Structure of health-enhancing behavior in adolescence: a latent-variable approach.

PubMed

Donovan, J E; Jessor, R; Costa, F M

1993-12-01

The structure of the interrelations among a variety of health-enhancing behaviors was examined using structural equation modeling analyses of questionnaire data from 1,280 middle school students and 2,219 high school students. The health-enhancing behaviors included seat belt use, adequate hours of sleep, attention to healthy diet, adequate exercise, low sedentary behavior, and regular toothbrushing. In the middle school sample, all of the health-enhancing behaviors correlated significantly but modestly with each other, except for sleep with toothbrushing. In the high school sample, all but three of the 15 correlations among the behaviors were significant. The results further show that a single underlying factor can account for the modest correlations among these health-enhancing behaviors in both samples. The generality of the single-factor model was also established for male, female, White, Hispanic, and Black students at each school level. These findings provide some support for the existence of health-related lifestyles in adolescence.

Combining nonoverlap and trend for single-case research: Tau-U.

PubMed

Parker, Richard I; Vannest, Kimberly J; Davis, John L; Sauber, Stephanie B

2011-06-01

A new index for analysis of single-case research data was proposed, Tau-U, which combines nonoverlap between phases with trend from within the intervention phase. In addition, it provides the option of controlling undesirable Phase A trend. The derivation of Tau-U from Kendall's Rank Correlation and the Mann-Whitney U test between groups is demonstrated. The equivalence of trend and nonoverlap is also shown, with supportive citations from field leaders. Tau-U calculations are demonstrated for simple AB and ABA designs. Tau-U is then field tested on a sample of 382 published data series. Controlling undesirable Phase A trend caused only a modest change from nonoverlap. The inclusion of Phase B trend yielded more modest results than simple nonoverlap. The Tau-U score distribution did not show the artificial ceiling shown by all other nonoverlap techniques. It performed reasonably well with autocorrelated data. Tau-U shows promise for single-case applications, but further study is desirable. Copyright © 2011. Published by Elsevier Ltd.

HeartWare HVAD for Biventricular Support in Children and Adolescents: The Stanford Experience.

PubMed

Stein, Mary Lyn; Yeh, Justin; Reinhartz, Olaf; Rosenthal, David N; Kaufman, Beth D; Almond, Chris S; Hollander, Seth A; Maeda, Katsuhide

2016-01-01

Despite increasing use of mechanical circulatory support in children, experience with biventricular device implantation remains limited. We describe our experience using the HeartWare HVAD to provide biventricular support to three patients and compare these patients with five patients supported with HeartWare left ventricular assist device (LVAD). At the end of the study period, all three biventricular assist device (BiVAD) patients had been transplanted and were alive. LVAD patients were out of bed and ambulating a median of 10.5 days postimplantation. The BiVAD patients were out of bed a median of 31 days postimplantation. Pediatric patients with both left ventricular and biventricular heart failure can be successfully bridged to transplantation with the HeartWare HVAD. Rapid improvement in functional status following HVAD implantation for isolated left ventricular support is seen. Patients supported with BiVAD also demonstrate functional recovery, albeit more modestly. In the absence of infection, systemic inflammatory response raises concern for inadequate support.

Trial Protocol: randomised controlled trial of the effects of very low calorie diet, modest dietary restriction, and sequential behavioural programme on hunger, urges to smoke, abstinence and weight gain in overweight smokers stopping smoking.

PubMed

Lycett, Deborah; Hajek, Peter; Aveyard, Paul

2010-10-07

Weight gain accompanies smoking cessation, but dieting during quitting is controversial as hunger may increase urges to smoke. This is a feasibility trial for the investigation of a very low calorie diet (VLCD), individual modest energy restriction, and usual advice on hunger, ketosis, urges to smoke, abstinence and weight gain in overweight smokers trying to quit. This is a 3 armed, unblinded, randomized controlled trial in overweight (BMI > 25 kg/m2), daily smokers (CO > 10 ppm); with at least 30 participants in each group. Each group receives identical behavioural support and NRT patches (25 mg(8 weeks),15 mg(2 weeks),10 mg(2 weeks)). The VLCD group receive a 429-559 kcal/day liquid formula beginning 1 week before quitting and continuing for 4 weeks afterwards. The modest energy restricted group (termed individual dietary and activity planning(IDAP)) engage in goal-setting and receive an energy prescription based on individual basal metabolic rate(BMR) aiming for daily reduction of 600 kcal. The control group receive usual dietary advice that accompanies smoking cessation i.e. avoiding feeling hungry but eating healthy snacks. After this, the VLCD participants receive IDAP to provide support for changing eating habits in the longer term; the IDAP group continues receiving this support. The control group receive IDAP 8 weeks after quitting. This allows us to compare IDAP following a successful quit attempt with dieting concurrently during quitting. It also aims to prevent attrition in the unblinded, control group by meeting their need for weight management. Follow-up occurs at 6 and 12 months.Outcome measures include participant acceptability, measured qualitatively by semi-structured interviewing and quantitatively by recruitment and attrition rates. Feasibility of running the trial within primary care is measured by interview and questionnaire of the treatment providers. Adherence to the VLCD is verified by the presence of urinary ketones measured weekly. Daily urges to smoke, hunger and withdrawal are measured using the Mood and Physical Symptoms Scale-Combined (MPSS-C) and a Hunger Craving Score (HCS). 24 hour, 7 day point prevalence and 4-week prolonged abstinence (Russell Standard) is confirmed by CO < 10 ppm. Weight, waist and hip circumference and percentage body fat are measured at each visit. Current controlled trials ISRCTN83865809.

The Lunar CELSS Test Module

NASA Technical Reports Server (NTRS)

Hoehn, Alexander; Gomez, Shawn; Luttges, Marvin W.

1992-01-01

The evolutionarily-developed Lunar Controlled Ecological Life Support System (CELSS) Test Module presented can address questions concerning long-term human presence-related issues both at LEO and in the lunar environment. By achieving well-defined research goals at each of numerous developmental stages (each economically modest), easily justifiable operations can be undertaken. Attention is given to the possibility of maximizing non-NASA involvement in these CELSS developmental efforts via the careful definability and modest risk of each developmental stage.

Reconsidering the "Good Divorce"

PubMed

Amato, Paul R; Kane, Jennifer B; James, Spencer

2011-12-01

This study attempted to assess the notion that a "good divorce" protects children from the potential negative consequences of marital dissolution. A cluster analysis of data on postdivorce parenting from 944 families resulted in three groups: cooperative coparenting, parallel parenting, and single parenting. Children in the cooperative coparenting (good divorce) cluster had the smallest number of behavior problems and the closest ties to their fathers. Nevertheless, children in this cluster did not score significantly better than other children on 10 additional outcomes. These findings provide only modest support for the good divorce hypothesis.

Reconsidering the “Good Divorce”

PubMed Central

Amato, Paul R.; Kane, Jennifer B.; James, Spencer

2011-01-01

This study attempted to assess the notion that a “good divorce” protects children from the potential negative consequences of marital dissolution. A cluster analysis of data on postdivorce parenting from 944 families resulted in three groups: cooperative coparenting, parallel parenting, and single parenting. Children in the cooperative coparenting (good divorce) cluster had the smallest number of behavior problems and the closest ties to their fathers. Nevertheless, children in this cluster did not score significantly better than other children on 10 additional outcomes. These findings provide only modest support for the good divorce hypothesis. PMID:22125355

Composition and analysis of a model waste for a CELSS (Controlled Ecological Life Support System)

NASA Technical Reports Server (NTRS)

Wydeven, T. J.

1983-01-01

A model waste based on a modest vegetarian diet is given, including composition and elemental analysis. Its use is recommended for evaluation of candidate waste treatment processes for a Controlled Ecological Life Support System (CELSS).

Relief, restoration and reform: economic upturn yields modest and uneven health returns.

PubMed

Hurley, Robert; Katz, Aaron; Felland, Laurie

2008-01-01

The sensitivity of state budgets to economic cycles contributes to fluctuations in health coverage, eligibility, benefits and provider payment levels in public programs, as well as support for safety net hospitals and community health centers (CHCs). The aftershocks of the 2001 recession on state budgets were felt well into 2004. More recently, the economic recovery allowed many states to restore cuts and, in some cases, expand health services for low-income people, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Along with bolstering support of safety net providers and raising Medicaid payments for private physicians, some states advanced even more ambitious health reform proposals. Yet across communities, safety net systems face mounting challenges of caring for more uninsured patients, and these pressures will likely increase given the current economic downturn.

A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa.

PubMed

Andersen, Lena S; Magidson, Jessica F; O'Cleirigh, Conall; Remmert, Jessica E; Kagee, Ashraf; Leaver, Matthew; Stein, Dan J; Safren, Steven A; Joska, John

2018-05-01

Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa ( n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.

Proceedings of the third biennial conference of research on the Colorado Plateau

USGS Publications Warehouse

Deshler, Elena T.; van Riper, Charles

1997-01-01

The papers in this volume are contributions from federal, state, and private sector researchers, who have come together to share scientific information with land managers on the Colorado Plateau. This Proceedings is the third in a series of publications that focuses on providing information to land managers on baseline scientific information pertaining to physical, cultural and biological resources of the Colorado Plateau. Support for these studies came from a spectrum of federal, state, and private partners concerned about the well-being of the Plateau's resources. I applaud the effort of the contributors. With modest funding and a broad base of public and institutional support, these authors have pursued important lines of work in the four states that comprise the Colorado Plateau biogeographic region.

Bidirectional Relationships Between Parenting Processes and Deviance in a Sample of Inner-City African American Youth

PubMed Central

Harris, Charlene; Vazsonyi, Alexander T.; Bolland, John M.

2016-01-01

The current study assessed for bidirectional relationships among supportive parenting (knowledge), negative parenting (permissiveness), and deviance in a sample (N = 5,325) of poor, inner-city African American youth from the Mobile Youth Survey (MYS) over 4 years. Cross-lagged path analysis provided evidence of significant bidirectional paths among parenting processes (knowledge and permissiveness) and deviance over time. Follow-up multigroup tests provided only modest evidence of dissimilar relationships by sex and by developmental periods. The findings improve our understanding of developmental changes between parenting behaviors and deviance during adolescence and extended current research of the bidirectionality of parent and child relationships among inner-city African American youth. PMID:28316460

Experimental and numeric investigation of Impella pumps as cavopulmonary assistance for a failing Fontan.

PubMed

Haggerty, Christopher M; Fynn-Thompson, Francis; McElhinney, Doff B; Valente, Anne Marie; Saikrishnan, Neelakantan; Del Nido, Pedro J; Yoganathan, Ajit P

2012-09-01

This study sought to evaluate the performance of microaxial ventricular assist devices for the purposes of supporting failing Fontan physiology by decreasing central venous pressure. Three Abiomed Impella pumps (Abiomed, Inc, Danvers, Mass) were evaluated in a mock circulatory system of the Fontan circuit. The local response of pressures and flows to pump function was assessed as a function of pump speed and pulmonary vascular resistance at a high baseline central venous pressure. For one device, subsequent modeling studies were conducted using a lumped parameter model of the single ventricle circuit. The left ventricular devices (Impella 2.5, 5.0) were shown to be suboptimal as single device solutions for cavopulmonary support. The small area of these devices relative to vessel diameter led to significant flow recirculation without an obstructive separator in place. Furthermore, downstream pressure augmentation adversely affected the pressure in the superior vena cava. The use of 2 devices would be mandatory for successful support. The right-sided device (Impella RP), whose outflow was positioned in the left pulmonary artery, demonstrated decreased flow recirculation and did not impede superior caval venous flow. Although static pressure is still required to drive flow through the opposite lung, numeric modeling demonstrated the potential for modest but significant improvements in lowering the central venous pressure (2-8 mm Hg). Left-sided microaxial pumps are not well suited for cavopulmonary support because of severe flow recirculation and the need for multiple devices. The right-ventricular Impella device provides improved performance by directing flow into the pulmonary artery, resulting in modest decreases in central venous pressure. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

The Role of the National Science Foundation in Graduate Education.

ERIC Educational Resources Information Center

Humphreys, Lloyd

The National Science Foundation has traditionally supported education in the sciences, engineering, and technology through traineeships, fellowships, grants and other awards. This year's budget will probably not allow any money for generalized traineeships, there will be a modest increase in research support, some money for fellowships and limited…

Advancing Understanding of Acculturation for Adolescents of Asian Immigrants: Person-Oriented Analysis of Acculturation Strategy Among Korean American Youth.

PubMed

Choi, Yoonsun; Tan, Kevin Poh Hiong; Yasui, Miwa; Hahm, Hyeouk Chris

2016-07-01

Acculturation strategy, a significant predictor of immigrant adaptation, has been under-studied with Asian Americans, in particular, Asian American youth. Using person-oriented latent profile analysis, this study identified acculturation strategies among Korean American early adolescents living in the Midwest. Two-hundred ninety-one families were interviewed in 2007 that included 220 youth (mean age 13, 47.7 % female), along with 272 mothers and 164 fathers (N = 656). They were re-interviewed in 2008 (N = 588). The study found three distinct acculturation strategies: separation (11.8 %, n = 26), integrated bicultural (66.9 %, n = 150), and modest bicultural (21.3 %, n = 44). Integrated bicultural youth reported the strongest sense of ethnic identity and the most favorable characteristics, providing empirical support for the benefit of biculturalism. The findings further suggest that separation may not be as detrimental as previously thought, and modest bicultural-biculturalism that is not fully developed-may in fact be less desirable among Korean American youth.

Trial Protocol: Randomised controlled trial of the effects of very low calorie diet, modest dietary restriction, and sequential behavioural programme on hunger, urges to smoke, abstinence and weight gain in overweight smokers stopping smoking

PubMed Central

2010-01-01

Background Weight gain accompanies smoking cessation, but dieting during quitting is controversial as hunger may increase urges to smoke. This is a feasibility trial for the investigation of a very low calorie diet (VLCD), individual modest energy restriction, and usual advice on hunger, ketosis, urges to smoke, abstinence and weight gain in overweight smokers trying to quit. Methods This is a 3 armed, unblinded, randomized controlled trial in overweight (BMI > 25 kg/m2), daily smokers (CO > 10 ppm); with at least 30 participants in each group. Each group receives identical behavioural support and NRT patches (25 mg(8 weeks),15 mg(2 weeks),10 mg(2 weeks)). The VLCD group receive a 429-559 kcal/day liquid formula beginning 1 week before quitting and continuing for 4 weeks afterwards. The modest energy restricted group (termed individual dietary and activity planning(IDAP)) engage in goal-setting and receive an energy prescription based on individual basal metabolic rate(BMR) aiming for daily reduction of 600 kcal. The control group receive usual dietary advice that accompanies smoking cessation i.e. avoiding feeling hungry but eating healthy snacks. After this, the VLCD participants receive IDAP to provide support for changing eating habits in the longer term; the IDAP group continues receiving this support. The control group receive IDAP 8 weeks after quitting. This allows us to compare IDAP following a successful quit attempt with dieting concurrently during quitting. It also aims to prevent attrition in the unblinded, control group by meeting their need for weight management. Follow-up occurs at 6 and 12 months. Outcome measures include participant acceptability, measured qualitatively by semi-structured interviewing and quantitatively by recruitment and attrition rates. Feasibility of running the trial within primary care is measured by interview and questionnaire of the treatment providers. Adherence to the VLCD is verified by the presence of urinary ketones measured weekly. Daily urges to smoke, hunger and withdrawal are measured using the Mood and Physical Symptoms Scale-Combined (MPSS-C) and a Hunger Craving Score (HCS). 24 hour, 7 day point prevalence and 4-week prolonged abstinence (Russell Standard) is confirmed by CO < 10 ppm. Weight, waist and hip circumference and percentage body fat are measured at each visit. Trial Registration Current controlled trials ISRCTN83865809 PMID:20929584

The impact and cost of the HIV/AIDS investment framework for adolescents.

PubMed

Stover, John; Rosen, Jim; Kasedde, Susan; Idele, Priscilla; McClure, Craig

2014-07-01

In 2005, the resources needed to support orphans and vulnerable children in sub-Saharan Africa were estimated at US$ 1.1-4.1 billion. Approaches to support vulnerable children have changed considerably since then. This study updates previous estimates by including new types of support and information on support costs. We considered 16 types of support categorized as economic strengthening, education support, social care and community outreach, and program support. The estimates combine the number of children in need of each intervention with unit costs derived from the literature and coverage goals based on current coverage and feasible future improvements. The number of children affected by AIDS in low- and middle-income countries varies from 58 million to 315 million depending on the definition of need. The resources required to provide support to children living in poor households will grow from US$ 4.2 billion in 2012 to US$ 5-8 billion by 2020. Almost two-thirds of these resources will be needed for Sub-Saharan Africa. The largest needs are for cash transfers, community care workers, early childhood development, block grants for education, M&E monitoring and evaluation, and direct material support. The results show that we can significantly improve the coverage of services for vulnerable children with only modest increases in resources. This results from stable or declining numbers of orphans and children living with HIV plus economic growth that is moving more households out of poverty. The results also reflect an important shift toward providing support to strengthen families and communities that care for children rather than direct material support. More resources are required to support children affected by AIDS, but new approaches to provide that support will be cost effective and have broad social and economic benefits.

Implementation of behavior change techniques in mobile applications for physical activity.

PubMed

Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

2015-04-01

Mobile applications (apps) for physical activity are popular and hold promise for promoting behavior change and reducing non-communicable disease risk. App marketing materials describe a limited number of behavior change techniques (BCTs), but apps may include unmarketed BCTs, which are important as well. To characterize the extent to which BCTs have been implemented in apps from a systematic user inspection of apps. Top-ranked physical activity apps (N=100) were identified in November 2013 and analyzed in 2014. BCTs were coded using a contemporary taxonomy following a user inspection of apps. Users identified an average of 6.6 BCTs per app and most BCTs in the taxonomy were not represented in any apps. The most common BCTs involved providing social support, information about others' approval, instructions on how to perform a behavior, demonstrations of the behavior, and feedback on the behavior. A latent class analysis of BCT configurations revealed that apps focused on providing support and feedback as well as support and education. Contemporary physical activity apps have implemented a limited number of BCTs and have favored BCTs with a modest evidence base over others with more established evidence of efficacy (e.g., social media integration for providing social support versus active self-monitoring by users). Social support is a ubiquitous feature of contemporary physical activity apps and differences between apps lie primarily in whether the limited BCTs provide education or feedback about physical activity. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Patient Participation in Research in the Managed Care Environment: Key Perceptions of Members in an HMO

PubMed Central

Purdy, Sarah; Finkelstein, Jonathan A; Fletcher, Robert; Christiansen, Cindy; Inui, Thomas S

2000-01-01

This study's objective was to elicit the views of research among enrollees in an HMO. A questionnaire was mailed to 207 adult enrollees, 55% had been exposed to research and 45% had not. Ninety-four percent of respondents supported research within the HMO, and 87% thought using information from medical records for research was acceptable. Sixty-three percent thought participation in research increased patient understanding of health care. Significantly more prior research participants thought that participation in research improves care. More patients would participate if written information were provided (67%), if feedback of results was provided (72%), and if their clinician invited them (67%). Only a modest percentage (20%) of patients would participate in a randomized trial. PMID:10940136

Handling PBIS with Care: Scaling up to School-Wide Implementation

ERIC Educational Resources Information Center

Cressey, James M.; Whitcomb, Sara A.; McGilvray-Rivet, Susan J.; Morrison, Rebecca J.; Shander-Reynolds, Katherine J.

2015-01-01

This case study describes the leadership of a school counselor in implementing positive behavioral interventions and supports (PBIS) in a low-income, diverse elementary school with a modest level of external supports. After initiating a grade-level pilot program, the school counselor partnered with university-based consultants to expand the PBIS…

Beyond the average marital communication: Latent profiles of the observed interactions among Chinese newlywed couples.

PubMed

Cao, Hongjian; Fang, Xiaoyi; Fine, Mark A; Ju, Xiaoyan; Lan, Jing; Liu, Xuanwen

2015-12-01

Employing a multicontext observational design, using a person-centered approach, and treating the marital dyad as the unit of analysis, this study examined the within-couple communication patterning of 144 Chinese newlywed couples and its association with relationship satisfaction. Latent profile analysis consistently revealed 3 profiles of spouses' interactive behaviors across contexts differing in both topic nature (i.e., problem-solving vs. social support) and initiator (i.e., husbands vs. wives): (a) traditionally undemonstrative profile, (b) emotionally quarrelling profile, and (c) warmly supportive profile. The prevalence of communication profiles changed markedly with the nature of the discussion topic and the topic initiator. Further, using latent class analysis, we classified couples into subgroups based on their identified profile memberships across contexts (i.e., consistency of interaction mode across contexts). Three classes were identified: (a) consistently quarrelling class, (b) consistently supportive class, and (c) modestly traditional class. Both the consistently supportive class and the modestly traditional class reported significantly higher levels of marital satisfaction than did the consistently quarrelling class. (c) 2015 APA, all rights reserved).

Using a higher criticism statistic to detect modest effects in a genome-wide study of rheumatoid arthritis

PubMed Central

2009-01-01

In high-dimensional studies such as genome-wide association studies, the correction for multiple testing in order to control total type I error results in decreased power to detect modest effects. We present a new analytical approach based on the higher criticism statistic that allows identification of the presence of modest effects. We apply our method to the genome-wide study of rheumatoid arthritis provided in the Genetic Analysis Workshop 16 Problem 1 data set. There is evidence for unknown bias in this study that could be explained by the presence of undetected modest effects. We compared the asymptotic and empirical thresholds for the higher criticism statistic. Using the asymptotic threshold we detected the presence of modest effects genome-wide. We also detected modest effects using 90th percentile of the empirical null distribution as a threshold; however, there is no such evidence when the 95th and 99th percentiles were used. While the higher criticism method suggests that there is some evidence for modest effects, interpreting individual single-nucleotide polymorphisms with significant higher criticism statistics is of undermined value. The goal of higher criticism is to alert the researcher that genetic effects remain to be discovered and to promote the use of more targeted and powerful studies to detect the remaining effects. PMID:20018032

Biodiversity can support a greener revolution in Africa

PubMed Central

Snapp, Sieglinde S.; Blackie, Malcolm J.; Gilbert, Robert A.; Bezner-Kerr, Rachel; Kanyama-Phiri, George Y.

2010-01-01

The Asian green revolution trebled grain yields through agrochemical intensification of monocultures. Associated environmental costs have subsequently emerged. A rapidly changing world necessitates sustainability principles be developed to reinvent these technologies and test them at scale. The need is particularly urgent in Africa, where ecosystems are degrading and crop yields have stagnated. An unprecedented opportunity to reverse this trend is unfolding in Malawi, where a 90% subsidy has ensured access to fertilization and improved maize seed, with substantive gains in productivity for millions of farmers. To test if economic and ecological sustainability could be improved, we preformed manipulative experimentation with crop diversity in a countrywide trial (n = 991) and at adaptive, local scales through a decade of participatory research (n = 146). Spatial and temporal treatments compared monoculture maize with legume-diversified maize that included annual and semiperennial (SP) growth habits in temporal and spatial combinations, including rotation, SP rotation, intercrop, and SP intercrop systems. Modest fertilizer intensification doubled grain yield compared with monoculture maize. Biodiversity improved ecosystem function further: SP rotation systems at half-fertilizer rates produced equivalent quantities of grain, on a more stable basis (yield variability reduced from 22% to 13%) compared with monoculture. Across sites, profitability and farmer preference matched: SP rotations provided twofold superior returns, whereas diversification of maize with annual legumes provided more modest returns. In this study, we provide evidence that in Africa, crop diversification can be effective at a countrywide scale, and that shrubby, grain legumes can enhance environmental and food security. PMID:21098285

Do the Effects of a Relationship Education Program Vary for Different Types of Couples? Exploratory Subgroup Analysis in the Supporting Healthy Marriage Evaluation. OPRE Report 2014-22

ERIC Educational Resources Information Center

Gubits, Daniel; Lowenstein, Amy E.; Harris, Jorgen; Hsueh, JoAnn

2014-01-01

The Supporting Healthy Marriage (SHM) evaluation was launched in 2003 to test the effectiveness of a skills-based relationship education program designed to help low-and modest-income married couples strengthen their relationships and to support more stable and more nurturing home environments and more positive outcomes for parents and their…

The relationship between societal change and rising support for gender egalitarianism among men and women: Results from counterfactual analyses in the Netherlands, 1979-2012.

PubMed

Thijs, Paula; Te Grotenhuis, Manfred; Scheepers, Peer

2017-11-01

This study examines the relationship between important social, cultural, economic, and demographic changes and the rise of support for gender egalitarianism within the Dutch population between 1979 and 2012. Cohort replacement, educational expansion, secularization, and the feminization of the labor force are important processes that have taken place in western societies in ways that may have fostered support for gender egalitarianism. Using unique data from 16 repeated cross-sectional surveys in the Netherlands, we estimate age-period-cohort regression models, and the outcomes are subsequently applied in counterfactual simulation designs. Our results show that the social, cultural, economic, and demographic changes explain only a small part of the modest rise in support for gender egalitarianism for men, while they provide a much better explanation of the stronger rise among women. Especially the replacement of older female cohorts by younger ones seems to have propelled support for gender egalitarianism among women throughout the years. Copyright © 2017 Elsevier Inc. All rights reserved.

Effective Supervision: Supporting the Art and Science of Teaching

ERIC Educational Resources Information Center

Marzano, Robert; Livingston, David; Frontier, Tony

2011-01-01

It's true that even modest improvements in teacher effectiveness can lead to impressive gains in student achievement. But what hasn't been clear is what exactly district leaders should do to encourage and support teachers in practicing the art and science of great teaching ... until now. Like in his landmark book "The Art and Science of Teaching",…

Implications of work and community demands and resources for work-to-family conflict and facilitation.

PubMed

Voydanoff, Patricia

2004-10-01

Based on a differential salience approach, this article examines the combined effects of work and community demands and resources on work-to-family conflict and facilitation. The study uses information from 2,507 employed respondents from the 1995 National Survey of Midlife Development in the United States. The findings indicate that work demands are relatively strongly related to work-to-family conflict, whereas work resources are relatively more important in relation to work-to-family facilitation. Social incoherence and friend demands are positively related to work-to-family conflict, whereas sense of community and support from friends have positive effects on facilitation. Community resources also show weak amplifying effects on some of the positive relationships between work resources and work-to-family facilitation. The findings provide modest support for the hypotheses.

Illusive Competition in School Reform: Commentary on Merrifield's "Imagined Evidence and False Imperatives" and Merrifield's Reply

ERIC Educational Resources Information Center

Berg, Nathan; Merrifield, John

2009-01-01

Merrifield (2009) provides a useful polemic about the sad state of data analysis too frequently encountered in the school choice literature. Available data come from limited policy experiments with only modest amounts of choice and competition. The effects of very modest changes in school choice on school performance are, as one might expect,…

The case and opportunity for public-supported financial incentives to implement integrated pest management.

PubMed

Brewer, Michael J; Hoard, Robert J; Landis, Joy N; Elworth, Lawrence E

2004-12-01

Food, water, and worker protection regulations have driven availability, and loss, of pesticides for use in pest management programs. In response, public-supported research and extension projects have targeted investigation and demonstration of reduced-risk integrated pest management (IPM) techniques. But these new techniques often result in higher financial burden to the grower, which is counter to the IPM principle that economic competitiveness is critical to have IPM adopted. As authorized by the 2002 Farm Bill and administered by the U.S. Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS), conservation programs exist for delivering public-supported financial incentives to growers to increase environmental stewardship on lands in production. NRCS conservation programs are described, and the case for providing financial incentives to growers for implementing IPM is presented. We also explored the opportunity and challenge to use one key program, the Environmental Quality Incentives Program (EQIP), to aid grower adoption of IPM. The EQIP fund distribution to growers from 1997 to 2002 during the last Farm Bill cycle totaled approximately 1.05 billion dollars with a portion of funds supporting an NRCS-designed pest management practice. The average percentage of allocation of EQIP funds to this pest management practice among states was 0.77 +/- 0.009% (mean +/- SD). Using Michigan as an example, vegetable and fruit grower recognition of the program's use to implement IPM was modest (25% of growers surveyed), and their recognition of its use in aiding implementation of IPM was improved after educational efforts (74%). Proposals designed to enhance program usefulness in implementing IPM were delivered through the NRCS advisory process in Michigan. Modifications for using the NRCS pest management practice to address resource concerns were adopted, incentive rates for pest management were adjusted, and an expanded incentive structure for IPM technique adoption was tabled for future consideration. The case is strong for using public-supported financial incentives offered by the EQIP to aid grower adoption of IPM as a means to address resource concerns, but current use of the EQIP for this purpose is modest to meager. With appropriate program adjustments and increased grower awareness, USDA NRCS conservation programs, and the EQIP in particular, may provide an important opportunity for growers to increase their use of IPM as a resource conservation and farm management tool.

Allogeneic mesenchymal precursor cells (MPCs): an innovative approach to treating advanced heart failure.

PubMed

Westerdahl, Daniel E; Chang, David H; Hamilton, Michele A; Nakamura, Mamoo; Henry, Timothy D

2016-09-01

Over 37 million people worldwide are living with Heart Failure (HF). Advancements in medical therapy have improved mortality primarily by slowing the progression of left ventricular dysfunction and debilitating symptoms. Ultimately, heart transplantation, durable mechanical circulatory support (MCS), or palliative care are the only options for patients with end-stage HF. Regenerative therapies offer an innovative approach, focused on reversing myocardial dysfunction and restoring healthy myocardial tissue. Initial clinical trials using autologous (self-donated) bone marrow mononuclear cells (BMMCs) demonstrated excellent safety, but only modest efficacy. Challenges with autologous stem cells include reduced quality and efficacy with increased patient age. The use of allogeneic mesenchymal precursor cells (MPCs) offers an "off the shelf" therapy, with consistent potency and less variability than autologous cells. Preclinical and initial clinical trials with allogeneic MPCs have been encouraging, providing the support for a large ongoing Phase III trial-DREAM-HF. We provide a comprehensive review of preclinical and clinical data supporting MPCs as a therapeutic option for HF patients. The current data suggest allogeneic MPCs are a promising therapy for HF patients. The results of DREAM-HF will determine whether allogeneic MPCs can decrease major adverse clinical events (MACE) in advanced HF patients.

Factors promoting and inhibiting sustained impact of a mental health task-shifting program for HIV providers in Ethiopia.

PubMed

Jerene, D; Biru, M; Teklu, A; Rehman, T; Ruff, A; Wissow, L

2017-01-01

Task-shifting mental health into general medical care requires more than brief provider training. Generalists need long-term support to master new skills and changes to work context are required to sustain change in the face of competing priorities. We examined program and context factors promoting sustainability of a mental health task-shifting training for hospital-based HIV providers in Ethiopia. Convergent mixed-methods quasi-experimental study. Sustained impact was measured by trained/not-trained provider differences in case detection and management 16 months following the end of formal support. Factors related to sustainability were examined through interviews with trained providers. Extent of sustained impact: Trained providers demonstrated modest but better agreement with standardized screeners (greater sensitivity with similar specificity). They were more likely to request that patients with mental health problems return to see them v. making a referral. Factors promoting sustainability (reported in semi-structured interviews): provider belief that the treatments they had learned were effective. New interactions with on-site mental health staff were a source of ongoing learning and encouragement. Factors diminishing sustainability: providers feelings of isolation when mental health partners left for work elsewhere, failure to incorporate mental health indicators into administrative data, to re-stock staff education materials, and to build formal mechanisms for generalist-mental health staff interaction. An intervention seen as feasible and effective, and promotion of relationships across professional lines, helped generalists sustain new skills. Failure to address key system context issues made use of the skills unsustainable as external supports ended.

Impact of ingestion of rice bran and shitake mushroom extract on lymphocyte function and cytokine production in healthy rats.

PubMed

Giese, Scott; Sabell, George Richard; Coussons-Read, Mary

2008-01-01

This article provides a controlled evaluation of the ability of dietary supplementation with a commercially available rice bran extract modified with shitake mushroom extract (MGN-3) to support the immune function by assessing the ability of immunocytes to proliferate and produce cytokines in response to a mitogenic challenge. Twenty-four male Lewis rats were fed a control diet (Maypo sweetened oatmeal) or Maypo containing the recommended daily dose of MGN-3 for 2 weeks. This treatment modestly enhanced mitogen enhanced proliferation of splenocytes and interferon-gamma (IFN-g) production, and significantly increased proliferation of splenocytes to the superantigen toxic shock syndrome toxin-1 (TSST-1) as well as natural killer (NK) cell activity and production of interleukin-2 (IL-2) by stimulated lymphocytes. These data support the contention that ingestion of MGN-3 can support immune cell function. These data add to a growing body of data showing that ingestion of MGN-3 improves the ability of immune cells to proliferate the lyse tumor cells, suggesting that it may have utility as a dietary aid to support the immune system.

Social Media and Obesity in Adults: a Review of Recent Research and Future Directions.

PubMed

Waring, Molly E; Jake-Schoffman, Danielle E; Holovatska, Marta M; Mejia, Claudia; Williams, Jamasia C; Pagoto, Sherry L

2018-04-18

Social media is widely used and has potential to connect adults with obesity with information and social support for weight loss and to deliver lifestyle interventions. The purpose of this review is to summarize recent observational and intervention research on social media and obesity. Online patient communities for weight loss abound but may include misinformation. Systematic reviews and meta-analyses suggest that social media-delivered lifestyle interventions modestly impact weight, yet how social media was used and participant engagement varies widely. The rapidly changing social media landscape poses challenges for patients, clinicians, and researchers. Research is needed on how patients can establish supportive communities for weight loss and the role of clinicians in these communities. Emerging research on meaningful engagement in, and the efficacy and cost-effectiveness of, social media-delivered lifestyle interventions should provide insights into how to leverage social media to address the obesity epidemic.

Emotional processing and outcome of imaginal flooding therapy in Vietnam veterans with chronic posttraumatic stress disorder.

PubMed

Pitman, R K; Orr, S P; Altman, B; Longpre, R E; Poiré, R E; Macklin, M L; Michaels, M J; Steketee, G S

1996-01-01

This study examined emotional processing and outcome in 20 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent imaginal flooding therapy. Results supported the occurrence of emotional processing, as manifest in significant activation, within-session habituation, and partial across-session habituation of physiologic and self-reported process variables. The flooding therapy produced only modest overall improvement, which was statistically significant for avoidance symptomatology measured by the impact of Events Scale (IOES) and number of intrusions per day recorded by the subject in a log. Symptomatic improvement appeared to generalize from a treated to an untreated experience. Heart rate activation during the first flooding session predicted a decrease in daily number of intrusive combat memories across the therapy. Otherwise, there was little association between extent of emotional processing and therapeutic outcome. The results provide limited support for the notion that mobilization of psychophysiologic arousal during exposure therapy predicts improvement.

Pulsed polarimetry progress on the LANL MSX magnetized shock experiment

NASA Astrophysics Data System (ADS)

Smith, R. J.; Intrator, T. P.; Weber, T. E.; Hutchinson, T. M.; Boguski, J. C.

2013-10-01

The UW pulsed polarimeter is a Lidar Thomson scattering diagnostic that can also provide measurements of the internal distribution of B| | as well as ne and Te for Magnetized High Energy Density targets with cm resolution. Scattering has now been observed in MSX and mirror issues that interrupted the last campaign have been corrected. Subsidiary diagnostics are being developed along side to aid in calibration. Fiber optic pulsed polarimetry is also being explored as both measurements can be performed simultaneously with the one instrument. The fiber sensing would allow measurements of modest fields using an internal cladded fiber. Progress in these directions will be presented. This work is supported by DOE Office of Fusion Energy Sciences.

Studies of benzamide- and thiol-based histone deacetylase inhibitors in models of oxidative-stress-induced neuronal death: identification of some HDAC3-selective inhibitors.

PubMed

Chen, Yufeng; He, Rong; Chen, Yihua; D'Annibale, Melissa A; Langley, Brett; Kozikowski, Alan P

2009-05-01

We compare three structurally different classes of histone deacetylase (HDAC) inhibitors that contain benzamide, hydroxamate, or thiol groups as the zinc binding group (ZBG) for their ability to protect cortical neurons in culture from cell death induced by oxidative stress. This study reveals that none of the benzamide-based HDAC inhibitors (HDACIs) provides any neuroprotection whatsoever, in distinct contrast to HDACIs that contain other ZBGs. Some of the sulfur-containing HDACIs, namely the thiols, thioesters, and disulfides present modest neuroprotective activity but show toxicity at higher concentrations. Taken together, these data demonstrate that the HDAC6-selective mercaptoacetamides that were reported previously provide the best protection in the homocysteic acid model of oxidative stress, thus further supporting their study in animal models of neurodegenerative diseases.

Retrofitting Las Vegas. Implementing Energy Efficiency in Two Las Vegas Test Homes

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

Puttagunta, S.

2013-04-01

In 2009, the state of Nevada received nearly $40 million in Neighborhood Stabilization Funds from the Department of Housing and Urban Development to use to stabilize communities that have suffered from foreclosures and abandonment. In order to provide guidance to local officials and maximize how effectively this NSP funding is used in retrofitting homes, the CARB team provided design specifications, energy modeling, and technical support for the BARA team and its local partners—Better Building Performance, Nevada Energy Star Partners Green Alliance, and Home Free Nevada—for two retrofit test homes. One home demonstrated a modest retrofit and the other a deepmore » energy retrofit. This report describes the retrofit packages, which were used as an educational experience for home performance professionals, building trades, remodelers, and the general public.« less

Assessing efficacy and therapeutic claims in emerging indications for recombinant factor VIIa: regulatory perspectives.

PubMed

Farrugia, Albert

2006-01-01

When compared with the evidence-based, cost-effectiveness criteria underpinning most government reimbursement schemes in the social market economies, the three regulatory hurdles of safety, quality and efficacy are probably of modest impact in influencing increased usage of recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark). Nevertheless, efficacy claims must be supported if regulatory approval is to be granted for the wider range of indications that have been proposed for rFVIIa. With the refinement of clinical trial designs over the past 40 years, the randomized controlled trial (RCT) has assumed the role of gold standard, providing the highest level of evidence for therapeutic efficacy. However, it is incorrect to assume that regulatory authorities give sole credence to RCTs in assessing claims. It is noteworthy that the indications already accepted for rFVIIa by international regulatory authorities--including the treatment of inhibitors to factor VIII and factor IX, substitution for FVII deficiency, and treatment of Glanzmann's thrombasthenia--were supported not by RCTs but by studies conventionally considered to provide modest evidence levels. Therefore, the use of studies other than RCTs for the more recently proposed indications for rFVIIa in a range of conditions requiring hemostatic correction is perfectly feasible. What regulators expect are well-conducted and well-described studies adhering to principles of good clinical practice, which can be scrutinized for evidence of clinical efficacy and which are based on the initially proven principle for the drug. This paper discusses the regulatory history of rFVIIa in the major regulatory authorities and assesses the route needed to support claims being made in the mainstream literature. Recent episodes where post-market events have forced regulators to be more than usually cautious will be used as examples to suggest possible pitfalls to the extension of approved claims for rFVIIa. The major paths for enhancing access for indications in small patient numbers, where RCTs are even more difficult to perform, will be described and their use for possible extension of rFVIIa indications will be discussed.

Religious participation is associated with increases in religious social support in a national longitudinal study of African Americans

PubMed Central

Le, Daisy; Holt, Cheryl L.; Hosack, Dominic P.; Huang, Jin; Clark, Eddie M.

2015-01-01

Objective This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. Design The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. Participants RHIAA participants were 3,173 African American men (1,281) and women (1,892). A total of 1,251 men (456) and women (795) participated in wave 2 of data collection. Results Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p<.001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p<.001), emotional support provided (p<.001), negative interaction (p<.001), and anticipated support (p<.001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. Conclusions African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people’s lives. PMID:26493343

Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans.

PubMed

Le, Daisy; Holt, Cheryl L; Hosack, Dominic P; Huang, Jin; Clark, Eddie M

2016-08-01

This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. RHIAA participants were 3173 African American men (1281) and women (1892). A total of 1251 men (456) and women (795) participated in wave 2 of data collection. Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p < .001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p < .001), emotional support provided (p < .001), negative interaction (p < .001), and anticipated support (p < .001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people's lives.

Endometrial cancer and a family history of cancer.

PubMed

Cook, Linda S; Nelson, Harold E; Stidley, Christine A; Dong, Yan; Round, Pamela J; Amankwah, Ernest K; Magliocco, Anthony M; Friedenreich, Christine M

2013-08-01

Lynch Syndrome (LS), an inherited genetic syndrome, predisposes to cancers such as colorectal and endometrial. However, the risk for endometrial cancer (EC) in women not affected by LS, but with a family history of cancer, is currently unknown. We examined the association between a family history of cancer and the risk for EC in non-LS patients. This population-based case-control study included 519 EC cases and 1015 age-matched controls and took place in Alberta, Canada between 2002 and 2006. Information about risk factors, including family history of cancer in first and second degree relatives, was ascertained via in-person interviews. Microsatellite instability (MSI) status of tumor tissue was assessed to determine involvement of DNA mismatch repair (MMR) genes. A first or second degree family history of uterine cancer was modestly associated with the risk for overall EC [odds ratio (OR), 1.3; 95% confidence interval (CI), 0.9, 1.9], and the risks were similar for MSI+cancer (OR=1.5, 95%CI=0.7, 3.3) and MSI- cancer (OR=1.3, 95%CI=0.8, 2.4). Although consistent, these associations were modest and not significant. In contrast, the risk for MSI+cancer was elevated with a reported family history of colorectal cancer (OR=1.4, 95%CI=1.0, 2.2), but not for MSI- cancer. A family history of uterine cancer may be modestly associated with EC risk in non-LS patients regardless of MSI status, suggesting that risk was not related to inherited defects in the MMR gene pathway. These results provide preliminary support for an EC-specific genetic syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

The utility of the NEO-PI-R validity scales to detect response distortion: a comparison with the MMPI-2.

PubMed

Morasco, Benjamin J; Gfeller, Jeffrey D; Elder, Katherine A

2007-06-01

In this psychometric study, we compared the recently developed Validity Scales from the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992b) with the MMPI-2 (Butcher, Dahstrom, Graham, Tellegen, & Kaemmer, 1989) Validity Scales. We collected data from clients (n = 74) who completed comprehensive psychological evaluations at a university-based outpatient mental health clinic. Correlations between the Validity Scales of the NEO-PI-R and MMPI-2 were significant and in the expected directions. The relationships provide support for convergent and discriminant validity of the NEO-PI-R Validity Scales. The percent agreement of invalid responding on the two measures was high, although the diagnostic agreement was modest (kappa = .22-.33). Finally, clients who responded in an invalid manner on the NEO-PI-R Validity Scales produced significantly different clinical profiles on the NEO-PI-R and MMPI-2 than clients with valid protocols. These results provide additional support for the clinical utility of the NEO-PI-R Validity Scales as indicators of response bias.

HIV Treatment Produces Economic Returns Through Increased Work And Education, And Warrants Continued US Support

PubMed Central

Thirumurthy, Harsha; Galárraga, Omar; Larson, Bruce; Rosen, Sydney

2013-01-01

Federal expenditures are under scrutiny in the United States, and the merits of continuing and expanding the President’s Emergency Plan for AIDS Relief (PEPFAR) to support access to antiretroviral therapy have become a topic of debate. A growing body of research on the economic benefits of treatment with antiretroviral therapy has important implications for these discussions. For example, research conducted since the inception of PEPFAR shows that HIV-infected adults who receive antiretroviral therapy often begin or resume productive work, and that children living in households with infected adults who are on treatment are more likely to attend school than those in households with untreated adults. These benefits should be considered when weighing the overall benefits of providing antiretroviral therapy against its costs, particularly in the context of discussions about the future of PEPFAR. A modest case can also be made in favor of having private companies in HIV-affected countries provide antiretroviral therapy to their employees and dependents, thus sharing some of the burden of funding HIV treatment. PMID:22778336

A Needs Assessment in Employee Services--Industrial Recreation.

ERIC Educational Resources Information Center

Whitlock, Michael; And Others

1980-01-01

Industrial recreation is becoming an important company support service. Budgets for recreation are modest compared to services offered and additional sources are needed. Employees take an active part in administration of programs. Competitive athletics, special social programs and local services are popular. (JAC)

Decision Tools for Transportation Infrastructure Reinvestment: User Guidelines for Microcomputer Decision Support System (DSS)

DOT National Transportation Integrated Search

1988-07-01

This report is intended to improve the quality of decisions about reinvestments, : and modest new investments, in highway transportation infrastructure. Decisions : of this type comprise the majority of planning actions taken in the field of : public...

Employment and educational outcomes in early intervention programmes for early psychosis: a systematic review.

PubMed

Bond, G R; Drake, R E; Luciano, A

2015-10-01

Young adults with early psychosis want to pursue normal roles - education and employment. This paper summarises the empirical literature on the effectiveness of early intervention programmes for employment and education outcomes. We conducted a systematic review of employment/education outcomes for early intervention programmes, distinguishing three programme types: (1) those providing supported employment, (2) those providing unspecified vocational services and (3) those without vocational services. We summarised findings for 28 studies. Eleven studies evaluated early intervention programmes providing supported employment. In eight studies that reported employment outcomes separately from education outcomes, the employment rate during follow-up for supported employment patients was 49%, compared with 29% for patients receiving usual services. The two groups did not differ on enrolment in education. In four controlled studies, meta-analysis showed that the employment rate for supported employment participants was significantly higher than for control participants, odds ratio = 3.66 [1.93-6.93], p < 0.0001. Five studies (four descriptive and one quasi-experimental) of early intervention programmes evaluating unspecified vocational services were inconclusive. Twelve studies of early intervention programmes without vocational services were methodologically heterogeneous, using diverse methods for evaluating vocational/educational outcomes and precluding a satisfactory meta-analytic synthesis. Among studies with comparison groups, 7 of 11 (64%) reported significant vocational/education outcomes favouring early intervention over usual services. In early intervention programmes, supported employment moderately increases employment rates but not rates of enrolment in education. These improvements are in addition to the modest effects early programmes alone have on vocational/educational outcomes compared with usual services.

Does Racial Isolation in School Lead to Long-Term Disadvantages? Labor Market Consequences of High School Racial Composition.

PubMed

Gamoran, Adam; Barfels, Sarah; Collares, Ana Cristina

2016-01-01

School racial composition has modest effects on test score gaps, but evidence of a longer-term impact is scarce. Perpetuation theory suggests that blacks who attend schools with higher proportions of white classmates may have better job outcomes. Multilevel analyses of two national longitudinal surveys reveal no effects of high school racial composition on occupational status, employment, or annual earnings for blacks or whites. For other minority groups, attending schools with more whites impedes occupational advancement. For all groups, however, school racial composition predicts workplace racial composition: Whites who attend high schools with higher proportions of white students have higher proportions of white coworkers, while nonwhites who attend schools with higher proportions of whites have fewer same-race coworkers. The findings are modest in size but robust to alternative specifications, and sensitivity analyses support a causal interpretation for same-race coworkers. These results support perpetuation theory for workplace composition but not for stratification outcomes.

Community health workers and medicaid managed care in New Mexico.

PubMed

Johnson, Diane; Saavedra, Patricia; Sun, Eugene; Stageman, Ann; Grovet, Dodie; Alfero, Charles; Maynes, Carmen; Skipper, Betty; Powell, Wayne; Kaufman, Arthur

2012-06-01

We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.

Teaching Physics Using Appropriate Technology Projects

ERIC Educational Resources Information Center

Pearce, Joshua M.

2007-01-01

Appropriate technologies able to be easily and economically constructed from readily available materials by local craftspeople have a central role in the alleviation of poverty in the developing world. However, research and development of these technologies are generally apportioned relatively modest support by the developed world's institutions,…

Ground state destabilization from a positioned general base in the ketosteroid isomerase active site.

PubMed

Ruben, Eliza A; Schwans, Jason P; Sonnett, Matthew; Natarajan, Aditya; Gonzalez, Ana; Tsai, Yingssu; Herschlag, Daniel

2013-02-12

We compared the binding affinities of ground state analogues for bacterial ketosteroid isomerase (KSI) with a wild-type anionic Asp general base and with uncharged Asn and Ala in the general base position to provide a measure of potential ground state destabilization that could arise from the close juxtaposition of the anionic Asp and hydrophobic steroid in the reaction's Michaelis complex. The analogue binding affinity increased ~1 order of magnitude for the Asp38Asn mutation and ~2 orders of magnitude for the Asp38Ala mutation, relative to the affinity with Asp38, for KSI from two sources. The increased level of binding suggests that the abutment of a charged general base and a hydrophobic steroid is modestly destabilizing, relative to a standard state in water, and that this destabilization is relieved in the transition state and intermediate in which the charge on the general base has been neutralized because of proton abstraction. Stronger binding also arose from mutation of Pro39, the residue adjacent to the Asp general base, consistent with an ability of the Asp general base to now reorient to avoid the destabilizing interaction. Consistent with this model, the Pro mutants reduced or eliminated the increased level of binding upon replacement of Asp38 with Asn or Ala. These results, supported by additional structural observations, suggest that ground state destabilization from the negatively charged Asp38 general base provides a modest contribution to KSI catalysis. They also provide a clear illustration of the well-recognized concept that enzymes evolve for catalytic function and not, in general, to maximize ground state binding. This ground state destabilization mechanism may be common to the many enzymes with anionic side chains that deprotonate carbon acids.

Private Philanthropy and Basic Research in Mid-Twentieth Century America: The Hickrill Chemical Research Foundation.

PubMed

Gortler, Leon; Weininger, Stephen J

2017-02-01

The Hickrill Chemical Research Foundation, located north of New York City on the estate of its patrons, Sylvan and Ruth Alice Norman Weil, had a short (1948-59) but productive life. Ruth Alice Weil received a Ph.D. in organic chemistry in 1947, directed by William von Eggers Doering of Columbia University. She intended that Hickrill contribute to cancer chemotherapy while providing resources for Doering's more speculative research. Ultimately, Doering's commitment to theoretical organic chemistry set Hickrill's research agenda. Lawrence Knox, an African American with a Harvard Ph.D., supervised the laboratory's daily activities. Hickrill's two dozen postdoctoral fellows produced path-breaking results in Hückel aromatic theory and reactive intermediate chemistry, fostering the postwar emphasis on "basic science." This essay places the Laboratory's successes in the wider context of postwar politics and scientific priorities. Private philanthropic support of basic science arose because it received little pre-World War II government support. In the immediate postwar period, modest organisations like Hickrill still met a need, but the increasing governmental defence- and non-defence-related support for science eventually rendered them unnecessary.

Systems and methods for the magnetic insulation of accelerator electrodes in electrostatic accelerators

DOEpatents

Grisham, Larry R

2013-12-17

The present invention provides systems and methods for the magnetic insulation of accelerator electrodes in electrostatic accelerators. Advantageously, the systems and methods of the present invention improve the practically obtainable performance of these electrostatic accelerators by addressing, among other things, voltage holding problems and conditioning issues. The problems and issues are addressed by flowing electric currents along these accelerator electrodes to produce magnetic fields that envelope the accelerator electrodes and their support structures, so as to prevent very low energy electrons from leaving the surfaces of the accelerator electrodes and subsequently picking up energy from the surrounding electric field. In various applications, this magnetic insulation must only produce modest gains in voltage holding capability to represent a significant achievement.

Method for adding nodes to a quantum key distribution system

DOEpatents

Grice, Warren P

2015-02-24

An improved quantum key distribution (QKD) system and method are provided. The system and method introduce new clients at intermediate points along a quantum channel, where any two clients can establish a secret key without the need for a secret meeting between the clients. The new clients perform operations on photons as they pass through nodes in the quantum channel, and participate in a non-secret protocol that is amended to include the new clients. The system and method significantly increase the number of clients that can be supported by a conventional QKD system, with only a modest increase in cost. The system and method are compatible with a variety of QKD schemes, including polarization, time-bin, continuous variable and entanglement QKD.

Implementation of Perioperative Music Using the Consolidated Framework for Implementation Research.

PubMed

Carter, Jessica E; Pyati, Srinivas; Kanach, Frances A; Maxwell, Ann Miller W; Belden, Charles M; Shea, Christopher M; Van de Ven, Thomas; Thompson, Jillian; Hoenig, Helen; Raghunathan, Karthik

2018-06-12

Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework for Implementation Research (CFIR) can help mitigate this translational problem. We reviewed evidence for several nonpharmacological treatments (CFIR domain: characteristics of interventions) and studied external context and organizational readiness for change by surveying providers at 11 Veterans Affairs (VA) hospitals (domains: outer and inner settings). We asked patients about their willingness to receive music and studied the association between this and known risk factors for opioid use (domain: characteristics of individuals). We implemented a protocol for the perioperative use of digital music players loaded with veteran-preferred playlists and evaluated its penetration in a subgroup of patients undergoing joint replacements over a 6-month period (domain: process of implementation). We then extracted data on postoperative recovery time and other outcomes, comparing them with historic and contemporary cohorts. Evidence varied from strong and direct for perioperative music and acupuncture, to modest or weak and indirect for mindfulness, yoga, and tai chi, respectively. Readiness for change surveys completed by 97 perioperative providers showed overall positive scores (mean >0 on a scale from -2 to +2, equivalent to >2.5 on the 5-point Likert scale). Readiness was higher at Durham (+0.47) versus most other VA hospitals (range +0.05 to +0.63). Of 3307 veterans asked about willingness to receive music, approximately 68% (n = 2252) answered "yes." In multivariable analyses, a positive response (acceptability) was independently predicted by younger age and higher mean preoperative pain scores (>4 out of 10 over 90 days before admission), factors associated with opioid overuse. Penetration was modest in the targeted subset (39 received music out of a possible 81 recipients), potentially reduced by device nonavailability due to diffusion into nontargeted populations. Postoperative recovery time was not changed, suggesting smooth integration into workflow. CFIR-guided implementation of perioperative music was feasible at a tertiary VA hospital, with moderate penetration in a high-risk subset of patients. Use of digital music players with preferred playlists was supported by strong evidence, tension for change, modest readiness among providers, good acceptability among patients (especially those at risk for opioid overuse), and a protocolized approach. Further study is needed to identify similar frameworks for effective knowledge-translation activities.

Leveraging a Modest Success for Curriculum Development

ERIC Educational Resources Information Center

Lyon, Kathy A.

2017-01-01

The primary goal of honors administrators is to deliver the highest quality honors education possible at their institutions; however, this has become more of a challenge since budgets at state-supported institutions have decreased dramatically over the last decade. Although this situation often appears to paint a gloomy picture, honors…

Don't Adopt; Adapt: A Reminder for Every Year.

ERIC Educational Resources Information Center

Davis, O. L., Jr.

1994-01-01

Urges educators to beware adopting new programs during the coming academic year. A better approach is to adapt worthy innovations without throwing out last year's innovations. The history of American educational practice supports this approach, emphasizing the value of familiar continuity sprinkled with modest and occasionally some significant…

An Efficacy Trial of Research-Based Curriculum Materials with Curriculum-Based Professional Development

ERIC Educational Resources Information Center

Taylor, Joseph A.; Getty, Stephen R.; Kowalski, Susan M.; Wilson, Christopher D.; Carlson, Janet; Van Scotter, Pamela

2015-01-01

This study examined the efficacy of a curriculum-based intervention for high school science students. Specifically, the intervention was two years of research-based, multidisciplinary curriculum materials for science supported by comprehensive professional development for teachers that focused on those materials. A modest positive effect was…

Student Happiness: An Update

ERIC Educational Resources Information Center

Huebner, Scott

2017-01-01

In 2010, Scott Huebner authored an article in "Communiqué" in which he suggested that happiness was a neglected but important topic in education in general and school psychology in particular (Huebner, 2010). At the time, there was a rapidly developing, but still rather modest body of evidence to support the contention. The purpose of…

Social capital and burnout among mental healthcare providers.

PubMed

Eliacin, Johanne; Flanagan, Mindy; Monroe-DeVita, Maria; Wasmuth, Sarah; Salyers, Michelle P; Rollins, Angela L

2018-01-06

Provider burnout is a critical problem in mental health services. Contributing factors have been explicated across three domains: personal, job and organizational characteristics. Of these, organizational characteristics, including workplace environment, appear to be particularly important given that most interventions addressing burnout via the other domains (e.g. bolstering personal coping skills) have been modestly effective at best. This study builds on previous research by using social capital as a framework for the experience of work social milieu, and aims to provide a richer understanding of how workplace social environment might impact burnout and help create more effective ways to reduce burnout. Providers (n = 40) taking part in a larger burnout intervention study were randomly selected to take part in interviews regarding their workplace environment and burnout. Participant responses were analyzed thematically. Workplace social milieu revolved around two primary themes: workplace social capital in provider burnout and the protective qualities of social capital in cohesive work teams that appear to mitigate burnout. These results imply that work environments where managers support collaboration and social interaction among work teams may reduce burnout.

NASA Photovoltaic Village Project in Arizona

NASA Image and Video Library

1978-11-21

National Aeronautics and Space Administration (NASA) Lewis Research Center. NASA signed an agreement with the Papago tribe in May 1978 to provide the village with solar-generated electricity within the year. The project was funded by the Department of Energy and managed by NASA Lewis. Lewis provided all of the equipment and technical assistance while the tribe’s construction team built the arrays and support equipment, seen here. The 3.5-kilowatt system was modest in scope, but resulted in the first solar electric village. The system provided power to operate a refrigerator, freezer, washing machine, and water pump for the village and lights in each of the 16 homes. The system was activated on December 16, 1978. During the next year officials from around the world travelled to Schuchuli to ascertain if the system was applicable to their areas. The major television networks and over 100 publications covered the story. Less than one percent of the cells failed during the first year of operation.

Medical students' subjective ratings of stress levels and awareness of student support services about mental health.

PubMed

Walter, Garry; Soh, Nerissa Li-Wey; Norgren Jaconelli, Sanna; Lampe, Lisa; Malhi, Gin S; Hunt, Glenn

2013-06-01

To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals.

Efficacy of web-based personalized normative feedback: a two-year randomized controlled trial.

PubMed

Neighbors, Clayton; Lewis, Melissa A; Atkins, David C; Jensen, Megan M; Walter, Theresa; Fossos, Nicole; Lee, Christine M; Larimer, Mary E

2010-12-01

Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = -0.16, 95% CI [-0.02, -0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = -0.29, 95% CI [-0.15, -0.58]). Few other effects were evident. The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies. (c) 2010 APA, all rights reserved.

A Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST)

NASA Astrophysics Data System (ADS)

Conti, Alberto; Arenberg, Jonathan; Baldauf, Brian

2017-01-01

The “Search for Life” (direct imaging of earth-like planets) will require extremely stable telescopes with apertures in the 10 m to 20 m range. Such apertures are larger than what can be delivered to space using current or planned future launch vehicles. Building and assembling large telescopes in space is therefore likely to require not only multiple launches but importantly assembly in spce. As a result, space-based telescopes with large apertures will require major changes to our conventional telescope design and architecture.Here we report on the concept for the Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST) to demonstrates the on-orbit robotic and/or astronaut assembly of an optical telescope in space. MODEST is a proposed International Space Station (ISS demonstration that will make use of the standard Express Logistics Carriers (ELCs) and can mounted to one of a variety of ISS pallets.MODEST will provides significant risk reduction for the next generation of space observatories, and demonstrates the technology needed to assemble a six-mirror phased telescope. Key modest features include the use of an active primary optical surface with wavefront feedback control to allow on-orbit optimization, and the precise surface control to meet optical system wavefront and stability requirements.MODEST will also be used to evaluate advances in lightweight mirror and metering structure materials such as SiC or Carbon Fiber Reinforced Polymer (CFRP) that have excellent mechanical and thermal properties, e.g. high stiffness, high modulus, high thermal conductivity, and low thermal expansion. Mirrors built from these materials can be rapidly replicated in a highly cost effective manner, making them an excellent candidate for a low cost, high performance Optical Telescope Assembly paving the way for enabling affordable solutions for the next generation of large aperture space-based telescope.MODEST post-assembly value includes space, ground, and environmental studies, a testbed for new instruments, and a tool for student’s exploration of space.

Influences of gender identity on children's maltreatment of gender-nonconforming peers: a person × target analysis of aggression.

PubMed

Pauletti, Rachel E; Cooper, Patrick J; Perry, David G

2014-05-01

We investigated whether gender identity influences preadolescents' tendency to single out gender-atypical peers for abuse. Data were gathered from 195 boys and girls (M age = 10.1 years) in the fall and spring of a school year. Children self-reported multiple dimensions of gender identity (intergroup bias, felt pressure for gender differentiation, felt gender typicality, gender contentedness); peers assessed each other's social behavior (gender nonconformity, aggression toward each classmate). Using multilevel modeling, we examined how children's attacks on gender-nonconforming peers (relative to their attacks on other peers) changed over the school year depending on their gender identity. There was modest support for the hypothesis that overconfident, arrogant gender identity promotes abuse of gender-atypical peers but considerable support for the hypothesis that insecure, self-questioning gender identity fosters this tendency. Implications for issues central to contemporary personality theory (e.g., Person × Situation interaction) are discussed. New and somewhat surprising information about the cognitive and behavioral characteristics of gender-nonconforming preadolescents is provided.

Easily configured real-time CPOE Pick Off Tool supporting focused clinical research and quality improvement.

PubMed

Rosenbaum, Benjamin P; Silkin, Nikolay; Miller, Randolph A

2014-01-01

Real-time alerting systems typically warn providers about abnormal laboratory results or medication interactions. For more complex tasks, institutions create site-wide 'data warehouses' to support quality audits and longitudinal research. Sophisticated systems like i2b2 or Stanford's STRIDE utilize data warehouses to identify cohorts for research and quality monitoring. However, substantial resources are required to install and maintain such systems. For more modest goals, an organization desiring merely to identify patients with 'isolation' orders, or to determine patients' eligibility for clinical trials, may adopt a simpler, limited approach based on processing the output of one clinical system, and not a data warehouse. We describe a limited, order-entry-based, real-time 'pick off' tool, utilizing public domain software (PHP, MySQL). Through a web interface the tool assists users in constructing complex order-related queries and auto-generates corresponding database queries that can be executed at recurring intervals. We describe successful application of the tool for research and quality monitoring.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

PubMed

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

The Character Strengths of Special Forces Personnel: Insights for Civilian Health Care Practitioners.

PubMed

Gayton, Scott D; Kehoe, E James

2016-09-01

Civilian employees, contractors, and private community clinicians are increasingly providing health treatment to currently serving and former military personnel. This study addresses recent calls for evidence-based information to assist civilian practitioners in understanding the perspectives of their military clients. To this end, the self-reported character strengths of military personnel were elicited as an operationalized expression of their underlying personal values that shape their perspectives and conduct as soldiers. Specifically, Australian Army Special Forces operators and support personnel (N = 337) were asked to rank themselves on 24 character strengths. The three character strengths of integrity, teamworker, and good judgment were ranked significantly above random assignment. Nearly all the respondents (84%) gave a top rank to at least one of these character strengths. Differences between the operators and support personnel were modest. Results are discussed with respect to establishing an effective relationship between military clients and civilian health care practitioners. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Mobile Technologies and Geographic Information Systems to Improve Health Care Systems: A Literature Review

PubMed Central

2014-01-01

Background A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation. Objective The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care. Methods The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review. Results A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These applications generally have modest benefits and may be appropriate for implementation. Integration of health data using GIS technology also exhibit modest benefits such as improved understanding of the interplay of psychological, social, environmental, area-level, and sociodemographic influences on physical activity. The studies evaluated showed promising results in helping patients treating different illnesses and managing their condition effectively. However, most studies use small sample sizes and short intervention periods, which means limited clinical or statistical significance. Conclusions A vast majority of the papers report positive results, including retention rate, benefits for patients, and economic gains for the health care provider. However, implementation issues are little discussed, which means the reasons for the scarcity of large-scale implementations, which might be expected given the overwhelmingly positive results, are yet unclear. There is also little combination between GIS and mobile technologies. In order for health care processes to be effective they must integrate different kinds of existing technologies and data. Further research and development is necessary to provide integration and better understand implementation issues. PMID:25099368

Mobile technologies and geographic information systems to improve health care systems: a literature review.

PubMed

Nhavoto, José António; Grönlund, Ake

2014-05-08

A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation. The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care. The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review. A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These applications generally have modest benefits and may be appropriate for implementation. Integration of health data using GIS technology also exhibit modest benefits such as improved understanding of the interplay of psychological, social, environmental, area-level, and sociodemographic influences on physical activity. The studies evaluated showed promising results in helping patients treating different illnesses and managing their condition effectively. However, most studies use small sample sizes and short intervention periods, which means limited clinical or statistical significance. A vast majority of the papers report positive results, including retention rate, benefits for patients, and economic gains for the health care provider. However, implementation issues are little discussed, which means the reasons for the scarcity of large-scale implementations, which might be expected given the overwhelmingly positive results, are yet unclear. There is also little combination between GIS and mobile technologies. In order for health care processes to be effective they must integrate different kinds of existing technologies and data. Further research and development is necessary to provide integration and better understand implementation issues.

Associated and Mediating Variables Related to Job Satisfaction among Professionals from Mental Health Teams.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François

2018-06-01

Using a structural analysis, this study examines the relationship between job satisfaction among 315 mental health professionals from the province of Quebec (Canada) and a wide range of variables related to provider characteristics, team characteristics, processes, and emergent states, and organizational culture. We used the Job Satisfaction Survey to assess job satisfaction. Our conceptual framework integrated numerous independent variables adapted from the input-mediator-output-input (IMOI) model and the Integrated Team Effectiveness Model (ITEM). The structural equation model predicted 47% of the variance of job satisfaction. Job satisfaction was associated with eight variables: strong team support, participation in the decision-making process, closer collaboration, fewer conflicts among team members, modest knowledge production (team processes), firm affective commitment, multifocal identification (emergent states) and belonging to the nursing profession (provider characteristics). Team climate had an impact on six job satisfaction variables (team support, knowledge production, conflicts, affective commitment, collaboration, and multifocal identification). Results show that team processes and emergent states were mediators between job satisfaction and team climate. To increase job satisfaction among professionals, health managers need to pursue strategies that foster a positive climate within mental health teams.

Risk of nursing home admission among older americans: does states' spending on home- and community-based services matter?

PubMed

Muramatsu, Naoko; Yin, Hongjun; Campbell, Richard T; Hoyem, Ruby L; Jacob, Martha A; Ross, Christopher O

2007-05-01

States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states' generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects. We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier. State HCBS effects were conditional on child availability among older Americans. Living in a state with higher HCBS expenditures was associated with lower risk of nursing home admission among childless seniors (p <.001). However, the association was not statistically significant among seniors with living children. Doubling state HCBS expenditures per person aged 65 or older would reduce the risk of nursing home admission among childless seniors by 35%. Results provided modest but important evidence supportive of increasing state investment in HCBS. Within-state allocation of HCBS resources, however, requires further research and careful consideration about fairness for individual seniors and their families as well as cost effectiveness.

Bullying Interventions: A Binocular Perspective

PubMed Central

Pepler, Debra J.

2006-01-01

Introduction Bullying is a complex relationship problem associated with many psychosocial difficulties for children who bully, as well as those who are victimized. A recent international volume of school-based bullying programs revealed modest effectiveness, highlighting the need to refine interventions using research on developmental profiles of children who bully and those who are victimized, as well as on their relationships. Method Based on developmental-systemic theory, a research review was conducted on individual and relationship risk factors associated with bullying and being victimized. Results The review led to the proposal of two organizing principles for interventions: Scaffolding and Social Architecture. Scaffolding focuses on providing tailored and dynamic supports for the needs of individual children who bully or who are victimized. Social architecture requires that adults focus on the social dynamics of children’s groups and create social contexts that promote positive peer interactions and dissipate contexts that foster negative interactions. Conclusion Interventions for bullying require a combination of scaffolding and social architecture to provide comprehensive supports and to change the social dynamics that enable bullying. With an empirically derived, comprehensive perspective, we may move closer to reducing the burden of these relationship problems in the lives of children and youth. PMID:18392191

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

PubMed

Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

Valeria Fike: College of DuPage Library, Glen Ellyn, IL

ERIC Educational Resources Information Center

Berry, John N., III

2006-01-01

In this article, the author profiles Valeria Fike, supervisor of reference support and College and Career Information Center services at the College of DuPage Library (CODL), Glen Ellyn, Illinois. Valeria Fike, who supervises some 21 paraprofessionals at CODL, modestly attributes her successful career there to her being "simply in the right…

Collaborative Learning Supported by Rubrics Improves Critical Thinking

ERIC Educational Resources Information Center

Saiz, Carlos; Rivas, Silvia F.; Olivares, Sonia

2015-01-01

In previous works we developed and assessed a teaching program, ARDESOS v.1, with which we aimed to improve the fundamental skills of critical thinking. The results obtained were positive, but modest. After analyzing the limitations of the program we introduced certain modifications and assessed the new version. The changes involved designing the…

Bullying and Stress in Early Adolescence: The Role of Coping and Social Support

ERIC Educational Resources Information Center

Konishi, Chiaki; Hymel, Shelley

2009-01-01

Prior research from Norway and Japan has demonstrated positive relationships between stress and bullying--The more stress students experience, the more they engage in bullying. The modest correlations, however, suggest that other variables may moderate the stress-bullying link, serving as protective factors that make such negative responses to…

Unlocking Potential: How Political Skill Can Maximize Superintendent Effectiveness

ERIC Educational Resources Information Center

Hill, Paul; Jochim, Ashley

2018-01-01

Local superintendents must do an important job while equipped with, at best, modest authority. Superintendents are ultimately responsible for all the schools in their district, and they at least nominally supervise everything that happens in those schools. Yet superintendents cannot count on obedience or even support from the people who work for…

Self-Efficacy in Freshman and Sophomore Nursing Students

ERIC Educational Resources Information Center

Chatman, Mary B.

2012-01-01

Healthcare disparities and inequities have been at the forefront of the health agenda, thus supporting that minority healthcare is of poorer quality than that experienced by the majority population. Compounding this issue is the fact that our nation is growing more diverse. Only modest strides have been made to increase the diversity in the…

The DELTA PREP Initiative" Accelerating Coalition Capacity for Intimate Partner Violence Prevention

ERIC Educational Resources Information Center

Zakocs, Ronda; Freire, Kimberley E.

2015-01-01

Background: The DELTA PREP Project aimed to build the prevention capacity of 19 state domestic violence coalitions by offering eight supports designed to promote prevention integration over a 3-year period: modest grant awards, training events, technical assistance, action planning, coaching hubs, the Coalition Prevention Capacity Assessment, an…

The Impact of Single-Container Malt Liquor Sales Restrictions on Urban Crime.

PubMed

McKee, Patricia; Erickson, Darin J; Toomey, Traci; Nelson, Toben; Less, Elyse Levine; Joshi, Spruha; Jones-Webb, Rhonda

2017-04-01

Many US cities have adopted legal restrictions on high-alcohol malt liquor sales in response to reports of crime and nuisance behaviors around retail alcohol outlets. We assessed whether these policies are effective in reducing crime in urban areas. We used a rigorous interrupted time-series design with comparison groups to examine monthly crime rates in areas surrounding alcohol outlets in the 3 years before and after adoption of malt liquor sales restrictions in two US cities. Crime rates in matched comparison areas not subject to restrictions served as covariates. Novel methods for matching target and comparison areas using virtual neighborhood audits conducted in Google Street View are described. In Minneapolis, Minnesota, sales of single containers of 16 oz or less were prohibited in individual liquor stores (n = 6). In Washington, D.C., the sale of single containers of any size were prohibited in all retail alcohol outlets within full or partial wards (n = 6). Policy adoption was associated with modest reductions in crime, particularly assaults and vandalism, in both cities. All significant outcomes were in the hypothesized direction. Our results provide evidence that retail malt liquor sales restrictions, even relatively weak ones, can have modest effects on a range of crimes. Policy success may depend on community support and concurrent restrictions on malt liquor substitutes.

Multilevel models of fertility determination in four Southeast Asian countries: 1970 and 1980.

PubMed

Hirschman, C; Guest, P

1990-08-01

Using microdata from the 1970 and 1980 censuses, we specify and test multilevel models of fertility determination for four Southeast Asian societies--Indonesia, Peninsular Malaysia, the Philippines, and Thailand. Social context is indexed by provincial characteristics representing women's status, the roles of children, and infant mortality. These contextual variables are hypothesized to have direct and indirect (through individual socioeconomic characteristics) effects on current fertility. The contextual variables account for a modest but significant share of individual variation in fertility and about one-half of the total between area variation in fertility. The women's status contextual variables, particularly modern sector employment, have the largest and most consistent effect on lowered fertility. The results based on the other contextual variables provide mixed support for the initial hypotheses.

Hydration of Kr(aq) in dilute and concentrated solutions

DOE PAGES

Chaudhari, Mangesh I.; Sabo, Dubravko; Pratt, Lawrence R.; ...

2014-10-13

Molecular dynamics simulations of water with both multi-Kr and single Kr atomic solutes are carried out to implement quasi-chemical theory evaluation of the hydration free energy of Kr(aq). This approach obtains free energy differences reflecting Kr–Kr interactions at higher concentrations. Those differences are negative changes in hydration free energies with increasing concentrations at constant pressure. The changes are due to a slight reduction of packing contributions in the higher concentration case. The observed Kr–Kr distributions, analyzed with the extrapolation procedure of Krüger et al., yield a modestly attractive osmotic second virial coefficient, B2 ≈ -60 cm 3/mol. Moreover, the thermodynamicmore » analysis interconnecting these two approaches shows that they are closely consistent with each other, providing support for both approaches.« less

The effect of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature.

PubMed Central

Mumford, E; Schlesinger, H J; Glass, G V

1982-01-01

A quantitative review of 34 controlled studies demonstrates that, on the average, surgical or coronary patients who are provided information or emotional support to help them master the medical crisis do better than patients who receive only ordinary care. A review of 13 studies that used hospital days post-surgery or post-heart attack as outcome indicators showed that on the average psychological intervention reduced hospitalization approximately two days below the control group's average of 9.92 days. Most of the interventions were modest and, in most studies, were not matched in any way to the needs of particular patients or their coping styles. Beyond the intrinsic value of offering humane and considerate care, the evidence is that psychological care can be cost-effective. PMID:7055315

Modest Amounts of Voluntary Exercise Reduce Pain- and Stress-Related Outcomes in a Rat Model of Persistent Hind Limb Inflammation.

PubMed

Pitcher, Mark H; Tarum, Farid; Rauf, Imran Z; Low, Lucie A; Bushnell, Catherine

2017-06-01

Aerobic exercise improves outcomes in a variety of chronic health conditions, yet the support for exercise-induced effects on chronic pain in humans is mixed. Although many rodent studies have examined the effects of exercise on persistent hypersensitivity, the most used forced exercise paradigms that are known to be highly stressful. Because stress can also produce analgesic effects, we studied how voluntary exercise, known to reduce stress in healthy subjects, alters hypersensitivity, stress, and swelling in a rat model of persistent hind paw inflammation. Our data indicate that voluntary exercise rapidly and effectively reduces hypersensitivity as well as stress-related outcomes without altering swelling. Moreover, the level of exercise is unrelated to the analgesic and stress-reducing effects, suggesting that even modest amounts of exercise may impart significant benefit in persistent inflammatory pain states. Modest levels of voluntary exercise reduce pain- and stress-related outcomes in a rat model of persistent inflammatory pain, independently of the amount of exercise. As such, consistent, self-regulated activity levels may be more relevant to health improvement in persistent pain states than standardized exercise goals. Published by Elsevier Inc.

PLCs on Steroids: Moving Teacher Practice to the Center of Data Teams

ERIC Educational Resources Information Center

Wasta, Michael J.

2017-01-01

Research on educators' professional learning communities (PLCs) suggest that while they often help teachers to make sense of student performance data, they tend to spend relatively little time studying what teachers actually do in the classroom. Evidence suggests that, given modest amounts of guidance and support, PLCs can collect useful data on…

Sex and Locus of Control as Determinants of Children's Responses to Peer versus Adult Praise.

ERIC Educational Resources Information Center

Henry, Susan E.; And Others

1979-01-01

Black first graders varying in internal-external control completed digit substitution problems during which performance was praised by a Black boy and girl or a Black man and woman. Boys were most responsive to peer feedback and girls to adult feedback. Predictions involving locus of control were modestly supported. (Author/RD)

A Head Start for Poor Children? Backgrounder. No. 1755

ERIC Educational Resources Information Center

Kafer, Krista

2004-01-01

As the 39-year-old federal Head Start program once again comes before Congress for reauthorization, several unanswered questions that have dogged the program since its inception should be considered: (1) Does it work? (2) Does it make any difference in the long run? and (3) Will modest changes supported by the Bush Administration gain traction?…

No Child Left Unchallenged

ERIC Educational Resources Information Center

Beigie, Darin

2011-01-01

Providing student choice and opportunities for independent study are recognized as viable differentiation techniques. Daily homework sets that contain more demanding problems even though not required allow the teacher to provide challenge without incurring undue stress. The modest incentive of some homework bonus points is enough to whet the…

The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis

PubMed Central

Free, Caroline; Phillips, Gemma; Watson, Louise; Galli, Leandro; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy

2013-01-01

Background Mobile health interventions could have beneficial effects on health care delivery processes. We aimed to conduct a systematic review of controlled trials of mobile technology interventions to improve health care delivery processes. Methods and Findings We searched for all controlled trials of mobile technology based health interventions using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990–Sept 2010). Two authors independently extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and we used random effects meta-analysis to give pooled estimates. We identified 42 trials. None of the trials had low risk of bias. Seven trials of health care provider support reported 25 outcomes regarding appropriate disease management, of which 11 showed statistically significant benefits. One trial reported a statistically significant improvement in nurse/surgeon communication using mobile phones. Two trials reported statistically significant reductions in correct diagnoses using mobile technology photos compared to gold standard. The pooled effect on appointment attendance using text message (short message service or SMS) reminders versus no reminder was increased, with a relative risk (RR) of 1.06 (95% CI 1.05–1.07, I 2 = 6%). The pooled effects on the number of cancelled appointments was not significantly increased RR 1.08 (95% CI 0.89–1.30). There was no difference in attendance using SMS reminders versus other reminders (RR 0.98, 95% CI 0.94–1.02, respectively). To address the limitation of the older search, we also reviewed more recent literature. Conclusions The results for health care provider support interventions on diagnosis and management outcomes are generally consistent with modest benefits. Trials using mobile technology-based photos reported reductions in correct diagnoses when compared to the gold standard. SMS appointment reminders have modest benefits and may be appropriate for implementation. High quality trials measuring clinical outcomes are needed. Please see later in the article for the Editors' Summary PMID:23458994

The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis.

PubMed

Free, Caroline; Phillips, Gemma; Watson, Louise; Galli, Leandro; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy

2013-01-01

Mobile health interventions could have beneficial effects on health care delivery processes. We aimed to conduct a systematic review of controlled trials of mobile technology interventions to improve health care delivery processes. We searched for all controlled trials of mobile technology based health interventions using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors independently extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and we used random effects meta-analysis to give pooled estimates. We identified 42 trials. None of the trials had low risk of bias. Seven trials of health care provider support reported 25 outcomes regarding appropriate disease management, of which 11 showed statistically significant benefits. One trial reported a statistically significant improvement in nurse/surgeon communication using mobile phones. Two trials reported statistically significant reductions in correct diagnoses using mobile technology photos compared to gold standard. The pooled effect on appointment attendance using text message (short message service or SMS) reminders versus no reminder was increased, with a relative risk (RR) of 1.06 (95% CI 1.05-1.07, I(2) = 6%). The pooled effects on the number of cancelled appointments was not significantly increased RR 1.08 (95% CI 0.89-1.30). There was no difference in attendance using SMS reminders versus other reminders (RR 0.98, 95% CI 0.94-1.02, respectively). To address the limitation of the older search, we also reviewed more recent literature. The results for health care provider support interventions on diagnosis and management outcomes are generally consistent with modest benefits. Trials using mobile technology-based photos reported reductions in correct diagnoses when compared to the gold standard. SMS appointment reminders have modest benefits and may be appropriate for implementation. High quality trials measuring clinical outcomes are needed. Please see later in the article for the Editors' Summary.

Hypothyroidism and obesity: An intriguing link.

PubMed

Sanyal, Debmalya; Raychaudhuri, Moutusi

2016-01-01

According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH) could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity. High leptin levels may play a role in the hyperthyrotropinemia of obesity and also increase susceptibility to thyroid autoimmunity and subsequent hypothyroidism. There is at most a modest effect of L-T4 treatment in overt hypothyroidism in inducing weight loss; benefit in subclinical hypothyroidism is not established with no data supporting thyroid hormone use in euthyroid obese patients.

The IUE Science Operations Ground System

NASA Technical Reports Server (NTRS)

Pitts, Ronald E.; Arquilla, Richard

1994-01-01

The International Ultraviolet Explorer (IUE) Science Operations System provides full realtime operations capabilities and support to the operations staff and astronomer users. The components of this very diverse and extremely flexible hardware and software system have played a major role in maintaining the scientific efficiency and productivity of the IUE. The software provides the staff and user with all the tools necessary for pre-visit and real-time planning and operations analysis for any day of the year. Examples of such tools include the effects of spacecraft constraints on target availability, maneuver times between targets, availability of guide stars, target identification, coordinate transforms, e-mail transfer of Observatory forms and messages, and quick-look analysis of image data. Most of this extensive software package can also be accessed remotely by individual users for information, scheduling of shifts, pre-visit planning, and actual observing program execution. Astronomers, with a modest investment in hardware and software, may establish remote observing sites. We currently have over 20 such sites in our remote observers' network.

Valence and arousal-based affective evaluations of foods.

PubMed

Woodward, Halley E; Treat, Teresa A; Cameron, C Daryl; Yegorova, Vitaliya

2017-01-01

We investigated the nutrient-specific and individual-specific validity of dual-process models of valenced and arousal-based affective evaluations of foods across the disordered eating spectrum. 283 undergraduate women provided implicit and explicit valence and arousal-based evaluations of 120 food photos with known nutritional information on structurally similar indirect and direct affect misattribution procedures (AMP; Payne et al., 2005, 2008), and completed questionnaires assessing body mass index (BMI), hunger, restriction, and binge eating. Nomothetically, added fat and added sugar enhance evaluations of foods. Idiographically, hunger and binge eating enhance activation, whereas BMI and restriction enhance pleasantness. Added fat is salient for women who are heavier, hungrier, or who restrict; added sugar is influential for less hungry women. Restriction relates only to valence, whereas binge eating relates only to arousal. Findings are similar across implicit and explicit affective evaluations, albeit stronger for explicit, providing modest support for dual-process models of affective evaluation of foods. Copyright © 2016 Elsevier Ltd. All rights reserved.

A company-instituted program to improve blood pressure control in primary care.

PubMed

Alderman, M H; Melcher, L A

1981-01-01

An occupation-based effort to improve the outcome of antihypertensive therapy provided in the community was instituted by the Massachusetts Mutual Life Insurance Company in 1977. The goal of the program was to utilize the administrative and organizational resources of the company to enhance employee/patient adherence to treatment provided in conventional primary care settings. Key elements of the program were: companywide education and on-site screening, referral to community physicians and company assumption of all patient costs, linked to a monitoring system to permit oversight of care. Initially, 98% of employees were screened, 70% accepted referral for care and 59% fully adhered to program performance criteria. Blood pressure control has risen from 36% at the beginning to 69% at the end of the second year. Fully compliant patients have achieved the greatest lowering of blood pressure and compiled the best work attendance record. Program costs are modest and acceptance by employees and physicians supports the concept that occupation-based, systematic efforts can enhance the impact of primary care.

An Optical Frequency Comb Tied to GPS for Laser Frequency/Wavelength Calibration

PubMed Central

Stone, Jack A.; Egan, Patrick

2010-01-01

Optical frequency combs can be employed over a broad spectral range to calibrate laser frequency or vacuum wavelength. This article describes procedures and techniques utilized in the Precision Engineering Division of NIST (National Institute of Standards and Technology) for comb-based calibration of laser wavelength, including a discussion of ancillary measurements such as determining the mode order. The underlying purpose of these calibrations is to provide traceable standards in support of length measurement. The relative uncertainty needed to fulfill this goal is typically 10−8 and never below 10−12, very modest requirements compared to the capabilities of comb-based frequency metrology. In this accuracy range the Global Positioning System (GPS) serves as an excellent frequency reference that can provide the traceable underpinning of the measurement. This article describes techniques that can be used to completely characterize measurement errors in a GPS-based comb system and thus achieve full confidence in measurement results. PMID:27134794

A Comprehensive Climate Science and Solutions Education Curriculum

NASA Astrophysics Data System (ADS)

Byrne, J. M.; Cook, J.; Little, L. J.; Peacock, K.; Sinclair, P.; Zeller, C.

2016-12-01

We are creating a broadly based curriculum for a multidisciplinary University/College course on climate change science and solutions. Climate change is a critical topic for all members of society and certainly for all students in postsecondary education. The curriculum will feature a wide range of topic presentations on the (i) science of climate change; and (ii) multidisciplinary solutions to climate change challenges. The end result will be an online textbook featuring short contributions from session participants and other invited specialists. First authors in this AGU Education Session will provide a 20-minute comprehensive lecture that will be recorded and shared as part of the online textbook. The recorded talks will be merged with author provided PowerPoint slides and appropriate high definition video footage to support the discussion, where possible. Authors will be asked to sign a waiver allowing the video recording to be part of the online textbook. Access to the videos and textbook chapters will be provided online to students registered in recognized university classes on climate change science and solutions for a modest fee.

Developmental Trends in the Dance Performance of Children Age Six to Nine

ERIC Educational Resources Information Center

Little, Stephanie Lane

2011-01-01

Quality elementary physical education programs recognize the changing development and movement abilities of children (NASPE, 2007). Educational dance within these programs provides opportunities to engage in developmentally appropriate rhythmic activities. Research to date provides modest information for physical educators regarding what rhythmic…

Volume guarantee ventilation during surgical closure of patent ductus arteriosus.

PubMed

Keszler, Martin; Abubakar, Kabir

2015-01-01

Surgical closure of patent ductus arteriosus (PDA) is associated with adverse outcomes. Surgical exposure requires retraction of the lung, resulting in decreased aeration and compliance. Optimal respiratory support for PDA surgery is unknown. Experience with volume guarantee (VG) ventilation at our institution led us to hypothesize that surgery would be better tolerated with automatic adjustment of pressure by VG to maintain tidal volume (VT) during retraction. The objective of this study was to describe ventilator support, VT, and oxygenation of infants supported with VG during PDA surgery. Ventilator variables, oxygen saturation, and heart rate were recorded during PDA surgery in a convenience sample of infants during PDA closure on VG. Pressure limit increased 11% and set VT was 26% lower during lung retraction. Fentanyl and pancuronium/vecuronium were used for anesthesia/muscle relaxation. Longitudinal data were analyzed by analysis of variance for repeated measures. Seven infants, 25.4 ± 1.5 weeks and 723 ± 141 g, underwent closure of PDA on VG at a mean age 29.9 days. No air leak, bradycardia, or death occurred. Target VT was maintained with a modest increase in inflation pressure. Oxygenation remained adequate. VG avoided hypoxemia and maintained adequate VT with only a modest increase in peak inflation pressure and thus may be a useful mode during PDA surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

PubMed

Subramanian, Sujha; Hoover, Sonja; Wagner, Joann L; Donovan, Jennifer L; Kanaan, Abir O; Rochon, Paula A; Gurwitz, Jerry H; Field, Terry S

2012-01-01

In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.

Analysis and design of a 10 to 30 kW grid-connected solar power system for the JPL fire station and first aid station

NASA Technical Reports Server (NTRS)

Josephs, R. H.

1982-01-01

The design and performance of a modestly sized utility-connected power conditioning system and its supporting photovoltaic collector are described and estimated. Utility preparations and guidelines to conform with the output of a small generating station with that of a large power network are examined.

A Critical Meta-Analysis of All Evaluations of State-Funded Preschool from 1977 to 1998: Implications for Policy, Service Delivery and Program Evaluation.

ERIC Educational Resources Information Center

Gilliam, Walter S.; Zigler, Edward F.

2000-01-01

Presents a meta-analytic review of evaluations of state-funded preschool programs over 20 years. Identifies several methodological flaws but also suggests that pattern of findings offers modest support for positive impact in improving children's developmental competence, improving later school attendance and performance, and reducing subsequent…

Student Outcomes from Experiential Learning on a Student-Run Certified Organic Farm

ERIC Educational Resources Information Center

Reeve, Jennifer R.; Hall, Kelsey; Kalkman, Carol

2014-01-01

The USU Student Organic Farm was initiated in April 2008 on 1 acre (0.4 ha) of land at Utah State University (USU). Students plant, weed, harvest, and market the produce on campus. Proceeds support the student farm in terms of operating expenses, equipment purchases, and modest student stipends. Since 2009, the students have operated a community…

Cooling optically levitated dielectric nanoparticles via parametric feedback

NASA Astrophysics Data System (ADS)

Neukirch, Levi; Rodenburg, Brandon; Bhattacharya, Mishkatul; Vamivakas, Nick

2015-05-01

The inability to leverage resonant scattering processes involving internal degrees of freedom differentiates optical cooling experiments performed with levitated dielectric nanoparticles, from similar atomic and molecular traps. Trapping in optical cavities or the application of active feedback techniques have proven to be effective ways to circumvent this limitation. We present our nanoparticle optical cooling apparatus, which is based on parametric feedback modulation of a single-beam gradient force optical trap. This scheme allows us to achieve effective center-of-mass temperatures well below 1 kelvin for our ~ 1 ×10-18 kg particles, at modest vacuum pressures. The method provides a versatile platform, with parameter tunability not found in conventional tethered nanomechanical systems. Potential applications include investigations of nonequilibrium nanoscale thermodynamics, ultra-sensitive force metrology, and mesoscale quantum mechanics and hybrid systems. Supported by the office of Naval Research award number N000141410442.

Rethinking construction: inclusion of slow learners as taker-off in quantity surveying practice

NASA Astrophysics Data System (ADS)

Majid, Masidah Abdul; Ashaari, Norul Izzati M.; @ Suhana Kamarudin Nurul Aini Osman, Suhaida; Suhaimi, Mohamad Saifulnizam Mohd

2017-11-01

The objective of this paper is to present the preliminary findings regarding the participation of OKU with learning disability in Science Technology, Engineering and Mathematics (STEM) sectors. Review of the works of past researchers suggested that OKU is a potential workforce in STEM sectors but still under-represented due to lack of efforts from stakeholders and learning institutions in providing information on the opportunities that are available. A research has been initiated to explore the potential of slow learners to become workforce in the construction industry as a taker off - part of work of a Quantity Surveyor. Against the findings from the literature review, the modest attempt to attract slow learners to become taker off in the construction industry require the formulation of appropriate learning environment and strong support from the respective key players and stakeholders.

Do Spin-Offs Make the Academics’ Heads Spin?

PubMed Central

Jongbloed, Ben W. A.; Enders, Jürgen

2010-01-01

As public research organisations are increasingly driven by their national and regional governments to engage in knowledge transfer, they have started to support the creation of companies. These research based spin-off companies (RBSOs) often keep contacts with the research institutes they originate from. In this paper we present the results of a study of four research institutes within two universities and two non-university public research organisations (PROs) in the Netherlands. We show that research organisations have distinct motivations to support the creation of spin-off companies. In terms of resources RBSOs contribute, mostly in a modest way, to research activities by providing information, equipment and monetary resources. In particular, RBSOs are helpful for researchers competing for research grants that demand participation of industry. Furthermore, RBSOs may be seen as a proactive response by Dutch public research organisations to demands of economic relevance from their institutional environment. RBSOs enhance the prestige of their parent organisations and create legitimacy for public funds invested in PROs. At the same time, most RBSOs do not have a significant impact on the direction of the research conducted at the PROs. PMID:20936164

NASA's Optical Measurement Program 2014 H.

NASA Astrophysics Data System (ADS)

Cowardin, H.; Lederer, S.; Stansbery, G.; Seitzer, P.; Buckalew, B.; Abercromby, K.; Barker, E.

2014-09-01

The Optical Measurements Group (OMG) within the NASA Orbital Debris Program Office (ODPO) addresses U.S. National Space Policy goals by monitoring and characterizing debris. Since 2001, the OMG has used the Michigan Orbital Debris Survey Telescope (MODEST) at Cerro Tololo Inter-American Observatory (CTIO) in Chile for general orbital debris survey. The 0.6-m Schmidt MODEST provides calibrated astronomical data of GEO targets, both catalogued and uncatalogued debris, with excellent image quality. The data are utilized by the ODPO modeling group and are included in the Orbital Debris Engineering Model (ORDEM) v. 3.0. MODEST and the CTIO/SMARTS (Small and Moderate Aperture Research Telescope System)0.9 m both acquire filter photometric data, as well as synchronously observing targets in selected optical filters. This information provides data used in material composition studies as well as longer orbital arc data on the same target, without time delay or bias from a rotating, tumbling, or spinning target. NASA, in collaboration with the University of Michigan, began using the twin 6.5-m Magellan telescopes at Las Campanas Observatory in Chile for deep imaging (Baade) and spectroscopic data (Clay) in 2011. Through the data acquired on Baade, debris have been detected that are ~3 magnitudes fainter than detections with MODEST, while the data from Clay provide better resolved information used in material characterization analyses via selected bandpasses. To better characterize and model optical data, the Optical Measurements Center (OMC) at NASA/JSC has been in operation since 2005, resulting in a database of comparison laboratory data. The OMC is designed to emulate illumination conditions in space using equipment and techniques that parallel telescopic observations and source-target-sensor orientations. Lastly, the OMG is building the Meter Class Autonomous Telescope (MCAT) at Ascension Island. The 1.3-m telescope is designed to observe GEO and LEO targets, using a modified Ritchey-Chrétien configuration on a double horseshoe equatorial mount to allow tracking objects at LEO rates through the domes keyhole at zenith. Through the data collection techniques employed at these unique facilities, NASAs ODPO has developed a multi-faceted approach to characterize the orbital debris risk to satellites in various altitudes and provide material characterization of debris via photometric and spectroscopic measurements. Ultimately, the data are used in conjunction with in-situ and radar measurements to provide accurate data for models of our space environment and service spacecraft risk assessment.

NASA's Optical Measurement Program 2014

NASA Technical Reports Server (NTRS)

Cowardin, H.; Lederer, S.; Stansbery, G.; Seitzer, P.; Buckalew, B.; Abercromby, K.; Barker, E.

2014-01-01

The Optical Measurements Group (OMG) within the NASA Orbital Debris Program Office (ODPO) addresses U.S. National Space Policy goals by monitoring and characterizing debris. Since 2001, the OMG has used the Michigan Orbital Debris Survey Telescope (MODEST) at Cerro Tololo Inter-American Observatory (CTIO) in Chile for general orbital debris survey. The 0.6-m Schmidt MODEST provides calibrated astronomical data of GEO targets, both catalogued and uncatalogued debris, with excellent image quality. The data are utilized by the ODPO modeling group and are included in the Orbital Debris Engineering Model (ORDEM) v. 3.0. MODEST and the CTIO/SMARTS (Small and Moderate Aperture Research Telescope System) 0.9 m both acquire filter photometric data, as well as synchronously observing targets in selected optical filters. This information provides data used in material composition studies as well as longer orbital arc data on the same target, without time delay or bias from a rotating, tumbling, or spinning target. NASA, in collaboration with the University of Michigan, began using the twin 6.5-m Magellan telescopes at Las Campanas Observatory in Chile for deep imaging (Baade) and spectroscopic data (Clay) in 2011. Through the data acquired on Baade, debris have been detected that are 3 magnitudes fainter than detections with MODEST, while the data from Clay provide better resolved information used in material characterization analyses via selected bandpasses. To better characterize and model optical data, the Optical Measurements Center (OMC) at NASA/JSC has been in operation since 2005, resulting in a database of comparison laboratory data. The OMC is designed to emulate illumination conditions in space using equipment and techniques that parallel telescopic observations and source-target-sensor orientations. Lastly, the OMG is building the Meter Class Autonomous Telescope (MCAT) at Ascension Island. The 1.3-m telescope is designed to observe GEO and LEO targets, using a modified Ritchey-Chrétien configuration on a double horseshoe equatorial mount to allow tracking objects at LEO rates through the dome's keyhole at zenith. Through the data collection techniques employed at these unique facilities, NASA's ODPO has developed a multi-faceted approach to characterize the orbital debris risk to satellites in various altitudes and provide material characterization of debris via photometric and spectroscopic measurements. Ultimately, the data are used in conjunction with in-situ and radar measurements to provide accurate data for models of our space environment and service spacecraft risk assessment.

Building Social Networks for Health Promotion: Shout-out Health, New Jersey, 2011

PubMed Central

Jones, Veronica M.; Storm, Deborah S.; Parrott, J. Scott; O’Brien, Kathy Ahearn

2013-01-01

Background Building social networks for health promotion in high-poverty areas may reduce health disparities. Community involvement provides a mechanism to reach at-risk people with culturally tailored health information. Shout-out Health was a feasibility project to provide opportunity and support for women at risk for or living with human immunodeficiency virus infection to carry out health promotion within their informal social networks. Community Context The Shout-out Health project was designed by an academic–community agency team. During 3 months, health promotion topics were chosen, developed, and delivered to community members within informal social networks by participants living in Paterson and Jersey City, New Jersey. Methods We recruited women from our community agency partner’s clients; 57 women participated in in-person or online meetings facilitated by our team. The participants identified and developed the health topics, and we discussed each topic and checked it for message accuracy before the participants provided health promotion within their informal social networks. The primary outcome for evaluating feasibility included the women’s feedback about their experiences and the number of times they provided health promotion in the community. Other data collection included participant questionnaires and community-recipient evaluations. Outcome More than half of the participants reported substantial life challenges, such as unemployment and housing problems, yet with technical support and a modest stipend, women in both groups successfully provided health promotion to 5,861 people within their informal social networks. Interpretation Shout-out Health was feasible and has implications for building social networks to disseminate health information and reduce health disparities in communities. PMID:23987253

Association and haplotype analysis of the insulin-degrading enzyme (IDE) gene, a strong positional and biological candidate for type 2 diabetes susceptibility.

PubMed

Groves, Christopher J; Wiltshire, Steven; Smedley, Damian; Owen, Katherine R; Frayling, Timothy M; Walker, Mark; Hitman, Graham A; Levy, Jonathan C; O'Rahilly, Stephen; Menzel, Stephan; Hattersley, Andrew T; McCarthy, Mark I

2003-05-01

The gene for insulin-degrading enzyme (IDE) represents a strong positional and biological candidate for type 2 diabetes susceptibility. IDE maps to chromosome 10q23.3, a region linked to diabetes in several populations; the rat homolog has been directly implicated in diabetes susceptibility; and known functions of IDE support an important role in glucose homeostasis. We sought evidence for association between IDE variation and diabetes by mutation screening, defining local haplotype structure, and genotyping variants delineating common haplotypic diversity. An initial case-control analysis (628 diabetic probands from multiplex sibships and 604 control subjects) found no haplotypic associations, although one variant (IDE2, -179T-->C) showed modest association with diabetes (odds ratio [OR]1.25, P = 0.03). Linkage partitioning analyses failed to support this association, but provided borderline evidence for a different variant (IDE10, IVS20-405A-->G) (P = 0.06). Neither variant was associated with diabetes when replication was sought in 377 early onset diabetic subjects and 825 control subjects, though combined analysis of all typed cohorts indicated a nominally significant effect at IDE2 (OR 1.21 [1.04-1.40], P = 0.013). In the absence of convincing support for this association from linkage partitioning or analyses of continuous measures of glycemia, we conclude that analysis of over 2,400 samples provides no compelling evidence that variation in IDE contributes to diabetes susceptibility in humans.

Institute a modest carbon tax to reduce carbon emissions, finance clean energy technology development, cut taxes, and reduce the deficit

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

Muro, Mark; Rothwell, Jonathan

The nation should institute a modest carbon tax in order to help clean up the economy and stabilize the nation’s finances. Specifically, Congress and the president should implement a $20 per ton, steadily increasing carbon excise fee that would discourage carbon dioxide emissions while shifting taxation onto pollution, financing energy efficiency (EE) and clean technology development, and providing opportunities to cut taxes or reduce the deficit. The net effect of these policies would be to curb harmful carbon emissions, improve the nation’s balance sheet, and stimulate job-creation and economic renewal.

Stability of attachment-related anxiety and avoidance and their relationships with the five-factor model and the psychobiological model of personality.

PubMed

Picardi, Angelo; Caroppo, Emanuele; Toni, Alessandro; Bitetti, Daniela; Di Maria, Giuseppe

2005-09-01

The stability of attachment-related anxiety and avoidance and their relationship with influential personality models are issues worth further investigation. Studying discriminant validity with respect to aspects of personality deemed as prevalently heritable, such as temperament, is particularly important. Our aims were to examine the stability of attachment dimensions and to study their relationship with psychological distress, the Big Five factors, and temperament and character dimensions. The Experiences in Close Relationships (ECR) questionnaire, the State-Trait Anxiety Inventory (STAI), the Zung depression scale (ZDS), the Temperament and Character Inventory (TCI-125), and the Big Five Questionnaire (BFQ) were administered to 222 undergraduate and graduate students. After 1 month, 115 participants completed again the ECR, the STAI, and the ZDS. Attachment-related anxiety was modestly correlated with depression and anxiety, while attachment-related avoidance was modestly correlated with depression. The test-retest reliability of ECR scores was high. Changes in attachment-related anxiety were not related to changes in depression or anxiety, and changes in attachment-related avoidance were modestly correlated with changes in depression. In separate multiple regression models also including gender and age, attachment-related anxiety was correlated with harm avoidance, reward dependence, low novelty seeking, low self-directedness and low cooperativeness; low energy/extraversion and low emotional stability; attachment-related avoidance was correlated with low reward dependence and tended to be correlated with low self-directedness. These findings corroborate the reliability and the convergent and discriminant validity of the ECR, and support the notion that the attachment dimensions are only modestly related to psychological distress and are not redundant with constructs developed within influential personality models such as the five-factor model and the psychobiological model.

Musings of Someone in the Disability Support Services Field for Almost 40 Years

ERIC Educational Resources Information Center

Goodin, Sam

2014-01-01

As the title states, this article is a collection of musings with only modest attempts at establishing an order for them or connections between them. It is not quite "free association," but it is close. This structure or perhaps lack of it reflects the variety of things we do in our work. Many of the things we do have little in common…

Policy Options for University of California Budgeting. Research & Occasional Paper Series: CSHE.5.11

ERIC Educational Resources Information Center

Young, Charles E.

2011-01-01

Within a quarter century after the end of World War II (1945-1970), largely because of the support and investment it received from the State, the University of California had changed from two modest-size general campuses (Berkeley and Los Angeles) and the medical campus in San Francisco (UCSF), to a system of eight general campuses. California was…

Adenosine A1 receptor activation increases myocardial protein S-nitrosothiols and elicits protection from ischemia-reperfusion injury in male and female hearts

PubMed Central

Shao, Qin; Casin, Kevin M.; Mackowski, Nathan; Murphy, Elizabeth; Steenbergen, Charles

2017-01-01

Nitric oxide (NO) plays an important role in cardioprotection, and recent work from our group and others has implicated protein S-nitrosylation (SNO) as a critical component of NO-mediated protection in different models, including ischemic pre- and post-conditioning and sex-dependent cardioprotection. However, studies have yet to examine whether protein SNO levels are similarly increased with pharmacologic preconditioning in male and female hearts, and whether an increase in protein SNO levels, which is protective in male hearts, is sufficient to increase baseline protection in female hearts. Therefore, we pharmacologically preconditioned male and female hearts with the adenosine A1 receptor agonist N6-cyclohexyl adenosine (CHA). CHA administration prior to ischemia significantly improved functional recovery in both male and female hearts compared to baseline in a Langendorff-perfused heart model of ischemia-reperfusion injury (% of preischemic function ± SE: male baseline: 37.5±3.4% vs. male CHA: 55.3±3.2%; female baseline: 61.4±5.7% vs. female CHA: 76.0±6.2%). In a separate set of hearts, we found that CHA increased p-Akt and p-eNOS levels. We also used SNO-resin-assisted capture with LC-MS/MS to identify SNO proteins in male and female hearts, and determined that CHA perfusion induced a modest increase in protein SNO levels in both male (11.4%) and female (12.3%) hearts compared to baseline. These findings support a potential role for protein SNO in a model of pharmacologic preconditioning, and provide evidence to suggest that a modest increase in protein SNO levels is sufficient to protect both male and female hearts from ischemic injury. In addition, a number of the SNO proteins identified with CHA treatment were also observed with other forms of cardioprotective stimuli in prior studies, further supporting a role for protein SNO in cardioprotection. PMID:28493997

Toward an Immodest Experiment in Cable Television: Modestly Produced.

ERIC Educational Resources Information Center

Crichton, Judy

The new capability of cable television (CATV) to provide relevant programming to local communities should be recognized so that inner city consumers can be provided with direct, personal information--warning, comparative prices, and the sense that someone cares. At least one channel should be devoted as a key to these services, with other channels…

Interest in internet lung cancer support among rural cardiothoracic patients.

PubMed

Quin, Jacquelyn; Stams, Victor; Phelps, Beth; Boley, Theresa; Hazelrigg, Stephen

2010-05-01

The Internet may provide an alternative option for rural lung cancer patients who lack access to on-site cancer support; however, Internet access and use among rural patients is unknown. An anonymous waiting-room survey was administered to all outpatient cardiothoracic surgery patients over 3 mo. Survey questions included age, gender, and diagnosis, possession of a home computer and Internet service, estimated Internet use, and use of the Internet for health information. Patients with known or suspected lung cancer were asked to indicate their interest in on-site and Internet cancer support. There were 597 returned surveys (response rate 96%). The mean age was 64.6 y (SE 0.55), and 58% were men. Diagnoses included known or possible lung cancer (15.4%), lung disease (9.5%), heart disease (30.4%), other diagnoses (13.9%), and undetermined (30.6%). There were 343 patients (57.4%) with a home computer and 299 (50.1%) with home Internet service. Average Internet use was 8.5 h per wk (n = 298), and 225 patients used the Internet for health information. Of the 92 patients with lung cancer, 10 indicated interest in on-site support services while 37 expressed interest in Internet-based support. Based on survey results, a slight majority of rural patients have a home computer and Internet access. Internet use for health information appears relatively common. Overall interest for support services among lung cancer patients appears modest with a greater interest in Internet-based services compared with on-site support. Copyright 2010 Elsevier Inc. All rights reserved.

Targeted drug induces responses in aggressive lymphomas

Cancer.gov

Preliminary results from clinical trials in a subtype of lymphoma show that for a number of patients whose disease was not cured by other treatments, the drug ibrutinib can provide significant anti-cancer responses with modest side effects.

Results of a pilot randomised controlled trial to measure the clinical and cost effectiveness of peer support in increasing hope and quality of life in mental health patients discharged from hospital in the UK

PubMed Central

2014-01-01

Background Mental health patients can feel anxious about losing the support of staff and patients when discharged from hospital and often discontinue treatment, experience relapse and readmission to hospital, and sometimes attempt suicide. The benefits of peer support in mental health services have been identified in a number of studies with some suggesting clinical and economic gains in patients being discharged. Methods This pilot randomised controlled trial with economic evaluation aimed to explore whether peer support in addition to usual aftercare for patients during the transition from hospital to home would increase hope, reduce loneliness, improve quality of life and show cost effectiveness compared with patients receiving usual aftercare only, with follow-up at one and three-months post-discharge. Results A total of 46 service users were recruited to the study; 23 receiving peer support and 23 in the care-as-usual arm. While this pilot trial found no statistically significant benefits for peer support on the primary or secondary outcome measures, there is an indication that hope may be further increased in those in receipt of peer support. The total cost per case for the peer support arm of the study was £2154 compared to £1922 for the control arm. The mean difference between costs was minimal and not statistically significant. However, further analyses demonstrated that peer support has a reasonably high probability of being more cost effective for a modest positive change in the measure of hopelessness. Challenges faced in recruitment and follow-up are explored alongside limitations in the delivery of peer support. Conclusions The findings suggest there is merit in conducting further research on peer support in the transition from hospital to home consideration should be applied to the nature of the patient population to whom support is offered; the length and frequency of support provided; and the contact between peer supporters and mental health staff. There is no conclusive evidence to support the cost effectiveness of providing peer support, but neither was it proven a costly intervention to deliver. The findings support an argument for a larger scale trial of peer support as an adjunct to existing services. Trial registration Current Controlled Trials ISRCTN74852771 PMID:24495599

Results of a pilot randomised controlled trial to measure the clinical and cost effectiveness of peer support in increasing hope and quality of life in mental health patients discharged from hospital in the UK.

PubMed

Simpson, Alan; Flood, Chris; Rowe, Julie; Quigley, Jody; Henry, Susan; Hall, Cerdic; Evans, Richard; Sherman, Paul; Bowers, Len

2014-02-05

Mental health patients can feel anxious about losing the support of staff and patients when discharged from hospital and often discontinue treatment, experience relapse and readmission to hospital, and sometimes attempt suicide. The benefits of peer support in mental health services have been identified in a number of studies with some suggesting clinical and economic gains in patients being discharged. This pilot randomised controlled trial with economic evaluation aimed to explore whether peer support in addition to usual aftercare for patients during the transition from hospital to home would increase hope, reduce loneliness, improve quality of life and show cost effectiveness compared with patients receiving usual aftercare only, with follow-up at one and three-months post-discharge. A total of 46 service users were recruited to the study; 23 receiving peer support and 23 in the care-as-usual arm. While this pilot trial found no statistically significant benefits for peer support on the primary or secondary outcome measures, there is an indication that hope may be further increased in those in receipt of peer support. The total cost per case for the peer support arm of the study was £2154 compared to £1922 for the control arm. The mean difference between costs was minimal and not statistically significant. However, further analyses demonstrated that peer support has a reasonably high probability of being more cost effective for a modest positive change in the measure of hopelessness. Challenges faced in recruitment and follow-up are explored alongside limitations in the delivery of peer support. The findings suggest there is merit in conducting further research on peer support in the transition from hospital to home consideration should be applied to the nature of the patient population to whom support is offered; the length and frequency of support provided; and the contact between peer supporters and mental health staff. There is no conclusive evidence to support the cost effectiveness of providing peer support, but neither was it proven a costly intervention to deliver. The findings support an argument for a larger scale trial of peer support as an adjunct to existing services. Current Controlled Trials ISRCTN74852771.

Towards efficient chemical synthesis via engineering enzyme catalysis in biomimetic nanoreactors.

PubMed

Liu, Jia; Yang, Qihua; Li, Can

2015-09-18

Biocatalysis with immobilized enzymes as catalysts holds enormous promise in developing more efficient and sustainable processes for the synthesis of fine chemicals, chiral pharmaceuticals and biomass feedstocks. Despite the appealing potentials, nowadays the industrial-scale application of biocatalysts is still quite modest in comparison with that of traditional chemical catalysts. A critical issue is that the catalytic performance of enzymes, the sophisticated and vulnerable catalytic machineries, strongly depends on their intracellular working environment; however the working circumstances provided by the support matrix are radically different from those in cells. This often leads to various adverse consequences on enzyme conformation and dynamic properties, consequently decreasing the overall performance of immobilized enzymes with regard to their activity, selectivity and stability. Engineering enzyme catalysis in support nanopores by mimicking the physiological milieu of enzymes in vivo and investigating how the interior microenvironment of nanopores imposes an influence on enzyme behaviors in vitro are of paramount significance to modify and improve the catalytic functions of immobilized enzymes. In this feature article, we have summarized the recent advances in mimicking the working environment and working patterns of intracellular enzymes in nanopores of mesoporous silica-based supports. Especially, we have demonstrated that incorporation of polymers into silica nanopores could be a valuable approach to create the biomimetic microenvironment for enzymes in the immobilized state.

The Generic Resolution Advisor and Conflict Evaluator (GRACE) for Detect-And-Avoid Systems

NASA Technical Reports Server (NTRS)

Abramson, Michael; Refai, Mohamad; Santiago, Confesor

2017-01-01

Java Architecture for Detect-And-Avoid (DAA) Extensibility and Modeling (JADEM) was developed at NASA Ames Research Center as a research and modeling tool for Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS). UAS will be required to have DAA systems in order to fulfill the regulatory requirement to remain well clear'' of other traffic. JADEM supports research on technological requirements and Minimum Operational Performance Standards (MOPS) for UAS DAA systems by providing a flexible and extensible software platform that includes models and algorithms for all major DAA functions. This paper describes one of these algorithms, the Generic Resolution Advisor and Conflict Evaluator (GRACE). GRACE supports two core DAA functions: threat evaluation and guidance. GRACE is generic in the sense that it is designed to work with any aircraft or sensor type (both cooperative and non-cooperative), and to be used in various applications and DAA guidance concepts, thus supporting evolving MOPS requirements and research. GRACE combines flexibility, robustness, and computational efficiency. It has modest memory requirements and can handle multiple cooperative and noncooperative intruders. GRACE has been used as a core JADEM component in several real-time and fast-time experiments, including human-in-the-loop simulations and live flight tests.

Parenting, self-control, and the gender gap in heavy drinking: the case of Russia.

PubMed

Botchkovar, Ekaterina V; Broidy, Lisa

2013-03-01

Drawing on Gottfredson and Hirschi's theory linking parenting to deviant behavior via development of self-control, the authors assess the association between parenting styles, self-control ability, and frequent alcohol use separately for males and females. The authors' findings from a random sample of 440 Russian respondents provide mixed support for self-control theory. Contrary to the theory, but in line with extant research, the authors failed to uncover significant gender differences in childhood upbringing or establish a strong link between parenting techniques and self-control. Furthermore, whereas parental upbringing appears to increase the likelihood of frequent drinking among men, self-control does not mediate this relationship but rather acts as an independent predictor of men's alcohol abuse. Finally, the relatively modest contribution of self-control differences to the gender gap in frequent drinking suggests that higher alcohol consumption among men likely stems from alternative, possibly context-embedded factors.

A Gastroenterologist’s Guide to Probiotics

PubMed Central

Ciorba, Matthew A

2012-01-01

The enteric microbiota contributes to gastrointestinal health and its disruption has been associated with many disease states. Some patients consume probiotic products in attempts to manipulate the intestinal microbiota for health benefit. It is important for gastroenterologists to improve their understanding of the mechanisms of probiotics and the evidence that support their use in practice. Clinical trials have assessed the therapeutic effects of probiotics for several disorders, including antibiotic-or Clostridium difficile-associated diarrhea, irritable bowel syndrome, and the inflammatory bowel diseases. Although probiotic research is a rapidly evolving field, there are sufficient data to justify a trial of probiotics for treatment or prevention of some of these conditions. However, the capacity of probiotics to modify disease symptoms is likely to be modest and varies among probiotic strains—not all probiotics are right for all diseases. The current review provides condition-specific rationale for using probiotics as therapy and literature-based recommendations. PMID:22504002

CMS Use of a Data Federation

NASA Astrophysics Data System (ADS)

Bloom, Kenneth; Cms Collaboration

2014-06-01

CMS is in the process of deploying an Xrootd based infrastructure to facilitate a global data federation. The services of the federation are available to export data from half the physical capacity and the majority of sites are configured to read data over the federation as a back-up. CMS began with a relatively modest set of use-cases for recovery of failed local file opens, debugging and visualization. CMS is finding that the data federation can be used to support small scale analysis and load balancing. Looking forward we see potential in using the federation to provide more flexibility in the location workflows are executed as the difference between local access and wide area access are diminished by optimization and improved networking. In this presentation we discuss the application development work and the facility deployment work, the use-cases currently in production, and the potential for the technology moving forward.

Systemic hypothermia for the treatment of acute cervical spinal cord injury in sports.

PubMed

Dietrich, William Dalton; Cappuccino, Andrew; Cappuccino, Helen

2011-01-01

Spinal cord injury is a devastating condition that affects approximately 12,000 patients each year in the United States. Major causes for spinal cord injury include motor vehicle accidents, sports-related injuries, and direct trauma. Moderate hypothermia has gained attention as a potential therapy due to recent experimental and clinical studies and the use of modest systemic hypothermia (MSH) in high profile case of spinal cord injury in a National Football League (NFL) player. In experimental models of spinal cord injury, moderate hypothermia has been shown to improve functional recovery and reduce overall structural damage. In a recent Phase I clinical trial, systemic hypothermia has been shown to be safe and provide some encouraging results in terms of functional recovery. This review will summarize recent preclinical data, as well as clinical findings that support the continued investigations for the use of hypothermia in severe cervical spinal cord injury.

Hypoconnectivity and hyperfrontality in retired American football players.

PubMed

Hampshire, Adam; MacDonald, Alex; Owen, Adrian M

2013-10-17

Recent research has raised concerns about the long-term neurological consequences of repetitive concussive and sub-concussive injuries in professional players of American Football. Despite this interest, the neural and psychological status of retired players remains unknown. Here, we evaluated the performances and brain activation patterns of retired National Football League players (NFL alumni) relative to controls using an fMRI-optimised neuropsychological test of executive function. Behaviourally, the NFL alumni showed only modest performance deficits on the executive task. By contrast, they showed pronounced hyperactivation and hypoconnectivity of the dorsolateral frontal and frontopolar cortices. Critically, abnormal frontal-lobe function was correlated with the number of times that NFL alumni reported having been removed from play after head injury and was evident in individual players. These results support the hypothesis that NFL alumni have a heightened probability of developing executive dysfunction and suggest that fMRI provides the most sensitive biomarker of the underlying neural abnormality.

Measuring the executive regulation of emotion with self-rating scales in a nonclinical population.

PubMed

Spinella, Marcello

2007-01-01

Prefrontal systems play an important role in the regulation of emotion as evidenced by clinical neuroimaging studies. Both subjective and objective neuropsychological tests provide functional evidence of executive dysfunction in emotional deregulation. The present authors evaluated these relationships here in a nonclinical community sample using the Frontal Systems Behavior Scale, Profile of Mood States (POMS), and Depression Anxiety Stress Scales (DASS). Positive correlations uniformly emerged between prefrontal system dysfunction and negative emotional states (anger, depression, anxiety, stress, confusion, and fatigue), whereas positive emotion (vigor) showed a modest inverse correlation with prefrontal system dysfunction, even after control for demographic influences. These relationships may result from cognitive strategies for managing emotion mediated by reciprocal connections between prefrontal systems and the limbic system. The findings corroborated those of other methodologies, supporting the Frontal Systems Behavior Scale (FrSBe) as a valid tool to measure prefrontal function in nonclinical populations.

Optimal back-to-front airplane boarding.

PubMed

Bachmat, Eitan; Khachaturov, Vassilii; Kuperman, Ran

2013-06-01

The problem of finding an optimal back-to-front airplane boarding policy is explored, using a mathematical model that is related to the 1+1 polynuclear growth model with concave boundary conditions and to causal sets in gravity. We study all airplane configurations and boarding group sizes. Optimal boarding policies for various airplane configurations are presented. Detailed calculations are provided along with simulations that support the main conclusions of the theory. We show that the effectiveness of back-to-front policies undergoes a phase transition when passing from lightly congested airplanes to heavily congested airplanes. The phase transition also affects the nature of the optimal or near-optimal policies. Under what we consider to be realistic conditions, optimal back-to-front policies lead to a modest 8-12% improvement in boarding time over random (no policy) boarding, using two boarding groups. Having more than two groups is not effective.

Hypoconnectivity and Hyperfrontality in Retired American Football Players

NASA Astrophysics Data System (ADS)

Hampshire, Adam; MacDonald, Alex; Owen, Adrian M.

2013-10-01

Recent research has raised concerns about the long-term neurological consequences of repetitive concussive and sub-concussive injuries in professional players of American Football. Despite this interest, the neural and psychological status of retired players remains unknown. Here, we evaluated the performances and brain activation patterns of retired National Football League players (NFL alumni) relative to controls using an fMRI-optimised neuropsychological test of executive function. Behaviourally, the NFL alumni showed only modest performance deficits on the executive task. By contrast, they showed pronounced hyperactivation and hypoconnectivity of the dorsolateral frontal and frontopolar cortices. Critically, abnormal frontal-lobe function was correlated with the number of times that NFL alumni reported having been removed from play after head injury and was evident in individual players. These results support the hypothesis that NFL alumni have a heightened probability of developing executive dysfunction and suggest that fMRI provides the most sensitive biomarker of the underlying neural abnormality.

Student Perceptions of Chemistry Laboratory Learning Environments, Student-Teacher Interactions and Attitudes in Secondary School Gifted Education Classes in Singapore

NASA Astrophysics Data System (ADS)

Lang, Quek Choon; Wong, Angela F. L.; Fraser, Barry J.

2005-09-01

This study investigated the chemistry laboratory classroom environment, teacher-student interactions and student attitudes towards chemistry among 497 gifted and non-gifted secondary-school students in Singapore. The data were collected using the 35-item Chemistry Laboratory Environment Inventory (CLEI), the 48-item Questionnaire on Teacher Interaction (QTI) and the 30-item Questionnaire on Chemistry-Related Attitudes (QOCRA). Results supported the validity and reliability of the CLEI and QTI for this sample. Stream (gifted versus non-gifted) and gender differences were found in actual and preferred chemistry laboratory classroom environments and teacher-student interactions. Some statistically significant associations of modest magnitude were found between students' attitudes towards chemistry and both the laboratory classroom environment and the interpersonal behaviour of chemistry teachers. Suggestions for improving chemistry laboratory classroom environments and the teacher-student interactions for gifted students are provided.

Spherical torus fusion reactor

DOEpatents

Peng, Yueng-Kay M.

1989-04-04

A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

Spherical torus fusion reactor

DOEpatents

Peng, Yueng-Kay M.

1989-01-01

A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

ATP Synthase, a Target for Dementia and Aging?

PubMed

Larrick, James W; Larrick, Jasmine W; Mendelsohn, Andrew R

2018-02-01

Advancing age is the biggest risk factor for development for the major life-threatening diseases in industrialized nations accounting for >90% of deaths. Alzheimer's dementia (AD) is among the most devastating. Currently approved therapies fail to slow progression of the disease, providing only modest improvements in memory. Recently reported work describes mechanistic studies of J147, a promising therapeutic molecule previously shown to rescue the severe cognitive deficits exhibited by aged, transgenic AD mice. Apparently, J147 targets the mitochondrial alpha-F1-ATP synthase (ATP5A). Modest inhibition of the ATP synthase modulates intracellular calcium to activate AMP-activated protein kinase to inhibit mammalian target of rapamycin, a known mechanism of lifespan extension from worms to mammals.

An atmosphere on Ganymede from its occultation of SAO 186800 on 7 June 1972.

NASA Technical Reports Server (NTRS)

Carlson, R. W.; Bhattacharyya, J. C.; Smith, B. A.; Johnson, T. V.; Hidayat, B.; Smith, S. A.; Taylor, G. E.; O'Leary, B.; Brinkmann, R. T.

1973-01-01

The observational data obtained during the occultation are of sufficient quality to determine the occultation radius and to support the inference that Ganymede does possess at least a modest atmosphere. Assuming a circular cross section, the diameter of Ganymede was found to be 5271 km. Effects of the atmosphere on the accuracy of the value obtained for the Ganymede diameter are discussed.

Deck the Halls: Physics on an Air Track.

ERIC Educational Resources Information Center

Koopmann, Rebecca A.; Maleki, S.

1989-01-01

Discusses the general construction of an air track. Describes three demonstrations including elastic collision, forced oscillators, and coupled oscillators. Provides a diagram and four pictures. Suggests how a similar exhibit could be constructed with a modest budget. (YP)

NASA's Optical Measurement Program 2014

NASA Technical Reports Server (NTRS)

Cowardin, H.; Lederer, S. M.; Stansbery, G.; Seitzer, P.; Buckalew, B.; Abercromby, K.; Barker, E.

2014-01-01

The Optical Measurements Group (OMG) within the NASA Orbital Debris Program Office (ODPO) addresses U.S. National Space Policy goals by monitoring and characterizing debris. Since 2001, the OMG has used the Michigan Orbital Debris Survey Telescope (MODEST) at Cerro Tololo Inter-American Observatory (CTIO) in Chile for general orbital debris surveys. The 0.6-m Schmidt MODEST provides calibrated astronomical data of GEO targets, both catalogued and uncatalogued debris, with excellent image quality. The data are utilized by the ODPO modeling group and are included in the Orbital Debris Engineering Model (ORDEM) v. 3.0. MODEST and the CTIO/SMARTS (Small and Moderate Aperture Research Telescope System) 0.9 m are both employed to acquire filter photometry data as well as synchronously observe targets in selected optical filters. Obtaining data synchronously yields data for material composition studies as well as longer orbital arc data on the same target without time delay or bias from a rotating, tumbling, or spinning target. Observations of GEO orbital debris using the twin 6.5-m Magellan telescopes at Las Campanas Observatory in Chile for deep imaging (Baade) and spectroscopic data (Clay) began in 2011. Through the data acquired on Baade, debris has been detected that reaches approx. 3 magnitudes fainter than detections with MODEST, while the spectral data from Clay provide better resolved information used in material characterization analyses. To better characterize and model optical data, the Optical Measurements Center (OMC) at NASA/JSC has been in operation since 2005, resulting in a database of comparison laboratory data. The OMC is designed to emulate illumination conditions in space using equipment and techniques that parallel telescopic observations and sourcetarget- sensor orientations. Lastly, the OMG is building the Meter Class Autonomous Telescope (MCAT) at Ascension Island. The 1.3-m telescope is designed to observe GEO and LEO targets, using a modified Ritchey-Chrétien configuration on a double horseshoe equatorial mount to allow tracking objects at LEO rates through the dome's keyhole at zenith. Through the data collection techniques employed at these unique facilities, NASA's ODPO has developed a multifaceted approach to characterize the orbital debris risk to satellites in various altitudes and provide insight leading toward material characterization of debris via photometric and spectroscopic measurements. Ultimately, the data are used in conjunction with in-situ and radar measurements to provide accurate data for models of our space environment and for facilitating spacecraft risk assessment.

US cardiologist workforce from 1995 to 2007: modest growth, lasting geographic maldistribution, especially in rural areas

PubMed Central

Aneja, Sanjay; Ross, Joseph S.; Wang, Yongfei; Matsumoto, Masatoshi; Rodgers, George P.; Bernheim, Susannah M.; Rathore, Saif S.; Krumholz, Harlan M.

2012-01-01

A sufficient cardiology workforce is necessary to ensure access to cardiovascular care. Specifically, access to cardiologists is important in the management and treatment of chronic cardiovascular disease. Previous workforce analyses focused narrowly on the total numbers necessary to care for the entire population and not the geographic distribution of the workforce. To examine the supply and distribution of the cardiologist workforce, we mapped the ratios of cardiologists, primary care physicians, and total physicians to the population aged 65 years or older within different Hospital Referral Regions from the years 1995 and 2007. We found within the 12-year span of our study growth in the cardiology workforce was modest compared to the primary care physician and total physician workforces. Also we found a persistent geographic misdistribution of cardiologists associated with socioeconomic population characteristics. Our results suggest that large segments of our population, specifically in rural areas, continue to have decreased access to cardiologists despite a modest growth in the overall workforce. Policy initiatives focused upon increasing the cardiologist workforces in these areas in necessary to provide adequate cardiovascular care. PMID:22147857

Becoming disabled: The association between disability onset in younger adults and subsequent changes in productive engagement, social support, financial hardship and subjective wellbeing.

PubMed

Emerson, Eric; Kariuki, Maina; Honey, Anne; Llewellyn, Gwynnyth

2014-10-01

Very few population-based studies have investigated the association between the onset of health conditions/impairments associated with disability and subsequent well-being. To examine the association between the onset of disability and four indicators of well-being (full-time engagement in employment or education, financial hardship, social support, subjective well-being) among a nationally representative sample of Australian adolescents and young adults. Secondary analysis of the first eight waves (2001-2008) of the survey of Household Income and Labour Dynamics in Australia. For financial hardship and subjective well-being, the majority of participants belonged to trajectory classes for which there was no evidence that the onset of disability was associated with a subsequent lowering of well-being. For participation in employment and education, the majority of participants belonged to trajectory classes for which there was evidence of a modest immediate reduction in participation rates followed by subsequent stability. For social support, the majority of participants belonged to trajectory classes for which there was evidence of a modest temporary reduction in support followed by rebound back to initial levels. Membership of classes associated with poorer outcomes was associated with a number of covariates including: male gender; younger age of disability onset; being born overseas; not living with both parents at age 14; lower proficiency in the English language; and parental education being year 12 or below. The results of our analyses illustrate the existence of clear empirically defined trajectory classes following the onset of disability across a range of indicators of well-being. Copyright © 2014 Elsevier Inc. All rights reserved.

Effectiveness of cognitive rehabilitation following acquired brain injury: a meta-analytic re-examination of Cicerone et al.'s (2000, 2005) systematic reviews.

PubMed

Rohling, Martin L; Faust, Mark E; Beverly, Brenda; Demakis, George

2009-01-01

The present study provides a meta-analysis of cognitive rehabilitation literature (K = 115, N = 2,014) that was originally reviewed by K. D. Cicerone et al. (2000, 2005) for the purpose of providing evidence-based practice guidelines for persons with acquired brain injury. The analysis yielded a small treatment effect size (ES = .30, d(+) statistic) directly attributable to cognitive rehabilitation. A larger treatment effect (ES = .71) was found for single-group pretest to posttest outcomes; however, modest improvement was observed for nontreatment control groups as well (ES = .41). Correction for this effect, which was not attributable to cognitive treatments, resulted in the small, but significant, overall estimate. Treatment effects were moderated by cognitive domain treated, time postinjury, type of brain injury, and age. The meta-analysis revealed sufficient evidence for the effectiveness of attention training after traumatic brain injury and of language and visuospatial training for aphasia and neglect syndromes after stroke. Results provide important quantitative documentation of effective treatments, complementing recent systematic reviews. Findings also highlight gaps in the scientific evidence supporting cognitive rehabilitation, thereby indicating future research directions. (c) 2009 APA, all rights reserved.

Final Report: "Recreating Planet Cores in the Laboratory"

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

Jeanloz, Raymond

2017-06-02

The grant supported a combination of experimental and theoretical research characterizing materials at high pressures (above 0.1-1 TPa = 1-10 million atmospheres) and modest temperatures (below 20,000-100,000 K). This is the “warm dense” (sub-nuclear) regime relevant to understanding the properties of planets, and also to characterizing the chemical bonding forces between atoms. As such, the experiments provide important validation and extensions of theoretical simulations based on quantum mechanics, and offer new insights into the nature and evolution of planets, including the thousands of recently discovered extra-solar planets. In particular, our experiments have documented that: 1) helium can separate from hydrogenmore » at conditions existing inside Jupiter and Saturn, providing much of these planets’ internal energy hence observed luminosities; 2) water ice is likely present in a superionic state with mobile protons inside Uranus and Neptune; 3) rock (oxides) can become metallic at conditions inside “super-Earths” and other large planets, thereby contributing to their magnetic fields; and 4) the “statistical atom” regime that provides the theoretical foundation for characterizing materials at planetary and astrophysical conditions is now accessible to experimental testing.« less

Less is (sometimes) more in cognitive engineering: the role of automation technology in improving patient safety

PubMed Central

Vicente, K

2003-01-01



 There is a tendency to assume that medical error can be stamped out by automation. Technology may improve patient safety, but cognitive engineering research findings in several complex safety critical systems, including both aviation and health care, show that more is not always better. Less sophisticated technological systems can sometimes lead to better performance than more sophisticated systems. This "less is more" effect arises because safety critical systems are open systems where unanticipated events are bound to occur. In these contexts, decision support provided by a technological aid will be less than perfect because there will always be situations that the technology cannot accommodate. Designing sophisticated automation that suggests an uncertain course of action seems to encourage people to accept the imperfect advice, even though information to decide independently on a better course of action is available. It may be preferable to create more modest designs that merely provide feedback about the current state of affairs or that critique human generated solutions than to rush to automate by creating sophisticated technological systems that recommend (fallible) courses of action. PMID:12897363

Automation in Animal Housing and Production

USDA-ARS?s Scientific Manuscript database

Intensive, controlled environment animal production began modestly in the mid-20th century as poultry were brought indoors. While mankind had utilized structures to provide shelter for their animals for centuries, the availability of relatively inexpensive energy and the electrification of rural are...

Magnetic Fluids--Part 2.

ERIC Educational Resources Information Center

Hoon, S. B.; Tanner, B. K.

1985-01-01

Continues a discussion of magnetic fluids by providing background information on and procedures for conducting several demonstrations. Indicates that, with a little patience and ingenuity, only modest magnetic fields and about 20 ml of low-viscosity, commercial magnetite-water-based magnetic fluid are required. (JN)

Psychosocial enhancement of the Green Prescription for obesity recovery: a randomised controlled trial.

PubMed

Sellman, Doug; Schroder, Ria; Deering, Daryle; Elmslie, Jane; Foulds, James; Frampton, Chris

2017-02-17

Kia Ākina is a low-cost obesity recovery network providing ongoing addiction-orientated psychosocial support. This study explored the impact of Kia Ākina when added to the Green Prescription, a key government-funded health promotion programme in New Zealand. A randomised controlled trial (ACTRN12613001160729) involving 108 participants recruited from primary care compared Green Prescription plus Kia Ākina (KA/GRx) with Green Prescription alone (GRx) over 12 months. The primary a priori outcome measure was achieving 5% loss of weight from baseline. KA/GRx participants lost more weight overall than GRx (3.6kg vs 0.7kg, p=0.03), while 39% of the GRx group gained weight compared with 21% of KA/GRx (p=0.04). However, KA/GRx and GRx had similar proportions with weight loss of 5% or greater (20% vs 17%, p=0.62). KA/GRx participants had greater changes in confidence about recovery (p=0.02), and quality of life measures (p=0.03) and greater overall satisfaction with assistance received (p<0.001) compared with GRx participants. Psychosocial support provided through Kia Ākina enhanced treatment outcomes for people with obesity at 12 months when added to GRx, although weight-loss outcomes were modest. Before Kia Ākina is expanded, improved weight-loss outcomes are required, which may be achieved through individualised assessment and targeted dietary assistance.

A meta-analysis of heritability of cognitive aging: minding the "missing heritability" gap.

PubMed

Reynolds, Chandra A; Finkel, Deborah

2015-03-01

The etiologies underlying variation in adult cognitive performance and cognitive aging have enjoyed much attention in the literature, but much of that attention has focused on broad factors, principally general cognitive ability. The current review provides meta-analyses of age trends in heritability of specific cognitive abilities and considers the profile of genetic and environmental factors contributing to cognitive aging to address the 'missing heritability' issue. Our findings, based upon evaluating 27 reports in the literature, indicate that verbal ability demonstrated declining heritability, after about age 60, as did spatial ability and perceptual speed more modestly. Trends for general memory, working memory, and spatial ability generally indicated stability, or small increases in heritability in mid-life. Equivocal results were found for executive function. A second meta-analysis then considered the gap between twin-based versus SNP-based heritability derived from population-based GWAS studies. Specifically, we considered twin correlation ratios to agnostically re-evaluate biometrical models across age and by cognitive domain. Results modestly suggest that nonadditive genetic variance may become increasingly important with age, especially for verbal ability. If so, this would support arguments that lower SNP-based heritability estimates result in part from uncaptured non-additive influences (e.g., dominance, gene-gene interactions), and possibly gene-environment (GE) correlations. Moreover, consistent with longitudinal twin studies of aging, as rearing environment becomes a distal factor, increasing genetic variance may result in part from nonadditive genetic influences or possible GE correlations. Sensitivity to life course dynamics is crucial to understanding etiological contributions to adult cognitive performance and cognitive aging.

Clinical Perspective of Oxidative Stress in Sporadic ALS

PubMed Central

D’Amico, Emanuele; Factor-Litvak, Pam; Santella, Regina M.; Mitsumoto, Hiroshi

2013-01-01

Sporadic amyotrophic lateral sclerosis (sALS) is one of the most devastating neurological diseases; most patients die within 3 to 4 years after symptom onset. Oxidative stress is a disturbance in the pro-oxidative/anti-oxidative balance favoring the pro-oxidative state. Autopsy and laboratory studies in ALS indicate that oxidative stress plays a major role in motor neuron degeneration and astrocyte dysfunction. Oxidative stress biomarkers in cerebrospinal fluid, plasma, and urine, are elevated, suggesting that abnormal oxidative stress is generated outside of the central nervous system. Our review indicates that agricultural chemicals, heavy metals, military service, professional sports, excessive physical exertion, chronic head trauma, and certain foods might be modestly associated with ALS risk, with a stronger association between risk and smoking. At the cellular level, these factors are all involved in generating oxidative stress. Experimental studies indicate that a combination of insults that induce modest oxidative stress can exert additive deleterious effects on motor neurons, suggesting multiple exposures in real-world environments are important. As the disease progresses, nutritional deficiency, cachexia, psychological stress, and impending respiratory failure may further increase oxidative stress. Moreover, accumulating evidence suggests that ALS is possibly a systemic disease. Laboratory, pathologic, and epidemiologic evidence clearly support the hypothesis that oxidative stress is central in the pathogenic process, particularly in genetically susceptive individuals. If we are to improve ALS treatment, well-designed biochemical and genetic epidemiological studies, combined with a multidisciplinary research approach, are needed and will provide knowledge crucial to our understanding of ALS etiology, pathophysiology, and prognosis. PMID:23797033

Neuraminidase inhibitor therapy in a military population.

PubMed

Fairchok, Mary P; Chen, Wei-Ju; Arnold, John C; Schofield, Christina; Danaher, Patrick J; McDonough, Erin A; Ottolini, Martin; Mor, Deepika; Ridore, Michelande; Burgess, Timothy H; Millar, Eugene V

2015-06-01

Although neuraminidase inhibitors (NI) are the mainstay of treatment for influenza infection, prescribing practice for these agents is not well described. Additionally, benefit is contested. We examined provider prescriptions of NI during the 2009 pandemic and post-pandemic periods. We also evaluated the effectiveness of NI in reducing severity of influenza infection. Data on NI prescription and severity of influenza infection were compiled in healthy pediatric and adult beneficiaries enrolled in a prospective study of influenza like illness conducted at five military medical centers over five years. Subjects underwent nasal swabs to determine viral etiology of their infection. Demographic, medication and severity data were collected. Subjects with positive influenza were included. Two hundred sixty three subjects were influenza positive [38% [H1N1] pdm09, 38.4% H3N2, and 20.5% B); 23.9% were treated with NI. NI were initiated within 48h in 63% of treated subjects. Although NI use increased over the five years of the study, early use declined. Most measures for severity of illness were not significantly reduced with NI; adults treated within 48h had only a modest reduction in duration and severity of some of their symptoms. NI use in our population is increasing, but early use is not. NI use resulted in no reduction in complications of illness. Resolution of symptoms and reduction in severity of some symptoms were slightly better in adults who were treated early. These modest benefits do not support routine treatment with NI in otherwise healthy individuals with influenza. Copyright © 2015 Elsevier B.V. All rights reserved.

The role of social support in facilitating postpartum women's return to employment.

PubMed

Killien, Marcia Gruis

2005-01-01

More than half of mothers with infants under 1 year are employed. This study explored the role of social support in facilitating women's return to employment during the 1st year postpartum. Analysis of existing longitudinal, repeated-measures questionnaire data gathered at 4 and 12 months postpartum. 94 postpartum women who were married or partnered, employed, and residing in a large urban area in the northwestern United States. Satisfaction with decision to return to work, role performance, work-family balance. Relationships between indicators of social support and return-to-work experiences were absent to modest. Satisfaction with child care was related to satisfaction with the decision to return to work. Workplace support was related to work-family balance at 12 months postpartum. Satisfactory child care arrangements and supportive relationships in the workplace are the most significant facilitators of women's return to work postpartum.

Free Compulsory Education: A Natural Next Step after "Two Exceptions and One Subsidy" (TEOS)

ERIC Educational Resources Information Center

Brock, Andy; Wenbin, Hu; Wong, Christine

2008-01-01

Since 2001, the Chinese central government has begun to take on more financial responsibility for basic education beginning with a modest RMB100 million to provide free textbooks to poor students in western rural areas. This practice has been gradually expanded with the central government providing free textbooks to a widening pool of poor rural…

How will provider-focused payment reform impact geographic variation in Medicare spending?

PubMed

Auerbach, David; Mehrotra, Ateev; Hussey, Peter; Huckfeldt, Peter J; Alpert, Abby; Lau, Christopher; Shier, Victoria

2015-06-01

The Institute of Medicine has recently argued against a value index as a mechanism to address geographic variation in spending and instead promoted payment reform targeted at individual providers. It is unknown whether such provider-focused payment reform reduces geographic variation in spending. We estimated the potential impact of 3 Medicare provider-focused payment policies-pay-for-performance, bundled payment, and accountable care organizations-on geographic variation in Medicare spending across Hospital Referral Regions (HRRs). We compared geographic variation in spending, measured using the coefficient of variation (CV) across HRRs, between the baseline case and a simulation of each of the 3 policies. Policy simulation based on 2008 national Medicare data combined with other publicly available data. Compared with the baseline (CV, 0.171), neither pay-for-performance nor accountable care organizations would change geographic variation in spending (CV, 0.171), while bundled payment would modestly reduce geographic variation (CV, 0.165). In our models, the bundled payment for inpatient and post acute care services in Medicare would modestly reduce geographic variation in spending, but neither accountable care organizations nor pay-for-performance appear to have an impact.

Refeeding syndrome in a young woman with argininosuccinate lyase deficiency.

PubMed

Stuy, M; Chen, G-F; Masonek, J M; Scharschmidt, B F

2015-09-01

A severely chronically protein and calorie restricted young woman with argininosuccinate lyase deficiency developed transient refeeding syndrome (RFS) and hyperammonemia after modest diet liberalization following initiation of glycerol phenylbutyrate (GPB). The patient required IV supportive care and supplementation with potassium, magnesium and calcium. She is now doing well on GPB and an appropriate maintenance diet. Susceptibility to RFS should be considered in chronically nutritionally restricted patients with metabolic disorders after liberalization of diet.

CTC Sentinel. Volume 2, Issue 7, July 2009

DTIC Science & Technology

2009-07-01

group also admitted that they had received modest government funding in the shape of a religious donation, or zakat.9 History of Qari Zain’s Split...and Ayro’s factions also received at the very least rhetorical support from al- Qa`ida. Aweys and Turki, representing the fundamentalist-nationalist...1990s, AIAI received funding from al-Qa`ida,15 and its leaders have been implicated in terrorist attacks against Ethiopia over the disputed Ogaden

Energetic costs of calcification under ocean acidification

NASA Astrophysics Data System (ADS)

Spalding, Christopher; Finnegan, Seth; Fischer, Woodward W.

2017-05-01

Anthropogenic ocean acidification threatens to negatively impact marine organisms that precipitate calcium carbonate skeletons. Past geological events, such as the Permian-Triassic Mass Extinction, together with modern experiments generally support these concerns. However, the physiological costs of producing a calcium carbonate skeleton under different acidification scenarios remain poorly understood. Here we present an idealized mathematical model to quantify whole-skeleton costs, concluding that they rise only modestly (up to ˜10%) under acidification expected for 2100. The modest magnitude of this effect reflects in part the low energetic cost of inorganic, calcium carbonate relative to the proteinaceous organic matrix component of skeletons. Our analysis does, however, point to an important kinetic constraint that depends on seawater carbonate chemistry, and we hypothesize that the impact of acidification is more likely to cause extinctions within groups where the timescale of larval development is tightly constrained. The cheapness of carbonate skeletons compared to organic materials also helps explain the widespread evolutionary convergence upon calcification within the metazoa.

Abatement of an aircraft exhaust plume using aerodynamic baffles.

PubMed

Bennett, Michael; Christie, Simon M; Graham, Angus; Garry, Kevin P; Velikov, Stefan; Poll, D Ian; Smith, Malcolm G; Mead, M Iqbal; Popoola, Olalekan A M; Stewart, Gregor B; Jones, Roderic L

2013-03-05

The exhaust jet from a departing commercial aircraft will eventually rise buoyantly away from the ground; given the high thrust/power (i.e., momentum/buoyancy) ratio of modern aero-engines, however, this is a slow process, perhaps requiring ∼ 1 min or more. Supported by theoretical and wind tunnel modeling, we have experimented with an array of aerodynamic baffles on the surface behind a set of turbofan engines of 124 kN thrust. Lidar and point sampler measurements show that, as long as the intervention takes place within the zone where the Coanda effect holds the jet to the surface (i.e., within about 70 m in this case), then quite modest surface-mounted baffles can rapidly lift the jet away from the ground. This is of potential benefit in abating both surface concentrations and jet blast downstream. There is also some modest acoustic benefit. By distributing the aerodynamic lift and drag across an array of baffles, each need only be a fraction of the height of a single blast fence.

Public support for social financing of health care in Switzerland.

PubMed

Perneger, Thomas V; Hudelson, Patricia M

2005-01-01

The purpose of this study was to identify factors associated with the public's preference for financing health care according to people's ability to pay. The authors compared voters' support in 26 Swiss cantons for a legislative proposal to replace regionally rated health insurance premiums (current system) with premiums proportional to income and wealth, and co-financed through the value added tax. The vote took place in May 2003, and the initiative was rejected, with only 27 percent of support nationwide. However, support varied more than threefold, from 13 to 44 percent, among cantons. In multivariate analysis, support was most strongly correlated with the approval rate of the 1994 law on health insurance, which strengthened solidarity between the sick and the healthy. More modest associations were seen between support for the initiative and the health insurance premium of 2003, and proportions of elderly and urban residents in the population. Hence support for more social financing of health care was best explained by past preference for a social health insurance system in the local community.

Determinants of Children's Mental Health in War-Torn Settings: Translating Research Into Action.

PubMed

Miller, Kenneth E; Jordans, Mark J D

2016-06-01

Research on the mental health and psychosocial wellbeing of children in conflict-affected settings has undergone a significant paradigm shift in recent years. Earlier studies based on a war exposure model primarily emphasized the effects of direct exposure to armed conflict; this has gradually given way to a broader understanding of the diverse pathways by which organized violence affects children. A robustly supported comprehensive model includes risk factors at multiple points in time (prior war exposure, ongoing daily stressors) and at all levels of the social ecology. In particular, findings suggest that material deprivation and a set of family variables, including harsh parenting, parental distress, and witnessing intimate partner violence, are important mediators of the relationship between armed conflict and children's wellbeing. To date, however, interventions aimed at supporting war-affected children's wellbeing, both preventive and treatment-focused, have focused primarily on direct work with children, while paying only modest attention to ongoing risk factors in their families and broader environments. Possible reasons for the ongoing prioritization of child-focused interventions are considered, and examples are provided of recent evidence-based interventions that have reduced toxic stressors (harsh parenting and the use of violent discipline by teachers) in conflict-affected communities.

Unsentimental Education.

ERIC Educational Resources Information Center

Guiney, Anne

2001-01-01

Explains how architect Mathias Klotz skillfully exploited qualities of Santiago, Chile's, urban landscape, including mountains, low buildings, wide streets, modest houses, and cars to create a simple elementary and high school building that provides occupants with a sophisticated and rich environment. Includes nine photographs, three plans, and a…

Post O-Level English--The Study of Language

ERIC Educational Resources Information Center

Gannon, P.

1976-01-01

Examines objections to the study of language and linguistics in secondary education and suggests that it is time to resolve the false dichotomy between English literature and English language by providing a modest optional language element in A-level English. (Author/RK)

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings.

PubMed

Kumar, Somesh; Yadav, Vikas; Balasubramaniam, Sudharsanam; Jain, Yashpal; Joshi, Chandra Shekhar; Saran, Kailash; Sood, Bulbul

2016-11-08

India accounts for 27 % of world's neonatal deaths. Although more Indian women deliver in facilities currently than a decade ago, early neonatal mortality has not declined, likely because of insufficient quality of care. The WHO Safe Childbirth Checklist (SCC) was developed to support health workers to perform essential practices known to reduce preventable maternal and new-born deaths around the time of childbirth. Despite promising early research many outstanding questions remain about effectiveness of the SCC in low-resource settings. In collaboration with the Ministry of Health SCC was modified for Indian context and introduced in 101 intervention facilities in Rajasthan, India and 99 facilities served as comparison to study if it reduces mortality. This Quasi experimental Observational intervention-comparison was embedded in this larger program to test whether a program for introduction of SCC with simple implementation package was associated with increased adherence to 28 evidence-based practices. This study was conducted in 8 intervention and 8 comparison sites. Program interventions to promote appropriate use of the SCC included orienting providers to the checklist, modest modifications of the SCC to promote provider uptake and accountability, ensuring availability of essential supplies, and providing supportive supervision for helping providers in using the SCC. The SCC was used by providers in 86 % of 240 deliveries observed in the eight intervention facilities. Providers in the intervention group significantly adhered to practices included in the SCC than providers in the comparison group controlling for baseline scores and confounders. Women delivering in the intervention facilities received on an average 11.5 more of the 28 practices included compared with women in the comparison facilities. For selected practices provider performance in the intervention group increased as much as 93 % than comparison sites. Use of the SCC and provider performance of best practices increased in intervention facilities reflecting improvement in quality of facility childbirth care for women and new-born in low resource settings.

End-Tidal Carbon Dioxide Measurement during Pediatric Polysomnography: Signal Quality, Association with Apnea Severity, and Prediction of Neurobehavioral Outcomes.

PubMed

Paruthi, Shalini; Rosen, Carol L; Wang, Rui; Weng, Jia; Marcus, Carole L; Chervin, Ronald D; Stanley, Jeffrey J; Katz, Eliot S; Amin, Raouf; Redline, Susan

2015-11-01

To identify the role of end-tidal carbon dioxide (EtCO2) monitoring during polysomnography in evaluation of children with obstructive sleep apnea syndrome (OSAS), including the correlation of EtCO2 with other measures of OSAS and prediction of changes in cognition and behavior after adenotonsillectomy. Analysis of screening and endpoint data from the Childhood Adenotonsillectomy Trial, a randomized, controlled, multicenter study comparing early adenotonsillectomy (eAT) to watchful waiting/supportive care (WWSC) in children with OSAS. Multisite clinical referral settings. Children, ages 5.0 to 9.9 y with suspected sleep apnea. eAT or WWSC. Quality EtCO2 waveforms were present for ≥ 75% of total sleep time (TST) in 876 of 960 (91.3%) screening polysomnograms. Among the 322 children who were randomized, 55 (17%) met pediatric criteria for hypoventilation. The mean TST with EtCO2 > 50 mmHg was modestly correlated with apnea-hypopnea index (AHI) (r = 0.33; P < 0.0001) and with oxygen saturation ≤ 92% (r = 0.26; P < 0.0001). After adjusting for AHI, obesity, and other factors, EtCO2 > 50 mmHg was higher in African American children than others. The TST with EtCO2 > 50 mmHg decreased significantly more after eAT than WWSC. In adjusted analyses, baseline TST with EtCO2 > 50 mmHg did not predict postoperative changes in cognitive and behavioral measurements. Among children with suspected obstructive sleep apnea syndrome, overnight end-tidal carbon dioxide (EtCO2) levels are weakly to modestly correlated with other polysomnographic indices and therefore provide independent information on hypoventilation. EtCO2 levels improve with adenotonsillectomy but are not as responsive as AHI and do not provide independent prediction of cognitive or behavioral response to surgery. Childhood Adenotonsillectomy Study for Children with OSAS (CHAT). ClinicalTrials.gov Identifier #NCT00560859. © 2015 Associated Professional Sleep Societies, LLC.

Using Programmable Calculators to Solve Electrostatics Problems.

ERIC Educational Resources Information Center

Yerian, Stephen C.; Denker, Dennis A.

1985-01-01

Provides a simple routine which allows first-year physics students to use programmable calculators to solve otherwise complex electrostatic problems. These problems involve finding electrostatic potential and electric field on the axis of a uniformly charged ring. Modest programing skills are required of students. (DH)

Charging Electric Vehicles in Smart Cities: An EVI-Pro Analysis of Columbus, Ohio

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

Wood, Eric W.; Rames, Clement L.; Muratori, Matteo

With the support of the U.S. Department of Energy's Vehicle Technologies Office, the National Renewable Energy Laboratory (NREL) worked with the City of Columbus, Ohio, to develop a plan for the expansion of the region's network of charging stations to support increased adoption of plug-in electric vehicles (PEVs) in the local market. NREL's Electric Vehicle Infrastructure Projection (EVI-Pro) model was used to generate scenarios of regional charging infrastructure to support consumer PEV adoption. Results indicate that approximately 400 Level 2 plugs at multi-unit dwellings and 350 Level 2 plugs at non-residential locations are required to support Columbus' primary PEV goalmore » of 5,300 PEVs on the road by the end of 2019. This analysis finds that while consumer demand for fast charging is expected to remain low (due to modest anticipated adoption of short-range battery electric vehicles), a minimum level of fast charging coverage across the city is required to ease consumer range anxiety concerns by providing a safety net for unexpected charging events. Sensitivity analyses around some key assumptions have also been performed; of these, consumer preference for PHEV versus BEV and for their electric driving range, ambient conditions, and availability of residential charging at multi-unit dwellings were identified as key determinants of the non-residential PEV charging infrastructure required to support PEV adoption. The results discussed in this report can be leveraged by similar U.S. cities as part of a strategy to accelerate PEV adoption in the light-duty vehicle market.« less

Behavioral control in at-risk toddlers: the influence of the family check-up.

PubMed

Shelleby, Elizabeth C; Shaw, Daniel S; Cheong, Jeewon; Chang, Hyein; Gardner, Frances; Dishion, Thomas J; Wilson, Melvin N

2012-01-01

This study examines the role of one component of emotion regulation, behavioral control, in the growth of children's early behavior problems by examining whether increases in parental positive behavior support brought about by a family-centered intervention were associated with greater child behavioral control, and whether greater behavioral control at age 3 mediated the association between improvements in aspects of positive behavior support from ages 2 to 3 and decreases in growth of behavior problems from ages 2 to 4. The sample included 713 at-risk children (50% female) and their primary caregivers (50% European American, 28% African American, 13% biracial, 9% other) who were randomly assigned to the intervention or control group. Children had a mean age of 29.91 months at the initial assessment. Data were collected through home visits at child ages 2 to 4, which involved questionnaires for primary caregivers and structured and unstructured play activities for children with primary and alternative caregivers and siblings. Results indicated that the intervention improved parental positive behavior support and reduced growth of child behavior problems. One dimension of positive behavior support, proactive parenting, was modestly associated with behavioral control at age 3, which in turn was significantly associated with growth in behavior problems from ages 2 to 4, with greater behavioral control related to lower levels of growth in behavior problems. Results provide support for the notion that proactive parenting is an important factor in the development of children's behavioral control and that behavioral control plays an important role in the growth of behavior problems.

Diversification of Processors Based on Redundancy in Instruction Set

NASA Astrophysics Data System (ADS)

Ichikawa, Shuichi; Sawada, Takashi; Hata, Hisashi

By diversifying processor architecture, computer software is expected to be more resistant to plagiarism, analysis, and attacks. This study presents a new method to diversify instruction set architecture (ISA) by utilizing the redundancy in the instruction set. Our method is particularly suited for embedded systems implemented with FPGA technology, and realizes a genuine instruction set randomization, which has not been provided by the preceding studies. The evaluation results on four typical ISAs indicate that our scheme can provide a far larger degree of freedom than the preceding studies. Diversified processors based on MIPS architecture were actually implemented and evaluated with Xilinx Spartan-3 FPGA. The increase of logic scale was modest: 5.1% in Specialized design and 3.6% in RAM-mapped design. The performance overhead was also modest: 3.4% in Specialized design and 11.6% in RAM-mapped design. From these results, our scheme is regarded as a practical and promising way to secure FPGA-based embedded systems.

Recovery and identification of human remains in post-conflict environments: A comparative study of the humanitarian forensic programs in Cyprus and Kosovo.

PubMed

Mikellide, Maria

2017-10-01

This study follows the humanitarian forensic programs in Cyprus and Kosovo over a ten-year period with an emphasis on the role of local capacity building. It begins by providing an in-depth historical account of forensic activities, followed by a comparison of the rate of excavations, exhumations and identifications. Through this analysis, a repeated pattern emerges whereby forensic activities in Kosovo start with a surge in values, which drop drastically in the first few years of operations, followed by a steadily declining productivity curve. By contrast, in Cyprus, activities begin modestly, with lower values allowing for some modest growth. Close observation of the two programs provides indications as to the factors that may influence the development of forensic programs as well as the elements that need to be set in place to create an environment conducive to greater sustainability through local ownership and responsibility. Copyright © 2017 Elsevier B.V. All rights reserved.

A Transformative Approach to Academic Medicine: The Partnership Between the University of Arizona and Banner Health.

PubMed

Cairns, Charles B; Bollinger, Kathy; Garcia, Joe G N

2017-01-01

The University of Arizona Health Network (UAHN) was a modestly successful health care delivery organization with a vibrant academic portfolio and stable finances. By 2013, however, market forces, health care financing changes, and the burden of technology and informatics upgrades led to a compromised financial position at UAHN, a situation experienced by many academic medical centers. Concurrently, Banner Health had been interested in forming an academic partnership to enhance innovation, including the incorporation of new approaches into health care delivery, and to recruit high-quality providers to the organization. In 2015, the University of Arizona (UA) and Banner Health entered into a unique partnership known as Banner - University Medicine. The objective was to create a statewide system that provides reliable, compassionate, high-quality health care across all of its providers and facilities and to make a 30-year commitment to UA's College of Medicine in Tucson and the College of Medicine in Phoenix to support the State of Arizona's position as a first-tier research and training destination with world-class physicians. The goal of the Banner - University Medicine partnership is to create a nationally leading organization that transforms health care by delivering better care, enhanced service, and lower costs through new approaches focused on wellness. Key elements of this partnership are highlighted in this Commentary, including the unique governance structure of the Academic Management Council, the creation of the Academic Enhancement Fund to support the UA Colleges of Medicine in Tucson and Phoenix, and novel approaches to medical education, research, innovation, and care.

Comparing the Bioburden Measured by Adenosine Triphosphate (ATP) Luminescence Technology to Contact Plate-Based Microbiologic Sampling to Assess the Cleanliness of the Patient Care Environment.

PubMed

Salsgiver, Elizabeth; Bernstein, Daniel; Simon, Matthew S; Greendyke, William; Jia, Haomiao; Robertson, Amy; Salter, Selma; Schuetz, Audrey N; Saiman, Lisa; Furuya, E Yoko; Calfee, David P

2018-05-01

The correlation between ATP concentration and bacterial burden in the patient care environment was assessed. These findings suggest that a correlation exists between ATP concentration and bacterial burden, and they generally support ATP technology manufacturer-recommended cutoff values. Despite relatively modest discriminative ability, this technology may serve as a useful proxy for cleanliness.Infect Control Hosp Epidemiol 2018;39:622-624.

Invited commentaries on... Abortion and mental health disorders.

PubMed

Casey, Patricia; Oates, Margaret; Jones, Ian; Cantwell, Roch

2008-12-01

The finding that induced abortion is a risk factor for subsequent psychiatric disorder in some women raises important clinical and training issues for psychiatrists. It also highlights the necessity for developing evidence-based interventions for these women. P.C. / Evidence suggesting a modest increase in mental health problems after abortion does not support the prominence of psychiatric issues in the abortion debate, which is primarily moral and ethical not psychiatric or scientific. M.O. et al.

Refeeding syndrome in a young woman with argininosuccinate lyase deficiency☆

PubMed Central

Stuy, M.; Chen, G.-F.; Masonek, J.M.; Scharschmidt, B.F.

2015-01-01

A severely chronically protein and calorie restricted young woman with argininosuccinate lyase deficiency developed transient refeeding syndrome (RFS) and hyperammonemia after modest diet liberalization following initiation of glycerol phenylbutyrate (GPB). The patient required IV supportive care and supplementation with potassium, magnesium and calcium. She is now doing well on GPB and an appropriate maintenance diet. Susceptibility to RFS should be considered in chronically nutritionally restricted patients with metabolic disorders after liberalization of diet. PMID:26937403

Masturbation Frequency and Sexual Function Domains Are Associated With Serum Reproductive Hormone Levels Across the Menopausal Transition

PubMed Central

Zheng, Huiyong; Avis, Nancy E.; Greendale, Gail A.; Harlow, Siobán D.

2015-01-01

Objective: To determine whether reproductive hormones are related to sexual function during the menopausal transition. Design: The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42–52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Main Outcome Measures: Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Results: Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Conclusions: Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance. PMID:25412335

Results of the Medicare Health Support disease-management pilot program.

PubMed

McCall, Nancy; Cromwell, Jerry

2011-11-03

In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition.

PubMed

Randolph, John F; Zheng, Huiyong; Avis, Nancy E; Greendale, Gail A; Harlow, Siobán D

2015-01-01

To determine whether reproductive hormones are related to sexual function during the menopausal transition. The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.

Coping with historic drought in California rangelands

USDA-ARS?s Scientific Manuscript database

The current drought in California is of historic proportion, both in its intensity and its effect on agriculture. Although storms of the 2015-16 winter rainfall season have provided modest drought relief, their effects on alleviating the multi-year drought are unknown. Short- and mid-term forecasts...

Noncovalent Interactions in the Asymmetric Synthesis of Rigid, Conjugated Helical Structures

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

Miyasaka, Makoto; Pink, Maren; Rajca, Suchada

Tetrakis({beta}-trithiophene) 1 folds into a helical conformation (RRR) that facilitates double ring annelation, with high diastereoselectivity and modest enantioselectivity, to provide bis[7]helicene 2 (MRM). This rigid, helically locked structure has enhanced chiroptical properties similar to the corresponding [15]helicene.

Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation.

PubMed

Camacho, Jhon; Medina Ch, Ana María; Landis-Lewis, Zach; Douglas, Gerald; Boyce, Richard

2018-04-13

The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. Our study will further the understanding of the role of mobile decision support systems in the implementation of clinical practice guidelines. Furthermore, we will provide qualitative evidence to aid decisions made by low- and middle-income countries' ministries of health about investments in these technologies. ©Jhon Camacho, Ana María Medina Ch, Zach Landis-Lewis, Gerald Douglas, Richard Boyce. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 13.04.2018.

Moral Education in Canadian Social Studies: A Modest Proposal

ERIC Educational Resources Information Center

Cochrane, Don; Williams, David

1977-01-01

Recent ideas and publications concerning values and moral education have had little impact on social studies teaching in Canada. The article provides eight suggestions for improving values education, including leadership from provincial ministers of education, development of a values education rationale, and improvement of teacher education and…

Exercise Prescriptions for Active Seniors: A Team Approach for Maximizing Adherence.

ERIC Educational Resources Information Center

Brennan, Fred H., Jr.

2002-01-01

Exercise is an important "medication" that healthcare providers can prescribe for their geriatric patients. Increasing physical fitness by participating in regular exercise can reduce the effects of aging that lead to functional declines and poor health. Modest regular exercise can substantially lower the risk of death from coronary…

Documentation and Development. Experience in Algeria

ERIC Educational Resources Information Center

Tchuigoua, J. Founou

1972-01-01

A description of the activities of the Documentation, Library and Archives Department of the Algiers Chamber of Commerce and Industry, which is run by a small staff on a modest budget, provides documentation services for the staff of the Chamber of Commerce and also assists other centers in Algeria. (Author)

76 FR 72488 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... investment and risk management strategies and decisions. The Exchange further believes this proposed rule change will provide investors with additional Weekly option classes for investment, trading and risk management purposes. Therefore, the Exchange requests a modest expansion of the current Weeklys Program. The...

Home Health Care: Services and Cost

ERIC Educational Resources Information Center

Widmer, Geraldine; And Others

1978-01-01

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

24 CFR 1007.20 - Eligible housing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... standards that: (1) Provide sufficient flexibility to permit the use of various designs and materials; and (2) Require each dwelling unit to: (i) Be decent, safe, sanitary, and modest in size and design; (ii... kitchen sink and a partitional bathroom with lavatory, toilet, and bath or shower; and (C) Uses water...

HSP90 empowers evolution of resistance to hormonal therapy in human breast cancer models.

PubMed

Whitesell, Luke; Santagata, Sandro; Mendillo, Marc L; Lin, Nancy U; Proia, David A; Lindquist, Susan

2014-12-23

The efficacy of hormonal therapies for advanced estrogen receptor-positive breast cancers is limited by the nearly inevitable development of acquired resistance. Efforts to block the emergence of resistance have met with limited success, largely because the mechanisms underlying it are so varied and complex. Here, we investigate a new strategy aimed at the very processes by which cancers evolve resistance. From yeast to vertebrates, heat shock protein 90 (HSP90) plays a unique role among molecular chaperones by promoting the evolution of heritable new traits. It does so by regulating the folding of a diverse portfolio of metastable client proteins, many of which mediate adaptive responses that allow organisms to adapt and thrive in the face of diverse challenges, including those posed by drugs. Guided by our previous work in pathogenic fungi, in which very modest HSP90 inhibition impairs resistance to mechanistically diverse antifungals, we examined the effect of similarly modest HSP90 inhibition on the emergence of resistance to antiestrogens in breast cancer models. Even though this degree of inhibition fell below the threshold for proteotoxic activation of the heat-shock response and had no overt anticancer activity on its own, it dramatically impaired the emergence of resistance to hormone antagonists both in cell culture and in mice. Our findings strongly support the clinical testing of combined hormone antagonist-low-level HSP90 inhibitor regimens in the treatment of metastatic estrogen receptor-positive breast cancer. At a broader level, they also provide promising proof of principle for a generalizable strategy to combat the pervasive problem of rapidly emerging resistance to molecularly targeted therapeutics.

Leisure Time Physical Activity Among U.S. Adults With Arthritis, 2008-2015.

PubMed

Murphy, Louise B; Hootman, Jennifer M; Boring, Michael A; Carlson, Susan A; Qin, Jin; Barbour, Kamil E; Brady, Teresa J; Helmick, Charles G

2017-09-01

In 2016, leisure time physical activity among U.S. adults aged ≥18 years with and without arthritis was studied to provide estimates using contemporary guidelines (2008 Physical Activity Guidelines for Americans) and population-based data (U.S. National Health Interview Survey). Estimated prevalence of: (1) meeting aerobic, muscle strengthening, and both aerobic and muscle strengthening guidelines, by arthritis status, from 2008 to 2015; and (2) meeting guidelines across selected sociodemographic characteristics and health status and behaviors, among adults with arthritis, in 2015. In 2015, 36.2%, 17.9%, and 13.7% of adults with arthritis met aerobic, muscle strengthening, and both guidelines, respectively; age-standardized prevalence of meeting each guideline was significantly lower among those with arthritis versus those without (e.g., 41.9% [95% CI=39.5%, 44.3%] and 52.2% [95% CI=51.2%, 53.2%] met the aerobic guideline, respectively; p<0.001). From 2008 to 2015, meeting aerobic guideline rose modestly (3 percentage points) among those with arthritis compared with larger gains (7 percentage points) among those without arthritis; the percentage of adults with arthritis meeting muscle strengthening and both guidelines remained the same in contrast to modest (statistically significant) increases among those without arthritis. Among adults with arthritis, age-standardized percentage meeting each guideline was highest among those with at least a university degree. Percentage meeting each guideline was persistently low among adults with arthritis. The lower prevalence among adults with arthritis versus those without suggests that adults with arthritis need additional strategies to address potential barriers (e.g., pain, psychological distress, inadequate medical support) to physical activity. Published by Elsevier Inc.

Immersive Earth: Teaching Earth and Space with inexpensive immersive technology

NASA Astrophysics Data System (ADS)

Reiff, P. H.; Sumners, C.; Law, C. C.; Handron, K.

2003-12-01

In 1995 we pioneered "Space Update", the Digital Library for the rest of us", software that was so simple that a child could use it without a keyboard and yet would allow one-click updating of the daily earth and space science images without the dangers of having an open web browser on display. Thanks to NASA support, it allowed museums and schools to have a powerful exhibit for a tiny price. Over 40,000 disks in our series have been distributed so far to educators and the public. In 2003, with our partners we are again revolutionizing educational technology with a low-cost hardware and software solution to creating and displaying immersive content. Recently selected for funding as part of the REASoN competition, Immersive Earth is a partnership of scientists, museums, educators, and content providers. The hardware consists of a modest projector with a special fisheye lens to be used in an inflatable dome which many schools already have. This, coupled with a modest personal computer, can now easily project images and movies of earth and space, allows training students in 3-D content at a tiny fraction of the cost of a cave or fullscale dome theater. Another low-cost solution is the "Imove" system, where spherical movies can play on a personal computer, with the user changing the viewing direction with a joystick. We were the first to create immersive earth science shows, remain the leader in creating educational content that people want to see. We encourage people with "allsky" images or movies to bring it and see what it looks like inside a dome! Your content could be in our next show!

Effect of Information and Telephone-Guided Access to Community Support for People with Chronic Kidney Disease: Randomised Controlled Trial

PubMed Central

Blakeman, Tom; Blickem, Christian; Kennedy, Anne; Reeves, David; Bower, Peter; Gaffney, Hannah; Gardner, Caroline; Lee, Victoria; Jariwala, Praksha; Dawson, Shoba; Mossabir, Rahena; Brooks, Helen; Richardson, Gerry; Spackman, Eldon; Vassilev, Ivaylo; Chew-Graham, Carolyn; Rogers, Anne

2014-01-01

Background Implementation of self-management support in traditional primary care settings has proved difficult, encouraging the development of alternative models which actively link to community resources. Chronic kidney disease (CKD) is a common condition usually diagnosed in the presence of other co-morbidities. This trial aimed to determine the effectiveness of an intervention to provide information and telephone-guided access to community support versus usual care for patients with stage 3 CKD. Methods and Findings In a pragmatic, two-arm, patient level randomised controlled trial 436 patients with a diagnosis of stage 3 CKD were recruited from 24 general practices in Greater Manchester. Patients were randomised to intervention (215) or usual care (221). Primary outcome measures were health related quality of life (EQ-5D health questionnaire), blood pressure control, and positive and active engagement in life (heiQ) at 6 months. At 6 months, mean health related quality of life was significantly higher for the intervention group (adjusted mean difference = 0.05; 95% CI = 0.01, 0.08) and blood pressure was controlled for a significantly greater proportion of patients in the intervention group (adjusted odds-ratio = 1.85; 95% CI = 1.25, 2.72). Patients did not differ significantly in positive and active engagement in life. The intervention group reported a reduction in costs compared with control. Conclusions An intervention to provide tailored information and telephone-guided access to community resources was associated with modest but significant improvements in health related quality of life and better maintenance of blood pressure control for patients with stage 3 CKD compared with usual care. However, further research is required to identify the mechanisms of action of the intervention. Trial Registration Controlled-Trials.com ISRCTN45433299 PMID:25330169

A modifier of Huntington's disease onset at the MLH1 locus.

PubMed

Lee, Jong-Min; Chao, Michael J; Harold, Denise; Abu Elneel, Kawther; Gillis, Tammy; Holmans, Peter; Jones, Lesley; Orth, Michael; Myers, Richard H; Kwak, Seung; Wheeler, Vanessa C; MacDonald, Marcy E; Gusella, James F

2017-10-01

Huntington's disease (HD) is a dominantly inherited neurodegenerative disease caused by an expanded CAG repeat in HTT. Many clinical characteristics of HD such as age at motor onset are determined largely by the size of HTT CAG repeat. However, emerging evidence strongly supports a role for other genetic factors in modifying the disease pathogenesis driven by mutant huntingtin. A recent genome-wide association analysis to discover genetic modifiers of HD onset age provided initial evidence for modifier loci on chromosomes 8 and 15 and suggestive evidence for a locus on chromosome 3. Here, genotyping of candidate single nucleotide polymorphisms in a cohort of 3,314 additional HD subjects yields independent confirmation of the former two loci and moves the third to genome-wide significance at MLH1, a locus whose mouse orthologue modifies CAG length-dependent phenotypes in a Htt-knock-in mouse model of HD. Both quantitative and dichotomous association analyses implicate a functional variant on ∼32% of chromosomes with the beneficial modifier effect that delays HD motor onset by 0.7 years/allele. Genomic DNA capture and sequencing of a modifier haplotype localize the functional variation to a 78 kb region spanning the 3'end of MLH1 and the 5'end of the neighboring LRRFIP2, and marked by an isoleucine-valine missense variant in MLH1. Analysis of expression Quantitative Trait Loci (eQTLs) provides modest support for altered regulation of MLH1 and LRRFIP2, raising the possibility that the modifier affects regulation of both genes. Finally, polygenic modification score and heritability analyses suggest the existence of additional genetic modifiers, supporting expanded, comprehensive genetic analysis of larger HD datasets. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The evolution of autodigestion in the mushroom family Psathyrellaceae (Agaricales) inferred from Maximum Likelihood and Bayesian methods.

PubMed

Nagy, László G; Urban, Alexander; Orstadius, Leif; Papp, Tamás; Larsson, Ellen; Vágvölgyi, Csaba

2010-12-01

Recently developed comparative phylogenetic methods offer a wide spectrum of applications in evolutionary biology, although it is generally accepted that their statistical properties are incompletely known. Here, we examine and compare the statistical power of the ML and Bayesian methods with regard to selection of best-fit models of fruiting-body evolution and hypothesis testing of ancestral states on a real-life data set of a physiological trait (autodigestion) in the family Psathyrellaceae. Our phylogenies are based on the first multigene data set generated for the family. Two different coding regimes (binary and multistate) and two data sets differing in taxon sampling density are examined. The Bayesian method outperformed Maximum Likelihood with regard to statistical power in all analyses. This is particularly evident if the signal in the data is weak, i.e. in cases when the ML approach does not provide support to choose among competing hypotheses. Results based on binary and multistate coding differed only modestly, although it was evident that multistate analyses were less conclusive in all cases. It seems that increased taxon sampling density has favourable effects on inference of ancestral states, while model parameters are influenced to a smaller extent. The model best fitting our data implies that the rate of losses of deliquescence equals zero, although model selection in ML does not provide proper support to reject three of the four candidate models. The results also support the hypothesis that non-deliquescence (lack of autodigestion) has been ancestral in Psathyrellaceae, and that deliquescent fruiting bodies represent the preferred state, having evolved independently several times during evolution. Copyright © 2010 Elsevier Inc. All rights reserved.

Sociology of Low Expectations: Recalibration as Innovation Work in Biomedicine.

PubMed

Gardner, John; Samuel, Gabrielle; Williams, Clare

2015-11-01

Social scientists have drawn attention to the role of hype and optimistic visions of the future in providing momentum to biomedical innovation projects by encouraging innovation alliances. In this article, we show how less optimistic, uncertain, and modest visions of the future can also provide innovation projects with momentum. Scholars have highlighted the need for clinicians to carefully manage the expectations of their prospective patients. Using the example of a pioneering clinical team providing deep brain stimulation to children and young people with movement disorders, we show how clinicians confront this requirement by drawing on their professional knowledge and clinical expertise to construct visions of the future with their prospective patients; visions which are personalized, modest, and tainted with uncertainty. We refer to this vision-constructing work as recalibration, and we argue that recalibration enables clinicians to manage the tension between the highly optimistic and hyped visions of the future that surround novel biomedical interventions, and the exigencies of delivering those interventions in a clinical setting. Drawing on work from science and technology studies, we suggest that recalibration enrolls patients in an innovation alliance by creating a shared understanding of how the "effectiveness" of an innovation shall be judged.

Obstetrics and gynaecology residents' self-rated knowledge, motivation, skill, and practice patterns in counselling for contraception, STI prevention, sexual dysfunction, and intimate partner violence and sexual coercion.

PubMed

Garcia, Meivys; Fisher, William A

2008-01-01

This research provides an initial exploration of obstetrics and gynaecology residents' self-rated knowledge base, motivation to practise, skills, and practice patterns with respect to patient counselling concerning contraception, prevention of sexually transmitted infection (STI), sexual dysfunction, and intimate partner violence and sexual coercion. Obstetrics and gynaecology residents (N = 27) at all levels of training at four Ontario postgraduate programs completed self-reports of knowledge, motivation, skills, and practice patterns for counselling concerning four focal issues in women's sexual and reproductive health. Obstetrics and gynaecology residents generally possessed a sound knowledge base in the areas under study, but significant gaps were observed in their knowledge of condom use, abortion, sexual dysfunction, and intimate partner violence and sexual coercion. Residents were well-motivated to provide counselling in these areas, and, with the exceptions of counselling concerning sexual dysfunction and intimate partner violence and sexual coercion, felt that they were well trained to do so. Participants, however, consistently perceived only modest levels of support from their peers and from consultants with respect to counselling in the domains of contraceptive choice and adherence, STI prevention, sexual dysfunction, and intimate partner violence and sexual coercion. These findings suggest the need to review instruction and support for obstetrics and gynaecology resident training in patient counselling in important but clinically neglected areas of women's sexual and reproductive health.

Hippocampus and Retrograde Amnesia in the Rat Model: A Modest Proposal for the Situation of Systems Consolidation

PubMed Central

Sutherland, Robert J.; Sparks, Fraser; Lehmann, Hugo

2010-01-01

The properties of retrograde amnesia after damage to the hippocampus have been explicated with some success using a rat model of human medial temporal lobe amnesia. We review the results of this experimental work with rats focusing on several areas of consensus in this growing literature. We evaluate the theoretically significant hypothesis that hippocampal retrograde amnesia normally exhibits a temporal gradient, affecting recent, but sparing remote memories. Surprisingly, the evidence does not provide much support for the idea that there is a lengthy process of systems consolidation following a learning episode. Instead, recent and remote memories tend to be equally affected. The extent of damage to the hippocampus is a significant factor in this work since it is likely that spared hippocampal tissue can support at least partial memory retrieval. With extensive hippocampal damage gradients are flat or, in the case of memory tasks with flavour/odour retrieval cues, the retrograde amnesia covers a period of about 1 – 3 days. There is consistent evidence that at the time of learning the hippocampus interferes with or overshadows memory acquisition by other systems. This contributes to the breadth and severity of retrograde amnesia relative to anterograde amnesia in the rat. The fact that multiple, distributed learning episodes can overcome this overshadowing is consistent with a parallel dual-store theory or a Distributed Reinstatement Theory in which each learning episode triggers a short period of memory replay that provides a brief hippocampal-dependent systems consolidation. PMID:20430043

Macroinvertebrate Taxonomic and Functional Trait Compositions within Lotic Habitats Affected By River Restoration Practices

NASA Astrophysics Data System (ADS)

White, J. C.; Hill, M. J.; Bickerton, M. A.; Wood, P. J.

2017-09-01

The widespread degradation of lotic ecosystems has prompted extensive river restoration efforts globally, but many studies have reported modest ecological responses to rehabilitation practices. The functional properties of biotic communities are rarely examined within post-project appraisals, which would provide more ecological information underpinning ecosystem responses to restoration practices and potentially pinpoint project limitations. This study examines macroinvertebrate community responses to three projects which aimed to physically restore channel morphologies. Taxonomic and functional trait compositions supported by widely occurring lotic habitats (biotopes) were examined across paired restored and non-restored (control) reaches. The multivariate location (average community composition) of taxonomic and functional trait compositions differed marginally between control and restored reaches. However, changes in the amount of multivariate dispersion were more robust and indicated greater ecological heterogeneity within restored reaches, particularly when considering functional trait compositions. Organic biotopes (macrophyte stands and macroalgae) occurred widely across all study sites and supported a high alpha (within-habitat) taxonomic diversity compared to mineralogical biotopes (sand and gravel patches), which were characteristic of restored reaches. However, mineralogical biotopes possessed a higher beta (between-habitat) functional diversity, although this was less pronounced for taxonomic compositions. This study demonstrates that examining the functional and structural properties of taxa across distinct biotopes can provide a greater understanding of biotic responses to river restoration works. Such information could be used to better understand the ecological implications of rehabilitation practices and guide more effective management strategies.

The BIG ’L’ American Logistics in World War II

DTIC Science & Technology

1997-03-01

relatively short island hopping bet~veen shore bases in the Southwest Pacific, and more modest ship- ping requirements, versus long steaming...raw materials to build new muni t ions factories; he used materials to build new munit ions. ~%en he discovered that the war was to be a long one...States Army division in World War I1 required the support of 400,000 horsepowe," to keep it moving, versus 3,500 for one of GeneralJohnJ

Role of Copper in the Performance of CdS/CdTe Solar Cells (Poster)

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

Demtsu, S.; Albin, D.; Sites, J.

2006-05-01

The performance of CdS/CdTe solar cells made with evaporated Cu as a primary back contact was studied through current-voltage (JV) at different intensities, quantum efficiency (QE) under light and voltage bias, capacitance-voltage (CV), and drive-level capacitance profiling (DLCP) measurements. The results show that while modest amounts of Cu enhance cell performance, excessive amounts degrade device quality and reduce performance. The analysis is supported with numerical simulations to reproduce and explain some of the experimental results.

Mars geoscience/climatology orbiter low cost mission operations

NASA Technical Reports Server (NTRS)

Erickson, K. D.

1984-01-01

It will not be possible to support the multiple planetary missions of the magnitude and order of previous missions on the basis of foreseeable NASA funding. It is, therefore, necessary to seek innovative means for accomplishing the goals of planetary exploration with modestly allocated resources. In this connection, a Core Program set of planetary exploration missions has been recommended. Attention is given to a Mission Operations design overview which is based on the Mars Geoscience/Climatology Orbiter Phase-A study performed during spring of 1983.

Careers in Drug and Alcohol Research: AN Innovative Program for Young Appalachian Women

NASA Astrophysics Data System (ADS)

Noland, Melody Powers; Leukefeld, Carl; Reid, Caroline

Supported by a grant from the National Institute on Drug Abuse, the University of Kentucky's Center on Drug and Alcohol Research developed the Young Women in Science Program to encourage young women from Appalachia to pursue scientific careers гп drug and alcohol research. This 3-year program, which involved 26 young women entering the ninth grade in 13 counties in southeastern Kentucky, included a summer residential program, community educational sessions, and matching students with mentors. When participants' scores prior to and after the 3-week residential program were compared, it was found that participants increased their science knowledge and improved their scores on confidence in science. Other significant changes occurred as well. These preliminary data indicated that some positive changes resulted from the program, even though contact time with the young women has been modest to date. The program shows considerable promise for providing the encouragement and skills needed for these young women to pursue careers in drug and alcohol research.

Clinfo: A Research Data Management and Analysis System Acceptable to Physician Users

PubMed Central

Thompson, Howard K.; Baker, William R.; Christopher, T. Graham; Lacy, William; Groner, Gabriel

1977-01-01

Since 1972 a national consortium has studied the needs of clinical research investigators for automation support. After determining that the most pressing need was to provide a data storage retrieval, and analysis capability which the physician investigator himself would find convenient, easy to use, and “friendly,” a prototype minicomputer-based system was designed and implemented. The system (CLINFO) has been extensively tried out by numerous clinical investigators at three sites and found to be very much to the liking of the investigators. It greatly accelerates the time between the posing of a research question and an answer to that question. With the current availability of the CLINFO system and as automated medical record-keeping systems become available, it is reasonable to anticipate that it will soon be feasible for practicing physicians to carry out modest clinical research efforts on panels of their own patients, a valuable source of information which is rarely tapped for research purposes.

The comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2 Restructured Form (MMPI-2-RF) validity scales to detect suspected malingering in a disability claimant sample.

PubMed

Chmielewski, Michael; Zhu, Jiani; Burchett, Danielle; Bury, Alison S; Bagby, R Michael

2017-02-01

The current study expands on past research examining the comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) overreporting validity scales to detect suspected malingering, as assessed by the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), in a sample of public insurance disability claimants (N = 742) who were considered to have potential incentives to malinger. Results provide support for the capacity of both the MMPI-2 and the MMPI-2-RF overreporting validity scales to predict suspected malingering of psychopathology. The MMPI-2-RF overreporting validity scales proved to be modestly better predictors of suspected psychopathology malingering-compared with the MMPI-2 overreporting scales-in dimensional predictive models and categorical classification accuracy analyses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Genetic association analyses implicate aberrant regulation of innate and adaptive immunity genes in the pathogenesis of systemic lupus erythematosus

PubMed Central

Graham, Deborah S Cunninghame; Pinder, Christopher L; Tombleson, Philip; Behrens, Timothy W; Martín, Javier; Fairfax, Benjamin P; Knight, Julian C; Chen, Lingyan; Replogle, Joseph; Syvänen, Ann-Christine; Rönnblom, Lars; Graham, Robert R; Wither, Joan E; Rioux, John D; Alarcón-Riquelme, Marta E; Vyse, Timothy J

2015-01-01

Systemic lupus erythematosus (SLE; OMIM 152700) is a genetically complex autoimmune disease characterized by loss of immune tolerance to nuclear and cell surface antigens. Previous genome-wide association studies (GWAS) had modest sample sizes, reducing their scope and reliability. Our study comprised 7,219 cases and 15,991 controls of European ancestry: a new GWAS, meta-analysis with a published GWAS and a replication study. We have mapped 43 susceptibility loci, including 10 novel associations. Assisted by dense genome coverage, imputation provided evidence for missense variants underpinning associations in eight genes. Other likely causal genes were established by examining associated alleles for cis-acting eQTL effects in a range of ex vivo immune cells. We found an over-representation (n=16) of transcription factors among SLE susceptibility genes. This supports the view that aberrantly regulated gene expression networks in multiple cell types in both the innate and adaptive immune response contribute to the risk of developing SLE. PMID:26502338

Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

PubMed

Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

2009-12-01

Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

Efficient Functionalization of Polyethylene Fibers for the Uranium Extraction from Seawater through Atom Transfer Radical Polymerization

DOE PAGES

Neti, Venkata S.; Das, Sadananda; Brown, Suree; ...

2017-08-29

Brush-on-brush structures are proposed as one method to overcome support effects in grafted polymers. Utilizing glycidyl methacrylate (GMA) grafted on polyethylene (PE) fibers using radiation-induced graft polymerization (RIGP) provides a hydrophilic surface on the hydrophobic PE. When integrated with atom transfer radical polymerization (ATRP), the grafting of acrylonitrile (AN) and hydroxyethyl acrylate (HEA) can be controlled and manipulated more easily than with RIGP. Poly(acrylonitrile)-co-poly(hydroxyethyl acrylate) chains were grown via ATRP on PE-GMA fibers to generate an adsorbent for the extraction of uranium from seawater. The prepared adsorbents in this study demonstrated promise (159.9 g-U/kg of adsorbent) in laboratory screening testsmore » using a high uranium concentration brine and 1.24 g-U/Kg of adsorbent in the filtered natural seawater in 21-days. Here, the modest capacity in 21-days exceeds previous efforts to generate brush-on-brush adsorbents by ATRP while manipulating the apparent surface hydrophilicity of the trunk material (PE).« less

Perceiving expressions of emotion: What evidence could bear on questions about perceptual experience of mental states?

PubMed

Butterfill, Stephen A

2015-11-01

What evidence could bear on questions about whether humans ever perceptually experience any of another's mental states, and how might those questions be made precise enough to test experimentally? This paper focusses on emotions and their expression. It is proposed that research on perceptual experiences of physical properties provides one model for thinking about what evidence concerning expressions of emotion might reveal about perceptual experiences of others' mental states. This proposal motivates consideration of the hypothesis that categorical perception of expressions of emotion occurs, can be facilitated by information about agents' emotions, and gives rise to phenomenal expectations. It is argued that the truth of this hypothesis would support a modest version of the claim that humans sometimes perceptually experience some of another's mental states. Much available evidence is consistent with, but insufficient to establish, the truth of the hypothesis. We are probably not yet in a position to know whether humans ever perceptually experience others' mental states. Copyright © 2015 Elsevier Inc. All rights reserved.

Hypothesis: The Intratumoral Immune Response against a Cancer Progenitor Cell Impacts the Development of Well-Differentiated versus Dedifferentiated Disease in Liposarcoma

PubMed Central

Tseng, William W.; Chopra, Shefali; Engleman, Edgar G.; Pollock, Raphael E.

2016-01-01

Well-differentiated/dedifferentiated (WD/DD) liposarcoma is a rare malignancy of adipocyte origin (“fat cancer”). Tumors may be entirely WD, WD with a DD component, or rarely DD without a clear WD component. WD tumors are low grade and generally indolent, while tumors with a DD component are high grade and behave much more aggressively, with a modest potential for distant metastasis. The presence of cancer progenitor cells in WD/DD liposarcoma is suggested by clinical evidence and reported research findings. In addition, there are emerging data to support the existence of a naturally occurring, antigen-driven, and adaptive immune response within the tumor microenvironment. We hypothesize that the intratumoral immune response is directed against a cancer progenitor cell and that the outcome of this response impacts the development of WD versus DD disease. Further study will likely provide interesting insights into the disease biology of WD/DD liposarcoma that may be readily translated to other more common cancers. PMID:27376027

Melanopsin tristability for sustained and broadband phototransduction.

PubMed

Emanuel, Alan Joseph; Do, Michael Tri Hoang

2015-03-04

Mammals rely upon three ocular photoreceptors to sense light: rods, cones, and intrinsically photosensitive retinal ganglion cells (ipRGCs). Rods and cones resolve details in the visual scene. Conversely, ipRGCs integrate over time and space, primarily to support "non-image" vision. The integrative mechanisms of ipRGCs are enigmatic, particularly since these cells use a phototransduction motif that allows invertebrates like Drosophila to parse light with exceptional temporal resolution. Here, we provide evidence for a single mechanism that allows ipRGCs to integrate over both time and wavelength. Light distributes the visual pigment, melanopsin, across three states, two silent and one signaling. Photoequilibration among states maintains pigment availability for sustained signaling, stability of the signaling state permits minutes-long temporal summation, and modest spectral separation of the silent states promotes uniform activation across wavelengths. By broadening the tuning of ipRGCs in both temporal and chromatic domains, melanopsin tristability produces signal integration for physiology and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

Efficient Functionalization of Polyethylene Fibers for the Uranium Extraction from Seawater through Atom Transfer Radical Polymerization

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

Neti, Venkata S.; Das, Sadananda; Brown, Suree

Brush-on-brush structures are proposed as one method to overcome support effects in grafted polymers. Utilizing glycidyl methacrylate (GMA) grafted on polyethylene (PE) fibers using radiation-induced graft polymerization (RIGP) provides a hydrophilic surface on the hydrophobic PE. When integrated with atom transfer radical polymerization (ATRP), the grafting of acrylonitrile (AN) and hydroxyethyl acrylate (HEA) can be controlled and manipulated more easily than with RIGP. Poly(acrylonitrile)-co-poly(hydroxyethyl acrylate) chains were grown via ATRP on PE-GMA fibers to generate an adsorbent for the extraction of uranium from seawater. The prepared adsorbents in this study demonstrated promise (159.9 g-U/kg of adsorbent) in laboratory screening testsmore » using a high uranium concentration brine and 1.24 g-U/Kg of adsorbent in the filtered natural seawater in 21-days. Here, the modest capacity in 21-days exceeds previous efforts to generate brush-on-brush adsorbents by ATRP while manipulating the apparent surface hydrophilicity of the trunk material (PE).« less

Efficient Functionalization of Polyethylene Fibers for the Uranium Extraction from Seawater through Atom Transfer Radical Polymerization

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

Neti, Venkata S.; Das, Sadananda; Brown, Suree

Brush-on-brush structures are proposed as one method to overcome support effects in grafted polymers. Utilizing glycidyl methacrylate (GMA) grafted on polyethylene (PE) fibers using radiation-induced graft polymerization (RIGP) provides a hydrophilic surface on the hydrophobic PE. When integrated with atom transfer radical polymerization (ATRP), the grafting of acrylonitrile (AN) and hydroxyethyl acrylate (HEA) can be controlled and manipulated more easily than with RIGP. Poly(acrylonitrile)-co-poly(hydroxyethyl acrylate) chains were grown via ATRP on PE-GMA fibers to generate an adsorbent for the extraction of uranium from seawater. The prepared adsorbents in this study demonstrated promise (159.9 g- U/kg of adsorbent) in laboratory screeningmore » tests using a high uranium concentration brine and 1.24 g-U/Kg of adsorbent in the filtered natural seawater in 21-days. The modest capacity in 21- days exceeds previous efforts to generate brush-on-brush adsorbents by ATRP while manipulating the apparent surface hydrophilicity of the trunk material (PE).« less

Violence against women in Pakistan: a framework for analysis.

PubMed

Ali, Parveen Azam; Gavino, Maria Irma Bustamante

2008-04-01

Understanding violence against women is as complex as its process. As a perusal of literature shows that most of the explanations were contextually and culturally based, this review attempts to analyze the issue of violence against women using theories applicable within the Pakistani context. Literature examining the issue of violence against women and its various theories was reviewed. A framework using the determinants of violence against women as proposed, include intrinsic and extrinsic factors within the people, the socio-economic-political and cultural system of Pakistan and the influences of surrounding countries. The Pakistani scenario has been described and the theoretical bases were presented. Each determinant has been discussed with supporting literature. Further studies are needed to strengthen the framework; however, it provided a modest view of violence against women in Pakistan. The framework would help the policy and decision makers to understand the dynamics of violence against women and may move them to action to bring about improvements in women's' lives.

In Silico Measurements of Twist and Bend Moduli for β-Solenoid Protein Self-Assembly Units.

PubMed

Heinz, Leonard P; Ravikumar, Krishnakumar M; Cox, Daniel L

2015-05-13

We compute potentials of mean force for bend and twist deformations via force pulling and umbrella sampling experiments for four β-solenoid proteins (BSPs) that show promise in nanotechnology applications. In all cases, we find quasi-Hooke's law behavior until the point of rupture. Bending moduli show modest anisotropy for two-sided and three-sided BSPs, and little anisotropy for a four-sided BSP. There is a slight clockwise/counterclockwise asymmetry in the twist potential of mean force, showing greater stiffness when the applied twist follows the intrinsic twist. When we extrapolate to beam theory appropriate for amyloid fibrils of the BSPs, we find bend/twist moduli which are somewhat smaller than those in the literature for other amyloid fibrils. Twist persistence lengths are on the order of a micron, and bend persistence lengths are several microns. Provided the intrinsic twist can be reversed, these results support the usage of BSPs in biomaterials applications.

The impact of lean production and related new systems of work organization on worker health.

PubMed

Landsbergis, P A; Cahill, J; Schnall, P

1999-04-01

New systems of work organization, such as lean production and total quality management, have been introduced by employers throughout the industrialized world to improve productivity, quality, and profitability. However, few studies have examined the impact of such systems on occupational injuries or illnesses or on job characteristics related to job strain, which has been linked to hypertension and cardiovascular disease. The studies reviewed provide little evidence to support the hypothesis that lean production "empowers" auto workers. In fact, auto industry studies suggest that lean production creates intensified work pace and demands. Increases in decision authority and skill levels are modest or temporary, whereas decision latitude typically remains low. Thus, such work can be considered to have job strain. In jobs with ergonomic stressors, intensification of labor appears to lead to increases in musculoskeletal disorders. The evidence for adverse health effects remains inconclusive for related new work systems in other industries, such as modular manufacturing or patient-focused care.

Effects of Violent-Video-Game Exposure on Aggressive Behavior, Aggressive-Thought Accessibility, and Aggressive Affect Among Adults With and Without Autism Spectrum Disorder.

PubMed

Engelhardt, Christopher R; Mazurek, Micah O; Hilgard, Joseph; Rouder, Jeffrey N; Bartholow, Bruce D

2015-08-01

Recent mass shootings have prompted the idea among some members of the public that exposure to violent video games can have a pronounced effect on individuals with autism spectrum disorder (ASD). Empirical evidence for or against this claim has been missing, however. To address this issue, we assigned adults with and without ASD to play a violent or nonviolent version of a customized first-person shooter video game. After they played the game, we assessed three aggression-related outcome variables (aggressive behavior, aggressive-thought accessibility, and aggressive affect). Results showed strong evidence that adults with ASD, compared with typically developing adults, are not differentially affected by acute exposure to violent video games. Moreover, model comparisons provided modest evidence against any effect of violent game content whatsoever. Findings from this experiment suggest that societal concerns that exposure to violent games may have a unique effect on adults with autism are not supported by evidence. © The Author(s) 2015.

Comparing nonlinear MHD simulations of low-aspect-ratio RFPs to RELAX experiments

NASA Astrophysics Data System (ADS)

McCollam, K. J.; den Hartog, D. J.; Jacobson, C. M.; Sovinec, C. R.; Masamune, S.; Sanpei, A.

2016-10-01

Standard reversed-field pinch (RFP) plasmas provide a nonlinear dynamical system as a validation domain for numerical MHD simulation codes, with applications in general toroidal confinement scenarios including tokamaks. Using the NIMROD code, we simulate the nonlinear evolution of RFP plasmas similar to those in the RELAX experiment. The experiment's modest Lundquist numbers S (as low as a few times 104) make closely matching MHD simulations tractable given present computing resources. Its low aspect ratio ( 2) motivates a comparison study using cylindrical and toroidal geometries in NIMROD. We present initial results from nonlinear single-fluid runs at S =104 for both geometries and a range of equilibrium parameters, which preliminarily show that the magnetic fluctuations are roughly similar between the two geometries and between simulation and experiment, though there appear to be some qualitative differences in their temporal evolution. Runs at higher S are planned. This work is supported by the U.S. DOE and by the Japan Society for the Promotion of Science.

Major Cereal Grain Fibers and Psyllium in Relation to Cardiovascular Health

PubMed Central

Bernstein, Adam M.; Titgemeier, Brigid; Kirkpatrick, Kristin; Golubic, Mladen; Roizen, Michael F.

2013-01-01

Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oats and barley, and soluble fiber from psyllium reduces the risk of coronary heart disease; inulin-type fructans added to foods and beverages may modestly decrease serum triacylglycerols; arabinoxylan and resistant starch may improve glycemic control. Individuals with low cereal fiber intake should increase their intake of whole grains in order to receive the benefits of whole grains in addition to fiber. For those adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake. PMID:23628720

Is pre-K classroom quality associated with kindergarten and middle-school academic skills?

PubMed

Anderson, Sara; Phillips, Deborah

2017-06-01

We employed data from a longitudinal investigation of over 1,000 children who participated in Tulsa's universal school-based pre-K program in 2005, and path modeling techniques, to examine the contribution of pre-K classroom quality to both kindergarten- and middle-school academic skills. We also examined gender and income-related differences in quality-outcome associations. Both Instructional and Emotional Support in pre-K classrooms, but not Classroom Management, assessed with the Classroom Assessment Scoring System (CLASS), were associated with kindergarten academic skills and, modestly indirectly associated through these immediate impacts, to middle-school test scores. Linear associations were found for Instructional Support whereas nonlinear patterns of association were evident for Emotional Support. Gender and income differences characterized Instructional Support-outcome associations. Results are discussed in terms of implications for improving pre-K quality as one avenue for supporting the ongoing development of academic skills. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Classroom and Teacher Support in Kindergarten: Associations with the Behavioral and Academic Adjustment of Low-Income Students

PubMed Central

Lee, Phyllis; Bierman, Karen L.

2016-01-01

For socio-economically disadvantaged children, a positive experience in kindergarten may play a particularly important role in fostering the behavioral adjustment and learning engagement necessary for school success. Prior research has identified supportive student-teacher relationships and classroom emotional support as two features of the classroom context that can promote student adjustment; however, very few studies have examined these two aspects of the classroom context simultaneously. Given their modest inter-correlations, these dimensions of classroom context may have both unique and shared associations with child progress. This study followed 164 children as they transitioned from Head Start into elementary school, and regressions revealed significant unique associations between each type of kindergarten support and children’s aggressive behaviors, social withdrawal, learning engagement, and emergent literacy skills in first grade, controlling for their pre-kindergarten adjustment. In addition, learning engagement significantly mediated the association between a supportive relationship with the kindergarten teacher and first grade literacy skills. PMID:27274606

Prenatal and perinatal risk factors and testicular cancer: a hospital-based case-control study.

PubMed

Sonke, Gabe S; Chang, Shine; Strom, Sara S; Sweeney, Anne M; Annegers, J Fred; Sigurdson, Alice J

2007-01-01

Some evidence exists to support the hypothesis that elevated levels of circulating maternal estrogens during early pregnancy may increase risk of testicular germ cell cancer. However, the results from studies evaluating maternal factors have been mixed. We evaluated maternal factors, particularly those associated with excess estrogen levels, as risk factors for testicular cancer. We conducted a hospital-based case-control study at The University of Texas M. D. Anderson Cancer Center in Houston, Texas of 144 testicular cancer patients diagnosed between 1990 and 1996 and 86 friend controls matched to cases on age, race, and state of residence. Risk factor data about the mother, the son, and the pregnancy were obtained from the mothers by telephone interviews and from the sons by self-administered questionnaires. Extreme nausea during the first trimester of pregnancy was associated with an elevated risk of testicular cancer [odds ratio (OR) = 2.0; 95% confidence interval (CI) = 1.0-3.9]. Adjustment for potential confounders slightly lowered this risk (OR = 1.8; 95% CI = 0.9-3.8). Risks were modestly increased for other factors that are proxy measures for maternal estrogens, including preterm delivery (OR = 2.2; 95% CI = 0.4-12.9), birth weight <3000 g (OR = 2.4: 95% CI = 0.7-8.1), and birth weight >4000 g (OR = 1.7; 95% CI = 0.9-3.2), albeit nonsignificantly so. Our finding that severe nausea was associated with increased testicular cancer risk adds evidence to support the in utero estrogen exposure hypothesis because nausea early in pregnancy is related to rising levels of circulating estrogens. For other factors, which are less direct measures of maternal estrogens, the modest associations found indicate a suggestive pattern in support of the excess estrogen hypothesis.

Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

PubMed

Zimlichman, Eyal; Keohane, Carol; Franz, Calvin; Everett, Wendy L; Seger, Diane L; Yoon, Catherine; Leung, Alexander A; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan E; Bates, David W

2013-07-01

In-hospital adverse events are a major cause of morbidity and mortality and represent a major cost burden to health care systems. A study was conducted to evaluate the return on investment (ROI) for the adoption of vendor-developed computerized physician oder entry (CPOE) systems in four community hospitals in Massachusetts. Of the four hospitals, two were under one management structure and implemented the same vendor-developed CPOE system (Hospital Group A), while the other two were under a second management structure and implemented another vendor-developed CPOE system (Hospital Group B). Cost savings were calculated on the basis of reduction in preventable adverse drug event (ADE) rates as measured previously. ROI, net cash flow, and the breakeven point during a 10-year cost-and-benefit model were calculated. At the time of the study, none of the participating hospitals had implemented more than a rudimentary decision support system together with CPOE. Implementation costs were lower for Hospital Group A than B ($7,130,894 total or $83/admission versus $19,293,379 total or $113/admission, respectively), as were preventable ADE-related avoided costs ($7,937,651 and $16,557,056, respectively). A cost-benefit analysis demonstrated that Hospital Group A had an ROI of 11.3%, breaking even on the investment eight years following implementation. Hospital Group B showed a negative return, with an ROI of -3.1%. Adoption of vendor CPOE systems in community hospitals was associated with a modest ROI at best when applying cost savings attributable to prevention of ADEs only. The modest financial returns can beattributed to the lack of clinical decision support tools.

A Cis-Lunar Propellant Infrastructure for Flexible Path Exploration and Space Commerce

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.

2012-01-01

This paper describes a space infrastructure concept that exploits lunar water for propellant production and delivers it to users in cis-lunar space. The goal is to provide responsive economical space transportation to destinations beyond low Earth orbit (LEO) and enable in-space commerce. This is a game changing concept that could fundamentally affect future space operations, provide greater access to space beyond LEO, and broaden participation in space exploration. The challenge is to minimize infrastructure development cost while achieving a low operational cost. This study discusses the evolutionary development of the infrastructure from a very modest robotic operation to one that is capable of supporting human operations. The cis-lunar infrastructure involves a mix of technologies including cryogenic propellant production, reusable lunar landers, propellant tankers, orbital transfer vehicles, aerobraking technologies, and electric propulsion. This cislunar propellant infrastructure replaces Earth-launched propellants for missions beyond LEO. It enables users to reach destinations with smaller launchers or effectively multiplies the user s existing payload capacity. Users can exploit the expanded capacity to launch logistics material that can then be traded with the infrastructure for propellants. This mutually beneficial trade between the cis-lunar infrastructure and propellant users forms the basis of in-space commerce.

Physical Activity and Health: "What is Old is New Again".

PubMed

Hills, Andrew P; Street, Steven J; Byrne, Nuala M

2015-01-01

Much recent interest has focused on the relationship between physical activity and health and supported with an abundance of scientific evidence. However, the concept of Exercise is Medicine™ copromoted by the American College of Sports Medicine and American Medical Association and similar august bodies worldwide is far from new--the importance of exercise for health has been reported for centuries. Participation in regular physical activity and exercise provides numerous benefits for health with such benefits typically varying according to the volume completed as reflected by intensity, duration, and frequency. Evidence suggests a dose-response relationship such that being active, even to a modest level, is preferable to being inactive or sedentary. Greatest benefits are commonly associated with the previously sedentary individual assuming a more active lifestyle. There is an apparent linear relationship between physical activity and health status and as a general rule, increases in physical activity and fitness result in additional improvements in health status. This narrative review provides a selective appraisal of the evidence for the importance of physical activity for health, commencing with a baseline historical perspective followed by a summary of key health benefits associated with an active lifestyle. © 2015 Elsevier Inc. All rights reserved.

Management strategies in pancreatic cancer.

PubMed

Campen, Christopher J; Dragovich, Tomislav; Baker, Amanda F

2011-04-01

Current first-line and adjuvant chemotherapeutic strategies for management of patients with pancreatic cancer are reviewed. Pancreatic adenocarcinoma is the 10th most prevalent cancer and the fourth most common cause of cancer deaths in the United States. More than 80% of patients with pancreatic cancer are diagnosed with locally advanced or metastatic disease and are not candidates for surgery; these patients often require multimodal treatment. The most widely used chemotherapy for such patients, as well as patients requiring adjuvant therapy after surgery, is gemcitabine or gemcitabine-based chemotherapy. All current chemotherapies for pancreatic cancer are associated with dose-limiting hematologic toxicity and other adverse effects that require ongoing monitoring and dosage adjustment to balance the benefits and risks of treatment. Pharmacists can play an important role in monitoring and providing drug information and guidance to patients and oncologists. Current investigational strategies include efforts to improve chemotherapy response rates and outcomes through modulation of cell signaling pathways and use of nanotechnology to improve drug delivery. Current management of pancreatic cancer is multifaceted, involving anticancer therapy, supportive care, and toxicity management. Standard systemic therapy with gemcitabine as a single agent or in combination with other cytotoxic agents provides modest benefits in terms of response and symptom control.

Predictors of exercise frequency in breast cancer survivors in Taiwan.

PubMed

Hsu, Hsin-Tien; Dodd, Marylin J; Guo, Su-Er; Lee, Kathryn A; Hwang, Shiow-Li; Lai, Yu-Hung

2011-07-01

To apply social cognitive theory to elucidate factors that motivate change in exercise frequency in breast cancer survivors during the six months after completing cancer treatment. Exercise is now a well-recognised quality-of-life intervention in breast cancer survivors. However, only regular exercise yields long-term benefits. Motivations for exercise have not been analysed in Taiwan patients with cancer. A prospective, longitudinal and repeated measures design was used. A convenience sample of 196 breast cancer survivors was recruited from hospitals in metropolitan areas of north and south Taiwan. Study participants were allowed to select their preferred exercised activities. Exercise behaviour and other factors were then recorded using various standardised instruments. Medical charts were also reviewed. Data were analysed by a linear mixed model and by hierarchical multiple regression equations. Exercise frequency significantly changed over time. Explained variance in exercise frequency change was modest. Baseline exercise frequency was the best significant predictor of exercise frequency during the six-month study. The study also identified possible age-related differences in the effect of social support on exercise. The effect of social support for exercise on exercise frequency was apparently larger in older subjects, especially those over 40 years old, than in younger subjects. Mental health, exercise barriers and exercise outcome expectancy significantly contributed to change in exercise frequency during the six-month study. The analytical results revealed several ways to increase exercise frequency in breast cancer survivors: (1) encourage exercise as early as possible; (2) improve health status and provide social support for exercise, especially in women aged 40 years or older; (3) reduce exercise barriers and promote mental health; (4) reinforce self-efficacy and positive expectations of exercise outcomes and (5) provide strategies for minimising fatigue in early stages of rehabilitation. Relevance to clinical practice.  Social cognitive theory provides a useful framework for understanding the motivation to exercise in breast cancer survivors. © 2011 Blackwell Publishing Ltd.

Impact of personal economic environment and personality factors on individual financial decision making.

PubMed

Prinz, Susanne; Gründer, Gerhard; Hilgers, Ralf D; Holtemöller, Oliver; Vernaleken, Ingo

2014-01-01

This study on healthy young male students aimed to enlighten the associations between an individual's financial decision making and surrogate makers for environmental factors covering long-term financial socialization, the current financial security/responsibility, and the personal affinity to financial affairs as represented by parental income, funding situation, and field of study. A group of 150 male young healthy students underwent two versions of the Holt and Laury (2002) lottery paradigm (matrix and random sequential version). Their financial decision was mainly driven by the factor "source of funding": students with strict performance control (grants, scholarships) had much higher rates of relative risk aversion (RRA) than subjects with support from family (ΔRRA = 0.22; p = 0.018). Personality scores only modestly affected the outcome. In an ANOVA, however, also the intelligence quotient significantly and relevantly contributed to the explanation of variance; the effects of parental income and the personality factors "agreeableness" and "openness" showed moderate to modest - but significant - effects. These findings suggest that environmental factors more than personality factors affect risk aversion.

Impact of personal economic environment and personality factors on individual financial decision making

PubMed Central

Prinz, Susanne; Gründer, Gerhard; Hilgers, Ralf D.; Holtemöller, Oliver; Vernaleken, Ingo

2014-01-01

This study on healthy young male students aimed to enlighten the associations between an individual’s financial decision making and surrogate makers for environmental factors covering long-term financial socialization, the current financial security/responsibility, and the personal affinity to financial affairs as represented by parental income, funding situation, and field of study. A group of 150 male young healthy students underwent two versions of the Holt and Laury (2002) lottery paradigm (matrix and random sequential version). Their financial decision was mainly driven by the factor “source of funding”: students with strict performance control (grants, scholarships) had much higher rates of relative risk aversion (RRA) than subjects with support from family (ΔRRA = 0.22; p = 0.018). Personality scores only modestly affected the outcome. In an ANOVA, however, also the intelligence quotient significantly and relevantly contributed to the explanation of variance; the effects of parental income and the personality factors “agreeableness” and “openness” showed moderate to modest – but significant – effects. These findings suggest that environmental factors more than personality factors affect risk aversion. PMID:24624100

A Modest Critical Pedagogy for English as a Foreign Language Education

ERIC Educational Resources Information Center

Kim, Mi Kyong; Pollard, Vikki Ann

2017-01-01

This paper uses the introduction of critical pedagogy to an English as a Foreign Language class in the Republic of Korea as a case study for a "modest critical pedagogy" (Tinning 2002). Focusing on the stress and resistances experienced during the introduction, we suggest a modest critical pedagogy that 1) makes the paradigm itself an…

The Projected Responses of Residency-Sponsoring Institutions to a Reduction in Medicare Support for Graduate Medical Education: A National Survey.

PubMed

Riaz, Mahrukh; Palermo, Tia; Yen, Michael; Edelman, Norman H

2015-10-01

To assess the projected responses of residency-sponsoring institutions to the proposed reduction in Medicare's indirect medical education (IME) payments. In 2012, the authors surveyed directors of graduate medical education (GME) programs, examining (1) overall responses to a reduction in IME reimbursement and (2) the value of individual residencies to the institution from the economic/operational and educational/public service points of view, to determine which programs may be at risk for downsizing. Responses from 192 of 555 institutions (35% response rate) varied by the size of the institution's GME program. Of large programs (six or more residencies), 33 (33%) would downsize at a 10% reduction in IME reimbursement, focusing cuts on specific programs. Small programs (five or fewer residencies) were more likely to retain their existing residencies with modest IME payment reductions and to make across-the-board cuts. The economic/operational value of specialties varied widely, with hospital-intensive residencies valued highest. Family medicine was valued highly from an economic/operational point of view only by small programs. Educational/public service value scores varied less and were higher for all specialties. Preventive medicine was not highly valued in either category. Even a modest decrease in IME reimbursement could trigger institutions to downsize their GME programs. Programs at the greatest risk for cuts may be those with modest economic/operational value but high societal value, like family medicine. The retention or expansion of training in family medicine may be most easily accomplished then at smaller institutions.

Informing Investment to Reduce Inequalities: A Modelling Approach.

PubMed

McAuley, Andrew; Denny, Cheryl; Taulbut, Martin; Mitchell, Rory; Fischbacher, Colin; Graham, Barbara; Grant, Ian; O'Hagan, Paul; McAllister, David; McCartney, Gerry

2016-01-01

Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. To provide estimates of the impact of a range of interventions on health and health inequalities. Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a 'living wage'; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Introduction of a 'living wage' generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities.

A collaborative institutional model for integrating computer applications in the medical curriculum.

PubMed Central

Friedman, C. P.; Oxford, G. S.; Juliano, E. L.

1991-01-01

The introduction and promotion of information technology in an established medical curriculum with existing academic and technical support structures poses a number of challenges. The UNC School of Medicine has developed the Taskforce on Educational Applications in Medicine (TEAM), to coordinate this effort. TEAM works as a confederation of existing research and support units with interests in computers and education, along with a core of interested faculty with curricular responsibilities. Constituent units of the TEAM confederation include the medical center library, medical television studios, basic science teaching laboratories, educational development office, microcomputer and network support groups, academic affairs administration, and a subset of course directors and teaching faculty. Among our efforts have been the establishment of (1) a mini-grant program to support faculty initiated development and implementation of computer applications in the curriculum, (2) a symposium series with visiting speakers to acquaint faculty with current developments in medical informatics and related curricular efforts at other institution, (3) 20 computer workstations located in the multipurpose teaching labs where first and second year students do much of their academic work, (4) a demonstration center for evaluation of courseware and technologically advanced delivery systems. The student workstations provide convenient access to electronic mail, University schedules and calendars, the CoSy computer conferencing system, and several software applications integral to their courses in pathology, histology, microbiology, biochemistry, and neurobiology. The progress achieved toward the primary goal has modestly exceeded our initial expectations, while the collegiality and interest expressed toward TEAM activities in the local environment stand as empirical measures of the success of the concept. PMID:1807705

A Multi-Purpose Modular Electronics Integration Node for Exploration Extravehicular Activity

NASA Technical Reports Server (NTRS)

Hodgson, Edward; Papale, William; Wichowski, Robert; Rosenbush, David; Hawes, Kevin; Stankiewicz, Tom

2013-01-01

As NASA works to develop an effective integrated portable life support system design for exploration Extravehicular activity (EVA), alternatives to the current system s electrical power and control architecture are needed to support new requirements for flexibility, maintainability, reliability, and reduced mass and volume. Experience with the current Extravehicular Mobility Unit (EMU) has demonstrated that the current architecture, based in a central power supply, monitoring and control unit, with dedicated analog wiring harness connections to active components in the system has a significant impact on system packaging and seriously constrains design flexibility in adapting to component obsolescence and changing system needs over time. An alternative architecture based in the use of a digital data bus offers possible wiring harness and system power savings, but risks significant penalties in component complexity and cost. A hybrid architecture that relies on a set of electronic and power interface nodes serving functional models within the Portable Life Support System (PLSS) is proposed to minimize both packaging and component level penalties. A common interface node hardware design can further reduce penalties by reducing the nonrecurring development costs, making miniaturization more practical, maximizing opportunities for maturation and reliability growth, providing enhanced fault tolerance, and providing stable design interfaces for system components and a central control. Adaptation to varying specific module requirements can be achieved with modest changes in firmware code within the module. A preliminary design effort has developed a common set of hardware interface requirements and functional capabilities for such a node based on anticipated modules comprising an exploration PLSS, and a prototype node has been designed assembled, programmed, and tested. One instance of such a node has been adapted to support testing the swingbed carbon dioxide and humidity control element in NASA s advanced PLSS 2.0 test article. This paper will describe the common interface node design concept, results of the prototype development and test effort, and plans for use in NASA PLSS 2.0 integrated tests.

Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2014-04-01

Conduct a pilot trial testing whether a brief cognitive-behavioral (CB) group reduced depressive symptoms and secondary outcomes relative to bibliotherapy and brochure controls in college students with elevated depressive symptoms. 82 college students (M age=19.0, SD=0.9; 70% female, 80% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, bibliotherapy, or educational brochure control condition, completing assessments at pretest, posttest, and at 6- and 12-month follow-up. Planned contrasts found no significant effects for CB group on depressive symptoms compared to either bibliotherapy or brochure controls at posttest (d=-.08 and .06, respectively) or over follow-up (d=-.04 and -.10, respectively). There were no intervention effects for social adjustment and substance use, though CB group participants had improved knowledge of CB concepts at posttest, versus brochure controls. Condition differences in major depression onset were nonsignificant but suggested support for CB interventions (CB group=7.4%, bibliotherapy=4.5%, brochure control=15.2%). Unexpectedly modest support was found for a brief CB group depression prevention intervention, compared to bibliotherapy or brochure control, when provided to self-selected college students, suggesting that alternative screening or interventions approaches are needed for this population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health education and promotion for STD prevention: lessons for the next millennium.

PubMed Central

Darrow, W W

1997-01-01

OBJECTIVE: To review the evolution of health promotion for STD prevention. MAIN OBSERVATIONS: Information and education programmes were provided at the beginning of the 20th century to warn the public about the dangers of venereal infection and to support the medical model of case identification and case management under the care of qualified physicians. The public health approach offered advice about chemical, chemotherapeutic, and barrier prophylaxis, but avoided the issue of social prophylaxis. With the failure of antimicrobial agents to eradicate syphilis in the 1960s, rapid increases of viral sexually transmitted diseases (STDs) and resistant strains of gonorrhoea in the 1970s, and the discovery of AIDS in the 1980s, alternatives to the traditional public health approach were sought and supported with a modest increase of resources. Three major innovations have been introduced to STD prevention as a result: social marketing, community involvement, and behaviour change programmes based on social and psychological concepts and theoretical models. CONCLUSIONS: Health promotion for STD prevention in the future will be characterised by careful assessments of the social and behavioural determinants of sexual risk taking, development and implementation of targeted interventions designed to reduce risk taking, and evaluation of social and behavioural interventions for improvements in STD prevention. Images PMID:9215087

Results from a pilot study of a computer-based role-playing game for young people with psychosis.

PubMed

Olivet, Jeffrey; Haselden, Morgan; Piscitelli, Sarah; Kenney, Rachael; Shulman, Alexander; Medoff, Deborah; Dixon, Lisa

2018-03-15

Recent research on first episode psychosis (FEP) has demonstrated the effectiveness of coordinated specialty care (CSC) models to support young adults and their families, yet few tools exist to promote engagement in care. This study aimed to develop a prototype computer-based role-playing game (RPG) designed for young people who have experienced FEP, and conduct a pilot study to determine feasibility and test whether the game improves consumers' attitudes toward treatment and recovery. Twenty young people with FEP who were receiving services at a CSC program enrolled in the study and played the game for 1 hour. Pre- and post-quantitative assessments measured change in hope, recovery, stigma, empowerment and engagement in treatment. Qualitative interviews explored participants' experience with the game and ideas for further product development. Participants showed significant increase in positive attitudes toward recovery. The qualitative findings further demonstrated the game's positive impact across these domains. Of all game features, participants most highly valued video testimonials of other young adults with FEP telling their stories of hope and recovery. These findings provide modest support for the potential benefits of this type of computer-based RPG, if further developed for individuals experiencing psychosis. © 2018 John Wiley & Sons Australia, Ltd.

The Long Duration Exposure Facility (LDEF). Mission 1 Experiments.

ERIC Educational Resources Information Center

Clark, Lenwood G., Ed.; And Others

The Long Duration Exposure Facility (LDEF) has been designed to take advantage of the two-way transportation capability of the space shuttle by providing a large number of economical opportunities for science and technology experiments that require modest electrical power and data processing while in space and which benefit from postflight…

Tuition Reciprocity in the United States

ERIC Educational Resources Information Center

Stewart, Gregory; Wright, Dianne Brown; Kennedy, Angelica

2008-01-01

Reciprocity agreements are contracts between two or more parties whereby students pay reduced tuition rates. The rate of reduction is determined by the parameters set forth in each individual state's agreement but may range from a modest reduction in fees to a waiver of full non-resident tuition. In addition to providing tuition relief,…

Changing the Discourse in Schools.

ERIC Educational Resources Information Center

Eubanks, Eugene; Parish, Ralph

Efforts in the United States to provide a higher quality education for everyone regardless of race, class, and gender have had, at best, a very modest effect. This paper suggests that the effect of a change strategy depends on the discourse (how things are talked about when teachers solve problems, plan their work, create policy, and explain…

Maternal Attachment State of Mind Moderates the Impact of Postnatal Depression on Infant Attachment

ERIC Educational Resources Information Center

McMahon, Catherine A.; Barnett, Byranne; Kowalenko, Nicholas M.; Tennant, Christopher C.

2006-01-01

Background: Empirical studies have revealed a significant, but modest association between maternal depression and insecure mother-child attachment. Across studies, however, a substantial number of mothers with depression are able to provide a sensitive caretaking environment for their children. This paper aimed to explore whether a mother's own…

2016-17 KASB Enrollment Projection Report

ERIC Educational Resources Information Center

Carter, Ted

2017-01-01

This report presents the findings from the Kansas Association of School Boards (KASB's) 2016-17 Enrollment Projections for the state of Kansas as a whole, and also provides instructions on how these projections can be accessed at the district level. Key Findings include: (1) Total headcount enrollment will see modest increases from 2016-17 through…

Metallized polymeric foam material

NASA Technical Reports Server (NTRS)

Birnbaum, B. A.; Bilow, N.

1974-01-01

Open-celled polyurethane foams can be coated uniformly with thin film of metal by vapor deposition of aluminum or by sensitization of foam followed by electroless deposition of nickel or copper. Foam can be further processed to increase thickness of metal overcoat to impart rigidity or to provide inert surface with only modest increase in weight.

Are Tobacco Dependence and Withdrawal Related Amongst Heavy Smokers? Relevance to Conceptualizations of Dependence

PubMed Central

Baker, Timothy B.; Piper, Megan E.; Schlam, Tanya R.; Cook, Jessica W.; Smith, Stevens S.; Loh, Wei-Yin; Bolt, Daniel

2013-01-01

Measured tobacco dependence is typically only modestly related to tobacco withdrawal severity amongst regular smokers making a quit attempt. The weak association between dependence and withdrawal is notable because it conflicts with core theories of dependence and because both measures predict cessation outcomes, suggesting they both index a common dependence construct. This study used data from a smoking cessation comparative effectiveness trial (N = 1504) to characterize relations of tobacco dependence with craving and negative affect withdrawal symptoms using multiple dependence measures and analytic methods to detect both additive and interactive effects and to determine whether withdrawal meaningfully mediates the influence of dependence on smoking cessation. We conclude: (1) while univariate analyses suggest dependence and withdrawal measures are only modestly interrelated, more powerful analytic techniques show they are, in fact, meaningfully related and their shared variance is associated with cessation likelihood; (2) there are clear differences between craving and negative affective withdrawal symptoms, with the former more related to smoking heaviness and the latter related to trait measures of negative affect; moreover, craving more strongly mediates dependence effects on cessation; (3) both craving and negative affect withdrawal symptoms are strongly related to a pattern of regular smoking that is sensitive to the passage of time and powerfully affected by smoking cues. These findings support models that accord an important role for associative processes and withdrawal symptoms, especially craving, in drug dependence. The findings also support the use of withdrawal variables as criteria for the evaluation of dependence measures. PMID:22642839

An evaluation of fitness for practice curricula: self-efficacy, support and self-reported competence in preregistration student nurses and midwives.

PubMed

Lauder, William; Watson, Roger; Topping, Keith; Holland, Karen; Johnson, Martin; Porter, Mary; Roxburgh, Michelle; Behr, Aga

2008-07-01

This element of the larger Scottish evaluation aimed to explore differences between access routes, cohorts and higher education institutes (HEI) (universities and colleges) in levels of self-efficacy, student support and self-reported competence in a nationally representative sample of student nurses and midwives. This paper reports findings from the National Review of Pre-Registration Nursing and Midwifery Programmes in Scotland. Fitness for practice curricula have been the heart of many recent developments in nurse and midwifery education. Fitness for practice set out to map out the future direction of preregistration nursing and midwifery education with the aim of ensuring fitness for practice based on healthcare need. There have been no national evaluations of the effectiveness of this strategic objective. Previous major evaluations in the 1990s suggested that students may not have had the skills needed to be fit for practice. The study design was a cross-sectional survey of a stratified random sample of student nurses and midwives (n = 777). Data collected included demographic information, generalised perceived self-efficacy, student support and self-reported competency. Students reported high levels of self-reported competency. There were no significant differences between two cohorts or between students with different access routes. Students rated support from family and friends highest and support from HEI lowest. There was a significant difference in support levels between HEI. Self-efficacy scores were similar to other population means and showed small-moderate correlations with self-report competence. Similarly, self-reported competency appears to be at the higher end of the spectrum, although older students may have a more realistic perception of their competence. However, support from HEI was seen as less satisfactory and varied from one institution to another. This study portrays a relatively positive picture of preregistration fitness for practice curricula. Questions are raised about the relative value students place on support from educationalists and mentors and whether support from family and friends and from peers needs to feature more prominently in curricula. The study provides modest support for social cognitive theory. The major drivers for changes in preregistration curricula stemmed from fears about the competence of students. This study did not provide support for this viewpoint, and students' self-reports suggest that curricula are, in this respect, meeting their objectives. Nevertheless support from mentors and from educational institutes may need to be improved.

The effect of U.S. policies on the economics of libraries.

PubMed Central

Cummings, M M

1985-01-01

The decline in federal support of educational programs has made it difficult for libraries to apply new technologies to improve practices and services. While federal support has declined in constant dollars, there has been a modest increase in grants from private foundations. Current U.S. policies require federal agencies to recover full costs of rendering services (Circular A-25) and require the transfer of many federal service-oriented activities to the commercial sector (Circular A-76). Additionally, the Paperwork Reduction Act of 1980 is inhibiting the production and dissemination of federal publications. Government pursuit of these policies adds a heavy economic burden to libraries and threatens to reduce access to the scholarly and scientific record. PMID:3978292

A new approach for assessing the future of aquifers supporting irrigated agriculture

NASA Astrophysics Data System (ADS)

Butler, James J.; Whittemore, Donald O.; Wilson, Blake B.; Bohling, Geoffrey C.

2016-03-01

Aquifers supporting irrigated agriculture are under stress worldwide as a result of large pumping-induced water deficits. To aid in the formulation of more sustainable management plans for such systems, we have developed a water balance approach for assessing the impact of proposed management actions and the prospects for aquifer sustainability. Application to the High Plains aquifer (HPA) in the state of Kansas in the United States reveals that practically achievable reductions in annual pumping (<22%) would have stabilized areally averaged water levels over much of the Kansas HPA from 1996 to 2013. This demonstrates that modest pumping reductions can have a significant impact and highlights the importance of reliable pumping data for determining the net inflow (capture) component of the water balance. The HPA is similar to many aquifers supporting critically needed agricultural production, so the presented approach should prove of value far beyond the area of this initial application.

Controlling and Autonomy-Supportive Parenting in the United States and China: Beyond Children's Reports.

PubMed

Cheung, Cecilia S; Pomerantz, Eva M; Wang, Meifang; Qu, Yang

2016-11-01

Research comparing the predictive power of parents' control and autonomy support in the United States and China has relied almost exclusively on children's reports. Such reports may lead to inaccurate conclusions if they do not reflect parents' practices to the same extent in the two countries. A total of 394 American and Chinese children (M age  = 13.19 years) and their mothers reported on mothers' controlling and autonomy-supportive parenting in the academic arena; trained observers coded such parenting in the laboratory. Children's reports were associated modestly with mothers' reports and weakly, if at all, with observers' reports in both the United States and China. Parenting predicted children's academic and emotional functioning similarly in the two countries, irrespective of reporter. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Legal perspectives on cross-border reproductive care.

PubMed

Crockin, Susan L

2011-12-01

Global cross-border reproductive care (CBRC), and the challenges accompanying it, are here to stay. A recent issue of this journal devoted to CBRC provides an extraordinary array of insights into multiple facets, with a focus on the legal dimensions of practices by restrictive countries such as Turkey and Italy. The articles identify restrictive laws that challenge and create vulnerabilities for both citizens and providers involved in CBRC, and call instead for more modest and nuanced legislation and the closing paper presents a thoughtful and ambitious outline for a future research agenda. This commentary reflects on the implications of these legal dimensions, including their applicability to countries with more permissive CBRC policies, discusses three specific examples of legal concerns that have arisen in the USA and identifies numerous legal issues meriting future study. Together with the nuanced, more modest legislation recommended for restrictive countries, consistent legal and judicial principles for CBRC in permissive countries would respect varying perspectives on family building while attempting to address a central legal concern of CBRC, the protection of families, third-parties and providers. Any future agenda should include research and recommendations on the legal dimensions of CBRC in both restrictive and permissive countries. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Allegations of Sexual Abuse of a Child: What to Do when a Single Forensic Interview Isn't Enough

ERIC Educational Resources Information Center

Faller, Kathleen Coulborn; Cordisco-Steele, Linda; Nelson-Gardell, Debra

2010-01-01

This article describes the state of knowledge about extended assessments/forensic evaluations in situations of possible sexual abuse. It provides a critical review of the modest body of relevant research, describes two models for extended assessments, and presents descriptive survey findings of 62 professionals conducting extended assessments,…

Curriculum Rhythm and HPE Practice: Making Sense of a Complex Relationship

ERIC Educational Resources Information Center

Bowes, Margot; Ovens, Alan

2014-01-01

In this paper we suggest that official curriculum statements provide a relatively modest influence on the emergence of Health and Physical Education (HPE) in school settings and that not enough attention is paid to the other factors that influence curriculum practice in schools. We argue that while the perspectives of teachers may reflect the…

Comparing the Effectiveness of Public and Private Schools: A Review of Evidence and Interpretations. Occasional Paper.

ERIC Educational Resources Information Center

McEwan, Patrick J.

This paper explores two questions: (1) Do private schools produce greater academic achievement or attainment than public schools? and (2) Does this evidence provide guidance on the potential impact of voucher plans? Based on recent experimental evidence, it finds that Catholic elementary schools have modest effects on the mathematics achievement…

A Decade Review of Selected Risky Behaviors and Attitudes of Alabama Adolescents. Summary Report.

ERIC Educational Resources Information Center

Nagy, Stephen; Adcock, Anthony G.; Leaver-Dunn, Deidre; Elder, Craig; Jacobs, Donna P.

This report examines the behaviors and attitudes of Alabama adolescents and provides insights into changes and trends in the selected areas. Relatively few meaningful changes on risky behaviors were found. Risky health behaviors remained a serious, immediate, and future threat to the well-being of Alabama's teens. Changes were extremely modest in…

Consuming Prose: The Delectable Rhetoric of Food Writing

ERIC Educational Resources Information Center

Bloom, Lynn Z.

2008-01-01

Food writing, like cooking, offers control over at least a small slice of an otherwise refractory world. As practiced by writers so good that whether they can cook or not is beside the point, food writing is most often upbeat and nurturing, providing successes and triumphs--modest and major--for readers to feast on, with occasional glimpses of…

Three-dimension imaging lidar

NASA Technical Reports Server (NTRS)

Degnan, John J. (Inventor)

2007-01-01

This invention is directed to a 3-dimensional imaging lidar, which utilizes modest power kHz rate lasers, array detectors, photon-counting multi-channel timing receivers, and dual wedge optical scanners with transmitter point-ahead correction to provide contiguous high spatial resolution mapping of surface features including ground, water, man-made objects, vegetation and submerged surfaces from an aircraft or a spacecraft.

Waterspout, Gust Fronts and Associated Cloud Systems

NASA Technical Reports Server (NTRS)

Simpson, J.

1983-01-01

Nine waterspouts observed on five experimental days during the GATE period of observations are discussed. Primary data used are from 2 aircraft flying in different patterns, one above the other between 30 and 300 m. There is strong evidence associating whirl initiation with cumulus outflow. Computations prepared from estimates of convergence with the region suggest the possibility of vortex generation within 4 minutes. This analysis supports (1) the importance cumulus outflows may have in waterspout initiation and (2) the possibility that sea surface temperature gradients may be important in enabling waterspout development from modest size cumuli.

Strategies And Initiatives That Revitalize Wesley College STEM Programs.

PubMed

D'Souza, Malcolm J; Kroen, William K; Stephens, Charlene B; Kashmar, Richard J

Church-related small private liberal arts baccalaureate minority-serving institutions like Wesley College have modest endowments, are heavily tuition-dependent, and have large numbers of financially-challenged students. In order to sustain the level of academic excellence and to continue to build student demographic diversity in its accessible robust Science and Mathematics (STEM) programs, the faculty sought federal and state funds to implement a coordinated program of curriculum enhancements and student support programs that will increase the number of students choosing STEM majors, increase their academic success, and improve retention.

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

PubMed

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

2014-12-01

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

Making progress: the role of cancer councils in Australia in indigenous cancer control.

PubMed

Thompson, Sandra C; Shahid, Shaouli; DiGiacomo, Michelle; Pilkington, Leanne; Davidson, Patricia M

2014-04-11

Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of "Closing the Gap" and research in the larger CCs have been other avenues for increasing knowledge and activity in Indigenous cancer control. This environmental scan measured progress, allowed sharing of information and provided critical assessment of progress across areas of importance for increasing Indigenous cancer control. Structured examination of policies, institutional support systems, programs and interventions is a useful means of highlighting opportunities for progress with minority groups relevant for many organisations. Progress has occurred with momentum likely to increase in the future and benefit from commitment to long-term monitoring and sharing of achievements.

Global analysis of advanced/metastatic breast cancer: Decade report (2005-2015).

PubMed

Cardoso, Fatima; Spence, Danielle; Mertz, Shirley; Corneliussen-James, Dian; Sabelko, Kimberly; Gralow, Julie; Cardoso, Maria-João; Peccatori, Fedro; Paonessa, Diego; Benares, Ann; Sakurai, Naomi; Beishon, Marc; Barker, Sarah-Jane; Mayer, Musa

2018-06-01

Approximately 0.5 million people worldwide die from metastatic breast cancer (mBC) every year. This manuscript provides an overview on the status of mBC in several regions of the world, highlighting the gaps in care, resources, and support available for patients with mBC. Primary research was conducted in 2015 and 2016, comprising four global qualitative and quantitative surveys of approximately 15,000 individuals in 34 countries. Secondary research was conducted using literature reviews of peer-reviewed publications, patient survey reports, and media or online articles. There have been modest improvements in mBC outcomes over the past decade. Patients are not provided with adequate information about mBC. There is a need for open discussion with patients and caregivers about realistic goals; however, physicians are not trained in communicating with patients about their disease. Maintaining patients' quality of life is a crucial goal; however, this has not improved, and in some cases, may have declined in the past decade. Public awareness and understanding of mBC is limited, with damaging consequences for patients and caregivers. Issues affecting employment remain relevant to patients with mBC and their caregivers. Globally, mBC is associated with a substantial economic burden. Relationships with caregivers are crucial to patients with mBC, and caregiver support needs are often overlooked. A strong and united global effort among healthcare professionals, including clinicians, oncologists, pharmaceutical manufacturers, payers, and policy makers, and with advocates, families, and patients, is necessary to improve the outcome and quality of life for patients with mBC. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Hypothesis of the Co-evolution of Cooperation and Responses to Inequity

PubMed Central

Brosnan, Sarah F.

2011-01-01

Recent evidence demonstrates that humans are not the only species to respond negatively to inequitable outcomes which are to their disadvantage. Several species respond negatively if they subsequently receive a less good reward than a social partner for completing the same task. While these studies suggest that the negative response to inequity is not a uniquely human behavior, they do not provide a functional explanation for the emergence of these responses due to similar characteristics among these species. However, emerging data support the hypothesis that an aversion to inequity is a mechanism to promote successful long-term cooperative relationships amongst non-kin. In this paper, I discuss several converging lines of evidence which illustrate the need to further evaluate this relationship. First, cooperation can survive modest inequity; in explicitly cooperative interactions, individuals are willing to continue to cooperate despite inequitable outcomes as long as the partner's overall behavior is equitable. Second, the context of inequity affects reactions to it in ways which support the idea that joint efforts lead to an expectation of joint payoffs. Finally, comparative studies indicate a link between the degree and extent of cooperation between unrelated individuals in a species and that species’ response to inequitable outcomes. This latter line of evidence indicates that this behavior evolved in conjunction with cooperation and may represent an adaptation to increase the payoffs associated with cooperative interactions. Together these data inform a testable working hypothesis for understanding decision-making in the context of inequity and provide a new, comparative framework for evaluating decision-making behavior. PMID:21519380

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial

PubMed Central

Peterson, Donna J.; Christiansen, Ann L.; Mahoney, Jane; Laud, Purushottam; Layde, Peter M.

2015-01-01

Objectives. We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. Methods. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Results. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007–2008) to follow-up (2010–2011). No significant difference was found between enhanced and standard support communities. Conclusions. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice. PMID:25602891

Responsive partisanship: public support for the clinton and obama health care plans.

PubMed

Kriner, Douglas L; Reeves, Andrew

2014-08-01

We examine the contours of support for the Clinton and Obama health care plans during the 1990s and 2000s based on our own compilation of 120,000 individual-level survey responses from throughout the debates. Despite the rise of the Tea Party, and the racialization of health care politics, opinion dynamics are remarkably similar in both periods. Party ID is the single most powerful predictor of support for reform and the president's handling of it. Contrary to prominent claims, after controlling for partisanship, demographic characteristics are at best weak predictors of support for reform. We also show that Clinton and Obama did not "lose" blacks, seniors, or wealthy voters over the course of the debate. The small and often nonexistent relationship between these characteristics and support for the plan are constant over time. Instead, the modest fluctuations in support for reform appear to follow the ebb and flow of elite rhetoric. Both mean levels of support and its volatility over time covary with elite partisan discourse. These findings suggest that presidents courting public opinion should seek consensus among their own party's elites before appealing to other narrower interests. Copyright © 2014 by Duke University Press.

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial.

PubMed

Guse, Clare E; Peterson, Donna J; Christiansen, Ann L; Mahoney, Jane; Laud, Purushottam; Layde, Peter M

2015-07-01

We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007-2008) to follow-up (2010-2011). No significant difference was found between enhanced and standard support communities. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice.

Individuals' quality of life linked to major life events, perceived social support, and personality traits.

PubMed

Pocnet, Cornelia; Antonietti, Jean-Philippe; Strippoli, Marie-Pierre F; Glaus, Jennifer; Preisig, Martin; Rossier, Jérôme

2016-11-01

The aim of this study was to investigate the relationship between major recent life events that occurred during the last 5 years, social and personal resources, and subjective quality of life (QoL). A total of 1801 participants from the general population (CoLaus/PsyCoLaus study) completed the Life Events Questionnaire, the Social Support Questionnaire, the NEO Five-Factor Inventory Revised, and the Manchester Short Assessment of Quality of Life. Major life events were modestly associated with the QoL (about 5 % of the explained variance). However, QoL was significantly related to perceived social support and personality traits (about 37 % of the explained variance). Particularly, perceived social support, extraversion and conscientiousness personality dimensions were positively linked to life satisfaction, whereas a high level of neuroticism was negatively associated with QoL. This study highlights the negative but temporary association between critical events and QoL. However, a combination of high conscientiousness and extraversion, and positive social support may explain better variances for a high-perceived QoL.

Measuring the level of interstellar inheritance in the solar protoplanetary disk

NASA Astrophysics Data System (ADS)

Alexander, Conel M. O'd.; Nittler, Larry R.; Davidson, Jemma; Ciesla, Fred J.

2017-09-01

The timing and extent to which the initial interstellar material was thermally processed provide fundamental constraints for models of the formation and early evolution of the solar protoplanetary disk. We argue that the nonsolar (solar Δ17O ≈ -29‰) and near-terrestrial (Δ17O ≈ 0‰) O-isotopic compositions of the Earth and most extraterrestrial materials (Moon, Mars, asteroids, and comet dust) were established very early by heating of regions of the disk that were modestly enriched (dust/gas ≥ 5-10 times solar) in primordial silicates (Δ17O ≈ -29‰) and water-dominated ice (Δ17O ≈ 24‰) relative to the gas. Such modest enrichments could be achieved by grain growth and settling of dust to the midplane in regions where the levels of turbulence were modest. The episodic heating of the disk associated with FU Orionis outbursts were the likely causes of this early thermal processing of dust. We also estimate that at the time of accretion the CI chondrite and interplanetary dust particle parent bodies were composed of 5-10% of pristine interstellar material. The matrices of all chondrites included roughly similar interstellar fractions. Whether this interstellar material avoided the thermal processing experienced by most dust during FU Orionis outbursts or was accreted by the disk after the outbursts ceased to be important remains to be established.

Strategic communication related to academic performance: Evidence from China.

PubMed

Zhao, Li; Chen, Lulu; He, Luwei; Heyman, Gail D

2017-09-01

We examined a range of forms of strategic communication relevant to academic performance among 151 seventh- and eleventh-grade adolescents in China. Participants were asked to rate the frequency of their engagement of strategic communication and to evaluate the possible motives for each strategy. The most commonly adopted strategy was to give a vague response about one's own performance, and the predominant motives for strategic communication were the desires to outcompete others, to be prosocial, and to be modest. Males were more likely than females to focus on gaining social approval, and eleventh graders were more likely than seventh graders to focus on being prosocial and modest when engaging in strategic communication. These findings provide insight into the development of strategic communication beyond Western culture. Statement of contribution What is already known on this subject? Adolescents in the West often hide their effort to appear more competent or to gain social acceptance. Little is known about other communication strategies related to academic performance. Little is known about the development of these strategies in non-Western samples. What does this study add? We show that in China, as in Western cultures, children often engage in strategic communication. We demonstrate links between different forms of strategic communication and specific motives. We demonstrate that strategic communication can be motivated by outcompeting others, by being prosocial, and by being modest. © 2017 The British Psychological Society.

A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

PubMed

Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R

2003-01-01

Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.

Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP)

PubMed Central

Hur, Nam Wook; Kim, Hyeon Chang; Waite, Linda

2018-01-01

Objective To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. Methods We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support. Results Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women. Conclusion Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women. PMID:29422922

Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP).

PubMed

Hur, Nam Wook; Kim, Hyeon Chang; Waite, Linda; Youm, Yoosik

2018-01-01

To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support. Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women. Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.

Core dimensions of personality broadly account for the link from perceived social support to symptoms of depression and anxiety.

PubMed

Lewis, Gary J; Bates, Timothy C; Posthuma, Danielle; Polderman, Tinca J C

2014-08-01

Specific personality traits and poor social support are risk factors for anxiety and depression. Little work, however, has considered the effects of social support and personality on these aspects of psychopathology simultaneously. We examined whether perceived social support mediates the effects of core personality domains on symptoms of anxiety and depression. Measures of personality (based on the Five-Factor Model [FFM]), perceived social support, and symptoms of depression and anxiety were collected in a large Dutch adult population-based sample (n = 555), and, except for depression symptoms, in an independent U.S. adult population-based sample (n = 511). Path modeling was used to test the effects of FFM traits on symptoms of depression and anxiety, with and without the mediation of perceived social support. Social support showed no link to symptoms of anxiety and only modest links to symptoms of depression when controlling for the FFM traits. Neuroticism had the strongest effect on symptoms of both depression and anxiety, with Extraversion also showing links to symptoms of depression. Social support has limited influence on symptoms of depression, and no effects on anxiety, over and above the effects of personality. Links between social support and anxiety/depression may largely reflect influences of Neuroticism and Extraversion. © 2013 Wiley Periodicals, Inc.

Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis.

PubMed

Moskowitz, David; Vittinghoff, Eric; Schmidt, Laura

2013-02-01

Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and "net social support," defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.

Retrofitting Vegas: Implementing Energy Efficiency in Two Las Vegas Test Homes

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

Puttagunta, S.

2013-04-01

In 2009, the state of Nevada received nearly forty million dollars in Neighborhood Stabilization Funds from the Department of Housing and Urban Development. The purpose of this funding was to stabilize communities that have suffered from foreclosures and abandonment. In an effort to provide guidance to local officials and maximize how effectively this NSP funding is utilized in retrofitting homes, CARB provided design specifications, energy modeling, and technical support for the Building America Retrofit Alliance (BARA) team and its local partners - Better Building Performance, Nevada Energy Star Partners Green Alliance, and Home Free Nevada - for two retrofit testmore » homes. One home was to demonstrate a modest retrofit and the other a deep energy retrofit. Through this project, CARB has provided two robust solution packages for retrofitting homes built in this region between the 1980s and early 1990s without substantially inconveniencing the occupants. The two test homes, the Carmen and Sierra Hills, demonstrate how cost-effectively energy efficient upgrades can be implemented in the hot, dry climate of the Southwest. In addition, the homes were used as an educational experience for home performance professionals, building trades, remodelers, and the general public. In-field trainings on air-sealing, HVAC upgrades, and insulating were provided to local contractors during the retrofit and BARA documented these retrofits through a series of video presentations, beginning with a site survey and concluding with the finished remodel and test out.« less

Cardiovascular reactivity patterns and pathways to hypertension: a multivariate cluster analysis.

PubMed

Brindle, R C; Ginty, A T; Jones, A; Phillips, A C; Roseboom, T J; Carroll, D; Painter, R C; de Rooij, S R

2016-12-01

Substantial evidence links exaggerated mental stress induced blood pressure reactivity to future hypertension, but the results for heart rate reactivity are less clear. For this reason multivariate cluster analysis was carried out to examine the relationship between heart rate and blood pressure reactivity patterns and hypertension in a large prospective cohort (age range 55-60 years). Four clusters emerged with statistically different systolic and diastolic blood pressure and heart rate reactivity patterns. Cluster 1 was characterised by a relatively exaggerated blood pressure and heart rate response while the blood pressure and heart rate responses of cluster 2 were relatively modest and in line with the sample mean. Cluster 3 was characterised by blunted cardiovascular stress reactivity across all variables and cluster 4, by an exaggerated blood pressure response and modest heart rate response. Membership to cluster 4 conferred an increased risk of hypertension at 5-year follow-up (hazard ratio=2.98 (95% CI: 1.50-5.90), P<0.01) that survived adjustment for a host of potential confounding variables. These results suggest that the cardiac reactivity plays a potentially important role in the link between blood pressure reactivity and hypertension and support the use of multivariate approaches to stress psychophysiology.

Reinforcing Doses of Intravenous Cocaine Produce Only Modest Dopamine Uptake Inhibition.

PubMed

Brodnik, Zachary D; Ferris, Mark J; Jones, Sara R; España, Rodrigo A

2017-02-15

The reinforcing efficacy of cocaine is thought to stem from inhibition of the dopamine transporter (DAT) and subsequent increases in extracellular dopamine concentrations in the brain. In humans, this hypothesis has generally been supported by positron emission tomography imaging studies where the percent of DATs occupied by cocaine is used as a measure of cocaine activity in the brain. Interpretation of these studies, however, often relies on the assumption that measures of DAT occupancy directly correspond with functional DAT blockade. In the current studies, we used in vivo and in vitro fast scan cyclic voltammetry in mice to measure dopamine uptake inhibition following varying doses of cocaine as well as two high affinity DAT inhibitors. We then compared dopamine clearance rates following these drug treatments to dopamine clearance obtained from DAT knockout mice as a proxy for complete DAT blockade. We found that administration of abused doses of cocaine resulted in approximately 2% of maximal DAT blockade. Overall, our data indicate that abused doses of cocaine produce a relatively modest degree of DA uptake inhibition, and suggest that the relationship between DAT occupancy and functional blockade of the DAT is more complex than originally posited.

Prevention of chronic lung disease

PubMed Central

Laughon, Matthew M.; Smith, P. Brian; Bose, Carl

2010-01-01

Considerable effort has been devoted to the development of strategies to reduce the incidence of chronic lung disease, including use of medications, nutritional therapies, and respiratory care practices. Unfortunately, most of these strategies have not been successful. To date, the only two treatments developed specifically to prevent CLD whose efficacy is supported by evidence from randomized, controlled trials are the parenteral administration of vitamin A and corticosteroids. Two other therapies, the use of caffeine for the treatment of apnea of prematurity and aggressive phototherapy for the treatment of hyperbilirubinemia were evaluated for the improvement of other outcomes and found to reduce CLD. Cohort studies suggest that the use of CPAP as a strategy for avoiding mechanical ventilation might also be beneficial. Other therapies reduce lung injury in animal models but do not appear to reduce CLD in humans. The benefits of the efficacious therapies have been modest, with an absolute risk reduction in the 7–11% range. Further preventive strategies are needed to reduce the burden of this disease. However, each will need to be tested in randomized, controlled trials, and the expectations of new therapies should be modest reductions of the incidence of the disease. PMID:19736053

Improving the Linkages between Air Pollution Epidemiology and Quantitative Risk Assessment

PubMed Central

Bell, Michelle L.; Walker, Katy; Hubbell, Bryan

2011-01-01

Background: Air pollution epidemiology plays an integral role in both identifying the hazards of air pollution as well as supplying the risk coefficients that are used in quantitative risk assessments. Evidence from both epidemiology and risk assessments has historically supported critical environmental policy decisions. The extent to which risk assessors can properly specify a quantitative risk assessment and characterize key sources of uncertainty depends in part on the availability, and clarity, of data and assumptions in the epidemiological studies. Objectives: We discuss the interests shared by air pollution epidemiology and risk assessment communities in ensuring that the findings of epidemiological studies are appropriately characterized and applied correctly in risk assessments. We highlight the key input parameters for risk assessments and consider how modest changes in the characterization of these data might enable more accurate risk assessments that better represent the findings of epidemiological studies. Discussion: We argue that more complete information regarding the methodological choices and input data used in epidemiological studies would support more accurate risk assessments—to the benefit of both disciplines. In particular, we suggest including additional details regarding air quality, demographic, and health data, as well as certain types of data-rich graphics. Conclusions: Relatively modest changes to the data reported in epidemiological studies will improve the quality of risk assessments and help prevent the misinterpretation and mischaracterization of the results of epidemiological studies. Such changes may also benefit epidemiologists undertaking meta-analyses. We suggest workshops as a way to improve the dialogue between the two communities. PMID:21816702

Maintenance of Vinyl Asbestos and Asphalt Tile Floors in Institutional, Industrial and Commercial Buildings.

ERIC Educational Resources Information Center

Asphalt and Vinyl Asbestos Tile Inst., New York, NY.

The claim is made that proper planning and modest outlays of time, labor, and material costs can provide and maintain a high appearance level for floors in institutional, commercial, and industrial buildings. Instructions for four basic steps in maintaining the good looks of vinyl asbestos and asphalt tile floors are treated in the booklet--(1)…

Preschoolers' Reading Skills Benefit from One Modest Change by Teachers

ERIC Educational Resources Information Center

Grabmeier, Jeff

2012-01-01

A small change in how teachers and parents read aloud to preschoolers may provide a big boost to their reading skills later on, a new study found. That change involves making specific references to print in books while reading--such as pointing out letters and words on the pages, showing capital letters, and showing how they read from left to…

Biliteracy, or the Bilingual Child's Right to Read.

ERIC Educational Resources Information Center

Andersson, Theodore

So far bilingual education has had only the most modest success in providing for children of limited English-speaking ability (LESAS) an educational opportunity equal to that of English-speaking children. In fact, to aim only at equality is self-defeating because it is impossible for a LESA child with a five-to-six year handicap ever to catch up…

The Ed.D. Program at the University of Illinois at Chicago: Using Continuous Improvement to Promote School Leadership Preparation

ERIC Educational Resources Information Center

Cosner, Shelby; Tozer, Steve; Smylie, Mark

2012-01-01

This article describes the process of replacing a modest Master's level school leader preparation program with an innovative Ed.D. program at the University of Illinois at Chicago (UIC). The new doctoral program is intensive, highly selective, intellectually rigorous, and field-based. The authors provide side-by-side comparisons of the difference…

How Much for Whom? Lessons from an Efficacy Study of Modest Professional Development for Child Care Providers

ERIC Educational Resources Information Center

Gerde, Hope K.; Duke, Nell K.; Moses, Annie M.; Spybrook, Jessaca; Shedd, Meagan K.

2014-01-01

Research Findings: Examining the effects of professional development of the early childhood workforce that fit within the constraints of government policy is crucial for identifying types and amounts of effective training and informing child care policy. The present study used a cluster-randomized trial to evaluate the effects of a professional…

Implementing 15 Essential Elements for High Quality: A State and Local Policy Scan

ERIC Educational Resources Information Center

Barnett, W. Steven; Weisenfeld, G. G.; Brown, Kirsty; Squires, Jim; Horowitz, Michelle

2016-01-01

This report explores the extent to which states (and several large cities) are positioned to provide high quality preschool education on a large scale. States and cities that are already doing so or that could do so with modest improvements offer opportunities for advocacy to advance access to high quality early education as well as for rigorous…

A Home Away from Home: Consumer Information on Board and Care Homes.

ERIC Educational Resources Information Center

Haske, Margaret; Cohen, Rebecca, Ed.

This report provides consumer information on board and care homes, a housing alternative for older persons which serves a broad spectrum of the population, ranging from those needing a modest amount of care and assistance to those who are physically or mentally disabled, but do not need to be institutionalized. The first section of this two-part…

Mixed dementia: A review of the evidence

PubMed Central

Custodio, Nilton; Montesinos, Rosa; Lira, David; Herrera-Pérez, Eder; Bardales, Yadira; Valeriano-Lorenzo, Lucía

2017-01-01

ABSTRACT. Mixed dementia is the coexistence of Alzheimer's disease and cerebrovascular disease (CVD) in the same demented patient. Currently, its diagnosis and treatment remains a challenge for practitioners. To provide an overview of the epidemiology, pathogenesis, natural history, diagnosis, and therapy of Mixed Vascular-Alzheimer Dementia (MVAD). The literature was reviewed for articles published between 1990-2016 by using the keywords linked to MVAD. Neuropathological studies indicate that MVAD is a very common pathological finding in the elderly with a prevalence about of 22%. The distinction between Alzheimer's dementia and vascular dementia (VD) is complex because their clinical presentation can overlap. There are international criteria for the MVAD diagnosis. The pharmacologic therapy shows modest clinical benefits that are similar among all drugs used in patients with Alzheimer's dementia and VD. The non-pharmacologic therapy includes the rigorous management of cardiovascular risk factors (especially hypertension) and the promotion of a healthy diet. The diagnosis and treatment of MVAD cannot be improved without further studies. Currently available medications provide only modest clinical benefits once a patient has developed MVAD. In subjects at risk, the antihypertensive therapy and healthy diet should be recommend for preventing or slowing the progression of MVAD. PMID:29354216

Mixed dementia: A review of the evidence.

PubMed

Custodio, Nilton; Montesinos, Rosa; Lira, David; Herrera-Pérez, Eder; Bardales, Yadira; Valeriano-Lorenzo, Lucía

2017-01-01

Mixed dementia is the coexistence of Alzheimer's disease and cerebrovascular disease (CVD) in the same demented patient. Currently, its diagnosis and treatment remains a challenge for practitioners. To provide an overview of the epidemiology, pathogenesis, natural history, diagnosis, and therapy of Mixed Vascular-Alzheimer Dementia (MVAD). The literature was reviewed for articles published between 1990-2016 by using the keywords linked to MVAD. Neuropathological studies indicate that MVAD is a very common pathological finding in the elderly with a prevalence about of 22%. The distinction between Alzheimer's dementia and vascular dementia (VD) is complex because their clinical presentation can overlap. There are international criteria for the MVAD diagnosis. The pharmacologic therapy shows modest clinical benefits that are similar among all drugs used in patients with Alzheimer's dementia and VD. The non-pharmacologic therapy includes the rigorous management of cardiovascular risk factors (especially hypertension) and the promotion of a healthy diet. The diagnosis and treatment of MVAD cannot be improved without further studies. Currently available medications provide only modest clinical benefits once a patient has developed MVAD. In subjects at risk, the antihypertensive therapy and healthy diet should be recommend for preventing or slowing the progression of MVAD.

Straddling the tholeiitic/calc-alkaline transition: the effects of modest amounts of water on magmatic differentiation at Newberry Volcano, Oregon

USGS Publications Warehouse

Mandler, Ben E.; Donnelly-Nolan, Julie M.; Grove, Timothy L.

2014-01-01

Melting experiments have been performed at 1 bar (anhydrous) and 1- and 2-kbar H2O-saturated conditions to study the effect of water on the differentiation of a basaltic andesite. The starting material was a mafic pumice from the compositionally zoned tuff deposited during the ~75 ka caldera-forming eruption of Newberry Volcano, a rear-arc volcanic center in the central Oregon Cascades. Pumices in the tuff of Newberry caldera (TNC) span a continuous silica range from 53 to 74 wt% and feature an unusually high-Na2O content of 6.5 wt% at 67 wt% SiO2. This wide range of magmatic compositions erupted in a single event makes the TNC an excellent natural laboratory in which to study the conditions of magmatic differentiation. Our experimental results and mineral–melt hygrometers/thermometers yield similar estimates of pre-eruptive H2O contents and temperatures of the TNC liquids. The most primitive (mafic) basaltic andesites record a pre-eruptive H2O content of 1.5 wt% and a liquidus temperature of 1,060–1,070 °C at upper crustal pressure. This modest H2O content produces a distinctive fractionation trend that is much more enriched in Na, Fe, and Ti than the calc-alkaline trend typical of wetter arc magmas, but slightly less enriched in Fe and Ti than the tholeiitic trend of dry magmas. Modest H2O contents might be expected at Newberry Volcano given its location in the Cascade rear arc, and the same fractionation trend is also observed in the rim andesites of the rear-arc Medicine Lake volcano in the southern Cascades. However, the Na–Fe–Ti enrichment characteristic of modest H2O (1–2 wt%) is also observed to the west of Newberry in magmas erupted from the arc axis, such as the Shevlin Park Tuff and several lava flows from the Three Sisters. This shows that modest-H2O magmas are being generated directly beneath the arc axis as well as in the rear arc. Because liquid lines of descent are particularly sensitive to water content in the range of 0–3 wt% H2O, they provide a quantitative and reliable tool for precisely determining pre-eruptive H2O content using major-element data from pumices or lava flows. Coupled enrichment in Na, Fe, and Ti relative to the calc-alkaline trend is a general feature of fractional crystallization in the presence of modest amounts of H2O, which may be used to look for “damp” fractionation sequences elsewhere.

Examination of association of genes in the serotonin system to autism.

PubMed

Anderson, B M; Schnetz-Boutaud, N C; Bartlett, J; Wotawa, A M; Wright, H H; Abramson, R K; Cuccaro, M L; Gilbert, J R; Pericak-Vance, M A; Haines, J L

2009-07-01

Autism is characterized as one of the pervasive developmental disorders, a spectrum of often severe behavioral and cognitive disturbances of early development. The high heritability of autism has driven multiple efforts to identify genetic variation that increases autism susceptibility. Numerous studies have suggested that variation in peripheral and central metabolism of serotonin (5-hydroxytryptamine) may play a role in the pathophysiology of autism. We screened 403 autism families for 45 single nucleotide polymorphisms in ten serotonin pathway candidate genes. Although genome-wide linkage scans in autism have provided support for linkage to various loci located within the serotonin pathway, our study does not provide strong evidence for linkage to any specific gene within the pathway. The most significant association (p = 0.0002; p = 0.02 after correcting for multiple comparisons) was found at rs1150220 (HTR3A) located on chromosome 11 ( approximately 113 Mb). To test specifically for multilocus effects, multifactor dimensionality reduction was employed, and a significant two-way interaction (p value = 0.01) was found between rs10830962, near MTNR1B (chromosome11; 92,338,075 bp), and rs1007631, near SLC7A5 (chromosome16; 86,413,596 bp). These data suggest that variation within genes on the serotonin pathway, particularly HTR3A, may have modest effects on autism risk.

Constraints on Porosity and Mass Loss in O-star Winds from the Modeling of X-ray Emission Line Profile Shapes

NASA Technical Reports Server (NTRS)

Leutenegger, Maurice A.; Cohen, David H.; Sundqvist, Jon O.; Owocki, Stanley P.

2013-01-01

We fit X-ray emission line profiles in high resolution XMM-Newton and Chandra grating spectra of the early O supergiant Zeta Pup with models that include the effects of porosity in the stellar wind. We explore the effects of porosity due to both spherical and flattened clumps. We find that porosity models with flattened clumps oriented parallel to the photosphere provide poor fits to observed line shapes. However, porosity models with isotropic clumps can provide acceptable fits to observed line shapes, but only if the porosity effect is moderate. We quantify the degeneracy between porosity effects from isotropic clumps and the mass-loss rate inferred from the X-ray line shapes, and we show that only modest increases in the mass-loss rate (40%) are allowed if moderate porosity effects (h(sub infinity) less than approximately R(sub *)) are assumed to be important. Large porosity lengths, and thus strong porosity effects, are ruled out regardless of assumptions about clump shape. Thus, X-ray mass-loss rate estimates are relatively insensitive to both optically thin and optically thick clumping. This supports the use of X-ray spectroscopy as a mass-loss rate calibration for bright, nearby O stars

Soy provides modest benefits on endothelial function without affecting inflammatory biomarkers in adults at cardiometabolic risk

PubMed Central

Reverri, Elizabeth J.; LaSalle, Colette D.; Franke, Adrian A.; Steinberg, Francene M.

2015-01-01

Scope Systemic inflammation, endothelial dysfunction, and oxidative stress are involved in the pathogenesis of the metabolic syndrome (MetS). Epidemiological evidence supports an association between whole soy food consumption and reduced risk of cardiovascular disease (CVD). The objective of this randomized, controlled, crossover study was to evaluate the effects of soy nut consumption on inflammatory biomarkers and endothelial function and to assess whether isoflavone metabolism to secondary products, equol and/or O-desmethylangolensin (ODMA), modifies these responses. Methods and Results n=17 adults at cardiometabolic risk were randomly assigned to the order of two snack interventions, soy nuts and macronutrient-matched control snack, for four weeks each, separated by a two week washout period. Outcome measures included biomarkers of inflammation, oxidative stress, and glycemic control (ELISA and clinical analyzers), endothelial function and arterial stiffness (peripheral arterial tonometry (PAT)), and isoflavone metabolites (LC-MS/MS). Results revealed that consuming soy nuts improved arterial stiffness as assessed by the augmentation index using PAT (P=0.03), despite lack of improvement in inflammatory biomarkers. Addition of equol and/ODMA production status as covariates did not significantly change these results. Conclusions Soy nuts when added to a usual diet for one month provide some benefit on arterial stiffness in adults at cardiometabolic risk. PMID:25351805

Lean leadership: an ethnographic study.

PubMed

Aij, Kjeld Harald; Visse, Merel; Widdershoven, Guy A M

2015-01-01

The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre. This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis. Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one's own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset. In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author's experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.

Complete distributed computing environment for a HEP experiment: experience with ARC-connected infrastructure for ATLAS

NASA Astrophysics Data System (ADS)

Read, A.; Taga, A.; O-Saada, F.; Pajchel, K.; Samset, B. H.; Cameron, D.

2008-07-01

Computing and storage resources connected by the Nordugrid ARC middleware in the Nordic countries, Switzerland and Slovenia are a part of the ATLAS computing Grid. This infrastructure is being commissioned with the ongoing ATLAS Monte Carlo simulation production in preparation for the commencement of data taking in 2008. The unique non-intrusive architecture of ARC, its straightforward interplay with the ATLAS Production System via the Dulcinea executor, and its performance during the commissioning exercise is described. ARC support for flexible and powerful end-user analysis within the GANGA distributed analysis framework is also shown. Whereas the storage solution for this Grid was earlier based on a large, distributed collection of GridFTP-servers, the ATLAS computing design includes a structured SRM-based system with a limited number of storage endpoints. The characteristics, integration and performance of the old and new storage solutions are presented. Although the hardware resources in this Grid are quite modest, it has provided more than double the agreed contribution to the ATLAS production with an efficiency above 95% during long periods of stable operation.

Optimal Health (Spirit, Mind, and Body): A Feasibility Study Promoting Well-Being for Health Behavior Change.

PubMed

Walker, Jenelle; Ainsworth, Barbara; Hooker, Steven; Keller, Colleen; Fleury, Julie; Chisum, Jack; Swan, Pamela

2015-10-01

Faith-based programs have shown beneficial effects for health and behaviors. Few have specifically intervened on the spiritual, mental (i.e., stress), and physical dimensions of well-being combined for health and healthy behaviors (i.e., exercise and diet). The purpose of this report is to describe the feasibility of executing a spirituality-based health behavior change, program founded upon the Spiritual Framework of Coping. This study was a quasi-experimental one group pretest-posttest design. Feasibility objectives were assessed, and limited efficacy of pretest and posttest measures was analyzed using paired t test (p < .05). Acceptance of the program was positive, and modest demand was shown with initial interest and an average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy measures showed no pre-post changes. This study provided preliminary support for the design and further testing of the theoretical components of the Spiritual Framework of Coping that informed the program.

Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome (CRPS) Recurrence after Amputation for CRPS, and Failure of Conventional Spinal Cord Stimulation.

PubMed

Goebel, Andreas; Lewis, Sarah; Phillip, Rhodri; Sharma, Manohar

2018-01-01

Limb amputation is sometimes being performed in long-standing complex regional pain syndrome (CRPS), although little evidence is available guiding management decisions, including how CRPS recurrence should be managed. This report details the management of a young soldier with CRPS recurrence 2 years after midtibial amputation for CRPS. Conventional spinal cord stimulation did not achieve paraesthetic coverage, or pain relief in the stump, whereas L4 dorsal root ganglion stimulation achieved both coverage and initially modest pain relief, and over time, substantial pain relief. Current evidence does not support the use of amputation to improve either pain or function in CRPS. Before a decision is made, in exceptional cases, about referral for amputation, dorsal root ganglion stimulation should be considered as a potentially effective treatment, even where conventional spinal cord stimulator treatment has failed to achieve reliable paraesthetic cover. Furthermore, this treatment may provide pain relief in those patients with CRPS recurrence in the stump after amputation. © 2017 World Institute of Pain.

Alternative theories of the relationship of schooling and work to family formation: evidence from Mexico.

PubMed

Lindstrom, D P; Brambila Paz, C

2001-01-01

Role incompatibility, education as an investment in human capital, and schooling as a transformative experience are three mechanisms that link women's education to the timing of marriage and first birth. We simultaneously evaluate these different explanations using retrospective life history data for two cohorts of Mexican women collected in a nationally representative sample. Our analyses provide evidence in support of all three hypotheses. While in school young women are at a substantially lower risk of marriage and of a first birth. We find no evidence that women leave school to enter into unions nor do we find evidence that the effect of being a student diminishes with age. Women who work for a wage are also at a lower risk of marriage and a first birth. Once we control for student and employment status, the direct effects of cumulative education on family formation are relatively modest, although cumulative education is strongly associated with positive attitudes towards women's work and a significant increase in the likelihood of premarital and postmarital employment.

Family members' views on the benefits of harp music vigils for terminally-ill or dying loved ones.

PubMed

Ganzini, Linda; Rakoski, Alexa; Cohn, Sharilyn; Mularski, Richard A

2015-02-01

Music-thanatology is a palliative modality that uses harp and voice to provide bedside vigils, particularly for terminally ill or actively dying. We sought to determine the benefits of music vigils for terminally ill patients. Survey of 55 family members, whose terminally ill loved one experienced a music vigil during hospitalization, regarding effects on the patient's breathing, relaxation, comfort, pain and ability to sleep. Written comments on negative and positive results of the vigils were coded using content analysis. Family members perceived that the vigils resulted in modest improvement in the patients' breathing, relaxation, comfort, and ability to sleep, with fewer positive effects on pain, and almost no negative effects. Open ended comments focused on the positive benefit in increasing calm, relaxation, comfort. Comments on the positive effects for the family were almost as common as comments on the positive results for the patient. The use of music-vigils in palliative care should be investigated more extensively as our study supports that this intervention has benefits, almost no risk, minimal cost, and may improve patient-family experience of the dying process.

The deep underground science and engineering laboratory at Homestake

NASA Astrophysics Data System (ADS)

Lesko, Kevin T.

2009-06-01

The US National Science Foundation and the US underground science community are well into the campaign to establish a world-class, multi-disciplinary deep underground science and engineering laboratory — DUSEL. The NSF's review committee, following the first two NSF solicitations, selected Homestake as the prime site to be developed into an international, multidisciplinary, world-class research facility. Homestake DUSEL will provide much needed underground research space to help relieve the worldwide shortage, particularly at great depth, and will develop research campuses at different depths to satisfy the research requirements for the coming decades. The State of South Dakota has demonstrated remarkable support for the project and has secured the site with the transfer of the former Homestake Gold Mine and has initiated re-entry and rehabilitation of the facility to host a modest interim science program with state funds and those from a substantial philanthropic donor. I review the scientific case for DUSEL and the progress in developing the preliminary design of DUSEL in Homestake and the initial suite of experiments to be funded along with the facility.

The Deep Underground Science and Engineering Laboratory at Homestake

NASA Astrophysics Data System (ADS)

Lesko, Kevin T.

2009-12-01

The US National Science Foundation and the US underground science community are well into the campaign to establish a world-class, multi-disciplinary deep underground science and engineering laboratory—DUSEL. The NSF's review committee, following the first two NSF solicitations, selected Homestake as the prime site to be developed into an international, multidisciplinary, world-class research facility. Homestake DUSEL will provide much needed underground research space to help relieve the worldwide shortage, particularly at great depth, and will develop research campuses at different depths to satisfy the research requirements for the coming decades. The State of South Dakota demonstrates remarkable support for the project and has secured the site with the transfer of the former Homestake Gold Mine and has initiated re-entry and rehabilitation of the facility to host a modest interim science program with state funds and those from a substantial philanthropic donor. I review the scientific case for DUSEL and the progress in developing the preliminary design of DUSEL in Homestake and the integrated suite of experiments to be funded along with the facility.

Additive Manufactured Superconducting Cavities

NASA Astrophysics Data System (ADS)

Holland, Eric; Rosen, Yaniv; Woolleet, Nathan; Materise, Nicholas; Voisin, Thomas; Wang, Morris; Mireles, Jorge; Carosi, Gianpaolo; Dubois, Jonathan

Superconducting radio frequency cavities provide an ultra-low dissipative environment, which has enabled fundamental investigations in quantum mechanics, materials properties, and the search for new particles in and beyond the standard model. However, resonator designs are constrained by limitations in conventional machining techniques. For example, current through a seam is a limiting factor in performance for many waveguide cavities. Development of highly reproducible methods for metallic parts through additive manufacturing, referred to colloquially as 3D printing\\x9D, opens the possibility for novel cavity designs which cannot be implemented through conventional methods. We present preliminary investigations of superconducting cavities made through a selective laser melting process, which compacts a granular powder via a high-power laser according to a digitally defined geometry. Initial work suggests that assuming a loss model and numerically optimizing a geometry to minimize dissipation results in modest improvements in device performance. Furthermore, a subset of titanium alloys, particularly, a titanium, aluminum, vanadium alloy (Ti - 6Al - 4V) exhibits properties indicative of a high kinetic inductance material. This work is supported by LDRD 16-SI-004.

Predictors of how often and when people fall in love.

PubMed

Galperin, Andrew; Haselton, Martie

2010-01-19

A leading theory of romantic love is that it functions to make one feel committed to one's beloved, as well as to signal this commitment to the beloved (Frank, 1988). Because women tend to be skeptical of men's commitment, this view entails that men may have evolved to fall in love first, in order to show their commitment to women. Using a sample of online participants of a broad range of ages, this study tested this sex difference and several related individual difference hypotheses concerning the ease of falling in love. There was mixed evidence for sex differences: only some measures indicated that men are generally more love-prone than are women. We also found that men were more prone to falling in love if they tended to overestimate women's sexual interest and highly valued physical attractiveness in potential partners. Women were more prone to falling in love if they had a stronger sex drive. These results provide modest support for the existence of sex differences in falling in love, as well as initial evidence for links between several individual difference variables and the propensity to fall in love.

Adopting a corporate perspective on databases. Improving support for research and decision making.

PubMed

Meistrell, M; Schlehuber, C

1996-03-01

The Veterans Health Administration (VHA) is at the forefront of designing and managing health care information systems that accommodate the needs of clinicians, researchers, and administrators at all levels. Rather than using one single-site, centralized corporate database VHA has constructed several large databases with different configurations to meet the needs of users with different perspectives. The largest VHA database is the Decentralized Hospital Computer Program (DHCP), a multisite, distributed data system that uses decoupled hospital databases. The centralization of DHCP policy has promoted data coherence, whereas the decentralization of DHCP management has permitted system development to be done with maximum relevance to the users'local practices. A more recently developed VHA data system, the Event Driven Reporting system (EDR), uses multiple, highly coupled databases to provide workload data at facility, regional, and national levels. The EDR automatically posts a subset of DHCP data to local and national VHA management. The development of the EDR illustrates how adoption of a corporate perspective can offer significant database improvements at reasonable cost and with modest impact on the legacy system.

Joint Discussion 14 Modeling dense stellar systems

NASA Astrophysics Data System (ADS)

Sills, Alison I.; Subr, Ladislav; Portegies Zwart, Simon F.

2007-08-01

Joint Discussion 14 was held at the General Assembly of the International Astronomical Union from August 17 until 23 in the beautiful Bohemian capital, Prague. The blueprints for this meeting were laid out during the MODEST-5 workshop, held in the Canadian city of Hamilton, Ontario in August 2004. We were sitting in a nice cafe with local brew and food, discussing the future of the MODEST community when we posed the idea for this Joint Discussion at the General Assembly. The meeting was then coined MODEST-7.

Informing Investment to Reduce Inequalities: A Modelling Approach

PubMed Central

McAuley, Andrew; Denny, Cheryl; Taulbut, Martin; Mitchell, Rory; Fischbacher, Colin; Graham, Barbara; Grant, Ian; O’Hagan, Paul; McAllister, David; McCartney, Gerry

2016-01-01

Background Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. Objectives To provide estimates of the impact of a range of interventions on health and health inequalities. Materials and Methods Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a ‘living wage’; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Results Introduction of a ‘living wage’ generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Conclusions Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities. PMID:27486857

Silicosis decreases bone mineral density in rats.

PubMed

Hui, Zhang; Dingjie, Xu; Yuan, Yuan; Zhongqiu, Wei; Na, Mao; Mingjian, Bei; Yu, Gou; Guangyuan, Liu; Xuemin, Gao; Shifeng, Li; Yucong, Geng; Fang, Yang; Summer, Ross; Hong, Xu

2018-06-01

Silicosis is the most common occupational lung disease in China, and is associated with a variety of complications, many of which are poorly understood. For example, recent data indicate that silicosis associates with the development of osteopenia, and in some cases this bone loss is severe, meeting criteria for osteoporosis. Although many factors are likely to contribute to this relationship, including a sedentary lifestyle in patients with advanced silicotic lung disease, we hypothesized that silica might directly reduce bone mineral density. In the present study, six Wistar rats were exposed to silica for 24 weeks in order to induce pulmonary silicosis and examine the relationship to bone mineral density. As expected, all rats exposed to silica developed severe pulmonary fibrosis, as manifested by the formation of innumerable silicotic nodules and the deposition of large amounts of interstitial collagen. Moreover, micro-CT results showed that bone mineral density (BMD) was also significantly reduced in rats exposed to silica when compared control animals and this associated with a modest reduction in serum calcium and 25-hydroxyvitamin D levels. In addition, we found that decreased BMD was also linked to increased osteoclast activity as well as fibrosis-like changes, and to the deposition of silica within bone marrow. In summary, our findings support the hypothesis that silicosis reduces bone mineral density and provide support for ongoing investigations into the mechanisms causing osteopenia in silicosis patients. Copyright © 2018. Published by Elsevier Inc.

More than just nickels and dimes: a cross-national analysis of working poverty in affluent democracies.

PubMed

Brady, David; Fullerton, Andrew S; Cross, Jennifer Moren

2010-01-01

Despite its centrality to contemporary inequality, working poverty is often popularly discussed but rarely studied by sociologists. Using the Luxembourg Income Study (2009), we analyze whether an individual is working poor across 18 affluent democracies circa 2000. We demonstrate that working poverty does not simply mirror overall poverty and that there is greater cross-national variation in working than overall poverty. We then examine four explanations for working poverty: demographic characteristics, economic performance, unified theory, and welfare generosity. We utilize Heckman probit models to jointly model the likelihood of employment and poverty among the employed. Our analyses provide the least support for the economic performance explanation. There is modest support for unified theory as unionization reduces working poverty in some models. However, most of these effects appear to be mediated by welfare generosity. More substantial evidence exists for the demographic characteristics and welfare generosity explanations. An individual's likelihood of being working poor can be explained by (a) a lack of multiple earners or other adults in one's household, low education, single motherhood, having children and youth; and (b) the generosity of the welfare state in which he or she resides. Also, welfare generosity does not undermine employment and reduces working poverty even among demographically vulnerable groups. Ultimately, we encourage a greater role for the welfare state in debates about working poverty.

A review of the effects of impermeable bedding encasements on dust-mite allergen exposure and bronchial hyper-responsiveness in dust-mite-sensitized patients.

PubMed

Recer, G M

2004-02-01

Sensitization and exposure to dust-mite antigens are causative factors in the development and exacerbation of asthma. Impermeable bedding encasements are considered a first-line treatment to reduce dust-mite antigen exposure in clinical asthma-management guidelines. Public-health recommendations for environmental asthma treatments should be based on the weight of evidence supporting the reliability of environmental interventions so that uncertainties regarding their effectiveness can be accurately communicated to patients, and so that limited public-health resources can be most effectively utilized. To evaluate the strength of a clinical-trial evidence supporting the efficacy of bedding encasements as an asthma treatment. A narrative review was conducted of all clinical trials involving bedding encasement for the treatment of asthma. Collective statistical analyses were also performed to characterize the quantitative effect of bedding encasement on dust-mite allergen exposure and bronchial hyper-responsiveness (BHR) when used by asthma patients. Over 30 clinical trials were reviewed. Of those studies reporting adequate exposure and BHR results, four reported significant reduction in dust-mite allergen exposure and concomitant BHR reduction in active-treatment groups using bedding encasements. In 10 studies, mite-allergen exposure was reportedly decreased during the study, but BHR was not changed in the active-treatment group or was reduced to a similar degree in the active-treatment and control groups. Five other studies reported a lack of significant effect of the intervention on exposure and BHR. Collective paired analyses found that the effect of bedding encasement on allergen exposure and BHR tended toward only a modest, non-significant improvement. Collectively, effects of bedding encasement on BHR and dust-mite allergen exposure were modestly correlated only when the baseline exposure was above 2 microg Type 1 antigen per gram settled dust. Although bedding encasement might be an effective asthma treatment under some conditions, when implemented in clinical trials by asthma patients, its effectiveness is inconsistent and appears to be, at best, modest. Therefore, its significance as a reliable asthma management modality for any individual asthma patient is uncertain. Where resource constraints are significant, targeting the use of variably effective interventions such as bedding encasements toward those patient sub-populations most likely to derive substantial benefit may gain the largest net public-health benefit.

Incentives for orphan drug research and development in the United States.

PubMed

Seoane-Vazquez, Enrique; Rodriguez-Monguio, Rosa; Szeinbach, Sheryl L; Visaria, Jay

2008-12-16

The Orphan Drug Act (1983) established several incentives to encourage the development of orphan drugs (ODs) to treat rare diseases and conditions. This study analyzed the characteristics of OD designations, approvals, sponsors, and evaluated the effective patent and market exclusivity life of orphan new molecular entities (NMEs) approved in the US between 1983 and 2007. Primary data sources were the FDA Orange Book, the FDA Office of Orphan Drugs Development, and the US Patent and Trademark Office. Data included all orphan designations and approvals listed by the FDA and all NMEs approved by the FDA during the study period. The FDA listed 1,793 orphan designations and 322 approvals between 1983 and 2007. Cancer was the main group of diseases targeted for orphan approvals. Eighty-three companies concentrated 67.7% of the total orphan NMEs approvals. The average time from orphan designation to FDA approval was 4.0 +/- 3.3 years (mean +/- standard deviation). The average maximum effective patent and market exclusivity life was 11.7 +/- 5.0 years for orphan NME. OD market exclusivity increased the average maximum effective patent and market exclusivity life of ODs by 0.8 years. Public programs, federal regulations, and policies support orphan drugs R&D. Grants, research design support, FDA fee waivers, tax incentives, and orphan drug market exclusivity are the main incentives for orphan drug R&D. Although the 7-year orphan drug market exclusivity provision had a positive yet relatively modest overall effect on effective patent and market exclusivity life, economic incentives and public support mechanisms provide a platform for continued orphan drug development for a highly specialized market.

A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence.

PubMed

DiFranza, Joseph; Ursprung, W W Sanouri; Lauzon, Béatrice; Bancej, Christina; Wellman, Robert J; Ziedonis, Douglas; Kim, Sun S; Gervais, André; Meltzer, Bruce; McKay, Colleen E; O'Loughlin, Jennifer; Okoli, Chizimuzo T C; Fortuna, Lisa R; Tremblay, Michèle

2010-05-01

The Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence (DSM-ND) are based on the proposition that dependence is a syndrome that can be diagnosed only when a minimum of 3 of the 7 proscribed features are present. The DSM-ND criteria are an accepted research measure, but the validity of these criteria has not been subjected to a systematic evaluation. To systematically review evidence of validity and reliability for the DSM-ND criteria, a literature search was conducted of 16 national and international databases. Each article with original data was independently reviewed by two or more reviewers. In total, 380 potentially relevant articles were examined and 169 were reviewed in depth. The DSM-ND criteria have seen wide use in research settings, but sensitivity and specificity are well below the accepted standards for clinical applications. Predictive validity is generally poor. The 7 DSM-ND criteria are regarded as having face validity, but no data support a 3-symptom ND diagnostic threshold, or a 4-symptom withdrawal syndrome threshold. The DSM incorrectly states that daily smoking is a prerequisite for withdrawal symptoms. The DSM shows poor to modest concurrence with all other measures of nicotine dependence, smoking behaviors and biological measures of tobacco use. The data support the DSM-ND criteria as a valid measure of nicotine dependence severity for research applications. However, the data do not support the central premise of a 3-symptom diagnostic threshold, and no data establish that the DSM-ND criteria provide an accurate diagnosis of nicotine dependence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Measuring efficiency: the association of hospital costs and quality of care.

PubMed

Jha, Ashish K; Orav, E John; Dobson, Allen; Book, Robert A; Epstein, Arnold M

2009-01-01

Providers with lower costs may be more efficient and, therefore, provide better care than those with higher costs. However, the relationship between risk-adjusted costs (often described as efficiency) and quality is not well understood. We examined the relationship between hospitals' risk-adjusted costs and their structural characteristics, nursing levels, quality of care, and outcomes. U.S. hospitals with low risk-adjusted costs were more likely to be for-profit, treat more Medicare patients, and employ fewer nurses. They provided modestly worse care for acute myocardial infarction and congestive heart failure but had comparable rates of risk-adjusted mortality. We found no evidence that low-cost providers provide better care.

From revolution to involution: the disappearance of the gay movement in France.

PubMed

Duyvendak, J W

1995-01-01

This essay sketches the development of the modern French gay movement in relation to its political context, in particular to the French Socialist Party. The author argues that its curvilinear development the movement started very modestly in the 1950s, spread within small, radical left-wing circles in the late 1960s and early 1970s, peaked around 1980, and declined rapidly in the course of the 1980s can be explained by the ups and downs in political repression on the one hand and political support and success on the other.

Age-Related Deficits in Auditory Confrontation Naming

PubMed Central

Hanna-Pladdy, Brenda; Choi, Hyun

2015-01-01

The naming of manipulable objects in older and younger adults was evaluated across auditory, visual, and multisensory conditions. Older adults were less accurate and slower in naming across conditions, and all subjects were more impaired and slower to name action sounds than pictures or audiovisual combinations. Moreover, there was a sensory by age group interaction, revealing lower accuracy and increased latencies in auditory naming for older adults unrelated to hearing insensitivity but modest improvement to multisensory cues. These findings support age-related deficits in object action naming and suggest that auditory confrontation naming may be more sensitive than visual naming. PMID:20677880

Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women

PubMed Central

Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

2014-01-01

Aim: To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. Methods: A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. Results: The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Conclusions: Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. PMID:25294689

Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women.

PubMed

Subramoney, Sreevidya; Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

2014-12-01

To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. © 2014 the Nordic Societies of Public Health.

Lifting options for stratospheric aerosol geoengineering: advantages of tethered balloon systems.

PubMed

Davidson, Peter; Burgoyne, Chris; Hunt, Hugh; Causier, Matt

2012-09-13

The Royal Society report 'Geoengineering the Climate' identified solar radiation management using albedo-enhancing aerosols injected into the stratosphere as the most affordable and effective option for geoengineering, but did not consider in any detail the options for delivery. This paper provides outline engineering analyses of the options, both for batch-delivery processes, following up on previous work for artillery shells, missiles, aircraft and free-flying balloons, as well as a more lengthy analysis of continuous-delivery systems that require a pipe connected to the ground and supported at a height of 20 km, either by a tower or by a tethered balloon. Towers are shown not to be practical, but a tethered balloon delivery system, with high-pressure pumping, appears to have much lower operating and capital costs than all other delivery options. Instead of transporting sulphuric acid mist precursors, such a system could also be used to transport slurries of high refractive index particles such as coated titanium dioxide. The use of such particles would allow useful experiments on opacity, coagulation and atmospheric chemistry at modest rates so as not to perturb regional or global climatic conditions, thus reducing scale-up risks. Criteria for particle choice are discussed, including the need to minimize or prevent ozone destruction. The paper estimates the time scales and relatively modest costs required if a tethered balloon system were to be introduced in a measured way with testing and development work proceeding over three decades, rather than in an emergency. The manufacture of a tether capable of sustaining the high tensions and internal pressures needed, as well as strong winds, is a significant challenge, as is the development of the necessary pumping and dispersion technologies. The greatest challenge may be the manufacture and launch of very large balloons, but means have been identified to significantly reduce the size of such balloons or aerostats.

An Attempt to Observe Debris from the Breakup of a Titan 3C-4 Transtage

NASA Technical Reports Server (NTRS)

Barker, E. S.; Matney, M. J.; Yanagisawa, T.; Liou, J.-C.; Abercromby, K. J.; Rodriquez, H. M.; Horstman, M. F.; Seitzer, P.

2007-01-01

In February 2007 dedicated observations were made of the orbital space predicted to contain debris from the breakup of the Titan 3C-4 transtage back on February 21, 1992. These observations were carried out on the Michigan Orbital DEbris Survey Telescope (MODEST) in Chile with its 1.3deg field of view. The search region or orbital space (inclination and right ascension of the ascending node (RAAN) was predicted using NASA#s LEGEND (LEO-to-GEO Environment Debris) code to generate a Titan debris cloud. Breakup fragments are created based on the NASA Standard Breakup Model (including fragment size, area-to-mass (A/M), and delta-V distributions). Once fragments are created, they are propagated forward in time with a subroutine GEOPROP. Perturbations included in GEOPROP are those due to solar/lunar gravity, radiation pressure, and major geopotential terms. Barker, et. al, (AMOS Conference Proceedings, 2006, pp. 596-604) used similar LEGEND predictions to correlate survey observations made by MODEST (February 2002) and found several possible night-to-night correlations in the limited survey dataset. One conc lusion of the survey search was to dedicate a MODEST run to observing a GEO region predicted to contain debris fragments and actual Titan debris objects (SSN 25000, 25001 and 30000). Such a dedicated run was undertaken with MODEST between February 17 and 23, 2007 (UT dates). MODEST#s limiting magnitude of 18.0 (S\\N approx.10) corresponds to a size of 22cm assuming a diffuse Lambertian albedo of 0.2. However, based on observed break-up data, we expect most debris fragments to be smaller than 22cm which implies a need to increase the effective sensitivity of MODEST for smaller objects. MODEST#s limiting size can be lowered by increasing the exposure time (20 instead of 5 seconds) and applying special image processing. The special processing combines individual CCD images to detect faint objects that are invisible on a single CCD image. Sub-images are cropped from six consecutive CCD images with pixel shifts between images being consistent with the predicted movement of a Titan object. A median image of all the sub-images is then created leaving only those objects with the proper Titan motion. Limiting the median image in this manner brings the needed computer time to process all images taken on one night down to about 50 hours of CPU time.

2007 accomplishment report for the Eastern and Western forest environmental threat assessment centers

Treesearch

Danny C. Lee; Jerome S. Beatty

2008-01-01

As chance would have it, the Eastern Forest and Western Wildland Environmental Threat Assessment Centers were created the same year (2005) that the Forest Service celebrated its centennial anniversary as an agency of the U.S. Department of Agriculture. The historic birth of the Forest Service provides a nice backdrop to view our own more modest beginnings. Both events...

"First Do No Harm": Factors Influencing Teachers' Ability and Willingness to Use ICT in Their Subject Teaching

ERIC Educational Resources Information Center

Haydn, Terry; Barton, Roy

2008-01-01

The paper reports on a Department of Culture, Museums and Sport (DCMS) funded project which provided modest amounts of time for teachers to be freed from their classroom teaching to explore the use of information and communications technology (ICT) in their subject teaching, and to meet up together to discuss their use of new technology. The…

Execute-Only Attacks against Execute-Only Defenses

DTIC Science & Technology

2015-11-13

attacks that have been widely used to bypass randomization-based memory corruption defenses. A recent technique, Readactor, provides one of the... corruption defenses with various impacts. We analyze the prevalence of opportunities for such attacks in popular code bases and build two proof-of-concept...our countermeasures introduce only a modest additional overhead. I. INTRODUCTION Memory corruption has been a primary vector of attacks against

The Seattle–King County Healthy Homes II Project: A Randomized Controlled Trial of Asthma Self-management Support Comparing Clinic-Based Nurses and In-Home Community Health Workers

PubMed Central

Krieger, James; Takaro, Tim K.; Song, Lin; Beaudet, Nancy; Edwards, Kristine

2009-01-01

Objective To compare the marginal benefit of in-home asthma self-management support provided by community health workers (CHWs) with standard asthma education from clinic-based nurses. Design Randomized controlled trial. Setting Community and public health clinics and homes. Participants Three hundred nine children aged 3 to 13 years with asthma living in low-income households. Interventions All participants received nurse-provided asthma education and referrals to community resources. Some participants also received CHW-provided home environmental assessments, asthma education, social support, and asthma-control resources. Outcome Measures Asthma symptom–free days, Pediatric Asthma Caretaker Quality of Life Scale score, and use of urgent health services. Results Both groups showed significant increases in caretaker quality of life (nurse-only group: 0.4 points; 95% confidence interval [CI], 0.3–0.6; nurse + CHW group: 0.6 points; 95% CI, 0.4–0.8) and number of symptom-free days (nurse only: 1.3 days; 95% CI, 0.5–2.1; nurse + CHW: 1.9 days; 95% CI, 1.1–2.8), and absolute decreases in the proportion of children who used urgent health services in the prior 3 months (nurse only: 17.6%; 95% CI, 8.1%–27.2%; nurse + CHW: 23.1%; 95% CI, 13.6%–32.6%). Quality of life improved by 0.22 more points in the nurse + CHW group (95% CI, 0.00–0.44; P=.049). The number of symptom-free days increased by 0.94 days per 2 weeks (95% CI, 0.02–1.86; P = .046), or 24.4 days per year, in the nurse + CHW group. While use of urgent health services decreased more in the nurse + CHW group, the difference between groups was not significant. Conclusion The addition of CHW home visits to clinic-based asthma education yielded a clinically important increase in symptom-free days and a modest improvement in caretaker quality of life. PMID:19188646

Making the Grid "Smart" Through "Smart" Microgrids: Real-Time Power Management of Microgrids with Multiple Distributed Generation Sources Using Intelligent Control

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

Nehrir, M. Hashem

In this Project we collaborated with two DOE National Laboratories, Pacific Northwest National Lab (PNNL) and Lawrence Berkeley National Lab (LBL). Dr. Hammerstrom of PNNL initially supported our project and was on the graduate committee of one of the Ph.D. students (graduated in 2014) who was supported by this project. He is also a committee member of a current graduate student of the PI who was supported by this project in the last two years (August 2014-July 2016). The graduate student is now supported be the Electrical and Computer Engineering (ECE) Department at Montana State University (MSU). Dr. Chris Marneymore » of LBL provided actual load data, and the software WEBOPT developed at LBL for microgrid (MG) design for our project. NEC-Labs America, a private industry, also supported our project, providing expert support and modest financial support. We also used the software “HOMER,” originally developed at the National Renewable Energy Laboratory (NREL) and the most recent version made available to us by HOMER Energy, Inc., for MG (hybrid energy system) unit sizing. We compared the findings from WebOpt and HOMER and designed appropriately sized hybrid systems for our case studies. The objective of the project was to investigate real-time power management strategies for MGs using intelligent control, considering maximum feasible energy sustainability, reliability and efficiency while, minimizing cost and undesired environmental impact (emissions). Through analytic and simulation studies, we evaluated the suitability of several heuristic and artificial-intelligence (AI)-based optimization techniques that had potential for real-time MG power management, including genetic algorithms (GA), ant colony optimization (ACO), particle swarm optimization (PSO), and multi-agent systems (MAS), which is based on the negotiation of smart software-based agents. We found that PSO and MAS, in particular, distributed MAS, were more efficient and better suited for our work. We investigated the following: • Intelligent load control - demand response (DR) - for frequency stabilization in islanded MGs (partially supported by PNNL). • The impact of high penetration of solar photovoltaic (PV)-generated power at the distribution level (partially supported by PNNL). • The application of AI approaches to renewable (wind, PV) power forecasting (proposed by the reviewers of our proposal). • Application of AI approaches and DR for real-time MG power management (partially supported by NEC Labs-America) • Application of DR in dealing with the variability of wind power • Real-time MG power management using DR and storage (partially supported by NEC Labs-America) • Application of DR in enhancing the performance of load-frequency controller • MAS-based whole-sale and retail power market design for smart grid A« less

Subthreshold psychotic symptom distress, self-stigma, and peer social support among college students with mental health concerns.

PubMed

Denenny, Danielle; Thompson, Elizabeth; Pitts, Steven C; Dixon, Lisa B; Schiffman, Jason

2015-06-01

The primary aim of this study was to explore the potential moderating effect of social support on the relation between distress caused by psychosis risk symptoms and self-stigma among college students with mental health diagnoses. Participants were young adult college students who endorsed having a past or present mental health diagnosis (n = 63). Self-report data were examined from the Prodromal Questionnaire-Brief, a measure of subthreshold psychosis risk symptoms; the Self-Concurrence/Application subscale of the Self-Stigma of Mental Illness Scale, a measure of self-stigma; and the Friendships subscale of the Lubben Social Network Scale-Revised, a measure of social support from peers. There was a modest direct relation between distress associated with psychosis risk symptoms and self-stigma. There was a larger relation between distress from risk symptoms and self-stigma for those with low social support compared to those with mean and high social support. Although causality cannot be determined based on this study, a strong relation between symptom distress and stigma was found among those reporting low peer social support. Interventions that target both self-stigma and social support might be relevant for young adults with a history of mental health concerns who currently endorse subthreshold psychotic symptoms. (c) 2015 APA, all rights reserved).

Support across two generations: children's closeness to grandparents following parental divorce and remarriage.

PubMed

Lussier, Gretchen; Deater-Deckard, Kirby; Dunn, Judy; Davies, Lisa

2002-09-01

There has been relatively little research on the role of grandparents as a source of support for children during and following their parents' marital transitions. In this study, we examined children's contact with and closeness to grandparents in different family types (i.e., two biological parents, single mother, stepparent). Participants included 155 children from the Avon Brothers and Sisters Study. Parent and child interviews and questionnaires regarding the children's relationships with maternal and paternal biological and stepgrandparents were examined. There were family type differences in rates of contact with grandparents as well as children's closeness to grandparents. Furthermore, children's and parents' view about these relationships with grandparents were modestly correlated, suggesting that children often held different views about their closeness to their grandparents than did their parents. Greater closeness to grandparents was associated with fewer adjustment problems.

Effectiveness of an Internet Community for Severely Obese Women.

PubMed

Chomutare, Taridzo; Årsand, Eirik; Hartvigsen, Gunnar

2016-01-01

While Internet communities have become thriving sources of support, little is yet known about their effectiveness. We retrospectively sampled morbidly obese (Body Mass Index, BMI > 40) women who were active for at least a year in an Internet community. We compared self-reported weight changes between women who had high online participation levels (n = 71) versus those with low participation levels as control (n = 69). Women who actively participated online lost on average 7.52%, while those who were passive lost 5.39% of their original body weight. For active women, there was positive, albeit weak, correlation (r = 0.22, p < 0.05) between online participation levels and weight loss, while no significant correlation was noted for the control. Current results indicate modest evidence supporting active participation in Internet groups as an effective weight loss strategy for the target group.

Value considerations in the treatment of head and neck cancer: radiation, chemotherapy, and supportive care.

PubMed

Baxi, Shrujal S; Sher, David J; Pfister, David G

2014-01-01

The management of head and neck cancer has advanced in many areas, including but not limited to diagnostic imaging and response assessment, radiation delivery, surgical approaches, combined-modality therapy, as well as new drug discovery. These advances have become widely used, however, the associated improvements in outcomes of interest compared with other options may at times be modest in magnitude or supported by limited data. In addition, the price tag of these advancements is often high. There is a growing mandate to look at existing data to identify insights into how to improve the value of care and to better understand the comparative effectiveness of one intervention versus another with regard to tumor control, quality of life, and other important outcomes; such insights become particularly important when considerable disparities exist in related costs. We review selected issues in radiotherapy, chemotherapy and supportive care applicable to the management of head and neck cancer and relevant to ascertaining the value of care.

Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.

PubMed

Samwald, Matthias; Miñarro Giménez, Jose Antonio; Boyce, Richard D; Freimuth, Robert R; Adlassnig, Klaus-Peter; Dumontier, Michel

2015-02-22

Every year, hundreds of thousands of patients experience treatment failure or adverse drug reactions (ADRs), many of which could be prevented by pharmacogenomic testing. However, the primary knowledge needed for clinical pharmacogenomics is currently dispersed over disparate data structures and captured in unstructured or semi-structured formalizations. This is a source of potential ambiguity and complexity, making it difficult to create reliable information technology systems for enabling clinical pharmacogenomics. We developed Web Ontology Language (OWL) ontologies and automated reasoning methodologies to meet the following goals: 1) provide a simple and concise formalism for representing pharmacogenomic knowledge, 2) finde errors and insufficient definitions in pharmacogenomic knowledge bases, 3) automatically assign alleles and phenotypes to patients, 4) match patients to clinically appropriate pharmacogenomic guidelines and clinical decision support messages and 5) facilitate the detection of inconsistencies and overlaps between pharmacogenomic treatment guidelines from different sources. We evaluated different reasoning systems and test our approach with a large collection of publicly available genetic profiles. Our methodology proved to be a novel and useful choice for representing, analyzing and using pharmacogenomic data. The Genomic Clinical Decision Support (Genomic CDS) ontology represents 336 SNPs with 707 variants; 665 haplotypes related to 43 genes; 22 rules related to drug-response phenotypes; and 308 clinical decision support rules. OWL reasoning identified CDS rules with overlapping target populations but differing treatment recommendations. Only a modest number of clinical decision support rules were triggered for a collection of 943 public genetic profiles. We found significant performance differences across available OWL reasoners. The ontology-based framework we developed can be used to represent, organize and reason over the growing wealth of pharmacogenomic knowledge, as well as to identify errors, inconsistencies and insufficient definitions in source data sets or individual patient data. Our study highlights both advantages and potential practical issues with such an ontology-based approach.

Family group conferences in public mental health care: an exploration of opportunities.

PubMed

de Jong, Gideon; Schout, Gert

2011-02-01

Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public mental health care. The present study reports on an exploratory study on the applicability of family group conferencing in public mental health care. Findings suggest that there are six reasons to start family group conference pilots in public mental health care. First, care providers who work in public mental health care often need to deal with clients who are not motivated in seeking help. Family group conferences could yield support or provide a plan, even without the presence of the client. Second, conferences might complement the repertoire of treatment options between voluntary help and coercive treatment. Third, clients in public mental health care often have a limited network. Conferences promote involvement, as they expand and restore relationships, and generate support. Fourth, conferences could succeed both in a crisis and in other non-critical situations. Sometimes pressure is needed for clients to accept help from their network (such as in the case of an imminent eviction), while in other situations, it is required that clients are stabilized before a conference can be organized (such as in the case of a psychotic episode). Fifth, clients who have negative experiences with care agencies and their representatives might be inclined to accept a conference because these agencies act in another (modest) role. Finally, the social network could elevate the work of professionals. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Improving the physical health of people with severe mental illness in a low secure forensic unit: An uncontrolled evaluation study of staff training and physical health care plans.

PubMed

Haddad, Mark; Llewellyn-Jones, Sian; Yarnold, Steve; Simpson, Alan

2016-12-01

The life expectancy of people with severe mental illnesses is substantially reduced, and monitoring and screening for physical health problems is a key part of addressing this health inequality. Inpatient admission presents a window of opportunity for this health-care activity. The present study was conducted in a forensic mental health unit in England. A personal physical health plan incorporating clearly-presented and easily-understood values and targets for health status in different domains was developed. Alongside this, a brief physical education session was delivered to health-care staff (n = 63). Printed learning materials and pedometers and paper tape measures were also provided. The impact was evaluated by a single-group pretest post-test design; follow-up measures were 4 months' post-intervention. The feasibility and acceptability of personal health plans and associated resources were examined by free-text questionnaire responses. Fifty-seven staff provided measures of attitudes and knowledge before training and implementation of the physical health plans. Matched-pairs analysis indicated a modest but statistically-significant improvement in staff knowledge scores and attitudes to involvement in physical health care. Qualitative feedback indicated limited uptake of the care plans and perceived need for additional support for better adoption of this initiative. Inpatient admission is a key setting for assessing physical health and promoting improved management of health problems. Staff training and purpose-designed personalized care plans hold potential to improve practice and outcomes in this area, but further support for such innovations appears necessary for their uptake in inpatient mental health settings. © 2016 Australian College of Mental Health Nurses Inc.

Accurate monitoring leads to effective control and greater learning of patient education materials.

PubMed

Rawson, Katherine A; O'Neil, Rochelle; Dunlosky, John

2011-09-01

Effective management of chronic diseases (e.g., diabetes) can depend on the extent to which patients can learn and remember disease-relevant information. In two experiments, we explored a technique motivated by theories of self-regulated learning for improving people's learning of information relevant to managing a chronic disease. Materials were passages from patient education booklets on diabetes from NIDDK. Session 1 included an initial study trial, Session 2 included self-regulated restudy, and Session 3 included a final memory test. The key manipulation concerned the kind of support provided for self-regulated learning during Session 2. In Experiment 1, participants either were prompted to self-test and then evaluate their learning before selecting passages to restudy, were shown the prompt questions but did not overtly self-test or evaluate learning prior to selecting passages, or were not shown any prompts and were simply given the menu for selecting passages to restudy. Participants who self-tested and evaluated learning during Session 2 had a small but significant advantage over the other groups on the final test. Secondary analyses provided evidence that the performance advantage may have been modest because of inaccurate monitoring. Experiment 2 included a group who also self-tested but who evaluated their learning using idea-unit judgments (i.e., by checking their responses against a list of key ideas from the correct response). Participants who self-tested and made idea-unit judgments exhibited a sizable advantage on final test performance. Secondary analyses indicated that the performance advantage was attributable in part to more accurate monitoring and more effective self-regulated learning. An important practical implication is that learning of patient education materials can be enhanced by including appropriate support for learners' self-regulatory processes. (c) 2011 APA, all rights reserved.

Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies

PubMed Central

Ussher, Michael; Aveyard, Paul; Coleman, Tim; Straus, Lianne; West, Robert; Marcus, Bess; Lewis, Beth; Manyonda, Isaac

2008-01-01

Background Pharmacotherapies for smoking cessation have not been adequately tested in pregnancy and women are reluctant to use them. Behavioural support alone has a modest effect on cessation rates; therefore, more effective interventions are needed. Even moderate intensity physical activity (e.g. brisk walk) reduces urges to smoke and there is some evidence it increases cessation rates in non-pregnant smokers. Two pilot studies assessed i) the feasibility of recruiting pregnant women to a trial of physical activity for smoking cessation, ii) adherence to physical activity and iii) womens' perceptions of the intervention. Methods Pregnant smokers volunteered for an intervention combining smoking cessation support, physical activity counselling and supervised exercise (e.g. treadmill walking). The first study provided six weekly treatment sessions. The second study provided 15 sessions over eight weeks. Physical activity levels and continuous smoking abstinence (verified by expired carbon monoxide) were monitored up to eight months gestation. Results Overall, 11.6% (32/277) of women recorded as smokers at their first antenatal booking visit were recruited. At eight months gestation 25% (8/32) of the women achieved continuous smoking abstinence. Abstinent women attended at least 85% of treatment sessions and 75% (6/8) achieved the target level of 110 minutes/week of physical activity at end-of-treatment. Increased physical activity was maintained at eight months gestation only in the second study. Women reported that the intervention helped weight management, reduced cigarette cravings and increased confidence for quitting. Conclusion It is feasible to recruit pregnant smokers to a trial of physical activity for smoking cessation and this is likely to be popular. A large randomised controlled trial is needed to examine the efficacy of this intervention. PMID:18811929

Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios.

PubMed Central

Harwood, Rowan H.; Sayer, Avan Aihie; Hirschfeld, Miriam

2004-01-01

OBJECTIVE: To estimate the number of people worldwide requiring daily assistance from another person in carrying out health, domestic or personal tasks. METHODS: Data from the Global Burden of Disease Study were used to calculate the prevalence of severe levels of disability, and consequently, to estimate dependency. Population projections were used to forecast changes over the next 50 years. FINDINGS: The greatest burden of dependency currently falls in sub-Saharan Africa, where the "dependency ratio" (ratio of dependent people to the population of working age) is about 10%, compared with 7-8% elsewhere. Large increases in prevalence are predicted in sub-Saharan Africa, the Middle East, Asia and Latin America of up to 5-fold or 6-fold in some cases. These increases will occur in the context of generally increasing populations, and dependency ratios will increase modestly to about 10%. The dependency ratio will increase more in China (14%) and India (12%) than in other areas with large prevalence increases. Established market economies, especially Europe and Japan, will experience modest increases in the prevalence of dependency (30%), and in the dependency ratio (up to 10%). Former Socialist economies of Europe will have static or declining numbers of dependent people, but will have large increases in the dependency ratio (up to 13%). CONCLUSION: Many countries will be greatly affected by the increasing number of dependent people and will need to identify the human and financial resources to support them. Much improved collection of data on disability and on the needs of caregivers is required. The prevention of disability and provision of support for caregivers needs greater priority. PMID:15259253

Electrical parameters and water permeability properties of monolayers formed by T84 cells cultured on permeable supports.

PubMed

Ozu, M; Toriano, R; Capurro, C; Parisi, M

2005-01-01

T84 is an established cell line expressing an enterocyte phenotype whose permeability properties have been widely explored. Osmotic permeability (POSM), hydraulic permeability (PHYDR) and transport-associated net water fluxes (JW-transp), as well as short-circuit current (ISC), transepithelial resistance (RT), and potential difference (deltaVT) were measured in T84 monolayers with the following results: POSM 1.3 +/- 0.1 cm.s-1 x 10-3; PHYDR 0.27 +/- 0.02 cm.s-1; RT 2426 +/- 109 omega.cm2, and deltaVT 1.31 +/- 0.38 mV. The effect of 50 microM 5,6-dichloro-1-ethyl-1,3-dihydro-2H-benzimidazol-2-one (DCEBIO), a "net Cl- secretory agent", on T84 cells was also studied. We confirm the reported important increase in ISC induced by DCEBIO which was associated here with a modest secretory deltaJW-transp. The present results were compared with those reported using the same experimental approach applied to established cell lines originating from intestinal and renal epithelial cells (Caco-2, LLC-PK1 and RCCD-1). No clear association between PHYDR and RT could be demonstrated and high PHYDR values were observed in an electrically tight epithelium, supporting the view that a "water leaky" barrier is not necessarily an "electrically leaky" one. Furthermore, the modest secretory deltaJW-transp was not consistent with previous results obtained with RCCD-1 cells stimulated with vasopressin (absorptive fluxes) or with T84 cells secreting water under the action of Escherichia coli heat stable enterotoxin. We conclude that, while the presence of aquaporins is necessary to dissipate an external osmotic gradient, coupling between water and ion transport cannot be explained by a simple and common underlying mechanism.

Energy and cost associated with ventilating office buildings in a tropical climate.

PubMed

Rim, Donghyun; Schiavon, Stefano; Nazaroff, William W

2015-01-01

Providing sufficient amounts of outdoor air to occupants is a critical building function for supporting occupant health, well-being and productivity. In tropical climates, high ventilation rates require substantial amounts of energy to cool and dehumidify supply air. This study evaluates the energy consumption and associated cost for thermally conditioning outdoor air provided for building ventilation in tropical climates, considering Singapore as an example locale. We investigated the influence on energy consumption and cost of the following factors: outdoor air temperature and humidity, ventilation rate (L/s per person), indoor air temperature and humidity, air conditioning system coefficient of performance (COP), and cost of electricity. Results show that dehumidification of outdoor air accounts for more than 80% of the energy needed for building ventilation in Singapore's tropical climate. Improved system performance and/or a small increase in the indoor temperature set point would permit relatively large ventilation rates (such as 25 L/s per person) at modest or no cost increment. Overall, even in a thermally demanding tropical climate, the energy cost associated with increasing ventilation rate up to 25 L/s per person is less than 1% of the wages of an office worker in an advanced economy like Singapore's. This result implies that the benefits of increasing outdoor air ventilation rate up to 25 L/s per person--which is suggested to provide for productivity increases, lower sick building syndrome symptom prevalence, and reduced sick leave--can be much larger than the incremental cost of ventilation.

A Rhodium(I)-Xylyl-BINAP Catalyzed Asymmetric Ynamide-[2 + 2 + 2] Cycloaddition in the Synthesis of Optically Enriched N,O-Biaryls

PubMed Central

Oppenheimer, Jossian; Johnson, Whitney L.; Figueroa, Ruth; Hayashi, Ryuji; Hsung, Richard P.

2009-01-01

A rhodium(I)-xylyl-BINAP catalyzed asymmetric [2 + 2 + 2] cycloaddition of achiral conjugated aryl ynamides with various diynes is described here. This asymmetric cycloaddition provides a series of structurally interesting chiral N,O-biaryls with excellent enantioselectivity along with a modest diastereoselectivity with respect to both C-C and C-N axial chirality. PMID:20161177

Higher-Order Thinking and Metacognition in the First-Year Core-Education Classroom: A Case Study in the Use of Color-Coded Drafts

ERIC Educational Resources Information Center

Murray, Jeffrey W.

2014-01-01

This article seeks to provide some modest insights into the pedagogy of higher-order thinking and metacognition and to share the use of color-coded drafts as a best practice in service of both higher-order thinking and metacognition. This article will begin with a brief theoretical exploration of thinking and of thinking about thinking--the latter…

Reform in Secondary Education: The Continuing Efforts to Reform Secondary Education, and a Modest Proposal. Curriculum Bulletin Vol. XXXII, No. 340.

ERIC Educational Resources Information Center

Saylor, Galen

The author begins by examining the functions of the school and the basic principles governing the provision of education in the American democracy as a way of providing a framework for analyzing proposals for the reform of secondary education. He then examines proposals for reform. His major focus is on ten proposals made by agencies,…

Three estimates of the association between linear growth failure and cognitive ability.

PubMed

Cheung, Y B; Lam, K F

2009-09-01

To compare three estimators of association between growth stunting as measured by height-for-age Z-score and cognitive ability in children, and to examine the extent statistical adjustment for covariates is useful for removing confounding due to socio-economic status. Three estimators, namely random-effects, within- and between-cluster estimators, for panel data were used to estimate the association in a survey of 1105 pairs of siblings who were assessed for anthropometry and cognition. Furthermore, a 'combined' model was formulated to simultaneously provide the within- and between-cluster estimates. Random-effects and between-cluster estimators showed strong association between linear growth and cognitive ability, even after adjustment for a range of socio-economic variables. In contrast, the within-cluster estimator showed a much more modest association: For every increase of one Z-score in linear growth, cognitive ability increased by about 0.08 standard deviation (P < 0.001). The combined model verified that the between-cluster estimate was significantly larger than the within-cluster estimate (P = 0.004). Residual confounding by socio-economic situations may explain a substantial proportion of the observed association between linear growth and cognition in studies that attempt to control the confounding by means of multivariable regression analysis. The within-cluster estimator provides more convincing and modest results about the strength of association.

Hypoxia-activated prodrug enhances therapeutic effect of sunitinib in melanoma

PubMed Central

Liu, Shujing; Tetzlaff, Michael T.; Wang, Tao; Chen, Xiang; Yang, Ruifeng; Kumar, Suresh M.; Vultur, Adina; Li, Pengxiang; Martin, James S.; Herlyn, Meenhard; Amaravadi, Ravi

2017-01-01

Angiogenesis is a critical step during tumor progression. Anti-angiogenic therapy has only provided modest benefits in delaying tumor progression despite its early promise in cancer treatment. It has been postulated that anti-angiogenic therapy may promote the emergence of a more aggressive cancer cell phenotype by generating increased tumor hypoxia—a well-recognized promoter of tumor progression. TH-302 is a 2-nitroimidazole triggered hypoxia-activated prodrug (HAP) which has been shown to selectively target the hypoxic tumor compartment and reduce tumor volume. Here, we show that melanoma cells grown under hypoxic conditions exhibit increased resistance to a wide variety of therapeutic agents in vitro and generate larger and more aggressive tumors in vivo than melanoma cells grown under normoxic conditions. However, hypoxic melanoma cells exhibit a pronounced sensitivity to TH-302 which is further enhanced by the addition of sunitinib. Short term sunitinib treatment fails to prolong the survival of melanoma bearing genetically engineered mice (Tyr::CreER; BRafCA;Ptenlox/lox) but increases tumor hypoxia. Long term TH-302 alone modestly prolongs the overall survival of melanoma bearing mice. Combination therapy of TH-302 with sunitinib further increases the survival of treated mice. These studies provide a translational rationale for combining hypoxic tumor cell targeted therapies with anti-angiogenics for treatment of melanoma. PMID:29383148

Reference Reactor Module for the Affordable Fission Surface Power System

NASA Astrophysics Data System (ADS)

Poston, David I.; Kapernick, Richard J.; Dixon, David D.; Amiri, Benjamin W.; Marcille, Thomas F.

2008-01-01

Surface fission power systems on the Moon and Mars may provide the first US application of fission reactor technology in space since 1965. The requirements of many surface power applications allow the consideration of systems with much less development risk than most other space reactor applications, because of modest power (10s of kWe) and no driving need for minimal mass (allowing temperatures <1000 K). The Affordable Fission Surface Power System (AFSPS) study was completed by NASA/DOE to determine the cost of a modest performance, low-technical risk surface power system. This paper describes the reference AFSPS reactor module concept, which is designed to provide a net power of 40 kWe for 8 years on the lunar surface; note, the system has been designed with technologies that are fully compatible with a Martian surface application. The reactor concept uses stainless-steel based, UO2-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The reactor shielding approach utilizes both in-situ and launched shielding to keep the dose to astronauts much lower than the natural background radiation on the lunar surface. One of the important ``affordability'' attributes is that the concept has been designed to minimize both the technical and programmatic safety risk.

Common variation near ROBO2 is associated with expressive vocabulary in infancy

PubMed Central

St Pourcain, Beate; Cents, Rolieke A.M.; Whitehouse, Andrew J.O.; Haworth, Claire M.A.; Davis, Oliver S.P.; O’Reilly, Paul F.; Roulstone, Susan; Wren, Yvonne; Ang, Qi W.; Velders, Fleur P.; Evans, David M.; Kemp, John P.; Warrington, Nicole M.; Miller, Laura; Timpson, Nicholas J.; Ring, Susan M.; Verhulst, Frank C.; Hofman, Albert; Rivadeneira, Fernando; Meaburn, Emma L.; Price, Thomas S.; Dale, Philip S.; Pillas, Demetris; Yliherva, Anneli; Rodriguez, Alina; Golding, Jean; Jaddoe, Vincent W.V.; Jarvelin, Marjo-Riitta; Plomin, Robert; Pennell, Craig E.; Tiemeier, Henning; Davey Smith, George

2014-01-01

Twin studies suggest that expressive vocabulary at ~24 months is modestly heritable. However, the genes influencing this early linguistic phenotype are unknown. Here we conduct a genome-wide screen and follow-up study of expressive vocabulary in toddlers of European descent from up to four studies of the EArly Genetics and Lifecourse Epidemiology consortium, analysing an early (15–18 months, ‘one-word stage’, NTotal=8,889) and a later (24–30 months, ‘two-word stage’, NTotal=10,819) phase of language acquisition. For the early phase, one single-nucleotide polymorphism (rs7642482) at 3p12.3 near ROBO2, encoding a conserved axon-binding receptor, reaches the genome-wide significance level (P=1.3 × 10−8) in the combined sample. This association links language-related common genetic variation in the general population to a potential autism susceptibility locus and a linkage region for dyslexia, speech-sound disorder and reading. The contribution of common genetic influences is, although modest, supported by genome-wide complex trait analysis (meta-GCTA h215–18-months=0.13, meta-GCTA h224–30-months=0.14) and in concordance with additional twin analysis (5,733 pairs of European descent, h224-months=0.20). PMID:25226531

Common variation near ROBO2 is associated with expressive vocabulary in infancy.

PubMed

St Pourcain, Beate; Cents, Rolieke A M; Whitehouse, Andrew J O; Haworth, Claire M A; Davis, Oliver S P; O'Reilly, Paul F; Roulstone, Susan; Wren, Yvonne; Ang, Qi W; Velders, Fleur P; Evans, David M; Kemp, John P; Warrington, Nicole M; Miller, Laura; Timpson, Nicholas J; Ring, Susan M; Verhulst, Frank C; Hofman, Albert; Rivadeneira, Fernando; Meaburn, Emma L; Price, Thomas S; Dale, Philip S; Pillas, Demetris; Yliherva, Anneli; Rodriguez, Alina; Golding, Jean; Jaddoe, Vincent W V; Jarvelin, Marjo-Riitta; Plomin, Robert; Pennell, Craig E; Tiemeier, Henning; Davey Smith, George

2014-09-16

Twin studies suggest that expressive vocabulary at ~24 months is modestly heritable. However, the genes influencing this early linguistic phenotype are unknown. Here we conduct a genome-wide screen and follow-up study of expressive vocabulary in toddlers of European descent from up to four studies of the EArly Genetics and Lifecourse Epidemiology consortium, analysing an early (15-18 months, 'one-word stage', N(Total) = 8,889) and a later (24-30 months, 'two-word stage', N(Total)=10,819) phase of language acquisition. For the early phase, one single-nucleotide polymorphism (rs7642482) at 3p12.3 near ROBO2, encoding a conserved axon-binding receptor, reaches the genome-wide significance level (P=1.3 × 10(-8)) in the combined sample. This association links language-related common genetic variation in the general population to a potential autism susceptibility locus and a linkage region for dyslexia, speech-sound disorder and reading. The contribution of common genetic influences is, although modest, supported by genome-wide complex trait analysis (meta-GCTA h(2)(15-18-months) = 0.13, meta-GCTA h(2)(24-30-months) = 0.14) and in concordance with additional twin analysis (5,733 pairs of European descent, h(2)(24-months) = 0.20).

Heat and extension at mid- and lower crustal levels of the Rio Grande rift

NASA Technical Reports Server (NTRS)

Olsen, K. H.; Baldridge, W. S.; Callender, J. F.

1985-01-01

The process by which large amounts (50 to 200 percent) of crustal extension are produced was concisely described by W. Hamilton in 1982 and 1983. More recently, England, Sawyer, P. Morgan and others have moved toward quantifying models of lithospheric thinning by incorporating laboratory and theoretical data on rock rheology as a function of composition, temperature, and strain rate. Hamilton's description identifies three main crustal layers, each with a distinctive mechanical behavior; brittle fracturing and rotation in the upper crust, discontinuous ductile flow in the middle crust and laminar ductile flow in the lower crust. The temperature and composition dependent brittle-ductile transition essentially defines the diffuse boundary between upper and middle crust. It was concluded that the heat responsible for the highly ductile nature of the lower crust and the lensoidal and magma body structures at mid-crustal depths in the rift was infused into the crust by relatively modest ( 10 percent by mass) magmatic upwelling (feeder dikes) from Moho levels. Seismic velocity-versus-depth data, supported by gravity modeling and the fact that volumes of rift related volcanics are relatively modest ( 6000 cubic km) for the Rio Grande system, all imply velocities and densities too small to be consistent with a massive, composite, mafic intrusion in the lower crust.

Promoting occupational health interventions in early return to work by implementing financial subsidies: a Swedish case study

PubMed Central

2013-01-01

Background In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. Methods The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. Results The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy – for coordinated interventions – was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. Conclusions The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law. PMID:23566064

Position of the American Dietetic Association: nutrition services in managed care.

PubMed

Chima, Cinda S; Pollack, Harold A

2002-10-01

It is the position of the American Dietetic Association that medical nutrition therapy is an essential component of disease management and healthcare provided by managed care organizations, and that such care must be provided by qualified nutrition professionals. Compared with traditional fee-for-service reimbursement systems, managed care presents new opportunities for dietetics professionals. Until recently, the lack of billing infrastructure has handicapped nutrition providers who wish to bill for their services and has made it difficult to track the outcomes of nutrition care. With the publication of current procedure terminology codes for medical nutrition therapy (MNT) and the implementation of MNT benefits in Medicare part B for diabetes and nondialysis kidney disease, commercial payers, including managed care organizations (MCOs) are likely to implement or expand their coverage of MNT. A large body of evidence supports the efficacy and cost-effectiveness of MNT coverage within managed care plans. This evidence includes cost analyses of conditions treated by MNT, and clinical trial data confirming the efficacy of MNT in improving patient outcomes. MNT is also an important part of national standards of care for many chronic disease conditions. Based on evidence supporting the role of MNT in improving patient outcomes, the Institute of Medicine (IOM) recommended that MNT services be reimbursed by Medicare when patients are referred by a physician. Provision of appropriate MNT can also help MCOs meet accreditation and quality standards established by entities such as the National Committee for Quality Assurance and the Joint Commission for the Accreditation of Health Care Organizations. Much of the work required to secure a place for MNT in MCOs will be done at the practitioner level, by nutrition professionals themselves. Registered dietitians must market MNT to their customers in managed care by addressing the needs of each player. By emphasizing the importance of MNT and other cost-effective forms of preventive care and disease management, MCOs will be well positioned to improve population health at modest cost.

Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia.

PubMed

Brotto, Lori A; Yong, Paul; Smith, Kelly B; Sadownik, Leslie A

2015-01-01

For many years, multidisciplinary approaches, which integrate psychological, physical, and medical treatments, have been shown to be effective for the treatment of chronic pain. To date, there has been anecdotal support, but little empirical data, to justify the application of this multidisciplinary approach toward the treatment of chronic sexual pain secondary to provoked vestibulodynia (PVD). This study aimed to evaluate a 10-week hospital-based treatment (multidisciplinary vulvodynia program [MVP]) integrating psychological skills training, pelvic floor physiotherapy, and medical management on the primary outcomes of dyspareunia and sexual functioning, including distress. A total of 132 women with a diagnosis of PVD provided baseline data and agreed to participate in the MVP. Of this group, n = 116 (mean age 28.4 years, standard deviation 7.1) provided complete data at the post-MVP assessment, and 84 women had complete data through to the 3- to 4-month follow-up period. There were high levels of avoidance of intimacy (38.1%) and activities that elicited sexual arousal (40.7%), with many women (50.4%) choosing to focus on their partner's sexual arousal and satisfaction at baseline. With treatment, over half the sample (53.8%) reported significant improvements in dyspareunia. Following the MVP, there were strong significant effects for the reduction in dyspareunia (P = 0.001) and sex-related distress (P < 0.001), and improvements in sexual arousal (P < 0.001) and overall sexual functioning (P = 0.001). More modest but still statistically significant were improvements in sexual desire, lubrication, orgasmic function, and sexual satisfaction. All improvements were retained at 2- to 3-month follow-up. This study provides strong support for the efficacy of a multidisciplinary approach (psychological, pelvic floor physiotherapy, and medical management) for improving dyspareunia and all domains of sexual functioning among women with PVD. The study also highlights the benefits of incorporating sexual health education into general pain management strategies for this population. © 2014 International Society for Sexual Medicine.

Estimating Poromechanical and Hydraulic Properties of Fractured Media Aquifers Using a Model of the Aquifer at Ploemeur France: Broad Applications and Future Uses

NASA Astrophysics Data System (ADS)

Wilson, M. W.; Burbey, T. J.

2017-12-01

Aquifers in fractured crystalline bedrock are located over half of the earth's surface and are vital civil and economic resources particularly in places where ample, safe surface water is not available. With fractured media aquifers providing large percentages of water for municipal, industrial, and agricultural use in many regions of the world. Distinguishing sustainable quantities of extraction is of paramount importance to the continuing viability of these important resources and the communities they serve. The fractured and faulted crystalline-rock aquifer system supporting the community of Ploemeur France has been providing one million cubic meters of water annually, resulting in a modest long-term drawdown of about 15m. To understand the sources and mechanisms of recharge that support this aquifer system, a three-dimensional ABAQUS model was developed using known geologic, water-level and geodetic (tiltmeters and GPS) data to simulate the natural aquifer system that is dominated by a permeable sub-vertical fault and an intersecting semi-horizontal contact zone. The model is used to constrain the poromechanical properties of the fault and contact zones relative to the host crystalline rocks and overlying saprolite by taking advantage of the tilt and seasonal GPS responses caused by municipal pumping along with water-level data for the area. A chief goal in this modeling effort is to assess the sources of recharge to this aquifer system that is atypically productive for a crystalline-rock setting. Preliminary results suggest that the source of water supplying this community is a combination of rapid localized recharge through the saprolite and fault zone and recharge along the contact zone, both from the north (older water) and where it is exposed to the south (younger water). The modeling effort also shows the importance of combining GPS and surface tiltmeter data with water-level measurements for constraining the properties of this complex aquifer system and providing a realistic framework of the recharge and flow characteristics.

Walking the Talk: Empowering Science Communication at the University of Washington

NASA Astrophysics Data System (ADS)

Meyer, J. J.; Davison, J.; Graumlich, L. J.; McCarthy, M. M.

2016-12-01

Interest is growing within the academy to strengthen scientists' abilities to be better communicators about their research and how connects to society. Yet communicating the complexities of science to external audiences — media, policy-makers, funders, and others — in a way that resonates falls outside the realm of traditional academic training. Many institutions do not provide adequate resources for their faculty, students and staff to build skills to their share their work more broadly. The University of Washington College of the Environment has built a program that breaks down some of these barriers, building capacity for faculty, students and staff to become powerful spokespeople for their work. Leadership within the College values strong science communication skills and is reflected in the College's strategic plan. As a result, the College has built a science communication program that offers numerous services to meet researchers where they are to help amplify the impact of their work. Stemming from the recommendations of a Science Communication Task Force, the College of the Environment focuses on advancing three critical areas: building and connecting networks of science communicators, offering tools and trainings to develop communication skills, and providing opportunity for researchers to share their work outside of academia. These areas are related by 1) connecting researchers to a robust and growing community of their peers interested in science communication, 2) matching interest with the skills needed to engage productively, and 3) helping provide outlets for engagement that align with the goals of the researcher. As a result, more and more scientists in the College are seeking assistance to build this skillset for engagement. Many institutions express support for increasing science communication skills, yet it can be difficult to deliver a suite of cohesive resources. Through a modest investment, we have built a replicable program that not only empowers and supports faculty, students and staff, but also helps elevate the reputation, reach and impact of our research institution.

Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs

PubMed Central

McCarty, Dennis; Fuller, Bret E.; Arfken, Cynthia; Miller, Michael; Nunes, Edward V.; Edmundson, Eldon; Copersino, Marc; Floyd, Anthony; Forman, Robert; Laws, Reesa; Magruder, Kathy M.; Oyama, Mark; Sindelar, Jody; Wendt, William W.

2010-01-01

Objective Individuals with direct care responsibilities in 348 drug abuse treatment units were surveyed to obtain a description of the workforce and to assess support for evidence-based therapies. Methods Surveys were distributed to 112 programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN). Descriptive analyses characterized the workforce. Analyses of covariance tested the effects of job category (counselors, medical staff, manager-supervisors, and support staff) on opinions about evidence-based practices and controlled for the effects of education, modality (outpatient or residential), race, and gender. Results Women made up two-thirds of the CTN workforce. One-third of the workforce had a master’s or doctoral degree. Responses from 1,757 counselors, 908 support staff, 522 managers-supervisors, and 511 medical staff (71% of eligible participants) suggested that the variables that most consistently influenced responses were job category (19 of 22 items) and education (20 of 22 items). Managers-supervisors were the most supportive of evidence-based therapies, and support staff were the least supportive. Generally, individuals with graduate degrees had more positive opinions about evidence-based therapies. Support for using medications and contingency management was modest across job categories. Conclusions The relatively traditional beliefs of support staff could inhibit the introduction of evidence-based practices. Programs initiating changes in therapeutic approaches may benefit from including all employees in change efforts. PMID:17287373

Making progress: the role of cancer councils in Australia in indigenous cancer control

PubMed Central

2014-01-01

Background Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. Methods The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. Results All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of “Closing the Gap” and research in the larger CCs have been other avenues for increasing knowledge and activity in Indigenous cancer control. Conclusions This environmental scan measured progress, allowed sharing of information and provided critical assessment of progress across areas of importance for increasing Indigenous cancer control. Structured examination of policies, institutional support systems, programs and interventions is a useful means of highlighting opportunities for progress with minority groups relevant for many organisations. Progress has occurred with momentum likely to increase in the future and benefit from commitment to long-term monitoring and sharing of achievements. PMID:24725974

End-Tidal Carbon Dioxide Measurement during Pediatric Polysomnography: Signal Quality, Association with Apnea Severity, and Prediction of Neurobehavioral Outcomes

PubMed Central

Paruthi, Shalini; Rosen, Carol L.; Wang, Rui; Weng, Jia; Marcus, Carole L.; Chervin, Ronald D.; Stanley, Jeffrey J.; Katz, Eliot S.; Amin, Raouf; Redline, Susan

2015-01-01

Study Objectives: To identify the role of end-tidal carbon dioxide (EtCO2) monitoring during polysomnography in evaluation of children with obstructive sleep apnea syndrome (OSAS), including the correlation of EtCO2 with other measures of OSAS and prediction of changes in cognition and behavior after adenotonsillectomy. Design: Analysis of screening and endpoint data from the Childhood Adenotonsillectomy Trial, a randomized, controlled, multicenter study comparing early adenotonsillectomy (eAT) to watchful waiting/supportive care (WWSC) in children with OSAS. Setting: Multisite clinical referral settings. Participants: Children, ages 5.0 to 9.9 y with suspected sleep apnea. Interventions: eAT or WWSC. Measurements and Results: Quality EtCO2 waveforms were present for ≥ 75% of total sleep time (TST) in 876 of 960 (91.3%) screening polysomnograms. Among the 322 children who were randomized, 55 (17%) met pediatric criteria for hypoventilation. The mean TST with EtCO2 > 50 mmHg was modestly correlated with apnea-hypopnea index (AHI) (r = 0.33; P < 0.0001) and with oxygen saturation ≤ 92% (r = 0.26; P < 0.0001). After adjusting for AHI, obesity, and other factors, EtCO2 > 50 mmHg was higher in African American children than others. The TST with EtCO2 > 50 mmHg decreased significantly more after eAT than WWSC. In adjusted analyses, baseline TST with EtCO2 > 50 mmHg did not predict postoperative changes in cognitive and behavioral measurements. Conclusions: Among children with suspected obstructive sleep apnea syndrome, overnight end-tidal carbon dioxide (EtCO2) levels are weakly to modestly correlated with other polysomnographic indices and therefore provide independent information on hypoventilation. EtCO2 levels improve with adenotonsillectomy but are not as responsive as AHI and do not provide independent prediction of cognitive or behavioral response to surgery. Clinical Trial Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT). ClinicalTrials.gov Identifier #NCT00560859. Citation: Paruthi S, Rosen CL, Wang R, Weng J, Marcus CL, Chervin RD, Stanley JJ, Katz ES, Amin R, Redline S. End-tidal carbon dioxide measurement during pediatric polysomnography: signal quality, association with apnea severity, and prediction of neurobehavioral outcomes. SLEEP 2015;38(11):1719–1726. PMID:26414902

A Central Flash at an Occultation of a Bright Star by Pluto Soon Before New Horizons' Flyby

NASA Astrophysics Data System (ADS)

Pasachoff, Jay M.; Babcock, Bryce A.; Durst, Rebecca F.; Seeger, Christina H.; Levine, Stephen E.; Bosh, Amanda S.; Sickafoose, Amanda A.; Person, Michael J.; Abe, Fumio; Suzuki, Daisuke; Nagakane, Masayuki; Tristam, Paul J.

2015-11-01

From the Mt. John Observatory, New Zealand, we were so close to the center of the occultation path on 29 June 2015 UTC that we observed a modest central flash from the focusing of starlight from a 12th-magnitude star. The star was one of the brightest ever in our years of continual monitoring that started in 2002. At the time of Pluto's perihelion in 1989, it was feared from models that Pluto's atmosphere might collapse by now, a motivation for the timely launch of New Horizons; some models now allow Pluto to retain its atmosphere throughout its orbit.We used our frame-transfer CCD at 10 Hz with GPS timing on the 1-m McLellan telescope of Canterbury U. We also observed with a Lowell Obs. infrared camera on the "AAVSO" 0.6-m Optical Craftsman telescope; and obtained 3-color photometry at a slower cadence on a second 0.6-m telescope. We coordinated with the overflight of SOFIA and its 2.5-m telescope, which benefited from last-minute astrometry, and the Auckland Observatory's and other ground-based telescopes.Our light curves show a modest central flash; our tentative geometrical solution shows that we were only about 50 km from the occultation path's centerline. The flash is from rays lower than otherwise accessible in Pluto's atmosphere. Our light curves, at such high cadence that we see spikes caused by atmospheric effects that we had not seen so well since our 2002 Mauna Kea occultation observations, show that Pluto's atmosphere had not changed drastically since our previous year's observations. Our data provide a long-term context for New Horizon's highly-detailed observations of Pluto's atmosphere in addition to providing a chord for the geometrical solution that includes SOFIA's observations.Our observations were supported by NASA Planetary Astronomy grants NNX12AJ29G to Williams College, NNX15AJ82G to Lowell Observatory, and NNX10AB27G to MIT, and by the National Research Foundation of South Africa. We are grateful to Alan Gilmore, Pam Kilmartin, Robert Lucas, and Carolle Varughese for assistance at Mt. John. We thank the AAVSO for use of the AAVSOnet 0.6-m telescope and Arne Henden for assistance.

Synergistic Effect of Carbon Nanotubes and Graphene on Diopside Scaffolds.

PubMed

Liu, Tingting; Wu, Ping; Gao, Chengde; Feng, Pei; Xiao, Tao; Deng, Youwen; Shuai, Cijun; Peng, Shuping

2016-01-01

A synergetic effect between carbon nanotubes (CNTs) and graphene on diopside (Di) scaffolds was demonstrated. 3D network architecture in the matrix was formed through the 1D CNTs inlaid among the 2D graphene platelets (GNPs). The mechanical properties of the CNTs/GNPs/Di scaffolds were significantly improved compared with the CNTs/Di scaffolds and GNPs/Di scaffolds. In addition, the scaffolds exhibited excellent apatite-forming ability, a modest degradation rate, and stable mechanical properties in simulated body fluid (SBF). Moreover, cell culturing tests indicated that the scaffolds supported the cells attachment and proliferation. Taken together, the CNTs/GNPs/Di scaffolds offered great potential for bone tissue engineering.

An Empirical Test of the Theory of Planned Behaviour Applied to Contraceptive Use in Rural Uganda

PubMed Central

Kiene, Susan M.; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K.

2013-01-01

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health behaviour change theories to contraceptive use amongst this population. The present study tested the Theory of Planned Behaviour’s ability to predict contraceptive use-related behaviours among postpartum women in rural Uganda. Results gave modest support to the theory’s application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. PMID:23928989

The intercrater plains of Mercury and the Moon: Their nature, origin and role in terrestrial planet evolution. Alternative thermal histories. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Leake, M. A.

1982-01-01

Interpretations supporting a differentiated, once active Mercury are listed. Alternative scenarios of the planet's thermal history involve: different distributions of accreted materials, including uranium and thorium-rich materials; variations of early melting; and different modes of plains and scarp formation. Arguments are advanced which strongly favor plains formation by volcanism, lack of a primordial surface, and possible identification of remnant tensional features. Studies of remotely sensed data which strongly suggest a modestly homogeneous surface of silicates imply core separation. Reasons for accepting or rejecting various hypotheses for thermal histories of the planet are mentioned.

Improving the health of sex workers in NSW: maintaining success.

PubMed

Donovan, Basil; Harcourt, Christine; Egger, Sandra; Fairley, Christopher K

2010-01-01

NSW has a diverse sex industry that is limited in its size by modest demand. There is no evidence that decriminalisation in 1995 increased the frequency of commercial sex in NSW. Though the largest sector, female brothels, is now mainly staffed by Asian women, condom use for vaginal and anal sex exceeds 99% and sexually transmissible infection rates are at historic lows. These gains are attributable to the long-term support of the NSW Department of Health in collaboration with the community-based Sex Workers Outreach Project and sexual health services, facilitated by the removal of criminal sanctions without the expense and access barriers of licensing systems.

Review of Strategies to Enhance Outcomes for Patients with Type 2 Diabetes: Payers' Perspective

PubMed Central

Greenapple, Rhonda

2011-01-01

Background Diabetes and its clinical consequences exact a great toll on patients and on society in terms of its effects on morbidity and mortality and its staggering economic impact. Objective To review various programs and strategies that aim at enhancing adherence to antihyperglycemic therapy and suggest the best approach to improving patient outcomes and reducing healthcare costs. Discussion Treatment goals for patients with diabetes have been defined, and multiple safe and effective medications are available. Nevertheless, the majority of patients with diabetes fail to achieve treatment goals, because of difficulty with adherence to medication regimens and lifestyle modifications, and because of economic barriers. This article discusses various initiatives developed to improve patient outcomes, including consumer-driven health plans and wellness and prevention programs. Furthermore, economic incentives to patients, such as value-based insurance design, may increase adherence; nevertheless, evidence suggests that such programs alone provide only modest gains. Primary providers in disease management programs can include nurses, case managers, or pharmacists. Supportive interventions across several modalities have been shown to be effective. Conclusion An approach that uses a combination of strategies designed to impact patients' health-related behaviors across a variety of modalities may help to improve outcomes and reduce costs. Additional novel, innovative interdisciplinary initiatives are necessary to effect meaningful change that can facilitate improved health outcomes for patients with diabetes and maximize cost-effectiveness approaches for payers. PMID:25126364

Pancreatic cancer and exposure to dietary nitrate and nitrite in the NIH-AARP Diet and Health Study.

PubMed

Aschebrook-Kilfoy, Briseis; Cross, Amanda J; Stolzenberg-Solomon, Rachael Z; Schatzkin, Arthur; Hollenbeck, Albert R; Sinha, Rashmi; Ward, Mary H

2011-08-01

Nitrate and nitrite are precursors of N-nitroso compounds, which induce tumors of the pancreas in animals. The authors evaluated the relation of dietary nitrate and nitrite to pancreatic cancer risk in the NIH-AARP Diet and Health Study. Nitrate and nitrite intakes were assessed at baseline using a 124-item food frequency questionnaire. During approximately 10 years of follow-up between 1995 and 2006, 1,728 incident pancreatic cancer cases were identified. There was no association between total nitrate or nitrite intake and pancreatic cancer in men or women. However, men in the highest quintile of summed nitrate/nitrite intake from processed meat had a nonsignificantly elevated risk of pancreatic cancer (hazard ratio = 1.18, 95% confidence interval: 0.95, 1.47; P-trend = 0.11). The authors observed a stronger increase in risk among men for nitrate/nitrite intake from processed meat at ages 12-13 years (highest quintile vs. lowest: hazard ratio = 1.32, 95% confidence interval: 0.99, 1.76; P-trend = 0.11), though the relation did not achieve statistical significance. The authors found no associations between adult or adolescent nitrate or nitrite intake from processed meats and pancreatic cancer among women. These results provide modest evidence that processed meat sources of dietary nitrate and nitrite may be associated with pancreatic cancer among men and provide no support for the hypothesis in women.

The Pegasus-Upgrade Experiment

NASA Astrophysics Data System (ADS)

Fonck, R. J.; Bongard, M. W.; Barr, J. L.; Frerichs, H. G.; Lewicki, B. T.; Reusch, J. A.; Schmitz, O.; Winz, G. R.

2015-11-01

Tokamak operation at near-unity aspect ratio provides access to advanced tokamak physics at modest parameters. High plasma current is accessible at very low toroidal field. This offers H-mode performance at Te levels that allow use of electrostatic and magnetic probe arrays through the edge pedestal region into the plasma core. An upgrade to the Pegasus ST is planned to exploit these features and pursue unique studies in three areas: local measurements of pedestal and ELM dynamics at Alfvenic timescales; direct measurement of the local plasma response to application of 3D magnetic perturbations with high spectral flexibility; and extension of Local Helicity Injection for nonsolenoidal startup to NSTX-U-relevant confinement and stability regimes. Significant but relatively low-cost upgrades to the facility are proposed: a new centerstack with larger solenoid and 2x the number of toroidal field conductors; a new TF power supply and conversion of the 200 MVA OH power supply to a cascaded multilevel inverter configuration; and installation of an extensive 3D-magnetic perturbation coil system for ELM mitigation and suppression studies. The upgraded facility will provide 0.3 MA plasmas with pulse lengths of 50-100 msec flattop, aspect ratio <1.25, and toroidal field up to 0.4 T. These research activities will be integrated into related efforts on DIII-D and NSTX-U. Work supported by US DOE grant DE-FG02-96ER54375.

Sex differences in emotion recognition: Evidence for a small overall female superiority on facial disgust.

PubMed

Connolly, Hannah L; Lefevre, Carmen E; Young, Andrew W; Lewis, Gary J

2018-05-21

Although it is widely believed that females outperform males in the ability to recognize other people's emotions, this conclusion is not well supported by the extant literature. The current study sought to provide a strong test of the female superiority hypothesis by investigating sex differences in emotion recognition for five basic emotions using stimuli well-calibrated for individual differences assessment, across two expressive domains (face and body), and in a large sample (N = 1,022: Study 1). We also assessed the stability and generalizability of our findings with two independent replication samples (N = 303: Study 2, N = 634: Study 3). In Study 1, we observed that females were superior to males in recognizing facial disgust and sadness. In contrast, males were superior to females in recognizing bodily happiness. The female superiority for recognition of facial disgust was replicated in Studies 2 and 3, and this observation also extended to an independent stimulus set in Study 2. No other sex differences were stable across studies. These findings provide evidence for the presence of sex differences in emotion recognition ability, but show that these differences are modest in magnitude and appear to be limited to facial disgust. We discuss whether this sex difference may reflect human evolutionary imperatives concerning reproductive fitness and child care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Does case misclassification threaten the validity of studies investigating the relationship between neck manipulation and vertebral artery dissection stroke? Yes.

PubMed

Paulus, Jessica K; Thaler, David E

2016-01-01

For patients and health care providers who are considering spinal manipulative therapy of the neck, it is crucial to establish if it is a trigger for cervical artery dissection and/or stroke, and if it is, the magnitude of the risk. We discuss the biological plausibility of how neck manipulation could cause cervical artery dissection. We also discuss how case misclassification threatens the validity of influential published studies that have investigated the relationship between neck manipulation and dissection. Our position is supported by the fact that the largest epidemiologic studies of neck manipulation safety with respect to neurological outcomes have relied on International Classification of Diseases-9 codes for case identification. However, the application of these codes in prior studies failed to identify dissections (rather than strokes in general) and so conclusions from those studies are invalid. There are several methodological challenges to understanding the association between neck manipulation and vertebral artery dissection. Addressing these issues is critical because even a modest association between neck manipulation and cervical artery dissection could translate into a significant number of avoidable dissections given the widespread use of neck manipulation by providers from various backgrounds. We believe that valid case classification, accurate measurement of manipulative procedures, and addressing reverse causation bias should be top priorities for future research.

Modest Labor-Management Bargains Continue in 1984 Despite the Recovery.

ERIC Educational Resources Information Center

Ruben, George

1985-01-01

Major collective bargaining agreements in 1984 resulted in modest settlements, due to concern about foreign competition, domestic deregulation, and inflation. Agreements occurred in the following industries: auto, soft coal, airlines, aircraft and aerospace, construction, petroleum refining, longshore industry, railroads, trucking, steel, West…

Interactions of psychosocial factors with built environments in explaining adolescents' active transportation.

PubMed

Wang, Xiaobo; Conway, Terry L; Cain, Kelli L; Frank, Lawrence D; Saelens, Brian E; Geremia, Carrie; Kerr, Jacqueline; Glanz, Karen; Carlson, Jordan A; Sallis, James F

2017-07-01

The present study examined independent and interacting associations of psychosocial and neighborhood built environment variables with adolescents' reported active transportation. Moderating effects of adolescent sex were explored. Mixed-effects regression models were conducted on data from the Teen Environment and Neighborhood observational study (N=928) in the Seattle, WA and Baltimore regions 2009-2011. Frequency index of active transportation to neighborhood destinations (dependent variable) and 7 psychosocial measures were reported by adolescents. Built environment measures included home walkability and count of nearby parks and recreation facilities using GIS procedures and streetscape quality from environmental audits. Results indicated all 3 environmental variables and 3 psychosocial variables (self-efficacy, social support from peers, and enjoyment of physical activity) had significant positive main effects with active transportation (Ps<0.05). Three of 21 two-way interactions were significant in explaining active transportation (Ps<0.1): self-efficacy×GIS-based walkability index, barriers to activity in neighborhood×MAPS streetscape scores, and self-efficacy×GIS-based counts of parks and recreation facilities. In each two-way interaction the highest active transportation was found among adolescents with the combination of activity-supportive built environment and positive psychosocial characteristics. Three-way interactions with sex indicated similar associations for girls and boys, with one exception. Results provided modest support for the ecological model principle of interactions across levels, highlight the importance of both built environment and psychosocial factors in shaping adolescents' active transportation, demonstrated the possibility of sex-specific findings, and suggested strategies for improving adolescents' active transportation may be most effective when targeting multiple levels of influence. Copyright © 2017 Elsevier Inc. All rights reserved.

Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data

PubMed Central

Bozzatello, Paola; Brignolo, Elena; De Grandi, Elisa; Bellino, Silvio

2016-01-01

A new application for omega-3 fatty acids has recently emerged, concerning the treatment of several mental disorders. This indication is supported by data of neurobiological research, as highly unsaturated fatty acids (HUFAs) are highly concentrated in neural phospholipids and are important components of the neuronal cell membrane. They modulate the mechanisms of brain cell signaling, including the dopaminergic and serotonergic pathways. The aim of this review is to provide a complete and updated account of the empirical evidence of the efficacy and safety that are currently available for omega-3 fatty acids in the treatment of psychiatric disorders. The main evidence for the effectiveness of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has been obtained in mood disorders, in particular in the treatment of depressive symptoms in unipolar and bipolar depression. There is some evidence to support the use of omega-3 fatty acids in the treatment of conditions characterized by a high level of impulsivity and aggression and borderline personality disorders. In patients with attention deficit hyperactivity disorder, small-to-modest effects of omega-3 HUFAs have been found. The most promising results have been reported by studies using high doses of EPA or the association of omega-3 and omega-6 fatty acids. In schizophrenia, current data are not conclusive and do not allow us either to refuse or support the indication of omega-3 fatty acids. For the remaining psychiatric disturbances, including autism spectrum disorders, anxiety disorders, obsessive-compulsive disorder, eating disorders and substance use disorder, the data are too scarce to draw any conclusion. Concerning tolerability, several studies concluded that omega-3 can be considered safe and well tolerated at doses up to 5 g/day. PMID:27472373

Overview of the Fusion Z-Pinch Experiment FuZE

NASA Astrophysics Data System (ADS)

Weber, T. R.; Shumlak, U.; Nelson, B. A.; Golingo, R. P.; Claveau, E. L.; McLean, H. S.; Tummel, K. K.; Higginson, D. P.; Schmidt, A. E.; UW/LLNL Team

2016-10-01

Previously, the ZaP device, at the University of Washington, demonstrated sheared flow stabilized (SFS) Z-pinch plasmas. Instabilities that have historically plagued Z-pinch plasma confinement were mitigated using sheared flows generated from a coaxial plasma gun of the Marshall type. Based on these results, a new SFS Z-pinch experiment, the Fusion Z-pinch Experiment (FuZE), has been constructed. FuZE is designed to investigate the scaling of SFS Z-pinch plasmas towards fusion conditions. The experiment will be supported by high fidelity physics modeling using kinetic and fluid simulations. Initial plans are in place for a pulsed fusion reactor following the results of FuZE. Notably, the design relies on proven commercial technologies, including a modest discharge current (1.5 MA) and voltage (40 kV), and liquid metal electrodes. Supported by DoE FES, NNSA, and ARPA-E ALPHA.

"Unequal opportunity": neighbourhood disadvantage and the chance to buy illegal drugs.

PubMed

Storr, C L; Chen, C-Y; Anthony, J C

2004-03-01

This study investigates whether subgroups of people living in disadvantaged neighbourhoods may be more likely to come into contact with drug dealers as compared with persons living in more advantaged areas, with due attention to male-female and race-ethnicity differences. Standardised survey data collected using stratified, multistage area probability sampling. United States of America, 1998. Nationally representative sample of household residents age 12 or older (n = 25 500). Evidence supports an inference that women are less likely to be approached by someone selling illegal drugs. The study found no more than modest and generally null racial and ethnicity differences, even for residents living within socially disadvantaged neighbourhoods, where chances to buy illegal drugs are found to be more common. Limitations of survey data always merit attention, but this study evidence lends support to the inference that physical and social characteristics of a neighbourhood can set the stage for opportunities to become involved with drugs.

Testing Longitudinal Relationships Between Binge Drinking, Marijuana Use, and Depressive Symptoms and Moderation by Sex.

PubMed

Wilkinson, Andra L; Halpern, Carolyn Tucker; Herring, Amy H; Shanahan, Meghan; Ennett, Susan T; Hussey, Jon M; Harris, Kathleen Mullan

2016-12-01

Both substance use and depression are common in adolescence and often comorbid. Past research has produced conflicting results on whether there is a temporal relationship, and if so, in which direction it operates and how it may vary by sex. We examined the longitudinal associations between substance use frequency and depressive symptoms from adolescence into young adulthood and whether the associations were moderated by sex. With data from Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 9,816), we used growth curve models to test if depressive symptoms predicted marijuana use or binge drinking frequency (Self-Medication Model) or if substance use frequency predicted depressive symptoms (Stress Model). Moderation by sex and age was tested for both potential pathways. Increases in adolescent depressive symptoms, compared to no symptoms, were associated with a steeper predicted increase in marijuana use frequency from adolescence to young adulthood. Increases in persistent binge drinking or marijuana use frequency had concurrent positive associations with depressive symptoms from adolescence to young adulthood, and these associations were significantly stronger for females compared to males. The results not only support the Self-Medication Model for marijuana use but also provide modest support for the Stress Model, that substance use is associated with depressive symptoms, especially for females. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A systematic review on the role of anticonvulsants in the treatment of acute bipolar depression.

PubMed

Reinares, María; Rosa, Adriane R; Franco, Carolina; Goikolea, José Manuel; Fountoulakis, Kostas; Siamouli, Melina; Gonda, Xenia; Frangou, Sophia; Vieta, Eduard

2013-03-01

Despite the high morbidity and mortality associated with bipolar depression, the optimal treatment for this phase is still a matter of debate. The aim of the current review was to provide updated evidence about the efficacy and tolerability of anticonvulsants in the treatment of acute bipolar depression. A comprehensive review of randomized controlled trials (RCTs) evaluating the use of anticonvulsants for the treatment of acute bipolar depression up to June 2011 was conducted by means of the PubMed-Medline database. Eligibility criteria included active comparator-controlled or placebo-controlled randomized studies involving monotherapy or combination therapy. A total of 18 RCTs fulfilled the inclusion criteria. Studies supported the efficacy of divalproex as monotherapy in acute bipolar depression but small sample size was a common methodological limitation. Findings were inconclusive for lamotrigine and carbamazepine although overall lamotrigine may have a beneficial but modest effect. Negative results were found for levetiracetam and gabapentin but the evidence base on these agents is scant. All anticonvulsants were generally well tolerated. No double-blind RCTs were found for the use of other anticonvulsants such as oxcarbazepine, licarbazepine, zonisamide, retigabine, pregabalin, tiagabine, felbamate and vigabatrine in the acute treatment of bipolar depression. To sum up, taking into consideration the efficacy and tolerability profiles of anticonvulsants, current evidence supports the use of divalproex and lamotrigine in the treatment of acute bipolar depression. However, available data for most other anticonvulsants are inconclusive and further RCTs with larger sample sizes are needed before drawing firm conclusions.

A pilot study into a possible relationship between diet and stuttering.

PubMed

Hum, Jean; Rietveld, Toni; Wiedijk, Piet; van Lieshout, Pascal

2017-06-01

There are theoretical and empirical reasons to consider a potential role for copper metabolism in the brain in how it could influence stuttering. However, a link between stuttering and dietary intake has never been researched in a systematic way. This pilot study therefore aimed to explore a possible association between ingested amounts of copper and thiamine (vitamin B1) with stuttering frequency using a double blind cross-over longitudinal paradigm. 19 adults who stutter between 20 and 51 years old filled out an online survey for 9 consecutive weeks. The survey consisted of self-assessed fluency and mood state scales, as well as food journals. After 4 weeks, the participants consumed either copper or thiamine supplements for 2 weeks, followed by a 1-week washout period, and another period of two weeks taking the other supplement. Formal speech assessments were done pre/post baseline and at the end of each supplement intake. Participants were not informed about the nature of the supplements during the experiment and the investigators were blinded to the order of the supplements. The results demonstrated that copper and thiamine had no measurable effect on the amount of stuttering (self and formal assessments) but there was a moderate, significant correlation between mood state and fluency. The findings do not support notions of dietary influences of ingested copper or thiamine on stuttering but do provide modest support for a relationship between variations in stuttering and self-perceived anxiety. Copyright © 2017 Elsevier Inc. All rights reserved.

Longitudinal trends in hedonic hunger after Roux-en-Y gastric bypass in adolescents.

PubMed

Cushing, Christopher C; Benoit, Stephen C; Peugh, James L; Reiter-Purtill, Jennifer; Inge, Thomas H; Zeller, Meg H

2014-01-01

Initial outcome studies have reported that Roux-en-Y gastric bypass (RYGB) is safe and efficacious for adolescents with extreme obesity. Although rapid weight loss is seen initially, data also show that modest weight regain typically occurs as early as the second postoperative year. The contribution of various psychological factors, including hedonic hunger, to postoperative weight regain has not previously been studied in adolescents. The objective of this study was to examine the variability in hedonic hunger and body mass index (BMI) over the initial 2-year period of weight loss and modest weight regain in adolescent RYGB recipients. A total of 16 adolescents completed the Power of Food Scale before surgery and at 3, 6, 12, 18, and 24 months postoperatively. Height and weight were measured at each time point, from which BMI was calculated. Nonlinear trends were observed for time on both overall hedonic hunger and hedonic hunger specifically related to food available in the adolescent's environment. The BMI reduction during the first 18 months postoperatively was paralleled by reduction in hedonic hunger; increases in hedonic hunger also paralleled the modest BMI increase at 24 months. In growth analysis, significant power gains are available to models using 4 or more points of data. However, only large effect sizes that are>.85 were detectable with a sample of 16 patients. These data provide preliminary evidence that hedonic hunger is in need of further study in adolescent patients receiving RYGB both preoperatively and postoperatively. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Cost and quality trends in direct contracting arrangements.

PubMed

Lyles, Alan; Weiner, Jonathan P; Shore, Andrew D; Christianson, Jon; Solberg, Leif I; Drury, Patricia

2002-01-01

This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.

Acquisition of Ice-Tethered Profilers with Velocity (ITP-V) Instruments for Future Arctic Studies

DTIC Science & Technology

2015-09-30

jacketed wire rope tether and end weight should the ice fracture or melt , and to provide modest protection in the event of ice ridging. The profiler...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Acquisition of Ice -Tethered Profilers with Velocity (ITP...evolving thermohaline stratification, the ocean currents and air- ice -sea interactions on time scales of minutes to seasonal and longer. OBJECTIVES

Substantial contribution of extrinsic risk factors to cancer development | Office of Cancer Genomics

Cancer.gov

Recent research has highlighted a strong correlation between tissue-specific cancer risk and the lifetime number of tissue-specific stem-cell divisions. Whether such correlation implies a high unavoidable intrinsic cancer risk has become a key public health debate with the dissemination of the 'bad luck' hypothesis. Here we provide evidence that intrinsic risk factors contribute only modestly (less than ~10-30% of lifetime risk) to cancer development.

Strategy for D/He-3 fusion development

NASA Technical Reports Server (NTRS)

Santarius, John F.

1988-01-01

It is concluded that Deuterium/Helium-3 fusion faces a more difficult physics development path but an easier technology development path than does Deuterium/Tritium. Early D/He-3 tests in next generation D/T fusion experiments might provide a valuable D/He-3 proof-of-principle at modest cost. At least one high leverage alternate concept should be vigorously pursued. Space applications of D/He-3 fusion are critically important to large scale development.

Angle amplifying optics using plane and ellipsoidal reflectors

DOEpatents

Glass, Alexander J.

1977-01-01

An optical system for providing a wide angle input beam into ellipsoidal laser fusion target illumination systems. The optical system comprises one or more pairs of centrally apertured plane and ellipsoidal mirrors disposed to accept the light input from a conventional lens of modest focal length and thickness, to increase the angular divergence thereof to a value equivalent to that of fast lenses, and to direct the light into the ellipsoidal target illumination system.

Affording shared responsibility for universal coverage: insights from California.

PubMed

Curtis, Rick; Neuschler, Ed

2009-01-01

This paper presents key insights from California's recent experience in developing a plan for universal health coverage with "shared responsibility" among individuals, employers, and governments. A major challenge was finding an acceptable balance among the goals of affordability, equity, and cost to the state. Although reform did not pass, the state's approach-particularly differences from Massachusetts regarding modest-income workers and related employer and public roles-provides important insights for federal reform.

New Diversity Arrays Technology (DArT) markers for tetraploid oat (Avena magna Murphy et Terrell) provide the first complete oat linkage map and markers linked to domestication genes from hexaploid A. sativa L.

USDA-ARS?s Scientific Manuscript database

Nutritional benefits of cultivated oat (Avena sativa L., 2n = 6x = 42, AACCDD genomes) are well recognized; however, seed protein levels are modest and genetic resources for protein improvement are scarce. The wild tetraploid A. magna Ladiz. contains approximately 31% seed protein and has been hybr...

Aquarius Reflector Surface Temperature Monitoring Test and Analysis

NASA Technical Reports Server (NTRS)

Abbott, Jamie; Lee, Siu-Chun; Becker, Ray

2008-01-01

The presentation addresses how to infer the front side temperatures for the Aquarius L-band reflector based upon backside measurement sites. Slides discussing the mission objectives and design details are at the same level found on typical project outreach websites and in conference papers respectively. The test discussion provides modest detail of an ordinary thermal balance test using mockup hardware. The photographs show an off-Lab vacuum chamber facility with no compromising details.

Runaway Costs in Medi-Cal—A Myth

PubMed Central

Heckman, John R.; Jones, Michael W.

1980-01-01

An analysis of increases in Medi-Cal expenditures to their present level, more than $4 billion a year, shows them to be attributable largely to changes in eligibility and scope of benefits. The actual costs of providing care have risen at a relatively modest rate. If in fact costs are to be lowered from present levels, public policy makers must make important decisions concerning program changes which transcend merely altering payment and delivery methods. PMID:6996335

Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST)

NASA Astrophysics Data System (ADS)

Baldauf, Brian; Conti, Alberto

2016-01-01

The "Search for Life" via imaging of exoplanets is a mission that requires extremely stable telescopes with apertures in the 10 m to 20 m range. The High Definition Space Telescope (HDST) envisioned for this mission would have an aperture >10 m, which is a larger payload than what can be delivered to space using a single launch vehicle. Building and assembling the mirror segments enabling large telescopes will likely require multiple launches and assembly in space. Space-based telescopes with large apertures will require major changes to system architectures.The Optical Telescope Assembly (OTA) for HDST is a primary mission cost driver. Enabling and affordable solutions for this next generation of large aperture space-based telescope are needed.This paper reports on the concept for the Modular Orbital Demonstration of an Evolvable Space Telescope (MODEST), which demonstrates on-orbit robotic and/or astronaut assembly of a precision optical telescope in space. It will also facilitate demonstration of active correction of phase and mirror shape. MODEST is proposed to be delivered to the ISS using standard Express Logistics Carriers (ELCs) and can mounted to one of a variety of ISS pallets. Post-assembly value includes space, ground, and environmental studies, and a testbed for new instruments. This demonstration program for next generation mirror technology provides significant risk reduction and demonstrates the technology in a six-mirror phased telescope. Other key features of the demonstration include the use of an active primary optical surface with wavefront feedback control that allows on-orbit optimization and demonstration of precise surface control to meet optical system wavefront and stability requirements.MODEST will also be used to evaluate advances in lightweight mirror and metering structure materials such as SiC or Carbon Fiber Reinforced Polymer that have excellent mechanical and thermal properties, e.g. high stiffness, high modulus, high thermal conductivity, and low thermal expansion. It has been demonstrated that mirrors built from these materials can be rapidly replicated in a highly cost effective manner, making these materials excellent candidates for a low cost, high performance OTA.

Effect of self-efficacy and social support on adherence to antihypertensive drugs.

PubMed

Criswell, Thomas J; Weber, Cynthia A; Xu, Yinghui; Carter, Barry L

2010-05-01

To determine the relationship between poor adherence and self-efficacy or social support after a pharmacist intervention. Post-hoc analysis of data from two randomized controlled trials of physician-pharmacist collaborative interventions (6 and 9 mo, respectively) to improve blood pressure control. Eleven university-affiliated primary care clinics. Five hundred eighty-four patients (aged 21-85 yrs) with uncontrolled primary hypertension; 296 were in the intervention group and 288 were in the control group. Pharmacists provided intensified hypertension management and drug adherence counseling to patients in the intervention group. Social support and self-efficacy questionnaires were administered at baseline and end-of-study visits. Patient adherence was monitored by using the Morisky self-reported adherence questionnaire. Self-reported adherence scores improved significantly in the control group (p=0.0053) but not in the intervention group; however, adherence at baseline in both groups was high. There were small, but significant, improvements in self-efficacy (p<0.04) and social support (p<0.05) scores in the intervention group but not the control group at the end of the study. Social support and, to a lesser extent, self-efficacy improved as a function of duration of study participation (9-mo vs 6-mo intervention), regardless of whether the patient received the intervention. Blood pressure control in both groups improved significantly at the end of the study; however, mean blood pressure was significantly lower in the intervention group (129.7/76.6 mm Hg) compared with the control group (140.8/78.9 mm Hg; p<0.0001 for systolic, p=0.032 for diastolic). Social support and self-efficacy improved significantly in the intervention group at the end of the pharmacist intervention. Drug adherence was correlated with self-efficacy even though drug adherence did not improve significantly in the intervention group. The fact that social support and self-efficacy improved as a function of duration of study participation suggests that participation in a research study may have had a positive influence on these measures. Even though the changes in social support, self-efficacy, and drug adherence were modest, there was significantly better blood pressure control in the intervention group compared with the control group. These findings indicate that changes in drug adherence, self-efficacy, or social support probably played a minor role in the blood pressure outcomes in these studies.

Update on mesenchymal stem cell therapies for cartilage disorders

PubMed Central

Paschos, Nikolaos K; Sennett, Mackenzie L

2017-01-01

Cartilage disorders, including focal cartilage lesions, are among the most common clinical problems in orthopedic practice. Left untreated, large focal lesions may result in progression to osteoarthritis, with tremendous impact on the quality of life of affected individuals. Current management strategies have shown only a modest degree of success, while several upcoming interventions signify better outcomes in the future. Among these, stem cell therapies have been suggested as a promising new era for cartilage disorders. Certain characteristics of the stem cells, such as their potential to differentiate but also to support healing made them a fruitful candidate for lesions in cartilage, a tissue with poor healing capacity. The aim of this editorial is to provide an update on the recent advancements in the field of stem cell therapy for the management of focal cartilage defects. Our goal is to present recent basic science advances and to present the potential of the use of stem cells in novel clinical interventions towards enhancement of the treatment armamentarium for cartilage lesions. Furthermore, we highlight some thoughts for the future of cartilage regeneration and repair and to explore future perspectives for the next steps in the field. PMID:29312843

Mindfulness and the aging brain: a proposed paradigm shift

PubMed Central

Prakash, Ruchika Shaurya; De Leon, Angeline A.; Patterson, Beth; Schirda, Brittney L.; Janssen, Alisha L.

2014-01-01

There has been a proliferation of cognitive training studies investigating the efficacy of various cognitive training paradigms as well as strategies for improving cognitive control in the elderly. While some have found support for the transfer of training, the majority of training studies show modest to no transfer effects. When transfer effects have been observed, the mechanisms contributing to enhanced functioning have been difficult to dissociate. In this review, we provide a theoretical rationale for the study of mindfulness in older adults as a particular type of training program designed to improve cognitive control by capitalizing on older adults’ acquired behavioral orientation toward higher socioemotional goals. Given the synergistic relationship between emotional and cognitive control processes, the paradoxical divergence in older adults’ functional trajectory in these respective domains, and the harmonious interplay of cognitive and emotional control embedded in the practice of mindfulness, we propose mindfulness training as an opportunistic approach to cultivating cognitive benefits in older adults. The study of mindfulness within aging, we argue, capitalizes on a fundamental finding of the socioemotional aging literature, namely the preferential change in motivational goals of older adults from ones involving future-oriented wants and desires to present-focused emotion regulation and gratification. PMID:25009492

Reducing costs of managing and accessing navigation and ancillary data by relying on the extensive capabilities of NASA's spice system

NASA Technical Reports Server (NTRS)

Semenov, Boris V.; Acton, Charles H., Jr.; Bachman, Nathaniel J.; Elson, Lee S.; Wright, Edward D.

2005-01-01

The SPICE system of navigation and ancillary data possesses a number of traits that make its use in modern space missions of all types highly cost efficient. The core of the system is a software library providing API interfaces for storing and retrieving such data as trajectories, orientations, time conversions, and instrument geometry parameters. Applications used at any stage of a mission life cycle can call SPICE APIs to access this data and compute geometric quantities required for observation planning, engineering assessment and science data analysis. SPICE is implemented in three different languages, supported on 20+ computer environments, and distributed with complete source code and documentation. It includes capabilities that are extensively tested by everyday use in many active projects and are applicable to all types of space missions - flyby, orbiters, observatories, landers and rovers. While a customer's initial SPICE adaptation for the first mission or experiment requires a modest effort, this initial effort pays off because adaptation for subsequent missions/experiments is just a small fraction of the initial investment, with the majority of tools based on SPICE requiring no or very minor changes.

An overview of cartilage tissue engineering.

PubMed

Kim, H W; Han, C D

2000-12-01

Articular cartilage regeneration refers to the formation of new tissue that is indistinguishable from the native articular cartilage with respect to zonal organization, biochemical composition, and mechanical properties. Due to a limited capacity to repair cartilage, scar tissue frequently has a poorly organized structure and lacks the functional characteristics of normal cartilage. The degree of success to date achieved using a purely cell- or biological-based approach has been modest. Potentially the development of a hybrid strategy, whereby, chondrocytes or chondrogenic stem cells are combined with a matrix, making cartilage in vitro, which is then subsequently transplanted, offers a route towards a new successful treatment modality. The success of this approach depends upon the material being biocompatible, processable into a suitable three-dimensional structure and eventually biodegradable without harmful effects. In addition, the material should have a sufficient porosity to facilitate high cell loading and tissue ingrowth, and it should be able to support cell proliferation, differentiation, and function. The cell-polymer-bioreactor system provides a basis for studying the structural and functional properties of the cartilaginous matrix during its development, because tissue concentrations of glycosaminoglycan and collagen can be modulated by altering the conditions of tissue cultivation.

Advantages and Challenges of Radiative Liquid Lithium Divertor

NASA Astrophysics Data System (ADS)

Ono, Masayuki

2017-10-01

Steady-state fusion power plant designs present major divertor technology challenges, including high divertor heat flux both in steady-state and during transients. In addition to these concerns, there are the unresolved technology issues of long term dust accumulation and associated tritium inventory and safety issues. The application of lithium (Li) in NSTX resulted in improved H-mode confinement, H-mode power threshold reduction, and reduction in the divertor peak heat flux while maintaining essentially Li-free core plasma operation even during H-modes. These promising results in NSTX and related modeling calculations motivated the radiative liquid Li divertor (RLLD) concept and its variant, the active liquid Li divertor concept (ARLLD), taking advantage of the enhanced Li radiation in relatively poorly confined divertor plasmas. It has been suggested that radiation-based liquid lithium (LL) divertor concepts with a modest Li-loop could provide a possible solution for the outstanding fusion reactor technology issues such as divertor heat flux mitigation and real time dust removal, while potentially improving the reactor plasma performance. Laboratory tests are also planned to investigate the Li-T recover efficiency and other relevant research topics of the RLLD. This work supported by DoE Contract No. DE-AC02-09CH11466.

Population-Based Resequencing of Experimentally Evolved Populations Reveals the Genetic Basis of Body Size Variation in Drosophila melanogaster

PubMed Central

Turner, Thomas L.; Stewart, Andrew D.; Fields, Andrew T.; Rice, William R.; Tarone, Aaron M.

2011-01-01

Body size is a classic quantitative trait with evolutionarily significant variation within many species. Locating the alleles responsible for this variation would help understand the maintenance of variation in body size in particular, as well as quantitative traits in general. However, successful genome-wide association of genotype and phenotype may require very large sample sizes if alleles have low population frequencies or modest effects. As a complementary approach, we propose that population-based resequencing of experimentally evolved populations allows for considerable power to map functional variation. Here, we use this technique to investigate the genetic basis of natural variation in body size in Drosophila melanogaster. Significant differentiation of hundreds of loci in replicate selection populations supports the hypothesis that the genetic basis of body size variation is very polygenic in D. melanogaster. Significantly differentiated variants are limited to single genes at some loci, allowing precise hypotheses to be formed regarding causal polymorphisms, while other significant regions are large and contain many genes. By using significantly associated polymorphisms as a priori candidates in follow-up studies, these data are expected to provide considerable power to determine the genetic basis of natural variation in body size. PMID:21437274

Global Learning Communities: A Comparison of Online Domestic and International Science Class Partnerships

NASA Astrophysics Data System (ADS)

Kerlin, Steven C.; Carlsen, William S.; Kelly, Gregory J.; Goehring, Elizabeth

2013-08-01

The conception of Global Learning Communities (GLCs) was researched to discover potential benefits of the use of online technologies that facilitated communication and scientific data sharing outside of the normal classroom setting. 1,419 students in 635 student groups began the instructional unit. Students represented the classrooms of 33 teachers from the USA, 6 from Thailand, 7 from Australia, and 4 from Germany. Data from an international environmental education project were analyzed to describe grades 7-9 student scientific writing in domestic US versus international-US classroom online partnerships. The development of an argument analytic and a research model of exploratory data analysis followed by statistical testing were used to discover and highlight different ways students used evidence to support their scientific claims about temperature variation at school sites and deep-sea hydrothermal vents. Findings show modest gains in the use of some evidentiary discourse components by US students in international online class partnerships compared to their US counterparts in domestic US partnerships. The analytic, research model, and online collaborative learning tools may be used in other large-scale studies and learning communities. Results provide insights about the benefits of using online technologies and promote the establishment of GLCs.

Self-Paced Exercise, Affective Response, and Exercise Adherence: A Preliminary Investigation Using Ecological Momentary Assessment.

PubMed

Williams, David M; Dunsiger, Shira; Emerson, Jessica A; Gwaltney, Chad J; Monti, Peter M; Miranda, Robert

2016-06-01

Affective response to exercise may mediate the effects of self-paced exercise on exercise adherence. Fiftynine low-active (exercise <60 min/week), overweight (body mass index: 25.0-39.9) adults (ages 18-65) were randomly assigned to self-paced (but not to exceed 76% maximum heart rate) or prescribed moderate intensity exercise (64-76% maximum heart rate) in the context of otherwise identical 6-month print-based exercise promotion programs. Frequency and duration of exercise sessions and affective responses (good/bad) to exercise were assessed via ecological momentary assessment throughout the 6-month program. A regression-based mediation model was used to estimate (a) effects of experimental condition on affective response to exercise (path a = 0.20, SE = 0.28, f 2 = 0.02); (b) effects of affective response on duration/latency of the next exercise session (path b = 0.47, SE = 0.25, f 2 = 0.04); and (c) indirect effects of experimental condition on exercise outcomes via affective response (path ab = 0.11, SE = 0.06, f 2 = 0.10). Results provide modest preliminary support for a mediational pathway linking self-paced exercise, affective response, and exercise adherence.

Quantifying the contribution of neighborhood parks to physical activity.

PubMed

Han, Bing; Cohen, Deborah; McKenzie, Thomas L

2013-11-01

To quantify the contribution of U.S. neighborhood parks to the time spent in moderate-to-vigorous physical activity (MVPA) by the local population. Observational data on the use of 10 parks in five US cities collected during summer and fall 2008 were analyzed by a model-averaging approach. Estimated MVPA time accrued in parks was compared to estimated total MVPA time accrued by the local population, based upon national estimates. On average, parks provided roughly 4000hours of use and 1500 MVPA hours per week. Park use accounted for approximately 50% of the vigorous physical activity (VPA) time of those living within 0.5 miles of the park and 16% of those living within 1.0 miles of the park. Parks accounted for a modest proportion of moderate physical activity (MPA) time, about 14% and 4% for those living within 0.5 miles and 1.0 miles of the park, respectively. Parks have significant roles in supporting vigorous physical activity of the local population. Because they are underutilized and vigorous activity is critical to child development and adult physical fitness, efforts should be made to promote vigorous activity within local parks. © 2013.

Sources of Variation in the Gut Microbial Community of Lycaeides melissa Caterpillars.

PubMed

Chaturvedi, Samridhi; Rego, Alexandre; Lucas, Lauren K; Gompert, Zachariah

2017-09-12

Microbes can mediate insect-plant interactions and have been implicated in major evolutionary transitions to herbivory. Whether microbes also play a role in more modest host shifts or expansions in herbivorous insects is less clear. Here we evaluate the potential for gut microbial communities to constrain or facilitate host plant use in the Melissa blue butterfly (Lycaeides melissa). We conducted a larval rearing experiment where caterpillars from two populations were fed plant tissue from two hosts. We used 16S rRNA sequencing to quantify the relative effects of sample type (frass versus whole caterpillar), diet (plant species), butterfly population and development (caterpillar age) on the composition and diversity of the caterpillar gut microbial communities, and secondly, to test for a relationship between microbial community and larval performance. Gut microbial communities varied over time (that is, with caterpillar age) and differed between frass and whole caterpillar samples. Diet (host plant) and butterfly population had much more limited effects on microbial communities. We found no evidence that gut microbe community composition was associated with caterpillar weight, and thus, our results provide no support for the hypothesis that variation in microbial community affects performance in L. melissa.

Myeloproliferative Neoplasms in Danish Twins.

PubMed

Andersen, Michael Asger; Bjerrum, Ole Weis; Ranjan, Ajenthen; Skov, Vibe; Kruse, Torben A; Thomassen, Mads; Skytthe, Axel; Hasselbalch, Hans Carl; Christensen, Kaare

2018-01-01

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of diseases characterized by clonal hyperproliferation of immature and mature cells of the myeloid lineage. Genetic differences have been proposed to play a role in the development of MPNs. Monozygotic twin pairs with MPNs have been reported in a few case reports, but the MPN concordance pattern in twins remains unknown. All twin pairs born in the period 1900-2010 were identified in the nationwide Danish Twin Registry. Only pairs with both twins alive on January 1, 1977, and those born thereafter were included to allow identification in the Danish National Patient Registry. A total of 158 twin pairs were registered with an MPN diagnosis: 36 monozygotic, 104 dizygotic, and 18 pairs with unknown zygosity. MPNs were diagnosed in both twins in 4 pairs. The probandwise concordance rates for monozygotic twin pairs were higher than for dizygotic twin pairs (15 vs. 0%; p = 0.016). An estimated concordance rate of 15% (95% CI 0.059-0.31) is modest, but given the rarity of MPNs this finding is clinically relevant and provides further support for the role of genetic predisposition in the development of MPNs. © 2018 S. Karger AG, Basel.

The Search for Astronomical Alignments in the Seventh Century A.D. Silla Capital at Kyongju, Korea

NASA Astrophysics Data System (ADS)

Nelson, S. M.; Stencel, R. E.

1999-05-01

In the center of the modern Korean city of Kyongju stands a modest structure dating from the 7th century AD, known as Chomsongdae, or the Star Observatory. Known locally as the oldest observatory in Asia, details of its precise use are lost, but its construction coincided with the height of Silla culture and its dominance over the Korean peninsula. Radially from the structure are located the so-called Moon Fortress, numerous large tombsites for elite of the culture, plus hillside fortresses and elaborate Buddhist temples. During 1999, we've conducted a course at Denver as part of our Core Curriculum program for The Women's College, that has examined the astronomical and cultural aspects of the Kyongju site, to attempt to determine whether the architects may have included astronomical alignments into the ``Feng Shui" of their city planning, spanning centuries. The preliminary result of our studies suggests that east and west of Star Observatory lay fortress and wall features that may have been useful for equinox determination. A discussion of ethnographic supporting evidence will be provided, but additional on-site observations will be needed to confirm the idea.

Is there a specific fracture ‘cascade'?

PubMed Central

Melton, L Joseph; Amin, Shreyasee

2013-01-01

Different kinds of epidemiologic data provide varying views of the relationships among the main osteoporotic fractures. Descriptive incidence data indicate that distal forearm fractures typically occur earlier than vertebral fractures that, in turn, precede hip fractures late in life. In addition, relative risk estimates document the fact that one osteoporotic fracture increases the risk of subsequent ones. These two observations support the notion of a ‘fracture cascade' and justify the recent emphasis on secondary prevention, that is, more aggressive treatment of patients presenting with a fracture in order to prevent recurrences. However, the absolute risk of a subsequent fracture given an initial one is modest, and the degree to which the second fracture can be attributed to the first one is unclear. Moreover, the osteoporotic fractures encountered in the majority of patients are the first one experienced, and even these initial fractures lead to substantial morbidity and cost. These latter points reemphasize the importance of primary prevention, that is, the management of bone loss and other risk factors to prevent the first fracture. Continued efforts are needed to refine risk assessment algorithms so that candidates for such fracture prophylaxis can be identified more accurately and efficiently. PMID:24575296

What's law got to do with it Part 2: Legal strategies for healthier nutrition and obesity prevention

PubMed Central

Magnusson, Roger S

2008-01-01

This article is the second in a two-part review of law's possible role in a regulatory approach to healthier nutrition and obesity prevention in Australia. As discussed in Part 1, law can intervene in support of obesity prevention at a variety of levels: by engaging with the health care system, by targeting individual behaviours, and by seeking to influence the broader, socio-economic and environmental factors that influence patterns of behaviour across the population. Part 1 argued that the most important opportunities for law lie in seeking to enhance the effectiveness of a population health approach. Part 2 of this article aims to provide a systematic review of the legal strategies that are most likely to emerge, or are worth considering, as part of a suite of policies designed to prevent population weight gain and, more generally, healthier nutrition. While the impact of any one intervention may be modest, their cumulative impact could be significant and could also create the conditions for more effective public education campaigns. This article addresses the key contenders, with particular reference to Australia and the United States. PMID:18533999

The Impact of Rate Design and Net Metering on the Bill Savings from Distributed PV for Residential Customers in California

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

Energy and Resources Group, University of California, Berkeley; Darghouth, Naim R.; Barbose, Galen

2011-06-01

Net metering has become a widespread mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), but has faced challenges as PV installations grow to a larger share of generation in a number of states. This paper examines the value of the bill savings that customers receive under net metering, and the associated role of retail rate design, based on a sample of approximately two hundred residential customers of California's two largest electric utilities. We find that the bill savings per kWh of PV electricity generated varies by more than a factor of four across the customers inmore » the sample, which is largely attributable to the inclining block structure of the utilities' residential retail rates. We also compare the bill savings under net metering to that received under three potential alternative compensation mechanisms, based on California's Market Price Referent (MPR). We find that net metering provides significantly greater bill savings than a full MPR-based feed-in tariff, but only modestly greater savings than alternative mechanisms under which hourly or monthly net excess generation is compensated at the MPR rate.« less

Pelagic photoferrotrophy and iron cycling in a modern ferruginous basin.

PubMed

Llirós, Marc; García-Armisen, Tamara; Darchambeau, François; Morana, Cédric; Triadó-Margarit, Xavier; Inceoğlu, Özgül; Borrego, Carles M; Bouillon, Steven; Servais, Pierre; Borges, Alberto V; Descy, Jean-Pierre; Canfield, Don E; Crowe, Sean A

2015-09-08

Iron-rich (ferruginous) ocean chemistry prevailed throughout most of Earth's early history. Before the evolution and proliferation of oxygenic photosynthesis, biological production in the ferruginous oceans was likely driven by photoferrotrophic bacteria that oxidize ferrous iron {Fe(II)} to harness energy from sunlight, and fix inorganic carbon into biomass. Photoferrotrophs may thus have fuelled Earth's early biosphere providing energy to drive microbial growth and evolution over billions of years. Yet, photoferrotrophic activity has remained largely elusive on the modern Earth, leaving models for early biological production untested and imperative ecological context for the evolution of life missing. Here, we show that an active community of pelagic photoferrotrophs comprises up to 30% of the total microbial community in illuminated ferruginous waters of Kabuno Bay (KB), East Africa (DR Congo). These photoferrotrophs produce oxidized iron {Fe(III)} and biomass, and support a diverse pelagic microbial community including heterotrophic Fe(III)-reducers, sulfate reducers, fermenters and methanogens. At modest light levels, rates of photoferrotrophy in KB exceed those predicted for early Earth primary production, and are sufficient to generate Earth's largest sedimentary iron ore deposits. Fe cycling, however, is efficient, and complex microbial community interactions likely regulate Fe(III) and organic matter export from the photic zone.

On Basic Needs and Modest Media.

ERIC Educational Resources Information Center

Gunter, Jock

1978-01-01

The need for grass-roots participation and local control in whatever technology is used to meet basic educational needs is stressed. Successful uses of the audio cassette recorder and the portable half-inch video recorder are described; the 8-mm sound camera and video player are also suggested as viable "modest" technologies. (JEG)

Prophylactic G-CSF and antibiotics enable a significant dose-escalation of triplet-chemotherapy in non-small cell lung cancer.

PubMed

Timmer-Bonte, J N H; Punt, C J A; vd Heijden, H F M; van Die, C E; Bussink, J; Beijnen, J H; Huitema, A D R; Tjan-Heijnen, V C G

2008-05-01

In advanced non-small cell lung cancer (NSCLC) the clinical benefit of a platinum-based doublet is only modest, therefore, attenuated dosed three-drug combinations are investigated. We hypothesized that with adequate support a full dosed chemotherapy triplet is feasible. The study was designed as a dose finding study of paclitaxel in chemotherapy-naive patients. Paclitaxel was given as a 3-h infusion on day 1, followed by fixed doses of teniposide (or etoposide) 100mg/m(2) days 1, 3, 5 and cisplatin 80 mg/m(2) day 1 every 3 weeks. As myelotoxicity was expected to be the dose-limiting toxicity, prophylactic G-CSF and antibiotic support was evaluated. Indeed, paclitaxel 120 mg/m(2) resulted in dose-limiting neutropenia, despite G-CSF support. Teniposide/etoposide day 1, 3, 5 was less myelotoxic compared to day 1, 2, 3. G-CSF support allowed paclitaxel dose-escalation to 250 mg/m(2). The addition of prophylactic antibiotics enabled dose-escalation to 275 mg/m(2) without reaching MTD. In conclusion, G-CSF and antibiotics prophylaxis enables the delivery of a full dosed chemotherapy triplet in previously untreated NSCLC patients.

Innovating science communication: the structure supporting ATLAS Education & Outreach

NASA Astrophysics Data System (ADS)

Goldfarb, Steven; Marcelloni, Claudia; Shaw, Kate; ATLAS Experiment

2016-04-01

The ATLAS Education & Outreach project has, over the years, developed a strong reputation for supporting innovation. Animated event displays, musical CDs, 3d movies, 3-storey murals, photo books, data sonifications, multi-media art installations, pub slams, masterclasses, documentaries, pop-up books, LEGO® models, and virtual visits are among the many diverse methods being exploited to communicate to the world the goals and accomplishments of the ATLAS Experiment at CERN. This variety of creativity and innovation does not pop out of a vacuum. It requires underlying motivation by the collaboration to communicate with the public; freedom and encouragement to do so in a creative manner; and a support structure for developing, implementing and promoting these activities. The ATLAS Outreach project has built this support structure on a well-defined communication plan, high-quality content, and effective delivery platforms. Most importantly, implementation of the program has been based on the effective engagement of the participating institutes and other key partners, not only to leverage modest human resources and funding, but also to take advantage of the rich imagination and inspiration of a diverse, global human collaboration. We present our current plan, on-going activities, and a few more fun innovations for the future.

Association between triglyceride levels and cardiovascular disease in patients with acute pancreatitis.

PubMed

Copeland, Laurel A; Swendsen, C Scott; Sears, Dawn M; MacCarthy, Andrea A; McNeal, Catherine J

2018-01-01

Conventional wisdom supports prescribing "fibrates before statins", that is, prioritizing treatment of hypertriglyceridemia (hTG) to prevent pancreatitis ahead of low-density lipoprotein cholesterol to prevent coronary heart disease. The relationship between hTG and acute pancreatitis, however, may not support this approach to clinical management. This study analyzed administrative data from the Veterans Health Administration for evidence of (1) temporal association between assessed triglycerides level and days to acute pancreatitis admission; (2) association between hTG and outcomes in the year after hospitalization for acute pancreatitis; (3) relative rates of prescription of fibrates vs statins in patients with acute pancreatitis; (4) association of prescription of fibrates alone versus fibrates with statins or statins alone with rates of adverse outcomes after hospitalization for acute pancreatitis. Only modest association was found between above-normal or extremely high triglycerides and time until acute pancreatitis. CHD/MI/stroke occurred in 23% in the year following AP, supporting cardiovascular risk management. Fibrates were prescribed less often than statins, defying conventional wisdom, but the high rates of cardiovascular events in the year following AP support a clinical focus on reducing cardiovascular risk factors.

Mathematical evaluation of community level impact of combining bed nets and indoor residual spraying upon malaria transmission in areas where the main vectors are Anopheles arabiensis mosquitoes.

PubMed

Okumu, Fredros O; Kiware, Samson S; Moore, Sarah J; Killeen, Gerry F

2013-01-16

Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset, PermaNet 2.0, Icon Life nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset or PermaNet 2.0 nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus.

Designing Geoscience Educational Innovations That Propagate

NASA Astrophysics Data System (ADS)

Lea, P.

2014-12-01

NSF and other funders have supported the development of undergraduate STEM educational innovations over the past decades, only to see many yield limited uptake and impact beyond the grantee institutions. Numerous factors contribute to this complex problem, but one cause is likely insufficient incorporation of the understanding of how innovations propagate into project design. Following J.W. Dearing and colleagues, "dissemination" can be characterized by "push" approaches, which mainly emphasize one-to-many information sharing. In TUES/CCLI proposals, dissemination strategies have commonly taken the form of the "3 Ps" (presenting, publishing and posting) , with overall modest impact. Since the seminal work of Everett Rogers, however, "diffusion" of innovations has been understood as an inherently social process among potential adopters, which interacts with community norms and existing practices. Keys to diffusion include close understanding of the needs and context of the potential-adopter community and the development of "pull" within it, as well as support for implementation of innovations. Potential approaches to facilitating diffusion of innovations include a) using "lean start-up" methodologies (e.g., NSF's I-Corps-L program), in which explicit business-model hypotheses are tested through customer-discovery interviews, commonly leading to pivots where initial hypotheses are not confirmed, b) providing a range of potential commitment levels for adopters tailored to levels of support ("reverse Kickstarter model"), c) supporting decentralized communities of practice in which adaptations and tacit knowledge can readily be shared, d) encouraging crowd-sourcing of innovations, with an "architecture of participation" informed by successful open-source projects, and e) integrating innovations with discipline-based educational research, e.g., big-data approaches which allow A/B testing and analysis of clickstream data that reveal behaviors along a novice-to-expert continuum. Such new directions will be facilitated by stronger partnerships with technologists and data scientists, as well as community development of learning objectives and assessment standards that are sufficiently flexible and transparent and allow rapid feedback.

Predicting Employment in the Mental Health Treatment Study: Do Client Factors Matter?

PubMed

Metcalfe, Justin D; Drake, Robert E; Bond, Gary R

2017-05-01

For people with psychiatric disabilities, demographic characteristics and measures of clinical status are often used to allocate scarce employment services. This study examined a battery of potential client predictors of competitive employment, testing the hypothesis that evidence-based supported employment would mitigate the negative effects of poor work history, uncontrolled symptoms, substance abuse, and other client factors. In a secondary analysis of 2055 unemployed Social Security Disability Insurance beneficiaries with schizophrenia or affective disorders, we examined 20 baseline client factors as predictors of competitive employment. The analysis used logistic regression to identify significant client predictors and then examined interactions between significant predictors and receipt of evidence-based supported employment. Work history was a strong predictor of employment, and other client measures (fewer years on disability rolls, Hispanic ethnicity, and fewer physical health problems) were modestly predictive. Evidence-based supported employment mitigated negative client factors, including poor work history. Participants with a poor work history benefitted from supported employment even more than those with a recent work experience. Evidence-based supported employment helps people with serious mental illness, especially those with poor job histories, to obtain competitive employment. Factors commonly considered barriers to employment, such as diagnosis, substance use, hospitalization history, and misconceptions about disability benefits, often have little or no impact on competitive employment outcomes.

Development in helicopter tail boom strake applications in the US

NASA Technical Reports Server (NTRS)

Wilson, John C.; Kelley, Henry L.; Donahue, Cynthia C.; Yenni, Kenneth R.

1988-01-01

The use of a strake or spoiler on a helicopter tail boom to beneficially change helicopter tail boom air loads was suggested in the United States in 1975. The anticipated benefits were a change of tail boom loads to reduce required tail rotor thrust and power and improve directional control. High tail boom air loads experienced by the YAH-64 and described in 1978 led to a wind tunnel investigation of the usefullness of strakes in altering such loads on the AH-64, UH-60, and UH-1 helicopters. The wind tunnel tests of 2-D cross sections of the tail boom of each demonstrated that a strake or strakes would be effective. Several limited test programs with the U.S. Army's OH-58A, AH-64, and UH-60A were conducted which showed the effects of strakes were modest for those helicopters. The most recent flight test program, with a Bell 204B, disclosed that for the 204B the tail boom strake or strakes would provide more than a modest improvement in directional control and reduction in tail rotor power.

An international systematic review and meta-analysis of multisession psychosocial interventions compared with educational or minimal interventions on the HIV sex risk behaviors of people who use drugs.

PubMed

Meader, Nicholas; Semaan, Salaam; Halton, Marie; Bhatti, Henna; Chan, Melissa; Llewellyn, Alexis; Des Jarlais, Don C

2013-07-01

This systematic review and meta-analysis examines the effectiveness of multisession psychosocial interventions compared with educational interventions and minimal interventions in reducing sexual risk in people who use drugs (51 studies; 19,209 participants). We conducted comprehensive searches (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and PsychINFO 1998-2012). Outcomes (unprotected sex, condom use, or a composite outcome) were extracted by two authors and synthesised using meta-analysis. Subgroup analyses and meta-regression were conducted to explore heterogeneity. Multisession psychosocial interventions had modest additional benefits compared to educational interventions (K = 46; OR 0.86; 95% CI 0.77, 0.96), and large positive effects compared to minimal interventions (K = 7; OR 0.60; 95% CI 0.46, 0.78). Comparison with previous meta-analyses suggested limited progress in recent years in developing more effective interventions. Multisession psychosocial and educational interventions provided similar modest sexual risk reduction justifying offering educational interventions in settings with limited exposure to sexual risk reduction interventions, messages, and resources.

Sci-Thur PM – Brachytherapy 04: Commissioning and Implementation of a Cobalt-60 High Dose Rate Brachytherapy Source

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

Dysart, Jonathan

An Eckert & Ziegler Bebig Co0.A86 cobalt 60 high dose rate (HDR) brachytherapy source was commissioned for clinical use. Long-lived Co-60 HDR sources offer potential logistical and economic advantages over Ir-192 sources, and should be considered for low to medium workload brachytherapy departments where modest increases in treatment times are not a factor. In optimized plans, the Co-60 source provides a similar dose distribution to Ir-192 despite the difference in radiation energy. By switching to Co-60, source exchange frequency can be reduced by a factor of 20, resulting in overall financial savings of more than 50% compared to Ir-192 sources.more » In addition, a reduction in Physicist QA workload of roughly 200 hours over the 5 year life of the Co-60 source is also expected. These benefits should be considered against the modest increases in average treatment time compared to those of Ir-192 sources, as well as the centre-specific needs for operating room shielding modification.« less

Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed-methods longitudinal prospective cohort study.

PubMed

Gorter, Jan Willem; Stewart, Deb; Cohen, Eyal; Hlyva, Oksana; Morrison, Andrea; Galuppi, Barb; Nguyen, Tram; Amaria, Khush; Punthakee, Zubin

2015-05-06

To assess use, utility and impact of transition interventions designed to support and empower self-management in youth with chronic health conditions during transition into adult healthcare. A 4-year mixed-method prospective cohort study. 2 academic paediatric hospitals (13 clinics) in Canada. 50 adolescents (42% male; mean age 17.9±0.9 years; 20 underlying diagnoses) with transfer to adult care planned within 1 year. The Youth KIT (an organisational tool that includes goal setting activities); an online transition mentor. Frequency of use, utility and impact of the transition interventions; goal achievement; post-transfer qualitative interviews with youth. 50 participants were enrolled during their last year of paediatric care; 36 (72%) were followed into adult care. All participants had access to the transition interventions from enrolment until the end of the study (exposure time: 12-47 months). Most youth (85%) reported using the medical/health section of the Youth KIT at least once; 20 (40%) participants engaged in chats with the mentor. The overall perceived utility of both interventions was modest; the Youth KIT received the highest ratings for 'help with goal setting': (mean (SD): 4.2 (2.3)) on a 7-point Likert scale. 45 (90%) participants set 294 transition goals. Goal achievement performance and satisfaction increased over time (p≤0.001). The qualitative evidence revealed reasons behind the variability in use and utility of the interventions, the interconnectedness of life-course and healthcare transitions, and the need for stronger partnerships between paediatric and adult healthcare systems. Participants' perceptions about the utility of the Youth KIT and the online mentor were modest. Transition supports need to be carefully tailored, timed and integrated into healthcare systems. Individualised goal setting may be an important 'active ingredient' in optimising transition supports and outcomes. Interventions that focus on youth only are insufficient for empowering self-management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed-methods longitudinal prospective cohort study

PubMed Central

Gorter, Jan Willem; Stewart, Deb; Cohen, Eyal; Hlyva, Oksana; Morrison, Andrea; Galuppi, Barb; Nguyen, Tram; Amaria, Khush; Punthakee, Zubin

2015-01-01

Objectives To assess use, utility and impact of transition interventions designed to support and empower self-management in youth with chronic health conditions during transition into adult healthcare. Design A 4-year mixed-method prospective cohort study. Setting 2 academic paediatric hospitals (13 clinics) in Canada. Participants 50 adolescents (42% male; mean age 17.9±0.9 years; 20 underlying diagnoses) with transfer to adult care planned within 1 year. Interventions The Youth KIT (an organisational tool that includes goal setting activities); an online transition mentor. Main outcome measures Frequency of use, utility and impact of the transition interventions; goal achievement; post-transfer qualitative interviews with youth. Results 50 participants were enrolled during their last year of paediatric care; 36 (72%) were followed into adult care. All participants had access to the transition interventions from enrolment until the end of the study (exposure time: 12–47 months). Most youth (85%) reported using the medical/health section of the Youth KIT at least once; 20 (40%) participants engaged in chats with the mentor. The overall perceived utility of both interventions was modest; the Youth KIT received the highest ratings for ‘help with goal setting’: (mean (SD): 4.2 (2.3)) on a 7-point Likert scale. 45 (90%) participants set 294 transition goals. Goal achievement performance and satisfaction increased over time (p≤0.001). The qualitative evidence revealed reasons behind the variability in use and utility of the interventions, the interconnectedness of life-course and healthcare transitions, and the need for stronger partnerships between paediatric and adult healthcare systems. Conclusions Participants’ perceptions about the utility of the Youth KIT and the online mentor were modest. Transition supports need to be carefully tailored, timed and integrated into healthcare systems. Individualised goal setting may be an important ‘active ingredient’ in optimising transition supports and outcomes. Interventions that focus on youth only are insufficient for empowering self-management. PMID:25948409

Positive-Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support.

PubMed

Petrova, Mariya; Wyman, Peter A; Schmeelk-Cone, Karen; Pisani, Anthony R

2015-12-01

Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty-six classrooms in four schools (N = 706 students) were randomized to (1) peer leader modeling of healthy coping, (2) peer leader modeling plus audience involvement to identify trusted adults, or (3) control condition. Students' attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than nonsuicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors. © 2015 The American Association of Suicidology.

Effects of Web-Mediated Teacher Professional Development on the Language and Literacy Skills of Children Enrolled in Pre-Kindergarten Programs

PubMed Central

Downer, Jason; Pianta, Robert; Fan, Xitao; Hamre, Bridget; Mashburn, Andrew; Justice, Laura

2012-01-01

As early education grows in the United States, in-service professional development in key instructional and interaction skills is a core component of capacity-building in early childhood education. In this paper, we describe results from an evaluation of the effects of MyTeachingPartner, a web-based system of professional development, on language and literacy development during pre-kindergarten for 1338 children in 161 teachers’ classrooms. High levels of support for teachers’ implementation of language/literacy activities showed modest but significant effects for improving early language and literacy for children in classrooms in which English was the dominant language spoken by the students and teachers. The combination of web-based supports, including video-based consultation and web-based video teaching exemplars, was more effective at improving children’s literacy and language skills than was only making available to teachers a set of instructional materials and detailed lesson guides. These results suggest the importance of targeted, practice-focused supports for teachers in designing professional development systems for effective teaching in early childhood programs. PMID:23144591

Significance of Perceived Social Expectation and Implications to Conservation Education: Turtle Conservation as a Case Study

NASA Astrophysics Data System (ADS)

Lo, Alex Y.; Chow, Alex T.; Cheung, Sze Man

2012-11-01

The likelihood of participating in wildlife conservation programs is dependent on social influences and circumstances. This view is validated by a case study of behavioral intention to support conservation of Asian turtles. A total of 776 college students in China completed a questionnaire survey designed to identify factors associated with their intention to support conservation. A regression model explained 48 % of variance in the level of intention. Perceived social expectation was the strongest predictor, followed by attitudes toward turtle protection and perceived behavioral control, altogether explaining 44 %. Strong ethics and socio-economic variables had some statistical significant impacts and accounted for 3 % of the variance. The effects of general environmental awareness, trust and responsibility ascription were modest. Knowledge about turtles was a weak predictor. We conclude that perceived social expectation is a limiting factor of conservation behavior. Sustained interest and commitment to conservation can be created by enhancing positive social influences. Conservation educators should explore the potential of professionally supported, group-based actions that can nurture a sense of collective achievement as part of an educational campaign.

Positive-Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates’ Coping Attitudes and Perceptions of Adult Support

PubMed Central

Petrova, Mariya; Wyman, Peter A.; Schmeelk-Cone, Karen; Pisani, Anthony R.

2015-01-01

Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty six classrooms in four schools (N=706 students) were randomized to: (a) peer leader modeling of healthy coping, (b) peer leader modeling plus audience involvement to identify trusted adults, or (c) control condition. Students’ attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than non-suicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors. PMID:25692382

The development, evolution, and status of Holland's theory of vocational personalities: Reflections and future directions for counseling psychology.

PubMed

Nauta, Margaret M

2010-01-01

This article celebrates the 50th anniversary of the introduction of John L. Holland's (1959) theory of vocational personalities and work environments by describing the theory's development and evolution, its instrumentation, and its current status. Hallmarks of Holland's theory are its empirical testability and its user-friendliness. By constructing measures for operationalizing the theory's constructs, Holland and his colleagues helped ensure that the theory could be implemented in practice on a widespread basis. Empirical data offer considerable support for the existence of Holland's RIASEC types and their ordering among persons and environments. Although Holland's congruence hypotheses have received empirical support, congruence appears to have modest predictive power. Mixed support exists for Holland's hypotheses involving the secondary constructs of differentiation, consistency, and vocational identity. Evidence of the continued impact of Holland's theory on the field of counseling psychology, particularly in the area of interest assessment, can be seen from its frequent implementation in practice and its use by scholars. Ideas for future research and practice using Holland's theory are suggested.

Measuring Supportive Music and Imagery Interventions: The Development of the Music Therapy Self-Rating Scale.

PubMed

Meadows, Anthony; Burns, Debra S; Perkins, Susan M

2015-01-01

Previous research has demonstrated modest benefits from music-based interventions, specifically music and imagery interventions, during cancer care. However, little attention has been paid to measuring the benefits of music-based interventions using measurement instruments specifically designed to account for the multidimensional nature of music-imagery experiences. The purpose of this study was to describe the development of, and psychometrically evaluate, the Music Therapy Self-Rating Scale (MTSRS) as a measure for cancer patients engaged in supportive music and imagery interventions. An exploratory factor analysis using baseline data from 76 patients who consented to participate in a music-based intervention study during chemotherapy. Factor analysis of 14 items revealed four domains: Awareness of Body, Emotionally Focused, Personal Resources, and Treatment Specific. Internal reliability was excellent (Cronbach alphas ranging from 0.75 to 0.88) and construct and divergent-discriminant validity supported. The MTSRS is a psychometrically sound, brief instrument that captures essential elements of patient experience during music and imagery interventions. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Middle East in 2015: The Impact of Regional Trends in U.S. Strategic Planning

DTIC Science & Technology

2002-07-01

longevity , the activation of a Syrian- Israeli track, or the American election cycle—will eliminate the need to provide economic assistance and investment...to do so. But the movement toward elected, albeit still largely consultative, bodies pioneered by Kuwait has been followed in more modest measure in...The trends described in these chapters reflect an appreciation of demography , the natural laws of economics, history, and the deter- mination of human

An Interaction between KSHV ORF57 and UIF Provides mRNA-Adaptor Redundancy in Herpesvirus Intronless mRNA Export

PubMed Central

Jackson, Brian R.; Boyne, James R.; Noerenberg, Marko; Taylor, Adam; Hautbergue, Guillaume M.; Walsh, Matthew J.; Wheat, Rachel; Blackbourn, David J.; Wilson, Stuart A.; Whitehouse, Adrian

2011-01-01

The hTREX complex mediates cellular bulk mRNA nuclear export by recruiting the nuclear export factor, TAP, via a direct interaction with the export adaptor, Aly. Intriguingly however, depletion of Aly only leads to a modest reduction in cellular mRNA nuclear export, suggesting the existence of additional mRNA nuclear export adaptor proteins. In order to efficiently export Kaposi's sarcoma-associated herpesvirus (KSHV) intronless mRNAs from the nucleus, the KSHV ORF57 protein recruits hTREX onto viral intronless mRNAs allowing access to the TAP-mediated export pathway. Similarly however, depletion of Aly only leads to a modest reduction in the nuclear export of KSHV intronless mRNAs. Herein, we identify a novel interaction between ORF57 and the cellular protein, UIF. We provide the first evidence that the ORF57-UIF interaction enables the recruitment of hTREX and TAP to KSHV intronless mRNAs in Aly-depleted cells. Strikingly, depletion of both Aly and UIF inhibits the formation of an ORF57-mediated nuclear export competent ribonucleoprotein particle and consequently prevents ORF57-mediated mRNA nuclear export and KSHV protein production. Importantly, these findings highlight that redundancy exists in the eukaryotic system for certain hTREX components involved in the mRNA nuclear export of intronless KSHV mRNAs. PMID:21814512

Evaluating the buffering vs. direct effects hypotheses of emotional social support on inflammatory markers: the multi-ethnic study of atherosclerosis.

PubMed

Mezuk, Briana; Diez Roux, Ana V; Seeman, Teresa

2010-11-01

Social support is associated with cardiovascular disease mortality, however, the physiologic mechanisms underlying this relationship remains unspecified. This study evaluated the association of social support with inflammatory markers associated with cardiovascular risk: C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen. We evaluated two competing models of the support-inflammation relationship: first, that low social support is directly associated with inflammation, and second, that high support acts to buffer the effect of stress on inflammation. Using data from the baseline interview of the Multi-Ethnic Study of Atherosclerosis (N = 6814, 53% female, age 45-84 years) we assessed the independent and interacting associations of social support and stress with inflammation. Social support was measured by the emotional social support index. Stressors in multiple domains (work, family, finances, interpersonal) were assessed. Serum CRP, IL-6, and fibrinogen were analyzed from fasting samples using high-sensitivity assays. Multivariate linear regression, including models stratified by gender and age group (45-64 and 65-84 years), was used to assess the direct and buffering relationships between social support, stress, and inflammation. In bivariate analyses low social support was associated with higher levels of all three markers. In adjusted models, low support was associated with higher lnCRP (B: 0.15, 95% CI: 0.01, 0.30) among men but not women. High social support buffered the relationship between stress and CRP among middle-aged women only (P for interaction 0.042). Overall, social support was only modestly associated with inflammation in this relatively healthy sample, and these relationships varied by age and gender. Copyright © 2010 Elsevier Inc. All rights reserved.

Evaluating the buffering vs. direct effects hypotheses of emotional social support on inflammatory markers: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

Mezuk, Briana; Roux, Ana V. Diez; Seeman, Teresa

2010-01-01

Social support is associated with cardiovascular disease mortality, however the physiologic mechanisms underlying this relationship remains unspecified. This study evaluated the association of social support with inflammatory markers associated with cardiovascular risk: C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen. We evaluated two competing models of the support-inflammation relationship: first, that low social support is directly associated with inflammation, and second, that high support acts to buffer the effect of stress on inflammation. Using data from the baseline interview of the Multi-Ethnic Study of Atherosclerosis (N = 6,814, 53% female, age 45–84 years) we assessed the independent and interacting associations of social support and stress with inflammation. Social support was measured by the Emotional Social Support Index. Stressors in multiple domains (work, family, finances, interpersonal) were assessed. Serum CRP, IL-6, and fibrinogen were analyzed from fasting samples using high-sensitivity assays. Multivariate linear regression, including models stratified by gender and age group (45 – 64 and 65 – 84 years), was used to assess the direct and buffering relationships between social support, stress, and inflammation. In bivariate analyses low social support was associated with higher levels of all three markers. In adjusted models, low support was associated with higher lnCRP (B: 0.15, 95% CI: 0.01, 0.30) among men but not women. High social support buffered the relationship between stress and CRP among middle-aged women only (P for interaction 0.042). Overall, social support was only modestly associated with inflammation in this relatively healthy sample, and these relationships varied by age and gender. PMID:20600815

Energy and Cost Associated with Ventilating Office Buildings in a Tropical Climate

PubMed Central

Rim, Donghyun; Schiavon, Stefano; Nazaroff, William W.

2015-01-01

Providing sufficient amounts of outdoor air to occupants is a critical building function for supporting occupant health, well-being and productivity. In tropical climates, high ventilation rates require substantial amounts of energy to cool and dehumidify supply air. This study evaluates the energy consumption and associated cost for thermally conditioning outdoor air provided for building ventilation in tropical climates, considering Singapore as an example locale. We investigated the influence on energy consumption and cost of the following factors: outdoor air temperature and humidity, ventilation rate (L/s per person), indoor air temperature and humidity, air conditioning system coefficient of performance (COP), and cost of electricity. Results show that dehumidification of outdoor air accounts for more than 80% of the energy needed for building ventilation in Singapore’s tropical climate. Improved system performance and/or a small increase in the indoor temperature set point would permit relatively large ventilation rates (such as 25 L/s per person) at modest or no cost increment. Overall, even in a thermally demanding tropical climate, the energy cost associated with increasing ventilation rate up to 25 L/s per person is less than 1% of the wages of an office worker in an advanced economy like Singapore’s. This result implies that the benefits of increasing outdoor air ventilation rate up to 25 L/s per person — which is suggested to provide for productivity increases, lower sick building syndrome symptom prevalence, and reduced sick leave — can be much larger than the incremental cost of ventilation. PMID:25822504

Taking an Antibiotic Time-out: Utilization and Usability of a Self-Stewardship Time-out Program for Renewal of Vancomycin and Piperacillin-Tazobactam.

PubMed

Graber, Christopher J; Jones, Makoto M; Glassman, Peter A; Weir, Charlene; Butler, Jorie; Nechodom, Kevin; Kay, Chad L; Furman, Amy E; Tran, Thuong T; Foltz, Christopher; Pollack, Lori A; Samore, Matthew H; Goetz, Matthew Bidwell

2015-11-01

Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign. In the first 6 months of program implementation, vancomycin was discontinued by day 5 in 93/145 (64%) courses where a time-out was performed on day 4 versus in 96/199 (48%) 1 year prior (P = .04). Seven vancomycin continuations via template (5% of time-outs) were guideline-discordant by retrospective chart review versus none 1 year prior (P = .002). Piperacillin-tazobactam was discontinued by day 5 in 70/105 (67%) courses versus 58/93 (62%) 1 year prior (P = .55); 9 continuations (9% of time-outs) were guideline-discordant versus two 1 year prior (P = .06). A usability survey completed by 32 physicians demonstrated modest satisfaction with the overall program, antimicrobial dashboard, and renewal templates. By providing practitioners with clinical informatics support and guidance, the intervention increased provider confidence in making decisions to de-escalate antimicrobial therapy in ambiguous circumstances wherein they previously sought authorization for continuation from an antimicrobial steward.

Critically re-evaluating a common technique: Accuracy, reliability, and confirmation bias of EMG.

PubMed

Narayanaswami, Pushpa; Geisbush, Thomas; Jones, Lyell; Weiss, Michael; Mozaffar, Tahseen; Gronseth, Gary; Rutkove, Seward B

2016-01-19

(1) To assess the diagnostic accuracy of EMG in radiculopathy. (2) To evaluate the intrarater reliability and interrater reliability of EMG in radiculopathy. (3) To assess the presence of confirmation bias in EMG. Three experienced academic electromyographers interpreted 3 compact discs with 20 EMG videos (10 normal, 10 radiculopathy) in a blinded, standardized fashion without information regarding the nature of the study. The EMGs were interpreted 3 times (discs A, B, C) 1 month apart. Clinical information was provided only with disc C. Intrarater reliability was calculated by comparing interpretations in discs A and B, interrater reliability by comparing interpretation between reviewers. Confirmation bias was estimated by the difference in correct interpretations when clinical information was provided. Sensitivity was similar to previous reports (77%, confidence interval [CI] 63%-90%); specificity was 71%, CI 56%-85%. Intrarater reliability was good (κ 0.61, 95% CI 0.41-0.81); interrater reliability was lower (κ 0.53, CI 0.35-0.71). There was no substantial confirmation bias when clinical information was provided (absolute difference in correct responses 2.2%, CI -13.3% to 17.7%); the study lacked precision to exclude moderate confirmation bias. This study supports that (1) serial EMG studies should be performed by the same electromyographer since intrarater reliability is better than interrater reliability; (2) knowledge of clinical information does not bias EMG interpretation substantially; (3) EMG has moderate diagnostic accuracy for radiculopathy with modest specificity and electromyographers should exercise caution interpreting mild abnormalities. This study provides Class III evidence that EMG has moderate diagnostic accuracy and specificity for radiculopathy. © 2015 American Academy of Neurology.

Critically re-evaluating a common technique

PubMed Central

Geisbush, Thomas; Jones, Lyell; Weiss, Michael; Mozaffar, Tahseen; Gronseth, Gary; Rutkove, Seward B.

2016-01-01

Objectives: (1) To assess the diagnostic accuracy of EMG in radiculopathy. (2) To evaluate the intrarater reliability and interrater reliability of EMG in radiculopathy. (3) To assess the presence of confirmation bias in EMG. Methods: Three experienced academic electromyographers interpreted 3 compact discs with 20 EMG videos (10 normal, 10 radiculopathy) in a blinded, standardized fashion without information regarding the nature of the study. The EMGs were interpreted 3 times (discs A, B, C) 1 month apart. Clinical information was provided only with disc C. Intrarater reliability was calculated by comparing interpretations in discs A and B, interrater reliability by comparing interpretation between reviewers. Confirmation bias was estimated by the difference in correct interpretations when clinical information was provided. Results: Sensitivity was similar to previous reports (77%, confidence interval [CI] 63%–90%); specificity was 71%, CI 56%–85%. Intrarater reliability was good (κ 0.61, 95% CI 0.41–0.81); interrater reliability was lower (κ 0.53, CI 0.35–0.71). There was no substantial confirmation bias when clinical information was provided (absolute difference in correct responses 2.2%, CI −13.3% to 17.7%); the study lacked precision to exclude moderate confirmation bias. Conclusions: This study supports that (1) serial EMG studies should be performed by the same electromyographer since intrarater reliability is better than interrater reliability; (2) knowledge of clinical information does not bias EMG interpretation substantially; (3) EMG has moderate diagnostic accuracy for radiculopathy with modest specificity and electromyographers should exercise caution interpreting mild abnormalities. Classification of evidence: This study provides Class III evidence that EMG has moderate diagnostic accuracy and specificity for radiculopathy. PMID:26701380

Pharmacologic pain treatment of musculoskeletal disorders: current perspectives and future prospects.

PubMed

Curatolo, M; Bogduk, N

2001-03-01

The authors aimed to provide an educational update on the current evidence of the effectiveness of drug therapy in the treatment of musculoskeletal pain and to offer a perspective of possible future developments. The authors used a pragmatic review of data provided by available systematic reviews and seminal controlled studies pertaining to the treatment of regional musculoskeletal pain problems. Epidural steroids may offer limited, short-term benefit for sciatica. Local injections of steroids are either ineffective or provide short-lasting benefits. Nonsteroidal anti-inflammatory drugs and opioids reduce pain, but the effect size is modest. The literature does not support convincingly the use of antidepressants. Certain muscle relaxants may be useful in the treatment of back pain. Hyaluronic acid, neutraceutical agents, avocado-soybean unsaponifiable agents, oxaceprol and diacerein may be effective in the treatment of osteoarthritis, but the information regarding these new agents does not allow wholesale endorsement of these substances. Selective epidural injection of steroids at a target nerve root approached through the intervertebral foramin has the potential to replace the traditional epidural approach. Long-acting, C--fiber-specific local anesthetics are under investigation and could provide long-lasting pain relief without motor or sensory impairment. In the future, central hypersensitivity in chronic musculoskeletal pain might be treated using antagonists of the N-methyl-D-aspartate receptor. Cannabinoid agents produce antinociception and prevent experimentally induced hyperalgesia in animals, and they may find a role in pain management. Methods to optimize drug combinations are available. The effectiveness of the currently available drugs in the treatment of musculoskeletal pain conditions is disappointing. Recent developments may open new perspectives in this area of pain medicine.

What is "grazing"? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition.

PubMed

Conceição, Eva M; Mitchell, James E; Engel, Scott G; Machado, Paulo P P; Lancaster, Kathryn; Wonderlich, Stephen A

2014-01-01

Grazing, characterized by a repetitive eating pattern, has received increased attention among bariatric surgery patients. However, different definitions and terminology have been used, preventing the accurate measurement of this phenomenon and comparison of data across studies. To review existing definitions and associated clinical features of grazing among different samples and to propose a standardized definition that will allow for consistency in future work. University and Clinical Research Institute. Of the 39 studies found, 9 provided an original definition and 12 provided data of its association with weight outcomes. Six were studies of nonbariatric surgery populations. Based on this literature review, the most common criteria used in previous studies to define grazing were included in a survey that was sent to 24 individuals who have published work in the field. These experts were asked to provide their opinion on what should constitute grazing. Grazing is a frequent behavior in the bariatric surgery population as well as in eating disordered and community samples. Its association with psychopathology is not clear, but its negative impact on weight outcomes after bariatric surgery generally has been supported. Survey data provided a consensus regarding the definition of grazing as an eating behavior characterized by the repetitive eating (more than twice) of small/modest amounts of food in an unplanned manner, with what we characterize as compulsive and noncompulsive subtypes. Given the clinical relevance of grazing among bariatric surgery patients, a unique definition is crucial to better study its associated features and impact on different populations. Copyright © 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.

The DELTA PREP Initiative: Accelerating Coalition Capacity for Intimate Partner Violence Prevention.

PubMed

Zakocs, Ronda; Freire, Kimberley E

2015-08-01

The DELTA PREP Project aimed to build the prevention capacity of 19 state domestic violence coalitions by offering eight supports designed to promote prevention integration over a 3-year period: modest grant awards, training events, technical assistance, action planning, coaching hubs, the Coalition Prevention Capacity Assessment, an online workstation, and the online documentation support system. Using quantitative and qualitative data, we sought to explain how coalitions integrated prevention within their structures and functions and document how DELTA PREP supports contributed to coalitions' integration process. We found that coalitions followed a common pathway to integrate prevention. First, coalitions exhibited precursors of organizational readiness, especially having prevention champions. Second, coalitions engaged in five critical actions: engaging in dialogue, learning about prevention, forming teams, soliciting input from the coalition, and action planning. Last, by engaging in these critical actions, coalitions enhanced two key organizational readiness factors-developing a common understanding of prevention and an organizational commitment to prevention. We also found that DELTA PREP supports contributed to coalitions' abilities to integrate prevention by supporting learning about prevention, fostering a prevention team, and engaging in action planning by leveraging existing opportunities. Two DELTA PREP supports-coaching hubs and the workstation-did not work as initially intended. From the DELTA PREP experience, we offer several lessons to consider when designing future prevention capacity-building initiatives. © 2015 Society for Public Health Education.

Evidence for triclosan-induced activation of human and rodent xenobiotic nuclear receptors.

PubMed

Paul, Katie B; Thompson, Jerry T; Simmons, Steven O; Vanden Heuvel, John P; Crofton, Kevin M

2013-10-01

The bacteriostat triclosan (2,4,4'-trichloro-2'-hydroxydiphenylether) (TCS) decreases rat serum thyroxine via putative nuclear receptor (NR) interaction(s) and subsequent transcriptional up-regulation of hepatic catabolism and clearance. However, due to the evolutionary divergence of the constitutive androstane and pregnane-X receptors (CAR, PXR), TCS-mediated downstream effects may be species-dependent. To test the hypothesis that TCS activates xenobiotic NRs across species, cell-based NR reporter assays were employed to assess potential activation of rat, mouse, and human PXR, and rat, mouse, and three splice variants of human CAR. TCS activated hPXR, acted as an inverse agonist of hCAR1, and as a weak agonist of hCAR3. TCS failed to activate rPXR in full-length receptor reporter assays, and instead acted as a modest inverse agonist of rCAR. Consistent with the rat data, TCS also failed to activate mPXR and was a modest inverse agonist of mCAR. These data suggest that TCS may interact with multiple NRs, including hPXR, hCAR1, hCAR3, and rCAR in order to potentially affect hepatic catabolism. Overall these data support the conclusion that TCS may interact with NRs to regulate hepatic catabolism and downstream thyroid hormone homeostasis in both rat and human models, though perhaps by divergent mechanisms. Published by Elsevier Ltd.

Heritability of insomnia symptoms in youth and their relationship to depression and anxiety.

PubMed

Gehrman, Philip R; Meltzer, Lisa J; Moore, Melisa; Pack, Allan I; Perlis, Michael L; Eaves, Lindon J; Silberg, Judy L

2011-12-01

Insomnia is a highly prevalent sleep disorder yet little is known about the role of genetic factors in its pathophysiology. The aim of this study was to examine the relative contributions of genetic and environmental factors in explaining variability in insomnia symptoms. Traditional twin design. Academic medical center. 1412 twin pairs aged 8-16 years (48.8% MZ, 47.2% DZ, 4.0% indeterminate). None. Ratings of insomnia symptoms, depression, and overanxious disorder were made by trained interviewers based on DSM-III-R criteria. ACE models were conducted using Mx statistical software. Insomnia symptoms were prevalent in this sample based both on parental (6.6%) and youth (19.5%) reports. The overall heritability of insomnia symptoms was modest (30.7%), with the remaining variance attributed to unique environmental effects. There was no evidence of sex differences in the prevalence of insomnia symptoms or in the contribution of genetic and environmental effects. In multivariate models, there was support for insomnia-specific unique environmental effects over and above overlapping effects with depression and overanxious disorder, but no evidence for insomnia-specific genetic effects. Genetic factors play a modest role in the etiology of insomnia symptoms in 8-16 year-olds. These effects overlap with the genetics of depression and overanxious disorder. Further work is needed to determine which genes confer risk for all three disorders.

Self-phase modulation and two-photon absorption imaging of cells and active neurons

NASA Astrophysics Data System (ADS)

Fischer, Martin C.; Liu, Henry; Piletic, Ivan R.; Ye, Tong; Yasuda, Ryohei; Warren, Warren S.

2007-02-01

Even though multi-photon fluorescence microscopy offers higher resolution and better penetration depth than traditional fluorescence microscopy, its use is restricted to the detection of molecules that fluoresce. Two-photon absorption (TPA) imaging can provide contrast in non-fluorescent molecules while retaining the high resolution and sectioning capabilities of nonlinear imaging modalities. In the long-wavelength water window, tissue TPA is dominated by the endogenous molecules melanin and hemoglobin with an almost complete absence of endogenous two-photon fluorescence. A complementary nonlinear contrast mechanism is self-phase modulation (SPM), which can provide intrinsic signatures that can depend on local tissue anisotropy, chemical environment, or other structural properties. We have developed a spectral hole refilling measurement technique for TPA and SPM measurements using shaped ultrafast laser pulses. Here we report on a microscopy setup to simultaneously acquire 3D, high-resolution TPA and SPM images. We have acquired data in mounted B16 melanoma cells with very modest laser power levels. We will also discuss the possible application of this measurement technique to neuronal imaging. Since SPM is sensitive to material structure we can expect SPM properties of neurons to change during neuronal firing. Using our hole-refilling technique we have now demonstrated strong novel intrinsic nonlinear signatures of neuronal activation in a hippocampal brain slice. The observed changes in nonlinear signal upon collective activation were up to factors of two, unlike other intrinsic optical signal changes on the percent level. These results show that TPA and SPM imaging can provide important novel functional contrast in tissue using very modest power levels suitable for in vivo applications.

Endothelin-1 exacerbates development of hypertension and atherosclerosis in modest insulin resistant syndrome

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

Lin, Yan-Jie; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Juan, Chi-Chang

Endothelin-1 (ET-1) is known as potent vasoconstrictor, by virtue of its mitogenic effects, and may deteriorate the process of hypertension and atherosclerosis by aggravating hyperplasia and migration in VSMCs. Our previous study demonstrated that insulin infusion caused sequential induction of hyperinsulinemia, hyperendothelinemia, insulin resistance, and then hypertension in rats. However, the underlying mechanism of ET-1 interfere insulin signaling in VSMCs remains unclear. To characterize insulin signaling during modest insulin resistant syndrome, we established and monitored rats by feeding high fructose-diet (HFD) until high blood pressure and modest insulin resistance occurred. To explore the role of ET-1/ET{sub A}R during insulin resistance,more » ET{sub A}R expression, ET-1 binding, and insulin signaling were investigated in the HFD-fed rats and cultured A-10 VSMCs. Results showed that high blood pressure, tunica medial wall thickening, plasma ET-1 and insulin, and accompanied with modest insulin resistance without overweight and hyperglycemia occurred in early-stage HFD-fed rats. In the endothelium-denuded aorta from HFD-fed rats, ET{sub A}R expression, but not ET{sub B}R, and ET-1 binding in aorta were increased. Moreover, decreasing of insulin-induced Akt phosphorylation and increasing of insulin-induced ERK phosphorylation were observed in aorta during modest insulin resistance. Interestingly, in ET-1 pretreated VSMCs, the increment of insulin-induced Akt phosphorylation was decreased whereas the increment of insulin-induced ERK phosphorylation was increased. In addition, insulin potentiated ET-1-induced VSMCs migration and proliferation due to increasing ET-1 binding. ETAR antagonist reversed effects of ET-1 on insulin-induced signaling and VSMCs migration and proliferation. In summary, modest insulin resistance syndrome accompanied with hyperinsulinemia leading to the potentiation on ET-1-induced actions in aortic VSMCs. ET-1 via ET{sub A}R pathway suppressed insulin-induced AKT activation, whereas remained insulin-induced ERK activation. ET-1 and insulin synergistically potentiated migration and proliferation mainly through ET{sub A}R/ERK dependent pathway, which is dominant in VSMCs during modest insulin resistance syndrome. Therefore, ET-1 and ET{sub A}R are potential targets responsible for the observed synergism effect in the hypertensive atherosclerotic process through enhancement of ET-1 binding, ET-1 binding, ET{sub A}R expression, and ET-1-induced mitogenic actions in aortic VSMCs. - Highlights: • ET-1/ET{sub A}R signaling and insulin-induced pERK were high in modest insulin resistance. • ET-1 via ET{sub A}R suppressed insulin-induced pAKT but remained intact pERK in VSMCs. • Insulin potentiated ET-1-induced VSMC mitogenic action was ET{sub A}R/ERK dependent.« less

Calculating the costs of an 8-week, physiotherapy-led exercise intervention in deconditioned cancer survivors in the early survivorship period (the PEACH trial).

PubMed

Broderick, J M; Guinan, E; O' Donnell, D M; Hussey, J; Tyrrell, E; Normand, C

2014-06-01

Strong evidence exists for rehabilitation programmes following a cancer diagnosis, although little is known about their cost. The effects of an 8-week, physiotherapy-led, structured group intervention during the early survivorship phase were evaluated. Significant changes in quality of life and fatigue, and promising changes in fitness were found. The overall cost for this programme was €196 per participant, including the salaries of the clinicians, overheads and equipment costs. The modest costs associated with this programme may support more routine 'cancer rehabilitation', although more robust analyses are required. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Compact optics for high resolution spectroscopy of celestial x-ray sources

NASA Astrophysics Data System (ADS)

Cash, W.; Lillie, C.; McEntaffer, R.; Zhang, W.

2011-05-01

The astronomy community has never flown a celestial source spectrograph that can resolve natural line widths in absorption the way the ultraviolet community since OAO-3 Copernicus in 1972. Yet there is important science to be mined there, and right now there are now missions on track to pursue it. We present a modified off-plane grating spectrograph design that will support high resolution (λ/δλ ~ 4000) in the soft x-ray band with a high packing density that will enable a modest cost space mission. We discuss the design for the WHIMEx mission which was proposed as an Explorer earlier this year with the goal of detecting high temperature oxygen in the Intergalactic Medium.

Synergistic Effect of Carbon Nanotubes and Graphene on Diopside Scaffolds

PubMed Central

Liu, Tingting; Wu, Ping; Gao, Chengde; Feng, Pei; Xiao, Tao; Deng, Youwen; Shuai, Cijun; Peng, Shuping

2016-01-01

A synergetic effect between carbon nanotubes (CNTs) and graphene on diopside (Di) scaffolds was demonstrated. 3D network architecture in the matrix was formed through the 1D CNTs inlaid among the 2D graphene platelets (GNPs). The mechanical properties of the CNTs/GNPs/Di scaffolds were significantly improved compared with the CNTs/Di scaffolds and GNPs/Di scaffolds. In addition, the scaffolds exhibited excellent apatite-forming ability, a modest degradation rate, and stable mechanical properties in simulated body fluid (SBF). Moreover, cell culturing tests indicated that the scaffolds supported the cells attachment and proliferation. Taken together, the CNTs/GNPs/Di scaffolds offered great potential for bone tissue engineering. PMID:27144173

Structure of perceived handicap in middle-aged males with noise-induced hearing loss, with and without tinnitus.

PubMed

Hallberg, L R; Johnsson, T; Axelsson, A

1993-01-01

By using a modified stepwise regression analysis technique, the structure of self-perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing loss was described. Handicap was related to three clusters of variables, reflecting individual, environmental, and socioeconomic aspects, and 60% of the variance in self-perceived handicap was explained by the representatives of these clusters: i.e. 'acceptance of hearing problems', 'social support related to tinnitus' and 'years of education'. Tinnitus had no impact of its own on self-perceived handicap and only a modest portion (36%) of the variance in tinnitus annoyance was explained by 'sleep disturbance' and 'auditory perceptual difficulties'.

An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda.

PubMed

Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K

2014-12-01

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. © The Author(s) 2013.

Milestones toward Majorana-based quantum computing

NASA Astrophysics Data System (ADS)

Alicea, Jason

Experiments on nanowire-based Majorana platforms now appear poised to move beyond the preliminary problem of zero-mode detection and towards loftier goals of realizing non-Abelian statistics and quantum information applications. Using an approach that synthesizes recent materials growth breakthroughs with tools long successfully deployed in quantum-dot research, I will outline a number of relatively modest milestones that progressively bridge the gap between the current state of the art and these grand longer-term challenges. The intermediate Majorana experiments surveyed in this talk should be broadly adaptable to other approaches as well. Supported by the National Science Foundation (DMR-1341822), Institute for Quantum Information and Matter, and Walter Burke Institute at Caltech.

Social Support, Self-Efficacy for Decision Making, and Follow-up Care Use in Long-term Cancer Survivors

PubMed Central

Forsythe, Laura P.; Alfano, Catherine M.; Kent, Erin E.; Weaver, Kathryn E.; Bellizzi, Keith; Arora, Neeraj; Aziz, Noreen; Keel, Gretchen; Rowland, Julia H.

2014-01-01

Objective Cancer survivors play an important role in coordinating their follow-up care and making treatment-related decisions. Little is known about how modifiable factors like social support are associated with active participation in follow-up care. This study tests associations between social support, cancer-related follow-up care use, and self-efficacy for participation in decision making related to follow-up care (SEDM). We also identified sociodemographic and clinical factors associated with social support among long-term survivors. Methods The FOllow-up Care Use among Survivors (FOCUS) study is a cross-sectional, population based survey of breast, prostate, colon, and gynecologic cancer survivors (n=1522) 4 to 14 years post-diagnosis. Multivariable regression models were used to test associations between perceived social support (tangible and emotional/informational support modeled separately), follow-up care use (past two years), and SEDM, as well as to identify factors associated with perceived support. Results Neither support type was associated with follow-up care use (all p>0.05), although marital status was uniquely, positively associated with follow-up care use (p<0.05). Both tangible support (B for a standard deviation increase (SE)=9.75(3.15), p<0.05) and emotional/informational support (B(SE)=12.61(3.05), p<0.001) were modestly associated with SEDM. Being married, having adequate financial resources, history of recurrence, and better perceived health status were associated with higher perceived tangible and emotional support (all p<0.05). Conclusions While perceived social support may facilitate survivor efficacy for participation in decision making during cancer follow-up care, other factors, including marital satisfaction, appear to influence follow-up care use. Marital status and social support may be important factors to consider in survivorship care planning. PMID:24481884

Social support, self-efficacy for decision-making, and follow-up care use in long-term cancer survivors.

PubMed

Forsythe, Laura P; Alfano, Catherine M; Kent, Erin E; Weaver, Kathryn E; Bellizzi, Keith; Arora, Neeraj; Aziz, Noreen; Keel, Gretchen; Rowland, Julia H

2014-07-01

Cancer survivors play an important role in coordinating their follow-up care and making treatment-related decisions. Little is known about how modifiable factors such as social support are associated with active participation in follow-up care. This study tests associations between social support, cancer-related follow-up care use, and self-efficacy for participation in decision-making related to follow-up care (SEDM). We also identified sociodemographic and clinical factors associated with social support among long-term survivors. The FOllow-up Care Use among Survivors study is a cross-sectional, population-based survey of breast, prostate, colon, and gynecologic cancer survivors (n=1522) 4-14 years post-diagnosis. Multivariable regression models were used to test associations between perceived social support (tangible and emotional/informational support modeled separately), follow-up care use (past 2 years), and SEDM, as well as to identify factors associated with perceived support. Neither support type was associated with follow-up care use (all p>0.05), although marital status was uniquely, positively associated with follow-up care use (p<0.05). Both tangible support (B for a standard deviation increase (SE)=9.75(3.15), p<0.05) and emotional/informational support (B(SE)=12.61(3.05), p<0.001) were modestly associated with SEDM. Being married, having adequate financial resources, history of recurrence, and better perceived health status were associated with higher perceived tangible and emotional support (all p<0.05). While perceived social support may facilitate survivor efficacy for participation in decision-making during cancer follow-up care, other factors, including marital satisfaction, appear to influence follow-up care use. Marital status and social support may be important factors to consider in survivorship care planning. Copyright © 2014 John Wiley & Sons, Ltd.

An employee total health management-based survey of Iowa employers.

PubMed

Merchant, James A; Lind, David P; Kelly, Kevin M; Hall, Jennifer L

2013-12-01

To implement an Employee Total Health Management (ETHM) model-based questionnaire and provide estimates of model program elements among a statewide sample of Iowa employers. Survey a stratified random sample of Iowa employers, and characterize and estimate employer participation in ETHM program elements. Iowa employers are implementing less than 30% of all 12 components of ETHM, with the exception of occupational safety and health (46.6%) and workers' compensation insurance coverage (89.2%), but intend modest expansion of all components in the coming year. The ETHM questionnaire-based survey provides estimates of progress Iowa employers are making toward implementing components of Total Worker Health programs.

Constraints from primordial nucleosynthesis on the mass of the tau neutrino

NASA Technical Reports Server (NTRS)

Kolb, Edward W.; Turner, Michael S.; Chakravorty, A.; Schramm, David N.

1991-01-01

It is shown that primordial nucleosynthesis excludes a tau-neutrino mass from 0.3 to 25 MeV (Dirac) and 0.5 to 25 MeV (Majorana) provided that its lifetime is not less than about 1 sec, and from 0.3 to 30 MeV (Dirac) and 0.5 to 32 MeV (Majorana) for a lifetime of not less than about 1000 sec. A modest improvement in the laboratory mass limit - from 35 to 25 MeV - would imply that the tau-neutrino mass must be less than 0.5 MeV (provided the lifetime is not less than about 1 sec).

Applications of the Electrodynamic Tether to Interstellar Travel

NASA Technical Reports Server (NTRS)

Matloff, Gregory L.; Johnson, Les

2005-01-01

After considering relevant properties of the local interstellar medium and defining a sample interstellar mission, this paper considers possible interstellar applications of the electrodynamic tether, or EDT. These include use of the EDT to provide on-board power and affect trajectory modifications and direct application of the EDT to starship acceleration. It is demonstrated that comparatively modest EDTs can provide substantial quantities of on-board power, if combined with a large-area electron-collection device such as the Cassenti toroidal-field ramscoop. More substantial tethers can be used to accomplish large-radius thrustless turns. Direct application of the EDT to starship acceleration is apparently infeasible.

Nursing students' intentions to use research as a predictor of use one year post graduation: a prospective study.

PubMed

Forsman, Henrietta; Wallin, Lars; Gustavsson, Petter; Rudman, Ann

2012-09-01

Graduating nursing students are expected to have acquired the necessary skills to provide research-based care to patients. However, recent studies have shown that new graduate nurses report their extent of research use as relatively low. Because behavior intention is a well-known predictor of subsequent behavior, this gives reasons to further investigate graduating nursing students' intentions to use research in clinical practice after undergraduate study. To investigate graduating nursing students' intentions to use research in clinical practice and, furthermore, to investigate whether intention in itself and as a mediating variable can predict subsequent research use behavior in clinical practice one year post graduation. A follow-up study was performed of graduating nursing students in their final semester of undergraduate study (2006) and at one year post graduation (2008). Data were collected within the larger national survey LANE (Longitudinal Analysis of Nursing Education). A sample of 1319 respondents was prospectively followed. Graduating nursing students' intentions to use research instrumentally were studied as a predictor of their subsequent instrumental research use one year post graduation. A statistical full mediation model was tested to evaluate the effects of intention and factors from undergraduate study on subsequent research use in daily care. Thirty-four percent of the nursing students intended to use research on more than half or almost every working shift in their future clinical practice. Intention showed a direct effect on research use behavior. In addition, significant indirect effects on research use were shown for capability beliefs (regarding practicing the principles of evidence-based practice) and perceived support for research use (from campus and clinical education), where intention acted as a mediating factor for those effects. Students rated a modest level of intention to use research evidence. Intentions close to graduation acted as an essential predictor of subsequent research use behavior, both through a direct effect and as a mediating variable. These findings give support for designing future interventions aiming at influencing students' intention to use research to improve subsequent behavior. Focusing on strengthening students' capability beliefs and providing support for research use appear as promising target activities. Copyright © 2012 Elsevier Ltd. All rights reserved.

The reliability and validity of a portfolio designed as a programmatic assessment of performance in an integrated clinical placement.

PubMed

Roberts, Chris; Shadbolt, Narelle; Clark, Tyler; Simpson, Phillip

2014-09-20

Little is known about the technical adequacy of portfolios in reporting multiple complex academic and performance-based assessments. We explored, first, the influencing factors on the precision of scoring within a programmatic assessment of student learning outcomes within an integrated clinical placement. Second, the degree to which validity evidence supported interpretation of student scores. Within generalisability theory, we estimated the contribution that each wanted factor (i.e. student capability) and unwanted factors (e.g. the impact of assessors) made to the variation in portfolio task scores. Relative and absolute standard errors of measurement provided a confidence interval around a pre-determined pass/fail standard for all six tasks. Validity evidence was sought through demonstrating the internal consistency of the portfolio and exploring the relationship of student scores with clinical experience. The mean portfolio mark for 257 students, across 372 raters, based on six tasks, was 75.56 (SD, 6.68). For a single student on one assessment task, 11% of the variance in scores was due to true differences in student capability. The most significant interaction was context specificity (49%), the tendency for one student to engage with one task and not engage with another task. Rater subjectivity was 29%. An absolute standard error of measurement of 4.74%, gave a 95% CI of +/- 9.30%, and a 68% CI of +/- 4.74% around a pass/fail score of 57%. Construct validity was supported by demonstration of an assessment framework, the internal consistency of the portfolio tasks, and higher scores for students who did the clinical placement later in the academic year. A portfolio designed as a programmatic assessment of an integrated clinical placement has sufficient evidence of validity to support a specific interpretation of student scores around passing a clinical placement. It has modest precision in assessing students' achievement of a competency standard. There were identifiable areas for reducing measurement error and providing more certainty around decision-making. Reducing the measurement error would require engaging with the student body on the value of the tasks, more focussed academic and clinical supervisor training, and revisiting the rubric of the assessment in the light of feedback.

Obesity Prevention Programs for Children and Youth: Why Are Their Results so Modest?

ERIC Educational Resources Information Center

Thomas, Helen

2006-01-01

The purpose of this paper is to critically reflect upon the mixed/modest results of the primary studies related to the effectiveness of physical activity enhancement and improving nutritional intake in obesity prevention programs for children and youth. The results of a recent review of this topic that included 57 randomized controlled trials…

Impact of alternative land rental agreements on the profitability of cotton producers across the cotton belt

USDA-ARS?s Scientific Manuscript database

Across the Cotton Belt, cropland values increased, decreased, or remained constant, depending on the state, from 2007 to 2011. The average change in cropland values in the Cotton Belt from 2010 to 2011 was 3.6%, modest when compared to increases in the Corn Belt. However, even modest increases in la...

Manipulating riparian vegetation, large wood, and discharge in a gravel-cobble bed stream: channel response

NASA Astrophysics Data System (ADS)

McDowell, P. F.

2016-12-01

The Middle Fork John Day River at Oxbow Conservation Area, northeastern Oregon, experienced heavy cattle grazing for a number of decades and was dredge mined for gold in the 1930s-50s. As a result of dredging, flow was divided between the original meandering channel on the southern part of the floodplain and a straight dredged channel on the northern part of the floodplain. The Confederated Tribes of the Warm Springs acquired this property and began planning floodplain and instream restoration focused primarily on anadromous and resident salmonids. In 2000, cattle grazing in the riparian zone was eliminated, resulting in expansion of sedges and other plants on banks, bars and the channel bed. In 2003, riparian planting of woody vegetation began. In 2011, log structures were constructed in the south channel. The overarching goals of the log structure project were: 1) to add bank protection and roughness to accommodate the planned increase in discharge, and 2) to provide fish cover, pools, and channel complexity. In 2013, the north channel was closed and all flow was put in the south channel. This paper examines channel morphological response to these multiple actions. Channel adjustment was monitored through repeated channel cross-section surveys, longitudinal profile surveys, and analysis of planform change using high-resolution aerial imagery. I hypothesized that channel adjustment would be greatest where banks were less protected, and where bed materials were more mobile due to smaller size or local hydraulic factors such as bend curvature. The results indicate that there has been significant reorganization of riffle-pool structure in the longitudinal profile, but less change in cross-sections and planform. Cross-sections, both at log structures and not at structures, show limited bar aggradation and bank erosion. Some modest erosion occurred on banks protected by log structures. There is no increase in pool depth. The hypothesized relationship between channel change and hydraulic factors is not supported. With healthy riparian vegetation and log structures, this reach is relatively resistant to change, yet it continues to have an active and mobile gravel-cobble bed, even in years with modest floods.

Cynomolgus macaques naturally infected with Trypanosoma cruzi-I exhibit an overall mixed pro-inflammatory/modulated cytokine signature characteristic of human Chagas disease.

PubMed

Vitelli-Avelar, Danielle Marquete; Sathler-Avelar, Renato; Mattoso-Barbosa, Armanda Moreira; Gouin, Nicolas; Perdigão-de-Oliveira, Marcelo; Valério-Dos-Reis, Leydiane; Costa, Ronaldo Peres; Elói-Santos, Silvana Maria; Gomes, Matheus de Souza; Amaral, Laurence Rodrigues do; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; Dick, Edward J; Hubbard, Gene B; VandeBerg, Jane F; VandeBerg, John L

2017-02-01

Non-human primates have been shown to be useful models for Chagas disease. We previously reported that natural T. cruzi infection of cynomolgus macaques triggers clinical features and immunophenotypic changes of peripheral blood leukocytes resembling those observed in human Chagas disease. In the present study, we further characterize the cytokine-mediated microenvironment to provide supportive evidence of the utility of cynomolgus macaques as a model for drug development for human Chagas disease. In this cross-sectional study design, flow cytometry and systems biology approaches were used to characterize the ex vivo and in vitro T. cruzi-specific functional cytokine signature of circulating leukocytes from TcI-T. cruzi naturally infected cynomolgus macaques (CH). Results showed that CH presented an overall CD4+-derived IFN-γ pattern regulated by IL-10-derived from CD4+ T-cells and B-cells, contrasting with the baseline profile observed in non-infected hosts (NI). Homologous TcI-T. cruzi-antigen recall in vitro induced a broad pro-inflammatory cytokine response in CH, mediated by TNF from innate/adaptive cells, counterbalanced by monocyte/B-cell-derived IL-10. TcIV-antigen triggered a more selective cytokine signature mediated by NK and T-cell-derived IFN-γ with modest regulation by IL-10 from T-cells. While NI presented a cytokine network comprised of small number of neighborhood connections, CH displayed a complex cross-talk amongst network elements. Noteworthy, was the ability of TcI-antigen to drive a complex global pro-inflammatory network mediated by TNF and IFN-γ from NK-cells, CD4+ and CD8+ T-cells, regulated by IL-10+CD8+ T-cells, in contrast to the TcIV-antigens that trigger a modest network, with moderate connecting edges. Altogether, our findings demonstrated that CH present a pro-inflammatory/regulatory cytokine signature similar to that observed in human Chagas disease. These data bring additional insights that further validate these non-human primates as experimental models for Chagas disease.

Concepts of health: women's struggle for wholeness in the midst of poverty.

PubMed

Polakoff, Elizabeth; Gregory, David

2002-12-01

This article describes the findings of a modest qualitative study that deals with the concept of health and involves the women-centered interviewing of six women who live in poverty. The themes uncovered in this study identify the struggle for wholeness in the midst of poverty. The findings validate many of the nursing theorists' definitions of health as wholeness, and challenge care providers to bring an appreciation of this view to their understanding of women's health.

Tube furnace

DOEpatents

Foster, Kenneth G.; Frohwein, Eugene J.; Taylor, Robert W.; Bowen, David W.

1991-01-01

A vermiculite insulated tube furnace is heated by a helically-wound resistance wire positioned within a helical groove on the surface of a ceramic cylinder, that in turn is surroundingly disposed about a doubly slotted stainless steel cylindrical liner. For uniform heating, the pitch of the helix is of shorter length over the two end portions of the ceramic cylinder. The furnace is of large volume, provides uniform temperature, offers an extremely precise programmed heating capability, features very rapid cool-down, and has a modest electrical power requirement.

Advanced concepts in joining by conventional processes

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

Edwards, G.R.; Fasching-James, A.A.; Onsoien, M.I.

1994-12-31

Innovations which can be made to conventional arc welding processes so that advanced materials can be more efficiently joined are considered. Three examples are discussed: (1) GTA welding of iron aluminides, (2) GMA welding of advanced steels, and (3) SMA welding of structural steels. Advanced materials present new challenges for the materials joining specialist. The three examples discussed in this paper demonstrate, however, that modest but creative alterations of conventional GTAW, GMAW, or SMAW processes can provide new and better controls for solving advanced materials joining problems.

Public Health's Lean Year.

PubMed

Price, Sean

2017-08-01

Medicine's agenda advanced on many fronts in the 2017 Texas Legislature, but it made only modest gains in public health. The most significant came in a package of reforms and budget increases for mental health care. Other victories included the passage of House Bill 62, a statewide ban on texting while driving, and House Bill 3576, which provides resources to the Texas Department of State Health Services to track, study, and prevent the spread of Zika. Medicine kept several bad public health bills bottled up in committee.

Highly Loaded Low-Pressure Turbine: Design, Numerical and Experimental Analysis (Preprint)

DTIC Science & Technology

2010-06-01

can be up 30 percent of the total weight of an aircraft engine [2], and may contain as many as 1 Copyright c⃝ 2010 by ASME 2000 individual airfoils ...reduction in stage count in a gas turbine engine and a de- crease in the part count of an individual airfoil row. The test data presented here provide...the vane row having modest design goals. So, while the Zweifel coefficient of the blade row was set Figure 1. Turbine design loop used to define the

How To Improve Work In Planetarium?

NASA Astrophysics Data System (ADS)

Pavicic, G.

2009-09-01

Planetariums can provide an immersive environment for scientific education, virtual reality, and entertainment (Shaw 1998). Digital projection into domes, called "full dome projection", can be a technically challenging and expensive exercise, particularly for installation with a modest budget. Here we present an alternative full dome digital projection system, which consists of a single projector and a spherical mirror that scatter the light onto the dome surface. This approach offers many advantages over the fisheye lens alternatives, and results in a similar quality for just a fraction of costs.

Effects of nutritional supplementation on periodontal parameters, carotenoid antioxidant levels, and serum C-reactive protein.

PubMed

Harpenau, Lisa A; Cheema, Abida T; Zingale, Joseph A; Chambers, David W; Lundergan, William P

2011-05-01

Few studies have focused on the role of nutrition in periodontal disease. The purpose of this trial was to determine the effect of a nutritional supplement on gingival inflammation, bleeding, probing depth, clinical attachment level, carotenoid antioxidant level, and C-reactive protein. The test supplement, consisting of a standard multivitamin formula, as well as several phytonutrients associated with antiinflammatory/antioxidant effects, provided modest benefits in reducing inflammation; however, further studies with larger populations and longer intervention are warranted.

Glutaminase-Deficient Mice Display Hippocampal Hypoactivity, Insensitivity to Pro-Psychotic Drugs and Potentiated Latent Inhibition: Relevance to Schizophrenia

PubMed Central

Gaisler-Salomon, Inna; Miller, Gretchen M; Chuhma, Nao; Lee, Sooyeon; Zhang, Hong; Ghoddoussi, Farhad; Lewandowski, Nicole; Fairhurst, Stephen; Wang, Yvonne; Conjard-Duplany, Agnès; Masson, Justine; Balsam, Peter; Hen, René; Arancio, Ottavio; Galloway, Matthew P; Moore, Holly M; Small, Scott A; Rayport, Stephen

2009-01-01

Dysregulated glutamatergic neurotransmission has been strongly implicated in the pathophysiology of schizophrenia (SCZ). Recently, presynaptic modulation of glutamate transmission has been shown to have therapeutic promise. We asked whether genetic knockdown of glutaminase (gene GLS1) to reduce glutamatergic transmission presynaptically by slowing the recycling of glutamine to glutamate, would produce a phenotype relevant to SCZ and its treatment. GLS1 heterozygous (GLS1 het) mice showed about a 50% global reduction in glutaminase activity, and a modest reduction in glutamate levels in brain regions relevant to SCZ pathophysiology, but displayed neither general behavioral abnormalities nor SCZ-associated phenotypes. Functional imaging, measuring regional cerebral blood volume, showed hippocampal hypometabolism mainly in the CA1 subregion and subiculum, the inverse of recent clinical imaging findings in prodromal and SCZ patients. GLS1 het mice were less sensitive to the behavioral stimulating effects of amphetamine, showed a reduction in amphetamine-induced striatal dopamine release and in ketamine-induced frontal cortical activation, suggesting that GLS1 het mice are resistant to the effects of these pro-psychotic challenges. Moreover, GLS1 het mice showed clozapine-like potentiation of latent inhibition, suggesting that reduction in glutaminase has antipsychotic-like properties. These observations provide further support for the pivotal role of altered glutamatergic synaptic transmission in the pathophysiology of SCZ, and suggest that presynaptic modulation of the glutamine–glutamate pathway through glutaminase inhibition may provide a new direction for the pharmacotherapy of SCZ. PMID:19516252

Allele Identification for Transcriptome-Based Population Genomics in the Invasive Plant Centaurea solstitialis

PubMed Central

Dlugosch, Katrina M.; Lai, Zhao; Bonin, Aurélie; Hierro, José; Rieseberg, Loren H.

2013-01-01

Transcriptome sequences are becoming more broadly available for multiple individuals of the same species, providing opportunities to derive population genomic information from these datasets. Using the 454 Life Science Genome Sequencer FLX and FLX-Titanium next-generation platforms, we generated 11−430 Mbp of sequence for normalized cDNA for 40 wild genotypes of the invasive plant Centaurea solstitialis, yellow starthistle, from across its worldwide distribution. We examined the impact of sequencing effort on transcriptome recovery and overlap among individuals. To do this, we developed two novel publicly available software pipelines: SnoWhite for read cleaning before assembly, and AllelePipe for clustering of loci and allele identification in assembled datasets with or without a reference genome. AllelePipe is designed specifically for cases in which read depth information is not appropriate or available to assist with disentangling closely related paralogs from allelic variation, as in transcriptome or previously assembled libraries. We find that modest applications of sequencing effort recover most of the novel sequences present in the transcriptome of this species, including single-copy loci and a representative distribution of functional groups. In contrast, the coverage of variable sites, observation of heterozygosity, and overlap among different libraries are all highly dependent on sequencing effort. Nevertheless, the information gained from overlapping regions was informative regarding coarse population structure and variation across our small number of population samples, providing the first genetic evidence in support of hypothesized invasion scenarios. PMID:23390612

Pancreatic Cancer and Exposure to Dietary Nitrate and Nitrite in the NIH-AARP Diet and Health Study

PubMed Central

Aschebrook-Kilfoy, Briseis; Cross, Amanda J.; Stolzenberg-Solomon, Rachael Z.; Schatzkin, Arthur; Hollenbeck, Albert R.; Sinha, Rashmi; Ward, Mary H.

2011-01-01

Nitrate and nitrite are precursors of N-nitroso compounds, which induce tumors of the pancreas in animals. The authors evaluated the relation of dietary nitrate and nitrite to pancreatic cancer risk in the NIH-AARP Diet and Health Study. Nitrate and nitrite intakes were assessed at baseline using a 124-item food frequency questionnaire. During approximately 10 years of follow-up between 1995 and 2006, 1,728 incident pancreatic cancer cases were identified. There was no association between total nitrate or nitrite intake and pancreatic cancer in men or women. However, men in the highest quintile of summed nitrate/nitrite intake from processed meat had a nonsignificantly elevated risk of pancreatic cancer (hazard ratio = 1.18, 95% confidence interval: 0.95, 1.47; P-trend = 0.11). The authors observed a stronger increase in risk among men for nitrate/nitrite intake from processed meat at ages 12–13 years (highest quintile vs. lowest: hazard ratio = 1.32, 95% confidence interval: 0.99, 1.76; P-trend = 0.11), though the relation did not achieve statistical significance. The authors found no associations between adult or adolescent nitrate or nitrite intake from processed meats and pancreatic cancer among women. These results provide modest evidence that processed meat sources of dietary nitrate and nitrite may be associated with pancreatic cancer among men and provide no support for the hypothesis in women. PMID:21685410

Glutaminase-deficient mice display hippocampal hypoactivity, insensitivity to pro-psychotic drugs and potentiated latent inhibition: relevance to schizophrenia.

PubMed

Gaisler-Salomon, Inna; Miller, Gretchen M; Chuhma, Nao; Lee, Sooyeon; Zhang, Hong; Ghoddoussi, Farhad; Lewandowski, Nicole; Fairhurst, Stephen; Wang, Yvonne; Conjard-Duplany, Agnès; Masson, Justine; Balsam, Peter; Hen, René; Arancio, Ottavio; Galloway, Matthew P; Moore, Holly M; Small, Scott A; Rayport, Stephen

2009-09-01

Dysregulated glutamatergic neurotransmission has been strongly implicated in the pathophysiology of schizophrenia (SCZ). Recently, presynaptic modulation of glutamate transmission has been shown to have therapeutic promise. We asked whether genetic knockdown of glutaminase (gene GLS1) to reduce glutamatergic transmission presynaptically by slowing the recycling of glutamine to glutamate, would produce a phenotype relevant to SCZ and its treatment. GLS1 heterozygous (GLS1 het) mice showed about a 50% global reduction in glutaminase activity, and a modest reduction in glutamate levels in brain regions relevant to SCZ pathophysiology, but displayed neither general behavioral abnormalities nor SCZ-associated phenotypes. Functional imaging, measuring regional cerebral blood volume, showed hippocampal hypometabolism mainly in the CA1 subregion and subiculum, the inverse of recent clinical imaging findings in prodromal and SCZ patients. GLS1 het mice were less sensitive to the behavioral stimulating effects of amphetamine, showed a reduction in amphetamine-induced striatal dopamine release and in ketamine-induced frontal cortical activation, suggesting that GLS1 het mice are resistant to the effects of these pro-psychotic challenges. Moreover, GLS1 het mice showed clozapine-like potentiation of latent inhibition, suggesting that reduction in glutaminase has antipsychotic-like properties. These observations provide further support for the pivotal role of altered glutamatergic synaptic transmission in the pathophysiology of SCZ, and suggest that presynaptic modulation of the glutamine-glutamate pathway through glutaminase inhibition may provide a new direction for the pharmacotherapy of SCZ.

Neuroimaging Mechanisms of Therapeutic Transcranial Magnetic Stimulation for Major Depressive Disorder.

PubMed

Philip, Noah S; Barredo, Jennifer; Aiken, Emily; Carpenter, Linda L

2018-03-01

Research into therapeutic transcranial magnetic stimulation (TMS) for major depression has dramatically increased in the last decade. Understanding the mechanism of action of TMS is crucial to improve efficacy and develop the next generation of therapeutic stimulation. Early imaging research provided initial data supportive of widely held assumptions about hypothesized inhibitory or excitatory consequences of stimulation. Early work also indicated that while TMS modulated brain activity under the stimulation site, effects at deeper regions, in particular, the subgenual anterior cingulate cortex, were associated with clinical improvement. Concordant with earlier findings, functional connectivity studies also demonstrated that clinical improvements were related to changes distal, rather than proximal, to the site of stimulation. Moreover, recent work suggests that TMS modulates and potentially normalizes functional relationships between neural networks. An important observation that emerged from this review is that similar patterns of connectivity changes are observed across studies regardless of TMS parameters. Though promising, we stress that these imaging findings must be evaluated cautiously given the widespread reliance on modest sample sizes and little implementation of statistical validation. Additional limitations included use of imaging before and after a course of TMS, which provided little insight into changes that might occur during the weeks of stimulation. Furthermore, as studies to date have focused on depression, it is unclear whether our observations were related to mechanisms of action of TMS for depression or represented broader patterns of functional brain changes associated with clinical improvement. Published by Elsevier Inc.

Off-duty deviance: Organizational policies and evidence for two prevention strategies.

PubMed

Lyons, Brian D; Hoffman, Brian J; Bommer, William H; Kennedy, Colby L; Hetrick, Andrea L

2016-04-01

Anecdotal evidence suggests that organizations are increasingly concerned with employee off-duty deviance (ODD), yet management research has rarely investigated this type of deviant behavior. We define ODD as behaviors committed outside the workplace or when off-duty that are deviant by organizational and/or societal standards, jeopardize the employee's status within the organization, and threaten the interests and well-being of the organization and its stakeholders. Three studies are presented to better understand the relevance of ODD to modern organizations and then to understand potential approaches to reduce the incidence of ODD. The first study provides a qualitative review of publicly available ODD policies within the Fortune 500; the results showed that 13.4% of the Fortune 500 had a publicly available ODD policy, with the majority prohibiting criminal forms of ODD to protect the firm's reputation. The next 2 studies examine the efficacy of different approaches to reduce criminal ODD: policy adoption and personnel selection. In the second study, a longitudinal, quasi-experimental design showed a significant-albeit modest-reduction in criminal ODD following the adoption of a conduct policy. In the third and final study, a criterion-related validity design supported the predictive validity of general mental ability and prior deviance in predicting criminal ODD. This compendium of studies provides an initial empirical investigation into ODD and offers implications relevant to the deviance literature, policy development, and personnel selection. (c) 2016 APA, all rights reserved).

Sleep disturbances as the hallmark of PTSD: where are we now?

PubMed

Germain, Anne

2013-04-01

The hypothesis that rapid eye movement (REM) sleep disturbances are the hallmark of posttraumatic stress disorder (PTSD), proposed by Ross and colleagues in 1989, has stimulated a wealth of clinical, preclinical, and animal studies on the role of sleep in the pathophysiology of PTSD. The present review revisits this influential hypothesis in light of clinical and experimental findings that have since accumulated. Polysomnographic studies conducted in adults with PTSD have yielded mixed findings regarding REM sleep disturbances, and they generally suggest modest and nonspecific sleep disruptions. Prospective and treatment studies have provided more robust evidence for the relationship between sleep disturbances and psychiatric outcomes and symptoms. Experimental animal and human studies that have probed the relationship between REM sleep and fear responses, as well as studies focused more broadly on sleep-dependent affective and memory processes, also provide strong support for the hypothesis that sleep plays an important role in PTSD-relevant processes. Overall, the literature suggests that disturbed REM or non-REM sleep can contribute to maladaptive stress and trauma responses and may constitute a modifiable risk factor for poor psychiatric outcomes. Clinicians need to consider that the chronic sleep disruption associated with nightmares may affect the efficacy of first-line PTSD treatments, but targeted sleep treatments may accelerate recovery from PTSD. The field is ripe for prospective and longitudinal studies in high-risk groups to clarify how changes in sleep physiology and neurobiology contribute to increased risk of poor psychiatric outcomes.

Dextran as a Generally Applicable Multivalent Scaffold for Improving Immunoglobulin-Binding Affinities of Peptide and Peptidomimetic Ligands

PubMed Central

2015-01-01

Molecules able to bind the antigen-binding sites of antibodies are of interest in medicine and immunology. Since most antibodies are bivalent, higher affinity recognition can be achieved through avidity effects in which a construct containing two or more copies of the ligand engages both arms of the immunoglobulin simultaneously. This can be achieved routinely by immobilizing antibody ligands at high density on solid surfaces, such as ELISA plates, but there is surprisingly little literature on scaffolds that routinely support bivalent binding of antibody ligands in solution, particularly for the important case of human IgG antibodies. Here we show that the simple strategy of linking two antigens with a polyethylene glycol (PEG) spacer long enough to span the two arms of an antibody results in higher affinity binding in some, but not all, cases. However, we found that the creation of multimeric constructs in which several antibody ligands are displayed on a dextran polymer reliably provides much higher affinity binding than is observed with the monomer in all cases tested. Since these dextran conjugates are simple to construct, they provide a general and convenient strategy to transform modest affinity antibody ligands into high affinity probes. An additional advantage is that the antibody ligands occupy only a small number of the reactive sites on the dextran, so that molecular cargo can be attached easily, creating molecules capable of delivering this cargo to cells displaying antigen-specific receptors. PMID:25073654

A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.

PubMed

Gordon, John B; Colby, Holly H; Bartelt, Tera; Jablonski, Debra; Krauthoefer, Mary L; Havens, Peter

2007-10-01

To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes. Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005. A tertiary care center pediatric hospital and medical school serving urban and rural patients. A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program. Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician. Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments. A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000. This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support.

Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.

PubMed

Oketch, Jecinter Akinyi; Paterson, Marie; Maunder, Eleni Winfred; Rollins, Nigel Campbell

2011-03-01

Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Responses of two understory herbs, Maianthemum canadense and Eurybia macrophylla, to experimental forest warming: early emergence is the key to enhanced reproductive output.

PubMed

Jacques, Marie-Hélène; Lapointe, Line; Rice, Karen; Montgomery, Rebecca A; Stefanski, Artur; Reich, Peter B

2015-10-01

Understory herbs might be the most sensitive plant form to global warming in deciduous forests, yet they have been little studied in the context of climate change. A field experiment set up in Minnesota, United States simulated global warming in a forest setting and provided the opportunity to study the responses of Maianthemum canadense and Eurybia macrophylla in their natural environment in interaction with other components of the ecosystem. Effects of +1.7° and +3.4°C treatments on growth, reproduction, phenology, and gas exchange were evaluated along with treatment effects on light, water, and nutrient availability, potential drivers of herb responses. Overall, growth and gas exchanges of these two species were modestly affected by warming. They emerged up to 16 (E. macrophylla) to 17 d (M. canadense) earlier in the heated plots than in control plots, supporting early-season carbon gain under high light conditions before canopy closure. This additional carbon gain in spring likely supported reproduction. Eurybia macrophylla only flowered in the heated plots, and both species had some aspect of reproduction that was highest in the +1.7°C treatment. The reduced reproductive effort in the +3.4°C plots was likely due to reduced soil water availability, counteracting positive effects of warming. Global warming might improve fitness of herbaceous species in deciduous forests, mainly by advancing their spring emergence. However, other impacts of global warming such as drier soils in the summer might partly reduce the carbon gain associated with early emergence. © 2015 Botanical Society of America.

How many genera and species of woolly monkeys (Atelidae, Platyrrhine, Primates) are there? The first molecular analysis of Lagothrix flavicauda, an endemic Peruvian primate species.

PubMed

Ruiz-García, Manuel; Pinedo-Castro, Myreya; Shostell, Joseph Mark

2014-10-01

We sequenced COI and COII mitochondrial genes of 141 Neotropical woolly monkeys to provide new insights concerning their phylogeography and phylogenetic relationships. For the first time, eight individuals of the endemic and extremely rare Peruvian yellow-tailed woolly monkey (flavicauda) were sequenced at these genes and compared with other Lagothrix taxa (poeppigii, lagotricha, lugens and cana). There were four main results. (1) L. flavicauda showed a gene diversity of zero, whereas poeppigii and lugens showed high levels of gene diversity and lagotricha and cana showed more modest levels of gene diversity. The absence of gene diversity found for L. flavicauda strongly supports that it is one of the 25 more endangered primates on earth; (2) Our genetic distance and phylogenetic analyses, which included many cases of genetic introgression and recent hybridization, suggest that all woolly monkeys could be included in one unique genus, Lagotrix, divided into two species: L. flavicauda and L. lagotricha. The last species is divided into at least four subspecies. Our molecular results agree with Fooden's (1963) classification, but do not support the classification proposed by Groves (2001). (3) Poeppigii was the first taxon within L. lagotricha to experience a mitochondrial haplotype diversification, while cana and lagotricha experienced more recent mitochondrial haplotype diversification; (4) Poeppigii and lagotricha were the taxa which showed the greatest evidence of population expansions in different Pleistocene periods, whereas lugens experienced a population declination in the last 25,000 YA. Copyright © 2014 Elsevier Inc. All rights reserved.

Aging Well: Observations From the Women’s Health Initiative Study

PubMed Central

Rillamas-Sun, Eileen; Cochrane, Barbara B.; La Croix, Andrea Z.; Seeman, Teresa E.; Tindle, Hilary A.; Zaslavsky, Oleg; Bird, Chloe E.; Johnson, Karen C.; Manson, JoAnn E.; Ockene, Judith K.; Seguin, Rebecca A.; Wallace, Robert B.

2016-01-01

Abstract Background. As the proportion of the population aged 80 and over accelerates, so does the value of understanding the processes of aging well. The purposes of this article are to: (a) review contemporary theoretical and conceptual perspectives on aging well, (b) describe indicators of aging well that reflect key concepts and perspectives as assessed in the Women’s Health Initiative (WHI) and (c) characterize the status of aging among women aged 80 and older using data obtained from WHI participants at the WHI Extension 2 follow-up. Methods. Data from the Lifestyle Questionnaire, which was administered from 2011 to 2012 during the WHI Follow-up Study (Extension 2), were analyzed to provide a profile of the WHI cohort with respect to aging well. Results. Data revealed substantial diversity in the cohort with respect to the various measures of aging well. Although many reported physical functioning levels consistent with disability, most rated their health as good or better. Most reported moderately high levels of resilience, self-control, and self-mastery but lower levels of environmental mastery. Finally, the cohort reported high levels of optimal aging as reflected by their high levels of emotional well-being and moderately high levels of life satisfaction and social support, but more modest levels of personal growth and purpose in life. Conclusions. The wide range of some dimensions of aging well suggest that further examination of predictors of positive coping and resilience in the face of aging-related disability could identify opportunities to support and facilitate aging well among U.S. women. PMID:26858322

Context and Opportunity: Multiple Perspectives on Parenting by Women With a Severe Mental Illness

PubMed Central

Barrow, Susan M.; Alexander, Mary Jane; McKinney, Jacki; Lawinski, Terese; Pratt, Christina

2014-01-01

Objective The capabilities framework and a community-based participatory research (CBPR) approach frame this study. We consider the real opportunities for parenting available for women with serious mental health diagnoses, despite complications posed by their own capacity, material constraints, social network disruptions, and, by law, custom and policy related to mental health conditions and child custody decisions. Method We convened focus groups with mothers currently living in shelters apart from their children, service providers in supported housing programs, grandmothers caring for children of mothers with mental health and substance use problems, and a policy discussion with mental health administrators. Qualitative analyses explored common and divergent perspectives on parenting experiences and aspirations of particularly marginalized mothers. Results Perspectives of mothers and other stakeholders converged in recognizing the parenting challenges facing mothers experiencing homelessness and mental health and substance use problems, but their views on the implications of this diverged sharply. Mothers’ current aspirations were limited by contextual obstacles to maintaining contact with children; other stakeholders saw contact as risky and reunification as improbable. All stakeholders described systemic barriers to supporting contact and ongoing mothering roles. Conclusions and Implications for Practice Evidence-based parenting interventions require facilitating policy contexts that do not foreclose parenting possibilities for mothers whose current challenges dictate modest immediate parenting goals. CBPR amplifies voices of lived experience to demonstrate what is possible over time for mothers with complex lives and histories. These become possibilities that a person can imagine for herself and are essential to inform the evidence base for practice and policy. PMID:24978622

Telephone Peer Counseling of Breastfeeding Among WIC Participants: A Randomized Controlled Trial

PubMed Central

Joyce, Ted; Sibley, Kelly; Arnold, Diane; Altindag, Onur

2014-01-01

OBJECTIVE: The US Surgeon General has recommended that peer counseling to support breastfeeding become a core service of the Supplemental Nutrition Program for Women, Infants, and Children (WIC). As of 2008, 50% of WIC clients received services from local WIC agencies that offered peer counseling. Little is known about the effectiveness of these peer counseling programs. Randomized controlled trials of peer counseling interventions among low-income women in the United States showed increases in breastfeeding initiation and duration, but it is doubtful that the level of support provided could be scaled up to service WIC participants nationally. We tested whether a telephone peer counseling program among WIC participants could increase breastfeeding initiation, duration, and exclusivity. METHODS: We randomly assigned 1948 WIC clients recruited during pregnancy who intended to breastfeed or were considering breastfeeding to 3 study arms: no peer counseling, 4 telephone contacts, or 8 telephone contacts. RESULTS: We combined 2 treatment arms because there was no difference in the distribution of peer contacts. Nonexclusive breastfeeding duration was greater at 3 months postpartum for all women in the treatment group (adjusted relative risk: 1.22; 95% confidence interval [CI]: 1.10–1.34) but greater at 6 months for Spanish-speaking clients only (adjusted relative risk: 1.29; 95% CI: 1.10–1.51). The likelihood of exclusive breastfeeding cessation was less among Spanish-speaking clients (adjusted odds ratio: 0.78; 95% CI: 0.68–0.89). CONCLUSIONS: A telephone peer counseling program achieved gains in nonexclusive breastfeeding but modest improvements in exclusive breastfeeding were limited to Spanish- speaking women. PMID:25092936

Treatment of severe male infertility by micromanipulation-assisted fertilization: an update.

PubMed

Tesarik, Jan; Mendoza, Carmen

2007-01-01

In the past 5-10 years the evolution of micromanipulation-assisted fertilization for the treatment of severe male infertility was marked by the introduction of new technical support, refinement of diagnostic methods for the evaluation of sperm developmental potential, and development of new treatment regimens for the newly discovered abnormalities. The new technical support involves the use of non-contact laser technology to assist micromanipulation for fertilization, the evolution of polarized microscopy-based optical systems to non-invasively detect the position of the meiotic spindle in living human oocytes, and the development of high-magnification optical systems for a better morphological selection of spermatozoa to be used for fertilization. Diagnostic approaches were enriched by commercial availability of kits for the analysis of sperm DNA integrity, leading to the definition of sperm nuclear DNA damage as a distinct cause of male infertility, and by the development of tests, based on heterologous ICSI, for detection of sperm failure to activate oocytes. Several treatment options for these conditions have been proposed and are currently being tested in larger-scale trials. Some technical improvement was also achieved in the field of in vitro maturation of germ cells from men with in vivo maturation arrest, but only a modest clinical improvement resulted from their application. As to the risk for the offspring, recent data are rather reassuring. Except for the risk of transmission of genetically based infertility, no straightforward evidence for a health risk derived from these techniques has been provided. Nevertheless, caution is necessary, particularly concerning the eventual increase in genomic-imprinting abnormalities.

Systematic review of SMART Recovery: Outcomes, process variables, and implications for research.

PubMed

Beck, Alison K; Forbes, Erin; Baker, Amanda L; Kelly, Peter J; Deane, Frank P; Shakeshaft, Anthony; Hunt, David; Kelly, John F

2017-02-01

Clinical guidelines recommend Self-Management and Recovery Training (SMART Recovery) and 12-step models of mutual aid as important sources of long-term support for addiction recovery. Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predominant 12-step approach. A similarly rigorous exploration of SMART Recovery has yet to be undertaken. We aim to address this gap by providing a systematic overview of the evidence for SMART Recovery in adults with problematic alcohol, substance, and/or behavioral addiction, including (i) a commentary on outcomes assessed, process variables, feasibility, current understanding of mental health outcomes, and (ii) a critical evaluation of the methodology. We searched six electronic peer-reviewed and four gray literature databases for English-language SMART Recovery literature. Articles were classified, assessed against standardized criteria, and checked by an independent assessor. Twelve studies (including three evaluations of effectiveness) were identified. Alcohol-related outcomes were the primary focus. Standardized assessment of nonalcohol substance use was infrequent. Information about behavioral addiction was restricted to limited prevalence data. Functional outcomes were rarely reported. Feasibility was largely indexed by attendance. Economic analysis has not been undertaken. Little is known about the variables that may influence treatment outcome, but attendance represents a potential candidate. Assessment and reporting of mental health status was poor. Although positive effects were found, the modest sample and diversity of methods prevent us from making conclusive remarks about efficacy. Further research is needed to understand the clinical and public health utility of SMART as a viable recovery support option. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

What do we know about the non-work determinants of workers' mental health? A systematic review of longitudinal studies

PubMed Central

2011-01-01

Background In the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers' mental health. Nevertheless, much less attention has been dedicated towards understanding the pathways through which other pivotal life environments might also concomitantly intervene, along with the work environment, to bring about mental health outcomes in the workforce. The aim of this study consisted in conducting a systematic review examining the relative contribution of non-work determinants to the prediction of workers' mental health in order to bridge that gap in knowledge. Methods We searched electronic databases and bibliographies up to 2008 for observational longitudinal studies jointly investigating work and non-work determinants of workers' mental health. A narrative synthesis (MOOSE) was performed to synthesize data and provide an assessment of study conceptual and methodological quality. Results Thirteen studies were selected for evaluation. Seven of these were of relatively high methodological quality. Assessment of study conceptual quality yielded modest analytical breadth and depth in the ways studies conceptualized the non-work domain as defined by family, network and community/society-level indicators. We found evidence of moderate strength supporting a causal association between social support from the networks and workers' mental health, but insufficient evidence of specific indicator involvement for other analytical levels considered (i.e., family, community/society). Conclusions Largely underinvestigated, non-work determinants are important to the prediction of workers' mental health. More longitudinal studies concomitantly investigating work and non-work determinants of workers' mental health are warranted to better inform healthy workplace research, intervention, and policy. PMID:21645393

Context and opportunity: multiple perspectives on parenting by women with a severe mental illness.

PubMed

Barrow, Susan M; Alexander, Mary Jane; McKinney, Jacki; Lawinski, Terese; Pratt, Christina

2014-09-01

The capabilities framework and a community-based participatory research (CBPR) approach frame this study. We consider the real opportunities for parenting available for women with serious mental health diagnoses, despite complications posed by their own capacity, material constraints, social network disruptions, and, by law, custom and policy related to mental health conditions and child custody decisions. We convened focus groups with mothers currently living in shelters apart from their children, service providers in supported housing programs, grandmothers caring for children of mothers with mental health and substance use problems, and a policy discussion with mental health administrators. Qualitative analyses explored common and divergent perspectives on parenting experiences and aspirations of particularly marginalized mothers. Perspectives of mothers and other stakeholders converged in recognizing the parenting challenges facing mothers experiencing homelessness and mental health and substance use problems, but their views on the implications of this diverged sharply. Mothers' current aspirations were limited by contextual obstacles to maintaining contact with children; other stakeholders saw contact as risky and reunification as improbable. All stakeholders described systemic barriers to supporting contact and ongoing mothering roles. Evidence-based parenting interventions require facilitating policy contexts that do not foreclose parenting possibilities for mothers whose current challenges dictate modest immediate parenting goals. CBPR amplifies voices of lived experience to demonstrate what is possible over time for mothers with complex lives and histories. These become possibilities that a person can imagine for herself and are essential to inform the evidence base for practice and policy. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Duration and mutual entrainment of changes in parenting practices engendered by behavioral parent training targeting recently separated mothers.

PubMed

Reed, Andrea; Snyder, James; Staats, Sarah; Forgatch, Marion S; Degarmo, David S; Patterson, Gerald R; Low, Sabina; Sinclair, Ryan; Schmidt, Nicole

2013-06-01

Parent management training (PMT) has beneficial effects on child and parent adjustment that last for 5 to 10 years. Short-term changes in parenting practices have been shown to mediate these effects, but the manner in which changes in specific components of parenting are sequenced and become reciprocally reinforcing (or mutually entrained) to engender and sustain the cascade of long-term beneficial effects resulting from PMT has received modest empirical attention. Long-term changes in parenting resulting from the Oregon model of PMT (PMTO) over a 2-year period were examined using data from the Oregon Divorce Study-II in which 238 recently separated mothers and their 6- to 10-year-old sons were randomly assigned to PMTO or a no treatment control (NTC) group. Multiple indicators of observed parenting practices were used to define constructs for positive parenting, monitoring and discipline at baseline, and at 6-, 12-, 18- and 30-months postbaseline. PMTO relative to NTC resulted in increased positive parenting and prevented deterioration in discipline and monitoring over the 30-month period. There were reliable sequential, transactional relationships among parenting practices; positive parenting supported better subsequent monitoring, and positive parenting and better monitoring supported subsequent effective discipline. Small improvements in parenting resulting from PMTO and small deteriorations in parenting in the NTC group may be sustained and amplified by mutually entrained relationships among parenting practices. These data about the change processes engendered by PMTO may provide information needed to enhance the power, effectiveness, and efficiency of behavioral parent training interventions.

STFM Behavioral Science/Family Systems Educator Fellowship: Evaluation of the First 4 Years.

PubMed

Gorski, Victoria; Taylor, Deborah A; Fletcher, Jason; Burge, Sandra K

2015-01-01

The discipline of family medicine has long valued the behavioral sciences. Most residency training programs employ a clinical psychologist, social worker, or family therapist to deliver behavioral science curriculum to their residents. However, the cultures and content of training for behavioral sciences and medical professions are quite different, leaving the lone behavioral scientist feeling professionally isolated and unprepared to translate knowledge and skills into tools for the family physician. In response to this need, a group of family medicine educators developed an STFM-sponsored fellowship for behavioral science faculty. The goals of the program were to improve fellows' understanding of the culture of family medicine, provide a curricular toolbox for the behavioral sciences, promote scholarship, and develop a supportive professional network. Senior behavioral science faculty at STFM developed a 1-year fellowship program, featuring "classroom learning" at relevant conferences, mentored small-group interactions, and scholarly project requirements. Achievement of program goals was evaluated annually with pre- and post-fellowship surveys. From 2010 to 2014, 59 fellows completed the program; most were psychologists or social workers; two thirds were women. One month after graduation, fellows reported significant increases in understanding the culture of medicine, improved confidence in their curricula and scholarship, and expanded professional networks, compared to pre-fellowship levels. The program required many hours of volunteer time by leaders, faculty, and mentors plus modest support from STFM staff. Leaders in family medicine education, confronted by the need for inter-professional development, designed and implemented a successful training program for behavioral science faculty.

Sexual behaviors and attitudes of high school students in the kingdom of Swaziland.

PubMed

Mclean, P E

1995-07-01

The author examined the sex behaviors and attitudes of 111 high school students with a steady partner in the Kingdom of Swaziland. Data were collected through participant observation during 1987-88, discussions with key informants during 1987-88 and 1990-91, and in-depth structured interviews with the adolescents from rural and urban government high schools. 78 of the students were coitally active, with 57.5% of boys and 68.4% of girls reporting first coitus at 16 years of age or younger. 15.0% of males and no females reported beginning coitus after 18 years of age. 45.0% of the boys and 68.4% of the girls reported never using contraception; 50% of males said they used condoms. Swaziland is largely polygynous. There were, however, modest gender differences on attitudes about multiple partners and demonstrating affection. The young women mainly expected financial support from a sex partner. Since many adolescent men cannot provide such support, many of the adolescent women pursue sexual relations with older, more financially capable men. The author notes that the parents of young Swazi women do not condone such relationships, especially if the man does not seem interested in marriage. No school policy exists on teaching family life education and both unplanned pregnancy and septic abortions are real problems. School policy demands the expulsion of pregnant girls for the duration of their pregnancy. Once delivered, the young mothers may attend a another school. Finally, although parental guidance is less influential than in the past, traditional values attached to gender roles remain intact among the adolescents interviewed for this study.

Modest Witness(ing) and Lively Stories: Paying Attention to Matters of Concern in Early Childhood

ERIC Educational Resources Information Center

Blaise, Mindy; Hamm, Catherine; Iorio, Jeanne Marie

2017-01-01

This article considers the role of early childhood education within these uncertain times of human induced climate change. It draws from feminism and environmental humanities to experiment with different ways of becoming-with the world. By bringing together Donna Haraway's figure of the Modest Witness and Deborah Bird Rose's notion of witnessing,…

A Librarian in Every School, Books in Every Home: A Modest Proposal

ERIC Educational Resources Information Center

Peterson, Bob

2010-01-01

This spring, the Milwaukee district announced major cuts to local school budgets for next year. At the 400-student elementary school where the author works, the projected cuts meant that, despite a modest increase in student enrollment, they had to cut an additional staff position. Given that in the past few years budget cuts had forced them to…

MODEST: a web-based design tool for oligonucleotide-mediated genome engineering and recombineering

PubMed Central

Bonde, Mads T.; Klausen, Michael S.; Anderson, Mads V.; Wallin, Annika I.N.; Wang, Harris H.; Sommer, Morten O.A.

2014-01-01

Recombineering and multiplex automated genome engineering (MAGE) offer the possibility to rapidly modify multiple genomic or plasmid sites at high efficiencies. This enables efficient creation of genetic variants including both single mutants with specifically targeted modifications as well as combinatorial cell libraries. Manual design of oligonucleotides for these approaches can be tedious, time-consuming, and may not be practical for larger projects targeting many genomic sites. At present, the change from a desired phenotype (e.g. altered expression of a specific protein) to a designed MAGE oligo, which confers the corresponding genetic change, is performed manually. To address these challenges, we have developed the MAGE Oligo Design Tool (MODEST). This web-based tool allows designing of MAGE oligos for (i) tuning translation rates by modifying the ribosomal binding site, (ii) generating translational gene knockouts and (iii) introducing other coding or non-coding mutations, including amino acid substitutions, insertions, deletions and point mutations. The tool automatically designs oligos based on desired genotypic or phenotypic changes defined by the user, which can be used for high efficiency recombineering and MAGE. MODEST is available for free and is open to all users at http://modest.biosustain.dtu.dk. PMID:24838561

The added value of world views over self-views: Predicting modest behaviour in Eastern and Western cultures.

PubMed

Chen, Sylvia Xiaohua; Ng, Jacky C K; Buchtel, Emma E; Guan, Yanjun; Deng, Hong; Bond, Michael Harris

2017-12-01

Personality research has been focused on different aspects of the self, including traits, attitudes, beliefs, goals, and motivation. These aspects of the self are used to explain and predict social behaviour. The present research assessed generalized beliefs about the world, termed 'social axioms' (Leung et al., ), and examined their additive power over beliefs about the self in explaining a communal behaviour, that is, modesty. Three studies predicted reported modest behaviour among Mainland Chinese, Hong Kong Chinese, East Asian Canadians, and European Canadians. In addition to self-reports in Studies 1 and 2, informant reports from participants' parents and close friends were collected in Study 3 to construct a behavioural composite after examining the resulting multitrait-multimethod matrix and intraclass correlations. World views (operationalized as social axioms) explained additional variance in modest behaviour over and above self-views (operationalized as self-efficacy, self-construals, and trait modesty) in both Eastern and Western cultures. Variation in reports on three factors of modest behaviour was found across self-, parent, and friend perspectives, with significant differences across perspectives in self-effacement and other-enhancement, but not in avoidance of attention-seeking. © 2017 The British Psychological Society.

Electrospun fiber membranes enable proliferation of genetically modified cells

PubMed Central

Borjigin, Mandula; Eskridge, Chris; Niamat, Rohina; Strouse, Bryan; Bialk, Pawel; Kmiec, Eric B

2013-01-01

Polycaprolactone (PCL) and its blended composites (chitosan, gelatin, and lecithin) are well-established biomaterials that can enrich cell growth and enable tissue engineering. However, their application in the recovery and proliferation of genetically modified cells has not been studied. In the study reported here, we fabricated PCL-biomaterial blended fiber membranes, characterized them using physicochemical techniques, and used them as templates for the growth of genetically modified HCT116-19 colon cancer cells. Our data show that the blended polymers are highly miscible and form homogenous electrospun fiber membranes of uniform texture. The aligned PCL nanofibers support robust cell growth, yielding a 2.5-fold higher proliferation rate than cells plated on standard plastic plate surfaces. PCL-lecithin fiber membranes yielded a 2.7-fold higher rate of proliferation, while PCL-chitosan supported a more modest growth rate (1.5-fold higher). Surprisingly, PCL-gelatin did not enhance cell proliferation when compared to the rate of cell growth on plastic surfaces. PMID:23467983

Episodic memory change in late adulthood: generalizability across samples and performance indices.

PubMed

Dixon, Roger A; Wahlin, Ake; Maitland, Scott B; Hultsch, David F; Hertzog, Christopher; Bäckman, Lars

2004-07-01

Younger adults recall more information from episodic memory tasks than do older adults. Because longitudinal studies are rare and often incompatible, the extent of actual late-life memory change is not well established. We assemble two different longitudinal samples of normal older adults, each of which is tested twice at a 3-year interval, using a large battery of episodic memory indicators. Together, two-wave data from both the Victoria Longitudinal Study in Canada (n = 400) and the Kungsholmen Project in Sweden (n = 168) cover a 40-year span of adulthood, ranging from 54 to 94 years of age. Principal memory tasks include categorizable word lists, story recall, and random word lists, as well as indicators of cognitive support. Overall, an examination of performance on sets of common and complementary episodic tasks reveals that, for both samples, actual 3-year changes are modest and that, when decline occurs, it is gradual. The exception-greater decline for more supported tasks-suggests that these may be especially sensitive to late-life changes.

Assessing Clinical Research Capacity in Vietnam: A Framework for Strengthening Capability for Clinical Trials in Developing Countries.

PubMed

Kagan, Jonathan; Giang, Dao Duc; Iademarco, Michael F; Phung, Van Tt; Lau, Chuen-Yen; Quang, Nguyen Ngo

2016-01-01

Although improving health systems promises important benefits, most developing nations lack the resources to support nationally driven clinical research. Strengthened clinical research capacity can advance national health goals by supporting greater autonomy in aligning research with national priorities. From March through June 2010, we assessed six elements of clinical research capacity in Vietnam: research agenda; clinical investigators and biostatisticians; donors and sponsors; community involvement; scientific, ethical, safety, and quality oversight; and clinical research institutions. Assessments were drawn from interviews with investigators, Ministry of Health staff members, nongovernment organizations, and U.S. Mission staff members, and document review. Observations and recommendations were shared with collaborators. Reassessment in 2015 found growth in the number of clinical trials, improved regulation in human subjects protection and community engagement, and modest advances in research agenda setting. Training and investment in institutions remain challenging. A framework for assessing clinical research capacity can affirm strengths and weaknesses and guide the coordination of capacity-building efforts.

Impact of electronic health record clinical decision support on the management of pediatric obesity.

PubMed

Shaikh, Ulfat; Berrong, Jeanette; Nettiksimmons, Jasmine; Byrd, Robert S

2015-01-01

Clinicians vary significantly in their adherence to clinical guidelines for overweight/obesity. This study assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. The study team programmed a point-of-care alert linked to a checklist and standardized documentation templates to appear during health maintenance visits for overweight/obese children in an outpatient teaching clinic and compared outcomes through medical record reviews of 574 (287 control and 287 intervention) visits. The results demonstrated a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity. Although clinical guideline adherence increased significantly, it was far from universal. It is unknown if modest improvements in adherence to clinical guidelines translate to improvements in children's health. However, this intervention was relatively easy to implement and produced measurable improvements in health care delivery. © 2014 by the American College of Medical Quality.

Effects of Couple Interactions and Relationship Quality on Plasma Oxytocin and Cardiovascular Reactivity: Empirical Findings and Methodological Considerations

PubMed Central

Smith, Timothy W.; Uchino, Bert N.; MacKenzie, Justin; Hicks, Angela; Campo, Rebecca A.; Reblin, Maija; Grewen, Karen; Amico, Janet A.; Light, Kathleen C.

2016-01-01

Cardiovascular reactivity is a potential mechanism underlying associations of close relationship quality with cardiovascular disease. Two models describe oxytocin as another mechanism. The “calm and connect” model posits an association between positive relationship experiences and oxytocin levels and responses, whereas the “tend and befriend” model emphasizes the effects of negative relationship experiences in evoking oxytocin release. In this study of 180 younger couples, relationship quality had a small, marginally significant inverse association with plasma oxytocin levels, and neither positive nor negative couple interactions evoked change in plasma oxytocin. Negative couple interactions evoked significant cardiovascular reactivity, especially among women. Hence, in the largest study of these issues to date, there was little support for key tenets of the “calm and connect” model, and only very modest support for the ”tend and befriend” model. However, findings were consistent with the view that CVR contributes to the effects of relationship difficulties on health. PMID:22543270

Family Structure Transitions and Changes in Maternal Resources and Well-Being

PubMed Central

Osborne, Cynthia; Berger, Lawrence M.; Magnuson, Katherine

2013-01-01

This paper uses data from the Fragile Families and Child Wellbeing Study to examine whether family instability is associated with changes in perceived social support, material hardship, maternal depression, and parenting stress among mothers of young children. In addition to accounting for the number of transitions a mother experiences over the first five years of her child’s life, we pay close attention to the type and timing of these transitions. We find that mothers who transition to cohabitation or marriage with their child’s biological father experience declines in material hardship and that those who transition to cohabitation or marriage with another man exhibit modest declines in both material hardship and depression. Mothers who exit cohabiting or marital relationships encounter decreases in perceived social support and increases in material hardship, depression, and parenting stress. Overall, our results suggest that both the type and, to a much lesser degree, the timing of family structure transitions may influence maternal well-being. PMID:22215507

Climate Change Impacts on Rice Farming Systems in Northwestern Sri Lanka. Chapter 10

NASA Technical Reports Server (NTRS)

Zubair, Lareef; Nissanka, Sarath P.; Weerakoon, W. M. W.; Herath, Dumindu I.; Karunaratne, Asha S; Prabodha, A. S. M.; Agalawatte, M. B.; Herath, Rasnayaka; Yahiya, S. Zeenas; Punyawardhene, B. V. R.;

Marital Conflict in the Context of Parental Depressive Symptoms: Implications for the Development of Children’s Adjustment Problems

PubMed Central

Keller, Peggy S.; Cummings, E. Mark; Peterson, Kristina M.; Davies, Patrick T.

2008-01-01

Relations among parental depressive symptoms, overt and covert marital conflict, and child internalizing and externalizing symptoms were examined in a community sample of 235 couples and their children. Families were assessed once yearly for three years, starting when children were in kindergarten. Parents completed measures of depressive symptoms and children’s internalizing and externalizing symptoms. Behavioral observations of marital conflict behaviors (insult, threat, pursuit, and defensiveness) and self-report of covert negativity (feeling worry, sorry, worthless, and helpless) were assessed based on problem solving interactions. Results indicated that fathers’ greater covert negativity and mothers’ overt destructive conflict behaviors served as intervening variables in the link between fathers’ depressive symptoms and child internalizing symptoms, with modest support for the pathway through fathers’ covert negativity found even after controlling for earlier levels of constructs. These findings support the role of marital conflict in the impact of fathers’ depressive symptoms on child internalizing symptoms. PMID:20161202

Workplace social networks and their relationship with job outcomes and other employment characteristics for people with severe mental illness

PubMed Central

Rollins, Angela L.; Bond, Gary R.; Jones, Amanda M.; Kukla, Marina; Collins, Linda A.

2013-01-01

Clients with severe mental illness (SMI) often struggle in their efforts to maintain employment. One cause of early job terminations is interpersonal difficulties in the workplace. This study explored workplace social networks and their relationship with job outcomes and other employment characteristics for people with SMI. Results indicated that clients generally had positive experiences with both supervisors and coworkers. Contrary to our hypothesis, employment model was not associated with better workplace network characteristics. Also contrary to our hypothesis, clients employed in group placements did not differ in workplace network characteristics from those in competitive employment settings. Workplace network characteristics were robustly correlated with job satisfaction, but not strongly related to hourly wages or overall job tenure. Job tenure at the time of the workplace network assessment did show a few modest negative correlations with supervisor and coworker support, indicating declining perceived social network support with increasing job tenure. Study limitations and future directions for research using this methodology are discussed. PMID:24013773

Adult extracorporeal life support: a failed or forgotten concept?

PubMed

Colafranceschi, Alexandre Siciliano; Monteiro, Andrey José de Oliveira; Canale, Leonardo Secchin; Campos, Luiz Antonio de Almeida; Montera, Marcelo Westerlund; Silva, Paulo Roberto Dutra da; Fernandes, Marcelo Ramalho; Pinto, Alexandre de Araújo; Molas, Stelmar Moura; Mesquita, Evandro Tinoco

2008-07-01

The extracorporeal membrane oxygenation (ECMO) has been used in the neonatal and childhood periods with excellent results. The adult experience has been modest with inferior immediate results. The intermediate survival, however, has been promising. We have been using the extracorporeal membrane oxygenation for temporary mechanical circulatory support of adults that present with acute refractory cardiogenic shock in our institution. There is no other published experience of the use of this system in this scenario in Brazil. To describe our experience with the use of the extracorporeal membrane oxygenation for circulatory support in adults. Retrospective analysis of the medical files of patients submitted to the implant of extracorporeal membrane oxygenation system for circulatory assistance in acute and refractory cardiogenic shock. Eleven patients (63,5 yo; 45,5% male) were considered for analysis from 2005 to 2007. Median support time was 77 hours (10-240 h) and 5 patients have survived 30 days (45,5%). Two patients were subsequently submitted to prolonged paracorporeal circulatory assistance. Mortality on ECMO (6 patients) was due to multiple organ failure (66,6%) and refractory bleeding (33,4%). ECMO system is an option to be used in acute refractory cardiogenic shock as a bridge to recovery or selecting patients that might benefit from prolonged paracorporeal assist devices (bridge to bridge).