numbers, emphasis is on human resource management, the structure of employment, labor productivity and income distribution. The long-term Philippine Development Plans reflect recognition of the dynamic interaction between fertility, productivity and welfare. Objectives of the 5-Year Philippine Development Plan 1978-1982, the 10-Year Plan 1978-1987, and the Long-Term Plan to year 2000 integrate population concerns and socioeconomic goals. These objectives include the following: promotion of social development and social justice; attainment of self-sufficiency in food and greater self-reliance in energy; increased development of lagging regions, especially rural areas; improvements of habitat through the development of human settlements and proper management of the environment; and maintenance of population growth at levels conducive to national welfare. Some population concerns that are directly relevant to welfare (in addition to those related to productivity) are distribution patterns of social goods and services, access to services by sectors of the population, and buying power of families. As a total population policy should establish closer linkages, operationally, between the demographic aspects and the productivity and welfare aspects of development, the mission of the National Population Program encompasses 3 areas: fertility; productivity; and welfare. Strategic policies include the following: abortion is unacceptable as a contraceptive method; the population program shall be non-coercive; and the program shall view individual and family welfare in the context and as the main objective of national socioeconomic programs.
Ahn, B K; Kwon, O J; Kang, C M
2012-01-01
The exchange donor program in renal transplantation is an efficient solution for recipients with a blood type or crossmatch-incompatible donor. However, this program has some difficulties to define unacceptable human leukocyte antigen matches, deteriorating clinical potential recipient condition, and withdrawal of donor consent. We analyzed the outcomes of exchange donor renal transplantation through the altruistic unbalanced chain. Among 152 cases of exchange donor renal transplantation from 1991 to 2010 in our hospital, we performed 58 procedures through altruistic unbalanced chains. We compared their outcomes with the direct and balanced chain group. We analyzed retrospectively whether this program expanded the donor pool, seeking better immunologic, size, and age matching. The graft survival and acute rejection rates did not differ significantly in the two groups. Of 152 cases, 58 (38.2%) renal transplantations were performed through an unbalanced chain. Seventeen waiting list recipients were transplanted through an altruistic unbalanced chain. In blood type O recipients (n = 32), the causes of registration in the exchange program were ABO incompatibility (93.3%), and positive crossmatch (6.7%). Nine altruistic blood type O donors and 9 (28.1%) type O recipients underwent transplantations through this chain. We suggest the altruistic unbalanced chain may expand the donor pool with advantages for difficult-to-match pairs. The disadvantages of type O recipients may be overcome through the use of an unbalanced chain. The altruistic unbalanced exchange transplantation program can help easy-to-match subjects, shortening the waiting periods. Copyright © 2012 Elsevier Inc. All rights reserved.
Oemichen, Megan; Smith, Chery
2016-06-01
Investigate food choice, food access, and food insecurity among seniors. Eight focus groups were conducted in 2 counties with high and low Supplemental Nutrition Assistance Program (SNAP) participation rates. A total of 62 seniors (aged ≥ 60 years) were recruited and each attended 1 focus group at a community center. The sample was 79% female and most were Caucasian (91%), similar to state demographics. The focus group themes of how seniors make food choices and access food, and food insecurity perceptions among this population were identified based on discussion commonalities. For quantitative data, P < .05 was significant. Five themes emerged: (1) former experiences affecting eating behaviors; (2) financial and food security driving use of food assistance programs; (3) food access strategies: restaurants, retail markets, and alternative sources; (4) physical changes associated with aging influencing food access and intake; and (5) social influences that play a role in decision making. Both SNAP and congregate dining offer food assistance to seniors, but SNAP use was considered unacceptable by some seniors living in county 1 because of the negative stigma attached to the program or because they lacked program knowledge about income criteria. More effort needs to be made to educate seniors about SNAP. It is important to gain insight into how food insecurity affects their food choices. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Ecologically Safe Geothermal Energy Resources in Western Siberia near high-rise construction zones
NASA Astrophysics Data System (ADS)
Shevchenko, Alexandr; Shiganova, Olga
2018-03-01
The development of geothermal energy in combination with other renewable energy sources (the sun, the wind) will help to solve the problem of heat supply and electrification in near high-rise construction zones of the country, especially in sparsely populated parts, where centralized energy and heat supply is economically unacceptable, and will improve the ecological situation. The aim of the research is to analyze the geothermal resources of the main aquifers in Western Siberia and to develop recommendations for further study and use of heat and power resources of this territory. The article gives retrospective of state research programs and potential use of hydrothermal resources of administrative units geographically entering the territory under consideration. It is noted that by now such programs have been curtailed for various reasons, although there are examples of their successful and effective use in various fields of industry and agriculture. According to the decision of the Supreme Ecological Council of the State Duma Committee of the Russian Federation adopted in 2014 on the beginning of the development of federal targeted programs for the use of heat power water as a source of electricity and heat supply, the Ministry of Natural Resources and Ecology of the Russian Federation made proposals for further research and use of hydrothermal waters in Western Siberia. Implementation of the programs proposed by the authors, alongside with other positive aspects, will solve the problems of heat supply in remote territories and improve the environmental situation in the region.
40 CFR 240.201-3 - Recommended procedures: Operations.
Code of Federal Regulations, 2010 CFR
2010-07-01
...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...
40 CFR 240.201-3 - Recommended procedures: Operations.
Code of Federal Regulations, 2011 CFR
2011-07-01
...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...
USDA-ARS?s Scientific Manuscript database
Although many antibodies to sulfonamides have been generated, immunoassays based on the current available antibodies for large multi-sulfonamide screening programs have properties dependent on the immunizing hapten structure and have always suffered from high selectivity for individual sulfonamides....
ERIC Educational Resources Information Center
Lipka, Sara
2008-01-01
Internships have become a prime form of professional capital, but many remain unpaid, and poorer students suffer. However, colleges--mostly small, private institutions--are coming to their aid, offering modest grants to make the all-important opportunities viable for a more diverse population. The programs reflect not only colleges' increased…
Who needs environmental monitoring?
Gary M. Lovett; Douglas A. Burns; Charles T. Driscoll; Jennifer C. Jenkins; Myron J. Mitchell; Lindsey Rustad; James B. Shanley; Gene E. Likens; Richard Haeuber
2007-01-01
Environmental monitoring is often criticized as being unscientific, too expensive, and wasteful. While some monitoring studies do suffer from these problems, there are also many highly successful long-term monitoring programs that have provided important scientific advances and crucial information for environmental policy. Here, we discuss the characteristics of...
Cold Comfort from the White House.
ERIC Educational Resources Information Center
McNamara, William
1979-01-01
When the Carter Administration's budget figures first appeared in December, higher education suffered a billion-dollar cut in student aid funds. Although basic and supplemental grant allowances were later increased, other higher education programs--including college libraries, campus facilities, and nurses' training--were cut heavily. (JMD)
ERIC Educational Resources Information Center
Love, Tyler S.; Ryan, Larry
2012-01-01
As science, technology education, and engineering programs suffer budget cuts, educators continue to seek cost-effective activities that engage students and reinforce standards. The featherweight challenge is a hands-on activity that challenges students to continually refine their design while not breaking the budget. This activity uses one of the…
ERIC Educational Resources Information Center
Woolley, Alma S.
1981-01-01
In studying the nurse's image at a liberal arts college, it was found that faculty and administrators view nurses as long-suffering drones. On the whole, the image of nursing was positive, with those who had the most contact with the nursing program having a more enlightened image. (CT)
ERIC Educational Resources Information Center
Guth, Douglas J.
2018-01-01
Community colleges are attempting to bridge America's widening blue-collar skills gap through workforce development programs promising living-wage jobs that don't require four years of college. While trade, construction and manufacturing companies are starving for talented workers, these fields also suffer from an image problem, one fueled by…
Monitoring trail conditions: New methodological considerations
Marion, Jeffrey L.; Leung, Yu-Fai; Nepal, Sanjay K.
2006-01-01
The U.S. National Park Service (NPS) accommodates nearly 300 million visitors per year, visitation that has the potential to produce negative effects on fragile natural and cultural resources. The policy guidance from the NPS Management Policies recognizes the legitimacy of providing opportunities for public enjoyment of parks while acknowledging the need for managers to “seek ways to avoid, or to minimize to the greatest degree practicable, adverse impacts on park resources and values” (NPS 2001). Thus, relative to visitor use, park managers must evaluate the types and extents of resource impacts associated with recreational activities, and determine to what extent they are unacceptable and constitute impairment. Visitor impact monitoring programs can assist managers in making objective evaluations of impact acceptability and impairment and in selecting effective impact management practices by providing quantitative documentation of the types and extent of recreationrelated impacts on natural resources. Monitoring programs are explicitly authorized in Section 4.1 of the Management Policies: Natural systems in the national park system, and the human influences upon them, will be monitored to detect change. The Service will use the results of monitoring and research to understand the detected change and to develop appropriate management actions.
NASA Technical Reports Server (NTRS)
Crusan, Jason
2005-01-01
Electronic Router (E-Router) is an application program for routing documents among the cognizant individuals in a government agency or other organization. E-Router supplants a prior 14 NASA Tech Briefs, May 2005 system in which paper documents were routed physically in packages by use of paper slips, packages could be lost, routing times were unacceptably long, tracking of packages was difficult, and there was a need for much photocopying. E-Router enables a user to create a digital package to be routed. Input accepted by E-Router includes the title of the package, the person(s) to whom the package is to be routed, attached files, and comments to reviewers. Electronic mail is used to notify reviewers of needed actions. The creator of the package can, at any time, see the status of the package in the routing structure. At the end of the routing process, E-Router keeps a record of the package and of approvals and/or concurrences of the reviewers. There are commercial programs that perform the general functions of E-Router, but they are more complicated. E-Router is Web-based, easy to use, and does not require the installation or use of client software.
The effect of an anger management program for family members of patients with alcohol use disorders.
Son, Ju-Young; Choi, Yun-Jung
2010-02-01
This study was aimed to test the structured anger management nursing program for the family members of patients with alcohol use disorders (AUDs). Families with the AUDs suffer from the dysfunctional family dynamic caused by the patients' deteriorative disease processes of alcohol dependence. Family members of AUDs feel bitter and angry about the uncontrolled behaviors and relapses of the patients in spite of great effort for a long time. This chronic anger threatens the optimal function of the family as well as obstructs the family to help the patients who are suffering from AUDs. Sixty three subjects were participated who were referred from community mental health centers, alcohol consultation centers, and an alcohol hospital in Korea. Pre-post scores of the Korean Anger Expression Inventory were used to test the program. An anger management program was developed and implemented to promote anger expression and anger management for the family members of the patients with AUDs. The total anger expression score of the experimental group was significantly more reduced as compared with that of the control group. Subjects in the experimental group reported after the program that they felt more comfortable and their life was changed in a better way. The anger management program was effective to promote anger expression and anger management for family members of AUDs. Nurses need to include family members in their nursing process as well as to care of patients with AUDs to maximize nursing outcome and patient satisfaction. 2010 Elsevier Inc. All rights reserved.
Health research in the developing world: a gastroenterological view from Bangladesh.
Hamilton, J R
1997-01-01
Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.
... and ability to form and sustain friendships. Understanding Bullying Behavior Kids bully for many reasons. Some bully ... children they perceive as weak. Helping Kids Stop Bullying Let your child know that bullying is unacceptable ...
Peplow, Daniel; Augustine, Sarah
2017-03-01
Previous studies found that while internationally financed economic development projects reduced poverty when measured in terms of per capita GDP, they also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide. In this study, we developed a needs assessment and a policy-oriented causal diagram to determine whether the impaired health of the people in this region was at least partially due to the role the country has played within the global economy. Specifically, could the health and well-being of indigenous people in Suriname be understood in terms of the foreign investment programs and economic development policies traceable to the Inter-American Development Bank's Suriname Land Management Project. Interviews took place from 2004 through 2015 involving stakeholders with an interest in public health and economic development. A policy-oriented causal diagram was created to model a complex community health system and weave together a wide range of ideas and views captured during the interview process. Converting land and resources held by indigenous people into private ownership has created an active market for land, increased investment and productivity, and reduced poverty when measured in terms of per capita GDP. However, it has also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows. While the effects of economic development programs on the health of vulnerable indigenous communities are clear, the governance response is not. The governance response appeared to be determined less by the urgency of the public health issue or by the compelling logic of an appropriate response, and more by competing economic interests and the exercise of power. The health and well-being of the indigenous Wayana in Suriname's interior region is at least partially due to the role the country has played within the global economy. Specifically, the health and well-being of indigenous people in Suriname can be understood to be a result of foreign development bank-funded projects that drive the government of Suriname to trade land and natural resources on the global market to manage their country's balance of payments.
Reusch, A; Weiland, R; Gerlich, C; Dreger, K; Derra, C; Mainos, D; Tuschhoff, T; Berding, A; Witte, C; Kaltz, B; Faller, H
2016-12-01
Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management skills, delivered in an interactive manner, and evaluated it in a large, cluster-randomized trial. We assigned 540 rehabilitation inpatients suffering from IBD (mean age 43 years, 66% female) to either the new intervention or a control group comprising the same overall intensity and the same medical information, but only general psychosocial information. The primary outcome was patient-reported IBD-related concerns. Secondary outcomes included disease knowledge, coping, self-management skills, fear of progression, anxiety, depression and quality of life. Assessments took place at baseline, end of rehabilitation and after 3 and 12 months.The psychoeducational self-management program did not prove superior to the control group regarding primary and secondary outcomes. However, positive changes over time occurred in both groups regarding most outcomes. The superior effectiveness of the newly developed psychoeducational program could not be demonstrated. Since the intervention and control groups may have been too similar, this trial may have been too conservative to produce between-group effects. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Engel, Monica T; Vaske, Jerry J; Bath, Alistair J; Marchini, Silvio
2017-09-01
We explored the overall acceptability of killing jaguars and pumas in different scenarios of people-big cat interactions, the influence of attitudes toward big cats on acceptability, and the level of consensus on the responses. Data were obtained from 326 self-administered questionnaires in areas adjacent to Intervales State Park and Alto Ribeira State Park. Overall, people held slightly positive attitudes toward jaguars and pumas and viewed the killing of big cats as unacceptable. However, individuals that held negative attitudes were more accepting of killing. As the severity of people-big cat interactions increased, the level of consensus decreased. Knowing whether killing a big cat is acceptable or unacceptable in specific situations allows managers to anticipate conflict and avoid illegal killing of big cats.
Energy balance measurement: when something is not better than nothing.
Dhurandhar, N V; Schoeller, D; Brown, A W; Heymsfield, S B; Thomas, D; Sørensen, T I A; Speakman, J R; Jeansonne, M; Allison, D B
2015-07-01
Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health-care policies, future research and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.
DEVELOPMENT OF AN ANTIBIOTIC OPTIONS INDEX FOR ANTIBIOTIC RESISTANCE MONITORING.
Manomayitthikan, Taweesuk; Borlace, Glenn N; Kessomboon, Nusaraporn
2016-11-01
Using antibiogram data to indicate the overall antibiotic resistance of a pathogen is complicated by the multiple antibiotic susceptibilities reported in the antibiogram. The objectives of this study were to develop and determine the benefits of an Antibiotic Options Index (AOI); an index that summarizes antibiotic susceptibility data for a pathogen by presenting it as the availability of antibiotic treatment options. The AOI was calculated using antibiogram data for the seven most commonly isolated pathogens from the National Antimicrobial Resistance Surveillance Center of Thailand between 1998 and 2014 and was classified as acceptable (AOI ≥ 0.8) or unacceptable (AOI < 0.8) based on the availability of treatment options. The AOI identified two problematic pathogens: Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA). For A. baumannii, the probability of having at least two viable antibiotic treatment options (AOIm2) decreased from an acceptable level (0.93) in 1998 to an unacceptable level (0.53) in 2014 and for MRSA the AOIm2 decreased from an acceptable level (0.82) in 1998 to an unacceptable level (0.47) in 2014. By including the idea that the problem with increasing antibiotic resistance is a problem with treating infections, the AOI effectively compiles susceptibility data to present it as the probability of having effective antibiotic treatment. This index is calculated from widely available antibiogram data, making it more suitable to be used to monitor antibiotic resistance at the hospital, provincial and national levels.
Influence of season and type of restaurants on sashimi microbiota.
Miguéis, S; Moura, A T; Saraiva, C; Esteves, A
2016-10-01
In recent years, an increase in the consumption of Japanese food in European countries has been verified, including in Portugal. These specialities made with raw fish, typical Japanese meals, have been prepared in typical and on non-typical restaurants, and represent a challenge to risk analysis on HACCP plans. The aim of this study was to evaluate the influence of the type of restaurant, season and type of fish used on sashimi microbiota. Sashimi samples (n = 114) were directly collected from 23 sushi restaurants and were classified as Winter and Summer Samples. They were also categorized according to the type of restaurant where they were obtained: as typical or non-typical. The samples were processed using international standards procedures. A middling seasonality influence was observed in microbiota using mesophilic aerobic bacteria, psychrotrophic microorganisms, Lactic acid bacteria, Pseudomonas spp., H 2 S positive bacteria, mould and Bacillus cereus counts parameters. During the Summer Season, samples classified as unacceptable or potentially Hazardous were observed. Non-typical restaurants had the most cases of Unacceptable/potentially hazardous samples 83.33%. These unacceptable results were obtained as a result of high values of pathogenic bacteria like Listeria monocytogenes and Staphylococcus aureus No significant differences were observed on microbiota counts from different fish species. The need to implement more accurate food safety systems was quite evident, especially in the warmer season, as well as in restaurants where other kinds of food, apart from Japanese meals, was prepared. © Crown copyright 2016.
Imperative - Redesign for Health Education.
ERIC Educational Resources Information Center
Nyquist, Ewald B.
Drug addiction, alcoholism, malnutrition, lung cancer, venereal disease, and emphysema represent not medical failures but educational failures, since people suffering from them are either beyond help or already seriously damaged by the time they see a physician. School programs are students must begin early. Moreover, for health education to be…
42 CFR 409.49 - Excluded services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathologic condition. (2) A biological is...
42 CFR 409.49 - Excluded services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathologic condition. (2) A biological is...
42 CFR 409.49 - Excluded services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathologic condition. (2) A biological is...
42 CFR 409.49 - Excluded services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathologic condition. (2) A biological is...
Experimenting with an Integrated Syllabus Design in Modern Languages.
ERIC Educational Resources Information Center
Towell, Richard
1991-01-01
Describes a university's experimental task-based French program that successfully integrated foreign language learning more fully with the learning of interpersonal skills and nonlinguistic content, although some language skills, especially those needed for advanced written language and translation, appeared to suffer. (14 references) (Author/CB)
Feitas, Juliana Pontes Pinto; Ribeiro, Lindioneza Adriano; Jorge, Miguel Tanús
2007-12-01
This study analyzes epidemiological and clinic characteristics of victims of traffic accidents. Data were obtained from medical records of children under 15 years of age (n = 1,123) admitted to a university hospital in Uberlândia, Minas Gerais State, Brazil, from 1999 to 2003. Mean age was eight years, 65.7% were boys, 76.6% were cyclists or pedestrians, 45.9% suffered head injuries, and 9% remained in hospital for more than two weeks. Fourteen (1.2%) died, 78.6% of these within 48 hours of hospitalization, and 85.7% with brain injuries. Among the passengers of motorcycles and larger vehicles, 58.8% were not using security devices properly at the time of the accident. Among the cyclists, 61% suffered isolated limb injuries. Meanwhile, pedestrians tended to suffer multiple lesions (57.5%) and be admitted to intensive care (7.1%), and represented 66.7% of the deaths. Epidemiological data on pediatric traffic victims can be useful for accident prevention programs.
Taking Psychedelics Seriously.
Byock, Ira
2018-04-01
Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically supervised and monitored approach. A single or brief series of sessions often results in substantial and sustained improvement among people with treatment-resistant depression and anxiety, including those with serious medical conditions. Need and Clinical Considerations: Palliative care clinicians occasionally encounter patients with emotional, existential, or spiritual suffering, which persists despite optimal existing treatments. Such suffering may rob people of a sense that life is worth living. Data from Oregon show that most terminally people who obtain prescriptions to intentionally end their lives are motivated by non-physical suffering. This paper overviews the history of this class of drugs and their therapeutic potential. Clinical cautions, adverse reactions, and important steps related to safe administration of psychedelics are presented, emphasizing careful patient screening, preparation, setting and supervision. Even with an expanding evidence base confirming safety and benefits, political, regulatory, and industry issues impose challenges to the legitimate use of psychedelics. The federal expanded access program and right-to-try laws in multiple states provide precendents for giving terminally ill patients access to medications that have not yet earned FDA approval. Given the prevalence of persistent suffering and growing acceptance of physician-hastened death as a medical response, it is time to revisit the legitimate therapeutic use of psychedelics.
[Long-term physical activity after a myocardial infarction : a permanent challenge].
Tessitore, Elena; Sigaud, Philippe; Meyer, Philippe; Mach, François
2017-05-24
Cardiac rehabilitation is a well-defined multidisciplinary program with the objective to reduce mortality and morbidity, while also improving the exercise capacity and quality of life of the patient following a myocardial infarction. Despite the fact that a cardiovascular rehabilitation program is now recommended by international guidelines for all patients who have suffered from an acute coronary syndrome, only half of all patients actually participate to such a program in Switzerland. Even worse, especially when taking into consideration the population in Geneva, less than 5 % of patients follow a long-term cardiac maintenance program (phase III). Since 2015, our project has been to encourage patients who have completed a phase II cardiac rehabilitation program, to resume regular physical activity in the long term.
Compound Words: A Problem in Post-Coordinate Retrieval Systems
ERIC Educational Resources Information Center
Jones, Kevin P.
1971-01-01
Compound words cause some difficulty in post-coordinate indexing systems: if too many are fractured, or the wrong categories are selected for fracturing noise will be produced at unacceptable levels on retrieval. (Author/MM)
DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS
When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...
Protocol to identify incompatible combinations of concrete materials : tech brief.
DOT National Transportation Integrated Search
2006-07-01
For this project, incompatibility of concrete materials is : defined as interactions between acceptable materials that result in unexpected or unacceptable performance. The most common problems are associated with premature stiffening (rapid sl...
Reception of distorted speech.
DOT National Transportation Integrated Search
1973-12-01
Noise, either in the form of masking or in the form of distortion products, interferes with speech intelligibility. When the signal-to-noise ratio is bad enough, articulation can drop to unacceptably--even dangerously--low levels. However, listeners ...
JPRS Report, Near East & South Asia, India
1991-08-06
country will suffer from economic recession and Clutches of Debt"] future developmental plans will be effected if welfare programs are cut instead of... Effects of Rupee Devaluation Pondered [INDIAN EXPRESS 6 Jun] ....................................................... 12 Papers Report ’Routine’ Rupee...Devaluations .............................................................................................. 13 Expected Effects [THE TIMES OF INDIA 2
Practicing What We Teach: Feminist Strategies for Teaching about Sexism
ERIC Educational Resources Information Center
Copp, Martha; Kleinman, Sherryl
2008-01-01
For decades, feminist teachers have been working in a chilly political climate. Rightwing critics claim that women's studies programs suffer from "insularity and narrowness, ideological bias, and a tendency toward misinformation." In the mainstream media, feminism is both vilified and trivialized. It's no wonder that many students doubt that…
CNN Newsroom Classroom Guides. March 1-31, 1997.
ERIC Educational Resources Information Center
Cable News Network, Atlanta, GA.
These classroom guides, designed to accompany the daily CNN (Cable News Network) Newsroom broadcasts for the month of March, provide program rundowns, suggestions for class activities and discussion, student handouts, and a list of related news terms. Topics include: monkeys cloned in Oregon, Iran suffers massive earthquake, tornados affect…
Social and Emotional Learning and Teachers
ERIC Educational Resources Information Center
Schonert-Reichl, Kimberly A.
2017-01-01
Teachers are the engine that drives social and emotional learning (SEL) programs and practices in schools and classrooms, and their own social-emotional competence and wellbeing strongly influence their students. But when teachers poorly manage the social and emotional demands of teaching, students' academic achievement and behavior both suffer.…
EPA's environmental justice program is charged with ensuring that no segment of the population, regardless of race, color, national origin, or income, suffers disproportionately from adverse human health or environmental effects and that all people live in clean, healthy, and s...
ERIC Educational Resources Information Center
Bushweller, Kevin
1994-01-01
Statistics indicate that young males are far more likely than young females to suffer from self-destructive behavior, commit suicide, and be in special education programs. Some schools are aggressively recruiting male teachers; others have found that all-male classes can help hold boys' interest. Some maintain the schools have short-changed girls…
The Unaccompanied Choral Rehearsal.
ERIC Educational Resources Information Center
Guelker-Cone, Leslie
1998-01-01
Contends that many choral programs suffer from a continued dependence on the piano for music learning and intonation. Provides suggestions that will help students develop sight-reading and singing skills that are not centered around the piano, such as creating a sight-reading system and having students read choral music immediately. (CMK)
EARLY SCHOOL ADMISSION PROJECT.
ERIC Educational Resources Information Center
JONES, EDGAR L.
CHILDREN FROM LOW-INCOME FAMILIES IN SUBSTANDARD OR OVERCROWDED INNER CITY DWELLINGS IN BALTIMORE WERE SELECTED FOR AN EXPERIMENTAL PRESCHOOL PROGRAM BECAUSE THEY TYPIFIED THE CULTURALLY DISADVANTAGED YOUNGSTERS WHO COULD BE EXPECTED TO SUFFER FAILURE OR FRUSTRATION UPON PUBLIC SCHOOL ENTRY AT THE AGES OF FIVE OR SIX. CENTERS WERE OPENED IN 1963.…
Putting the Fun in Fundraising
ERIC Educational Resources Information Center
Simons, Dave
2008-01-01
Today, school districts are faced with perpetually shrinking budgets, and all too often, music programs suffer the most. As a result, fundraising, once considered a supplemental effort, is now an integral part of the budgetary process for school trips and other extras. To make the most of their fundraising endeavors, music departments and…
ERIC Educational Resources Information Center
Black, Susan
2006-01-01
Just a few years ago Jefferson Elementary School in San Diego County, California suffered from low test scores and a lackluster "science from workbooks approach" that was not motivating many in the 75% Hispanic and 50% learning-to-speak-English student body. A partnership program with the San Diego Natural History Museum called…
76 FR 31590 - Endangered and Threatened Species; Take of Anadromous Fish
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-01
... proposed research programs are intended to increase knowledge of the species and to help guide management... management efforts, and to determine what salmonid life stages suffer the lowest survival and should be a focus of future management practices. Study 1 is a summer/fall juvenile salmonid population abundance...
ERIC Educational Resources Information Center
Miller, John K.
1998-01-01
In August 1995, a young football player died as a result of heat exhaustion suffered on the first day of football practice in Arkansas. Spurred by this tragedy, the district made some changes that every school district with an athletic program should consider. These include using a heat-stress monitor; abandoning the practice of group physical…
Ethnicity and Adolescent Depression: Prevalence, Access to Services, and Promising Interventions
ERIC Educational Resources Information Center
Wagstaff, Amanda E.; Polo, Antonio J.
2012-01-01
Depression is more common among adolescents of ethnic minority backgrounds, who also are less likely to receive professional help. This article presents information about prevalence of depression and service use across ethnic groups, and then outlines several promising intervention programs that are designed for adolescents suffering from…
Lessons for Teacher Education from Corporate Practice.
ERIC Educational Resources Information Center
Houston, W. Robert
1987-01-01
Teacher education suffers from parochialism and is essentially the same today as it was 50 years ago. Corporate education programs are large and well developed, and adoption of their promising ideas could improve teacher education. Eight conclusions about corporate educational practices are presented from a study of corporate training programs…
[Schizophrenia and informed consent to research].
Fovet, T; Amad, A; Thomas, P; Jardri, R
2015-10-01
Informed consent to research remains a complex issue, while sometimes staying difficult to obtain, even in the general population. This problem may be maximized with patients suffering from schizophrenia. This paper summarizes available data in the literature about informed consent for research involving patients suffering from schizophrenia. Medline and Google Scholar searches were conducted using the following MESH terms: schizophrenia, informed consent and research. Studies using dedicated standardized scales (e.g. MacCAT-CR) revealed a decrease in the capacity to consent of patients with schizophrenia when compared with healthy individuals. Keeping in mind that schizophrenia is an heterogeneous disorder, patients with the lowest insight as well as those with the most severe cognitive symptoms appeared more impaired in their capacity to consent. Such a poor capacity to understand and consent to trials was shown linked with alterations in decision-making. For these specific patients, interventions may be set up to increase their capacity to consent. Various strategies were proposed: enhanced consent forms, extended discussion, test/feedback method or multimedia interventions. Among them, interventions relying on communication and the growing field of information technologies (e.g. web-based tools) seem promising. Finally, associations grouping families and patients (like the French Association UNAFAM) may facilitate the involvement of patients in research programs with safer conditions. Patients suffering from schizophrenia appear able to consent to research programs when suitable interventions are proposed. Further studies are now needed to optimize and individualize such interventions. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
NASA Technical Reports Server (NTRS)
Gebreyesus, Fiyore; Cowings, Patricia S.; Toscano, William B.
2012-01-01
Airsickness is experienced by about 50% of military aviators some time in their career. Aviators who suffer from recurrent episodes of airsickness are typically referred to the Naval Aerospace Medical Institute (NAMI) at Pensacola where they undergo extensive evaluation and 8 weeks of training in the Self-Paced Airsickness Desensitization (SPAD) program. Researchers at NASA Ames have developed an alternative mitigation training program, Autogenic Feedback Training Exercise (AFTE) that has demonstrated an 80% success rate for improving motion sickness tolerance.
NASA Technical Reports Server (NTRS)
Chien, Andrew A.; Karamcheti, Vijay; Plevyak, John; Sahrawat, Deepak
1993-01-01
Concurrent object-oriented languages, particularly fine-grained approaches, reduce the difficulty of large scale concurrent programming by providing modularity through encapsulation while exposing large degrees of concurrency. Despite these programmability advantages, such languages have historically suffered from poor efficiency. This paper describes the Concert project whose goal is to develop portable, efficient implementations of fine-grained concurrent object-oriented languages. Our approach incorporates aggressive program analysis and program transformation with careful information management at every stage from the compiler to the runtime system. The paper discusses the basic elements of the Concert approach along with a description of the potential payoffs. Initial performance results and specific plans for system development are also detailed.
DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS (PRESENTATION)
When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...
19 CFR 134.45 - Approved markings of country name.
Code of Federal Regulations, 2011 CFR
2011-04-01
... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...
19 CFR 134.45 - Approved markings of country name.
Code of Federal Regulations, 2014 CFR
2014-04-01
... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...
19 CFR 134.45 - Approved markings of country name.
Code of Federal Regulations, 2013 CFR
2013-04-01
... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...
19 CFR 134.45 - Approved markings of country name.
Code of Federal Regulations, 2012 CFR
2012-04-01
... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...
43 CFR 3101.1-4 - Modification or waiver of lease terms and stipulations.
Code of Federal Regulations, 2013 CFR
2013-10-01
... determines that the factors leading to its inclusion in the lease have changed sufficiently to make the... unacceptable impacts. If the authorized officer has determined, prior to lease issuance, that a stipulation...
43 CFR 3101.1-4 - Modification or waiver of lease terms and stipulations.
Code of Federal Regulations, 2012 CFR
2012-10-01
... determines that the factors leading to its inclusion in the lease have changed sufficiently to make the... unacceptable impacts. If the authorized officer has determined, prior to lease issuance, that a stipulation...
10 CFR 862.5 - Procedures for removal of downed aircraft.
Code of Federal Regulations, 2014 CFR
2014-01-01
... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...
10 CFR 862.5 - Procedures for removal of downed aircraft.
Code of Federal Regulations, 2011 CFR
2011-01-01
... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...
10 CFR 862.5 - Procedures for removal of downed aircraft.
Code of Federal Regulations, 2010 CFR
2010-01-01
... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...
10 CFR 862.5 - Procedures for removal of downed aircraft.
Code of Federal Regulations, 2012 CFR
2012-01-01
... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...
10 CFR 862.5 - Procedures for removal of downed aircraft.
Code of Federal Regulations, 2013 CFR
2013-01-01
... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...
The use of micro-surfacing for pavement preservation : final report.
DOT National Transportation Integrated Search
2009-04-01
The Maine Department of Transportation (MaineDOT) is responsible for maintaining approximately 8300 : miles of public highways. Maintenance of these highways consists of rehabilitation or reconstruction : when the road has deteriorated to an unaccept...
Performance evaluation of subgrade stabilization with recycled materials.
DOT National Transportation Integrated Search
2016-02-29
Due to rising costs of good quality acceptable materials for remove/replace options and traditional : subgrade stabilization materials, MDOT is in need to identify potential recycled materials to treat : unacceptable subgrade soils. Use of recycled m...
Classroom Misbehavior in the Eyes of Students: A Qualitative Study
Sun, Rachel C. F.; Shek, Daniel T. L.
2012-01-01
Using individual interviews, this study investigated perceptions of classroom misbehaviors among secondary school students in Hong Kong (N = 18). Nineteen categories of classroom misbehaviors were identified, with talking out of turn, disrespecting teacher, and doing something in private being most frequently mentioned. Findings revealed that students tended to perceive misbehaviors as those actions inappropriate in the classroom settings and even disrupting teachers' teaching and other students' learning. Among various misbehaviors, talking out of turn and disrespecting teacher were seen as the most disruptive and unacceptable. These misbehaviors were unacceptable because they disturbed teaching and learning, and violated the values of respect, conformity, and obedience in the teacher-student relationship within the classroom. The frequency and intensity of misbehaviors would escalate if students found it fun, no punishment for such misbehaviors, or teachers were not authoritative enough in controlling the situations. Implications for further research and classroom management are discussed. PMID:22919316
For the greater goods? Ownership rights and utilitarian moral judgment.
Millar, J Charles; Turri, John; Friedman, Ori
2014-10-01
People often judge it unacceptable to directly harm a person, even when this is necessary to produce an overall positive outcome, such as saving five other lives. We demonstrate that similar judgments arise when people consider damage to owned objects. In two experiments, participants considered dilemmas where saving five inanimate objects required destroying one. Participants judged this unacceptable when it required violating another's ownership rights, but not otherwise. They also judged that sacrificing another's object was less acceptable as a means than as a side-effect; judgments did not depend on whether property damage involved personal force. These findings inform theories of moral decision-making. They show that utilitarian judgment can be decreased without physical harm to persons, and without personal force. The findings also show that the distinction between means and side-effects influences the acceptability of damaging objects, and that ownership impacts utilitarian moral judgment. Copyright © 2014 Elsevier B.V. All rights reserved.
An audit of the quality of operation notes in an otolaryngology unit.
Bateman, N D; Carney, A S; Gibbin, K P
1999-04-01
Hand-written operation notes are often produced as evidence in medico-legal cases. Incomplete and illegible notes, along with the use of confusing abbreviations, are a common source of weakness in a surgeon's defence. An audit of 100 sets of operation notes was carried out in a single otolaryngology department. Notes were scrutinised for the accuracy of data, ward, department and name of surgeon, as well as for the inclusion of unacceptable abbreviations. Using an aide-memoire attached to the front of the operation sheet, the audit was repeated with identical criteria. The aide-memoire improved the standard of operation note with respect to all measured criteria. Clear identification of operating surgeon improved from 74% to 93%, and the avoidance of unacceptable abbreviations rose from 53% to 84%. We conclude that a simple aide-memoire attached to operation note sheets can significantly improve the quality of note-keeping and potentially avoid medico-legal problems.
Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane.
Lapin, S L; Auden, S M; Goldsmith, L J; Reynolds, A M
1999-01-01
We prospectively studied one hundred ASA physical status I-II children, ages six months to six years, undergoing myringotomy surgery. Children were randomly assigned to one of four anaesthetic groups receiving either halothane or sevoflurane for anaesthesia and oral midazolam premedication or no premedication. We found that children anaesthetized with sevoflurane had significantly faster recovery times and discharge home times than those who received halothane. Patients given oral midazolam premedication had significantly longer recovery times, but no delay in discharge home compared with those not premedicated. However, children anaesthetized with sevoflurane and no premedication had an unacceptably high incidence (67%) of postoperative agitation. The use of oral midazolam preoperatively did decrease the amount of postoperative agitation seen with sevoflurane. We conclude that although sevoflurane does shorten recovery times, the degree of associated postoperative agitation makes it unacceptable as a sole anaesthetic for myringotomy surgery.
Image registration assessment in radiotherapy image guidance based on control chart monitoring.
Xia, Wenyao; Breen, Stephen L
2018-04-01
Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.
Pulse compression using a tapered microstructure optical fiber.
Hu, Jonathan; Marks, Brian S; Menyuk, Curtis R; Kim, Jinchae; Carruthers, Thomas F; Wright, Barbara M; Taunay, Thierry F; Friebele, E J
2006-05-01
We calculate the pulse compression in a tapered microstructure optical fiber with four layers of holes. We show that the primary limitation on pulse compression is the loss due to mode leakage. As a fiber's diameter decreases due to the tapering, so does the air-hole diameter, and at a sufficiently small diameter the guided mode loss becomes unacceptably high. For the four-layer geometry we considered, a compression factor of 10 can be achieved by a pulse with an initial FWHM duration of 3 ps in a tapered fiber that is 28 m long. We find that there is little difference in the pulse compression between a linear taper profile and a Gaussian taper profile. More layers of air-holes allows the pitch to decrease considerably before losses become unacceptable, but only a moderate increase in the degree of pulse compression is obtained.
New algorithms for optimal reduction of technical risks
NASA Astrophysics Data System (ADS)
Todinov, M. T.
2013-06-01
The article features exact algorithms for reduction of technical risk by (1) optimal allocation of resources in the case where the total potential loss from several sources of risk is a sum of the potential losses from the individual sources; (2) optimal allocation of resources to achieve a maximum reduction of system failure; and (3) making an optimal choice among competing risky prospects. The article demonstrates that the number of activities in a risky prospect is a key consideration in selecting the risky prospect. As a result, the maximum expected profit criterion, widely used for making risk decisions, is fundamentally flawed, because it does not consider the impact of the number of risk-reward activities in the risky prospects. A popular view, that if a single risk-reward bet with positive expected profit is unacceptable then a sequence of such identical risk-reward bets is also unacceptable, has been analysed and proved incorrect.
Freeling, Michelle; Parker, Steve
2015-02-01
This critical review evaluates the existing primary research literature to identify experienced registered nurses' attitudes, views and expectations of graduate nurses which may create a barrier for optimal graduate nurse performance. Relevant primary studies were identified by searching online databases using a wide variety of appropriate keyword combinations. Online databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and Google Scholar were comprehensively searched for relevant research. The selected studies were subjected to a rigorous critical appraisal to evaluate the studies and to determine if the findings were applicable to practice. A manual method of thematic analysis was conducted to highlight explicit and implicit themes from the reviewed studies. Themes were grouped and continually reduced until only essential themes remain. Themes and subthemes emerged which were then compared and contrasted to analyse results. The four major themes identified include nursing skills, inadequate preparation during academic program, attitudes and ward culture and concerns with confidence. Subthemes were identified within these categories. Findings indicate experienced registered nurses discussed themes including 'nursing skills', 'inadequate preparation during academic program', 'attitudes and ward culture' and 'concerns with confidence'. Concerns were raised including the value of traditional training versus tertiary education programs, coping with unprofessional behaviour and inadequate preparation for practice. Further research is required to fully address management of the theory-practice gap, as well as the attitudes of experienced registered nurses educated in traditional programs versus those in tertiary education programs. Nurse managers should be aware of the possible occurrence of unprofessional behaviour, and increased workplace training regarding lateral violence would assist in raising awareness regarding negative and unacceptable behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.
Schueller, Stephen M
2016-01-01
Background Perinatal depression and anxiety are common and debilitating conditions. Novel, cost effective services could improve the uptake and the impact of mental health resources among women who suffer from these conditions. E-mental health products are one example of such services. Many publically available e-mental health products exist, but these products lack validation and are not designed to be integrated into existing health care settings. Objective The objective of the study was to present a program to use 7 Cups of Tea (7Cups), an available technological platform that provides online peer (ie, listener) based emotional support, to supplement treatment for women experiencing perinatal depression or anxiety and to summarize patient’s feedback on the resultant program. Methods This study consisted of two stages. First, five clinicians specializing in the treatment of perinatal mood disorders received an overview of 7Cups. They provided feedback on the 7Cups platform and ways it could complement the existing treatment efforts to inform further adjustments. In the second stage, nine women with perinatal depression or anxiety used the platform for a single session and provided feedback. Results In response to clinicians’ feedback, guidelines for referring patients to use 7Cups as a supplement for treatment were created, and a training program for listeners was developed. Patients found the platform usable and useful and their attitudes toward the trained listeners were positive. Overall, patients noted a need for support outside the scheduled therapy time and believed that freely available online emotional support could help meet this need. Most patients were interested in receiving support from first time mothers and those who suffered in the past from perinatal mood disorders. Conclusions The study results highlight the use of 7Cups as a tool to introduce accessible and available support into existing treatment for women who suffer from perinatal mood disorders. Further research should focus on the benefits accrued from such a service. However, this article highlights how a publicly available eHealth product can be leveraged to create new services in a health care setting. PMID:27001373
Sousa, Luiz Cláudio Demes da Mata; Filho, Herton Luiz Alves Sales; Von Glehn, Cristina de Queiroz Carrascosa; da Silva, Adalberto Socorro; Neto, Pedro de Alcântara dos Santos; de Castro, José Adail Fonseca; do Monte, Semíramis Jamil Hadad
2011-12-01
The global challenge for solid organ transplantation programs is to distribute organs to the highly sensitized recipients. The purpose of this work is to describe and test the functionality of the EpHLA software, a program that automates the analysis of acceptable and unacceptable HLA epitopes on the basis of the HLAMatchmaker algorithm. HLAMatchmaker considers small configurations of polymorphic residues referred to as eplets as essential components of HLA-epitopes. Currently, the analyses require the creation of temporary files and the manual cut and paste of laboratory tests results between electronic spreadsheets, which is time-consuming and prone to administrative errors. The EpHLA software was developed in Object Pascal programming language and uses the HLAMatchmaker algorithm to generate histocompatibility reports. The automated generation of reports requires the integration of files containing the results of laboratory tests (HLA typing, anti-HLA antibody signature) and public data banks (NMDP, IMGT). The integration and the access to this data were accomplished by means of the framework called eDAFramework. The eDAFramework was developed in Object Pascal and PHP and it provides data access functionalities for software developed in these languages. The tool functionality was successfully tested in comparison to actual, manually derived reports of patients from a renal transplantation program with related donors. We successfully developed software, which enables the automated definition of the epitope specificities of HLA antibodies. This new tool will benefit the management of recipient/donor pairs selection for highly sensitized patients. Copyright © 2011 Elsevier B.V. All rights reserved.
A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation
Dubois, Sara; Fraser, David
2013-01-01
Simple Summary Human feeding of wildlife is a world-wide phenomenon with very diverse effects on conservation, animal welfare and public safety. From a review of the motivations, types and consequences of wildlife feeding, an evaluative framework is presented to assist policy-makers, educators and managers to make ethical- and biologically-based decisions about the appropriateness of feeding wildlife in the context of research, wildlife management, tourism and recreation. Abstract Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable. PMID:26479747
Wilson, Jefferson R; Radcliff, Kris; Schroeder, Gregory; Booth, Madison; Lucasti, Christopher; Fehlings, Michael; Ahmad, Nassr; Vaccaro, Alexander; Arnold, Paul; Sciubba, Daniel; Ching, Alex; Smith, Justin; Shaffrey, Christopher; Singh, Kern; Darden, Bruce; Daffner, Scott; Cheng, Ivan; Ghogawala, Zoher; Ludwig, Steven; Buchowski, Jacob; Brodke, Darrel; Wang, Jeffrey; Lehman, Ronald A; Hilibrand, Alan; Yoon, Tim; Grauer, Jonathan; Dailey, Andrew; Steinmetz, Michael; Harrop, James S
2018-06-01
Anterior cervical discectomy and fusion has a low but well-established profile of adverse events. The goal of this study was to gauge surgeon opinion regarding the frequency and acceptability of these events. A 2-page survey was distributed to attendees at the 2015 Cervical Spine Research Society (CSRS) meeting. Respondents were asked to categorize 18 anterior cervical discectomy and fusion-related adverse events as either: "common and acceptable," "uncommon and acceptable," "uncommon and sometimes acceptable," or "uncommon and unacceptable." Results were compiled to generate the relative frequency of these responses for each complication. Responses for each complication event were also compared between respondents based on practice location (US vs. non-US), primary specialty (orthopedics vs. neurosurgery) and years in practice. Of 150 surveys distributed, 115 responses were received (76.7% response rate), with the majority of respondents found to be US-based (71.3%) orthopedic surgeons (82.6%). Wrong level surgery, esophageal injury, retained drain, and spinal cord injury were considered by most to be unacceptable and uncommon complications. Dysphagia and adjacent segment disease occurred most often, but were deemed acceptable complications. Although surgeon experience and primary specialty had little impact on responses, practice location was found to significantly influence responses for 12 of 18 complications, with non-US surgeons found to categorize events more toward the uncommon and unacceptable end of the spectrum as compared with US surgeons. These results serve to aid communication and transparency within the field of spine surgery, and will help to inform future quality improvement and best practice initiatives.
Injury risk associated with ground hardness in junior cricket.
Twomey, Dara M; White, Peta E; Finch, Caroline F
2012-03-01
To establish if there is an association between ground hardness and injury risk in junior cricket. Nested case-series of players who played matches on specific grounds with objective ground hardness measures, within a prospective cohort study of junior community club cricket players. Monitoring of injuries and playing exposure occurred during 434 matches over the 2007/2008 playing season. Objective assessment of the hardness of 38 grounds was undertaken using a Clegg hammer at 13 sites on 19 different junior cricket grounds on the match eve across the season. Hardness readings were classified from unacceptably low (<30 g) to unacceptably high (>120 g) and two independent raters assessed the likelihood of each injury being related to ground hardness. Injuries sustained on tested grounds were related to the ground hardness measures. Overall, 31 match injuries were reported; 6.5% were rated as likely to be related to ground hardness, 16.1% as possibly related and 74.2% as unlikely to be related and 3.2% unknown. The two injuries likely to be related to ground hardness were sustained whilst diving to catch a ball resulting, in a graze/laceration from contact with hard ground. Overall, 31/38 (82%) ground assessments were rated as having 'unacceptably high' hardness and all others as 'high/normal' hardness. Only one injury occurred on an objectively tested ground. It remains unclear if ground hardness is a contributing factor to the most common injury mechanism of being struck by the ball, and needs to be confirmed in future larger-scale studies. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Community attitudes toward breastfeeding in public places among Western Australia Adults, 1995-2009.
Meng, Xingqiong; Daly, Alison; Pollard, Christina Mary; Binns, Colin William
2013-05-01
Community attitudes toward breastfeeding in public influence how comfortable women feel about continuing breastfeeding. Knowledge of the social context helps target breastfeeding-promoting interventions. To examine trends in Western Australian adult attitudes toward breastfeeding in public places. As part of 5 cross-sectional surveys from the Western Australian Nutrition Monitor Survey Series conducted between 1995 and 2009, 5496 adults aged 18 to 64 years were asked whether it was acceptable for mothers to breastfeed their babies in public places, including shopping centers, workplaces, and restaurants, and on public transport. Descriptive statistics and multinomial regressions were used to describe factors associated with attitudes toward publicly breastfeeding. There was no change in the acceptance of breastfeeding in shopping centers, restaurants, and workplaces and on public transport over time, but in 2009, significantly fewer people said that it was unacceptable to breastfeed in public compared with 1995. Women, people older than 44 years, those born outside Australia, and the less educated were those most likely to say that breastfeeding in public was unacceptable. In the years that the question was asked, more than 97% of respondents said that breastfeeding was acceptable if a separate room was provided. Making breastfeeding acceptable and pleasant for mothers in public spaces is a key policy recommendation. Women, people older than 44 years, and those born outside Australia were most likely to respond that breastfeeding in public was unacceptable unless a room was provided. Given that, on average, 70% of the population said that breastfeeding in public was acceptable, investigation into why some women do not think so is warranted.
A Comparison of Spectacles Purchased Online and in UK Optometry Practice.
Alderson, Alison J; Green, Alison; Whitaker, David; Scally, Andrew J; Elliott, David B
2016-10-01
To compare spectacles bought online with spectacles from optometry practices. Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Participants preferred the practice spectacles (median ranking 4th, IQR 1-6) more than online (6th, IQR 4-8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1-4) were particularly preferred (online 6.5th, IQR 4-9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher's exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher's exact p = 0.03). Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision.
ERIC Educational Resources Information Center
Kjellgren, Anette; Buhrkall, Hanne; Norlander, Torsten
2010-01-01
The focus of this study was to investigate experiences gained from treatment combining relaxation in flotation tank with psychotherapy for sufferers from "burn-out syndrome". Six people participated in a ten week program. They were all interviewed; the data were analyzed using the Empirical Phenomenological Psychological method. Five…
DOT National Transportation Integrated Search
2006-08-01
This study consists of continued field evaluations of treatments to four pavements suffering from distress due to alkali-silica reaction (ASR). One set of treatments was evaluated on existing pavements in Delaware, California, and Nevada that already...
AP Geography, Environmental Science Thrive
ERIC Educational Resources Information Center
Robelen, Erik W.
2012-01-01
Geography may not be particularly known as a hot topic among today's students--even some advocates suggest it suffers from an image problem--but by at least one measure, the subject is starting to come into its own. Across more than 30 topics covered in the Advanced Placement (AP) program, participation in geography is rising faster than any…
Helicopter Crewseat Cushion Program
1994-11-01
proportion of Army helicopter pilots suffer back pain caused by flying. Extended missions required during Desert Shield/Desert Storm emphasized this problem...Seat Cushions Lumbar Support Energy Absorbing Foam Lumbar Kyphosis 16. PRICE CODE Back Pain Thigh Support Helicopter Vibration Helicopter Seating _ 17...Bulging disks and stretched ligaments from lumbar kyphosis .................... 3 3 Measurement of anthropometric dimensions
Morita-Based Therapy and Its Use across Cultures in the Treatment of Bulimia Nervosa.
ERIC Educational Resources Information Center
LeVine, Peg
1993-01-01
Provides an overview of classical inpatient Morita therapy (a four-stage treatment for anxiety-based neurotic disorders), contrasts it with features of rational emotive therapy (RET), and illustrates an intervention program for women suffering from bulimia nervosa. A session-to-session short-term treatment methodology is provided. (Author/SR)
Postural Determinants in the Blind. Final Report.
ERIC Educational Resources Information Center
Siegel, Irwin M.; Murphy, Thomas J.
The problem of malposture in the blind and its affect on orientation and travel skills was explored. A group of 45 students were enrolled in a standard 3-month mobility training program. Each student suffered a postural problem, some compounded by severe orthopedic and/or neurological deficit. All subjects were given complete orthopedic and…
7 CFR 760.206 - Notice of loss and application process.
Code of Federal Regulations, 2011 CFR
2011-01-01
..., Honeybees, and Farm-Raised Fish Program § 760.206 Notice of loss and application process. (a) To apply for ELAP, the participant that suffered eligible livestock, honeybee, or farm-raised fish losses must... Application; (ii) For honeybee feed, honeybee colony, honeybee hive, or farm-raised fish feed or death losses...
Situational Dialogues in a Community College: English as a Second Language Curriculum
ERIC Educational Resources Information Center
Klinghoffer, Curtis L.
2008-01-01
A tuition-free, vocational, English as a second language (ESL) program offered at a large community college suffers from high attrition as well as student dissatisfaction with curriculum. The purpose of this quasi-experimental, longitudinal study was to assess the effectiveness of a specific ESL curriculum supplement as an intervention to…
A Behavioral Approach to Improving Self-Care Skills in OBS Patients.
ERIC Educational Resources Information Center
McEvoy, Cathy L.; Patterson, Roger L.
Traditionally, the treatment of geriatric patients suffering from Organic Brain Syndrome (OBS) has been characterized by non-therapeutic custodial care. To determine whether elderly clients with dementia can benefit from self-care skill training, and to compare their progress with clients without OBS, 30 clients of the Residential Aging Program in…
School Counseling Prevention and Intervention for Child Witnesses of Intimate Partner Violence
ERIC Educational Resources Information Center
Buser, Juleen K.; Saponara, Erin
2011-01-01
Children who witness intimate partner violence (IPV) often suffer a range of physical, behavioral, emotional, and familial consequences (Holt, Buckley, & Whelan, 2008). School counselors may be in a key position to implement prevention programs around this issue, identify children who have witnessed IPV, and to engage in intervention efforts.…
Teach and Be Taught: A Guide to Teaching Students with Batten Disease.
ERIC Educational Resources Information Center
Bills, Wendy; Johnston, Lance W.; Wilhelm, Robert; Graham, Leslie
This guide provides information on Batten Disease to assist in planning a quality educational program for the student with the disease. Because Batten Disease, or neuronal ceroid lipofuscinosis, causes the death of brain cells, students with the disease are described as suffering from mental impairment, worsening seizures, and progressive loss of…
ERIC Educational Resources Information Center
Al-Issa, Ali S. M.
2017-01-01
There is a growing body of literature about the qualities of professional teacher educators (TEs) and their impact on preparing professional teachers. However, English Language Teaching (ELT) research has fallen behind in this regard, despite the fact that different programs worldwide suffer from different limitations, due to certain aspects…
Education for the Gifted/Talented in Thailand
ERIC Educational Resources Information Center
Anuruthwong, Usanee
2017-01-01
Suffering of the underachievers and misdiagnosed cases brought a group of educators at Srinakharinwirot University to start a pilot project in 1980. This project led to the discovery of many issues on identification, programming, and school evaluation among experts. Questions raised from parents and teachers were in need of the right answers.…
Beyond the Transcript: Factors Influencing the Pursuit of Science and Mathematics Coursework
ERIC Educational Resources Information Center
Haag, Susan; Megowan, Colleen
2012-01-01
The nation's middle schools suffer from a shortage of qualified science and mathematics teachers. To address this need, one university in the southwest has developed the Modeling Institute, a master's degree program for in-service elementary educators interested in teaching science and mathematics at the middle school level. Identifying the…
ERIC Educational Resources Information Center
Bogdaniak, Roman C.
Dually diagnosed adolescents suffering from both severe emotional disturbance and substance abuse/addiction constitute a special population which poses a challenge to health professionals in special education as well as clinical settings. The prevalence of substance use, abuse, and addiction has been shown to be significantly above the national…
How to Setup a Continuous Experimental Teaching System: Case Study on the Tourism Management Program
ERIC Educational Resources Information Center
Hu, Jun; Zhang, Mu; Huang, Xiang
2014-01-01
Chinese higher tourism education witnesses 32-year continuous innovation and exploration since the reform and opening policies. And it has gained many successful experiences in the aspects of talents cultivation mentality, nurture target, subject construction, curriculum arrangement and training module. However, it suffers the shortage of tourism…
Instructional Computer Programs and the Phonological Deficits of Dyslexic Children
ERIC Educational Resources Information Center
Cammarata, Lisa
2006-01-01
The 21st century is a time to contemplate the power of the technological advances that have occurred today. Computers have become idea engines- a tool used for thinking, performing, processing, and instructing people. No one understands or appreciates this phenomenon more than children suffering with dyslexia. These children's ability to learn or…
ERIC Educational Resources Information Center
Stoops, Jack W.; Hull, Janis L.
This report synthesizes research findings with observations of three Pacific Northwest sites attempting service integration in rural settings. At case-study sites in Washington and Oregon, rural schools, communities, and service providers collaborate to deliver services to students and community members suffering from high unemployment, alcohol…
Surveying the Bullied to Set Policy
ERIC Educational Resources Information Center
McCartney, Mary Pat
2005-01-01
Too often, bullying goes undetected as victims suffer silently. Most anti-bullying programs must be strengthened to reduce or eliminate the quiet, sneaky bullying falling under adults' radar. Thus, there is a need to create a safe environment for children both above and below that radar. In this article, the author discusses the importance of…
Ergonomics and the dental office: an overview and consideration of regulatory influences.
Laderas, Sandy; Felsenfeld, Alan L
2002-02-01
Nearly 2 million workers suffer from musculoskeletal disorders each year. These problems are caused by repetitive, awkward, or stressful motions. Dental health care workers are susceptible to these types of injuries. This article will discuss state and federal programs to control job-related injuries and relate the regulations to dental practice.
3 CFR 8804 - Proclamation 8804 of April 23, 2012. National Crime Victims’ Rights Week, 2012
Code of Federal Regulations, 2013 CFR
2013-01-01
... suffer the vast majority of intimate partner violence, sexual assault, and rape. These outcomes are... continue to combat sexual violence and expand support for survivors. From disrupting human trafficking... Department of Justice, we are investing in programs to prevent crime, drug abuse, and violence in communities...