Visioning the Future: Scenarios Modeling of the Florida Coastal Everglades.

PubMed

Flower, Hilary; Rains, Mark; Fitz, Carl

2017-11-01

In this paper, we provide screening-level analysis of plausible Everglades ecosystem response by 2060 to sea level rise (0.50 m) interacting with macroclimate change (1.5 °C warming, 7% increase in evapotranspiration, and rainfall that either increases or decreases by 10%). We used these climate scenarios as input to the Ecological Landscape Model to simulate changes to seven interactive hydro-ecological metrics. Mangrove forest and other marine influences migrated up to 15 km inland in both scenarios, delineated by the saltwater front. Freshwater habitat area decreased by 25-30% under our two climate change scenarios and was largely replaced by mangroves and, in the increased rainfall scenario, open water as well. Significant mangroves drowned along northern Florida Bay in both climate change scenarios due to sea level rise. Increased rainfall of 10% provided significant benefits to the spatial and temporal salinity regime within the marine-influenced zone, providing a more gradual and natural adjustment for at-risk flora and fauna. However, increased rainfall also increased the risk of open water, due to water depths that inhibited mangrove establishment and reduced peat accumulation rates. We infer that ecological effects related to sea level rise may occur in the extreme front-edge of saltwater intrusion, that topography will control the incursion of this zone as sea level rises, and that differences in freshwater availability will have ecologically significant effects on ecosystem resilience through the temporal and spatial pattern of salinity changes.

Coffee and health: a review of recent human research.

PubMed

Higdon, Jane V; Frei, Balz

2006-01-01

Coffee is a complex mixture of chemicals that provides significant amounts of chlorogenic acid and caffeine. Unfiltered coffee is a significant source of cafestol and kahweol, which are diterpenes that have been implicated in the cholesterol-raising effects of coffee. The results of epidemiological research suggest that coffee consumption may help prevent several chronic diseases, including type 2 diabetes mellitus, Parkinson's disease and liver disease (cirrhosis and hepatocellular carcinoma). Most prospective cohort studies have not found coffee consumption to be associated with significantly increased cardiovascular disease risk. However, coffee consumption is associated with increases in several cardiovascular disease risk factors, including blood pressure and plasma homocysteine. At present, there is little evidence that coffee consumption increases the risk of cancer. For adults consuming moderate amounts of coffee (3-4 cups/d providing 300-400 mg/d of caffeine), there is little evidence of health risks and some evidence of health benefits. However, some groups, including people with hypertension, children, adolescents, and the elderly, may be more vulnerable to the adverse effects of caffeine. In addition, currently available evidence suggests that it may be prudent for pregnant women to limit coffee consumption to 3 cups/d providing no more than 300 mg/d of caffeine to exclude any increased probability of spontaneous abortion or impaired fetal growth.

Systemic racism moderates effects of provider racial biases on adherence to hypertension treatment for African Americans.

PubMed

Greer, Tawanda M; Brondolo, Elizabeth; Brown, Porschia

2014-01-01

The purpose of the current study was to examine perceived exposure to systemic racism as a moderator of the effects of perceived exposure to provider racial biases on treatment adherence and mistrust of health care for a sample of African American hypertensive patients. We hypothesized that patients who endorsed high levels of systemic racism would exhibit poor adherence to hypertension treatment and increased mistrust in health care in relation to perceptions of exposure to provider racial biases. The sample consisted of 100 African American patients who ranged in age from 24 to 82 years. All were diagnosed with hypertension and were recruited from an outpatient clinic located in the Southeastern region of the United States. Moderated regression analyses were performed to test the study hypotheses. Findings revealed a positive, significant main effect for perceived provider racial biases in predicting mistrust of care. This finding suggested that an increase in mistrust of health care was associated with increased perceptions of provider biases. In predicting treatment adherence, a significant interaction revealed that patients who endorsed low and moderate degrees of exposure to systemic racism displayed poor adherence to treatment in relation to greater perceptions of provider racial biases. The overall findings suggest that patients who perceive themselves as infrequently exposed to systemic racism possess the greatest risk for nonadherence to hypertension treatment in relation to increased perceptions of provider racial biases. Implications of the findings are discussed. 2014 APA, all rights reserved

Implementing electronic health records (EHRs): health care provider perceptions before and after transition from a local basic EHR to a commercial comprehensive EHR.

PubMed

Krousel-Wood, Marie; McCoy, Allison B; Ahia, Chad; Holt, Elizabeth W; Trapani, Donnalee N; Luo, Qingyang; Price-Haywood, Eboni G; Thomas, Eric J; Sittig, Dean F; Milani, Richard V

2018-06-01

We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models. A total of 223 providers completed all 3 surveys (30% response rate): 85.6% had outpatient practices, 56.5% were >45 years old, and 23.8% were primary care providers. The percentage of providers with positive perceptions significantly increased from baseline to long-term follow-up for patient communication, hospital transitions - access to clinical information, preventive care delivery, preventive care prompt, preventive lab prompt, satisfaction with system reliability, and sharing medical information (P < .05 for each). The percentage of providers with positive perceptions significantly decreased over time for overall satisfaction, productivity, better patient care, clinical decision quality, easy access to patient information, monitoring patients, more time for patients, coordination of care, computer access, adequate resources, and satisfaction with ease of use (P < 0.05 for each). Results varied by subgroup. After a transition to a commercial comprehensive EHR, items with significant increases and significant decreases in the percentage of providers with positive perceptions of EHR benefit were identified, overall and by subgroup.

Genetic education for primary care providers

PubMed Central

Carroll, June C.; Rideout, Andrea L.; Wilson, Brenda J.; Allanson, Judith MD; Blaine, Sean M.; Esplen, Mary Jane; Farrell, Sandra A.; Graham, Gail E.; MacKenzie, Jennifer; Meschino, Wendy; Miller, Fiona; Prakash, Preeti; Shuman, Cheryl; Summers, Anne; Taylor, Sherry

2009-01-01

ABSTRACT OBJECTIVE To increase primary care providers’ awareness and use of genetic services; increase their knowledge of genetic issues; increase their confidence in core genetic competencies; change their attitudes toward genetic testing for hereditary diseases; and increase their confidence as primary care genetic resources. DESIGN Participants completed a workshop and 3 questionnaires: a baseline questionnaire, a survey that provided immediate feedback on the workshop itself, and a follow-up questionnaire 6 months later. SETTING Ontario. PARTICIPANTS Primary care providers suggested by deans of nursing, midwifery, family medicine, and obstetric programs, as well as coordinators of nurse practitioner programs, in Ontario and by the Ontario College of Family Physicians. INTERVENTION A complex educational intervention was developed, including an interactive workshop and PowerPoint educational modules on genetic topics for participants’ use (available at www.mtsinai.on.ca/FamMedGen/). MAIN OUTCOME MEASURES Awareness and use of genetic services, knowledge of genetics, confidence in core clinical genetic skills, attitudes toward genetic testing, and teaching activities related to genetics. RESULTS The workshop was attended by 29 participants; of those, 21 completed the baseline questionnaire and the 6-month follow-up questionnaire. There was no significant change found in awareness or reported use of genetic services. There was significant improvement in self-assessed knowledge of (P = .001) and confidence in (P = .005) skills related to adult-onset genetic disorders. There were significant increases in confidence in many core genetic competencies, including assessing risk of hereditary disorders (P = .033), deciding who should be offered referral for genetic counseling (P = .003), discussing prenatal testing options (P = .034), discussing benefits, risks, and limitations of genetic testing (P = .033), and describing what to expect at a genetic counseling session (P = .022). There was a significant increase in the number of primary care providers agreeing that genetic testing was beneficial in the management of adult-onset diseases (P = .031) and in their confidence in being primary care genetic resources for adult-onset genetic disorders (P = .006). CONCLUSION Educational interventions that include interactive peer resource workshops and educational modules can increase knowledge of and confidence in the core competencies needed for the delivery of genetic services in primary care. PMID:20008584

Overview of paediatric obesity for the paediatric mental health provider.

PubMed

Scheimann, Ann O

2012-06-01

Childhood obesity represents a significant challenge for paediatric healthcare delivery. As obesity rates increase, obese children and adolescents are at significant risk for the development of a myriad of medical and surgical problems as well as mental health problems. Moreover, children with mental health problems are increasingly presenting to their psychiatrists with obesity. Treatment of paediatric obesity requires a multidisciplinary approach with incorporation of the family into the treatment plan although still typically only offering suboptimal results. Paediatric providers from all disciplines should focus efforts primarily on obesity prevention and encouragement of healthy lifestyles, while incorporating treatment for obesity when such efforts fail. The goals of this article are to provide an overview of the epidemiology, pathophysiology, genetics, clinical features and treatment strategies for paediatric obesity.

Caregiving for ill dependents and its association with employee health risks and productivity.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Conti, Daniel J; Pransky, Glenn; Edington, Dee W

2004-10-01

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and a self-report of time missed from work during the previous 2 weeks to care for an ill dependent. A total of 10.6% of the respondents reported an average of 7.7 hours absent from work during the previous 2-week period to provide care for an ill dependent. Caregiving also was associated with a significant increase in the number of health risks for the employee. As the demand for caregiving time increased, caregivers reported a significant increase in work limitations. Caregiving for an ill dependent is associated with increased absenteeism and significant work limitations while on the job. Programs and work organization that helps employees balance their caregiving responsibilities for ill dependents may have a positive effect on health and productivity.

AGN Science with AGIS

NASA Astrophysics Data System (ADS)

Coppi, Paolo

2009-05-01

AGIS, a proposed future gamma-ray telescope consisting of a square km array of 50 atmospheric Cherenkov telescopes, will provide a powerful new view of the high energy universe. The combination of its increased sensitivity (a factor 10 over current observatories), increased survey capabilities, and a low energy threshold (<30 GeV) that allows observations at energies not subject to absorption on extragalactic background light will result in a dramatic increase in the number of AGN accessible at high energies. The overall number of ``TeV blazar" AGN, those detected by current ground-based observatories, should increase by a factor 30 or more with a corresponding increase in the number of these that can be monitored at high statistical significance to test emission models rigorously. More excitingly, AGIS may also begin to pick up entirely new classes of AGN such as radio galaxies with X-ray emitting hotspots at large distances from the central engine, providing further insight into the outflows from AGN. The low AGIS threshold energy will also allow significant source overlap with objects detected by the recently launched Fermi gamma-ray space observatory at lower, GeV energies. AGIS will significantly improve on the localization and variability monitoring of the Fermi sources it sees.

Engaging traditional medicine providers in colorectal cancer screening education in a chinese american community: a pilot study.

PubMed

Wang, Jun; Burke, Adam; Tsoh, Janice Y; Le, Gem M; Stewart, Susan; Gildengorin, Ginny; Wong, Ching; Chow, Elaine; Woo, Kent; Nguyen, Tung T

2014-12-11

Although colorectal cancer (CRC) screening is effective in preventing colon cancer, it remains underused by Asian Americans. Because Chinese Americans often use traditional Chinese medicine (TCM), we conducted a pilot study to explore the feasibility and acceptability of having TCM providers deliver education about CRC screening. Four TCM providers (2 herbalists and 2 acupuncturists) were trained to deliver small-group educational sessions to promote CRC screening. Each provider recruited 15 participants aged 50 to 75. Participants completed a baseline survey on CRC-related knowledge, attitudes, and behaviors and then attended one 2-hour educational session delivered by the providers in Cantonese or Mandarin. Three months later, participants completed a postintervention survey. Sixty participants were recruited from the San Francisco Chinatown neighborhood. The average age was 62.4 years. Most participants had limited English proficiency (96.7%), annual household income less than $20,000 per year (60%), and low educational attainment (65.1% < high school education). At postintervention (n = 57), significant increases were found in having heard of CRC (from 52.6% to 79.0%, P < .001) and colon polyps (from 64.9% to 84.2%, P < .001). Knowledge regarding screening frequency recommendations also increased significantly. The rate of ever having received any CRC screening test increased from 71.9% to 82.5% (P <.001). The rate of up-to-date screening increased from 70.2% to 79.0% (P = .04). The findings suggest that TCM providers can be trained to deliver culturally and linguistically appropriate outreach on CRC screening within their community. Participants reached by TCM providers increased CRC knowledge and self-reported CRC screening.

Engaging Traditional Medicine Providers in Colorectal Cancer Screening Education in a Chinese American Community: A Pilot Study

PubMed Central

Burke, Adam; Tsoh, Janice Y.; Le, Gem M.; Stewart, Susan; Gildengorin, Ginny; Wong, Ching; Chow, Elaine; Woo, Kent; Nguyen, Tung T.

2014-01-01

Introduction Although colorectal cancer (CRC) screening is effective in preventing colon cancer, it remains underused by Asian Americans. Because Chinese Americans often use traditional Chinese medicine (TCM), we conducted a pilot study to explore the feasibility and acceptability of having TCM providers deliver education about CRC screening. Methods Four TCM providers (2 herbalists and 2 acupuncturists) were trained to deliver small-group educational sessions to promote CRC screening. Each provider recruited 15 participants aged 50 to 75. Participants completed a baseline survey on CRC-related knowledge, attitudes, and behaviors and then attended one 2-hour educational session delivered by the providers in Cantonese or Mandarin. Three months later, participants completed a postintervention survey. Results Sixty participants were recruited from the San Francisco Chinatown neighborhood. The average age was 62.4 years. Most participants had limited English proficiency (96.7%), annual household income less than $20,000 per year (60%), and low educational attainment (65.1% < high school education). At postintervention (n = 57), significant increases were found in having heard of CRC (from 52.6% to 79.0%, P < .001) and colon polyps (from 64.9% to 84.2%, P < .001). Knowledge regarding screening frequency recommendations also increased significantly. The rate of ever having received any CRC screening test increased from 71.9% to 82.5% (P <.001). The rate of up-to-date screening increased from 70.2% to 79.0% (P = .04). Conclusion The findings suggest that TCM providers can be trained to deliver culturally and linguistically appropriate outreach on CRC screening within their community. Participants reached by TCM providers increased CRC knowledge and self-reported CRC screening. PMID:25496557

Daily marijuana users with past alcohol problems increase alcohol consumption during marijuana abstinence.

PubMed

Peters, Erica N; Hughes, John R

2010-01-15

Drug abuse treatment programs typically recommend complete abstinence because of a fear that clients who stop use of one drug will substitute another. A within-subjects study investigated whether consumption of alcohol and other substances changes during marijuana abstinence. Twenty-eight daily marijuana users who were not trying to stop or reduce their marijuana consumption completed an 8-day baseline period in which they used marijuana and other drugs as usual, a 13-day marijuana abstinence period, and a 7-day return-to-baseline period. Participants provided self-report of substance use daily and submitted urine samples twice weekly to verify marijuana abstinence. A diagnosis of past alcohol abuse or dependence significantly moderated the alcohol increase from baseline to marijuana abstinence (p<0.01), such that individuals with this diagnosis significantly increased alcohol use (52% increase) but those without this history did not (3% increase). Increases in marijuana withdrawal discomfort scores and alcohol craving scores from baseline to marijuana abstinence significantly and positively correlated with increases in alcohol use. Increases in cigarettes, caffeine, and non-marijuana illicit drugs did not occur. This study provides empirical validation of drug substitution in a subgroup of daily marijuana users, but results need to be replicated in individuals who seek treatment for marijuana problems. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Do Lordotic Cages Provide Better Segmental Lordosis Versus Nonlordotic Cages in Lateral Lumbar Interbody Fusion (LLIF)?

PubMed

Sembrano, Jonathan N; Horazdovsky, Ryan D; Sharma, Amit K; Yson, Sharon C; Santos, Edward R G; Polly, David W

2017-05-01

A retrospective comparative radiographic review. To evaluate the radiographic changes brought about by lordotic and nonlordotic cages on segmental and regional lumbar sagittal alignment and disk height in lateral lumbar interbody fusion (LLIF). The effects of cage design on operative level segmental lordosis in posterior interbody fusion procedures have been reported. However, there are no studies comparing the effect of sagittal implant geometry in LLIF. This is a comparative radiographic analysis of consecutive LLIF procedures performed with use of lordotic and nonlordotic interbody cages. Forty patients (61 levels) underwent LLIF. Average age was 57 years (range, 30-83 y). Ten-degree lordotic PEEK cages were used at 31 lumbar interbody levels, and nonlordotic cages were used at 30 levels. The following parameters were measured on preoperative and postoperative radiographs: segmental lordosis; anterior and posterior disk heights at operative level; segmental lordosis at supra-level and subjacent level; and overall lumbar (L1-S1) lordosis. Measurement changes for each cage group were compared using paired t test analysis. The use of lordotic cages in LLIF resulted in a significant increase in lordosis at operative levels (2.8 degrees; P=0.01), whereas nonlordotic cages did not (0.6 degrees; P=0.71) when compared with preoperative segmental lordosis. Anterior and posterior disk heights were significantly increased in both groups (P<0.01). Neither cage group showed significant change in overall lumbar lordosis (lordotic P=0.86 vs. nonlordotic P=0.25). Lordotic cages provided significant increase in operative level segmental lordosis compared with nonlordotic cages although overall lumbar lordosis remained unchanged. Anterior and posterior disk heights were significantly increased by both cages, providing basis for indirect spinal decompression.

Therapeutic doses of oral methylphenidate significantly increase extracellular dopamine in the human brain.

PubMed

Volkow, N D; Wang, G; Fowler, J S; Logan, J; Gerasimov, M; Maynard, L; Ding, Y; Gatley, S J; Gifford, A; Franceschi, D

2001-01-15

Methylphenidate (Ritalin) is the most commonly prescribed psychoactive drug in children for the treatment of attention deficit hyperactivity disorder (ADHD), yet the mechanisms responsible for its therapeutic effects are poorly understood. Whereas methylphenidate blocks the dopamine transporter (main mechanism for removal of extracellular dopamine), it is unclear whether at doses used therapeutically it significantly changes extracellular dopamine (DA) concentration. Here we used positron emission tomography and [(11)C]raclopride (D2 receptor radioligand that competes with endogenous DA for binding to the receptor) to evaluate whether oral methylphenidate changes extracellular DA in the human brain in 11 healthy controls. We showed that oral methylphenidate (average dose 0.8 +/- 0.11 mg/kg) significantly increased extracellular DA in brain, as evidenced by a significant reduction in B(max)/K(d) (measure of D2 receptor availability) in striatum (20 +/- 12%; p < 0.0005). These results provide direct evidence that oral methylphenidate at doses within the therapeutic range significantly increases extracellular DA in human brain. This result coupled with recent findings of increased dopamine transporters in ADHD patients (which is expected to result in reductions in extracellular DA) provides a mechanistic framework for the therapeutic efficacy of methylphenidate. The increase in DA caused by the blockade of dopamine transporters by methylphenidate predominantly reflects an amplification of spontaneously released DA, which in turn is responsive to environmental stimulation. Because DA decreases background firing rates and increases signal-to-noise in target neurons, we postulate that the amplification of weak DA signals in subjects with ADHD by methylphenidate would enhance task-specific signaling, improving attention and decreasing distractibility. Alternatively methylphenidate-induced increases in DA, a neurotransmitter involved with motivation and reward, could enhance the salience of the task facilitating the "interest that it elicits" and thus improving performance.

Purified fish oil eliminating linoleic and alpha linolenic acid meets essential fatty acid requirements in rats.

PubMed

Ling, Pei-Ra; Puder, Mark; Bistrian, Bruce R

2012-10-01

This study examined whether purified fish oil (PFO) supplemented to an essential fatty acid deficient (EFAD) diet meets EFA needs in rats. The EFAD diet contained 10% hydrogenated coconut oil (HCO). A similar diet contained 7% HCO and 3% PFO which also provided 2.84% arachidonic acid (AA), 52.50% eicosapentaenoic acid (EPA) and 35.73% docosahexaenoic acid (DHA) but no linoleic acid (LA) or alpha linolenic acid (ALA). A 10% soybean oil control diet provided ample LA and ALA. After 4 weeks of feeding, blood glucose, plasma triglyceride and phospholipid fatty acid profiles, C-reactive protein (CRP), TNF and IL-6 were determined after saline or LPS injection. EFAD developed with the HCO diet with triene:tetraene ratios in plasma phospholipids >.20, which remained <.02 with the control and HCO+PFO diets. Mead acid levels significantly increased by a factor of 10 with the HCO diet compared to the AIN and HCO+PFO diets and were significantly lowest with the HCO+PFO diet. 18:1 n9 levels were significantly higher in plasma phospholipids and triglycerides with the HCO diet. CRP levels were significantly highest with the control diet and significantly lowest with the HCO diet. LPS significantly increased 18:1 n9 and cytokines, and decreased AA and plasma glucose in all diets and significantly increased plasma triglycerides and decreased plasma glucose in controls. Providing AA, EPA and DHA in EFAD prevents EFAD over the short-term as reflected in Mead acid production, triene:tetraene ratio, and de novo lipogenesis and may reduce the inflammatory response to LPS. Copyright © 2012 Elsevier Inc. All rights reserved.

Novel fiber-rich lentil flours as snack-type functional foods: an extrusion cooking effect on bioactive compounds.

PubMed

Morales, P; Berrios, J De J; Varela, A; Burbano, C; Cuadrado, C; Muzquiz, M; Pedrosa, M M

2015-09-01

Novel snack-type functional foods based on extruded lentil flours could convey the related health benefit of their bioactive compounds, provide a gluten-free alternative to consumers, and potentially increase the consumption of pulses. Extrusion treatment promoted an increase in galactopinitol, ciceritol, raffinose, stachyose and total α-galactoside content, in most lentil flours. As α-galactosides may act as prebiotics, they could convey beneficial effects to human and monogastric animals. Conversely, extrusion significantly (p < 0.05) reduced the inositol hexaphosphate content to less phosphorylated phytates (inositol pentaphosphate and inositol tetraphosphate), which provide health effects. The gluten-free formulation (control formulation #3) presented the highest significant (p < 0.05) drop in the inositol hexaphosphate of 14.7-fold decrease, but had a large increase in inositol pentaphosphate, due to extrusion processing. These two results are desirable in the finished product. Extrusion also caused a significant (p < 0.05) reduction in the trypsin content and completely inactivated lectin, in all processed samples.

The effects of horse riding simulation exercise on muscle activation and limits of stability in the elderly.

PubMed

Kim, Seong-Gil; Lee, Jung-Ho

2015-01-01

This study aimed to investigate the effect of horse riding simulation (HRS) on balance and trunk muscle activation as well as to provide evidence of the therapeutic benefits of the exercise. Thirty elderly subjects were recruited from a medical care hospital and randomly divided into an experimental and a control group. The experimental group performed the HRS exercise for 20 min, 5 times a week, for 8 weeks, and conventional therapy was also provided as usual. The muscle activation and limits of stability (LOS) were measured. The LOS significantly increased in the HRS group (p<0.05) but not in the control group (p>0.05). The activation of all muscles significantly increased in the HRS group. However, in the control group, the muscle activations of the lateral low-back (external oblique and quadratus lumborum) and gluteus medius (GM) significantly decreased, and there was no significant difference in other muscles. After the intervention, the LOS and all muscle activations significantly increased in the HRS group compared with the control group. The results suggest that the HRS exercise is effective for reducing the overall risk of falling in the elderly. Thus, it is believed that horse riding exercise would help to increase dynamic stability and to prevent elderly people from falling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Does Medicaid managed care market penetration impact provider participation, costs, utilization, and access?

PubMed

Minott, Jenny

2010-09-01

Key findings. (1) An increase in commercial plan penetration increased the liklihood [sic] that a physician would accept new Medicaid patients, but this did not significantly impact enrollee costs. (2) An increase in Medicaid-dominant HMO market penetration increased the probability that individuals reported using the ED as their primary source of care.

Frequent Immediate Knowledge of Results Enhances the Increase of Throwing Velocity in Overarm Handball Performance.

PubMed

Štirn, Igor; Carruthers, Jamie; Šibila, Marko; Pori, Primož

2017-02-01

In the present study, the effect of frequent, immediate, augmented feedback on the increase of throwing velocity was investigated. An increase of throwing velocity of a handball set shot when knowledge of results was provided or not provided during training was compared. Fifty female and seventy-three male physical education students were assigned randomly to the experimental or control group. All participants performed two series of ten set shots with maximal effort twice a week for six weeks. The experimental group received information regarding throwing velocity measured by a radar gun immediately after every shot, whereas the control group did not receive any feedback. Measurements of maximal throwing velocity of an ordinary handball and a heavy ball were performed, before and after the training period and compared. Participants who received feedback on results attained almost a four times greater relative increase of the velocity of the normal ball (size 2) as compared to the same intervention when feedback was not provided (8.1 ± 3.6 vs. 2.7 ± 2.9%). The velocity increases were smaller, but still significant between the groups for throws using the heavy ball (5.1 ± 4.2 and 2.5 ± 5.8 for the experimental and control group, respectively). Apart from the experimental group throwing the normal ball, no differences in velocity change for gender were obtained. The results confirmed that training oriented towards an increase in throwing velocity became significantly more effective when frequent knowledge of results was provided.

Sustainable forestry in theory and practice: recent advances in inventory and monitoring, statistics and modeling, information and knowledge management, and policy science.

Treesearch

Keith M. Reynolds

2006-01-01

The importance to society of environmental services, provided by forest ecosystems, has significantly increased during the last few decades. A growing global concern with the deterioration of forests, beginning perhaps most noticeably in the 1980s, has led to an increasing public awareness of the environmental, cultural, economic, and social values that forests provide...

Standardizing communication from acute care providers to primary care providers on critically ill adults.

PubMed

Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

2015-11-01

To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P < .001) and the communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

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

Smith, Barton; Rajic, Slobodan; Hunter, Scott Robert

The objective of this work was to demonstrate that a superhydrophobic coating technology developed at Oak Ridge National Laboratory (ORNL) increases the water repellency of ballistic fabric beyond that provided by existing water repellency treatments. This increased water repellency has the potential to provide durable ballistic fabric for body armor without adding significant weight to the armor or significant manufacturing cost. Specimens of greige and scoured ballistic fabric were treated with a superhydrophobic coating and their weights and degree of water repellency were compared to specimens of untreated fabric. Treatment of both greige and scoured ballistic fabrics yielded highly watermore » repellent fabrics. Our measurements of the water droplet contact angles gave values of approximately 150 , near the lower limit of 160 for superhydrophobic surfaces. The coatings increased the fabric weights by approximately 6%, an amount that is many times less than the estimated weight increase in a conventional treatment of ballistic fabric. The treated fabrics retained a significant amount of water repellency following a basic abrasion test, with water droplet contact angles decreasing by 14 to 23 . Microscopic analysis of the coating applied to woven fabrics indicated that the coating adhered equally well to fibers of greige and scoured yarns. Future evaluation of the superhydrophobic water repellent treatment will involve the manufacture of shoot packs of treated fabric for ballistic testing and provide an analysis of manufacturing scale-up and cost-to-benefit considerations.« less

How best to serve seniors on existing transit services

DOT National Transportation Integrated Search

2001-09-01

Increases in the size of the elderly population and changes in travel patterns are expected to create significant new mobility expectations. The research documented here is intended to provide tools for transit providers and public policy makers to m...

Effects of stand age on the demography of a temperate forest herb in post-agricultural forests.

PubMed

Jacquemyn, Hans; Brys, Rein

2008-12-01

Changes in land use have been shown to have profound effects on forest plant community structure and diversity. Dispersal limitation has been invoked as a major factor hampering colonization of forest plant species, while seed-sowing experiments and performance observations have provided some evidence for recruitment limitation determining forest plant distribution in post-agricultural forests. However, most of these studies were relatively short-term, and very few studies have investigated long-term growth rates of populations occurring in recent and ancient forests. In this study, matrix models using demographic data collected for four consecutive years were used to study the effect of forest age on population dynamics of the temperate forest herb Primula elatior. A life table response experiment (LTRE) and elasticity analysis were used to analyze the effect of forest age on population growth rate (lambda) and to decompose the effect of forest age on lambda into contributions from each matrix element. Population growth increased logarithmically with increasing forest age. Bootstrap analyses showed that populations located in very recent forests (< 50-years-old) had growth rates that were significantly < 1, whereas populations located in forests > 150-years-old had growth rates that were significantly > 1. Summed elasticities for individual growth significantly decreased with increasing forest age, whereas summed elasticities for survival and fertility significantly increased with increasing forest age. The LTRE analysis showed that the increase in lambda with increasing forest age was mainly due to increased seedling and juvenile growth and increased juvenile and adult survival. Our results indicate that past agricultural land use has long-lasting effects on the demography of forest herbs and may provide an additional mechanistic explanation for the poor colonization capacity of many forest herbs in post-agricultural forests.

The Development of the Institution of School Counselors in Rural Russia

ERIC Educational Resources Information Center

Gurianova, M. P.

2014-01-01

Two decades of experience with the use of school counselors in rural areas of Russia has demonstrated their necessity in supporting students, but their further development and increasing effectiveness requires a significant increase in resources provided to them.

Prevention of Teacher Burnout: The Challenge of the Future.

ERIC Educational Resources Information Center

Matthews, Doris B.; And Others

Strategies that may be used by schools to prevent teacher burnout suggested in this paper are: (1) increasing staff input in decision making; (2) improving the work environment; (3) increasing the flexibility of the school structure; (4) providing opportunities for individual time-out; (5) increasing the sense of individual work significance; and…

Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine.

PubMed

Lawler, Emily C

2017-03-01

I provide novel evidence on the effectiveness of two vaccination policies - simple non-binding recommendations to vaccinate versus mandates requiring vaccination prior to childcare or kindergarten attendance - in the context of the only disease whose institutional features permit a credible examination of both: hepatitis A. Using provider-verified immunization data I find that recommendations significantly increased hepatitis A vaccination rates among young children by at least 20 percentage points, while mandates increase rates by another 8 percentage points. These policies also significantly reduced population hepatitis A incidence. My results suggest a range of policy options for addressing suboptimally low population vaccination rates. Copyright © 2017 Elsevier B.V. All rights reserved.

[Evaluation of the Relapse Prevention Guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a "Private Finance Initiative" prison --the second report].

PubMed

Kobayashi, Ohji; Matsumoto, Toshihiko; Imamura, Fumi; Wada, Kiyoshi; Ozaki, Shiro; Takeuchi, Yoshio; Hasegawa, Masahiko; Imamura, Yoko; Tania, Yuko; Adachi, Yasumori

2011-06-01

There has been no relapse prevention program for drug dependent inmates in Japanese prisons. Recently, "Relapse Prevention Guidance" program is provided to the adult male inmates in Harima Rehabilitation Program Center (HRPC), one of the newly founded "Private Finance Initiative" prisons. To evaluate the effectiveness of the program by comparing the outcomes between groups of inmates with different severity level of dependence. The program was provided to 89 subjects in HRPC. Inmates were classified into 4 groups according to the severity measured by the Drug Abuse Screening Test (DAST). After a month of waiting period, self-teaching workbook was provided to each inmate for 4 weeks. The educational program consisting of 8 weekly psychoeducational group therapies was then provided to each group of 10 inmates. The evaluation was conducted both at the beginning and at the end of the workbook and the educational program intervention by administering 2 self-reporting questionnaires; the Self-efficacy Scale for drug dependence (SES), and the 8th version of the Stages of Change Readiness and Treatment Eagerness Scale for drug dependence (SOCRATES-8D). Only the "mild" group showed significant increase in SES during waiting period. After the workbook intervention, "moderate" group showed significant decrease in SES, and increase in the recognition and the ambivalence subscale of the SOCRATES-8D. The same increase in the subscales of SOCRATES-8D was noted in "Severe" group. Educational program produced increase in the recognition and the taking steps subscales of SOCRATES-8D in "mild" group, increase in SES score and the taking steps subscale in "moderate", increase in SES score and total score of SOCRATES-8D in "severe" group. No significant change was noted in "very severe" group in any of the interventions. The "Relapse Prevention Guidance" is sufficiently effective, improving self-efficacy and motivation for change in drug dependent adult male inmates.

A cumulative dose comparison between salbutamol and fenoterol metered dose aerosols in asthmatic patients.

PubMed Central

Bellamy, D.; Penketh, A.

1987-01-01

The potency and side effects of salbutamol and fenoterol inhalers have been compared in 8 asthmatic patients using a dose response curve. There was no significant difference in the absolute or percentage increase in FEV1 with the two treatments, but fenoterol caused a significantly greater (P less than 0.01) increase in heart rate than did salbutamol. A greater degree of bronchodilatation was observed with increased doses and we suggest that regular higher doses may provide better bronchodilatation and control of asthma in selected patients. PMID:3432172

Improving Tracheostomy Care Delivery: Instituting Clinical Care Pathways and Nursing Education to Improve Patient Outcomes.

PubMed

Colandrea, Maria; Eckardt, Patricia

2016-01-01

The complication rates for tracheostomy patients could be serious and life threatening. As a result, length of stay (LOS) increases and patient outcomes can be negatively impacted. Examples of complications include accidental decannulation, bleeding and total occlusion. Studies suggest there is an inconsistency in tracheostomy care among providers and institutions. Other studies suggest stronger patient outcomes can result from improved staff training and appropriate protocols. The purpose of this study was to develop and test a clinical care pathway (CCP) and nursing education program to improve tracheostomy patient outcomes. The use of a CCP and nursing education program at a tertiary VA Medical Center will: decrease length of stay (LOS). decrease 30 day tracheostomy readmissions. increase patient's readiness for discharge. increase nurses' comfort level with performing tracheostomy care. increase nurses' overall competence with performing tracheostomy care. A quasi-experimental pilot study examining the effect of a CCP compared LOS and complication rates of tracheostomy patients from admission to discharge. The population included veterans from a mid-Atlantic VA Medical Center. This study involved three phases. Phase 1: Administer the Readiness for Hospital Discharge Scale (RHDS) to tracheostomy patients' preintervention. Phase 2: Provide nurses with an educational program pre and post test assessment. Phase 3: Implement the CCP and evaluate patients' readiness for discharge. Comparing the pre-intervention sample of veterans (n = 10) to the post-intervention sample (n = 6), there was an increase in LOS by 1 day. There was a 15 point increase in RHDS from 165 (SD 25.8) to 180 (SD 14.42). This pilot was underpowered with an n = 6, so there was no significant difference in LOS and 30 day readmission rates. Bootstrapping of sample resulted in RHDS p = . 039 and readmission p = .007. A paired-samples t-test was conducted to assess nurses' competence in performing tracheostomy care and nursing comfort level in regards to providing tracheostomy care and discharge education. There was a significant increase in the post-test scores, nursing comfort level providing tracheostomy care and nurses' comfort level providing patient tracheostomy discharge education. The significance of this project improved overall tracheostomy care offered at a mid-Atlantic VA Medical Center. Standardizing tracheostomy care and properly educating nurses and patients, increased patients readiness for hospital discharge and decreased their readmission rates related to tracheostomies.

VET Provider Market Structures: History, Growth and Change. Research Report

ERIC Educational Resources Information Center

Korbel, Patrick; Misko, Josie

2016-01-01

This paper tracks the development of the Australian vocational education and training (VET) provider market over the last two decades in the context of significant policy changes and generally increased competition. It provides an insight into how the sector has arrived at its current position, painting a present-day picture of great diversity.…

Stepped nozzle

DOEpatents

Sutton, George P.

1998-01-01

An insert which allows a supersonic nozzle of a rocket propulsion system to operate at two or more different nozzle area ratios. This provides an improved vehicle flight performance or increased payload. The insert has significant advantages over existing devices for increasing nozzle area ratios. The insert is temporarily fastened by a simple retaining mechanism to the aft end of the diverging segment of the nozzle and provides for a multi-step variation of nozzle area ratio. When mounted in place, the insert provides the nozzle with a low nozzle area ratio. During flight, the retaining mechanism is released and the insert ejected thereby providing a high nozzle area ratio in the diverging nozzle segment.

Using the deductible for patient channeling: did preferred providers gain patient volume?

PubMed

van der Geest, Stéphanie A; Varkevisser, Marco

2016-06-01

In market-based health care systems, channeling patients to designated preferred providers can increase payer's bargaining clout, other things being equal. In the unique setting of the new Dutch health care system with regulated competition, this paper evaluates the impact of a 1-year natural experiment with patient channeling on providers' market shares. In 2009 a large regional Dutch health insurer designated preferred providers for two different procedures (cataract surgery and varicose veins treatment) and gave its enrollees a positive financial incentive for choosing them. That is, patients were exempted from paying their deductible when they went to a preferred provider. Using claims data over the period 2007-2009, we apply a difference-in-difference approach to study the impact of this channeling strategy on the allocation of patients across individual providers. Our estimation results show that, in the year of the experiment, preferred providers of varicose veins treatment on average experienced a significant increase in patient volume relative to non-preferred providers. However, for cataract surgery no significant effect is found. Possible explanations for the observed difference between both procedures may be the insurer's selection of preferred providers and the design of the channeling incentive resulting in different expected financial benefits for both patient groups.

Effect of a Diet Enriched with Fresh Coconut Saturated Fats on Plasma Lipids and Erythrocyte Fatty Acid Composition in Normal Adults.

PubMed

Nagashree, Rokkam Shankar; Manjunath, N K; Indu, M; Ramesh, M; Venugopal, V; Sreedhar, P; Pavithra, N; Nagendra, Hongasandra R

2017-07-01

The objective of this study was to compare the effects of increased saturated fatty acid (SFA) (provided by fresh coconut) versus monounsaturated fatty acid (MUFA) intake (provided by a combination of groundnuts and groundnut oil) on plasma lipids and erythrocyte fatty acid (EFA) composition in healthy adults. Fifty-eight healthy volunteers, randomized into 2 groups, were provided standardized diet along with 100 g fresh coconut or groundnuts and groundnut oil combination for 90 days in a Yoga University. Fasting blood samples were collected before and after the intervention period for the measurement of plasma lipids and EFA profile. Coconut diet increased low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels significantly. In contrast, the groundnut diet decreased total cholesterol (TC), mainly due to a decrease in HDL levels. There were no differences in the major SFA of erythrocytes in either group. However, coconut consumption resulted in an increase in C14:0 and C24:0 along with a decrease in levels of C18:1 n9 (oleic acid). There was a significant increase in levels of C20:3 n6 (dihomo-gamma linolenic acid, DGLA). Consumption of SFA-rich coconut for 3 months had no significant deleterious effect on erythrocytes or lipid-related factors compared to groundnut consumption. On the contrary, there was an increase in the anti-atherogenic HDL levels and anti-inflammatory precursor DGLA in erythrocyte lipids. This suggests that coconut consumption may not have any deleterious effects on cardiovascular risk in normal subjects.

Thinking Teacher Professional Learning Performatively: A Socio-Material Account

ERIC Educational Resources Information Center

Mulcahy, Dianne

2012-01-01

New socio-economic conditions have resulted in significant reconfiguration of professional learning in terms of the increasing integration of work into curriculum, pedagogy and inter-professional relationships. This article examines the significance of "more than human" dimensions for this learning, using resources provided by…

Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies.

PubMed

Page, Rupert; Shankar, Rohit; McLean, Brendan N; Hanna, Jane; Newman, Craig

2018-01-01

Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by the circumstances in which many such patients present. Despite increasing recognition of the importance of earlier identification of those at risk, there is little or no improvement in outcomes over more than 30 years. Despite ever increasing sophistication of drug development and delivery, there has been no meaningful improvement in 1-year seizure freedom rates over this time. However, in the last few years, there has been an increase in patient-triggered interventions based on automated monitoring of indicators and risk factors facilitated by technological advances. The opportunities such approaches provide will only be realized if accompanied by current working practice changes. Replacing traditional follow-up appointments at arbitrary intervals with dynamic interventions, remotely and at the point and place of need provides a better chance of a substantial reduction in seizures for people with epilepsy. Properly implemented, electronic platforms can offer new opportunities to provide expert advice and management from first presentation thus improving outcomes. This perspective paper provides and proposes an informed critical opinion built on current evidence base of an outline techno-therapeutic approach to harnesses these technologies. This conceptual framework is generic, rather than tied to a specific product or solution, and the same generalized approach could be beneficially applied to other long-term conditions.

Submersion criticality safety of tungsten-rhenium urania cermet fuel for space propulsion and power applications

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

A.E. Craft; R. C. O'Brien; S. D. Howe

Nuclear thermal rockets are the preferred propulsion technology for a manned mission to Mars, and tungsten–uranium oxide cermet fuels could provide significant performance and cost advantages for nuclear thermal rockets. A nuclear reactor intended for use in space must remain subcritical before and during launch, and must remain subcritical in launch abort scenarios where the reactor falls back to Earth and becomes submerged in terrestrial materials (including seawater, wet sand, or dry sand). Submersion increases reflection of neutrons and also thermalizes the neutron spectrum, which typically increases the reactivity of the core. This effect is typically very significant for compact,more » fast-spectrum reactors. This paper provides a submersion criticality safety analysis for a representative tungsten/uranium oxide fueled reactor with a range of fuel compositions. Each submersion case considers both the rhenium content in the matrix alloy and the uranium oxide volume fraction in the cermet. The inclusion of rhenium significantly improves the submersion criticality safety of the reactor. While increased uranium oxide content increases the reactivity of the core, it does not significantly affect the submersion behavior of the reactor. There is no significant difference in submersion behavior between reactors with rhenium distributed within the cermet matrix and reactors with a rhenium clad in the coolant channels. The combination of the flooding of the coolant channels in submersion scenarios and the presence of a significant amount of spectral shift absorbers (i.e. high rhenium concentration) further decreases reactivity for short reactor cores compared to longer cores.« less

Nutrition Counselling Practices among General Practitioners in Croatia.

PubMed

Dumic, Albina; Miskulin, Ivan; Matic Licanin, Matea; Mujkic, Aida; Cacic Kenjeric, Daniela; Miskulin, Maja

2017-12-04

Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia's general practitioners' nutrition counselling practice and determine the factors that influence such practice. A cross-sectional study was conducted among 444 (17.0%) randomly selected general practitioners (GPs) in Croatia from May to July 2013 via a 32-item anonymous questionnaire. Study showed that 77.0% of participants had provided nutrition counselling exclusively to patients with specific health risks; 18.7% participants had provided nutrition counselling for all patients, regardless of their individual risks, while 4.3% had not provide nutrition counselling. As the most significant stimulating factor for implementing nutrition counselling in their daily work with patients, 55.6% of the participants identified personal interest regarding nutrition and the effects it has on health. The latter factor was more frequently emphasized among female general practitioners ( p < 0.001) and general practitioners without chronic diseases ( p < 0.001). The most significant barrier for nutrition counselling was lack of time (81.6%). It is necessary to make additional efforts to increase the frequency of nutrition counselling provided by general practitioners in Croatia. The majority of Croatian general practitioners could increase their nutrition counselling practice in order to promote balanced nutrition and improve the overall health status of their patients.

Nutrition Counselling Practices among General Practitioners in Croatia

PubMed Central

Dumic, Albina; Mujkic, Aida; Miskulin, Maja

2017-01-01

Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia’s general practitioners’ nutrition counselling practice and determine the factors that influence such practice. A cross-sectional study was conducted among 444 (17.0%) randomly selected general practitioners (GPs) in Croatia from May to July 2013 via a 32-item anonymous questionnaire. Study showed that 77.0% of participants had provided nutrition counselling exclusively to patients with specific health risks; 18.7% participants had provided nutrition counselling for all patients, regardless of their individual risks, while 4.3% had not provide nutrition counselling. As the most significant stimulating factor for implementing nutrition counselling in their daily work with patients, 55.6% of the participants identified personal interest regarding nutrition and the effects it has on health. The latter factor was more frequently emphasized among female general practitioners (p < 0.001) and general practitioners without chronic diseases (p < 0.001). The most significant barrier for nutrition counselling was lack of time (81.6%). It is necessary to make additional efforts to increase the frequency of nutrition counselling provided by general practitioners in Croatia. The majority of Croatian general practitioners could increase their nutrition counselling practice in order to promote balanced nutrition and improve the overall health status of their patients. PMID:29207514

Using Lean Thinking at an otorhinolaryngology outpatient clinic to improve quality of care.

PubMed

van Leijen-Zeelenberg, Janneke E; Brunings, Jan Wouter; Houkes, Inge; van Raak, Arno J A; Ruwaard, Dirk; Vrijhoef, Hubertus J M; Kremer, Bernd

2016-04-01

Although Lean Thinking has led to considerable improvement in a variety of healthcare settings, its effects on otorhinolaryngology remain underexposed. This study reports on how the implementation of Lean Thinking at an otorhinolaryngology outpatient clinic has affected patient and provider satisfaction, waste reduction, and organizational culture. Prospective before-and-after design. The 18-month prospective before-and-after design used mixed methods for data collection and analysis. A survey was conducted to measure satisfaction among patients and providers. Semistructured interviews were conducted to evaluate the effect of Lean Thinking on waste and organizational culture. During the project, 69 issues were posted on the Lean board. Improvements were made on 36 inefficiency issues, not all concerning a specific type of waste. Employees reported considerable improvement in transportation, motion, and waiting. Patient satisfaction was high both at baseline and follow-up and did not change significantly. The effects on provider satisfaction were slight; satisfaction with autonomy and participation decreased significantly, but satisfaction with communication increased significantly. The implementation of Lean Thinking at an otorhinolaryngology outpatient clinic reduced waste and increased provider satisfaction with communication. Although patient satisfaction did not change significantly, it cannot be concluded that the intervention had no effect on perceived quality of care. Other approaches to measure patients' perceptions should be considered. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

The business end of health information technology. Can a fully integrated electronic health record increase provider productivity in a large community practice?

PubMed

De Leon, Samantha; Connelly-Flores, Alison; Mostashari, Farzad; Shih, Sarah C

2010-01-01

Electronic health records (EHRs) are expected to transform and improve the way medicine is practiced. However, providers perceive many barriers toward implementing new health information technology. Specifically, they are most concerned about the potentially negative impact on their practice finances and productivity. This study compares the productivity of 75 providers at a large urban primary care practice from January 2005 to February 2009, before and after implementing an EHR system, using longitudinal mixed model analyses. While decreases in productivity were observed at the time the EHR system was implemented, most providers quickly recovered, showing increases in productivity per month shortly after EHR implementation. Overall, providers had significant productivity increases of 1.7% per month per provider from pre- to post-EHR adoption. The majority of the productivity gains occurred after the practice instituted a pay-for-performance program, enabled by the data capture of the EHRs. Coupled with pay-for-performance, EHRs can spur rapid gains in provider productivity.

The effect of ocean acidification on carbon storage and sequestration in seagrass beds; a global and UK context.

PubMed

Garrard, Samantha L; Beaumont, Nicola J

2014-09-15

Ocean acidification will have many negative consequences for marine organisms and ecosystems, leading to a decline in many ecosystem services provided by the marine environment. This study reviews the effect of ocean acidification (OA) on seagrasses, assessing how this may affect their capacity to sequester carbon in the future and providing an economic valuation of these changes. If ocean acidification leads to a significant increase in above- and below-ground biomass, the capacity of seagrass to sequester carbon will be significantly increased. The associated value of this increase in sequestration capacity is approximately £500 and 600 billion globally between 2010 and 2100. A proportionally similar increase in carbon sequestration value was found for the UK. This study highlights one of the few positive stories for ocean acidification and underlines that sustainable management of seagrasses is critical to avoid their continued degradation and loss of carbon sequestration capacity. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Analogue Study of Counselor Ethnicity and Client Preference.

ERIC Educational Resources Information Center

Franco, Juan N.; LeVine, Elaine

1980-01-01

Providing student clients with background information about their prospective Chicano or Anglo counselors may increase the counselor's attractiveness, regardless of his ethnicity. Male counselors appear significantly more attractive as more information is provided about them, although subjects appear to have no preference for counselors of the…

Effects of health care provider work hours and sleep deprivation on safety and performance.

PubMed

Lockley, Steven W; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Czeisler, Charles A; Landrigan, Christopher P

2007-11-01

There has been increasing interest in the impact of resident-physician and nurse work hours on patient safety. The evidence demonstrates that work schedules have a profound effect on providers' sleep and performance, as well as on their safety and that of their patients. Nurses working shifts greater than 12.5 hours are at significantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. Physicians-in-training working traditional > 24-hour on-call shifts are at greatly increased risk of experiencing an occupational sharps injury or a motor vehicle crash on the drive home from work and of making a serious or even fatal medical error. As compared to when working 16-hours shifts, on-call residents have twice as many attentional failures when working overnight and commit 36% more serious medical errors. They also report making 300% more fatigue-related medical errors that lead to a patient's death. The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours routinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of preventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits.

The impact of grape skin bioactive functionality information on the acceptability of tea infusions made from wine by-products.

PubMed

Cheng, Vern Jou; Bekhit, Alaa El-Din A; Sedcole, Richard; Hamid, Nazimah

2010-05-01

The effect of information on the health benefits of bio-active compounds on the acceptability of 5 tea infusions made from grape skins generated from wine processing waste (from Vitis vinifera var. Pinot Noir and Pinot Gris) was investigated. Samples of tea infusions with natural additives (PNHGT25 and PGGT50) and without additives (control PN, control PG, and PNPG50) were evaluated by 45 in-home consumer panels (30 female, 15 male) before and after information on the health benefits of grape skins were provided. Information significantly increased the overall acceptability, overall aroma, flavor, and aftertaste of the infusions. The results obtained showed a clear tendency toward increased purchase intention (by 29%) when information on the health benefits of the tea infusion samples was provided to consumers. Interactions existed between gender/infusion samples and stage of information on the purchase intention. Females recorded a significant increase (by 53%) in purchase intention, whereas no change in the males' purchase intention was found after information was provided.

Increasing Discussions of Intimate Partner Violence in Prenatal Care Using Video Doctor Plus Provider Cueing: A Randomized Controlled Trial

PubMed Central

Tsoh, Janice Y.; Kohn, Michael A.; Gerbert, Barbara

2010-01-01

Purpose To report the effectiveness of a prenatal intervention and to provide evidence that prenatal visits provide an opportune time for health assessment and counseling with abused women. Methods Fifty ethnically diverse pregnant women who presented for routine prenatal care and who also reported being at risk for intimate partner violence (IPV) were recruited to the study. Participants were assigned to either usual care or the Video Doctor plus Provider Cueing intervention. At baseline and 1-month later at another routine prenatal visit, intervention group participants received a 15-minute Video Doctor assessment and interactive tailored counseling. Their providers received a printed Cue Sheet alert and suggested counseling statements. Main findings Participants in the intervention group were significantly more likely to report provider-patient discussions of IPV compared to participants receiving usual care at baseline (81.8% vs. 16.7%, p < 0.001) and at the 1-month follow-up (70.0% vs. 23.5%, p = 0.005). Summing the number of patient-provider discussions across the two visits at baseline and one month later, intervention participants were significantly more likely to have IPV risk discussion with their providers at one or both visits (90.0% vs. 23.6%, p< 0.001) compared to the participants who received usual care. When specifically asked about the helpfulness of these IPV-related discussions, 20 out of 22 (90.9%) participants rated the discussion as helpful or very helpful at baseline and all 18 (100%) participants rated the discussion as helpful or very helpful at the 1-month follow-up. Conclusions Video Doctor plus Provider Cueing intervention significantly increases the likelihood of provider-patient IPV discussion with pregnant women with a history of abuse. PMID:21185737

Effects of a Driver Cellphone Ban on Overall, Handheld, and Hands-Free Cellphone Use While Driving: New Evidence from Canada.

PubMed

Carpenter, Christopher S; Nguyen, Hai V

2015-11-01

We provide new evidence on the effects of increasingly common driver cellphone bans on self-reported overall, handheld, and hands-free cellphone use while driving by studying Ontario, Canada, which instituted a 3-month education campaign in November 2009 followed by a binding driver cellphone ban in February 2010. Using residents of Alberta as a control group in a difference-in-differences framework, we find visual and regression-based evidence that Ontario's cellphone ban significantly reduced overall and handheld cellphone use. We also find that the policies significantly increased hands-free cellphone use. The reductions in overall and handheld use are driven exclusively by women, whereas the increases in hands-free use are much larger for men. Our results provide the first direct evidence that cellphone bans have the unintended effect of inducing substitution to hands-free devices. Copyright © 2014 John Wiley & Sons, Ltd.

Health benefits of dietary fiber.

PubMed

Anderson, James W; Baird, Pat; Davis, Richard H; Ferreri, Stefanie; Knudtson, Mary; Koraym, Ashraf; Waters, Valerie; Williams, Christine L

2009-04-01

Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.

A reanalysis of cancer mortality in Canadian nuclear workers (1956-1994) based on revised exposure and cohort data.

PubMed

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-07

A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956-1994) in the updated Canadian cohort and provided revised risk estimates. Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. A significant heterogeneity of the dose-response for solid cancer was identified (P=0.02), with 3088 early (1956-1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42,228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=-1.20, 95% CI: <-1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance.

A reanalysis of cancer mortality in Canadian nuclear workers (1956–1994) based on revised exposure and cohort data

PubMed Central

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-01

Background: A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956–1994) in the updated Canadian cohort and provided revised risk estimates. Methods: Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. Results: A significant heterogeneity of the dose–response for solid cancer was identified (P=0.02), with 3088 early (1956–1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42 228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=−1.20, 95% CI: <−1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Conclusion: Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance. PMID:24231946

Differential effects of EPA versus DHA on postprandial vascular function and the plasma oxylipin profile in men.

PubMed

McManus, Seán; Tejera, Noemi; Awwad, Khader; Vauzour, David; Rigby, Neil; Fleming, Ingrid; Cassidy, Aedin; Minihane, Anne Marie

2016-09-01

Our objective was to investigate the impact of EPA versus DHA on arterial stiffness and reactivity and underlying mechanisms (with a focus on plasma oxylipins) in the postprandial state. In a three-arm crossover acute test meal trial, men (n = 26, 35-55 years) at increased CVD risk received a high-fat (42.4 g) test meal providing 4.16 g of EPA or DHA or control oil in random order. At 0 h and 4 h, blood samples were collected to quantify plasma fatty acids, long chain n-3 PUFA-derived oxylipins, nitrite and hydrogen sulfide, and serum lipids and glucose. Vascular function was assessed using blood pressure, reactive hyperemia index, pulse wave velocity, and augmentation index (AIx). The DHA-rich oil significantly reduced AIx by 13% (P = 0.047) with the decrease following EPA-rich oil intervention not reaching statistical significance. Both interventions increased EPA- and DHA-derived oxylipins in the acute postprandial state, with an (1.3-fold) increase in 19,20-dihydroxydocosapentaenoic acid evident after DHA intervention (P < 0.001). In conclusion, a single dose of DHA significantly improved postprandial arterial stiffness as assessed by AIx, which if sustained would be associated with a significant decrease in CVD risk. The observed increases in oxylipins provide a mechanistic insight into the AIx effect. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

Tort reform is associated with significant increases in Texas physicians relative to the Texas population.

PubMed

Stewart, Ronald M; West, Molly; Schirmer, Richard; Sirinek, Kenneth R

2013-01-01

Texas implemented comprehensive tort reform in 2003. We hypothesized that tort reform was followed by a significant increase of physicians practicing in Texas. To test this hypothesis, we compared the rate of physician growth prior to and following tort reform, and the number of licensed physicians and physicians per 100,000. Comparing before and after tort reform, the rate of increase in Texas physicians per 100,000 population increased significantly (p < 0.01). From 2002 to 2012, the Texas population increased 21 %. The number of actively practicing Texas physicians increased by 15,611 a 44 % increase (46 % metro areas vs. 9 % non-metro areas), an increase of 30 physicians per 100,000 population (p < 0.01). Non-metropolitan Texas had a net increase of 215 physicians; however, there was no change in the number of physicians per 100,000. Examining the data by trauma service areas (TSAs), 20 of 22 TSAs had an increase in both number of physicians and physicians per capita, five greater than 50 %. The post-tort reform period in Texas was associated with a significantly increased growth rate of physicians relative to the Texas population. Tort reform, as implemented in Texas, provides a needed framework for improving access to health care.

Mission and Identity: The Role of Faculty

ERIC Educational Resources Information Center

Briel, Don

2012-01-01

Although Catholic universities face a number of challenges in an increasingly unsettled economy, the situation also provides significant opportunities for Catholic universities to highlight the central importance of their Catholic identity in order both to recover their deepest commitments and to realize an advantage in an increasingly competitive…

NASA's Deep Space Telecommunications Roadmap

NASA Technical Reports Server (NTRS)

Edwards, C., Jr.; Stelzried, C.; Deutsch, L.; Swanson, L.

1998-01-01

This paper will present this roadmap, describe how it will support an increasing mission set while also providing significantly increased science data return, summarize the current state of key Ka-band and optical communications technologies, and identify critical path items in terms of technology developments, demonstrations, and mission users.

Effects of elastic bands on force and power characteristics during the back squat exercise.

PubMed

Wallace, Brian J; Winchester, Jason B; McGuigan, Michael R

2006-05-01

Athletes commonly use elastic bands as a training method to increase strength and performance. The purpose of this study was to investigate the effect of elastic bands on peak force (PF), peak power (PP), and peak rate of force development (RFD) during the back-squat exercise (BSE). Ten recreationally resistance-trained subjects (4 women, 6 men, mean age 21.3 +/- 1.5 years) were tested for their 1 repetition maximum (1RM) in the BSE (mean 117.6 +/- 48.2 kg) on a Smith machine. Testing was performed on 2 separate days, with 2 sets of 3 repetitions being performed for each condition. Testing was conducted at 60% and 85% of 1RM with and without using elastic bands. In addition, 2 elastic band loading conditions were tested (B1 and B2) at each of the 2 resistances. No bands (NB) represents where all of the resistance was acquired from free-weights. B1 represents where approximately 80% of the resistance was provided by free-weights, and approximately 20% was provided by bands. B2 represents where approximately 65% of the resistance was provided by free-weights, and approximately 35% was provided from bands. The subjects completed the BSE under each condition, whereas PF, PP, and RFD was recorded using a force platform. There was a significant (p < 0.05) increase in PF between NB-85 and B2-85 of 16%. Between B1-85 and B2-85, PF was increased significantly by 5% (p < 0.05). There was a significant (p < 0.05) increase in PP between NB-85 and B2-85 of 24%. No significant differences were observed in RFD during the 85% conditions or for any of the measured variables during the 60% conditions (p < 0.05). The results suggest that the use of elastic bands in conjunction with free weights can significantly increase PF and PP during the BSE over free-weight resistance alone under certain loading conditions. The greatest differences are observed during the higher loading conditions, with the B1-85 condition appearing to be optimal for athletic performance of the ones we tested. The strength training professional could use variable resistance training (VRT) to increase PF and PP more than the traditional BSE can. VRT could also be used to train these 2 performance characteristics together, which might be especially useful in season, when weight-room training volume can sometimes be limited.

Increased pulse wave transit time after percutaneous coronary intervention procedure in CAD patients.

PubMed

Ji, Lizhen; Liu, Chengyu; Li, Peng; Wang, Xinpei; Liu, Changchun; Hou, Yinglong

2018-01-08

Pulse wave transit time (PWTT) has been widely used as an index in assessing arterial stiffness. Percutaneous coronary intervention (PCI) is usually applied to the treatment of coronary artery disease (CAD). Research on the changes in PWTT caused by PCI is helpful for understanding the impact of the PCI procedure. In addition, effects of stent sites and access sites on the changes in PWTT have not been explored. Consequently, this study aimed to provide this information. The results showed that PWTT significantly increased after PCI (p < 0.01) while the standard deviation (SD) of PWTT time series had no statistically significant changes (p = 0.60) between before and after PCI. Significantly increased PWTT was found in the radial access group (p < 0.01), while there were no significant changes in the femoral access group (p > 0.4). Additionally, PWTT in the left anterior descending (LAD) group significantly increased after PCI (p < 0.01), but the increase that was found in the right coronary artery (RCA) group was not significant (p > 0.1). Our study indicates that arterial elasticity and left ventricular functions can benefit from a successful PCI procedure, and the increase of peripheral PWTT after PCI can help to better understand the effectiveness of the procedure.

Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

PubMed

Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

2016-01-01

Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P < .001 and r = 0.543, P < .001). The remaining clinics were not significantly correlated but demonstrated a weak positive correlation (r = 0.098, P = .560 and r = 0.069, P = .671). Implementation and increased use of electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

Texas Legislature Adopts School Funding Plan.

ERIC Educational Resources Information Center

Cortez, Albert

1991-01-01

This paper analyzes Texas Senate Bill 351 that reforms public school funding. The bill provides for additional state funding and significant increases in local property taxes. The bill creates county education taxing units to neutralize the enormous property wealth differences found among the state's 1,056 school districts. It also provides a…

NOAA announces significant investment in next generation of supercomputers

Science.gov Websites

provide more timely, accurate weather forecasts. (Credit: istockphoto.com) Today, NOAA announced the next phase in the agency's efforts to increase supercomputing capacity to provide more timely, accurate turn will lead to more timely, accurate, and reliable forecasts." Ahead of this upgrade, each of

Mental health first aid for eating disorders: pilot evaluation of a training program for the public

PubMed Central

2012-01-01

Background Eating disorders cause significant burden that may be reduced by early and appropriate help-seeking. However, despite the availability of effective treatments, very few individuals with eating disorders seek treatment. Training in mental health first aid is known to be effective in increasing mental health literacy and supportive behaviours, in the social networks of individuals with mental health problems. Increases in these domains are thought to improve the likelihood that effective help is sought. However, the efficacy of mental health first aid for eating disorders has not been evaluated. The aim of this research was to examine whether specific training in mental health first aid for eating disorders was effective in changing knowledge, attitudes and behaviours towards people with eating disorders. Methods A repeated measures, uncontrolled trial was conducted to establish proof of concept and provide guidance on the future design of a randomised controlled trial. Self-report questionnaires, administered at baseline, post-training and 6-month follow-up, assessed the effectiveness of the 4-hour, single session, mental health first aid training. Results 73 participants completed the training and all questionnaires. The training intervention was associated with statistically significant increases in problem recognition and knowledge of appropriate mental health first aid strategies, which were maintained at 6-month follow-up. Sustained significant changes in attitudes and behaviours were less clear. 20 participants reported providing assistance to someone with a suspected eating disorder, seven of whom sought professional help as a result of the first aid interaction. Results provided no evidence of a negative impact on participants or the individuals they provided assistance to. Conclusions This research provides preliminary evidence for the use of training in mental health first aid as a suitable intervention for increasing community knowledge of and support for people with eating disorders to seek appropriate help. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611001181998 PMID:22856517

Mental health first aid for eating disorders: pilot evaluation of a training program for the public.

PubMed

Hart, Laura M; Jorm, Anthony F; Paxton, Susan J

2012-08-02

Eating disorders cause significant burden that may be reduced by early and appropriate help-seeking. However, despite the availability of effective treatments, very few individuals with eating disorders seek treatment. Training in mental health first aid is known to be effective in increasing mental health literacy and supportive behaviours, in the social networks of individuals with mental health problems. Increases in these domains are thought to improve the likelihood that effective help is sought. However, the efficacy of mental health first aid for eating disorders has not been evaluated. The aim of this research was to examine whether specific training in mental health first aid for eating disorders was effective in changing knowledge, attitudes and behaviours towards people with eating disorders. A repeated measures, uncontrolled trial was conducted to establish proof of concept and provide guidance on the future design of a randomised controlled trial. Self-report questionnaires, administered at baseline, post-training and 6-month follow-up, assessed the effectiveness of the 4-hour, single session, mental health first aid training. 73 participants completed the training and all questionnaires. The training intervention was associated with statistically significant increases in problem recognition and knowledge of appropriate mental health first aid strategies, which were maintained at 6-month follow-up. Sustained significant changes in attitudes and behaviours were less clear. 20 participants reported providing assistance to someone with a suspected eating disorder, seven of whom sought professional help as a result of the first aid interaction. Results provided no evidence of a negative impact on participants or the individuals they provided assistance to. This research provides preliminary evidence for the use of training in mental health first aid as a suitable intervention for increasing community knowledge of and support for people with eating disorders to seek appropriate help. Australian New Zealand Clinical Trials Registry ACTRN12611001181998.

Effects of free sugars on blood pressure and lipids: a systematic review and meta-analysis of nutritional isoenergetic intervention trials.

PubMed

Fattore, Elena; Botta, Francesca; Agostoni, Carlo; Bosetti, Cristina

2017-01-01

Sugar has been suggested as a central risk factor in the development of noncommunicable diseases. We assessed the evidence of the effects of free sugars compared with complex carbohydrates on selected cardiovascular disease risk factors. We conducted a systematic review and meta-analysis of intervention trials to compare diets that provide a given amount of energy from free sugars with a control diet that provides the same amount of energy from complex carbohydrates. The primary outcomes were: blood pressure, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triacylglycerols, apolipoproteins A-I and B, or very low-density lipoprotein cholesterol. Body weight was also recorded but was not a primary outcome of the studies. In all, 28 studies involving 510 volunteers were included. When free sugars were substituted for complex carbohydrates, no significant increases were detected in systolic or diastolic blood pressure, and no heterogeneity was observed. There were significant increases in HDL cholesterol, LDL cholesterol, and triacylglycerols, although for LDL cholesterol and triacylglycerols there was significant heterogeneity between studies and evidence of publication bias. After adjustment for missing studies, these increases lost significance. Subgroup analyses showed that diets providing the largest total energy intake and energy exchange enhanced the effect of free sugars on total and LDL cholesterol and triacylglycerols. The increase of triacylglycerols was no longer significant when studies with the highest risk of bias were excluded or when only randomized trials were considered. Free sugars had no effect on body weight. In short- or moderate-term isoenergetic intervention trials, the substitution of free sugars for complex carbohydrates had no effect on blood pressure or body weight and an unclear effect on blood lipid profile. Further independent trials are required to assess whether the reduction of free sugars improves cardiovascular disease risk factors. This review was registered at http://www.crd.york.ac.uk/prospero as CRD42016042930. © 2017 American Society for Nutrition.

Does Increased Spending on Pharmaceutical Marketing Inhibit Pioneering Innovation?

PubMed

Arnold, Denis G; Troyer, Jennifer L

2016-04-01

The pharmaceutical industry has been criticized for developing and aggressively marketing drugs that do not provide significant health benefits relative to existing drugs but retain the benefits of patent protection. Critics argue that drug marketing increases health care expenditures and provides a disincentive for pioneering drug innovation. However, evidence that marketing expenditures have any relationship to new drug approvals has been anecdotal. We hypothesized that, at publicly traded pharmaceutical firms, increased marketing expenditures will result in a reduced volume of pioneering new drugs in comparison to less innovative new drugs. We also hypothesized that additional research and development spending will result in an increased volume of pioneering new drugs in comparison to less innovative drugs. Results confirm our hypotheses. Specific policy recommendations for altering firms' incentives for the development of pioneering drugs are provided. Copyright © 2016 by Duke University Press.

Stepped nozzle

DOEpatents

Sutton, G.P.

1998-07-14

An insert is described which allows a supersonic nozzle of a rocket propulsion system to operate at two or more different nozzle area ratios. This provides an improved vehicle flight performance or increased payload. The insert has significant advantages over existing devices for increasing nozzle area ratios. The insert is temporarily fastened by a simple retaining mechanism to the aft end of the diverging segment of the nozzle and provides for a multi-step variation of nozzle area ratio. When mounted in place, the insert provides the nozzle with a low nozzle area ratio. During flight, the retaining mechanism is released and the insert ejected thereby providing a high nozzle area ratio in the diverging nozzle segment. 5 figs.

Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery.

PubMed

Grant, Michael C; Hanna, Andrew; Benson, Andrew; Hobson, Deborah; Wu, Christopher L; Yuan, Christina T; Rosen, Michael; Wick, Elizabeth C

2018-03-01

Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

International Mutual Recognition: Progress and Prospects. Working Paper.

ERIC Educational Resources Information Center

Hager, Paul

Increasing the mobility of service providers, including professionals, via mutual recognition (of regulatory systems) agreements (MRAs) has become a significant issue worldwide. Despite increasing interest in MRAs, it may be argued that MRAs are but one of a larger range of major developments that have fueled current interest in occupational…

Alabama's Education Report Card, 2009-2010

ERIC Educational Resources Information Center

Alabama Department of Education, 2011

2011-01-01

In a more consistent and viable manner than ever before, education in Alabama is moving toward its ultimate goal of providing every student with a quality education, thereby preparing them for work, college, and life after high school. Alabama's graduation rates from 2002 to 2008 increased significantly, tripling the national average increase and…

Students with Intellectual Disability in Higher Education: Adult Service Provider Perspectives

ERIC Educational Resources Information Center

Sheppard-Jones, Kathleen; Kleinert, Harold Lawrence; Druckemiller, Wendy; Ray, Megan Kovacevich

2015-01-01

Postsecondary education (PSE) is increasingly becoming an option for students with intellectual disability (ID; Grigal & Hart, 2012). Postsecondary education offers the promise of pursuing a valued social role (that of college student), enhanced social networks, and, most significantly, increased employment options. To date, research and…

Challenges to Lake Superior's Condition, Assessment, and Management: A Few Observations Across a Generation of Change

EPA Science Inventory

Selected comparisons of water quality and biological properties in lakewide samplings of 1970s and 2005/2006 provide a simple illustration of significant changes within Lake Superior in the last three decades. Observations of warmed surface layers, increased nitrate and increase...

Providing Increased Transit Capacity During Peak Periods : Examination of Two Techniques

DOT National Transportation Integrated Search

1975-02-01

It is shown that reduction of bus route lengths increases the number of round trips per bus possible in a given time period. For bus routes accessed mainly by auto, it is shown that significant savings in energy due to reduced auto miles travelled ar...

Changes in Meat Quality Characteristics of the Sous-vide Cooked Chicken Breast during Refrigerated Storage.

PubMed

Hong, Go-Eun; Kim, Ji-Han; Ahn, Su-Jin; Lee, Chi-Ho

2015-01-01

This study was performed to investigate the changes in meat quality characteristics of the sous vide cooked chicken breast during refrigerated storage at 4℃ for 14 d between before and after sous-vide cooking. Cooking loss and shear force were significantly increased, whereas expressible drip was significantly decreased along with reduction in the water holding capacity in both of two groups. Redness of meat juice was significantly (p<0.05) increased during storage, and considerably increased in the refrigerated samples after sous-vide cooked at the 7 to 10 d. The thiobarbituric acid reactive substances (TBARS) was significantly increased and was higher in the refrigerator stored chicken breast samples after sous-vide cooking. The volatile basic nitrogen (VBN) value was significantly increased in both groups, but the VBN value of the stored raw meat sample before sous-vide cooking was increased at an early storage, while the VBN value of the stored sample after sous-vide cooking was increased gradually in this study. Total viable counts and coliform counts were significantly decreased during storage, and coliforms were not detected after 7 d of storage in both groups. Salmonella spp. was not detected during the whole studied period. The outcome of this research can provide preliminary data that could be used to apply for further study of chicken breast using sous-vide cooking method that could be attractive to consumers.

Elder physical abuse.

PubMed

Young, Lisa M

2014-11-01

Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

A direct comparison of spine rotational stiffness and dynamic spine stability during repetitive lifting tasks.

PubMed

Graham, Ryan B; Brown, Stephen H M

2012-06-01

Stability of the spinal column is critical to bear loads, allow movement, and at the same time avoid injury and pain. However, there has been a debate in recent years as to how best to define and quantify spine stability, with the outcome being that different methods are used without a clear understanding of how they relate to one another. Therefore, the goal of the present study was to directly compare lumbar spine rotational stiffness, calculated with an EMG-driven biomechanical model, to local dynamic spine stability calculated using Lyapunov analyses of kinematic data, during a series of continuous dynamic lifting challenges. Twelve healthy male subjects performed 30 repetitive lifts under three varying load and three varying rate conditions. With an increase in the load lifted (constant rate) there was a significant increase in mean, maximum, and minimum spine rotational stiffness (p<0.001) and a significant increase in local dynamic stability (p<0.05); both stability measures were moderately to strongly related to one another (r=-0.55 to -0.71). With an increase in lifting rate (constant load), there was also a significant increase in mean and maximum spine rotational stiffness (p<0.01); however, there was a non-significant decrease in the minimum rotational stiffness and a non-significant decrease in local dynamic stability (p>0.05). Weak linear relationships were found for the varying rate conditions (r=-0.02 to -0.27). The results suggest that spine rotational stiffness and local dynamic stability are closely related to one another, as they provided similar information when movement rate was controlled. However, based on the results from the changing lifting rate conditions, it is evident that both models provide unique information and that future research is required to completely understand the relationship between the two models. Using both techniques concurrently may provide the best information regarding the true effects of (in) stability under different loading and movement scenarios, and in comparing healthy and clinical populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies

PubMed Central

Page, Rupert; Shankar, Rohit; McLean, Brendan N.; Hanna, Jane; Newman, Craig

2018-01-01

Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by the circumstances in which many such patients present. Despite increasing recognition of the importance of earlier identification of those at risk, there is little or no improvement in outcomes over more than 30 years. Despite ever increasing sophistication of drug development and delivery, there has been no meaningful improvement in 1-year seizure freedom rates over this time. However, in the last few years, there has been an increase in patient-triggered interventions based on automated monitoring of indicators and risk factors facilitated by technological advances. The opportunities such approaches provide will only be realized if accompanied by current working practice changes. Replacing traditional follow-up appointments at arbitrary intervals with dynamic interventions, remotely and at the point and place of need provides a better chance of a substantial reduction in seizures for people with epilepsy. Properly implemented, electronic platforms can offer new opportunities to provide expert advice and management from first presentation thus improving outcomes. This perspective paper provides and proposes an informed critical opinion built on current evidence base of an outline techno-therapeutic approach to harnesses these technologies. This conceptual framework is generic, rather than tied to a specific product or solution, and the same generalized approach could be beneficially applied to other long-term conditions. PMID:29551988

"Tag you're it!"--providing flawless customer service in the healthcare security environment.

PubMed

Hogan, Michael V

2012-01-01

An adaptation of a childhood game as a means of providing flawless service to customers will allow security departments to increase their scope and quality of service, the author points out. Teaching our officers the concept of playing "tag, " embracing being "it" and finishing the game will provide a significant return on investment by expanding the value of our departments, he says.

Diet enriched with fresh coconut decreases blood glucose levels and body weight in normal adults.

PubMed

Vijayakumar, Venugopal; Shankar, Nagashree R; Mavathur, Ramesh; Mooventhan, A; Anju, Sood; Manjunath, N K

2018-02-20

Background There exist controversies about the health effects of coconut. Fresh coconut consumption on human health has not been studied substantially. Fresh coconut consumption is a regular part of the diet for many people in tropical countries like India, and thus there is an increasing need to understand the effects of fresh coconut on various aspects of health. Aim To compare the effects of increased saturated fatty acid (SFA) and fiber intake, provided by fresh coconut, versus monounsaturated fatty acid (MUFA) and fiber intake, provided by a combination of groundnut oil and groundnuts, on anthropometry, serum insulin, glucose levels and blood pressure in healthy adults. Materials Eighty healthy volunteers, randomized into two groups, were provided with a standardized diet along with either 100 g fresh coconut or an equivalent amount of groundnuts and groundnut oil for a period of 90 days. Assessments such as anthropometric measurements, blood pressure, blood sugar and insulin levels were performed before and after the supplementation period. Results Results of this study showed a significant reduction in fasting blood sugar (FBS) in both the groups. However, a significant reduction in body weight was observed in the coconut group, while a significant increase in diastolic pressure was observed in the groundnut group. Conclusions Results of this study suggest that fresh coconut-added diet helps reduce blood glucose levels and body weight in normal healthy individuals.

Teaching High School Chemistry in the Context of Pharmacology Helps Both Teachers and Students Learn

PubMed Central

Schwartz-Bloom, Rochelle D.; Halpin, Myra J.; Reiter, Jerome P.

2014-01-01

Few studies demonstrate the impact of teaching chemistry embedded in a context that has relevance to high school students. We build upon our prior work showing that pharmacology topics (i.e., drugs), which are inherently interesting to high school students, provide a useful context for teaching chemistry and biology. In those studies, teachers were provided professional development for the Pharmacology Education Partnership (PEP) in an onsite venue (either five-day or one-day workshop). Given financial difficulties to travel, teachers have asked for alternatives for professional development. Thus, we developed the same PEP training workshop using a distance learning (DL) (two-way live video) approach. In this way, 121 chemistry and biology teachers participated in the DL workshops to learn how to incorporate the PEP modules into their teaching. They field-tested the modules over the year in high school chemistry and biology classes. Teacher knowledge of chemistry and biology increased significantly after the workshop and was maintained for at least a year. Their students (N = 2309) demonstrated a significant increase in knowledge of chemistry and biology concepts, with higher scores as the number of modules used increased. The increase in both teacher and student knowledge in these subjects was similar to that found previously when teachers were provided with onsite professional development. PMID:24882881

Measuring and Advancing Experimental Design Ability in an Introductory Course without Altering Existing Lab Curriculum.

PubMed

Shanks, Ryan A; Robertson, Chuck L; Haygood, Christian S; Herdliksa, Anna M; Herdliska, Heather R; Lloyd, Steven A

2017-01-01

Introductory biology courses provide an important opportunity to prepare students for future courses, yet existing cookbook labs, although important in their own way, fail to provide many of the advantages of semester-long research experiences. Engaging, authentic research experiences aid biology students in meeting many learning goals. Therefore, overlaying a research experience onto the existing lab structure allows faculty to overcome barriers involving curricular change. Here we propose a working model for this overlay design in an introductory biology course and detail a means to conduct this lab with minimal increases in student and faculty workloads. Furthermore, we conducted exploratory factor analysis of the Experimental Design Ability Test (EDAT) and uncovered two latent factors which provide valid means to assess this overlay model's ability to increase advanced experimental design abilities. In a pre-test/post-test design, we demonstrate significant increases in both basic and advanced experimental design abilities in an experimental and comparison group. We measured significantly higher gains in advanced experimental design understanding in students in the experimental group. We believe this overlay model and EDAT factor analysis contribute a novel means to conduct and assess the effectiveness of authentic research experiences in an introductory course without major changes to the course curriculum and with minimal increases in faculty and student workloads.

Scalability of an endoluminal spring for distraction enterogenesis.

PubMed

Rouch, Joshua D; Huynh, Nhan; Scott, Andrew; Chiang, Elvin; Wu, Benjamin M; Shekherdimian, Shant; Dunn, James C Y

2016-12-01

Techniques of distraction enterogenesis have been explored to provide increased intestinal length to treat short bowel syndrome (SBS). Self-expanding, polycaprolactone (PCL) springs have been shown to lengthen bowel in small animal models. Their feasibility in larger animal models is a critical step before clinical use. Juvenile mini-Yucatan pigs underwent jejunal isolation or blind ending Roux-en-y jejunojejunostomy with insertion of either a PCL spring or a sham PCL tube. Extrapolated from our spring characteristics in rodents, proportional increases in spring constant and size were made for porcine intestine. Jejunal segments with 7mm springs with k between 9 and 15N/m demonstrated significantly increased lengthening in isolated segment and Roux-en-y models. Complications were noted in only two animals, both using high spring constant k>17N/m. Histologically, lengthened segments in the isolated and Roux models demonstrated significantly increased muscularis thickness and crypt depth. Restoration of lengthened, isolated segments back into continuity was technically feasible after 6weeks. Self-expanding, endoluminal PCL springs, which exert up to 0.6N force, safely achieve significant intestinal lengthening in a translatable, large-animal model. These spring characteristics may provide a scalable model for the treatment of SBS in children. Copyright © 2016 Elsevier Inc. All rights reserved.

Changes in Large-Scale Atmospheric Circulation Associated with Increased Extreme Precipitation Events in the Northeast United States

NASA Astrophysics Data System (ADS)

Collow, A.; Bosilovich, M. G.; Koster, R. D.

2016-12-01

Over the past two decades a statistically significant increase in the frequency of summertime extreme precipitation events has been observed over the northeastern United States - the largest such increase in the US in terms of area and magnitude. In an effort to characterize synoptic scale patterns and changes to the atmospheric circulation associated with extreme precipitation events in this region, atmospheric fields from the Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) are composited on days that exceed the 90th percentile of precipitation from the CPC-Unified daily gauge-based precipitation observations. Changes over time in composites of sea level pressure, 500 hPa height, and the vertical profile of equivalent potential temperature indicate that the observed increase in extreme precipitation events is associated with extratropical cyclones, including cut off low pressure and frontal systems. Analysis of the Eady maximum growth rate, an indicator for storm tracks, shows that storms tracks in recent years have shifted southward. In addition, mean summertime transient meridional winds have decreased over time, slowing baroclinic systems and causing stationary systems to become more frequent, in agreement with previous studies examining blocking due to high pressure systems. The Atlantic Ocean provides a significant supply of moisture that converges over the region when a cyclonic circulation is situated to the south, and the statistically significant increase in Eady maximum growth rate over time there provides an increasingly improved thermodynamic environment for extreme precipitation events.

Socioeconomic factors and suicide: an analysis of 18 industrialized countries for the years 1983 through 2007.

PubMed

Barth, Alfred; Sögner, Leopold; Gnambs, Timo; Kundi, Michael; Reiner, Andreas; Winker, Robert

2011-03-01

To evaluate the association between socioeconomic factors and suicide rates. Analysis of time series of suicide rates, gross domestic product, unemployment rates, labor force participation, and divorce rates of 18 countries are analyzed by the application of panel-vector error correction models. Main outcome measures are the association between the socioeconomic factors and suicide rates. Decreasing economic growth and increasing divorce rates are significantly associated with increasing suicide rates in men. For women, increasing economic growth, increasing unemployment, and increasing divorce rates are significantly associated with increasing suicides. Increasing female labor force participation is associated with decreasing suicides. Socioeconomic factors are associated with suicide rates. However, this relationship differs by sex. The current results provide a strong argument that suicide prevention strategies must include the monitoring of socioeconomic development.

NJ School Breakfast Snapshot: The Underachievers

ERIC Educational Resources Information Center

Advocates for Children of New Jersey, 2014

2014-01-01

Over the past few years, New Jersey schools have achieved significant progress in providing breakfast to more low-income students, with a 55 percent increase from 2010 to 2014. However, in May 2014, 49 New Jersey school districts with high levels of poverty continued to lag in providing breakfast to their students. This two-page report lists…

Can an increase in leaf iron reductase activity enhance seed iron accumulation in soybean?

USDA-ARS?s Scientific Manuscript database

Iron is an important micronutrient for human nutrition, with plant foods providing a significant amount of dietary iron in certain population groups, and in some cases, providing the sole source of dietary iron. Because iron deficiency is unfortunately common in many human populations, we have been...

Lifelong Learning in Public Libraries in 12 European Union Countries: Policy and Considerations

ERIC Educational Resources Information Center

Stanziola, Javier

2010-01-01

Public libraries have traditionally provided key inputs to support lifelong learning. More recently, significant social and technological changes have challenged this sector to redefine their role in this field. For most public libraries in Europe this has meant continuing their role as providers of information and advice while increasing services…

Double-duty caregivers: healthcare professionals juggling employment and informal caregiving. A survey on personal health and work experiences.

PubMed

Boumans, Nicolle P G; Dorant, Elisabeth

2014-07-01

This study compared the work-related experiences and personal health status of double-duty caregivers with those of caregivers who do not provide informal care to a family member or close friend in need. The interest in providing informal care alongside employment is growing. However, little attention has been paid to the dual role of the healthcare professional who also has caregiving responsibilities for a needy person in his/her private situation. It is important to study the negative and positive consequences of this combination of professional and family care giving. A cross-sectional study. In 2011, we distributed a digital questionnaire to employees with a professional care function working at a healthcare organization in the Netherlands. Descriptive statistics, analyses of covariance and tests of linearity were performed. Analyses of variance demonstrated that as professional healthcare workers provide more hours of informal care in their private lives, their mental and physical health significantly worsens, while their need for recovery increases. Also, statistical significant increases were seen for emotional exhaustion, presenteeism and negative experiences with Work-Home and Home-Work Interferences. Remarkably, positive Home-Work Interference increased significantly with increasing hours of informal care. Double-duty caregivers appeared to be equally motivated and satisfied with their work as their co-workers. No differences were seen with respect to absenteeism. Double-duty caregivers prove to be employees who are at risk of developing symptoms of overload. This finding calls for special attention, with long-term solutions at both legislative and organizational level. © 2013 John Wiley & Sons Ltd.

Modelling the physics in iterative reconstruction for transmission computed tomography

PubMed Central

Nuyts, Johan; De Man, Bruno; Fessler, Jeffrey A.; Zbijewski, Wojciech; Beekman, Freek J.

2013-01-01

There is an increasing interest in iterative reconstruction (IR) as a key tool to improve quality and increase applicability of X-ray CT imaging. IR has the ability to significantly reduce patient dose, it provides the flexibility to reconstruct images from arbitrary X-ray system geometries and it allows to include detailed models of photon transport and detection physics, to accurately correct for a wide variety of image degrading effects. This paper reviews discretisation issues and modelling of finite spatial resolution, Compton scatter in the scanned object, data noise and the energy spectrum. Widespread implementation of IR with highly accurate model-based correction, however, still requires significant effort. In addition, new hardware will provide new opportunities and challenges to improve CT with new modelling. PMID:23739261

Aerocapture Inflatable Decelerator for Planetary Entry

NASA Technical Reports Server (NTRS)

Reza, Sajjad; Hund, Richard; Kustas, Frank; Willcockson, William; Songer, Jarvis; Brown, Glen

2007-01-01

Forward Attached Inflatable Decelerators, more commonly known as inflatable aeroshells, provide an effective, cost efficient means of decelerating spacecrafts by using atmospheric drag for aerocapture or planetary entry instead of conventional liquid propulsion deceleration systems. Entry into planetary atmospheres results in significant heating and aerodynamic pressures which stress aeroshell systems to their useful limits. Incorporation of lightweight inflatable decelerator surfaces with increased surface-area footprints provides the opportunity to reduce heat flux and induced temperatures, while increasing the payload mass fraction. Furthermore, inflatable aeroshell decelerators provide the needed deceleration at considerably higher altitudes and Mach numbers when compared with conventional rigid aeroshell entry systems. Inflatable aeroshells also provide for stowage in a compact space, with subsequent deployment of a large-area, lightweight heatshield to survive entry heating. Use of a deployable heatshield decelerator enables an increase in the spacecraft payload mass fraction and may eliminate the need for a spacecraft backshell.

Remarkable cycle-activated capacity increasing in onion-like carbon nanospheres as lithium battery anode material

NASA Astrophysics Data System (ADS)

Dong, Jiajun; Zhang, Tong; Zhang, Dong; Zhang, Weiwei; Zhang, Huafang; Liu, Ran; Yao, Mingguang; Liu, Bingbing

2017-01-01

Onion-like carbon nanospheres (OCNSs) with an average diameter of 43 nm were produced on a large scale via a combustion method and examined as an anode material for lithium ion batteries. The OCNSs exhibit a remarkable electrochemical cycling behavior and a capacity much higher than that of graphite. The capacity increases significantly with increasing charge-discharge cycles and reaches a value of 178% of the initial value (from 586 mA h g-1to 1045 mA h g-1) after 200 cycles. Further investigation provides unambiguous experimental evidence that such a remarkable capacity increase is related to the stable onion-like structure of the OCNSs and to the existence of large numbers of disordered/short graphitic fragments, which gradually provide more active sites for Li ion storage. The unique electrochemical performance of OCNSs provides a new way to design a high-performance anode material for rechargeable batteries.

The Quality of Registration of Clinical Trials: Still a Problem

PubMed Central

Viergever, Roderik F.; Karam, Ghassan; Reis, Andreas; Ghersi, Davina

2014-01-01

Introduction The benefits of clinical trials registration include improved transparency on clinical trials for healthcare workers and patients, increased accountability of trialists, the potential to address publication bias and selective reporting, and possibilities for research collaboration and prioritization. However, poor quality of information in registered records of trials has been found to undermine these benefits in the past. Trialists' increasing experience with trial registration and recent developments in registration systems may have positively affected data quality. This study was conducted to investigate whether the quality of registration has improved. Methods We repeated a study from 2009, using the same methods and the same research team. A random sample of 400 records of clinical trials that were registered between 01/01/2012 and 01/01/2013 was taken from the International Clinical Trials Registry Platform (ICTRP) and assessed for the quality of information on 1) contact details, 2) interventions and 3) primary outcomes. Results were compared to the equivalent assessments from our previous study. Results There was a small and not statistically significant increase from 81.0% to 85.5% in the percentage of records that provided a name of a contact person. There was a significant increase from 68.7% to 74.9% in the number of records that provided either an email address or a telephone number. There was a significant increase from 44.2% to 51.9% in the number of intervention arms that were complete in registering intervention specifics. There was a significant increase from 38.2% to 57.6% in the number of primary outcomes that were specific measures with a meaningful timeframe. Approximately half of all trials continued to be retrospectively registered. Discussion There have been small but significant improvements in the quality of registration since 2009. Important problems with quality remain and continue to constitute an impediment to the meaningful utilization of registered trial information. PMID:24427293

Improving the numerical integration solution of satellite orbits in the presence of solar radiation pressure using modified back differences

NASA Technical Reports Server (NTRS)

Lundberg, J. B.; Feulner, M. R.; Abusali, P. A. M.; Ho, C. S.

1991-01-01

The method of modified back differences, a technique that significantly reduces the numerical integration errors associated with crossing shadow boundaries using a fixed-mesh multistep integrator without a significant increase in computer run time, is presented. While Hubbard's integral approach can produce significant improvements to the trajectory solution, the interpolation method provides the best overall results. It is demonstrated that iterating on the point mass term correction is also important for achieving the best overall results. It is also shown that the method of modified back differences can be implemented with only a small increase in execution time.

Forest Ecosystem Processes at the Watershed Scale: Ecosystem services, feedback and evolution in developing mountainous catchments

NASA Astrophysics Data System (ADS)

Band, Larry

2010-05-01

Mountain watersheds provide significant ecosystem services both locally and for surrounding regions, including the provision of freshwater, hydropower, carbon sequestration, habitat, forest products and recreational/aesthetic opportunities. The hydrologic connectivity along hillslopes in sloping terrain provides an upslope subsidy of water and nutrients to downslope ecosystem patches, producing characteristic ecosystem patterns of vegetation density and type, and soil biogeochemical cycling. Recent work suggests that optimal patterns of forest cover evolve along these flowpaths which maximize net primary productivity and carbon sequestration at the hillslope to catchment scale. These watersheds are under significant pressure from potential climate change, changes in forest management, increasing population and development, and increasing demand for water export. As water balance and flowpaths are altered by shifting weather patterns and new development, the spatial distribution and coupling of water, carbon and nutrient cycling will spur the evolution of different ecosystem patterns. These issues have both theoretical and practical implications for the coupling of water, carbon and nutrient cycling at the landscape level, and the potential to manage watersheds for bundled ecosystem services. If the spatial structure of the ecosystem spontaneously adjusts to maximize landscape level use of limiting resources, there may be trade-offs in the level of services provided. The well known carbon-for-water tradeoff reflects the growth of forests to maximize carbon uptake, but also transpiration which limits freshwater availability in many biomes. We provide examples of the response of bundled ecosystem services to climate and land use change in the Southern Appalachian Mountains of the United States. These mountains have very high net primary productivity, biodiversity and water yields, and provide significant freshwater resources to surrounding regions. There has been a significant increase in population in the Southern Appalachians, with new building of second homes in steep headwaters, requiring significant expansion in high altitude roads, in contrast with traditional valley bottom development. With additional increases in hydrologic extremes (heavy precipitation and drought), and progressive changes in forest composition there has been increases in hazard from flash flooding, landslide activity and degraded water quality. The evaluation of integrated watershed impacts of the expected changes in climate and land management requires an interdisciplinary approach including direct feedbacks between ecological, hydrological, geomorphic and atmospheric processes within the framework of an adapting social system. Advances in this type of interdisciplinary research require a network of ecohydrologic observatories generating long term, multi-dimensional data, and a science community working across the interface of multiple fields. Adding individual and institutional behavior as an input or interactive component of watershed ecosystems remains a challenge that spans ecological, hydrological and social science.

Preliminary marked increase in the national organ donation rate in Israel following implementation of a new organ transplantation law.

PubMed

Lavee, J; Ashkenazi, T; Stoler, A; Cohen, J; Beyar, R

2013-03-01

Israel's organ donation rate has always been among the lowest in Western countries. In 2008 two new laws relevant to organ transplantation were introduced. The Brain-Respiratory Death Law defines the precise circumstances and mechanisms to determine brain death. The Organ Transplantation Law bans reimbursing transplant tourism involving organ trade, grants prioritization in organ allocation to candidates who are registered donors and removes disincentives for living donation by providing modest insurance reimbursement and social supportive services. The preliminary impact of the gradual introduction and implementation of these laws has been witnessed in 2011. Compared to previous years, in 2011 there was a significant increase in the number of deceased organ donors directly related to an increase in organ donation rate (from 7.8 to 11.4 donors per million population), in parallel to a significant increase in the number of new registered donors. In addition the number of kidney transplantations from living donors significantly increased in parallel to a significant decrease in the number of kidney transplantations performed abroad (from 155 in 2006 to 35 in 2011). The new laws have significantly increased both deceased and living organ donation while sharply decreasing transplant tourism. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

The Role of the State Department of Education in Managing Teacher Education and Certification.

ERIC Educational Resources Information Center

Golden, William Cecil

The Florida State Department of Education research and development program is aimed at transforming three significant educational ideas into possibilities: increased productivity in the educational system, increased accountability for educational programs, and continuing self-renewal in all of education. Target dates provide that by 1972…

12 CFR 702.203 - Prompt corrective action for “significantly undercapitalized” credit unions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to increase except as provided in § 702.202(a)(3) and (4) Restrict member business loans. Not increase the total dollar amount of member business loans (defined as loans outstanding and unused... this part: (1) Requiring prior approval for acquisitions, branching, new lines of business. Prohibit a...

Building political and financial support for science and technology for agriculture.

PubMed

Beachy, Roger N

2014-04-05

The high rate of return on investments in research and development in agriculture, estimated at between 20- and 40-fold, provides a strong rationale for increasing financial support for such research. Furthermore, the urgency to provide sufficient nutrition for a growing population amid growing demands for an expanding bioeconomy, while facing population growth and changing global weather patterns heightens the urgency to expand research and development in this field. Unfortunately, support by governments for research has increased at a fraction of the rate of increases in support of research for health, energy, etc. Although there have been significant increases in investments by the private sector over the past two decades, much of the foundational research that supports private-sector activities is generated in the public sector. To achieve the greatest benefits of breakthroughs in research, it may be necessary to reconfigure research funding and technology transfer mechanisms in order to more rapidly apply discoveries to local needs as well as to global challenges. Some changes will likely require significant organizational, administrative and operational changes in education and research institutions.

Retinopathy of prematurity: a new epidemic?

PubMed

Gibson, D L; Sheps, S B; Schechter, M T; Wiggins, S; McCormick, A Q

1989-04-01

This study provides the first empiric evidence for the existence of a new epidemic of retinopathy of prematurity-induced blindness. Data from a population-based register of handicapping conditions in the Canadian province of British Columbia, and a birth weight-specific census of live-born infants in British Columbia, were used to determine annual, population-level incidences of retinopathy of prematurity-induced blindness during 1952 to 1983. Changes in incidence since the end of the original epidemic (1954) were determined by subdividing the 29-year period (1955 to 1983) into two intervals (1955 to 1964 and 1965 to 1983). Standardized incidence ratio analyses revealed a marginally significant increase in the overall incidence of retinopathy of prematurity-induced blindness in the later as compared with the earlier period. Infants weighing 750 to 999 g at birth had a significantly increased standardized incidence ratio of 3.07 (95% confidence interval 1.26, 11.06). No increases in risk were observed in heavier or lighter weight infants. Because ascertainment and diagnostic changes do not explain the weight-specific increases in incidence, these results provide the first population-level evidence for a new epidemic.

Building political and financial support for science and technology for agriculture

PubMed Central

Beachy, Roger N.

2014-01-01

The high rate of return on investments in research and development in agriculture, estimated at between 20- and 40-fold, provides a strong rationale for increasing financial support for such research. Furthermore, the urgency to provide sufficient nutrition for a growing population amid growing demands for an expanding bioeconomy, while facing population growth and changing global weather patterns heightens the urgency to expand research and development in this field. Unfortunately, support by governments for research has increased at a fraction of the rate of increases in support of research for health, energy, etc. Although there have been significant increases in investments by the private sector over the past two decades, much of the foundational research that supports private-sector activities is generated in the public sector. To achieve the greatest benefits of breakthroughs in research, it may be necessary to reconfigure research funding and technology transfer mechanisms in order to more rapidly apply discoveries to local needs as well as to global challenges. Some changes will likely require significant organizational, administrative and operational changes in education and research institutions. PMID:24535386

Higher price, fewer packs: evaluating a tobacco tax increase with cigarette sales data.

PubMed

Amato, Michael S; Boyle, Raymond G; Brock, Betsy

2015-03-01

In 2013, Minnesota increased cigarette taxes by $1.75, the largest US state increase since 2000. We obtained convenience store data of cigarette sales from January 2012 to December 2013 from the Nielsen Company. Analysis revealed significantly greater year-to-year reductions in numbers of packs purchased during posttax (-12.1%) than pretax (-3.2%; P<.001) periods. The results provide contemporary evidence that, despite reduced prevalence and increased tobacco control efforts, tax increases remain an effective tobacco control strategy.

Paracrine Regulation of Steroidogenesis in Theca Cells by Granulosa Cells Derived from Mouse Preantral Follicles.

PubMed

Liu, Xiaoqiang; Qiao, Pengyun; Jiang, Aifang; Jiang, Junyi; Han, Haiyan; Wang, Li; Ren, Chune

2015-01-01

Interaction partners of follicular cells play a significant role in steroidogenesis, follicular formation, and development. Androgen secreted by theca cells (TCs) can initiate follicle development and ovulation and provide precursor materials for estrogen synthesis. Therefore, studies on ovarian microenvironment will not only lead to better understanding of the steroidogenesis but also have clinical significance for ovarian endocrine abnormalities such as hyperandrogenism in polycystic ovary syndrome (PCOS). This study applied the Transwell coculture model to investigate if the interaction between granulosa and theca cells may affect androgen production in theca cells. Concentrations of testosterone and androstenedione in the spent medium were measured by radioimmunoassay and enzyme linked immunosorbent assay, respectively. The results show that the coculture with granulosa cells (GCs) increases steroidogenesis in TCs. In addition, testosterone and androstenedione productions in response to LH stimulation were also increased in the coculture model. Significantly increased mRNA expressions of steroidogenic enzymes (Star, Cyp11a1, Cyp17a1, and Hsd3b2) were observed in the cocultured TCs. Thus, GCs were capable of promoting steroidogenesis and LH responsiveness in TCs. This study provided a basis for further exploration of ovarian endocrine mechanism and pathologies.

Data centers as dispatchable loads to harness stranded power

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

Kim, Kibaek; Yang, Fan; Zavala, Victor M.

Here, we analyze how traditional data center placement and optimal placement of dispatchable data centers affect power grid efficiency. We use detailed network models, stochastic optimization formulations, and diverse renewable generation scenarios to perform our analysis. Our results reveal that significant spillage and stranded power will persist in power grids as wind power levels are increased. A counter-intuitive finding is that collocating data centers with inflexible loads next to wind farms has limited impacts on renewable portfolio standard (RPS) goals because it provides limited system-level flexibility. Such an approach can, in fact, increase stranded power and fossil-fueled generation. In contrast,more » optimally placing data centers that are dispatchable provides system-wide flexibility, reduces stranded power, and improves efficiency. In short, optimally placed dispatchable computing loads can enable better scaling to high RPS. In our case study, we find that these dispatchable computing loads are powered to 60-80% of their requested capacity, indicating that there are significant economic incentives provided by stranded power.« less

Data centers as dispatchable loads to harness stranded power

DOE PAGES

Kim, Kibaek; Yang, Fan; Zavala, Victor M.; ...

2016-07-20

Here, we analyze how traditional data center placement and optimal placement of dispatchable data centers affect power grid efficiency. We use detailed network models, stochastic optimization formulations, and diverse renewable generation scenarios to perform our analysis. Our results reveal that significant spillage and stranded power will persist in power grids as wind power levels are increased. A counter-intuitive finding is that collocating data centers with inflexible loads next to wind farms has limited impacts on renewable portfolio standard (RPS) goals because it provides limited system-level flexibility. Such an approach can, in fact, increase stranded power and fossil-fueled generation. In contrast,more » optimally placing data centers that are dispatchable provides system-wide flexibility, reduces stranded power, and improves efficiency. In short, optimally placed dispatchable computing loads can enable better scaling to high RPS. In our case study, we find that these dispatchable computing loads are powered to 60-80% of their requested capacity, indicating that there are significant economic incentives provided by stranded power.« less

Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang.

PubMed

Moss, Mark; Hewitt, Steven; Moss, Lucy; Wesnes, Keith

2008-01-01

This study provides further evidence for the impact of the aromas of plant essential oils on aspects of cognition and mood in healthy participants. One hundred and forty-four volunteers were randomly assigned to conditions of ylang-ylang aroma, peppermint aroma, or no aroma control. Cognitive performance was assessed using the Cognitive Drug Research computerized assessment battery, with mood scales completed before and after cognitive testing. The analysis of the data revealed significant differences between conditions on a number of the factors underpinning the tests that constitute the battery. Peppermint was found to enhance memory whereas ylang-ylang impaired it, and lengthened processing speed. In terms of subjective mood peppermint increased alertness and ylang-ylang decreased it, but significantly increased calmness. These results provide support for the contention that the aromas of essential oils can produce significant and idiosyncratic effects on both subjective and objective assessments of aspects of human behavior. They are discussed with reference to possible pharmacological and psychological modes of influence.

Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data

PubMed Central

Hanley, Adam W.; Goldin, Phillipe R.; Gross, James J.

2017-01-01

Background and objective The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation. Design We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis. Results Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy. Conclusion Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes. PMID:29211754

The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial

PubMed Central

2014-01-01

Background Decision aids offer promise as a practical solution to improve patient decision making about coronary heart disease (CHD) prevention medications and help patients choose medications to which they are likely to adhere. However, little data is available on decision aids designed to promote adherence. Methods In this paper, we report on secondary analyses of a randomized trial of a CHD adherence intervention (second generation decision aid plus tailored messages) versus usual care in an effort to understand how the decision aid facilitates adherence. We focus on data collected from the primary study visit, when intervention participants presented 45 minutes early to a previously scheduled provider visit; viewed the decision aid, indicating their intent for CHD risk reduction after each decision aid component (individualized risk assessment and education, values clarification, and coaching); and filled out a post-decision aid survey assessing their knowledge, perceived risk, decisional conflict, and intent for CHD risk reduction. Control participants did not present early and received usual care from their provider. Following the provider visit, participants in both groups completed post-visit surveys assessing the number and quality of CHD discussions with their provider, their intent for CHD risk reduction, and their feelings about the decision aid. Results We enrolled 160 patients into our study (81 intervention, 79 control). Within the decision aid group, the decision aid significantly increased knowledge of effective CHD prevention strategies (+21 percentage points; adjusted p<.0001) and the accuracy of perceived CHD risk (+33 percentage points; adjusted p<.0001), and significantly decreased decisional conflict (-0.63; adjusted p<.0001). Comparing between study groups, the decision aid also significantly increased CHD prevention discussions with providers (+31 percentage points; adjusted p<.0001) and improved perceptions of some features of patient-provider interactions. Further, it increased participants’ intentions for any effective CHD risk reducing strategies (+21 percentage points; 95% CI 5 to 37 percentage points), with a majority of the effect from the educational component of the decision aid. Ninety-nine percent of participants found the decision aid easy to understand and 93% felt it easy to use. Conclusions Decision aids can play an important role in improving decisions about CHD prevention and increasing patient-provider discussions and intent to reduce CHD risk. PMID:24575882

Interest in Providing Multiple Sclerosis Care and Subspecializing in Multiple Sclerosis Among Neurology Residents

PubMed Central

Teixeira-Poit, Stephanie; Kane, Heather L.; Frost, A. Corey; Keating, Michael; Olmsted, Murrey

2014-01-01

Background: Although detailed knowledge regarding treatment options for multiple sclerosis (MS) patients is largely limited to neurologists, shortages in the neurologist workforce, including MS subspecialists, are predicted. Thus, MS patients may have difficulties in gaining access to appropriate care. No systematic evaluation has yet been performed of the number of neurology residents planning to pursue MS subspecialization. This study identifies factors affecting interest in providing MS patient care or MS subspecialization among current neurology residents. Methods: We randomly selected half of all Accreditation Council of Graduate Medical Education–certified neurology residency programs in the continental United States to receive the neurology resident survey. Completed surveys were received from 218 residents. Results: Residents were significantly more likely to have increased interest in MS care when they participated in MS research, were interested in teaching, and indicated that the “ability to improve patient outcomes and quality of life” was a positive factor influencing their desire to provide MS patient care. Residents who were interested in providing MS care, interested in teaching, and indicated that “research opportunities” was a positive factor for providing MS patient care were significantly more likely to express interest in MS subspecialization. Conclusions: Increasing opportunities to interact with MS patients, learn about MS care, and participate in MS research may increase interest in MS care and subspecialization among neurology residents. Opportunities to educate residents regarding MS patient care may affect residents’ attitudes. PMID:24688352

Recommendations on Model Fidelity for Wind Turbine Gearbox Simulations; NREL (National Renewable Energy Laboratory)

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

Keller, J.; Lacava, W.; Austin, J.

2015-02-01

This work investigates the minimum level of fidelity required to accurately simulate wind turbine gearboxes using state-of-the-art design tools. Excessive model fidelity including drivetrain complexity, gearbox complexity, excitation sources, and imperfections, significantly increases computational time, but may not provide a commensurate increase in the value of the results. Essential designparameters are evaluated, including the planetary load-sharing factor, gear tooth load distribution, and sun orbit motion. Based on the sensitivity study results, recommendations for the minimum model fidelities are provided.

Innovative rapid construction/reconstruction methods.

DOT National Transportation Integrated Search

2005-07-01

Innovative construction and reconstruction methods provide the opportunity to significantly reduce the time of roadway projects while maintaining the necessary quality of workmanship. The need for these rapid methods stems from the increase in ...

Use of Traditional and Smartphone App Flashcards in an Introductory Psychology Class

ERIC Educational Resources Information Center

Burgess, Stephen R.; Murray, Ashley B.

2014-01-01

The use of traditional and smart phone flashcards was examined in two Introductory Psychology college classes. Student use of flashcards of some type increased significantly when they were provided by the instructor. Flashcards available via smartphone app were not used by many students even when provided by the instructor. The results are…

A look back at 2000: overabundance and deregulation.

PubMed

2001-04-01

(1) Ten or 20 years ago about half the new drugs released each year provided no significant advantage for the patient, relative to existing therapeutic means. This proportion has been increasing gradually over the last 5 years. (2) In 2000, approximately 80% of "new" drugs in fact provided "Nothing New" for the patient according to our rating system.

The Latino Workforce at Mid-Decade. CSRC Research Report. Number 10

ERIC Educational Resources Information Center

Catanzarite, Lisa; Trimble, Lindsey

2007-01-01

The Latino workforce is increasingly critical to the vitality of the U.S. economy. Despite the importance of Latinos in the labor market, their economic contributions are limited by significant disadvantages. This research report provides an overview of Latino workers in the United States at mid-decade. We provide background information on labor…

Race to the Top. New York Report. Year 1: School Year 2010-2011. [State-Specific Summary Report

ERIC Educational Resources Information Center

US Department of Education, 2012

2012-01-01

This State-specific summary report serves as an assessment of New York's Year 1 Race to the Top implementation, highlighting successes and accomplishments, identifying challenges, and providing lessons learned from implementation to date. New York significantly increased its capacity to provide support to its local educational agencies (LEAs). At…

Dialectical Behavioral Therapy and EMDR for Adolescents in Residential Treatment: A Practical and Theoretical Perspective

ERIC Educational Resources Information Center

Lovelle, Carole

2005-01-01

DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional…

Nutrient Concentrations, Loads, and Yields in the Eucha-Spavinaw Basin, Arkansas and Oklahoma, 2002-2004

USGS Publications Warehouse

Tortorelli, Robert L.

2006-01-01

The City of Tulsa, Oklahoma, uses Lake Eucha and Spavinaw Lake in the Eucha-Spavinaw basin in northwestern Arkansas and northeastern Oklahoma for public water supply. Taste and odor problems in the water attributable to blue-green algae have increased in frequency over time. Changes in the algae community in the lakes may be attributable to increases in nutrient levels in the lakes, and in the waters feeding the lakes. The U.S. Geological Survey, in cooperation with the City of Tulsa, conducted an investigation to summarize nitrogen and phosphorus concentrations and provide estimates of nitrogen and phosphorus loads, yields, and flow-weighted concentrations in the Eucha-Spavinaw basin for a 3-year period from January 2002 through December 2004. This report provides information needed to advance knowledge of the regional hydrologic system and understanding of hydrologic processes, and provides hydrologic data and results useful to multiple parties for interstate compacts. Nitrogen and phosphorus concentrations were significantly greater in runoff samples than in base-flow samples at Spavinaw Creek near Maysville, Arkansas; Spavinaw Creek near Colcord, Oklahoma, and Beaty Creek near Jay, Oklahoma. Runoff concentrations were not significantly greater than in base-flow samples at Spavinaw Creek near Cherokee, Arkansas; and Spavinaw Creek near Sycamore, Oklahoma. Nitrogen concentrations in base-flow samples significantly increased in the downstream direction in Spavinaw Creek from the Maysville to Sycamore stations then significantly decreased from the Sycamore to the Colcord stations. Nitrogen in base-flow samples from Beaty Creek was significantly less than in those from Spavinaw Creek. Phosphorus concentrations in base-flow samples significantly increased from the Maysville to Cherokee stations in Spavinaw Creek, probably due to a point source between those stations, then significantly decreased downstream from the Cherokee to Colcord stations. Phosphorus in base-flow samples from Beaty Creek was significantly less than phosphorus in base-flow samples from Spavinaw Creek downstream from the Maysville station. Nitrogen concentrations in runoff samples were not significantly different among the stations on Spavinaw Creek; however, the concentrations at Beaty Creek were significantly less than at all other stations. Phosphorus concentrations in runoff samples were not significantly different among the three downstream stations on Spavinaw Creek, and not significantly different at the Maysville station on Spavinaw Creek and the Beaty Creek station. Phosphorus and nitrogen concentrations in runoff samples from all stations generally increased with increasing streamflow. Estimated mean annual nitrogen total loads from 2002-2004 were substantially greater at the Spavinaw Creek stations than at Beaty Creek and increased in a downstream direction from Maysville to Colcord in Spavinaw Creek, with the load at the Colcord station about 2 times that of Maysville station. Estimated mean annual nitrogen base-flow loads at the Spavinaw Creek stations were about 5 to 11 times greater than base-flow loads at Beaty Creek. The runoff component of the annual nitrogen total load for Beaty Creek was 85 percent, whereas, at the Spavinaw Creek stations, the range in the runoff component was 60 to 66 percent. Estimated mean annual phosphorus total loads from 2002-2004 were greater at the Spavinaw Creek stations from Cherokee to Colcord than at Beaty Creek and increased in a downstream direction from Maysville to Colcord in Spavinaw Creek, with the load at the Colcord station about 2.5 times that of Maysville station. Estimated mean annual phosphorus base-flow loads at the Spavinaw Creek stations were about 2.5 to 19 times greater than at Beaty Creek. Phosphorus base-flow loads increased about 8 times from Maysville to Cherokee in Spavinaw Creek; the base-flow loads were about the same at the three downstream stations. The runoff component

The effects of New York's bypass surgery provider profiling on access to care and patient outcomes in the elderly.

PubMed

Peterson, E D; DeLong, E R; Jollis, J G; Muhlbaier, L H; Mark, D B

1998-10-01

The aim of this study was to examine the effects of provider profiling on bypass surgery access and outcomes in elderly patients in New York. Since 1989, New York (NY) has compiled provider-specific bypass surgery mortality reports. While some have proposed that "provider profiling" has led to lower surgical mortality rates, critics have suggested that such programs lower in-state procedural access (increasing out-of-state transfers) without improving patient outcomes. Using national Medicare data, we examined trends in the percentages of NY residents aged 65 years or older receiving out-of-state bypass surgery between 1987 and 1992 (before and after program initiation). We also examined in-state procedure use among elderly myocardial infarction patients during this period. Finally, we compared trends in surgical outcomes in NY Medicare patients with those for the rest of the nation. Between 1987 and 1992, the percentage of NY residents receiving bypass out-of-state actually declined (from 12.5% to 11.3%, p < 0.01 for trend). An elderly patient's likelihood for bypass following myocardial infarction in NY increased significantly since the program's initiation. Between 1987 and 1992, unadjusted 30-day mortality rates following bypass declined by 33% in NY Medicare patients compared with a 19% decline nationwide (p < 0.001). As a result of this improvement, NY had the lowest risk-adjusted bypass mortality rate of any state in 1992. We found no evidence that NY's provider profiling limited procedure access in NY's elderly or increased out-of-state transfers. Despite an increasing preoperative risk profile, procedural outcomes in NY improved significantly faster than the national average.

An initiative to provide emergency healthcare for older people in the community: the impact on carers.

PubMed

Knowles, E; Mason, S; Colwell, B

2011-04-01

The increase in the size and age of the UK older population has had a major effect on emergency services. Many older people will visit the emergency department but not necessarily require significant clinical intervention. The Paramedic Practitioner in Older People's Support (PPOPS) scheme was set up to provide community-based clinical assessment of older patients contacting the emergency services with minor acute conditions as an alternative approach to emergency department transfer. Patient carers were followed-up to evaluate the impact of this scheme when compared with standard transfer to the emergency department. Postal questionnaires, including items on the level of care provided, satisfaction with care received and carer impact, were administered to 561 carers. The overall response rate was 71.5% (401/561). The carers were predominantly female, approximately 60 years of age and family members, with more than three-quarters providing some form of physical care before the patient episode. Overall, carers did report an increase in the level of care provided before episode, significantly more so in the emergency department group (p=0.003). These increases related to more input needed in supporting physical activities. The carers in the PPOPS group were more likely to report greater satisfaction with their impression of care and staff attitude and would prefer treatment at home for the patient than those in the emergency department group (p<0.001). A minor health event does impact on the life of a carer. However, community-based schemes, such as PPOPS, do not increase the burden on carers and have high levels of satisfaction among this important group of the community.

Effectiveness of a worksite social & physical environment intervention on need for recovery, physical activity and relaxation; results of a randomized controlled trial.

PubMed

Coffeng, Jennifer K; Boot, Cécile R L; Duijts, Saskia F A; Twisk, Jos W R; van Mechelen, Willem; Hendriksen, Ingrid J M

2014-01-01

To investigate the effectiveness of a worksite social and physical environment intervention on need for recovery (i.e., early symptoms of work-related mental and physical fatigue), physical activity and relaxation. Also, the effectiveness of the separate interventions was investigated. In this 2 × 2 factorial design study, 412 office employees from a financial service provider participated. Participants were allocated to the combined social and physical intervention, to the social intervention only, to the physical intervention only or to the control group. The primary outcome measure was need for recovery. Secondary outcomes were work-related stress (i.e., exhaustion, detachment and relaxation), small breaks, physical activity (i.e., stair climbing, active commuting, sport activities, light/moderate/vigorous physical activity) and sedentary behavior. Outcomes were measured by questionnaires at baseline, 6 and 12 months follow-up. Multilevel analyses were performed to investigate the effects of the three interventions. In all intervention groups, a non-significant reduction was found in need for recovery. In the combined intervention (n = 92), exhaustion and vigorous physical activities decreased significantly, and small breaks at work and active commuting increased significantly compared to the control group. The social intervention (n = 118) showed a significant reduction in exhaustion, sedentary behavior at work and a significant increase in small breaks at work and leisure activities. In the physical intervention (n = 96), stair climbing at work and active commuting significantly increased, and sedentary behavior at work decreased significantly compared to the control group. None of the interventions was effective in improving the need for recovery. It is recommended to implement the social and physical intervention among a population with higher baseline values of need for recovery. Furthermore, the intervention itself could be improved by increasing the intensity of the intervention (for example weekly GMI-sessions), providing physical activity opportunities and exercise schemes, and by more drastic environment interventions (restructuring entire department floor). Nederlands Trial Register NTR2553.

The Role of the Government in Providing Access to Higher Education: The Case of Government-Sponsored Financial Aid in the US

ERIC Educational Resources Information Center

Landry, Lynette; Neubauer, Deane

2016-01-01

The overall financial structure of US higher education has changed dramatically over the past 30 years, resulting in a significant reduction of public funding. One result of this shift has been the steadily increasing costs of tuition as an increasing portion of the financial structure of higher education is shifted to students. Increased costs to…

Novel Application of a Reverse Triage Protocol Providing Increased Access to Care in an Outpatient, Primary Care Clinic Setting.

PubMed

Sacino, Amanda N; Shuster, Jonathan J; Nowicki, Kamil; Carek, Peter J; Wegman, Martin P; Listhaus, Alyson; Gibney, Joseph M; Chang, Ku-Lang

2016-02-01

As the number of patients with access to care increases, outpatient clinics will need to implement innovative strategies to maintain or enhance clinic efficiency. One viable alternative involves reverse triage. A reverse triage protocol was implemented during a student-run free clinic. Each patient's chief complaint(s) were obtained at the beginning of the clinic session and ranked by increasing complexity. "Complexity" was defined as the subjective amount of time required to provide a full, thorough evaluation of a patient. Less complex cases were prioritized first since they could be expedited through clinic processing and allow for more time and resources to be dedicated to complex cases. Descriptive statistics were used to characterize and summarize the data obtained. Categorical variables were analyzed using chi-square. A time series analysis of the outcome versus centered time in weeks was also conducted. The average number of patients seen per clinic session increased by 35% (9.5 versus 12.8) from pre-implementation of the reverse triage protocol to 6 months after the implementation of the protocol. The implementation of a reverse triage in an outpatient setting significantly increased clinic efficiency as noted by a significant increase in the number of patients seen during a clinic session.

Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

PubMed Central

Hex, Nick; Setters, Jo; Little, Stuart

2016-01-01

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers. Educational aims Provide update for oxygen prescribers on options for home oxygen provision. Provide update on the evidence base for available self-fill oxygen technologies. Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems. PMID:27408629

Stabilizing Gas Bearings In Free-Piston Machines

NASA Technical Reports Server (NTRS)

Dhar, Manmohan

1995-01-01

Gas bearings and clearance seals between pistons and cylinders in free-piston machines designed to reduce undesired dynamic forces and torques on pistons, gas bearings, and cylinders. Circumferential grooves and drain galleries added to piston or cylinder in improved design. Provides stabilization without significant reduction in length of seal, or significant increase in leakage and consequent reduction of efficiency.

Providing Access to Academic Content for High-School Students with Significant Intellectual Disability through Interactive Videos

ERIC Educational Resources Information Center

Evmenova, Anya S.; Graff, Heidi J.; Behrmann, Michael M.

2017-01-01

There has been a slight increase in the number of studies focused on the strategies used to introduce content-based instruction to students with moderate/severe disability. However, interventions for students with significant intellectual disability (ID) are lacking adapted materials to make instruction available in all major academic areas…

Carcinogenicity of acrylamide in B6C3F(1) mice and F344/N rats from a 2-year drinking water exposure.

PubMed

Beland, Frederick A; Mellick, Paul W; Olson, Greg R; Mendoza, Maria C B; Marques, M Matilde; Doerge, Daniel R

2013-01-01

Acrylamide is a component of roasted coffee and certain baked and fried carbohydrate-rich foods prepared at high temperatures. We have assessed the carcinogenicity of acrylamide in male and female B6C3F(1) mice and F344/N rats administered 0, 0.0875, 0.175, 0.35, or 0.70mM acrylamide in the drinking water ad libitum for 2 years. Acrylamide caused significant dose-related decreasing trends in the body weights of F344/N rats. Acrylamide administration resulted in significant dose-related decreasing trends in survival in both sexes of B6C3F(1) mice and in female F344/N rats. Histopathological analyses indicated significant dose-related increases in Harderian gland and lung tumors in male and female B6C3F(1) mice. Male B6C3F(1) mice also had a significantly increased incidence of forestomach tumors, while female B6C3F(1) mice had significant dose-related increases in mammary gland, ovary, and skin tumors. In male and female F344/N rats, there were significant increases in thyroid tumors. Male F344/N rats also had significant dose-related increases in testes, heart, and pancreas tumors, while female F344 rats demonstrated significant increases in clitoral gland, mammary gland, oral cavity, and skin tumors. These results, combined with previous mechanistic studies, provide strong support for the concept that acrylamide is activated to a carcinogen through metabolism to glycidamide. Published by Elsevier Ltd.

Provider knowledge, attitudes and treatment preferences for early pregnancy failure

PubMed Central

Dalton, Vanessa K.; Harris, Lisa H.; Gold, Katherine J.; Kane-Low, Lisa; Schulkin, Jay; Guire, Ken; Fendrick, A. Mark

2010-01-01

Objective To describe health care provider knowledge, attitudes and treatment preferences for early pregnancy failure (EPF). Study Design We surveyed 976 obstetrician/gynecologists, midwives and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices. Results Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments. Conclusions Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment. PMID:20227674

Response of Flight Nurses in a Simulated Helicopter Environment.

PubMed

Kaniecki, David M; Hickman, Ronald L; Alfes, Celeste M; Reimer, Andrew P

The purpose of this study was to determine if a helicopter flight simulator could provide a useful educational platform by creating experiences similar to those encountered by actual flight nurses. Flight nurse (FN) and non-FN participants completed a simulated emergency scenario in a flight simulator. Physiologic and psychological stress during the simulation was measured using heart rate and perceived stress scores. A questionnaire was then administered to assess the realism of the flight simulator. Subjects reported that the overall experience in the flight simulator was comparable with a real helicopter. Sounds, communications, vibrations, and movements in the simulator most approximated those of a real-life helicopter environment. Perceived stress levels of all participants increased significantly from 27 (on a 0-100 scale) before simulation to 51 at the peak of the simulation and declined thereafter to 28 (P < .001). Perceived stress levels of FNs increased significantly from 25 before simulation to 54 at the peak of the simulation and declined thereafter to 30 (P < .001). Perceived stress levels of non-FNs increased significantly from 31 before simulation to 49 at the peak of the simulation and declined thereafter to 25 (P < .001). There were no significant differences in perceived stress levels between FNs and non-FNs before (P = .58), during (P = .63), or after (P = .55) simulation. FNs' heart rates increased significantly from 77 before simulation to 100 at the peak of the simulation and declined thereafter to 72 (P < .001). The results of this study suggest that simulation of a critical care scenario in a high-fidelity helicopter flight simulator can provide a realistic helicopter transport experience and create physiologic and psychological stress for participants. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

A multicomponent theory-based intervention improves uptake of pelvic floor muscle training before radical prostatectomy: a 'before and after' cohort study.

PubMed

Hirschhorn, Andrew D; Kolt, Gregory S; Brooks, Andrew J

2014-03-01

To assess the effect of a multicomponent theory-based intervention, incorporating patient information guides, an evidence summary, audit and feedback processes and a provider directory, in the provision/receipt of preoperative pelvic floor muscle training (PFMT) among patients undergoing radical prostatectomy. Over an 18-month period (9 months before and 9 months after the intervention), we measured the provision/receipt of preoperative PFMT using surveys of patients undergoing radical prostatectomy at one public hospital (n = 32) and two private hospitals (n = 107) in Western Sydney, Australia, as well as practice audits of associated public sector (n = 4) and private sector (n = 2) providers of PFMT. Self-report urinary incontinence was assessed 3 months after radical prostatectomy using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Form (ICIQ-UI Short Form). There was a significant increase in the proportion of survey respondents receiving preoperative PFMT post-intervention (post-intervention: 42/58 respondents, 72% vs pre-intervention: 37/81 respondents, 46%, P = 0.002). There was a corresponding significant increase in provision of preoperative PFMT by private sector providers (mean [sd] post-intervention: 16.7 [3.7] patients/month vs pre-intervention: 12.1 [3.6] patients/month, P = 0.018). Respondents receiving preoperative PFMT had significantly better self-report urinary incontinence at 3 months after radical prostatectomy than those who did not receive preoperative PFMT (mean [sd] ICIQ-UI Short Form sum-scores: 6.2 [5.0] vs 9.2 [5.8], P = 0.002). The intervention increased the provision/receipt of preoperative PFMT among patients undergoing radical prostatectomy. Additional component strategies aimed at increasing the use of public sector providers may be necessary to further improve PFMT receipt among patients undergoing radical prostatectomy in the public hospital system. © 2013 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children

PubMed Central

2012-01-01

Background Strategies to increase fruit and vegetable consumption of preschool aged children are needed. Objectives Evaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1.) Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2.) Serving meals portioned and plated by providers. Methods Fifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers) was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once) were also included over the six week trial period. Childrens lunch intake was observed as a measure of food and nutrient intake during each experimental condition. Results Fruit intake was significantly higher (p<0.01) when fruits and vegetables were served in advance of other meal items (0.40 servings/meal) compared to the traditional family style meal service control condition when they were served in tandem with other menu items (0.32 servings/meal). Intakes of some nutrients found in fruits (vitamin A and folate) were concomitantly higher. In contrast, fruit and vegetable intakes were significantly lower and energy intake significantly higher during the provider portioned compared with control condition. Conclusions Serving fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings. PMID:22546262

Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children.

PubMed

Harnack, Lisa J; Oakes, J Michael; French, Simone A; Rydell, Sarah A; Farah, Farhiyah M; Taylor, Gretchen L

2012-04-30

Strategies to increase fruit and vegetable consumption of preschool aged children are needed. Evaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1.) Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2.) Serving meals portioned and plated by providers. Fifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers) was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once) were also included over the six week trial period. Childrens lunch intake was observed as a measure of food and nutrient intake during each experimental condition. Fruit intake was significantly higher (p<0.01) when fruits and vegetables were served in advance of other meal items (0.40 servings/meal) compared to the traditional family style meal service control condition when they were served in tandem with other menu items (0.32 servings/meal). Intakes of some nutrients found in fruits (vitamin A and folate) were concomitantly higher. In contrast, fruit and vegetable intakes were significantly lower and energy intake significantly higher during the provider portioned compared with control condition. Serving fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings.

Effect of cocoa and theobromine consumption on serum HDL-cholesterol concentrations: a randomized controlled trial.

PubMed

Neufingerl, Nicole; Zebregs, Yvonne E M P; Schuring, Ewoud A H; Trautwein, Elke A

2013-06-01

Evidence from clinical studies has suggested that cocoa may increase high-density lipoprotein (HDL)-cholesterol concentrations. However, it is unclear whether this effect is attributable to flavonoids or theobromine, both of which are major cocoa components. We investigated whether pure theobromine increases serum HDL cholesterol and whether there is an interaction effect between theobromine and cocoa. The study had a 2-center, double-blind, randomized, placebo-controlled, full factorial parallel design. After a 2-wk run-in period, 152 healthy men and women (aged 40-70 y) were randomly allocated to consume one 200-mL drink/d for 4 wk that contained 1) cocoa, which naturally provided 150 mg theobromine and 325 mg flavonoids [cocoa intervention (CC)], 2) 850 mg pure theobromine [theobromine intervention (TB)], 3) cocoa and added theobromine, which provided 1000 mg theobromine and 325 mg flavonoids [theobromine and cocoa intervention (TB+CC)], or 4) neither cocoa nor theobromine (placebo). Blood lipids and apolipoproteins were measured at the start and end of interventions. In a 2-factor analysis, there was a significant main effect of the TB (P < 0.0001) but not CC (P = 0.1288) on HDL cholesterol but no significant interaction (P = 0.3735). The TB increased HDL-cholesterol concentrations by 0.16 mmol/L (P < 0.0001). Furthermore, there was a significant main effect of the TB on increasing apolipoprotein A-I (P < 0.0001) and decreasing apolipoprotein B and LDL-cholesterol concentrations (P < 0.02). Theobromine independently increased serum HDL-cholesterol concentrations by 0.16 mmol/L. The lack of significant cocoa and interaction effects suggested that theobromine may be the main ingredient responsible for the HDL cholesterol-raising effect. This trial was registered at clinicaltrials.gov as NCT01481389.

Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits.

PubMed

Downey, Luke A; Sands, Helen; Jones, Lewis; Clow, Angela; Evans, Phil; Stalder, Tobias; Parrott, Andrew C

2015-05-01

The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users. Copyright © 2015 John Wiley & Sons, Ltd.

The pediatric mandible: I. A primer on growth and development.

PubMed

Smartt, James M; Low, David W; Bartlett, Scott P

2005-07-01

After studying this article, the participant should be able to: 1. Describe embryonic and fetal mandibular development. 2. Summarize the aggregate changes in mandibular form from birth to puberty. 3. Describe the eruption and maturation of the deciduous and permanent mandibular dentition. In this, the first of two articles addressing the surgical management of pediatric mandibular fractures, the authors provide a detailed discussion of mandibular development and anatomy during the fetal period, infancy, and childhood. A review of the pertinent literature was performed. The changing structure of the developing mandible is discussed, with particular attention to surgically relevant anatomical structures. Throughout development, key anatomical structures with relevance to surgical therapy change markedly in position. The mandible undergoes significant change in its bony structure and the composition of its surrounding soft tissues. The mandible's bony structure becomes more robust, with an increasingly acute gonial angle and enlargement of the ramus and body. Furthermore, the mandible provides the bony structure from which tooth buds erupt as the deciduous and permanent dentition--a process that generates significant growth of the alveolar process. As a consequence, the distance between the developing dentition and the inferior mandibular border increases. While the canal of the inferior alveolar nerve undergoes significant superior displacement, the mental foramen becomes positioned more posteriorly over time. In addition, the ligamentous and muscular attachments that surround the temporomandibular joint become increasingly robust. Throughout childhood and adolescence, the blood supply of the mandibular body changes little, with the buccal periosteal plexus and inferior dental artery making significant contributions. Mandibular growth provides the basis for normal occlusal relations and the generation of increasingly large masticatory force. Although the exact mechanisms of bone remodeling during mandibular development remain unclear, the process likely receives contributions from primary growth centers and the response to local alterations in biomechanical force produced by surrounding soft-tissue structures. A working knowledge of the changing mandibular anatomy is a prerequisite for effective clinical management of traumatic injury.

Impacts of Snow Darkening by Absorbing Aerosols on Eurasian Climate

NASA Technical Reports Server (NTRS)

Kim, Kyu-Myong; Lau, William K M.; Yasunari, Teppei J.; Kim, Maeng-Ki; Koster, Randal D.

2016-01-01

The deposition of absorbing aerosols on snow surfaces reduces snow-albedo and allows snowpack to absorb more sunlight. This so-called snow darkening effect (SDE) accelerates snow melting and leads to surface warming in spring. To examine the impact of SDE on weather and climate during late spring and early summer, two sets of NASA GEOS-5 model simulations with and without SDE are conducted. Results show that SDE-induced surface heating is particularly pronounced in Eurasian regions where significant depositions of dust transported from the North African deserts, and black carbon from biomass burning from Asia and Europe occur. In these regions, the surface heating due to SDE increases surface skin temperature by 3-6 degrees Kelvin near the snowline in spring. Surface energy budget analysis indicates that SDE-induced excess heating is associated with a large increase in surface evaporation, subsequently leading to a significant reduction in soil moisture, and increased risks of drought and heat waves in late spring to early summer. Overall, we find that rainfall deficit combined with SDE-induced dry soil in spring provide favorable condition for summertime heat waves over large regions of Eurasia. Increased frequency of summer heat waves with SDE and the region of maximum increase in heat-wave frequency are found along the snow line, providing evidence that early snowmelt by SDE may increase the risks of extreme summer heat wave. Our results suggest that climate models that do not include SDE may significantly underestimate the effect of global warming over extra-tropical continental regions.

Mechanisms of Enhanced Hemoglobin Electroactivity on Carbon Electrodes upon Exposure to a Water-Miscible Primary Alcohol.

PubMed

Tom, Justin; Jakubec, Philip J; Andreas, Heather A

2018-05-01

Exposing a carbon electrode to hemoglobin (Hb) and alcoholic solvents, such as methanol, ethanol or 1-propanol, drastically changes Hb electroactivity, but until this work, the important underlying mechanisms were unclear. For the first time, we show that these alcohols impact Hb electroactivity via three mechanisms: modification of the carbon surface oxides on the glassy carbon (GC) electrode, Hb film formation, and structural changes to Hb. C 1s X-ray photoelectron spectroscopy provided evidence for significant alcohol-induced modification of the carbon surface oxides, and differential pulse voltammetry showed links between these modifications and Hb electroactivity. Spectroscopic ellipsometry showed that Hb films formed during exposure to Hb- and alcohol-containing electrolytes increased in thickness with increasing alcohol content, although film thickness played only a minor role in Hb electroactivity. Alcohol-induced structural changes in Hb are confirmed with UV-visible absorption and fluorescence data, showing that Hb denaturation also was a significant factor in increasing Hb electroactivity. Carbon-surface-oxide modification and Hb denaturation worked in tandem to maximally increase the Hb electroactivity in 60% methanol. While in ethanol and 1-propanol, the significant increases in Hb electroactivity caused by Hb denaturation were offset by an increase in Hb-inhibiting carbon surface oxides. Knowledge of these mechanisms shows the impact of alcohols on both Hb and carbon electrodes, allows for thoughtful design of the Hb-sensing system, is vital for proper analysis of Hb electroactivity in the presence of these alcohols (e.g., when used as binder solvents for immobilizing Hb into films), and provides fundamental understanding of the Hb-carbon interactions.

Brain-controlled functional electrical stimulation therapy for gait rehabilitation after stroke: a safety study.

PubMed

McCrimmon, Colin M; King, Christine E; Wang, Po T; Cramer, Steven C; Nenadic, Zoran; Do, An H

2015-07-11

Many stroke survivors have significant long-term gait impairment, often involving foot drop. Current physiotherapies provide limited recovery. Orthoses substitute for ankle strength, but they provide no lasting therapeutic effect. Brain-computer interface (BCI)-controlled functional electrical stimulation (FES) is a novel rehabilitative approach that may generate permanent neurological improvements. This study explores the safety and feasibility of a foot-drop-targeted BCI-FES physiotherapy in chronic stroke survivors. Subjects (n = 9) operated an electroencephalogram-based BCI-FES system for foot dorsiflexion in 12 one-hour sessions over four weeks. Gait speed, dorsiflexion active range of motion (AROM), six-minute walk distance (6MWD), and Fugl-Meyer leg motor (FM-LM) scores were assessed before, during, and after therapy. The primary safety outcome measure was the proportion of subjects that deteriorated in gait speed by ≥0.16 m/s at one week or four weeks post-therapy. The secondary outcome measures were the proportion of subjects that experienced a clinically relevant decrease in dorsiflexion AROM (≥2.5°), 6MWD (≥20 %), and FM-LM score (≥10 %) at either post-therapy assessment. No subjects (0/9) experienced a clinically significant deterioration in gait speed, dorsiflexion AROM, 6MWT distance, or FM-LM score at either post-therapy assessment. Five subjects demonstrated a detectable increase (≥0.06 m/s) in gait speed, three subjects demonstrated a detectable increase (≥2.5°) in dorsiflexion AROM, five subjects demonstrated a detectable increase (≥10 %) in 6MWD, and three subjects demonstrated a detectable increase (≥10 %) in FM-LM. Five of the six subjects that exhibited a detectable increase in either post-therapy gait speed or 6MWD also exhibited significant (p < 0.01 using a Mann-Whitney U test) increases in electroencephalogram event-related synchronization/desynchronization. Additionally, two subjects experienced a clinically important increase (≥0.16 m/s) in gait speed, and four subjects experienced a clinically important increase (≥20 %) in 6MWD. Linear mixed models of gait speed, dorsiflexion AROM, 6MWD, and FM-LM scores suggest that BCI-FES therapy is associated with an increase in lower motor performance at a statistically, yet not clinically, significant level. BCI-FES therapy is safe. If it is shown to improve post-stroke gait function in future studies, it could provide a new gait rehabilitation option for severely impaired patients. Formal clinical trials are warranted.

76 FR 63302 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... propose any changes to the information that issuers must submit for each rate increase. Thus, burden... protections provided under Section 1003 of the Affordable Care Act. In absence of this change, a significant number of individual and small group rate increases for the 2012 plan year would not be subject to the...

Knowledge, Skills, and Attitudes Regarding the Use of Medical Cannabis in the Hospice Population: An Educational Intervention.

PubMed

Mendoza, Kelly S; McPherson, Mary Lynn

2018-05-01

Currently, 28 states and the District of Columbia have legalized cannabis for medical use despite its remaining Schedule I federally. Benefits of medical cannabis (MC) have been demonstrated in nausea/vomiting associated with chemotherapy, cachexia associated with HIV/AIDS, and certain types of neuropathic pain. However, it is unclear how comfortable hospice providers are with the concept of MC. The aim of this study is to determine changes in knowledge, self-perceived skills, and attitudes (KSA) of hospice providers regarding MC after an online educational intervention. The educational intervention consisted of 3 learning modules covering information from 6 learning domains. Participants took a pre- and postcourse survey to assess changes in KSA. Participant demographics were analyzed using descriptive statistics. To detect any differences between pre- and postsurvey answers, a paired t test was used to reduce intersubject variability. Attitudes about the importance of cannabis knowledge were overall positive and did not change significantly after the intervention (N = 94). Both self-perceived skills and knowledge increased significantly, with providers reporting more positive skills, and >75% of respondents answering questions correctly after the intervention. There was a significant difference in attitudes in all domains in the postsurvey between participants who have practiced in hospice <3 years or ≥4 years, but no difference in perceived skills or knowledge. Providers' attitudes regarding the importance of MC knowledge were strong and the same before and after. Both the self-perception of skills and direct knowledge were significantly increased after the educational intervention.

The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention.

PubMed

Becker, Christian; Holle, Rolf; Stollenwerk, Björn

2015-06-01

Coronary heart disease (CHD) is a major cause of death and important driver of health care costs. Recent German health care reforms have promoted integrated care contracts allowing statutory health insurance providers more room to organize health care provision. One provider offers KardioPro, an integrated primary care-based CHD prevention program. As insurance providers should be aware of the financial consequences when developing optional programs, this study aims to analyze the costs associated with KardioPro participation. 13,264 KardioPro participants were compared with a propensity score-matched control group. Post-enrollment health care costs were calculated based on routine data over a follow-up period of up to 4 years. For those people who incurred costs, KardioPro participation was significantly associated with increased physician costs (by 33%), reduced hospital costs (by 19%), and reduced pharmaceutical costs (by 16%). Overall costs were increased by 4%, but this was not significant. Total excess costs per observation year were €131 per person (95% confidence interval: [€-36.5; €296]). Overall, KardioPro likely affected treatment as the program increased costs of physician services and reduced costs of hospital services. Further effects of substituting potential inpatient care with increased outpatient care might become fully apparent only over a longer time horizon. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Measuring and Advancing Experimental Design Ability in an Introductory Course without Altering Existing Lab Curriculum†

PubMed Central

Shanks, Ryan A.; Robertson, Chuck L.; Haygood, Christian S.; Herdliksa, Anna M.; Herdliska, Heather R.; Lloyd, Steven A.

2017-01-01

Introductory biology courses provide an important opportunity to prepare students for future courses, yet existing cookbook labs, although important in their own way, fail to provide many of the advantages of semester-long research experiences. Engaging, authentic research experiences aid biology students in meeting many learning goals. Therefore, overlaying a research experience onto the existing lab structure allows faculty to overcome barriers involving curricular change. Here we propose a working model for this overlay design in an introductory biology course and detail a means to conduct this lab with minimal increases in student and faculty workloads. Furthermore, we conducted exploratory factor analysis of the Experimental Design Ability Test (EDAT) and uncovered two latent factors which provide valid means to assess this overlay model’s ability to increase advanced experimental design abilities. In a pre-test/post-test design, we demonstrate significant increases in both basic and advanced experimental design abilities in an experimental and comparison group. We measured significantly higher gains in advanced experimental design understanding in students in the experimental group. We believe this overlay model and EDAT factor analysis contribute a novel means to conduct and assess the effectiveness of authentic research experiences in an introductory course without major changes to the course curriculum and with minimal increases in faculty and student workloads. PMID:28904647

Promoting Best Practices for Managing Acute Low Back Pain in an Occupational Environment.

PubMed

Slaughter, Amanda Lynn; Frith, Karen; O'Keefe, Louise; Alexander, Susan; Stoll, Regina

2015-09-01

Providers treating low back pain must be confident and knowledgeable in evidence-based practice (EBP) to provide the best outcomes. An online education course was created in an effort to increase knowledge and confidence in EBP and clinical practice guidelines specific to low back pain in an occupational setting. There were 80 participants who completed the pre-test and post-test. The results showed a statistically significant improvement in knowledge and confidence scores after completion of the course. An online education course was shown to be a cost-effective, accessible tool to increase knowledge and confidence of EBP for different health care providers. © 2015 The Author(s).

Quantification of Acute Vocal Fold Epithelial Surface Damage with Increasing Time and Magnitude Doses of Vibration Exposure

PubMed Central

Kojima, Tsuyoshi; Van Deusen, Mark; Jerome, W. Gray; Garrett, C. Gaelyn; Sivasankar, M. Preeti; Novaleski, Carolyn K.; Rousseau, Bernard

2014-01-01

Because the vocal folds undergo repeated trauma during continuous cycles of vibration, the epithelium is routinely susceptible to damage during phonation. Excessive and prolonged vibration exposure is considered a significant predisposing factor in the development of vocal fold pathology. The purpose of the present study was to quantify the extent of epithelial surface damage following increased time and magnitude doses of vibration exposure using an in vivo rabbit phonation model. Forty-five New Zealand white breeder rabbits were randomized to nine groups and received varying phonation time-doses (30, 60, or 120 minutes) and magnitude-doses (control, modal intensity phonation, or raised intensity phonation) of vibration exposure. Scanning electron microscopy and transmission electron microscopy was used to quantify the degree of epithelial surface damage. Results revealed a significant reduction in microprojection density, microprojection height, and depth of the epithelial surface with increasing time and phonation magnitudes doses, signifying increased epithelial surface damage risk with excessive and prolonged vibration exposure. Destruction to the epithelial cell surface may provide significant insight into the disruption of cell function following prolonged vibration exposure. One important goal achieved in the present study was the quantification of epithelial surface damage using objective imaging criteria. These data provide an important foundation for future studies of long-term tissue recovery from excessive and prolonged vibration exposure. PMID:24626217

Electromyographic and kinematic analysis of graded treadmill walking and the implications for knee rehabilitation.

PubMed

Lange, G W; Hintermeister, R A; Schlegel, T; Dillman, C J; Steadman, J R

1996-05-01

Muscle activity, joints, angles, and heart rate during uphill walking were compared for application in knee rehabilitation. The objectives of this study were to quantify muscle activation levels at different treadmill grades and to determine the grade(s) at which knee range of motion would not further compromise the joint. Average and peak electromyographic activity of the quadriceps (vastus medialis oblique and vastus lateralis) and hamstrings (biceps femoris and medial hamstrings (semimembranosus/semitendinosus)] was recorded during walking at 0, 12, and 24% grade. Six subjects (age = 28.5 +/- 3.7 years, stature = 1.79 +/- .05 m, and mass = 74.7 +/- 7.9 kg) walked at self-selected speeds at each grade while ankle, knee and hip angles, heart rate, and electromyographic activity (surface electrodes) were recorded. Maximum voluntary contractions provided a relative reference for the electromyographic activity during walking. Average and peak electromyographic activity increased significantly across grades for the vastus medialis oblique (125 and 154%), vastus lateralis (109 and 139%), and biceps femoris (53 and 46%), but remained similar for the medial hamstrings. Maximum knee flexion at heel strike increased significantly with grade. Despite decreased self-selected speeds with increasing grade, there were significant increases in heart rate across grades. The results of this study provide a basic understanding of the quadriceps and hamstrings activity levels, lower extremity joint range of motion, and cardiovascular requirements of graded treadmill walking in normal subjects. The results also suggest that a grade just greater than 12% may be most beneficial for knee rehabilitation to minimize patellofemoral discomfort or potential strain on the anterior cruciate ligament. The benefits achieved through this functional activity encourage its implementation in rehabilitation and provide a basis for comparison with injured patients.

Photon enhanced thermionic emission

DOEpatents

Schwede, Jared; Melosh, Nicholas; Shen, Zhixun

2014-10-07

Photon Enhanced Thermionic Emission (PETE) is exploited to provide improved efficiency for radiant energy conversion. A hot (greater than 200.degree. C.) semiconductor cathode is illuminated such that it emits electrons. Because the cathode is hot, significantly more electrons are emitted than would be emitted from a room temperature (or colder) cathode under the same illumination conditions. As a result of this increased electron emission, the energy conversion efficiency can be significantly increased relative to a conventional photovoltaic device. In PETE, the cathode electrons can be (and typically are) thermalized with respect to the cathode. As a result, PETE does not rely on emission of non-thermalized electrons, and is significantly easier to implement than hot-carrier emission approaches.

The impact of heatwaves on workers' health and safety in Adelaide, South Australia

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

Xiang, Jianjun; Bi, Peng, E-mail: peng.bi@adelaide.edu.au; Pisaniello, Dino

This study aims to investigate the impact of heatwaves on worker's health and safety; to identify workers at higher risk of prevalent illnesses and injuries due to heatwaves; and to provide evidence for policy-makers and service providers. South Australian workers' compensation claims data for 2001–2010 were transformed into time series format, merged with meteorological data and analysed using generalized estimating equation (GEE) models. For total injury claims there was no significant difference detected between heatwave and non-heatwave periods. However, for outdoor industries, daily claims increased significantly by 6.2% during heatwaves. Over-represented in hot weather were male labourers and tradespersons agedmore » ≥55 years, and those employed in ‘agriculture, forestry and fishing’ and ‘electricity, gas and water’. Occupational burns, wounds, lacerations, and amputations as well as heat illnesses were significantly associated with heatwaves. Similarly, moving objects, contact with chemicals, and injuries related to environmental factors increased significantly during heatwaves, especially among middle-aged and older male workers. With the predicted increase of extremely hot weather, there is a need for relevant adaptation and prevention measures at both practice and policy levels for vulnerable work groups. - Highlights: • We investigate the impacts of heatwaves on workers' health and safety. • We identify workers at higher risk of illnesses and injuries during heatwaves. • The differences between two heatwave definitions on effect estimates are compared. • Daily injury claims for outdoor industries increased by 6.2% during heatwaves. • Relevant heat prevention measures are required for vulnerable workers.« less

Effects of different irrigation practices using treated wastewater on tomato yields, quality, water productivity, and soil and fruit mineral contents.

PubMed

Demir, Azize Dogan; Sahin, Ustun

2017-11-01

Wastewater use in agricultural irrigation is becoming a common practice in order to meet the rising water demands in arid and semi-arid regions. The study was conducted to determine the effects of the full (FI), deficit (DI), and partial root-zone drying (PRD) irrigation practices using treated municipal wastewater (TWW) and freshwater (FW) on tomato yield, water use, fruit quality, and soil and fruit heavy metal concentrations. The TWW significantly increased marketable yield compared to the FW, as well as decreased water consumption. Therefore, water use efficiency (WUE) in the TWW was significantly higher than in the FW. Although the DI and the PRD practices caused less yields, these practices significantly increased WUE values due to less irrigation water applied. The water-yield linear relationships were statistically significant. TWW significantly increased titratable acidity and vitamin C contents. Reduced irrigation provided significantly lower titratable acidity, vitamin C, and lycopene contents. TWW increased the surface soil and fruit mineral contents in response to FW. Greater increases were observed under FI, and mineral contents declined with reduction in irrigation water. Heavy metal accumulation in soils was within safe limits. However, Cd and Pb contents in fruits exceeded standard limits given by FAO/WHO. Higher metal pollution index values determined for fruits also indicated that TWW application, especially under FI, might cause health risks in long term.

Increasing Performance of Professional Soccer Players and Elite Track and Field Athletes with Peak Performance Training and Biofeedback: A Pilot Study.

PubMed

Rijken, Noortje H; Soer, Remko; de Maar, Ewold; Prins, Hilco; Teeuw, Wouter B; Peuscher, Jan; Oosterveld, Frits G J

2016-12-01

The aim of this pilot study was to investigate the effects of an intervention consisting of mental coaching combined with either electro encephalogram (EEG) alpha power feedback or heart rate variability (HRV) feedback on HRV, EEG outcomes and self-reported factors related to stress, performance, recovery and sleep quality in elite athletes. A prospective pilot study was performed with two distinct cohorts. Soccer players were provided with four sessions of mental coaching combined with daily HRV biofeedback (Group A); track and field athletes were provided with four sessions of mental coaching in combination with daily neurofeedback (Group B). Measurements were performed at baseline, post intervention and at 5 weeks follow-up. Objective measures: EEG and ECG. Subjective measures: Numeric Rating Scale for performance, Pittsburgh Sleep Quality Index, Rest and Stress Questionnaire and Sports Improvement-60. Group characteristics were too distinct to compare the interventions. Linear mixed models were used to analyze differences within groups over time. In Group A, significant changes over time were present in alpha power at 5 of 7 EEG locations (p < 0.01-0.03). LF/HF ratio significantly increased (p = 0.02) and the concentration (p = 0.02) and emotional scale (p = 0.03) of the SIM-60 increased significantly (p = 0.04). In Group B, the HRV low frequency power and recovery scale of the REST-Q significantly increased (p = 0.02 and <0.01 resp.). Other measures remained stable or improved non-significantly. A mental coaching program combined with either HRV or EEG alpha power feedback may increase HRV and alpha power and may lead to better performance-related outcomes and stress reduction. Further research is needed to elucidate the effects of either type of feedback and to compare effects with a control group.

Sensewheel: an adjunct to wheelchair skills training

PubMed Central

Taylor, Stephen J.G.; Holloway, Catherine

2016-01-01

The purpose of this Letter was to investigate the influence of real-time verbal feedback to optimise push arc during over ground manual wheelchair propulsion. Ten healthy non-wheelchair users pushed a manual wheelchair for a distance of 25 m on level paving, initially with no feedback and then with real-time verbal feedback aimed at controlling push arc within a range of 85°–100°. The real-time feedback was provided by a physiotherapist walking behind the wheelchair, viewing real-time data on a tablet personal computer received from the Sensewheel, a lightweight instrumented wheelchair wheel. The real-time verbal feedback enabled the participants to significantly increase their push arc. This increase in push arc resulted in a non-significant reduction in push rate and a significant increase in peak force application. The intervention enabled participants to complete the task at a higher mean velocity using significantly fewer pushes. This was achieved via a significant increase in the power generated during the push phase. This Letter identifies that a lightweight instrumented wheelchair wheel such as the Sensewheel is a useful adjunct to wheelchair skills training. Targeting the optimisation of push arc resulted in beneficial changes in propulsion technique. PMID:28008362

Increasing organ donation after cardiac death in trauma patients.

PubMed

Joseph, Bellal; Khalil, Mazhar; Pandit, Viraj; Orouji Jokar, Tahereh; Cheaito, Ali; Kulvatunyou, Narong; Tang, Andrew; O'Keeffe, Terence; Vercruysse, Gary; Green, Donald J; Friese, Randall S; Rhee, Peter

2015-09-01

Organ donation after cardiac death (DCD) is not optimal but still remains a valuable source of organ donation in trauma donors. The aim of this study was to assess national trends in DCD from trauma patients. A 12-year (2002 to 2013) retrospective analysis of the United Network for Organ Sharing database was performed. Outcome measures were the following: proportion of DCD donors over the years and number and type of solid organs donated. DCD resulted in procurement of 16,248 solid organs from 8,724 donors. The number of organs donated per donor remained unchanged over the study period (P = .1). DCD increased significantly from 3.1% in 2002 to 14.6% in 2013 (P = .001). There was a significant increase in the proportion of kidney (2002: 3.4% vs 2013: 16.3%, P = .001) and liver (2002: 1.6% vs 2013: 5%, P = .041) donation among DCD donors over the study period. DCD from trauma donors provides a significant source of solid organs. The proportion of DCD donors increased significantly over the last 12 years. Copyright © 2015 Elsevier Inc. All rights reserved.

A short-term increase of the postoperative naturally circulating dendritic cells subsets in flurbiprofen-treated patients with esophageal carcinoma undergoing thoracic surgery

PubMed Central

Chai, Xiao-qing; Shu, Shu-hua; Zhang, Xiao-lin; Xie, Yan-hu; Wei, Xin; Wu, Yu-jing; Wei, Wei

2016-01-01

The present study evaluated whether flurbiprofen increased the naturally circulating dendritic cells (DCs) subsets in patients with esophageal squamous cell carcinoma (ESCC) undergoing esophageal resection. Compared to healthy donors (n=20), the significantly depressed percentages of plasmacytoid DCs (pDCs), CD1c+ myeloid DCs (mDCs), and CD141+ mDCs among ESCC patients (n=60) were confirmed. Flurbiprofen was administered before skin incision and at the end of operation in group F (n=30), as well as placebo in group C (n=30). The postoperative suppressed percentages of pDCs, CD1c+ mDCs, and CD141+ mDCs increased significantly following the perioperative treatment with flurbiprofen. Flurbiprofen also significantly stimulated the postoperative IFN-f and IL-17 production, but inhibited the immunosuppressive IL-10 and TGF-β levels. Furthermore, flurbiprofen exerted a similar analgesic effect and brought a significantly less sufentanil consumption compared to group C. Taken together, flurbiprofen provided a short-term increase of postoperative naturally circulating DCs in ESCC patients. PMID:26959879

A short-term increase of the postoperative naturally circulating dendritic cells subsets in flurbiprofen-treated patients with esophageal carcinoma undergoing thoracic surgery.

PubMed

Wang, Di; Yang, Xin-lu; Chai, Xiao-qing; Shu, Shu-hua; Zhang, Xiao-lin; Xie, Yan-hu; Wei, Xin; Wu, Yu-jing; Wei, Wei

2016-04-05

The present study evaluated whether flurbiprofen increased the naturally circulating dendritic cells (DCs) subsets in patients with esophageal squamous cell carcinoma (ESCC) undergoing esophageal resection. Compared to healthy donors (n=20), the significantly depressed percentages of plasmacytoid DCs (pDCs), CD1c+ myeloid DCs (mDCs), and CD141+ mDCs among ESCC patients (n=60) were confirmed. Flurbiprofen was administered before skin incision and at the end of operation in group F (n=30), as well as placebo in group C (n=30). The postoperative suppressed percentages of pDCs, CD1c+ mDCs, and CD141+ mDCs increased significantly following the perioperative treatment with flurbiprofen. Flurbiprofen also significantly stimulated the postoperative IFN-f and IL-17 production, but inhibited the immunosuppressive IL-10 and TGF-β levels. Furthermore, flurbiprofen exerted a similar analgesic effect and brought a significantly less sufentanil consumption compared to group C. Taken together, flurbiprofen provided a short-term increase of postoperative naturally circulating DCs in ESCC patients.

Error assessment for emerging traffic data collection devices.

DOT National Transportation Integrated Search

2014-06-01

Because access to travel time information can significantly influence the decision making of both agencies : and travelers, accurate and reliable travel time information is increasingly needed. One important step in : providing that information is to...

Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial.

PubMed

Fernandez, Aaron; Tan, Kit-Aun; Knaak, Stephanie; Chew, Boon How; Ghazali, Sazlina Shariff

2016-12-01

If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students. One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up. A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up. Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.

Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

ERIC Educational Resources Information Center

Dixon, Decia Nicole

2009-01-01

Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

Calmness Fosters Compassionate Connections: Integrating Mindfulness to Support Diverse Parents, Their Young Children, and the Providers Who Serve Them

ERIC Educational Resources Information Center

Shahmoon-Shanok, Rebecca; Stevenson, Howard Carlton

2015-01-01

This article introduces and recommends mindfulness as a significant resource for earliest childhood practice, especially for parents and providers. Mindfulness is defined as it is coming to be understood and used by increasing numbers of people and systems in North America. The article also addresses how mindfulness is sometimes expressed and…

A public health initiative to increase annual influenza immunization among hospital health care personnel: the San Diego Hospital Influenza Immunization Partnership.

PubMed

Sawyer, Mark H; Peddecord, K Michael; Wang, Wendy; Deguire, Michelle; Miskewitch-Dzulynsky, Michelle; Vuong, David D

2012-09-01

A public health department-supported intervention to increase influenza immunization among hospital-based health care practitioners (HCPs) in San Diego County took place between 2005 and 2008. The study included all major hospitals in the county, with a population of approximately 3.5 million. Information on hospital activities was collected from before, during and after initiative activities. Vaccination status and demographics were collected directly from HCP using hospital-based and random-dialed telephone surveys. Between 2006 and 2008, hospitals increased promotion activities and reported increases in vaccination rates. Based on the random-dialed surveys, HCP influenza vaccination coverage rates did not increase significantly. Vaccination rates were significantly higher in HCPs who reported that employers provided free vaccination and those who believed that their employers mandated influenza vaccination. This local public health initiative and concurrent state legislation were effective in increasing employer efforts to promote influenza vaccination; however, population-based surveys of HCPs did not show significant increases in influenza vaccination. Overall, this study suggests that public health leadership, intensive employer promotion activities, and state-required declinations alone were not sufficient to significantly increase HCP influenza vaccination. Policymakers and employers should consider mandates to achieve optimal influenza vaccination among HCPs. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Trends in urological stone disease: a 5-year update of hospital episode statistics.

PubMed

Heers, Hendrik; Turney, Benjamin W

2016-11-01

To provide a 5-year follow-on update on the changes in prevalence and treatment of upper urinary tract (UUT) stone disease in England. Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarised, analysed, and presented. The total number of UUT stone hospital episodes increased slightly from 83 050 in 2009-2010 to 86 742 in 2014-2015 (4.4% increase). The use of shockwave lithotripsy (SWL) for treating all UUT stones remained stable over the 5-year study period following a significant increase in previous years. There was a 49.6% increase in the number of ureteroscopic stone treatments from 12 062 in 2009-2010 to 18 055 in 2014-2015. Increase in ureterorenoscopy (flexible ureteroscopy) showed the most rapid increase from 3 267 to 6 631 cases in the 5-year study period (103% increase). The gap between the total number of ureteroscopies and SWL treatments continues to narrow. Open stone surgery continued to decline with only 30 reported cases in 2014-2015. Due to the continued rapid increase in the number of ureteroscopies performed, treatment for stone disease has continued to increase significantly in comparison to other urological activity. This study provides an update on the changing landscape of the management of UUT stones in England. It shows a sustained high prevalence of stone disease commensurate with levels in other developed countries. This study reveals a trend in the last 5 years to surgically intervene on a higher proportion of patients with stones. As in other countries, there is a significant increase in the use of ureteroscopy (particularly intrarenal flexible ureteroscopy) in England. These data have important implications for work-force planning, training, service delivery, and research in the field of urolithiasis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Evaluating the impact of social franchising on family planning use in Kenya.

PubMed

Chakraborty, Nirali M; Mbondo, Mwende; Wanderi, Joyce

2016-06-18

In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya's largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18-24 and 41-49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: Results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial.

PubMed

Beaulieu, Tara; Patten, Scott; Knaak, Stephanie; Weinerman, Rivian; Campbell, Helen; Lauria-Horner, Bianca

2017-05-01

Most interventions to reduce stigma in health professionals emphasize education and social contact-based strategies. We sought to evaluate a novel skill-based approach: the British Columbia Adult Mental Health Practice Support Program. We sought to determine the program's impact on primary care providers' stigma and their perceived confidence and comfort in providing care for mentally ill patients. We hypothesized that enhanced skills and increased comfort and confidence on the part of practitioners would lead to diminished social distance and stigmatization. Subsequently, we explored the program's impact on clinical outcomes and health care costs. These outcomes are reported separately, with reference to this article. In a double-blind, cluster randomized controlled trial, 111 primary care physicians were assigned to intervention or control groups. A validated stigma assessment tool, the Opening Minds Scale for Health Care Providers (OMS-HC), was administered to both groups before and after training. Confidence and comfort were assessed using scales constructed from ad hoc items. In the primary analysis, no significant differences in stigma were found. However, a subscale assessing social distance showed significant improvement in the intervention group after adjustment for a variable (practice size) that was unequally distributed in the randomization. Significant increases in confidence and comfort in managing mental illness were observed among intervention group physicians. A positive correlation was found between increased levels of confidence/comfort and improvements in overall stigma, especially in men. This study provides some preliminary evidence of a positive impact on health care professionals' stigma through a skill-building approach to management of mild to moderate depression and anxiety in primary care. The intervention can be used as a primary vehicle for enhancing comfort and skills in health care providers and, ultimately, reducing an important dimension of stigma: preference for social distance.

Nutrient Concentrations, Loads, and Yields in the Eucha-Spavinaw Basin, Arkansas and Oklahoma, 2002-2006

USGS Publications Warehouse

Tortorelli, Robert L.

2008-01-01

The City of Tulsa, Oklahoma, uses Lake Eucha and Spavinaw Lake in the Eucha-Spavinaw basin in northwestern Arkansas and northeastern Oklahoma for public water supply. Taste and odor problems in the water attributable to blue-green algae have increased in frequency. Changes in the algae community in the lakes may be attributable to increases in nutrient levels in the lakes, and in the waters feeding the lakes. The U.S. Geological Survey, in cooperation with the City of Tulsa, investigated and summarized nitrogen and phosphorus concentrations and provided estimates of nitrogen and phosphorus loads, yields, and flow-weighted concentrations in the Eucha-Spavinaw basin for three 3-year periods - 2002-2004, 2003-2005, and 2004-2006, to update a previous report that used data from water-quality samples for a 3-year period from January 2002 through December 2004. This report provides information needed to advance knowledge of the regional hydrologic system and understanding of hydrologic processes, and provides hydrologic data and results useful to multiple agencies for interstate agreements. Nitrogen and phosphorus concentrations were significantly greater in runoff samples than in base-flow samples for all three periods at Spavinaw Creek near Maysville, Arkansas; Spavinaw Creek near Colcord, Oklahoma, and Beaty Creek near Jay, Oklahoma. Runoff concentrations were not significantly greater than base-flow concentrations at Spavinaw Creek near Cherokee, Arkansas; and Spavinaw Creek near Sycamore, Oklahoma except for phosphorus during 2003-2005. Nitrogen concentrations in base-flow samples significantly increased downstream in Spavinaw Creek from the Maysville to Sycamore stations then significantly decreased from the Sycamore to the Colcord stations for all three periods. Nitrogen in base-flow samples from Beaty Creek was significantly less than in samples from Spavinaw Creek. Phosphorus concentrations in base-flow samples significantly increased from the Maysville to Cherokee stations in Spavinaw Creek for all three periods, probably because of a wastewater-treatment plant point source between those stations, and then significantly decreased downstream from the Cherokee to Colcord stations. Phosphorus in base-flow samples from Beaty Creek was significantly less than phosphorus in base-flow samples from Spavinaw Creek downstream from the Maysville station. Nitrogen concentrations in runoff samples were not significantly different among the stations on Spavinaw Creek for most of the three periods, except during 2003-2005 when runoff samples at the Colcord station were less than at the Sycamore station; however, the concentrations at Beaty Creek were significantly less than at all other stations. Phosphorus concentrations in runoff samples were not significantly different among the three downstream stations on Spavinaw Creek and were significantly different at the Maysville station on Spavinaw Creek and the Beaty Creek station, only during 2004-2006. Phosphorus and nitrogen concentrations in runoff samples from all stations generally increased with increasing streamflow. Estimated mean annual nitrogen total loads for the three 3-year periods were substantially greater at the Spavinaw Creek stations than at Beaty Creek and increased downstream from Maysville to Colcord in Spavinaw Creek, with the load at the Colcord station about 2 times that at Maysville station. Estimated mean annual nitrogen base-flow loads at the Spavinaw Creek stations were about 5 to 11 times greater than base-flow loads at Beaty Creek. The runoff component of the annual nitrogen total load for Beaty Creek was 85 to 89 percent; whereas, the range in the runoff component at the Spavinaw Creek stations was 60 to 71 percent. Estimated mean annual phosphorus total loads for the three 3-year periods were greater at the Spavinaw Creek stations from Cherokee to Colcord than at Beaty Creek and increased downstream from Maysville to Colcord in Spavinaw Creek, wit

Development of Bioregenerative Life Support for Longer Missions: When Can Plants Begin to Contribute to Atmospheric Management?

NASA Technical Reports Server (NTRS)

Wheeler, Raymond M.

2015-01-01

Through photosynthesis, plants can be used to generate oxygen and food for life support in human exploration of space. Initial contributions of plants to life support would likely occur through the production of supplemental, fresh foods. For plants to provide significant contributions to oxygen production, larger areas and significant lighting would be needed. An area of 10 m2 of plants with moderate lighting could provide about 13 of a human's oxygen needs. As mission distances and durations increase, plant growing areas could be expanded to assume more of the human life support needs.

Occupational Skin Disease Prevention: An Educational Intervention for Hairdresser Cosmetology Students.

PubMed

Haughtigan, Kara; Main, Eve; Bragg-Underwood, Tonya; Watkins, Cecilia

2017-11-01

Cosmetologists frequently develop occupational skin disease related to workplace exposures. The purpose of this study was to evaluate an educational intervention to increase cosmetology students' occupational skin disease knowledge and use of preventive practices. A quasi-experimental design was used to evaluate students' knowledge, behaviors, intentions, expectancies, and expectations. A 20-minute verbal presentation and printed two-page educational handout were provided for participants. Statistically significant increases in knowledge, frequency of glove use, and frequency of moisturizer use were found, but the frequency of handwashing did not increase. In addition, the Behavioral Strategies subscale, the Intention subscale, and the Expectancies subscale showed statistically significant improvements. The results of this study suggest an educational intervention can increase cosmetology students' knowledge of occupational skin diseases and their use of preventive strategies.

Impact of a Pharmacist-Provided Spirometry Service on Access to Results in a Primary Care Setting.

PubMed

Mueller, Lisa A; Valentino, Alexa Sevin; Clark, Aaron D; Li, Junan

2018-01-01

The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service. Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014-September 2015) and after (January 2016-October 2016) the implementation of the pharmacy-provided spirometry service. Chart reviews were also used to determine the number and completion rate among referrals for internal and external services in the postimplementation time frame. Chart reviews also assessed medication recommendations made by the pharmacist. The results demonstrate an increase in referral completion rate from 38.1% to 47.0% ( P = .08) between the pre- and postimplementation time frames. In the postimplementation time frame, there was a statistically significant difference in the percentage of referrals completed between in-house referrals and external referrals (70.0% and 40.9%, respectively, P = .0004). Comparing clinics with and without the spirometry service, there was a statistically significant difference in the total number of spirometry referrals (1.13% and 0.59%, respectively, P < .0001) and the percent of referrals completed (0.55% and 0.27%, respectively, P = .0002). The results suggest that offering spirometry within the primary care setting helps to increase the rate of completed spirometry tests with results available to the primary care provider. Additionally, the results show that there is an increased completion rate in patients who receive an internal spirometry referral, which may be due to reduced barriers in obtaining this testing. Overall, these results demonstrate that providing spirometry in the primary care setting helps to increase spirometry results obtained and could be beneficial in other primary care settings.

Tuberin-deficiency downregulates N-cadherin and upregulates vimentin in kidney tumor of TSC patients

PubMed Central

Liang, Sitai; Salas, Tiffanie; Gencaslan, Emre; Li, Baojie; Habib, Samy L.

2014-01-01

Angiomyolipomas (AMLs) are associated with cell fibrosis in kidney of Tuberous Sclerosis Complex patients. The mechanism by which the fibrotic proteins accumulated in AMLs has not been explored. In the present study, we investigated the role of Akt/tuberin/mTOR pathway in the regulation cell fibrosis proteins. AML cells that expressed low levels of tuberin showed less expression of N-cadherin and higher of vimentin proteins compared to HEK293 cells. AML cells infected with Ad-tuberin showed a significant decrease in vimentin and an increase in N-cadherin protein expression. In addition, cells treated with rapamycin showed a significant increase in p-Akt and a decrease in p-p70S6K that was associated with a decrease expression of vimentin and a slight increase expression in N-cadherin. On the other hand, cells treated with Akt inhibitor revealed a significant decrease in p-Akt and p-p70S6K that was associated with a significant decrease in vimentin and an increase in N-cadherin expression. In addition, cells transfected with DN-Akt or DN-S6K show significant increase expression in N-cadherin and a decrease in vimentin. Moreover, cells transfected with siRNA against rictor or siRNA against raptor resulted in a decrease in vimentin and an increase N-cadherin expression. Kidney tumors from TSC patients showed significant decrease in N-cadherin and significant increased in vimentin protein expression compared to control kidney tissues. These data comprise the first report to provide the role of Akt/tuberin/mTORC1/2 in the regulation of N-cadherin and vimentin that are involved in the progression of fibrosis in kidney tumor of TSC patients. PMID:25149531

Aerocapture Inflatable Decelerator (AID)

NASA Technical Reports Server (NTRS)

Reza, Sajjad

2007-01-01

Forward Attached Inflatable Decelerators, more commonly known as inflatable aeroshells, provide an effective, cost efficient means of decelerating spacecrafts by using atmospheric drag for aerocapture or planetary entry instead of conventional liquid propulsion deceleration systems. Entry into planetary atmospheres results in significant heating and aerodynamic pressures which stress aeroshell systems to their useful limits. Incorporation of lightweight inflatable decelerator surfaces with increased surface-area footprints provides the opportunity to reduce heat flux and induced temperatures, while increasing the payload mass fraction. Furthermore, inflatable aeroshell decelerators provide the needed deceleration at considerably higher altitudes and Mach numbers when compared with conventional rigid aeroshell entry systems. Inflatable aeroshells also provide for stowage in a compact space, with subsequent deployment of a large-area, lightweight heatshield to survive entry heating. Use of a deployable heatshield decelerator not only enables an increase in the spacecraft payload mass fraction and but may also eliminate the need for a spacecraft backshell and cruise stage. This document is the viewgraph slides for the paper's presentation.

Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge.

PubMed

Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena

2014-01-01

Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P < .001) and loss of PCN allergy over time (54% vs 80%; P < .0001). Among those who reported attending an educational session (n = 62), preparedness to determine if an allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

A randomized intervention study of sun protection promotion in well-child care.

PubMed

Crane, Lori A; Deas, Ann; Mokrohisky, Stefan T; Ehrsam, Gretchen; Jones, Richard H; Dellavalle, Robert; Byers, Tim E; Morelli, Joseph

2006-03-01

This study evaluated the behavioral impact of a skin cancer prevention program in which health care providers delivered advice and materials to parents of infants over a 3-year period from 1998 to 2001. Fourteen offices of a large managed care organization in Colorado were randomly assigned to the intervention or control groups. 728 infants and their parents were recruited within 6 months of birth. At intervention offices, health care providers attended orientation sessions, prompts for delivering sun protection advice were placed in medical records, and parents received sun protection packets at each well-child visit between 2 and 36 months of age. Based on provider self-report and exit interviews of parents, providers in the intervention group delivered approximately twice as much sun protection advice as providers in the control group. Annual telephone interviews of parents indicated small but statistically significant differences in parent sun protection practices favoring the intervention. Skin exams revealed no significant differences in tanning, freckling, or number of nevi. Behavioral differences between groups appeared to grow over the 3 years of follow-up. This intervention strategy was successful in increasing the delivery of sun protection advice by health care providers and resulted in changes in parents' behaviors. While the behavioral effect was probably not strong enough to reduce risk for skin cancer, the effect may increase as children age and have more opportunities for overexposure to the sun.

Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital.

PubMed

Miller, Richard; Chalapati, Nirisha

2015-01-01

This paper aims to demonstrate how lean tools were applied to some unique issues of providing healthcare in a developing country where many patients face challenges not found in developed countries. The challenges provide insight into how lean tools can be utilized to provide similar results across the world. This paper is based on a qualitative case study carried out by a master's student implementing lean at a hospital in India. This paper finds that lean tools such as value-stream mapping and root cause analysis can lead to dramatic reductions in waste and improvements in productivity. The problems of the majority of patients paying for their own healthcare and lacking transportation created scheduling problems that required patients to receive their diagnosis and pay for treatment within a single day. Many additional wastes were identified that were significantly impacting the hospital's ability to provide care. As a result of this project, average outpatient wait times were reduced from 1 hour to 15 minutes along with a significant increase in labor productivity. The results demonstrate how lean tools can increase value to the patients. It also provides are framework that can be utilized for healthcare providers in developed and developing countries to analyze their value streams to reduce waste. This paper is one of the first to address the unique issues of implementing lean to a healthcare setting in a developing country.

Increased tumor localization and reduced immune response to adenoviral vector formulated with the liposome DDAB/DOPE.

PubMed

Steel, Jason C; Cavanagh, Heather M A; Burton, Mark A; Abu-Asab, Mones S; Tsokos, Maria; Morris, John C; Kalle, Wouter H J

2007-04-01

We aimed to increase the efficiency of adenoviral vectors by limiting adenoviral spread from the target site and reducing unwanted host immune responses to the vector. We complexed adenoviral vectors with DDAB-DOPE liposomes to form adenovirus-liposomal (AL) complexes. AL complexes were delivered by intratumoral injection in an immunocompetent subcutaneous rat tumor model and the immunogenicity of the AL complexes and the expression efficiency in the tumor and other organs was examined. Animals treated with the AL complexes had significantly lower levels of beta-galactosidase expression in systemic tissues compared to animals treated with the naked adenovirus (NA) (P<0.05). The tumor to non-tumor ratio of beta-galactosidase marker expression was significantly higher for the AL complex treated animals. NA induced significantly higher titers of adenoviral-specific antibodies compared to the AL complexes (P<0.05). The AL complexes provided protection (immunoshielding) to the adenovirus from neutralizing antibody. Forty-seven percent more beta-galactosidase expression was detected following intratumoral injection with AL complexes compared to the NA in animals pre-immunized with adenovirus. Complexing of adenovirus with liposomes provides a simple method to enhance tumor localization of the vector, decrease the immunogenicity of adenovirus, and provide protection of the virus from pre-existing neutralizing antibodies.

Tobacco control campaign in Uruguay: Impact on smoking cessation during pregnancy and birth weight.

PubMed

Harris, Jeffrey E; Balsa, Ana Inés; Triunfo, Patricia

2015-07-01

We analyzed a nationwide registry of all pregnancies in Uruguay during 2007-2013 to assess the impact of three types of tobacco control policies: (1) provider-level interventions aimed at the treatment of nicotine dependence, (2) national-level increases in cigarette taxes, and (3) national-level non-price regulation of cigarette packaging and marketing. We estimated models of smoking cessation during pregnancy at the individual, provider and national levels. The rate of smoking cessation during pregnancy increased from 15.4% in 2007 to 42.7% in 2013. National-level non-price policies had the largest estimated impact on cessation. The price response of the tobacco industry attenuated the effects of tax increases. While provider-level interventions had a significant effect, they were adopted by relatively few health centers. Quitting during pregnancy increased birth weight by an estimated 188 g. Tobacco control measures had no effect on the birth weight of newborns of non-smoking women. Copyright © 2015 Elsevier B.V. All rights reserved.

Care coordination in epilepsy: Measuring neurologists' connectivity using social network analysis.

PubMed

Altalib, Hamada Hamid; Fenton, Brenda T; Cheung, Kei-Hoi; Pugh, Mary Jo V; Bates, Jonathan; Valente, Thomas W; Kerns, Robert D; Brandt, Cynthia A

2017-08-01

The study sought to quantify coordination of epilepsy care, over time, between neurologists and other health care providers using social network analysis (SNA). The Veterans Health Administration (VA) instituted an Epilepsy Center of Excellence (ECOE) model in 2008 to enhance care coordination between neurologists and other health care providers. Provider networks in the 16 VA ECOE facilities (hub sites) were compared to a subset of 33 VA facilities formally affiliated (consortium sites) and 14 unaffiliated VA facilities. The number of connections between neurologists and each provider (node degree) was measured by shared epilepsy patients and tallied to generate estimates at the facility level separately within and across facilities. Mixed models were used to compare change of facility-level node degree over time across the three facility types, adjusted for number of providers per facility. Over the time period 2000-2013, epilepsy care coordination both within and across facilities significantly increased. These increases were seen in all three types of facilities namely hub, consortium, and unaffiliated site, relatively equally. The increase in connectivity was more dramatic with providers across facilities compared to providers within the same facilities. Establishment of the ECOE hub and spoke model contributed to an increase in epilepsy care coordination both within and across facilities from 2000 to 2013, but there was substantial variation across different facilities. SNA is a tool that may help measure coordination of specialty care. Published by Elsevier Inc.

Dieldrin exposure induces oxidative damage in the mouse nigrostriatal dopamine system

PubMed Central

Hatcher, Jaime M.; Richardson, Jason R.; Guillot, Thomas S.; McCormack, Alison L.; Di Monte, Donato A.; Jones, Dean P.; Pennell, Kurt D.; Miller, Gary W.

2007-01-01

Numerous epidemiological studies have shown an association between pesticide exposure and an increased risk of developing Parkinson’s disease (PD). Here, we provide evidence that the insecticide dieldrin causes specific oxidative damage in the nigrostriatal dopamine (DA) system. We report that exposure of mice to low levels of dieldrin for 30 days resulted in alterations in dopamine-handling as evidenced by a decrease in dopamine metabolites, DOPAC (31.7% decrease) and HVA (29.2% decrease) and significantly increased cysteinyl-catechol levels in the striatum. Furthermore, dieldrin resulted in a 53% decrease in total glutathione, an increase in the redox potential of glutathione, and a 90% increase in protein carbonyls. α-Synuclein protein expression was also significantly increased in the striatum (25% increase). Finally, dieldrin caused a significant decrease in striatal expression of the dopamine transporter as measured by 3H-WIN 35,428 binding and 3H-dopamine uptake. These alterations occurred in the absence of dopamine neuron loss in the substantia nigra pars compacta. These effects represent the ability of low doses of dieldrin to increase the vulnerability of nigrostriatal dopamine neurons by inducing oxidative stress and suggest that pesticide exposure may act as a promoter of PD. PMID:17291500

Observed use of automatic seat belts in 1987 cars.

PubMed

Williams, A F; Wells, J K; Lund, A K; Teed, N

1989-10-01

Usage of the automatic belt systems supplied by six large-volume automobile manufacturers to meet the federal requirements for automatic restraints were observed in suburban Washington, D.C., Chicago, Los Angeles, and Philadelphia. The different belt systems studied were: Ford and Toyota (motorized, nondetachable automatic shoulder belt), Nissan (motorized, detachable shoulder belt), VW and Chrysler (nonmotorized, detachable shoulder belt), and GM (nonmotorized detachable lap and shoulder belt). Use of automatic belts was significantly greater than manual belt use in otherwise comparable late-model cars for all manufacturers except Chrysler; in Chrysler cars, automatic belt use was significantly lower than manual belt use. The automatic shoulder belts provided by Ford, Nissan, Toyota, and VW increased use rates to about 90%. Because use rates were lower in Ford cars with manual belts, their increase was greater. GM cars had the smallest increase in use rates; however, lap belt use was highest in GM cars. The other manufacturers supply knee bolsters to supplement shoulder belt protection; all--except VW--also provide manual lap belts, which were used by about half of those who used the automatic shoulder belt. The results indicate that some manufacturers have been more successful than others in providing automatic belt systems that result in high use that, in turn, will mean fewer deaths and injuries in those cars.

Diagnosis, treatment, and nursing care of patients with chronic leukemia.

PubMed

Breed, Cheryl D

2003-05-01

To provide an update on the impact of new information about the molecular biology of chronic leukemia and new treatment modalities available to patients. Published articles, books, and research studies. There has been significant progress in the diagnosis and management of chronic myeloid and chronic lymphocytic leukemia. New therapies provide more options for patients and longer treatment periods. With increasing treatment options and longer survival, patients with chronic myelogenous or chronic lymphocytic leukemia need increased education, support, and assistance with symptom management. Nurses caring for these patients must remain knowledgeable about new treatments and their management.

Combination film/splash fill for overcoming film fouling

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

Phelps, P.M.; Minett, T.O.

1995-02-01

In summary, this large cooling tower user has found the Phelps film/splash Stack-Pack fill design to attain a substantial improvement in capability of their existing crossflow cooling towers, without increasing fan power or tower size. The lack of fouling in the film fill component of this fill design is due to the use of film fill with large (1 inch) spacing between sheets, coupled with effective water treatment as provided by Nalco. This combination of factors provides a proven method for significantly increasing crossflow or counterflow cooling tower capability while minimizing chances of serious fill fouling.

Digitizing the Facebow: A Clinician/Technician Communication Tool.

PubMed

Kalman, Les; Chrapka, Julia; Joseph, Yasmin

2016-01-01

Communication between the clinician and the technician has been an ongoing problem in dentistry. To improve the issue, a dental software application has been developed--the Virtual Facebow App. It is an alternative to the traditional analog facebow, used to orient the maxillary cast in mounting. Comparison data of the two methods indicated that the digitized virtual facebow provided increased efficiency in mounting, increased accuracy in occlusion, and lower cost. Occlusal accuracy, lab time, and total time were statistically significant (P<.05). The virtual facebow provides a novel alternative for cast mounting and another tool for clinician-technician communication.

Inductive gas line for pulsed lasers

DOEpatents

Benett, William J.; Alger, Terry W.

1985-01-01

A gas laser having a metal inlet gas feed line assembly shaped as a coil, to function as an electrical inductance and therefore high impedance to pulses of electric current applied to electrodes at opposite ends of a discharge tube of a laser, for example. This eliminates a discharge path for the laser through the inlet gas feed line. A ferrite core extends through the coil to increase the inductance of the coil and provide better electric isolation. By elimination of any discharge breakdown through the gas supply, efficiency is increased and a significantly longer operating lifetime of the laser is provided.

Inductive gas line for pulsed lasers

DOEpatents

Benett, W.J.; Alger, T.W.

1982-09-29

A gas laser having a metal inlet gas feed line assembly shaped as a coil, to function as an electrical inductance and therefore high impedance to pulses of electric current applied to electrodes at opposite ends of a discharge tube of a laser, for example. This eliminates a discharge path for the laser through the inlet gas feed line. A ferrite core extends through the coil to increase the inductance of the coil and provide better electric isolation. By elimination of any discharge breakdown through the gas supply, efficiency is increased and a significantly longer operating lifetime of the laser is provided.

Un Abrazo Para La Familia: an evidenced-based rehabilitation approach in providing cancer education to low-SES Hispanic co-survivors.

PubMed

Marshall, Catherine A; Curran, Melissa A; Koerner, Susan Silverberg; Kroll, Thilo; Hickman, Amy C; García, Francisco

2014-12-01

We discuss Un Abrazo Para La Familia as an effective, rehabilitation-informed evidence-based model of education, information-sharing, and skill teaching for use with low-income Hispanic co-survivors of cancer. Over 2 years, 120 co-survivors participated in the intervention. The majority of participants (96 %) were women and all but one reported being Hispanic. Both in years 1 and 2, we followed the same pre- and post-intervention evaluation design. Based on pre- and post-intervention assessments of cancer-related knowledge and self-efficacy, the percentage of questions answered correctly about cancer significantly increased for co-survivors. Self-efficacy significantly increased as well. Using item analysis, we explored skill teaching as a mechanism for the effective delivery of Un Abrazo and recommend the use of promotoras in providing the intervention. Of the 12 cancer knowledge items resulting in statistically significant increases of cancer knowledge, 5 were taught via interactive skill teaching. Given the projected rise in the incidence of cancer in Hispanic populations, coupled with the fact that people from low-income backgrounds face unique challenges in cancer prevention and management, implications of the Un Abrazo model for future research and policy regarding cancer and families are considered.

Incidence of caries lesions among patients treated with comprehensive orthodontics.

PubMed

Richter, Amy E; Arruda, Airton O; Peters, Mathilde C; Sohn, Woosung

2011-05-01

Dental caries, specifically decalcified white-spot lesions (WSL), is a well-known side-effect of orthodontic treatment. The incidence of labial incipient caries lesions and its relationship with various patient and treatment variables was investigated in patients treated with comprehensive orthodontics. Randomly selected orthodontic patient records (n = 350) were examined to determine incipient caries lesion development. Labial surfaces on pretreatment and posttreatment photographs were scored with a standardized scoring system. Independent variables were collected by chart abstraction. The incidence of patients who developed at least 1 new WSL during treatment was 72.9%, and this incidence was 2.3% for cavitated lesions. Treatment duration was significantly associated with new WSL development (P = 0.03). Development of WSL and cavitated lesions increased (both, P <0.00) despite increased attention to oral hygiene during treatment. Sex, age, extraction therapy, and various fluoridation sources were not associated with WSL development, but initial oral-hygiene score was moderately associated (P <0.06). The incidence of WSL in patients treated with comprehensive orthodontics was significantly high, and the preventive therapy provided appeared to be ineffective. This widespread problem is alarming and warrants significant attention from both patients and providers that should result in greatly increased emphasis on effective caries prevention. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Alcohol: Friend or Foe? Alcoholic Beverage Hormesis for Cataract and Atherosclerosis is Related to Plasma Antioxidant Activity

PubMed Central

Prickett, Claire D.; Lister, E.; Collins, Michelle; Trevithick-Sutton, C. C.; Hirst, M.; Vinson, J. A.; Noble, E.; Trevithick, J. R.

2004-01-01

Objectives: To correlate the oxidative state of postabsorptive blood plasma after consumption of one or three drinks of different beverages with known J-shaped epidemiological risk curves. Design, interventions, and main outcome measures: Red wine, lager beer, stout (alcoholic and alcohol-free), with antioxidant activity, and an aqueous solution of alcohol were compared for the plasma antioxidant or pro-oxidant activity in human volunteers following consumption of one or three typical drinks containing equivalent amounts of alcohol (except for an alcohol-free stout used as a control for stout). Results: One drink of red wine, lager beer, or stout (5% alcohol v/v, and alcohol-free) significantly increased the average antioxidant activity in plasma samples obtained from volunteers averaged over 240 min. Three drinks of red wine, lager beer, or stout (5% alcohol v/v, and alcohol-free) significantly increased the average pro-oxidant activity in plasma samples obtained from volunteers averaged over 360 min. For a solution of alcohol, three drinks resulted in pro-oxidant plasma on average, whereas while one drink did not significantly affect the plasma oxidative status. A preliminary experiment in which two volunteers showed a significantly increased time to metabolize ethanol after ingestion resulted in elevated antioxidant activity in plasma for lager beer and red wine. Conclusions: One drink of red wine, beer, or stout provided equivalent increases in plasma antioxidant activity. Three drinks of red wine, beer, or stout provided equivalent increases in plasma pro-oxidant activity. This may explain, at least in part, the decreased risk of cataract and atherosclerosis from daily consumption of one drink of different types of alcoholic beverages as well as the increased risk from daily consumption of three drinks of alcoholic beverages. The plasma pro-oxidant activity appears to be due to ethanol metabolism, whereas the antioxidant activity may be due to the absorption of polyphenols in the beverages. PMID:19330151

Good Asset Accounting Procedures for Schools.

ERIC Educational Resources Information Center

Golz, William C.

1981-01-01

Increased accountability is required in school accounting due to rising education costs and the significant investment made in property and equipment in educational facilities. Guidelines for planning and implementing a property record-keeping system are provided. (Author/MLF)

Design and Control of Chemical Grouting : Volume 3 - Engineering Practice

DOT National Transportation Integrated Search

1983-04-01

Recent improvements in the engineering practice of chemical grouting have provided increased confidence in this method of ground modification. Designers can significantly improve the success of chemical grouting by defining their grouting program obj...

Measuring Corporate Smarts.

ERIC Educational Resources Information Center

Delahoussaye, Martin; Ellis, Kristine; Bolch, Matt

2002-01-01

Provides empirical evidence that significant investment in work force development leads to increased shareholder value. Suggests that management should heed the evidence when considering cutting training and development budgets. Profiles 11 companies' stock performance and discusses their training and development initiatives. (JOW)

CLINICALLY SIGNIFICANT PSYCHOTROPIC DRUG-DRUG INTERACTIONS IN THE PRIMARY CARE SETTING

PubMed Central

English, Brett A.; Dortch, Marcus; Ereshefsky, Larry; Jhee, Stanford

2014-01-01

In recent years, the growing numbers of patients seeking care for a wide range of psychiatric illnesses in the primary care setting has resulted in an increase in the number of psychotropic medications prescribed. Along with the increased utilization of psychotropic medications, considerable variability is noted in the prescribing patterns of primary care providers and psychiatrists. Because psychiatric patients also suffer from a number of additional medical comorbidities, the increased utilization of psychotropic medications presents an elevated risk of clinically significant drug interactions in these patients. While life-threatening drug interactions are rare, clinically significant drug interactions impacting drug response or appearance of serious adverse drug reactions have been documented and can impact long-term outcomes. Additionally, the impact of genetic variability on the psychotropic drug’s pharmacodynamics and/or pharmacokinetics may further complicate drug therapy. Increased awareness of clinically relevant psychotropic drug interactions can aid clinicians to achieve optimal therapeutic outcomes in patients in the primary care setting. PMID:22707017

The role of television advertising in increasing pneumococcal vaccination coverage among the elderly, North Coast, New South Wales, 2006.

PubMed

Wallace, Cate; Corben, Paul; Turahui, John; Gilmour, Robin

2008-10-01

North Coast Area Health Service (NCAHS) conducted a seven week television advertising campaign to raise community awareness of the availability of free adult pneumococcal vaccination and to increase coverage among North Coast residents in high risk groups. Effectiveness of the campaign was evaluated by examining vaccine ordering patterns of North Coast vaccination providers from 2005/2006 as a proxy for vaccination coverage. In the months during and immediately following (June-September 2006) the advertising campaign, a significantly higher proportion of vaccines were despatched to North Coast immunisation service providers. The advertising campaign was an effective strategy to promote vaccination among NCAHS residents not immunised in the first year of the National Pneumococcal Program for Older Australians. This higher immunisation coverage is expected to contribute to the statewide trend of significant reductions in invasive pneumococcal disease (IPD) notifications.

Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities

PubMed Central

2016-01-01

Infections remain a significant cause of morbidity and mortality in cancer patients. The differential diagnosis for these patients is often wide, and the timely selection of the right clinical tests can have a significant impact on their survival. However, laboratory findings with current methodologies are often negative, challenging clinicians and laboratorians to continue the search for the responsible pathogen. Novel methodologies are providing increased sensitivity and rapid turnaround time to results but also challenging our interpretation of what is a clinically significant pathogen in cancer patients. This minireview provides an overview of the most common infections in cancer patients and discusses some of the challenges and opportunities for the clinical microbiologist supporting the care of cancer patients. PMID:27280421

Onboard Radar Processor Development for Disaster Response

NASA Technical Reports Server (NTRS)

Lou, Yunling; Clark, Duane; Hensley, Scott; Jones, Cathleen; Marks, Phillip; Muellerschoen, Ron; Wang, Charles C.

2013-01-01

Natural hazards often result in significant loss of human lives, economic assets and productivity as well as significant damage to the ecosystem. Scientists have reported more frequent and intense natural disasters in recent years, which may well be attributed to climate change. Many of the disaster response efforts were hampered by lack of up-to-date knowledge of the state of the affected areas because damaged infrastructure rendered the areas inaccessible. Radar remote sensing is playing an increasingly critical role in providing timely information to disaster response agencies due to the increasing fidelity and availability of geospatial information products.

Bacterial carriage on the fingernails of OR nurses.

PubMed

Wynd, C A; Samstag, D E; Lapp, A M

1994-11-01

This study provides statistically significant data that demonstrate that chipped fingernail polish or fingernail polish worn longer than four days fosters increased numbers of bacteria on the fingernails of OR nurses after surgical hand scrubs. There were no significant correlations between fingernail length and the numbers of bacterial colonies on the fingernails of the study groups tested after performing a standard surgical hand scrub. A convenience sample of 102 perioperative nurses with either freshly polished fingernails; chipped fingernail polish; or natural, polish-free fingernails participated. The data suggest OR nurses can wear fresh fingernail polish on healthy fingernails without risking increased bacterial counts.

Willingness to pay and determinants of choice for improved malaria treatment in rural Nepal.

PubMed

Morey, Edward R; Sharma, Vijaya R; Mills, Anne

2003-07-01

A logit model is used to estimate provider choice from six types by malaria patients in rural Nepal. Patient characteristics that influence choice include travel costs, income category, household size, gender, and severity of malaria. Income effects are introduced by assuming the marginal utility of money is a step function of expenditures on the numeraire. This method of incorporating income effects is ideally suited for situations when exact income data is not available. Significant provider characteristics include wait time for treatment and wait time for laboratory results. Household willingness to pay (wtp) is estimated for increasing the number of providers and for providing more sites with blood testing capabilities. Wtp estimates vary significantly across households and allow one to assess how much different households would benefit or lose under different government proposals.

Improving the food provided and food safety practices in out-of-school-hours services.

PubMed

Cooke, Lara; Sangster, Janice; Eccleston, Philippa

2007-04-01

Food provided and food safety and serving practices in out-of-school-hours (OOSH) services. Health promotion strategies, developed in partnership with an advisory committee, were directed at three main areas: supporting local services; developing statewide training and resources; and advocacy. Significant improvements were seen in the food provided, food safety and serving practices and the number of services with planned menus and nutrition and food safety policies. This project is one of the first implemented and evaluated in the OOSH setting. Statistically significant improvements were achieved in the food provided, food safety and serving practices, and menu and policy development. The project also increased the capacity of the OOSH sector to improve children's health by making suitable nutrition and food safety resources and training available to OOSH services across New South Wales.

Bcl-2 upregulation and neuroprotection in guinea pig brain following chronic simvastatin treatment.

PubMed

Franke, Cornelia; Nöldner, Michael; Abdel-Kader, Reham; Johnson-Anuna, Leslie N; Gibson Wood, W; Müller, Walter E; Eckert, Gunter P

2007-02-01

The present study determined if chronic simvastatin administration in vivo would provide neuroprotection in brain cells isolated from guinea pigs after challenge with the Bcl-2 inhibitor HA 14-1 or the NO donor sodium nitroprusside (SNP). Bcl-2 levels were significantly increased in brains of simvastatin-treated guinea pigs while levels of the pro-apoptotic protein Bax were significantly reduced. The ratio of Bax/Bcl-2, being a critical factor of the apoptotic state of cells, was significantly reduced in simvastatin-treated animals. Cholesterol levels in the brain remained unchanged in the simvastatin group. Brain cells isolated from simvastatin-treated guinea pigs were significantly less vulnerable to mitochondrial dysfunction and caspase-activation. These results provide new insight into potential mechanisms for the protective actions of statins within the CNS where programmed cell death has been implicated.

Increased iron availability resulting from increased CO2 enhances carbon and nitrogen metabolism in the economical marine red macroalga Pyropia haitanensis (Rhodophyta).

PubMed

Chen, Binbin; Zou, Dinghui; Yang, Yufeng

2017-04-01

Ocean acidification caused by rising CO 2 is predicted to increase the concentrations of dissolved species of Fe(II) and Fe(III), leading to the enhanced photosynthetic carbon sequestration in some algal species. In this study, the carbon and nitrogen metabolism in responses to increased iron availability under two CO 2 levels (390 μL L -1 and 1000 μL L -1 ), were investigated in the maricultivated macroalga Pyropia haitanensis (Rhodophyta). The results showed that, elevated CO 2 increased soluble carbonhydrate (SC) contents, resulting from enhanced photosynthesis and photosynthetic pigment synthesis in this algae, but declined its soluble protein (SP) contents, resulting in increased ratio of SC/SP. This enhanced photosynthesis performance and carbon accumulation was more significant under iron enrichment condition in seawater, with higher iron uptake rate at high CO 2 level. As a key essential biogenic element for algae, Fe-replete functionally contributed to P. haitanensis photosynthesis. Increased SC fundamentally provided carbon skeletons for nitrogen assimilation. The significant increase of carbon and nitrogen assimilation finally contributed to enhanced growth in this alga. This was also intuitively reflected by respiration that provided energy for cellular metabolism and algal growth. We propose that, in the predicted scenario of rising atmospheric CO 2 , P. haitanensis is capable to adjust its physiology by increasing its carbon and nitrogen metabolism to acclimate the acidified seawater, at the background of global climate change and simultaneously increased iron concentration due to decreased pH levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Protein nanocrystallography: growth mechanism and atomic structure of crystals induced by nanotemplates.

PubMed

Pechkova, E; Vasile, F; Spera, R; Fiordoro, S; Nicolini, C

2005-11-01

Protein nanocrystallography, a new technology for crystal growth based on protein nanotemplates, has recently been shown to produce diffracting, stable and radiation-resistant lysozyme crystals. This article, by computing these lysozyme crystals' atomic structures, obtained by the diffraction patterns of microfocused synchrotron radiation, provides a possible mechanism for this increased stability, namely a significant decrease in water content accompanied by a minor but significant alpha-helix increase. These data are shown to be compatible with the circular dichroism and two-dimensional Fourier transform spectra of high-resolution H NMR of proteins dissolved from the same nanotemplate-based crystal versus those from a classical crystal. Finally, evidence for protein direct transfer from the nanotemplate to the drop and the participation of the template proteins in crystal nucleation and growth is provided by high-resolution NMR spectrometry and mass spectrometry. Furthermore, the lysozyme nanotemplate appears stable up to 523 K, as confirmed by a thermal denaturation study using spectropolarimetry. The overall data suggest that heat-proof lysozyme presence in the crystal provides a possible explanation of the crystal's resistance to synchrotron radiation.

Does the Aged Care Funding Instrument provide increased funding in residential care? Comparisons with the Residential Classification Scale.

PubMed

Chan, Geoffrey Z P; Chin, Collin K L; McKitrick, Douglas J; Warne, Roger W

2014-06-01

To determine whether the Aged Care Funding Instrument (ACFI) provides more funding than the Residential Classification Scale (RCS) for residents in the Hellenic Residential Care Facility. All residents within the care facility were assessed over a six 6-month period using ACFI, RCS and Clifton Assessment Procedures for the Elderly (CAPE) scores. Differences in funding levels were calculated using ACFI and RCS instruments against a standardised CAPE score. CAPE dependency RCS funding per resident per day varied from $32.20 for grade A to $116.20 for grade E4 residents. CAPE ACFI funding varied from $20.20 for grade A to $127.50 for grade E4. There was no significant difference in mean overall funding between the two scales (ACFI $92.50 vs RCS $90.35, P = 0.76). The ACFI does provide a small but not significant increase in funding to residents in residential care. It redirects funding to higher dependency residents. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Promoting consumption of fruit and vegetables for better health. Have campaigns delivered on the goals?

PubMed

Rekhy, Reetica; McConchie, Robyn

2014-08-01

Daily intake of fruits and vegetables worldwide remains well below the recommended WHO levels, despite the established health benefits associated with fruit and vegetable consumption. A diversity of policy interventions designed to increase consumption have been conducted in the developed economies around the globe for over a decade, involving significant monetary outlays. The impact of these initiatives remains at best, modest to low, in effecting a significant increase in daily consumption on a sustained basis. Several factors have been identified in both promoting and impeding the increase in fruit and vegetable consumption, including the effects of consumer behaviour. This paper reviews several of the major promotional campaigns from around the world and provides analysis of their level of success, with a view to developing novel approaches for formulating more effective marketing and promotional interventions that will prompt significant change. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hepatic urea biosynthesis in the euryhaline elasmobranch Carcharhinus leucas.

PubMed

Anderson, W Gary; Good, Jonathan P; Pillans, Richard D; Hazon, Neil; Franklin, Craig E

2005-10-01

Plasma urea levels and hepatic urea production in the euryhaline bull shark, Carcharhinus leucas, acclimated to freshwater and seawater environments were measured. It was found that plasma urea concentration increased with salinity and that this increase was, in part, the result of a significant increase in hepatic production of urea. This study provides direct evidence that hepatic production of urea plays an important role in the osmoregulatory strategy of C. leucas. (c) 2005 Wiley-Liss, Inc.

Significant enhancement of yellow-green light emission of ZnO nanorod arrays using Ag island films

NASA Astrophysics Data System (ADS)

Lin, Chin-An; Tsai, Dung-Sheng; Chen, Cheng-Ying; He-Hau, Jr.

2011-03-01

Surface plasmon (SP) mediated emission from ZnO nanorod arrays (NRAs)/Ag/Si structures has been investigated. The ratio of visible emission to UV emission can be increased by over 30 times via coupling with SP without deterioration of the crystal quality. The fact that the effect of SP crucially depends on the size of Ag island films provides the feasibility to significantly enhance the yellow-green emission of the ZnO nanostructures without sacrificing the crystallinity of ZnO.Surface plasmon (SP) mediated emission from ZnO nanorod arrays (NRAs)/Ag/Si structures has been investigated. The ratio of visible emission to UV emission can be increased by over 30 times via coupling with SP without deterioration of the crystal quality. The fact that the effect of SP crucially depends on the size of Ag island films provides the feasibility to significantly enhance the yellow-green emission of the ZnO nanostructures without sacrificing the crystallinity of ZnO. Electronic supplementary information (ESI) available. See DOI: 10.1039/c0nr00732c

Cardiac regulation in the socially monogamous prairie vole

PubMed Central

Grippo, Angela J.; Lamb, Damon G.; Carter, C. Sue; Porges, Stephen W.

2007-01-01

Social experiences, both positive and negative, may influence cardiovascular regulation. Prairie voles (Microtus ochrogaster) are socially monogamous rodents that form social bonds similar to those seen in primates, and this species may provide a useful model for investigating neural and social regulation of cardiac function. Cardiac regulation has not been studied previously in the prairie vole. Radiotelemetry transmitters were implanted into adult female prairie voles under anesthesia, and electrocardiographic parameters were recorded. Autonomic blockade was performed using atenolol (8 mg/kg ip) and atropine methyl nitrate (4 mg/kg ip). Several variables were evaluated, including heart rate (HR), HR variability and the amplitude of respiratory sinus arrhythmia. Sympathetic blockade significantly reduced HR. Parasympathetic blockade significantly increased HR, and reduced HR variability and the amplitude of respiratory sinus arrhythmia. Combined autonomic blockade significantly increased HR, and reduced HR variability and respiratory sinus arrhythmia amplitude. The data indicate that autonomic function in prairie voles shares similarities with primates, with a predominant vagal influence on cardiac regulation. The current results provide a foundation for studying neural and social regulation of cardiac function during different behavioral states in this socially monogamous rodent model. PMID:17107695

Saccharification of ozonated sugarcane bagasse using enzymes from Myceliophthora thermophila JCP 1-4 for sugars release and ethanol production.

PubMed

de Cassia Pereira, Josiani; Travaini, Rodolfo; Paganini Marques, Natalia; Bolado-Rodríguez, Silvia; Bocchini Martins, Daniela Alonso

2016-03-01

The saccharification of ozonated sugarcane bagasse (SCB) by enzymes from Myceliophthora thermophila JCP 1-4 was studied. Fungal enzymes provided slightly higher sugar release than commercial enzymes, working at 50°C. Sugar release increased with temperature increase. Kinetic studies showed remarkable glucose release (4.99 g/L, 3%w/w dry matter) at 60°C, 8 h of hydrolysis, using an enzyme load of 10 FPU (filter paper unit). FPase and β-glucosidase activities increased during saccharification (284% and 270%, respectively). No further significant improvement on glucose release was observed increasing the enzyme load above 7.5 FPU per g of cellulose. Higher dry matter contents increased sugars release, but not yields. The fermentation of hydrolysates by Saccharomyces cerevisiae provided glucose-to-ethanol conversions around to 63%. Copyright © 2015 Elsevier Ltd. All rights reserved.

Feeding green vegetables to the young children in rural Bangladesh: an analysis of intake following education to the caregivers.

PubMed

Yunus, M; Aziz, K M; Chowdhury, A I; Sack, R B

1996-01-01

The study was undertaken to increase the intake of vegetables rich in beta-carotene by young children through nutrition education of their caregivers. 156 children aged 6-59 months were selected from households of very poor socioeconomic status in the comparison area of Matlab MCH-FP Project. Nutrition education intervention was provided to the caregivers of these children on the importance of feeding vegetables rich in beta-carotene. This education included verbal communication and cooking demonstrations. It was provided by trained female community health workers once every 2 months over a period of 12 months from April 1994 to March 1995. Information on the consumption of green leafy vegetables by the children for the preceding 3 days was collected at baseline and after the 12-month intervention by interviewing the caregivers. The green leafy vegetables were categorized into high, medium, and low contents of beta-carotene. The proportion of children who consumed vegetables with high content of beta-carotene increased from 28% at the baseline to 96% after the intervention, showing a highly significant increase (p .000). The mean frequency of intake of vegetables rose from 0.65 per 3 days at baseline to 4.33 after the intervention. This increase in intake was also highly significant (p .000). The significant increase in the consumption of vegetables was achieved within a period of one year from the intervention. This shows that changes in the feeding practices of young children were feasible through education and motivation, which can develop confidence among the caregivers regarding the beneficial outcome of the recommended foods.

Manganese Superoxide Dismutase Is a Promising Target for Enhancing Chemosensitivity of Basal-Like Breast Carcinoma

PubMed Central

Kumar, Alan Prem; Loo, Ser Yue; Shin, Sung Won; Tan, Tuan Zea; Eng, Chon Boon; Singh, Rajeev; Putti, Thomas Choudary; Ong, Chee Wee; Salto-Tellez, Manuel; Goh, Boon Cher; Park, Joo In; Thiery, Jean Paul; Pervaiz, Shazib

2014-01-01

Abstract Aims: Although earlier reports highlighted a tumor suppressor role for manganese superoxide dismutase (MnSOD), recent evidence indicates increased expression in a variety of human cancers including aggressive breast carcinoma. In the present article, we hypothesized that MnSOD expression is significantly amplified in the aggressive breast carcinoma basal subtype, and targeting MnSOD could be an attractive strategy for enhancing chemosensitivity of this highly aggressive breast cancer subtype. Results: Using MDA-MB-231 and BT549 as a model of basal breast cancer cell lines, we show that knockdown of MnSOD decreased the colony-forming ability and sensitized the cells to drug-induced cell death, while drug resistance was associated with increased MnSOD expression. In an attempt to develop a clinically relevant approach to down-regulate MnSOD expression in patients with basal breast carcinoma, we employed activation of the peroxisome proliferator-activated receptor gamma (PPARγ) to repress MnSOD expression; PPARγ activation significantly reduced MnSOD expression, increased chemosensitivity, and inhibited tumor growth. Moreover, as a proof of concept for the clinical use of PPARγ agonists to decrease MnSOD expression, biopsies derived from breast cancer patients who had received synthetic PPARγ ligands as anti-diabetic therapy had significantly reduced MnSOD expression. Finally, we provide evidence to implicate peroxynitrite as the mechanism involved in the increased sensitivity to chemotherapy induced by MnSOD repression. Innovation and Conclusion: These data provide evidence to link increased MnSOD expression with the aggressive basal breast cancer, and underscore the judicious use of PPARγ ligands for specifically down-regulating MnSOD to increase the chemosensitivity of this subtype of breast carcinoma. Antioxid. Redox Signal. 20, 2326–2346. PMID:23964924

Using Principles of Complex Adaptive Systems to Implement Secondary Prevention of Coronary Heart Disease in Primary Care

PubMed Central

Kottke, Thomas E; Huebsch, Jacquelyn A; McGinnis, Paul; Nichols, Jolleen M; Parker, Emily D; Tillema, Juliana O; Maciosek, Michael V

2016-01-01

Context: Primary care practice. Objective: To test whether the principles of complex adaptive systems are applicable to implementation of team-based primary care. Design: We used complex adaptive system principles to implement team-based care in a private, five-clinic primary care practice. We compared randomly selected samples of patients with coronary heart disease (CHD) and diabetes before system implementation (March 1, 2009, to February 28, 2010) and after system implementation (December 1, 2011, to March 31, 2013). Main Outcome Measures: Rates of patients meeting the composite goals for CHD (blood pressure < 140/90 mmHg, low-density lipoprotein cholesterol level < 100 mg/dL, tobacco-free, and using aspirin unless contraindicated) and diabetes (CHD goal plus hemoglobin A1c concentration < 8%) before and after the intervention. We also measured provider and patient satisfaction with preventive services. Results: The proportion of patients with CHD who met the composite goal increased from 40.3% to 59.9% (p < 0.0001) because documented aspirin use increased (65.2%–97.5%, p < 0.0001) and attainment of the cholesterol goal increased (77.0%–83.9%, p = 0.0041). The proportion of diabetic patients meeting the composite goal rose from 24.5% to 45.4% (p < 0.0001) because aspirin use increased (58.6%–97.6%, p < 0.0001). Increased percentages of patients meeting the CHD and diabetes composite goals were not significantly different (p = 0.2319). Provider satisfaction with preventive services delivery increased significantly (p = 0.0017). Patient satisfaction improved but not significantly. Conclusion: Principles of complex adaptive systems can be used to implement team-based care systems for patients with CHD and possibly diabetic patients. PMID:26784851

Using Principles of Complex Adaptive Systems to Implement Secondary Prevention of Coronary Heart Disease in Primary Care.

PubMed

Kottke, Thomas E; Huebsch, Jacquelyn A; Mcginnis, Paul; Nichols, Jolleen M; Parker, Emily D; Tillema, Juliana O; Maciosek, Michael V

2016-01-01

Primary care practice. To test whether the principles of complex adaptive systems are applicable to implementation of team-based primary care. We used complex adaptive system principles to implement team-based care in a private, five-clinic primary care practice. We compared randomly selected samples of patients with coronary heart disease (CHD) and diabetes before system implementation (March 1, 2009, to February 28, 2010) and after system implementation (December 1, 2011, to March 31, 2013). Rates of patients meeting the composite goals for CHD (blood pressure < 140/90 mmHg, low-density lipoprotein cholesterol level < 100 mg/dL, tobacco-free, and using aspirin unless contraindicated) and diabetes (CHD goal plus hemoglobin A1c concentration < 8%) before and after the intervention. We also measured provider and patient satisfaction with preventive services. The proportion of patients with CHD who met the composite goal increased from 40.3% to 59.9% (p < 0.0001) because documented aspirin use increased (65.2%-97.5%, p < 0.0001) and attainment of the cholesterol goal increased (77.0%-83.9%, p = 0.0041). The proportion of diabetic patients meeting the composite goal rose from 24.5% to 45.4% (p < 0.0001) because aspirin use increased (58.6%-97.6%, p < 0.0001). Increased percentages of patients meeting the CHD and diabetes composite goals were not significantly different (p = 0.2319). Provider satisfaction with preventive services delivery increased significantly (p = 0.0017). Patient satisfaction improved but not significantly. Principles of complex adaptive systems can be used to implement team-based care systems for patients with CHD and possibly diabetic patients.

Compositional Changes and Baking Performance of Rye Dough As Affected by Microbial Transglutaminase and Xylanase.

PubMed

Grossmann, Isabel; Döring, Clemens; Jekle, Mario; Becker, Thomas; Koehler, Peter

2016-07-20

Doughs supplemented with endoxylanase (XYL) and varying amounts of microbial transglutaminase (TG) were analyzed by sequential protein extraction, quantitation of protein fractions and protein types, and determination of water-extractable arabinoxylans. With increasing TG activity, the concentration of prolamins and glutelins decreased and increased, respectively, and the prolamin-to-glutelin ratio strongly declined. The overall amount of extractable protein decreased with increasing TG level showing that cross-linking by TG provided high-molecular-weight protein aggregates. The decrease of the high-molecular-weight arabinoxylan fraction and the concurrent increase of the medium-molecular-weight fraction confirmed the degradation of arabinoxylans by XYL. However, XYL addition did not lead to significant improved cross-linking of rye proteins by TG. Volume and crumb hardness measurements of bread showed increased protein connectivity induced by XYL and TG. Significant positive effects on the final bread quality were especially obtained by XYL addition.

The impact of RAC audits on US hospitals.

PubMed

Harrison, Jeffrey P; Barksdale, Rachel M

2013-01-01

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) authorized a three-year demonstration program using recovery audit contractors (RACs) to identify and correct improper payments in the Medicare Fee-For-Service program. More recently, Section 6411 of the Affordable Care Act (ACA) expanded the RAC program to include the Medicaid program. This shows the Cent ers for Medicare & Medicaid Services (CMS) believe RAC audits are a cost-effective method to ensure health care providers are paid correctly and thereby protect the Medicare Trust Fund. RAC audits are highly complex and require significant manpower to handle the large volume of requests received during a short period of time. Additionally, the RAC audit appeal process is complicated and requires a high level of technical expertise. The demonstration project found that RAC audits resulted in sizeable amounts of overpayments collected ("take-backs") from many providers. This research study assesses the potential impact of the RAC audit program on US acute care hospitals. Data obtained from CMS show that RAC overpayments collected for FY 2010 were $75.4 million, increased to $797.4 million in FY 2011, and increased to $986.2 million in the first six months of FY 2012. According to the American Hospital Association (AHA) RACTrac audit survey, the vast majority of these collections represent complex denials where hospitals are required to provide medical record documents in support of their billed claims. This study found that the RAC audit program collections are increasing significantly over time. As a result, these collections are having a significant negative impact on the profitability of US hospitals.

Unprovoked atrial tachyarrhythmias in aging spontaneously hypertensive rats: the role of the autonomic nervous system.

PubMed

Scridon, Alina; Gallet, Clément; Arisha, Moussa M; Oréa, Valérie; Chapuis, Bruno; Li, Na; Tabib, Alain; Christé, Georges; Barrès, Christian; Julien, Claude; Chevalier, Philippe

2012-08-01

Experimental models of unprovoked atrial tachyarrhythmias (AT) in conscious, ambulatory animals are lacking. We hypothesized that the aging, spontaneously hypertensive rat (SHR) may provide such a model. Baseline ECG recordings were acquired with radiotelemetry in eight young (14-wk-old) and eight aging (55-wk-old) SHRs and in two groups of four age-matched Wistar-Kyoto (WKY) rats. Quantification of AT and heart rate variability (HRV) analysis were performed based on 24-h ECG recordings in unrestrained rats. All animals were submitted to an emotional stress protocol (air-jet). In SHRs, carbamylcholine injections were also performed. Spontaneous AT episodes were observed in all eight aging SHRs (median, 91.5; range, 4-444 episodes/24 h), but not in young SHRs or WKY rats. HRV analysis demonstrated significantly decreased low frequency components in aging SHRs compared with age-matched WKY rats (P < 0.01) and decreased low/high frequency ratios in both young (P < 0.01) and aging (P = 0.01) SHRs compared with normotensive controls. In aging SHRs, emotional stress significantly reduced the number of arrhythmic events, whereas carbamylcholine triggered AT and significantly increased atrial electrical instability. This study reports the occurrence of unprovoked episodes of atrial arrhythmia in hypertensive rats, and their increased incidence with aging. Our results suggest that autonomic imbalance with relative vagal hyperactivity may be responsible for the increased atrial arrhythmogenicity observed in this model. We also provide evidence that, in this model, the sympatho-vagal imbalance preceded the occurrence of arrhythmia. These results indicate that aging SHRs may provide valuable insight into the understanding of atrial arrhythmias.

The role of intervention mapping in designing disease prevention interventions: A systematic review of the literature.

PubMed

Garba, Rayyan M; Gadanya, Muktar A

2017-01-01

To assess the role of Intervention Mapping (IM) in designing disease prevention interventions worldwide. Systematic search and review of the relevant literature-peer-reviewed and grey-was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Only five of the twenty two included studies reviewed were RCTs that compared intervention using IM protocol with placebo intervention, and provided the outcomes in terms of percentage increase in the uptake of disease-prevention programmes, and only one of the five studies provided an effect measure in the form of relative risk (RR = 1.59, 95% CI = 1.08-2.34, p = 0.02). Of the five RCTs, three were rated as strong evidences, one as a medium evidence and one as a weak evidence, and they all reported statistically significant difference between the two study groups, with disease prevention interventions that have used the intervention mapping approach generally reported significant increases in the uptake of disease-prevention interventions, ranging from 9% to 28.5% (0.0001 ≤ p ≤ 0.02), On the other hand, all the 22 studies have successfully identified the determinants of the uptake of disease prevention interventions that is essential to the success of disease prevention programmes. Intervention Mapping has been successfully used to plan, implement and evaluate interventions that showed significant increase in uptake of disease prevention programmes. This study has provided a good understanding of the role of intervention mapping in designing disease prevention interventions, and a good foundation upon which subsequent reviews can be guided.

The role of intervention mapping in designing disease prevention interventions: A systematic review of the literature

PubMed Central

Garba, Rayyan M.; Gadanya, Muktar A.

2017-01-01

Objective To assess the role of Intervention Mapping (IM) in designing disease prevention interventions worldwide. Methods Systematic search and review of the relevant literature—peer-reviewed and grey—was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Findings Only five of the twenty two included studies reviewed were RCTs that compared intervention using IM protocol with placebo intervention, and provided the outcomes in terms of percentage increase in the uptake of disease-prevention programmes, and only one of the five studies provided an effect measure in the form of relative risk (RR = 1.59, 95% CI = 1.08–2.34, p = 0.02). Of the five RCTs, three were rated as strong evidences, one as a medium evidence and one as a weak evidence, and they all reported statistically significant difference between the two study groups, with disease prevention interventions that have used the intervention mapping approach generally reported significant increases in the uptake of disease-prevention interventions, ranging from 9% to 28.5% (0.0001 ≤ p ≤ 0.02), On the other hand, all the 22 studies have successfully identified the determinants of the uptake of disease prevention interventions that is essential to the success of disease prevention programmes. Conclusion Intervention Mapping has been successfully used to plan, implement and evaluate interventions that showed significant increase in uptake of disease prevention programmes. This study has provided a good understanding of the role of intervention mapping in designing disease prevention interventions, and a good foundation upon which subsequent reviews can be guided. PMID:28358821

Milkweed (Gentianales: Apocynaceae): a farmscape resource for increasing parasitism of stink bugs (Hemiptera: Pentatomidae) and providing nectar to insect pollinators and monarch butterflies.

PubMed

Tillman, P G; Carpenter, J E

2014-04-01

In peanut-cotton farmscapes in Georgia, the stink bugs Nezara viridula (L.) and Chinavia hilaris (Say) (Hemiptera: Pentatomidae) and the leaffooted bug, Leptoglossus phyllopus (L.) (Hemiptera: Coreidae), disperse at crop-to-crop interfaces to feed on bolls in cotton. The main objective of this study was to determine whether insecticide-free tropical milkweed (Asclepias curassavica L.), a nectar-producing plant, can increase parasitism of these bugs by Trichopoda pennipes (F.) (Diptera: Tachinidae) and provide nectar to monarch butterflies and insect pollinators in these farmscapes. Peanut-cotton plots with and without flowering milkweed plants were established in 2009 and 2010. Adult T. pennipes, monarch butterflies, honey bees, and native insect pollinators readily fed on floral nectar of milkweed. Monarch larvae feeding on milkweed vegetation successfully developed into pupae. In 2009, N. viridula was the primary host of T. pennipes in cotton, and parasitism of this pest by the parasitoid was significantly higher in milkweed cotton (61.6%) than in control cotton (13.3%). In 2010, parasitism of N. viridula, C. hilaris, and L. phyllopus by T. pennipes was significantly higher in milkweed cotton (24.0%) than in control cotton (1.1%). For both years of the study, these treatment differences were not owing to a response by the parasitoid to differences in host density, because density of hosts was not significantly different between treatments. In conclusion, incorporation of milkweed in peanut-cotton plots increased stink bug parasitism in cotton and provided nectar to insect pollinators and monarch butterflies.

The Role of the Medical Provider in the Evaluation of Sexually Abused Children and Adolescents

ERIC Educational Resources Information Center

Newton, Alice Whittier; Vandeven, Andrea Marie

2010-01-01

It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…

HAARP 2011 Summer Student Research Campaign

DTIC Science & Technology

2012-10-16

in order to take advantage of a wide variety of background ionospheric conditions and to provide ample time for each student to investigate...The SSRC expands on the PARS Summer School by providing a significant increase in facility operational time. This has advantages in several areas...in several advantages for scheduling and conducting experiments: (1) Higher ionospheric density yields higher F-region critical frequency (foF2

The unique contribution of manual chest compression-vibrations to airflow during physiotherapy in sedated, fully ventilated children.

PubMed

Gregson, Rachael K; Shannon, Harriet; Stocks, Janet; Cole, Tim J; Peters, Mark J; Main, Eleanor

2012-03-01

This study aimed to quantify the specific effects of manual lung inflations with chest compression-vibrations, commonly used to assist airway clearance in ventilated patients. The hypothesis was that force applied during the compressions made a significant additional contribution to increases in peak expiratory flow and expiratory to inspiratory flow ratio over and above that resulting from accompanying increases in inflation volume. Prospective observational study. Cardiac and general pediatric intensive care. Sedated, fully ventilated children. Customized force-sensing mats and a commercial respiratory monitor recorded force and respiration during physiotherapy. Percentage changes in peak expiratory flow, peak expiratory to inspiratory flow ratios, inflation volume, and peak inflation pressure between baseline and manual inflations with and without compression-vibrations were calculated. Analysis of covariance determined the relative contribution of changes in pressure, volume, and force to influence changes in peak expiratory flow and peak expiratory to inspiratory flow ratio. Data from 105 children were analyzed (median age, 1.3 yrs; range, 1 wk to 15.9 yrs). Force during compressions ranged from 15 to 179 N (median, 46 N). Peak expiratory flow increased on average by 76% during compressions compared with baseline ventilation. Increases in peak expiratory flow were significantly related to increases in inflation volume, peak inflation pressure, and force with peak expiratory flow increasing by, on average, 4% for every 10% increase in inflation volume (p < .001), 5% for every 10% increase in peak inflation pressure (p = .005), and 3% for each 10 N of applied force (p < .001). By contrast, increase in peak expiratory to inspiratory flow ratio was only related to applied force with a 4% increase for each 10 N of force (p < .001). These results provide evidence of the unique contribution of compression forces in increasing peak expiratory flow and peak expiratory to inspiratory flow ratio bias over and above that related to accompanying changes from manual hyperinflations. Force generated during compression-vibrations was the single significant factor in multivariable analysis to explain the increases in expiratory flow bias. Such increases in the expiratory bias provide theoretically optimal physiological conditions for cephalad mucus movement in fully ventilated children.

Increasing immunization: a Medicaid managed care model.

PubMed

Browngoehl, K; Kennedy, K; Krotki, K; Mainzer, H

1997-01-01

To evaluate the impact of an immunization outreach program on immunization rates. A Pennsylvania independent practice association model managed care organization (100% Medicaid). Retrospective cohort study (N = 2511) of children 30 to 35 months of age from two age cohorts that compared immunization rates for Advisory Committee on Immunization Practices schedules for diphtheria-tetanus-pertussis, oral polio vaccine, measles-mumps-rubella, and Haemophilus influenza type b. An evaluation of the outreach component of the program compared treatment and nontreatment subgroups of one age cohort (N = 1002). The immunization program targeted approximately 19 000 members from birth to 6 years of age. The program components included computerized tracking and reminders, member and provider education, provider incentives, member incentives, and home visiting outreach. Data indicate that the treatment group has higher completed immunization rates at 35 months of age than does the control group. Furthermore, data show that members with home visits have significantly higher completed immunization rates than do other members. The corresponding comparisons for age-appropriate immunizations by 24 months indicate a nonsignificant trend of increased rates. The data provide evidence supporting a correlation between comprehensive strategies (computerized tracking, member and provider education and incentives, and home visiting) and increased immunization rates. Those individuals who received home visits were more likely to complete an immunization series by 35 months of age than those who did not. However, within the Mercy Health Plan program, age-appropriate immunizations are not significantly affected by home-visiting outreach.

Biophotonic logic devices based on quantum dots and temporally-staggered Förster energy transfer relays

NASA Astrophysics Data System (ADS)

Claussen, Jonathan C.; Algar, W. Russ; Hildebrandt, Niko; Susumu, Kimihiro; Ancona, Mario G.; Medintz, Igor L.

2013-11-01

Integrating photonic inputs/outputs into unimolecular logic devices can provide significantly increased functional complexity and the ability to expand the repertoire of available operations. Here, we build upon a system previously utilized for biosensing to assemble and prototype several increasingly sophisticated biophotonic logic devices that function based upon multistep Förster resonance energy transfer (FRET) relays. The core system combines a central semiconductor quantum dot (QD) nanoplatform with a long-lifetime Tb complex FRET donor and a near-IR organic fluorophore acceptor; the latter acts as two unique inputs for the QD-based device. The Tb complex allows for a form of temporal memory by providing unique access to a time-delayed modality as an alternate output which significantly increases the inherent computing options. Altering the device by controlling the configuration parameters with biologically based self-assembly provides input control while monitoring changes in emission output of all participants, in both a spectral and temporal-dependent manner, gives rise to two input, single output Boolean Logic operations including OR, AND, INHIBIT, XOR, NOR, NAND, along with the possibility of gate transitions. Incorporation of an enzymatic cleavage step provides for a set-reset function that can be implemented repeatedly with the same building blocks and is demonstrated with single input, single output YES and NOT gates. Potential applications for these devices are discussed in the context of their constituent parts and the richness of available signal.

Biophotonic logic devices based on quantum dots and temporally-staggered Förster energy transfer relays.

PubMed

Claussen, Jonathan C; Algar, W Russ; Hildebrandt, Niko; Susumu, Kimihiro; Ancona, Mario G; Medintz, Igor L

2013-12-21

Integrating photonic inputs/outputs into unimolecular logic devices can provide significantly increased functional complexity and the ability to expand the repertoire of available operations. Here, we build upon a system previously utilized for biosensing to assemble and prototype several increasingly sophisticated biophotonic logic devices that function based upon multistep Förster resonance energy transfer (FRET) relays. The core system combines a central semiconductor quantum dot (QD) nanoplatform with a long-lifetime Tb complex FRET donor and a near-IR organic fluorophore acceptor; the latter acts as two unique inputs for the QD-based device. The Tb complex allows for a form of temporal memory by providing unique access to a time-delayed modality as an alternate output which significantly increases the inherent computing options. Altering the device by controlling the configuration parameters with biologically based self-assembly provides input control while monitoring changes in emission output of all participants, in both a spectral and temporal-dependent manner, gives rise to two input, single output Boolean Logic operations including OR, AND, INHIBIT, XOR, NOR, NAND, along with the possibility of gate transitions. Incorporation of an enzymatic cleavage step provides for a set-reset function that can be implemented repeatedly with the same building blocks and is demonstrated with single input, single output YES and NOT gates. Potential applications for these devices are discussed in the context of their constituent parts and the richness of available signal.

Can the Palatability of Healthy, Satiety-Promoting Foods Increase with Repeated Exposure during Weight Loss?

PubMed Central

Anguah, Katherene O.-B.; Lovejoy, Jennifer C.; Craig, Bruce A.; Gehrke, Malinda M.; Palmer, Philip A.; Eichelsdoerfer, Petra E.; McCrory, Megan A.

2017-01-01

Repeated exposure to sugary, fatty, and salty foods often enhances their appeal. However, it is unknown if exposure influences learned palatability of foods typically promoted as part of a healthy diet. We tested whether the palatability of pulse containing foods provided during a weight loss intervention which were particularly high in fiber and low in energy density would increase with repeated exposure. At weeks 0, 3, and 6, participants (n = 42; body mass index (BMI) 31.2 ± 4.3 kg/m2) were given a test battery of 28 foods, approximately half which had been provided as part of the intervention, while the remaining half were not foods provided as part of the intervention. In addition, about half of each of the foods (provided as part or not provided as part of the intervention) contained pulses. Participants rated the taste, appearance, odor, and texture pleasantness of each food, and an overall flavor pleasantness score was calculated as the mean of these four scores. Linear mixed model analyses showed an exposure type by week interaction effect for taste, texture and overall flavor pleasantness indicating statistically significant increases in ratings of provided foods in taste and texture from weeks 0 to 3 and 0 to 6, and overall flavor from weeks 0 to 6. Repeated exposure to these foods, whether they contained pulses or not, resulted in a ~4% increase in pleasantness ratings. The long-term clinical relevance of this small increase requires further study. PMID:28231094

Zebra mussel effects on benthic invertebrates: physical or biotic?

USGS Publications Warehouse

Botts, P. Silver; Patterson, Benjamin A.; Schloesser, Don W.

1996-01-01

In soft sediments, Dreissena spp. create firm substrate in the form of aggregates of living mussels (druses) that roll free on the sediments. Druses provide physical structure which increases habitat heterogeneity, and the mussels increase benthic organic matter through the production of pseudofeces and feces. Descriptive and experimental studies were used to determine: 1) whether the density of benthic invertebrates in soft sediments increased in the presence of druses, and 2) whether the invertebrate assemblage responded to the physical structure provided by a druse or to some biotic effect associated with the presence of living mussels. In core samples collected biweekly during summer in Presque Isle Bay, Erie, Pennsylvania, amphipods, chironomids, oligochaetes, turbellarians, and hydrozoans were significantly more abundant in sand with druses than in bare sand. When mesh bags containing either a living druse, non-living druse, or no druse were incubated in the bay for 33 d, we found that chironomids were significantly more abundant in treatments with living druses than with non-living druses, and in treatments with non-living druses than with no druse; turbellarians, amphipods, and hydrozoans were significantly more abundant in treatments with living or non-living druses than with no druse; oligochaetes showed no significant differences among treatments. This study demonstrates that most taxa of benthic invertebrates in soft substrate respond specifically to the physical structure associated with aggregates of mussel shells, but further study is needed to examine chironomid responses to some biotic effect dependent on the presence of living mussels.

Vibration stimulates vocal mucosa-like matrix expression by hydrogel-encapsulated fibroblasts.

PubMed

Kutty, Jaishankar K; Webb, Ken

2010-01-01

The composition and organization of the vocal fold extracellular matrix (ECM) provide the viscoelastic mechanical properties that are required to sustain high-frequency vibration during voice production. Although vocal injury and pathology are known to produce alterations in matrix physiology, the mechanisms responsible for the development and maintenance of vocal fold ECM are poorly understood. The objective of this study was to investigate the effect of physiologically relevant vibratory stimulation on ECM gene expression and synthesis by fibroblasts encapsulated within hyaluronic acid hydrogels that approximate the viscoelastic properties of vocal mucosa. Relative to static controls, samples exposed to vibration exhibited significant increases in mRNA expression levels of HA synthase 2, decorin, fibromodulin and MMP-1, while collagen and elastin expression were relatively unchanged. Expression levels exhibited a temporal response, with maximum increases observed after 3 and 5 days of vibratory stimulation and significant downregulation observed at 10 days. Quantitative assays of matrix accumulation confirmed significant increases in sulphated glycosaminoglycans and significant decreases in collagen after 5 and 10 days of vibratory culture, relative to static controls. Cellular remodelling and hydrogel viscosity were affected by vibratory stimulation and were influenced by varying the encapsulated cell density. These results indicate that vibration is a critical epigenetic factor regulating vocal fold ECM and suggest that rapid restoration of the phonatory microenvironment may provide a basis for reducing vocal scarring, restoring native matrix composition and improving vocal quality. 2009 John Wiley & Sons, Ltd.

Timescales for detecting a significant acceleration in sea level rise

PubMed Central

Haigh, Ivan D.; Wahl, Thomas; Rohling, Eelco J.; Price, René M.; Pattiaratchi, Charitha B.; Calafat, Francisco M.; Dangendorf, Sönke

2014-01-01

There is observational evidence that global sea level is rising and there is concern that the rate of rise will increase, significantly threatening coastal communities. However, considerable debate remains as to whether the rate of sea level rise is currently increasing and, if so, by how much. Here we provide new insights into sea level accelerations by applying the main methods that have been used previously to search for accelerations in historical data, to identify the timings (with uncertainties) at which accelerations might first be recognized in a statistically significant manner (if not apparent already) in sea level records that we have artificially extended to 2100. We find that the most important approach to earliest possible detection of a significant sea level acceleration lies in improved understanding (and subsequent removal) of interannual to multidecadal variability in sea level records. PMID:24728012

Animal ethics and welfare education in wet-lab training can foster residents’ ethical values toward life

PubMed Central

Iki, Yuko; Ito, Takuya; Kudo, Katsuyoshi; Noda, Masafumi; Kanehira, Masahiko; Sueta, Teruko; Miyoshi, Ichiro; Kagaya, Yutaka; Okada, Yoshinori; Unno, Michiaki

2017-01-01

Live animals are used in surgical skills training in wet lab, which has undeniable effectiveness for the development of future surgeons. However, where such training is provided, animal welfare is a major consideration. Increasingly, institutions that offer wet-lab training are incorporating animal ethics and welfare-related content into their training courses, but the effectiveness of such animal ethics education has yet to be evaluated quantitatively. We investigated whether the animal ethics content of a training course affected trainees by measuring increase in ethical awareness using visual analog scale questionnaires before and after training. Our results demonstrated a significant and positive increase in awareness of animal ethics (significance level of 5%; 0.0380≤P≤0.0016). PMID:28592716

Animal ethics and welfare education in wet-lab training can foster residents' ethical values toward life.

PubMed

Iki, Yuko; Ito, Takuya; Kudo, Katsuyoshi; Noda, Masafumi; Kanehira, Masahiko; Sueta, Teruko; Miyoshi, Ichiro; Kagaya, Yutaka; Okada, Yoshinori; Unno, Michiaki

2017-10-30

Live animals are used in surgical skills training in wet lab, which has undeniable effectiveness for the development of future surgeons. However, where such training is provided, animal welfare is a major consideration. Increasingly, institutions that offer wet-lab training are incorporating animal ethics and welfare-related content into their training courses, but the effectiveness of such animal ethics education has yet to be evaluated quantitatively. We investigated whether the animal ethics content of a training course affected trainees by measuring increase in ethical awareness using visual analog scale questionnaires before and after training. Our results demonstrated a significant and positive increase in awareness of animal ethics (significance level of 5%; 0.0380≤P≤0.0016).

Management of Heart Failure in Cancer Patients and Cancer Survivors.

PubMed

Finet, Jose Emanuel

2017-04-01

The number of cancer survivors increases annually, because of advances in detection and treatment, and the aging and growth of the population. This increase has brought a concomitant increase in morbidity and mortality from other conditions related to the adverse effects of cancer treatments. Cardiovascular diseases, and in particular left ventricular dysfunction and heart failure, are among the most significant of these. There are no unified and universally accepted evidence-based practice guidelines on the management of heartfailure in this population. This article discusses the epidemiologic impact of cancer therapeutics-related cardiac dysfunction, and reviews its most significant mediators and provides a condensed but comprehensive synopsis on its evaluation and management. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

PubMed

Ho, Lara S; Labrecque, Guillaume; Batonon, Isatou; Salsi, Viviana; Ratnayake, Ruwan

2015-01-01

More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved maintenance of physical infrastructure. Changes occurred through many different mechanisms including provider actions in response to information, pressure from community representatives, or supervisors; and joint action and improved collaboration by health facility committees and providers. Although it is often assumed that confrontation is a primary mechanism for citizens to change state-provided services, this study demonstrates that healthcare providers may also be motivated to change through other means. Positive experiences of community scorecards can provide a structured space for interface between community members and the health system, allowing users to voice their opinions and preferences and bridge information gaps for both users and frontline healthcare providers. When solutions to problems identified through the scorecard are locally accessible, users and healthcare providers are able to work together to implement mutually acceptable solutions that improve quality of health services, and make them more responsive to users' needs.

Induction of heme oxygenase-1 by chamomile protects murine macrophages against oxidative stress

PubMed Central

Bhaskaran, Natarajan; Shukla, Sanjeev; Kanwal, Rajnee; Srivastava, Janmejai K; Gupta, Sanjay

2012-01-01

Aims Protection of cells from oxidative insult may be possible through direct scavenging of reactive oxygen species, or through stimulation of intracellular antioxidant defense mechanisms by induction of antioxidant gene expression. In this study we investigated the cytoprotective effect of chamomile and elucidated the underlying mechanisms. Main Methods The cytoprotective effect of chamomile was examined on H2O2-induced cellular stress in RAW 264.7 murine macrophages. Key Findings RAW 264.7 murine macrophages treated with chamomile were protected from cell death caused by H2O2. Treatment with 50 μM H2O2 for 6 h caused significant increase in cellular stress accompanied by cell death in RAW 264.7 macrophages. Pretreatment with chamomile at 10-20 μg/mL for 16 h followed by H2O2 treatment protected the macrophages against cell death. Chamomile exposure significantly increased the expression of antioxidant enzymes viz. heme oxygenase-1 (HO-1), peroxiredoxin-1 (Prx-1), and thioredoxin-1 (Trx-1) in a dose-dependent manner, compared with their respective controls. Chamomile increased nuclear translocation of Nrf2 with increased phosphorylated Nrf2 levels, and binding to the antioxidant response element in the nucleus. Significance These molecular findings for the first time provide insights into the mechanisms underlying the induction of phase 2 enzymes through the Keap1-Nrf2 signaling pathway by chamomile, and provide evidence that chamomile possesses antioxidant and cytoprotective properties. PMID:22683429

Personally Meaningful Rituals: A Way to Increase Compassion and Decrease Burnout among Hospice Staff and Volunteers.

PubMed

Montross-Thomas, Lori P; Scheiber, Caroline; Meier, Emily A; Irwin, Scott A

2016-10-01

Rituals can increase a sense of connectedness, meaning, and support, especially after the death of those for whom we care. Hospice staff may benefit from the use of personal rituals as they cope with the frequent deaths of their patients, ultimately aiming to provide compassionate care while minimizing burnout. This study investigated the role of personally meaningful rituals in increasing compassion and decreasing burnout among hospice staff and volunteers. An online survey was completed by members of the National Hospice and Palliative Care Organization (NHPCO) which inquired about personal ritual practices, and included the Professional Quality of Life (ProQOL) scale to measure current levels of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress. Three hundred ninety hospice staff and volunteers from across 38 states completed the online survey. The majority of participants were Caucasian and female, with an average of nine years of experience in hospice and palliative care. The majority of hospice staff and volunteers used personally meaningful rituals after the death of their patients to help them cope (71%). Those who used rituals demonstrated significantly higher Compassion Satisfaction and significantly lower Burnout as measured by the ProQOL, with professional support, social support, and age playing significant roles as well. Rituals may be an important way to increase compassion and decrease burnout among hospice staff and volunteers. Organizations may benefit from providing training and support for personalized rituals among team members, especially new staff who may be at greater risk for burnout.

Middle Ear Pressures in Wind Instrument Musicians.

PubMed

Osborne, Max Sallis; Morris, Simon; Clark, Matthew P; Begg, Philip

2018-05-22

This study aimed to assess if playing wind instruments leads to a measurable increase in middle ear pressure during note generation and to provide evidence to clinicians to advise musicians undergoing middle ear surgery. An observational cohort study of 40 volunteers in 7 different wind instrument categories underwent tympanometry at rest and during note production. Community. Recreational musicians aged over 18 years recruited from the student body attending Birmingham University, UK. None. Tympanometry is used as a noninvasive measure of middle ear pressure. The pressure at which peak compliance occurred was taken as an indirect measure of middle ear pressure. The data produced at rest and during note production was statistically analysed with paired t testing and significance set at a p value less than 0.01. Overall a statistically significant increase in middle ear pressure change of 0.63 mm Hg (p = 0.0001) during note production was identified. Musicians playing the oboe and trumpet demonstrate the largest increase in middle ear pressure of 1.46 mm Hg (p = 0.0053) and 0.78 mm Hg (p = 0.0005) respectively. The data provided by this study gives evidence for the first time that playing wind instruments does increase middle ear pressure. Although the clinical significance of this is yet to be determined the authors would advise that musicians who undergo otological procedures should refrain from playing their instruments until full recovery has been achieved as advised by their clinician following direct microscopic review.

Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics.

PubMed

Gittell, Jody Hoffer; Logan, Caroline; Cronenwett, Jack; Foster, Tina C; Freeman, Richard; Godfrey, Marjorie; Vidal, Dale Collins

2018-01-05

Pressures are increasing for clinicians to provide high-quality, efficient care, leading to increased concerns about staff burnout. This study asks whether staff well-being can be achieved in ways that are also beneficial for the patient's experience of care. It explores whether relational coordination can contribute to both staff well-being and patient satisfaction in outpatient surgical clinics where time constraints paired with high needs for information transfer increase both the need for and the challenge of achieving timely and accurate communication. We studied relational coordination among surgeons, nurses, residents, administrators, technicians, and secretaries in 11 outpatient surgical clinics. Data were combined from a staff and a patient survey to conduct a cross-sectional study. Data were analyzed using ordinary least squares and random effects regression models. Relational coordination among all workgroups was significantly associated with staff outcomes, including job satisfaction, work engagement, and burnout. Relational coordination was also significantly associated with patients' satisfaction with staff and their overall visit, though the association between relational coordination and patients' satisfaction with their providers did not reach statistical significance. Even when patient-staff interactions are relatively brief, as in outpatient settings, high levels of relational coordination among interdependent workgroups contribute to positive outcomes for both staff and patients, and low levels tend to have the opposite effect. Clinical leaders can increase the expectation of positive outcomes for both staff and their patients by implementing interventions to strengthen relational coordination.

The Changing Impact of Gastroesophageal Reflux Disease in Clinical Practice.

PubMed

Akst, Lee M; Haque, Omar J; Clarke, John O; Hillel, Alexander T; Best, Simon R A; Altman, Kenneth W

2017-03-01

The National Ambulatory Medical Care Survey (NAMCS) database was utilized to understand evolving national trends in diagnosis and management of reflux. The NAMCS database was queried for visits related to gastroesophageal reflux diagnosis and management. Analysis performed for time periods 1998-2001, 2002-2005, and 2006-2009 was weighted to provide national estimates of care. Results were compared to previously reported time periods from 1990 to 2001 to evaluate patterns in overall visits, age and ethnicity of patients, provider type, and prescriptions provided. The number of ambulatory visits for reflux increased from 8 684 000 in 1998-2001 to 15 750 000 in 2006-2009. Visits increased across each time period for internal medicine, family, and gastroenterology physicians. Among otolaryngologists, absolute visits increased from 1998-2001 to 2002-2005 but decreased in 2006-2009; difference between these time periods did not reach statistical significance. From 1998-2001 to 2006-2009, reflux medication use increased 233%, with continuing trends toward increased proton pump inhibitor use. Reflux visits have increased across all demographic subgroups studied. Knowledge of these trends may inform further paradigm shifts in diagnosis and management of reflux.

Increased frequency of retinopathy of prematurity over the last decade and significant regional differences.

PubMed

Holmström, Gerd; Tornqvist, Kristina; Al-Hawasi, Abbas; Nilsson, Åsa; Wallin, Agneta; Hellström, Ann

2018-03-01

Retinopathy of prematurity (ROP) causes childhood blindness globally in prematurely born infants. Although increased levels of oxygen supply lead to increased survival and reduced frequency of cerebral palsy, increased incidence of ROP is reported. With the help of a Swedish register for ROP, SWEDROP, national and regional incidences of ROP and frequencies of treatment were evaluated from 2008 to 2015 (n = 5734), as well as before and after targets of provided oxygen changed from 85-89% to 91-95% in 2014. Retinopathy of prematurity (ROP) was found in 31.9% (1829/5734) of all infants with a gestational age (GA) of <31 weeks at birth and 5.7% of the infants (329/5734) had been treated for ROP. Analyses of the national data revealed an increased incidence of ROP during the 8-year study period (p = 0.003), but there was no significant increase in the frequency of treatment. There were significant differences between the seven health regions of Sweden, regarding both incidence of ROP and frequency of treatment (p < 0.001). Comparison of regional data before and after the new oxygen targets revealed a significant increase in treated ROP in one region [OR: 2.24 (CI: 1.11-4.49), p = 0.024] and a borderline increase in one other [OR: 3.08 (CI: 0.99-9.60), p = 0.052]. The Swedish national ROP register revealed an increased incidence of ROP during an 8-year period and significant regional differences regarding the incidence of ROP and frequency of treatment. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Bringing Up Girls in Science (BUGS): The Effectiveness of an Afterschool Environmental Science Program for Increasing Female Students' Interest in Science Careers

ERIC Educational Resources Information Center

Tyler-Wood, Tandra; Ellison, Amber; Lim, Okyoung; Periathiruvadi, Sita

2012-01-01

Bringing Up Girls in Science (BUGS) was an afterschool program for 4th and 5th grade girls that provided authentic learning experiences in environmental science as well as valuable female mentoring opportunities in an effort to increase participants' academic achievement in science. BUGS participants demonstrated significantly greater amounts of…

Kinetics of the cervical spine in pediatric and adult volunteers during low speed frontal impacts.

PubMed

Seacrist, Thomas; Arbogast, Kristy B; Maltese, Matthew R; García-Espaňa, J Felipe; Lopez-Valdes, Francisco J; Kent, Richard W; Tanji, Hiromasa; Higuchi, Kazuo; Balasubramanian, Sriram

2012-01-03

Previous research has quantified differences in head and spinal kinematics between children and adults restrained in an automotive-like configuration subjected to low speed dynamic loading. The forces and moments that the cervical spine imposes on the head contribute directly to these age-based kinematic variations. To provide further explanation of the kinematic results, this study compared the upper neck kinetics - including the relative contribution of shear and tension as well as flexion moment - between children (n=20, 6-14 yr) and adults (n=10, 18-30 yr) during low-speed (<4 g, 2.5 m/s) frontal sled tests. The subjects were restrained by a lap and shoulder belt and photo-reflective targets were attached to skeletal landmarks on the head, spine, shoulders, sternum, and legs. A 3D infrared tracking system quantified the position of the targets. Shear force (F(x)), axial force (F(z)), bending moment (M(y)), and head angular acceleration (θ(head)) were computed using inverse dynamics. The method was validated against ATD measured loads. Peak F(z) and θ(head) significantly decreased with increasing age while M(y) significantly increased with increasing age. F(x) significantly increased with age when age was considered as a univariate variable; however when variations in head-to-neck girth ratio and change in velocity were accounted for, this difference as a function of age was not significant. These results provide insight into the relationship between age-based differences in head kinematics and the kinetics of the cervical spine. Such information is valuable for pediatric cervical spine models and when scaling adult-based upper cervical spine tolerance and injury metrics to children. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effects of stearidonic acid on serum triacylglycerol concentrations in overweight and obese subjects: a randomized controlled trial.

PubMed

Pieters, D J M; Mensink, R P

2015-01-01

Eicosapentaenoic acid (EPA), which may reduce the risk for coronary heart disease (CHD), can be synthesized at low rates from α-linolenic acid (ALA). The rate-limiting step for this conversion is the Δ6-desaturation of ALA into stearidonic acid (SDA). Thus providing oils rich in SDA may increase endogenous synthesis of EPA, which may subsequently lower serum triacylglycerol concentrations, an effect frequently observed after EPA supplementation. We therefore studied the effects of Echium oil on serum triacylglycerol concentrations and the omega-3 index, which correlate negatively with the risk for CHD. A randomized, double-blind, placebo-controlled crossover trial was conducted, in which 36 healthy overweight and slightly obese subjects daily received 10 g of Echium oil (providing 1.2 g of SDA) or a high oleic acid sunflower oil (HOSO) as control for 6 weeks, with a washout period of at least 14 days. Four subjects dropped out. Differences between periods were tested for statistical significance (P<0.05) using a paired t-test. Serum triacylglycerol and other lipid concentrations were not significantly affected by consumption of Echium oil compared with HOSO. Echium oil significantly increased percentage of EPA in red blood cell (RBC) membranes with 0.14 ± 0.25% (mean ± s.d.) compared with HOSO (P=0.02). No significant effects on docosahexaenoic acid in RBC membranes or on the omega-3 index were found. In healthy overweight and slightly obese subjects, an increased intake of SDA from Echium oil does not lower serum triacylglycerol concentrations. Despite an increase in the percentage of EPA in RBC membranes, the omega-3 index was not changed.

Evaluating the impact of the reconfiguration of gynaecology services at a University Hospital NHS trust in the United Kingdom.

PubMed

Choo, Teck; Deb, Shilpa; Wilkins, Joanne; Atiomo, William

2014-09-24

The project aim was to investigate the impact of reconfiguring gynaecology services on the key performance indicators of a University Hospital NHS Trust in the UK. The reconfiguration involved the centralisation of elective gynaecology on one hospital site and emergency gynaecology on the other. Data measuring outcomes of the Trust's performance indicators (clinical outcomes, patient experience, staff satisfaction, teaching/training, research/development and value for money) were collected. Two time periods, 12 months before and after the reconfiguration in March 2011, were compared for all outcome measures except patient experience. Retrospective data from the hospitals audit department on clinical activity/outcomes and emergency gynaecology patient's feedback questionnaires were analysed. Staff satisfaction, teaching/training and research/development were measured through an online survey of gynaecology consultants. Post reconfiguration, the total number of admissions reduced by 6% (6,867 vs 6,446). There was a 14% increase in elective theatre sessions available (902.29 vs 1030.57) and an 84% increase in elective theatre sessions cancelled (44.43 vs 81.71). However, the average number of elective operations performed during each theatre session remained similar (2.63 vs 2.5). There was a significant increase in medical devices related clinical incidents (2 vs 11). With patient experience, there was a significant reduction in patient's overall length of stay on the emergency gynaecology ward and waiting times for investigations. For staff satisfaction, Consultants were significantly more dissatisfied with workload (3.45 vs 2.85) and standards of care (3.75 vs 2.93). With research and development, consultants remained dissatisfied with time/funding/opportunities for research. No significant impact on undergraduate/postgraduate teaching was found. No financial data on gynaecology was provided for the assessment of value for money. Reconfiguration of gynaecology services at this Trust may have resulted in a reduction in gynaecological activity and increased cancellation of elective operations but did not significantly reduce the number of elective operations performed. Although consultants expressed increased dissatisfaction with standards of clinical care, clinical incident reports did not significantly increase apart from medical devices incidents. Patient experience of emergency gynaecology services was improved. This manuscript provides a framework for similar exercises evaluating the impact of service redesign in the NHS.

Actoprotective effect of ginseng: improving mental and physical performance

PubMed Central

Oliynyk, Sergiy; Oh, Seikwan

2013-01-01

Actoprotectors are preparations that increase the mental performance and enhance body stability against physical loads without increasing oxygen consumption. Actoprotectors are regarded as a subclass of adaptogens that hold a significant capacity to increase physical performance. The focus of this article is studying adaptogen herbs of genus Panax (P. ginseng in particular) and their capabilities as actoprotectors. Some animal experiments and human studies about actoprotective properties of genus Panax attest that P. ginseng (administered as an extract) significantly increased the physical and intellectual work capacities, and the data provided suggests that ginseng is a natural source of actoprotectors. Preparations of ginseng can be regarded as potential actoprotectors which give way to further research of its influence on physical and mental work capacity, endurance and restoration after exhaustive physical loads while compared with reference actoprotectors. PMID:23717168

Assessment of the American Recovery and Reinvestment Act Upon the Department of Energy Weatherization Assistance Program: Assessment of the ARRA

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

Tonn, Bruce; Hawkins, Beth; Rose, Erin

The Department of Energy (DOE) administers the national low-income Weatherization Assistance Program (WAP). Under this program, DOE provides grants to states (grantees), which then provide grants to local weatherization agencies (subgrantees), to weatherize income-eligible homes for free. The American Recovery and Reinvestment Act (ARRA) of 2009 allocated $5 billion in funding to WAP, a very significant increase from an annual appropriation that ranged in the $200–250 million range for many years. Furthermore, as part of a major evaluation of WAP, states and local weatherization agencies were surveyed, in part, to assess their experiences during the ARRA period. The substantial fundingmore » increase created a number of issues for the national weatherization network: the political visibility of their programs increased significantly, organizational responsibilities were shifted, new laws and regulations were passed that impacted their programs, media attention of their programs increased, federal oversight of their programs increased; and programmatic costs increased because of the increased oversight and because ARRA required WAP to operate under the provisions of the Davis-Bacon Act of 1931. There was also some concern within the national weatherization network that the influx of ARRA funds would permanently damage nonfederal funding leveraging relationships. However, two-thirds of grantees and over 40% of subgrantees stated that they believe that the long-term impacts of ARRA on leveraging relationships will be positive.« less

Mechanisms of bradykinin-induced expression of connective tissue growth factor and nephrin in podocytes

PubMed Central

Msallem, J. Abou; Chalhoub, H.; Al-Hariri, M.; Saad, L.; Jaffa, M. A.; Ziyadeh, F. N.

2015-01-01

Diabetic nephropathy (DN) is the main cause of morbidity and mortality in diabetes and is characterized by mesangial matrix deposition and podocytopathy, including podocyte loss. The risk factors and mechanisms involved in the pathogenesis of DN are still not completely defined. In the present study, we aimed to understand the cellular mechanisms through which activation of B2 kinin receptors contribute to the initiation and progression of DN. Stimulation of cultured rat podocytes with bradykinin (BK) resulted in a significant increase in ROS generation, and this was associated with a significant increase in NADPH oxidase (NOX)1 and NOX4 protein and mRNA levels. BK stimulation also resulted in a signicant increase in the phosphorylation of ERK1/2 and Akt, and this effect was inhibited in the presence of NOX1 and Nox4 small interfering (si)RNA. Furthermore, podocytes stimulated with BK resulted in a significant increase in protein and mRNA levels of connective tissue growth factor (CTGF) and, at the same time, a significant decrease in protein and mRNA levels of nephrin. siRNA targeted against NOX1 and NOX4 significantly inhibited the BK-induced increase in CTGF. Nephrin expression was increased in response to BK in the presence of NOX1 and NOX4 siRNA, thus implicating a role for NOXs in modulating the BK response in podocytes. Moreover, nephrin expression in response to BK was also significantly increased in the presence of siRNA targeted against CTGF. These findings provide novel aspects of BK signal transduction pathways in pathogenesis of DN and identify novel targets for interventional strategies. PMID:26447218

Educating health care trainees and professionals about suicide prevention in depressed adolescents.

PubMed

Rice, Timothy R; Sher, Leo

2013-01-01

Adolescent depression is a highly prevalent disorder with significant morbidity and suicide mortality. It is simultaneously highly responsive to treatment. Adolescents wish to discuss depression with their providers, and providers routinely receive opportunities to do so. These characteristics of prevalence, morbidity, mortality, responsiveness, and accessibility make adolescent depression an excellent target of care. However, most health care trainees and professionals report low confidence in caring for adolescent depression. As a caregiver community, we fare poorly in routine matters of assessment and management of adolescent depression. All health care professionals are trained within a medical model. In this light, the conceptualization of adolescent depression and suicidality within the medical model may increase provider confidence and performance. Epidemiology and neurobiology are presented with emphasis in this review. Legal concerns also affect health care professionals. For example, providers may deviate from evidence-based medicine owing to anxieties that the identification and treatment of depression may induce suicide and consequent legal culpability. A review of the historical context and relevant outcome trials concerning the increased risk of suicidality in depressed adolescents treated with selective-serotonin reuptake inhibitors may increase provider comfort. Furthermore, increased didactic and experiential training improve provider performance. In this work, proven models were discussed, and the testable hypothesis that education incorporating the views of this article can produce the best care for depressed adolescents.

Automated detection of physiologic deterioration in hospitalized patients

PubMed Central

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-01-01

Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. PMID:25164256

Developmental toxicity and thyroid hormone-disrupting effects of 2,4-dichloro-6-nitrophenol in Chinese rare minnow (Gobiocypris rarus).

PubMed

Chen, Rui; Yuan, Lilai; Zha, Jinmiao; Wang, Zijian

2017-04-01

In the present study, to evaluate embryonic toxicity and the thyroid-disrupting effects of 2,4-dichloro-6-nitrophenol (DCNP), embryos and adults of Chinese rare minnow (Gobiocypris rarus) were exposed to 2, 20, and 200μg/L DCNP. In the embryo-larval assay, increased percentages of mortality and occurrence of malformations, decreased percentage of hatching, and decreased body length and body weight were observed after DCNP treatment. Moreover, the whole-body T3 levels were significantly increased at 20 and 200μg/L treatments, whereas the T4 levels were markedly decreased significantly (p<0.05) for all DCNP concentrations. In the adult fish assay, plasma T3 levels were significantly increased whereas plasma T4 levels were significantly reduced in the fish treated with 20 and 200μg/L (p<0.05). In addition, DCNP exposure significantly changed the transcription levels of thyroid system related genes, including dio1, dio2, me, nis, tr, and ttr. The increased responsiveness of thyroid hormone and mRNA expression levels of thyroid system related genes suggested that DCNP could disrupt the thyroid hormone synthesis and transport pathways. Therefore, our findings provide new insights of DCNP as a thyroid hormone-disrupting chemical. Copyright © 2017 Elsevier B.V. All rights reserved.

The Development of Experimentation and Evidence Evaluation Skills at Preschool Age

NASA Astrophysics Data System (ADS)

Piekny, Jeanette; Grube, Dietmar; Maehler, Claudia

2014-01-01

Researchers taking a domain-general approach to the development of scientific reasoning long thought that the ability to engage in scientific reasoning did not develop until adolescence. However, more recent studies have shown that preschool children already have a basic ability to evaluate evidence and a basic understanding of experimentation. Data providing insights into when exactly in the preschool years significant gains in these abilities occur are scarce. Drawing on a sample of 138 preschool children, this longitudinal study therefore examined how children's ability to evaluate evidence and their understanding of experimentation develop between the ages of four and six. Findings showed that the ability to evaluate evidence was already well developed at age four and increased steadily and significantly over time as long as the pattern of covariation was perfect. In the case of imperfect covariation, the proportion of correct answers was low over the period of observation, but showed a significant increase between the ages of four and five. If the data did not allow relationship between variables to be inferred, the proportion of correct answers was low, with a significant increase between the ages of five and six. The children's understanding of experimentation increased significantly between the ages of five and six. The implications of these findings for age-appropriate science programs in preschool are discussed.

Effectiveness of a Worksite Social & Physical Environment Intervention on Need for Recovery, Physical Activity and Relaxation; Results of a Randomized Controlled Trial

PubMed Central

Coffeng, Jennifer K.; Boot, Cécile R. L.; Duijts, Saskia F. A.; Twisk, Jos W. R.; van Mechelen, Willem; Hendriksen, Ingrid J. M.

2014-01-01

Objective To investigate the effectiveness of a worksite social and physical environment intervention on need for recovery (i.e., early symptoms of work-related mental and physical fatigue), physical activity and relaxation. Also, the effectiveness of the separate interventions was investigated. Methods In this 2×2 factorial design study, 412 office employees from a financial service provider participated. Participants were allocated to the combined social and physical intervention, to the social intervention only, to the physical intervention only or to the control group. The primary outcome measure was need for recovery. Secondary outcomes were work-related stress (i.e., exhaustion, detachment and relaxation), small breaks, physical activity (i.e., stair climbing, active commuting, sport activities, light/moderate/vigorous physical activity) and sedentary behavior. Outcomes were measured by questionnaires at baseline, 6 and 12 months follow-up. Multilevel analyses were performed to investigate the effects of the three interventions. Results In all intervention groups, a non-significant reduction was found in need for recovery. In the combined intervention (n = 92), exhaustion and vigorous physical activities decreased significantly, and small breaks at work and active commuting increased significantly compared to the control group. The social intervention (n = 118) showed a significant reduction in exhaustion, sedentary behavior at work and a significant increase in small breaks at work and leisure activities. In the physical intervention (n = 96), stair climbing at work and active commuting significantly increased, and sedentary behavior at work decreased significantly compared to the control group. Conclusion None of the interventions was effective in improving the need for recovery. It is recommended to implement the social and physical intervention among a population with higher baseline values of need for recovery. Furthermore, the intervention itself could be improved by increasing the intensity of the intervention (for example weekly GMI-sessions), providing physical activity opportunities and exercise schemes, and by more drastic environment interventions (restructuring entire department floor). Trial Registration Nederlands Trial Register NTR2553 PMID:25542039

Prospective evaluation of magnetic resonance imaging guided in-bore prostate biopsy versus systematic transrectal ultrasound guided prostate biopsy in biopsy naïve men with elevated prostate specific antigen.

PubMed

Quentin, Michael; Blondin, Dirk; Arsov, Christian; Schimmöller, Lars; Hiester, Andreas; Godehardt, Erhard; Albers, Peter; Antoch, Gerald; Rabenalt, Robert

2014-11-01

Magnetic resonance imaging guided biopsy is increasingly performed to diagnose prostate cancer. However, there is a lack of well controlled, prospective trials to support this treatment method. We prospectively compared magnetic resonance imaging guided in-bore biopsy with standard systematic transrectal ultrasound guided biopsy in biopsy naïve men with increased prostate specific antigen. We performed a prospective study in 132 biopsy naïve men with increased prostate specific antigen (greater than 4 ng/ml). After 3 Tesla functional multiparametric magnetic resonance imaging patients were referred for magnetic resonance imaging guided in-bore biopsy of prostate lesions (maximum 3) followed by standard systematic transrectal ultrasound guided biopsy (12 cores). We analyzed the detection rates of prostate cancer and significant prostate cancer (greater than 5 mm total cancer length or any Gleason pattern greater than 3). A total of 128 patients with a mean ± SD age of 66.1 ± 8.1 years met all study requirements. Median prostate specific antigen was 6.7 ng/ml (IQR 5.1-9.0). Transrectal ultrasound and magnetic resonance imaging guided biopsies provided the same 53.1% detection rate, including 79.4% and 85.3%, respectively, for significant prostate cancer. Magnetic resonance imaging and transrectal ultrasound guided biopsies missed 7.8% and 9.4% of clinically significant prostate cancers, respectively. Magnetic resonance imaging biopsy required significantly fewer cores and revealed a higher percent of cancer involvement per biopsy core (each p <0.01). Combining the 2 methods provided a 60.9% detection rate with an 82.1% rate for significant prostate cancer. Magnetic resonance imaging guided in-bore and systematic transrectal ultrasound guided biopsies achieved equally high detection rates in biopsy naïve patients with increased prostate specific antigen. Magnetic resonance imaging guided in-bore biopsies required significantly fewer cores and revealed a significantly higher percent of cancer involvement per biopsy core. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Role of Fundamental Physics in Human Space Exploration

NASA Technical Reports Server (NTRS)

Turyshev, Slava

2004-01-01

This talk will discuss the critical role that fundamental physics research plays for the human space exploration. In particular, the currently available technologies can already provide significant radiation reduction, minimize bone loss, increase crew productivity and, thus, uniquely contribute to overall mission success. I will discuss how fundamental physics research and emerging technologies may not only further reduce the risks of space travel, but also increase the crew mobility, enhance safety and increase the value of space exploration in the near future.

Novel mechanism of transcriptional regulation of cell matrix protein through CREB

PubMed Central

Habib, Samy L; Mohan, Sumathy; Liang, Sitai; Li, Baojie; Yadav, Mukesh

2015-01-01

The transcription mechanism(s) of renal cell matrix accumulation in diabetes does not explored. Phosphorylation of the transcription factor cAMP-responsive element binding protein (CREB) significantly increased in cells treated with high glucose (HG) compared to cell grown in normal glucose (NG). Cells pretreated with rapamycin before exposure to HG showed significant decrease phosphorylation of CREB, increase in AMPK activity and decrease protein/mRNA and promoter activity of fibronectin. In addition, cells transfected with siRNA against CREB showed significant increase in AMPK activity, decrease in protein/mRNA and promoter activity of fibronectin. Cells treated with HG showed nuclear localization of p-CREB while pretreated cells with rapamycin reversed HG effect. Moreover, gel shift analysis shows increase binding of CREB to fibronectin promoter in cells treated with HG while cells pretreated with rapamycin reversed the effect of HG. Furthermore, db/db mice treated with rapamycin showed significant increase in AMPK activity, decrease in expression of p-CREB and protein/mRNA of fibronectin. Strong staining of fibronectin and p-CREB was detected in kidney cortex of db/db mice while treated mice with rapamycin reversed hyperglycemia effect. In summary, our data provide a novel mechanism of transcriptional regulation of fibronectin through CREB that may be used as therapeutic approach to prevent diabetes complications. PMID:26115221

Ion Monitoring

DOEpatents

Orr, Christopher Henry; Luff, Craig Janson; Dockray, Thomas; Macarthur, Duncan Whittemore

2003-11-18

The apparatus and method provide a technique for significantly reducing capacitance effects in detector electrodes arising due to movement of the instrument relative to the item/location being monitored in ion detection based techniques. The capacitance variations are rendered less significant by placing an electrically conducting element between the detector electrodes and the monitored location/item. Improved sensitivity and reduced noise signals arise as a result. The technique also provides apparatus and method suitable for monitoring elongate items which are unsuited to complete enclosure in one go within a chamber. The items are monitored part by part as the pass through the instrument, so increasing the range of items or locations which can be successfully monitored.

Poisonous plants of the United States

USDA-ARS?s Scientific Manuscript database

Poisonous plants cause significant economic losses to the livestock industry throughout the world from death losses, abortions, birth defects, increased veterinary care, and other related factors. This chapter is not intended to be all-inclusive, but provides current research information on importan...

Lightweight, High Performance, Low Cost Propulsion Systems for Mars Exploration Missions to Maximize Science Payload

NASA Astrophysics Data System (ADS)

Trinh, H. P.

2012-06-01

Utilization of new cold hypergolic propellants and leverage Missile Defense Agency technology for propulsion systems on Mars explorations will provide an increase of science payload and have significant payoffs and benefits for NASA missions.

Multiple 60-Minute Massages per Week Offer Relief for Chronic Neck Pain

MedlinePlus

... 4-week wait list, which served as the control group. Therapists used a wide range of massage techniques ... provide significant benefits compared with the wait-list control group. However, beneficial effects of 60-minute massages increased ...

Asphalt mixture cold temperature performance using the Bending Beam Rheometer (BBR).

DOT National Transportation Integrated Search

2013-03-01

The use of recycled materials providing substitution of virgin binder in asphalt mixtures : continues to increase. The current level of funding for highway construction is : significantly less than 3 years ago and the level of competition between bid...

Predicting Psychotic-Like Experiences during Sensory Deprivation

PubMed Central

Daniel, Christina; Mason, Oliver J.

2015-01-01

Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs) reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis. PMID:25811027

Internet Interventions for Hearing Loss.

PubMed

Thorén, Elisabet Sundewall; Öberg, Marie; Andersson, Gerhard; Lunner, Thomas

2015-09-01

The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed. Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group. The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve. The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

PubMed Central

Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

2012-01-01

Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility. PMID:22383944

Evaluation of the Acceptance of Audience Response System by Corporations Using the Technology Acceptance Model

NASA Astrophysics Data System (ADS)

Chu, Hsing-Hui; Lu, Ta-Jung; Wann, Jong-Wen

The purpose of this research is to explore enterprises' acceptance of Audience Response System (ARS) using Technology Acceptance Model (TAM). The findings show that (1) IT characteristics and facilitating conditions could be external variables of TAM. (2) The degree of E-business has positive significant correlation with behavioral intention of employees. (3) TAM is a good model to predict and explain IT acceptance. (4) Demographic variables, industry and firm characteristics have no significant correlation with ARS acceptance. The results provide useful information to managers and ARS providers that (1) ARS providers should focus more on creating different usages to enhance interactivity and employees' using intention. (2) Managers should pay attention to build sound internal facilitating conditions for introducing IT. (3) According to the degree of E-business, managers should set up strategic stages of introducing IT. (4) Providers should increase product promotion and also leverage academic and government to promote ARS.

Provision of Palliative Care Services by Family Physicians Is Common.

PubMed

Ankuda, Claire K; Jetty, Anuradha; Bazemore, Andrew; Petterson, Stephen

2017-01-01

Provision of palliative care services by primary care physicians is increasingly important with an aging population, but it is unknown whether US primary care physicians see themselves as palliative practitioners. This study used cross-sectional analysis of data from the 2013 American Board of Family Medicine Maintenance of Certification Demographic Survey. Of 10,894 family physicians, 33.1% (n = 3609) report providing palliative care. Those providing palliative care are significantly more likely to provide non-clinic-based services such as care in nursing homes, home visits, and hospice. Controlling for other characteristics, physicians reporting palliative care provision are significantly ( P < .05) more likely to be older, white, male, rural, and practicing in a patient-centered medical home. One third of family physicians recertifying in 2013 reported providing palliative care, with physician and practice characteristics driving reporting palliative care provision. © Copyright 2017 by the American Board of Family Medicine.

FELIN: tailored optronics and systems solutions for dismounted combat

NASA Astrophysics Data System (ADS)

Milcent, A. M.

2009-05-01

The FELIN French modernization program for dismounted combat provides the Armies with info-centric systems which dramatically enhance the performances of the soldier and the platoon. Sagem now has available a portfolio of various equipments, providing C4I, data and voice digital communication, and enhanced vision for day and night operations, through compact high performance electro-optics. The FELIN system provides the infantryman with a high-tech integrated and modular system which increases significantly their detection, recognition, identification capabilities, their situation awareness and information sharing, and this in any dismounted close combat situation. Among the key technologies used in this system, infrared and intensified vision provide a significant improvement in capability, observation performance and protection of the ground soldiers. This paper presents in detail the developed equipments, with an emphasis on lessons learned from the technical and operational feedback from dismounted close combat field tests.

Providing Mailing Cost Reimbursements: The Effect on Reporting Timeliness of Sexually Transmitted Diseases in Virginia.

PubMed

Vasiliu, Oana E; Stover, Jeffrey A; Mays, Marissa J E; Bissette, Jennifer M; Dolan, Carrie B; Sirbu, Corina M

2009-01-01

We investigated the effect of providing mailing cost reimbursements to local health departments on the timeliness of the reporting of sexually transmitted diseases (STDs) in Virginia. The Division of Disease Prevention, Virginia Department of Health, provided mailing cost reimbursements to 31 Virginia health districts from October 2002 to December 2004. The difference (in days) between the diagnosis date (or date the STD paperwork was initiated) and the date the case/STD report was entered into the STD surveillance database was used in a negative binomial regression model against time (as divided into three periods-before, during, and after reimbursement) to estimate the effect of providing mailing cost reimbursements on reporting timeliness. We observed significant decreases in the number of days between diagnosis and reporting of a case, which were sustained after the reimbursement period ended, in 25 of the 31 health districts included in the analysis. We observed a significant initial decrease (during the reimbursement period) followed by a significant increase in the after-reimbursement phase in one health district. Two health districts had a significant initial decrease, while one health district had a significant decrease in reporting timeliness in the period after reimbursement. Two health districts showed no significant changes in the number of days to report to the central office. Providing reimbursements for mailing costs was statistically associated with improved STD reporting timeliness in almost all of Virginia's health districts. Sustained improvement after the reimbursement period ended is likely indicative of improved local health department reporting habits.

Rrsm: The European Rapid Raw Strong-Motion Database

NASA Astrophysics Data System (ADS)

Cauzzi, C.; Clinton, J. F.; Sleeman, R.; Domingo Ballesta, J.; Kaestli, P.; Galanis, O.

2014-12-01

We introduce the European Rapid Raw Strong-Motion database (RRSM), a Europe-wide system that provides parameterised strong motion information, as well as access to waveform data, within minutes of the occurrence of strong earthquakes. The RRSM significantly differs from traditional earthquake strong motion dissemination in Europe, which has focused on providing reviewed, processed strong motion parameters, typically with significant delays. As the RRSM provides rapid open access to raw waveform data and metadata and does not rely on external manual waveform processing, RRSM information is tailored to seismologists and strong-motion data analysts, earthquake and geotechnical engineers, international earthquake response agencies and the educated general public. Access to the RRSM database is via a portal at http://www.orfeus-eu.org/rrsm/ that allows users to query earthquake information, peak ground motion parameters and amplitudes of spectral response; and to select and download earthquake waveforms. All information is available within minutes of any earthquake with magnitude ≥ 3.5 occurring in the Euro-Mediterranean region. Waveform processing and database population are performed using the waveform processing module scwfparam, which is integrated in SeisComP3 (SC3; http://www.seiscomp3.org/). Earthquake information is provided by the EMSC (http://www.emsc-csem.org/) and all the seismic waveform data is accessed at the European Integrated waveform Data Archive (EIDA) at ORFEUS (http://www.orfeus-eu.org/index.html), where all on-scale data is used in the fully automated processing. As the EIDA community is continually growing, the already significant number of strong motion stations is also increasing and the importance of this product is expected to also increase. Real-time RRSM processing started in June 2014, while past events have been processed in order to provide a complete database back to 2005.

A study on moral hazard in dentistry: costs of care in the private and the public sector.

PubMed

Tuominen, Risto; Eriksson, Anna-Leena

2011-10-01

The aim of this study was to evaluate the costs of subsidized care for an adult population provided by private and public sector dentists. A sample of 210 patients was drawn systematically from the waiting list for nonemergency dental treatment in the city of Turku. Questionnaire data covering sociodemographic background, dental care utilization and marginal time cost estimates were combined with data from patient registers on treatment given. Information was available on 104 patients (52 from each of the public and the private sectors). The overall time taken to provide treatment was 181 days in the public sector and 80 days in the private sector (P<0.002). On average, public sector patients had significantly (P < 0.01) more dental visits (5.33) than private sector patients (3.47), which caused higher visiting fees. In addition, patients in the public sector also had higher other out-of-pocket costs than in the private sector. Those who needed emergency dental treatment during the waiting time for comprehensive care had significantly more costly treatment and higher total costs than the other patients. Overall time required for dental visits significantly increased total costs. The total cost of dental care in the public sector was slightly higher (P<0.05) than in the private sector. There is no direct evidence of moral hazard on the provider side from this study. The observed cost differences between the two sectors may indicate that private practitioners could manage their publicly funded patients more quickly than their private paying patients. On the other hand, private dentists providing more treatment per visit could be explained by private dentists providing more than is needed by increasing the content per visit. © 2011 John Wiley & Sons A/S.

Implantable brain computer interface: challenges to neurotechnology translation.

PubMed

Konrad, Peter; Shanks, Todd

2010-06-01

This article reviews three concepts related to implantable brain computer interface (BCI) devices being designed for human use: neural signal extraction primarily for motor commands, signal insertion to restore sensation, and technological challenges that remain. A significant body of literature has occurred over the past four decades regarding motor cortex signal extraction for upper extremity movement or computer interface. However, little is discussed regarding postural or ambulation command signaling. Auditory prosthesis research continues to represent the majority of literature on BCI signal insertion. Significant hurdles continue in the technological translation of BCI implants. These include developing a stable neural interface, significantly increasing signal processing capabilities, and methods of data transfer throughout the human body. The past few years, however, have provided extraordinary human examples of BCI implant potential. Despite technological hurdles, proof-of-concept animal and human studies provide significant encouragement that BCI implants may well find their way into mainstream medical practice in the foreseeable future.

Evaluating the impact of pharmacist health education on the perceptions of the pharmacist’s role among women living in a homeless shelter

PubMed Central

Tsu, Laura; Buckley, Kelsey; Nguyen, Sarah; Kohn, Jennifer

2015-01-01

Objectives: To determine the impact of pharmacist-provided educational seminars on the participant’s perception of the pharmacist’s role in providing women’s health education. Secondary objectives include the participant’s level of perceived benefit from the information provided during each presentation, as well as determining characteristics of participants who are interested in attending seminars. Methods: This is a prospective study conducted within a homeless women’s shelter in Phoenix, Arizona. Pharmacists and pharmacy students provided 10 monthly educational seminars on topics related to women’s health. Participants completed a pre- and post-seminar survey regarding their perceptions of the presentations and pharmacists. Results: Fifty-six participants attended at least one of 10 seminars from January to November 2014. The average age was 46 years old, taking approximately 3 medications, and 66% completed a high school degree or lower. Prior to the presentations, 30% of participants agreed or strongly agreed that they would seek advice from a pharmacist on the topic presented, which increased significantly to 82% of participants after the presentation (p<0.001). Similarly, 55% of participants rated themselves as agreeing or strongly agreeing with being knowledgeable on the topic presented prior to the presentation, and this increased significantly to 77% after the presentation (p=0.001). After attending the educational session, 70% of participants agreed or strongly agreed that they would make changes to their health, and that they would attend an additional session. The participants noted their increased learning about the topic, the clarity of visual aids and presentation, and knowledge of the presenters as the best parts of the presentation. Conclusion: Pharmacist’s participation in providing educational seminars in the homeless women’s population increases the participant’s knowledge and perception of the pharmacist’s role within the population. Future studies can further investigate an evolving role of pharmacists in optimizing healthcare in the homeless population. PMID:26759620

Improving human papilloma virus vaccination rates throughout military treatment facilities.

PubMed

Dawson, Rachel; Lemmon, Keith; Trivedi, Nidhi J; Hansen, Shana

2018-03-07

The four objectives of this study were to (1) educate military healthcare providers on HPV disease and vaccine, (2) assess short term recall of information presented at educational sessions, (3) assess provider comfort level with the vaccine, and (4) assess improvement in HPV vaccination rates. Standardized interactive educational sessions were conducted at military primary care clinics with pre- and post-educational quizzes administered before and immediately following the sessions. Provider attitudes were assessed using Likert scale questionnaires. Vaccination rates in children and young adolescents ages 11-18 at one of the participating regions that had a champion and started a Quality Improvement (QI) project were assessed at baseline, at 3-months and at 6-months post sessions. 200 providers were reached at 48 primary care clinics during May 2014 through October 2015 with 200 quizzes and Likert scale questionnaires returned. There was increase in knowledge following the educational sessions as revealed in the pre- and post- test scores [t(57) = -5.04, p < 0.001]. There was a significant overall increase in comfort in answering patients' and parents' questions about HPV vaccine [p = 0.003]. There was a significant increase in the number of vaccines given at all the clinics 3-months after the educational sessions at the region who had a champion dedicated to monitoring vaccine rates and ensuring implementation efforts [p = 0.01] and started a QI project. This increase was not sustained at 6-months [p = 0.324]. Improvement in provider short term knowledge recall and comfort level in answering parents' questions was seen. We found that educational sessions can improve HPV vaccination rates in military clinics that have a vaccine champion for up to 3-months. Further research into the effects of having clinic vaccine champions is critical. Copyright © 2018. Published by Elsevier Ltd.

Ten Most Important Things to Know About Caring for Transgender Patients.

PubMed

Chipkin, Stuart R; Kim, Fred

2017-11-01

Transgender people have a gender that is not in agreement with their birth sex. Previous barriers, including lack of provider knowledge, have created significant healthcare disparities for this population. Recent societal changes are increasing the numbers of transgender people seen by primary care practitioners. Ten key principles are provided to help primary care practitioners create more welcoming environments and provide quality care to transgender patients. Overall, all members of the healthcare team (primary and specialty) need to become aware of the transition process and maintain communication regarding risks, benefits, and goals. Transwomen (aka male to female) can be treated with estrogens, antiandrogens, or a combination. Benefits include change in fat distribution, skin softening, and breast development. Significant risks for thrombosis from estrogens have been linked to genetic mutations, smoking, prolonged inactivity, and hormone formulation. Oral administration may provide increased risk over peripheral administration. Transmen (aka female to male) can be treated with peripheral testosterone preparations. Benefits include deepening of voice and development of facial and body hair with variable changes in muscle mass. Risks from testosterone appear to be less common than from estrogen. Laboratory monitoring can guide treatment decisions and provide early detection of some complications. Monitoring of "existing" anatomy (either hormonally or surgically created or removed) is an important component of healthcare for transgender patients. Primary care providers also should be aware of resources in their community and online, which can help patients optimize their transition. Copyright © 2017 Elsevier Inc. All rights reserved.

Preparation of silica stabilized biological templates for the production of metal and layered nanoparticles

DOEpatents

Culver, James N; Royston, Elizabeth; Brown, Adam; Harris, Michael

2013-02-26

The present invention relates to a system and method providing for increased silica growth on a bio-template, wherein the bio-template is pretreated with aniline to produce a uniform silica attractive surface and yielding a significant silica layers of at least 10 nm, and more preferably at least 20 nm in thickness, thereby providing for a high degree of stability to the bio-template.

Comparison of four software packages for CT lung volumetry in healthy individuals.

PubMed

Nemec, Stefan F; Molinari, Francesco; Dufresne, Valerie; Gosset, Natacha; Silva, Mario; Bankier, Alexander A

2015-06-01

To compare CT lung volumetry (CTLV) measurements provided by different software packages, and to provide normative data for lung densitometric measurements in healthy individuals. This retrospective study included 51 chest CTs of 17 volunteers (eight men and nine women; mean age, 30 ± 6 years), who underwent spirometrically monitored CT at total lung capacity (TLC), functional residual capacity (FRC), and mean inspiratory capacity (MIC). Volumetric differences assessed by four commercial software packages were compared with analysis of variance (ANOVA) for repeated measurements and benchmarked against the threshold for acceptable variability between spirometric measurements. Mean lung density (MLD) and parenchymal heterogeneity (MLD-SD) were also compared with ANOVA. Volumetric differences ranged from 12 to 213 ml (0.20 % to 6.45 %). Although 16/18 comparisons (among four software packages at TLC, MIC, and FRC) were statistically significant (P < 0.001 to P = 0.004), only 3/18 comparisons, one at MIC and two at FRC, exceeded the spirometry variability threshold. MLD and MLD-SD significantly increased with decreasing volumes, and were significantly larger in lower compared to upper lobes (P < 0.001). Lung volumetric differences provided by different software packages are small. These differences should not be interpreted based on statistical significance alone, but together with absolute volumetric differences. • Volumetric differences, assessed by different CTLV software, are small but statistically significant. • Volumetric differences are smaller at TLC than at MIC and FRC. • Volumetric differences rarely exceed spirometric repeatability thresholds at MIC and FRC. • Differences between CTLV measurements should be interpreted based on comparison of absolute differences. • MLD increases with decreasing volumes, and is larger in lower compared to upper lobes.

A Novel Application of Eddy Current Braking for Functional Strength Training during Gait

PubMed Central

Washabaugh, Edward P.; Claflin, Edward S.; Gillespie, R. Brent; Krishnan, Chandramouli

2016-01-01

Functional strength training is becoming increasingly popular when rehabilitating individuals with neurological injury such as stroke or cerebral palsy. Typically, resistance during walking is provided using cable robots or weights that are secured to the distal shank of the subject. However, there exists no device that is wearable and capable of providing resistance across the joint, allowing over ground gait training. In this study, we created a lightweight and wearable device using eddy current braking to provide resistance to the knee. We then validated the device by having subjects wear it during a walking task through varying resistance levels. Electromyography and kinematics were collected to assess the biomechanical effects of the device on the wearer. We found that eddy current braking provided resistance levels suitable for functional strength training of leg muscles in a package that is both lightweight and wearable. Applying resistive forces at the knee joint during gait resulted in significant increases in muscle activation of many of the muscles tested. A brief period of training also resulted in significant aftereffects once the resistance was removed. These results support the feasibility of the device for functional strength training during gait. Future research is warranted to test the clinical potential of the device in an injured population. PMID:26817456

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed Central

2010-01-01

Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services. PMID:21062460

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed

Qureshi, Asma M

2010-11-09

To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.

A Novel Application of Eddy Current Braking for Functional Strength Training During Gait.

PubMed

Washabaugh, Edward P; Claflin, Edward S; Gillespie, R Brent; Krishnan, Chandramouli

2016-09-01

Functional strength training is becoming increasingly popular when rehabilitating individuals with neurological injury such as stroke or cerebral palsy. Typically, resistance during walking is provided using cable robots or weights that are secured to the distal shank of the subject. However, there exists no device that is wearable and capable of providing resistance across the joint, allowing over ground gait training. In this study, we created a lightweight and wearable device using eddy current braking to provide resistance to the knee. We then validated the device by having subjects wear it during a walking task through varying resistance levels. Electromyography and kinematics were collected to assess the biomechanical effects of the device on the wearer. We found that eddy current braking provided resistance levels suitable for functional strength training of leg muscles in a package that is both lightweight and wearable. Applying resistive forces at the knee joint during gait resulted in significant increases in muscle activation of many of the muscles tested. A brief period of training also resulted in significant aftereffects once the resistance was removed. These results support the feasibility of the device for functional strength training during gait. Future research is warranted to test the clinical potential of the device in an injured population.

Feasibility of magnetic bearings for advanced gas turbine engines

NASA Technical Reports Server (NTRS)

Hibner, David; Rosado, Lewis

1992-01-01

The application of active magnetic bearings to advanced gas turbine engines will provide a product with major improvements compared to current oil lubricated bearing designs. A rethinking of the engine rotating and static structure design is necessary and will provide the designer with significantly more freedom to meet the demanding goals of improved performance, increased durability, higher reliability, and increased thrust to weight ratio via engine weight reduction. The product specific technology necessary for this high speed, high temperature, dynamically complex application has been defined. The resulting benefits from this approach to aircraft engine rotor support and the complementary engine changes and improvements have been assessed.

Patient-centered technological assessment and monitoring of depression for low-income patients.

PubMed

Wu, Shinyi; Vidyanti, Irene; Liu, Pai; Hawkins, Caitlin; Ramirez, Magaly; Guterman, Jeffrey; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Ell, Kathleen

2014-01-01

Depression is a significant challenge for ambulatory care because it worsens health status and outcomes, increases health care utilizations and costs, and elevates suicide risk. An automatic telephonic assessment (ATA) system that links with tasks and alerts to providers may improve quality of depression care and increase provider productivity. We used ATA system in a trial to assess and monitor depressive symptoms of 444 safety-net primary care patients with diabetes. We assessed system properties, evaluated preliminary clinical outcomes, and estimated cost savings. The ATA system is feasible, reliable, valid, safe, and likely cost-effective for depression screening and monitoring for low-income primary care population.

Climate Change and Underserved Communities.

PubMed

Ziegler, Carol; Morelli, Vincent; Fawibe, Omotayo

2017-03-01

Climate change is the greatest global health threat of the twenty-first century, yet it is not widely understood as a health hazard by primary care providers in the United States. Aside from increasing displacement of populations and acute trauma resulting from increasing frequency of natural disasters, the impact of climate change on temperature stress, vector-borne illnesses, cardiovascular and respiratory illnesses, and mental health is significant, with disproportionate impact on underserved and marginalized populations. Primary care providers must be aware of the impact of climate change on the health of their patients and advocate for adaptation and mitigation policies for the populations they serve. Copyright © 2016 Elsevier Inc. All rights reserved.

Dispersion toughened ceramic composites and method for making same

DOEpatents

Stinton, David P.; Lackey, Walter J.; Lauf, Robert J.

1986-01-01

Ceramic composites exhibiting increased fracture toughness are produced by the simultaneous codeposition of silicon carbide and titanium disilicide by chemical vapor deposition. A mixture of hydrogen, methyltrichlorosilane and titanium tetrachloride is introduced into a furnace containing a substrate such as graphite or silicon carbide. The thermal decomposition of the methyltrichlorosilane provides a silicon carbide matrix phase and the decomposition of the titanium tetrachloride provides a uniformly dispersed second phase of the intermetallic titanium disilicide within the matrix phase. The fracture toughness of the ceramic composite is in the range of about 6.5 to 7.0 MPa.sqroot.m which represents a significant increase over that of silicon carbide.

Dispersion toughened ceramic composites and method for making same

DOEpatents

Stinton, D.P.; Lackey, W.J.; Lauf, R.J.

1984-09-28

Ceramic composites exhibiting increased fracture toughness are produced by the simultaneous codeposition of silicon carbide and titanium disilicide by chemical vapor deposition. A mixture of hydrogen, methyltrichlorosilane and titanium tetrachloride is introduced into a furnace containing a substrate such as graphite or silicon carbide. The thermal decomposition of the methyltrichlorosilane provides a silicon carbide matrix phase and the decomposition of the titanium tetrachloride provides a uniformly dispersed second phase of the intermetallic titanium disilicide within the matrix phase. The fracture toughness of the ceramic composite is in the range of about 6.5 to 7.0 MPa..sqrt..m which represents a significant increase over that of silicon carbide.

Significance of dual polarized long wavelength radar for terrain analysis

NASA Technical Reports Server (NTRS)

Macdonald, H. C.; Waite, W. P.

1978-01-01

Long wavelength systems with improved penetration capability have been considered to have the potential for minimizing the vegetation contribution and enhancing the surface return variations. L-band imagery of the Arkansas geologic test site provides confirmatory evidence of this effect. However, the increased wavelength increases the sensitivity to larger scale structure at relatively small incidence angles. The regularity of agricultural and urban scenes provides large components in the low frequency-large scale portion of the roughness spectrum that are highly sensitive to orientation. The addition of a cross polarized channel is shown to enable the interpreter to distinguish vegetation and orientational perturbations in the surface return.

Internet pharmaceutical sales: attributes, concerns, and future forecast.

PubMed

Bruckel, Katy; Capozzoli, Ernest A

2003-01-01

Internet pharmaceutical sales continue to skyrocket as healthcare providers and consumers are increasingly relying on the efficiencies and convenience that is available via such transactions. Managed care companies, increasing demands to reduce healthcare inefficiencies while maximizing the quality of patient care is a significant contributing factor to the expanding utilization and success of online pharmaceutical sales. However, with the expansion of Internet pharmaceutical sales, healthcare providers, pharmacy benefit management and insurance companies, and consumers realize new opportunities and risks. This paper will review the attributes and concerns associated with online pharmaceutical sales, discussing current and pending legislation intended to more effectively manage these parameters.

Mechanisms of callose deposition in rice regulated by exogenous abscisic acid and its involvement in rice resistance to Nilaparvata lugens Stål (Hemiptera: Delphacidae).

PubMed

Liu, Jinglan; Du, Haitao; Ding, Xu; Zhou, Yaodong; Xie, Pengfei; Wu, Jincai

2017-12-01

Callose is a plant cell wall polysaccharide controlled by β-1,3-glucanase and synthase. Abscisic acid (ABA) is an important plant hormone. Exogenous ABA promotes rice resistance to pests. Whether exogenous ABA could reduce the decline in rice yield after brown planthopper (Nilaparvata lugens Stål; BPH) feeding is an important question, however, the mechanisms behind rice resistance induced by ABA remain obscure. Electronic penetration graph (EPG) recording indicated a significant increase in rice resistance to BPH, and the number of BPH eggs decreased significantly upon application of exogenous ABA. As the concentration of ABA increased, the reduction in rice yield decreased significantly after BPH feeding. Further studies showed that β-1,3-glucanase activity was significantly lower, but synthase activity was higher after ABA treatment than in controls. Our results demonstrated that exogenous ABA suppressed β-1,3-glucanase and induced synthase activity, and promoted callose deposition. This is an important defense mechanism that prevents BPH from ingesting phloem sap. These studies provide support for an insect-resistance mechanism after ABA treatment and provide a reference for the integrated management of other piercing-sucking pests. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

DOES TRAINING IN THE CIRCLE OF SECURITY FRAMEWORK INCREASE RELATIONAL UNDERSTANDING IN INFANT/CHILD AND FAMILY WORKERS?

PubMed

McMahon, Catherine; Huber, Anna; Kohlhoff, Jane; Camberis, Anna-Lisa

2017-09-01

This article evaluated whether attendance at Circle of Security training workshops resulted in attendees showing greater empathy and attachment-related knowledge and understanding, and fewer judgmental responses to viewing a stressful parent-child interaction. Participants were 202 practitioners who attended and completed a 2-day (n = 70), 4-day (n = 105), or 10-day (n = 27) COS training workshop in Australia or New Zealand in 2015. In a pre/post design, participant reactions to a video clip of a challenging parent-child interaction were coded for empathic, judgmental, or attachment-focused language. Attachment understanding was coded in response to questions about the greatest challenge that the dyad faced. In all training conditions, participants provided significantly more attachment-focused descriptors and showed significantly greater attachment understanding after training, but significantly fewer empathic descriptors. While participants at the longer workshops provided significantly fewer judgmental/critical descriptors, there was no change for those attending the 2-day workshop. Irrespective of workshop duration or professional background, participants took a more relational perspective on the vignette after the training workshops. More detailed research is required to establish the extent to which this increased knowledge and understanding is retained and integrated into infant mental health practice with parents and young children. © 2017 Michigan Association for Infant Mental Health.

Therapeutically targeting mitochondrial redox signalling alleviates endothelial dysfunction in preeclampsia.

PubMed

McCarthy, Cathal; Kenny, Louise C

2016-09-08

Aberrant placentation generating placental oxidative stress is proposed to play a critical role in the pathophysiology of preeclampsia. Unfortunately, therapeutic trials of antioxidants have been uniformly disappointing. There is provisional evidence implicating mitochondrial dysfunction as a source of oxidative stress in preeclampsia. Here we provide evidence that mitochondrial reactive oxygen species mediates endothelial dysfunction and establish that directly targeting mitochondrial scavenging may provide a protective role. Human umbilical vein endothelial cells exposed to 3% plasma from women with pregnancies complicated by preeclampsia resulted in a significant decrease in mitochondrial function with a subsequent significant increase in mitochondrial superoxide generation compared to cells exposed to plasma from women with uncomplicated pregnancies. Real-time PCR analysis showed increased expression of inflammatory markers TNF-α, TLR-9 and ICAM-1 respectively in endothelial cells treated with preeclampsia plasma. MitoTempo is a mitochondrial-targeted antioxidant, pre-treatment of cells with MitoTempo protected against hydrogen peroxide-induced cell death. Furthermore MitoTempo significantly reduced mitochondrial superoxide production in cells exposed to preeclampsia plasma by normalising mitochondrial metabolism. MitoTempo significantly altered the inflammatory profile of plasma treated cells. These novel data support a functional role for mitochondrial redox signaling in modulating the pathogenesis of preeclampsia and identifies mitochondrial-targeted antioxidants as potential therapeutic candidates.

Data for Improvement and Clinical Excellence: a report of an interrupted time series trial of feedback in home care.

PubMed

Fraser, Kimberly D; Sales, Anne E; Baylon, Melba Andrea B; Schalm, Corinne; Miklavcic, John J

2017-05-18

There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits. A 10-month audit with feedback intervention study was conducted with care providers in seven home care offices in Alberta, Canada, which involved delivery of four quarterly feedback reports consisting of data derived from the Resident Assessment Instrument - Home Care (RAI-HC). The primary evaluation employed an interrupted time series design using segmented regression analysis to assess the effects of feedback reporting on the four quality indicators: pain, falls, delirium, and hospitalization. Changes in level and trend of the quality indicators were measured before, during, and after the implementation of feedback reports. Pressure ulcer reporting was analyzed as a comparator condition not included in the feedback report. Care providers were surveyed on responses to feedback reporting which informed a process evaluation. At initiation of feedback report implementation, the percentage of clients reporting pain and falls significantly increased. Though the percentage of clients reporting pain and falls tended to increase and reporting of delirium and hospital visits tended to decrease relative to the pre-intervention period, there was no significant effect of feedback reporting on quality indicators during the 10-month intervention. The percentage of clients reporting falls, delirium, and hospital visits significantly increased in the 6-month period following feedback reporting relative to the intervention period. About 50% of the care providers that read and understand the feedback reports found the reports useful to make changes to the way clients are cared for. Routinely collected data used over time for feedback is feasible in home care settings. A high proportion of care providers find feedback reports useful for informing how they care for clients. Since reporting on the frequency of quality indicators increased in the post-intervention period, this study suggests that ongoing use of audit with feedback to enhance health outcomes in home care may promote improved reporting on standardized instruments.

System Study: Emergency Power System 1998-2014

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

Schroeder, John Alton

2015-12-01

This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2014 for selected components were obtained from the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The unreliability results are trended for the most recent 10 year period while yearly estimates for system unreliability are provided for the entire active period. An extremely statistically significant increasing trend was observed for EPS system unreliability for an 8-hour mission. A statistically significant increasing trend was observed for EPS system start-onlymore » unreliability.« less

Intragastric pressure during food intake: a physiological and minimally invasive method to assess gastric accommodation.

PubMed

Janssen, P; Verschueren, S; Ly, H Giao; Vos, R; Van Oudenhove, L; Tack, J

2011-04-01

The stomach relaxes upon food intake and thereby provides a reservoir while keeping the intragastric pressure (IGP) low. We set out to determine whether we could use IGP as a measurement for stomach accommodation during food intake. In fasted healthy volunteers (n = 7-17) a manometer and an infusion catheter were positioned in the proximal stomach. After a stabilization period a nutrient drink was intragastrically infused at 15, 30 and 60 mL min(-1). To investigate the effect of impaired accommodation the effect of N(G)-monomethyl-L-arginine (L-NMMA) was examined. The volunteers scored satiation until maximum, when the experiment ended. The IGP was presented as a change from baseline (mean ± SEM) and compared with repeated measures anova. Independent on the ingestion speed, the IGP decreased initially and gradually increased thereafter. Volunteers scored maximal satiation after 699 ± 62, 809 ± 90 and 997 ± 120 mL nutrient drink infused (15, 30 and 60 mL min(-1) respectively; P < 0.01). Maximum IGP decrease was 3.4 ± 0.5 mmHg after 205 ± 28 mL, 5.1 ± 0.7 mmHg after 212 ± 46 mL, and 5.2 ± 0.7 mmHg after 296 ± 28 mL infused volume [15, 30 and 60 mL min(-1) respectively; not significant (ns)]. Post hoc analysis showed significant correlations between IGP and satiation score increase. During L-NMMA infusion IGP was significantly increased while subjects drank significantly less (816 ± 91 vs 1032 ± 71 mL; P < 0.005). Interestingly, the correlation between IGP increase and satiation score increase did not differ after L-NMMA treatment. The IGP during nutrient drink ingestion provides a minimally invasive alternative to the barostat for the assessment of gastric accommodation. These findings furthermore indicate that IGP is a major determinant of satiation. © 2011 Blackwell Publishing Ltd.

Evaluation of knowledge and confidence following opioid overdose prevention training: A comparison of types of training participants and naloxone administration methods.

PubMed

Ashrafioun, Lisham; Gamble, Stephanie; Herrmann, Michele; Baciewicz, Gloria

2016-01-01

The purpose of the current study was to assess the effect of opioid overdose prevention training on participants' knowledge about opioid overdose and confidence to recognize and respond to opioid overdose situations as a function of naloxone administration (i.e., injection vs. intranasal spray) and participant type (friend/family, provider, "other"). Opioid overdose prevention trainings were offered throughout a mid-sized metropolitan area in the northeast. Participants (n = 428) were trained to administer naloxone via intramuscular injection (n = 154) or intranasal spray (n = 274). All training participants were given pre-post assessments of knowledge about opioid overdose and confidence to recognize and respond to opioid overdose situations. Participants' overall knowledge and confidence increased significantly from pre- to post-training (ps < .001). There was no significant association between knowledge and route of administration or participant type. Knowledge significantly increased from pre- to post-training in all participant types (ps < .001). Confidence improved significantly from pre- to post-training across both routes of administration (ps < .001). However, confidence was higher among those who were trained using the intranasal naloxone compared to those who were trained using the intramuscular injection naloxone at pre- (p = .011) and post-training (p < .001). Confidence increased from pre- to post-training in each of the participant types (ps < .001). Post-hoc tests revealed that confidence was higher among providers and friends/family members compared to "other" participants, such as first responders, only at post-training (p < .05). Opioid overdose trainings are effective in increasing knowledge and confidence related to opioid overdose situations. Findings suggest that trainees are more confident administering naloxone via intranasal spray compared to injection. Future research should attempt to identify other factors that may increase the likelihood of trainees' effectively intervening in opioid overdose situations.

Effects of warming on uptake and translocation of cadmium (Cd) and copper (Cu) in a contaminated soil-rice system under Free Air Temperature Increase (FATI).

PubMed

Ge, Li-Qiang; Cang, Long; Liu, Hui; Zhou, Dong-Mei

2016-07-01

Global warming has received growing attentions about its potential threats to human in recent, however little is known about its effects on transfer of heavy metals in agro-ecosystem, especially for Cd in rice. Pot experiments were conducted to evaluate Cd/Cu translocation in a contaminated soil-rice system under Free Air Temperature Increase (FATI). The results showed that warming gradually decreased soil porewater pH and increased water-soluble Cd/Cu concentration, reduced formation of iron plaque on root surface, and thus significantly increased total uptake of Cd/Cu by rice. Subsequently, warming significantly promoted Cd translocation from root to shoot, and increased Cd distribution percentage in shoot, while Cu was not significantly affected. Enhanced Cd uptake and translocation synergistically resulted in higher rice grain contamination with increasing concentration from 0.27 to 0.65 and 0.14-0.40 mg kg(-1) for Indica and Japonica rice, respectively. However increase of Cu in brown grain was only attributed to its uptake enhancement under warming. Our study provides a new understanding about the food production insecurity of heavy metal contaminated soil under the future global warming. Copyright © 2016. Published by Elsevier Ltd.

Halobetasol Propionate Lotion, 0.05% Provides Superior Hydration Compared to Halobetasol Propionate Cream, 0.05% in a Double-Blinded Study of Occlusivity and Hydration.

PubMed

Grove, Gary; Zerweck, Charles; Houser, Tim; Andrasfay, Anthony; Gauthier, Bob; Holland, Charles; Piacquadio, Daniel

2017-02-01

This study measured skin hydration and occlusivity of two test products [halobetasol propionate lotion, 0.05% (HBP Lotion) and Ultravate® (halobetasol propionate) cream, 0.05% (HBP Cream)] at 2, 4, and 6 hours after application to skin test sites previously challenged by dry shaving, which was performed to compromise the integrity of the stratum corneum barrier. Trans-epidermal water loss (TEWL), an indicator of skin barrier function, was measured using cyberDERM, inc. RG-1 evaporimeter. Skin hydration was evaluated using IBS SkiCon-200 conductance meter. Test products were applied bilaterally on dry-shaved sites on the volar forearm sites, according to a randomization scheme, with two test sites untreated to serve as "dry-shaved" controls. TEWL and conductance were measured at 2, 4, and 6 hours post-treatment. HBP Lotion displayed a significant increase in skin hydration at 2, 4, and 6 hours post-treatment compared to the baseline values and dry-shaved controls (each, P less than 0.001). However, HBP Cream produced statistically significant increased skin hydration only after 6 hours (P less than 0.05). HBP Lotion was significantly more effective than HBP Cream in increasing skin hydration at 2 and 4 hours post-treatment (each, P less than 0.001), and had a directional advantage (not statistically significant) at 6 hours. Neither test product had a significant occlusive effect as measured by TEWL at 2, 4, and 6 hours post-application. Both formulations of HBP (Lotion and Cream) contributed to skin moisturization, as measured by skin conductance. HBP Lotion produced a significantly more rapid onset and higher level of moisturization at 2 and 4 hours post-application compared to HBP Cream. The TEWL results indicate that neither HBP Lotion nor HBP Cream provided any significant occlusivity to the skin.

J Drugs Dermatol. 2017;16(2):140-144.

Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial.

PubMed

Buesing, Carolyn; Fisch, Gabriela; O'Donnell, Megan; Shahidi, Ida; Thomas, Lauren; Mummidisetty, Chaithanya K; Williams, Kenton J; Takahashi, Hideaki; Rymer, William Zev; Jayaraman, Arun

2015-08-20

Robots offer an alternative, potentially advantageous method of providing repetitive, high-dosage, and high-intensity training to address the gait impairments caused by stroke. In this study, we compared the effects of the Stride Management Assist (SMA®) System, a new wearable robotic device developed by Honda R&D Corporation, Japan, with functional task specific training (FTST) on spatiotemporal gait parameters in stroke survivors. A single blinded randomized control trial was performed to assess the effect of FTST and task-specific walking training with the SMA® device on spatiotemporal gait parameters. Participants (n=50) were randomly assigned to FTST or SMA. Subjects in both groups received training 3 times per week for 6-8 weeks for a maximum of 18 training sessions. The GAITRite® system was used to collect data on subjects' spatiotemporal gait characteristics before training (baseline), at mid-training, post-training, and at a 3-month follow-up. After training, significant improvements in gait parameters were observed in both training groups compared to baseline, including an increase in velocity and cadence, a decrease in swing time on the impaired side, a decrease in double support time, an increase in stride length on impaired and non-impaired sides, and an increase in step length on impaired and non-impaired sides. No significant differences were observed between training groups; except for SMA group, step length on the impaired side increased significantly during self-selected walking speed trials and spatial asymmetry decreased significantly during fast-velocity walking trials. SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points. These results indicate that the SMA® device could be a useful therapeutic tool to improve spatiotemporal parameters and contribute to improved functional mobility in stroke survivors. Further research is needed to determine the feasibility of using this device in a home setting vs a clinic setting, and whether such home use provides continued benefits. This study is registered under the title "Development of walk assist device to improve community ambulation" and can be located in clinicaltrials.gov with the study identifier: NCT01994395 .

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

PubMed Central

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. Conclusions The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

PubMed

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

A contemporary decennial global Landsat sample of changing agricultural field sizes

NASA Astrophysics Data System (ADS)

White, Emma; Roy, David

2014-05-01

Agriculture has caused significant human induced Land Cover Land Use (LCLU) change, with dramatic cropland expansion in the last century and significant increases in productivity over the past few decades. Satellite data have been used for agricultural applications including cropland distribution mapping, crop condition monitoring, crop production assessment and yield prediction. Satellite based agricultural applications are less reliable when the sensor spatial resolution is small relative to the field size. However, to date, studies of agricultural field size distributions and their change have been limited, even though this information is needed to inform the design of agricultural satellite monitoring systems. Moreover, the size of agricultural fields is a fundamental description of rural landscapes and provides an insight into the drivers of rural LCLU change. In many parts of the world field sizes may have increased. Increasing field sizes cause a subsequent decrease in the number of fields and therefore decreased landscape spatial complexity with impacts on biodiversity, habitat, soil erosion, plant-pollinator interactions, and impacts on the diffusion of herbicides, pesticides, disease pathogens, and pests. The Landsat series of satellites provide the longest record of global land observations, with 30m observations available since 1982. Landsat data are used to examine contemporary field size changes in a period (1980 to 2010) when significant global agricultural changes have occurred. A multi-scale sampling approach is used to locate global hotspots of field size change by examination of a recent global agricultural yield map and literature review. Nine hotspots are selected where significant field size change is apparent and where change has been driven by technological advancements (Argentina and U.S.), abrupt societal changes (Albania and Zimbabwe), government land use and agricultural policy changes (China, Malaysia, Brazil), and/or constrained by historic patterns of LCLU (Albania, France and India). Landsat images sensed in two time periods, up to 25 years apart, are used to extract field object classifications at each hotspot using a multispectral image segmentation approach. The field size distributions for the two periods are compared statistically and quantify examples of significant increasing field size associated primarily with agricultural technological innovation (Argentina and U.S.) and decreasing field size associated with rapid societal changes (Albania and Zimbabwe). The implications of this research, and the potential of higher spatial resolution data from planned global coverage satellites, to provide improved agricultural monitoring are discussed.

Increased cardiac output, not pulmonary artery systolic pressure, increases intrapulmonary shunt in healthy humans breathing room air and 40% O2

PubMed Central

Elliott, Jonathan E; Duke, Joseph W; Hawn, Jerold A; Halliwill, John R; Lovering, Andrew T

2014-01-01

Blood flow through intrapulmonary arteriovenous anastomoses (IPAVAs) has been demonstrated to increase in healthy humans during a variety of conditions; however, whether or not this blood flow represents a source of venous admixture (/) that impairs pulmonary gas exchange efficiency (i.e. increases the alveolar-to-arterial difference (A–aDO2)) remains controversial and unknown. We hypothesized that blood flow through IPAVAs does provide a source of /. To test this, blood flow through IPAVAs was increased in healthy humans at rest breathing room air and 40% O2: (1) during intravenous adrenaline (epinephrine) infusion at 320 ng kg−1 min−1 (320 ADR), and (2) with vagal blockade (2 mg atropine), before and during intravenous adrenaline infusion at 80 ng kg−1 min−1 (ATR + 80 ADR). When breathing room air the A–aDO2 increased by 6 ± 2 mmHg during 320 ADR and by 5 ± 2 mmHg during ATR + 80 ADR, and the change in calculated / was +2% in both conditions. When breathing 40% O2, which minimizes contributions from diffusion limitation and alveolar ventilation-to-perfusion inequality, the A–aDO2 increased by 12 ± 7 mmHg during 320 ADR, and by 9 ± 6 mmHg during ATR + 80 ADR, and the change in calculated / was +2% in both conditions. During 320 ADR cardiac output () and pulmonary artery systolic pressure (PASP) were significantly increased; however, during ATR + 80 ADR only was significantly increased, yet blood flow through IPAVAs as detected with saline contrast echocardiography was not different between conditions. Accordingly, we suggest that blood flow through IPAVAs provides a source of intrapulmonary shunt, and is mediated primarily by increases in rather than PASP. PMID:25085889

Grant Success for Early-Career Faculty in Patient-Oriented Research: Difference-in-Differences Evaluation of an Interdisciplinary Mentored Research Training Program.

PubMed

Libby, Anne M; Hosokawa, Patrick W; Fairclough, Diane L; Prochazka, Allan V; Jones, Pamela J; Ginde, Adit A

2016-12-01

Since 2004, the Clinical Faculty Scholars Program (CFSP) at the University of Colorado Anschutz Medical Campus has provided intensive interdisciplinary mentoring and structured training for early-career clinical faculty from multiple disciplines conducting patient-oriented clinical and outcomes research. This study evaluated the two-year program's effects by comparing grant outcomes for CFSP participants and a matched comparison cohort of other junior faculty. Using 2000-2011 institutional grant and employment data, a cohort of 25 scholars was matched to a cohort of 125 comparison faculty (using time in rank and pre-period grant dollars awarded). A quasi-experimental difference-in-differences design was used to identify the CFSP effect on grant outcomes. Grant outcomes were measured by counts and dollars of grant proposals and awards as principal investigator. Outcomes were compared within cohorts over time (pre- vs. post-period) and across cohorts. From pre- to post-period, mean annual counts and dollars of grant awards increased significantly for both cohorts, but mean annual dollars increased significantly more for the CFSP than for the comparison cohort (delta $83,427 vs. $27,343, P < .01). Mean annual counts of grant proposals also increased significantly more for the CFSP than for the comparison cohort: 0.42 to 2.34 (delta 1.91) versus 0.77 to 1.07 (delta 0.30), P < .01. Institutional investment in mentored research training for junior faculty provided significant grant award gains that began after one year of CFSP participation and persisted over time. The CFSP is a financially sustainable program with effects that are predictable, significant, and enduring.

Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.

PubMed

Dor, Avi; Encinosa, William E; Carey, Kathleen

2015-01-01

Previous research has found that Hospital Compare, Medicare's public reporting initiative, has had little impact on patient outcomes. However, little is known about the initiative's impact on hospital prices, which may be significant because private insurers are generally well positioned to respond to quality information when negotiating prices with hospitals. We estimated difference-in-differences models of the effects of Hospital Compare quality reporting on transaction prices for two major cardiac procedures, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). States that had mandated their own public reporting systems before the implementation of Hospital Compare formed the control group. We found that prices for these procedures continued to increase overall after the initiation of Hospital Compare quality scores, but the rate of increase was significantly lower in states with no quality reporting metrics of their own before Hospital Compare, when compared to the control states (annual rates of increase of 4.4 percent versus 8.7 percent for PCI, and 3.9 percent versus 10.6 percent for CABG, adjusted for overall inflation). This finding implies that Hospital Compare provided leverage to purchasers in moderating price increases, while adding competitive pressures on hospitals. Providing accurate quality information on both hospitals and health plans could benefit consumers. Project HOPE—The People-to-People Health Foundation, Inc.

Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

PubMed Central

Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander; Ben-David, Boaz M.; Saragosa, Marianne; Boscart, Veronique M.; Wilson, Rozanne; Galimidi-Epstein, Karmit K.

2016-01-01

Background: Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care. Purpose: To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden. Method: The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study. Results: The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden. Conclusion: The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden. PMID:27899433

Effect of ACL Transection on Internal Tibial Rotation in an in Vitro Simulated Pivot Landing

PubMed Central

Oh, Youkeun K.; Kreinbrink, Jennifer L.; Ashton-Miller, James A.; Wojtys, Edward M.

2011-01-01

Background: The amount of resistance provided by the ACL (anterior cruciate ligament) to axial tibial rotation remains controversial. The goal of this study was to test the primary hypotheses that ACL transection would not significantly affect tibial rotation under the large impulsive loads associated with a simulated pivot landing but would increase anterior tibial translation. Methods: Twelve cadaveric knees (mean age of donors [and standard deviation] at the time of death, 65.0 ± 10.5 years) were mounted in a custom testing apparatus to simulate a single-leg pivot landing. A compound impulsive load was applied to the distal part of the tibia with compression (∼800 N), flexion moment (∼40 N-m), and axial tibial torque (∼17 N-m) in the presence of five trans-knee muscle forces. A differential variable reluctance transducer mounted on the anteromedial aspect of the ACL measured relative strain. With the knee initially in 15° of flexion, and after five combined compression and flexion moment (baseline) loading trials, six trials were conducted with the addition of either internal or external tibial torque (internal or external loading), and then six baseline trials were performed. The ACL was then sectioned, six baseline trials were repeated, and then six trials of either the internal or the external loading condition, whichever had initially resulted in the larger relative ACL strain, were carried out. Tibiofemoral kinematics were measured optoelectronically. The results were analyzed with a nonparametric Wilcoxon signed-rank test. Results: Following ACL transection, the increase in the normalized internal tibial rotation was significant but small (0.7°/N-m ± 0.3°/N-m to 0.8°/N-m ± 0.3°/N-m, p = 0.012), while anterior tibial translation increased significantly (3.8 ± 2.9 to 7.0 ± 2.9 mm, p = 0.017). Conclusions: ACL transection leads to a small increase in internal tibial rotation, equivalent to a 13% decrease in the dynamic rotational resistance, under the large forces associated with a simulated pivot landing, but it leads to a significant increase in anterior tibial translation. Clinical Relevance: An ACL reconstruction that restores both ligament orientation and stiffness will provide major resistance to anterior tibial translation while providing minor resistance to axial tibial rotation. PMID:21325589

Climate Change Impacts on Texas Water: A White Paper Assessment of the Past, Present and Future and Recommendations for Action

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

Banner, Jay L.; Jackson, Charles S.; Yang, Zong-Liang

2010-09-01

Texas comprises the eastern portion of the Southwest region, where the convergence of climatological and geopolitical forces has the potential to put extreme stress on water resources. Geologic records indicate that Texas experienced large climate changes on millennial time scales in the past, and over the last thousand years, tree-ring records indicate that there were significant periods of drought in Texas. These droughts were of longer duration than the 1950s 'drought of record' that is commonly used in planning, and they occurred independently of human-induced global climate change. Although there has been a negligible net temperature increase in Texas overmore » the past century, temperatures have increased more significantly over the past three decades. Under essentially all climate model projections, Texas is susceptible to significant climate change in the future. Most projections for the 21st century show that with increasing atmospheric greenhouse gas concentrations, there will be an increase in temperatures across Texas and a shift to a more arid average climate. Studies agree that Texas will likely become significantly warmer and drier, yet the magnitude, timing, and regional distribution of these changes are uncertain. There is a large uncertainty in the projected changes in precipitation for Texas for the 21st century. In contrast, the more robust projected increase in temperature with its effect on evaporation, which is a dominant component in the region's hydrologic cycle, is consistent with model projections of frequent and extended droughts throughout the state. For these reasons, we recommend that Texas invest resources to investigate and anticipate the impacts of climate change on Texas water resources, with the goal of providing data to inform resource planning. This investment should support development of (1) research programs that provide policy-relevant science; (2) education programs to engage future researchers and policy-makers; and (3) connections between policy-makers, scientists, water resource managers, and other stakeholders. It is proposed that these goals may be achieved through the establishment of a Texas Climate Consortium, consisting of representatives from academia, industry, government agencies, water authorities, and other stakeholders. The mission of this consortium would be to develop the capacity to provide decision makers with the information needed to develop adaptation strategies in the face of future climate change and uncertainty.« less

Accuracy of PSA Self-Reports among Low-Income Men with Prostate Cancer after a Public Health Nursing Intervention.

PubMed

Zavala, Mary Wassel; Yule, Arthur; Kwan, Lorna; Lambrechts, Sylvia; Maliski, Sally L; Litwin, Mark S

2016-11-01

To examine accuracy of patient-reported prostate-specific antigen (PSA) levels among indigent, uninsured men in a state-funded prostate cancer treatment program that provides case management, care coordination, and health education. Program evaluation. About 114 men with matched self- and lab-reported PSA levels at program enrollment and another time point within 18 months. Abstraction of self- and lab-reported PSA levels to determine self-report as "accurate" or "inaccurate," and evaluate accuracy change over time, before and after nursing interventions. Chi-square tests compared patients with accurate versus inaccurate PSA values. Nonlinear multivariate analyses explored trends in self-reported accuracy over time. Program enrollees receive prostate cancer education from a Nurse Case Manager (NCM), including significance of PSA levels. Men self-report PSA results to their NCM following lab draws and appointments. The NCM provides ongoing education about PSA levels. Of the sample, 46% (n = 53) accurately reported PSA levels. Accuracy of PSA self-reports improved with increasing time since program enrollment. Compared with men at public facilities, those treated at private facilities showed increasing accuracy in self-reported PSA (p = .038). A targeted nursing intervention may increase specific knowledge of PSA levels. Additionally, the provider/treatment setting significantly impacts a patient's disease education and knowledge. © 2016 Wiley Periodicals, Inc.

Cancer Training for Frontline Healthcare Providers in Tanzania.

PubMed

Rick, Tara J; Deming, Cassondra M; Helland, Janey R; Hartwig, Kari A

2017-08-16

Cervical and breast cancer are responsible for the highest cancer-related mortality in Tanzania, although both are preventable or curable if diagnosed at an early stage. Limited knowledge of cervical cancer by clinic and dispensary level healthcare providers in Tanzania is a barrier for prevention and control strategies. The purpose of the study was to provide basic oncology training to frontline healthcare workers with a focus on cervical and breast cancer in order to increase knowledge. A 1-day cancer training symposium was conducted in Arusha, Tanzania, with 43 clinicians. Pre- and post-intervention surveys assessed cancer knowledge and confidence of clinicians in risk assessment. Sixty-nine percent of the participants reported never receiving any cervical cancer training in the past. A significant difference was found between the pre- and post-test in a majority of knowledge questions and in reported confidence recognizing signs and symptoms of breast and cervical cancer (p < 0.05). The 1-day community oncology training symposium was effective in delivering and increasing basic knowledge about cervical and breast cancers to these healthcare providers. The low level of baseline cancer knowledge among frontline medical providers in Tanzania illustrates the need for increased training around the country.

System and process for pulsed multiple reaction monitoring

DOEpatents

Belov, Mikhail E

2013-05-17

A new pulsed multiple reaction monitoring process and system are disclosed that uses a pulsed ion injection mode for use in conjunction with triple-quadrupole instruments. The pulsed injection mode approach reduces background ion noise at the detector, increases amplitude of the ion signal, and includes a unity duty cycle that provides a significant sensitivity increase for reliable quantitation of proteins/peptides present at attomole levels in highly complex biological mixtures.

Conditional Survival in Anal Carcinoma Using the National Population-Based Survey of Epidemiology and End Results Database (1988-2012).

PubMed

Kim, Ellen; Kim, Jong S; Choi, Mehee; Thomas, Charles R

2016-04-01

Conditional survival can provide valuable information for both patients and healthcare providers about the changing prognosis in surviving patients over time. This study estimated conditional survival for patients with anal cancer in the United States through analysis of a national population-based cancer registry. Log-rank test identified significant covariates of cause-specific survival (defined as time from diagnosis until death from anal cancer). Significant covariates were considered in the multivariable regression of cause-specific survival using Cox proportional hazards models. Covariates included cancer stage and demographic variables. Patients in Surveillance, Epidemiology, and End Results regions diagnosed with anal squamous cell carcinoma as their first and only cancer diagnosis from 1988 to 2012 were selected from this database, and 5145 patients were included in the retrospective cohort study. Five-year conditional survival stratified by each variable in the final Cox models was measured : The final multivariable models of overall and cause-specific survivals included stage, grade, sex, age, race, and relationship status. Over the first 6 years after diagnosis, conditional survival of distant stage increased from 37% to 89%, whereas regional stage increased from 65% to 93% and localized stage increased from 84% to 96%. The other variables had increasing prognosis as well, but the subgroups increased at a more similar rate over time. The data source used does not include information on chemotherapy treatment, patient comorbidities, or socioeconomic status. Conditional survival showed improvement over time. Patients with advanced stage had the greatest improvement in conditional survival. This is the first study to provide specific conditional survival probabilities for patients with anal cancer.

Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children.

PubMed

Bitsko, Rebecca H; Holbrook, Joseph R; Ghandour, Reem M; Blumberg, Stephen J; Visser, Susanna N; Perou, Ruth; Walkup, John T

2018-06-01

This study documents the prevalence and impact of anxiety and depression in US children based on the parent report of health care provider diagnosis. National Survey of Children's Health data from 2003, 2007, and 2011-2012 were analyzed to estimate the prevalence of anxiety or depression among children aged 6 to 17 years. Estimates were based on the parent report of being told by a health care provider that their child had the specified condition. Sociodemographic characteristics, co-occurrence of other conditions, health care use, school measures, and parenting aggravation were estimated using 2011-2012 data. Based on the parent report, lifetime diagnosis of anxiety or depression among children aged 6 to 17 years increased from 5.4% in 2003 to 8.4% in 2011-2012. Current anxiety or depression increased from 4.7% in 2007 to 5.3% in 2011-2012; current anxiety increased significantly, whereas current depression did not change. Anxiety and depression were associated with increased risk of co-occurring conditions, health care use, school problems, and having parents with high parenting aggravation. Children with anxiety or depression with effective care coordination or a medical home were less likely to have unmet health care needs or parents with high parenting aggravation. By parent report, more than 1 in 20 US children had current anxiety or depression in 2011-2012. Both were associated with significant comorbidity and impact on children and families. These findings may inform efforts to improve the health and well-being of children with internalizing disorders. Future research is needed to determine why child anxiety diagnoses seem to have increased from 2007 to 2012.

Teen Intervention Project--Cherokee (TIP-C).

PubMed

Lowe, John

2006-01-01

To test the feasibility of providing a cultural school-based substance abuse intervention for Cherokee adolescents and to examine the relationship between Cherokee self-reliance, substance abuse, and stress. A 10-week group intervention was implemented over a 3-year period for Cherokee adolescent substance abusers. Pre-intervention, immediate post-intervention, and 90-day post-intervention measures of Cherokee self-reliance, substance abuse, and stress were administered to 108 Cherokee adolescent high school students who participated in the intervention. Immediate and 90-day post-intervention substance abuse rates were significantly lower than pre-intervention rates. Cherokee self-reliance scores were significantly increased. Perceived stress scores were significantly lower immediately post-intervention but increased 90-day post-intervention. The Teen Intervention Project--Cherokee is an effective and culturally appropriate school-based intervention for Cherokee adolescent substance abusers.

"Dance Dance Revolution" Used by 7- and 8-Year-Olds to Boost Physical Activity: Is Coaching Necessary for Adherence to an Exercise Prescription?

PubMed

Errickson, Sadye Paez; Maloney, Ann E; Thorpe, Deborah; Giuliani, Carol; Rosenberg, Angela M

2012-02-01

To increase opportunities for physical activity (PA) for children in children's homes, we used a "Dance Dance Revolution" (DDR) (Konami of America, Redwood City, CA) coaching protocol for 7- and 8-year-olds. We randomly assigned youth to either an Enhanced (coaching) or Basic (no coaching) group. A DDR prescription of 120 minutes/week was provided to 40 children. Motor learning principles guided the coaching protocol, provided by adult graduate students, which took place weekly during weeks 1-5. PA was measured with accelerometry, DDR logs, and Sony (New York, NY) Playstation(®)2 memory cards at baseline and at week 10. Total accelerometer-measured PA was not significantly different between the groups at baseline or week 10; however, vigorous PA increased significantly in both groups at week 10. DDR logs showed a large range from 0 to 660 minutes/week of dance time. Respective playing time for each week (1 and 10) averaged 149 and 64 minutes for the Basic group and 184 and 47 minutes for the Enhanced group. Coaching significantly increased DDR use patterns in this population of youngsters during weeks 1 through 5 (P<0.001). Adult coaching deserves further study to determine how to maintain high levels of participation in exergames for youth who live in an obesogenic environment.

Bridging the gap from prenatal karyotyping to whole-genome array comparative genomic hybridization in Hong Kong: survey on knowledge and acceptance of health-care providers and pregnant women.

PubMed

Cheng, Hiu Yee Heidi; Kan, Anita Sik-Yau; Hui, Pui Wah; Lee, Chin Peng; Tang, Mary Hoi Yin

2017-12-01

The use of array comparative genomic hybridization (aCGH) has been increasingly widespread. The challenge of integration of this technology into prenatal diagnosis was the interpretation of results and communicating findings of unclear clinical significance. This study assesses the knowledge and acceptance of prenatal aCGH in Hong Kong obstetricians and pregnant women. The aim is to identify the needs and gaps before implementing the replacement of karyotyping with aCGH. Questionnaires with aCGH information in the form of pamphlets were sent by post to obstetrics and gynecology doctors. For the pregnant women group, a video presentation, pamphlets on aCGH and a self-administered questionnaire were provided at the antenatal clinic. The perception of aCGH between doctors and pregnant women was similar. Doctors not choosing aCGH were more concerned about the difficulty in counseling of variants of unknown significance and adult-onset disease in pregnant women, whereas pregnant women not choosing aCGH were more concerned about the increased waiting time leading to increased anxiety. Prenatal aCGH is perceived as a better test by both doctors and patients. Counseling support, training, and better understanding and communication of findings of unclear clinical significance are necessary to improve doctor-patient experience.

A Noninvasive Method to Study Regulation of Extracellular ...

EPA Pesticide Factsheets

Time-domain nuclear magnetic resonance (TD-NMR)-based measurement of body composition of rodents is an effective method to quickly and repeatedly measure proportions of fat, lean, and fluid without anesthesia. TD-NMR provides a measure of free water in a living animal, termed % fluid, and is a measure of unbound water in the vascular and extracelular spaces. We hypothesized that injecting a bolus of fluid into the peritoneal cavity would lead to an abrupt increase in %fluid and the rate of clearance monitored with TD-NMR would provide a noninvasive assessment of the free water homeostasis in an awake rat. Several strains of laboratory rats were injected intraperitoneally with 10 ml/kg isotonic or hypertonic saline and % fluid was monitored repeatedly with a Bruker "Minispec" TD-NMR body composition system.Following isotonic saline, %fluid increased immediately by 0.5% followed by a recovery over ~6h. Injecting hypertonic (3 times normal saline) resulted in a significantly greater rise in %fluid and longer recovery. lntraperitoneal and subcutaneous fluid injection led to similar rates of clearance. The Wistar-Kyoto rat strain displayed significantly slower recovery to fluid loads compared with Long-Evans and Sprague-Dawley strains. Rats exercised chronically showed significant increases in %fluid, but the rate of clearance of fluid was similar to that of sedentary animals. We conclude that this technique could be used to study vascular and extracellular volume ho

Measurement of Cough Aerodynamics in Healthy Adults.

PubMed

Feinstein, Aaron J; Zhang, Zhaoyan; Chhetri, Dinesh K; Long, Jennifer

2017-05-01

Cough is a critical human reflex and also among the most frequent symptoms in medicine. Despite the prevalence of disordered cough in laryngeal pathologies, comprehensive and quantitative evaluation of cough in these patients is lacking. Herein we seek to establish normative values for cough aerodynamics to provide a population standard for reference in future studies. Healthy subjects were recruited from an outpatient clinic to perform voluntary cough. Subjects were instructed on the technique for maximal voluntary cough production with measurements recorded on pneumotachograph. Fifty-two subjects were studied, including 29 women and 23 men with a mean age of 51.6 and 52.3 years, respectively. Main Outcomes and Measures: Cough peak airflow, peak pressure, and expiratory rise time. Results were stratified by age, gender, and height. Peak airflow demonstrated significant differences across age, gender, and height, with flow increasing according to increasing height. Peak cough pressure also increased with height and was significantly greater in males versus females. Expiratory rise time, the time from glottal opening to peak airflow, did not vary with age or height but was statistically significantly longer in women. Cough aerodynamics can be readily measured objectively in the outpatient setting. Expiratory rise time, peak flow, and peak pressure are important aspects of each cough epoch. Normative data provided herein can be used for future studies of patients with laryngotracheal disorders, and these cough parameters may prove to be simple, accessible, and repeatable outcome measures.

Differences in incidence and trends of haematological malignancies in Japan and the United States

PubMed Central

Chihara, Dai; Ito, Hidemi; Matsuda, Tomohiro; Shibata, Akiko; Katsumi, Akira; Nakamura, Shigeo; Tomotaka, Sobue; Morton, Lindsay M; Weisenburger, Dennis D; Matsuo, Keitaro

2014-01-01

The incidence of a malignant disease reflects the genetic and cumulative exposure to the environment of a population. Therefore, evaluation of the incidence and trends of a disease in different populations may provide insights into its aetiology and pathogenesis. To evaluate the incidence of haematological malignancies according to specific subtypes, we used population-based registry data in Japan (N = 125 148) and the United States (US; N = 172 925) from 1993 to 2008. The age-adjusted incidence of haematological malignancies in Japan was approximately one-half that in the US but has been increasing significantly, whereas no significant change was seen in the US [annual percent change (95% C confidence interval): Japan, +2·4% (1·7, 3·1); US, +0·1% (−0·1, 0·2)]. Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) showed the largest differences in incidence, with the most remarkable differences observed for chronic lymphocytic leukaemia, HL-nodular sclerosis, mycosis fungoides and cutaneous T-cell lymphoma. HL and NHL are increasing substantially in Japan but not in the US, suggesting that environmental exposures, such as Westernization of the life style may be causing this increase. Differences in the incidence and trends for specific subtypes also showed a marked contrast across subtypes, which, in turn, may provide significant new insights into disease aetiology in the future. PMID:24245986

Leadership Matters: Addressing the Student Success and Completion Agenda

ERIC Educational Resources Information Center

McClenney, Byron N.

2013-01-01

This chapter describes a movement to significantly increase student attainment in community and technical colleges. The observations of Leadership Coaches in Achieving the Dream, developed over a nine-year period of involvement, provide insight into the leadership required to transform institutional culture.

Testing of selected metallic reinforcing bars for extending the service life of concrete bridges : testing in solutions.

DOT National Transportation Integrated Search

2003-01-01

Stainless steel-clad rebar provides an opportunity to significantly increase the Cl- threshold concentration associated with active corrosion initiation compared to plain carbon steel. However, threshold Cl- concentrations for 316L stainless steel-cl...

Teaching and Learning with Hypervideo in Vocational Education and Training

ERIC Educational Resources Information Center

Cattaneo, Alberto A. P.; Nguyen, Anh Thu; Aprea, Carmela

2016-01-01

Audiovisuals offer increasing opportunities as teaching-and-learning materials while also confronting educators with significant challenges. Hypervideo provides one means of overcoming these challenges, offering new possibilities for interaction and support for reflective processes. However, few studies have investigated the instructional…

Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: Results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial

PubMed Central

Patten, Scott; Knaak, Stephanie; Weinerman, Rivian; Campbell, Helen; Lauria-Horner, Bianca

2017-01-01

Objective: Most interventions to reduce stigma in health professionals emphasize education and social contact–based strategies. We sought to evaluate a novel skill-based approach: the British Columbia Adult Mental Health Practice Support Program. We sought to determine the program’s impact on primary care providers’ stigma and their perceived confidence and comfort in providing care for mentally ill patients. We hypothesized that enhanced skills and increased comfort and confidence on the part of practitioners would lead to diminished social distance and stigmatization. Subsequently, we explored the program’s impact on clinical outcomes and health care costs. These outcomes are reported separately, with reference to this article. Methods: In a double-blind, cluster randomized controlled trial, 111 primary care physicians were assigned to intervention or control groups. A validated stigma assessment tool, the Opening Minds Scale for Health Care Providers (OMS-HC), was administered to both groups before and after training. Confidence and comfort were assessed using scales constructed from ad hoc items. Results: In the primary analysis, no significant differences in stigma were found. However, a subscale assessing social distance showed significant improvement in the intervention group after adjustment for a variable (practice size) that was unequally distributed in the randomization. Significant increases in confidence and comfort in managing mental illness were observed among intervention group physicians. A positive correlation was found between increased levels of confidence/comfort and improvements in overall stigma, especially in men. Conclusions: This study provides some preliminary evidence of a positive impact on health care professionals’ stigma through a skill-building approach to management of mild to moderate depression and anxiety in primary care. The intervention can be used as a primary vehicle for enhancing comfort and skills in health care providers and, ultimately, reducing an important dimension of stigma: preference for social distance. PMID:28095259

Provider use of a participatory decision-making style with youth and caregivers and satisfaction with pediatric asthma visits.

PubMed

Sleath, Betsy; Carpenter, Delesha M; Coyne, Imelda; Davis, Scott A; Hayes Watson, Claire; Loughlin, Ceila E; Garcia, Nacire; Reuland, Daniel S; Tudor, Gail E

2018-01-01

We conducted a randomized controlled trial to test the effectiveness of an asthma question prompt list with video intervention to engage the youth during clinic visits. We examined whether the intervention was associated with 1) providers including youth and caregiver inputs more into asthma treatment regimens, 2) youth and caregivers rating providers as using more of a participatory decision-making style, and 3) youth and caregivers being more satisfied with visits. English- or Spanish-speaking youth aged 11-17 years with persistent asthma and their caregivers were recruited from four pediatric clinics and randomized to the intervention or usual care groups. The youth in the intervention group watched the video with their caregivers on an iPad and completed a one-page asthma question prompt list before their clinic visits. All visits were audiotaped. Generalized estimating equations were used to analyze the data. Forty providers and their patients (n=359) participated in this study. Providers included youth input into the asthma management treatment regimens during 2.5% of visits and caregiver input during 3.3% of visits. The youth in the intervention group were significantly more likely to rate their providers as using more of a participatory decision-making style (odds ratio=1.7, 95% confidence interval=1.1, 2.5). White caregivers were significantly more likely to rate the providers as more participatory (odds ratio=2.3, 95% confidence interval=1.2, 4.4). Youth (beta=4.9, 95% confidence interval=3.3, 6.5) and caregivers (beta=7.5, 95% confidence interval=3.1, 12.0) who rated their providers as being more participatory were significantly more satisfied with their visits. Youth (beta=-1.9, 95% confidence interval=-3.4, -0.4) and caregivers (beta=-8.8, 95% confidence interval=-16.2, -1.3) who spoke Spanish at home were less satisfied with visits. The intervention did not increase the inclusion of youth and caregiver inputs into asthma treatment regimens. However, it did increase the youth's perception of participatory decision-making style of the providers, and this in turn was associated with greater satisfaction.

Infrared imaging results of an excited planar jet

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

Farrington, R.B.

1991-12-01

Planar jets are used for many applications including heating, cooling, and ventilation. Generally such a jet is designed to provide good mixing within an enclosure. In building applications, the jet provides both thermal comfort and adequate indoor air quality. Increased mixing rates may lead to lower short-circuiting of conditioned air, elimination of dead zones within the occupied zone, reduced energy costs, increased occupant comfort, and higher indoor air quality. This paper discusses using an infrared imaging system to show the effect of excitation of a jet on the spread angle and on the jet mixing efficiency. Infrared imaging captures amore » large number of data points in real time (over 50,000 data points per image) providing significant advantages over single-point measurements. We used a screen mesh with a time constant of approximately 0.3 seconds as a target for the infrared camera to detect temperature variations in the jet. The infrared images show increased jet spread due to excitation of the jet. Digital data reduction and analysis show change in jet isotherms and quantify the increased mixing caused by excitation. 17 refs., 20 figs.« less

Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in scotland.

PubMed Central

MacKie, R. M.; Aitchison, T.

1982-01-01

A case-control study of occupational and recreational sun exposure, Mediterranean and other sun-exposed holidays, tanning history and history of isolated episodes of severe sunburn has been carried out on 113 patients with cutaneous malignant melanoma and 113 age- and sex-matched controls. Social class and skin type were also considered in the analysis of the data which involved the use of conditional multiple logistic regression. A highly significant increase in the history of severe sunburn was recorded in melanoma patients of both sexes in the 5-year period preceding presentation with their tumour. Higher social class and negative history of recreational sun exposure were also significantly increased in patients by comparison with controls. In the male group severe sunburn, lack of occupational sun exposure and higher social class were significant factors while in the female group only severe sunburn was significantly increased in the melanoma patients. This study thus provides evidence to suggest that short intense episodes of UV exposure resulting in burning may be one of the aetiological factors involved in subsequent development of melanoma. PMID:7150488

Antibacterial Efficacy of Several Surgical Hand Preparation Products Used by Veterinary Students.

PubMed

Chou, Po-Yen; Doyle, Aimie J; Arai, Shiori; Burke, Pierre J; Bailey, Trina R

2016-05-01

To compare the antibacterial efficacy of different surgical hand antisepsis protocols used by veterinary students. Prospective, randomized, controlled study. Third year veterinary students (n=45). The participants were randomly assigned to 4 of the following 12 hand preparation product/time combinations: nonabrasive hand scrub method with 4% chlorhexidine gluconate (CH); hand rub with a mixture of 30% 1-propanol and 45% 2-propanol solution (MPS), 70% 2-propanol solution (IPS), or 61% ethanol solution with 1% chlorhexidine gluconate (ES/CH), with a contact time of 1.5, 3, or 5 minutes. Antibacterial efficacy was assessed after surgical hand preparation and at the end of surgery. Log reductions of total bacterial colony forming unit (CFU)/mL and positive aerobic culture rates were compared using multivariable analysis of variance and multivariable logistic regression, respectively. After surgical hand preparation, CH and ES/CH provided significantly higher log CFU reduction and lower positive culture rate for Gram-positive and spore-forming bacteria compared to MPS and IPS. Increase in contact time did not provide significant improvement in bacterial reduction. At the end of surgery, ES/CH provided significantly higher log CFU reduction compared to IPS and lower positive culture rate for Gram-positive bacteria compared to CH, MPS, and IPS. Increase in contact time significantly improved log CFU reduction in ES/CH and MPS groups. In our population of veterinary students ES/CH hand rubs or CH scrubs were more effective in reducing bacterial CFU during surgical hand preparation than MPS or IPS. © Copyright 2016 by The American College of Veterinary Surgeons.

Sarcomeric protein modification during adrenergic stress enhances cross-bridge kinetics and cardiac output

PubMed Central

Gresham, Kenneth S.; Mamidi, Ranganath; Li, Jiayang; Kwak, Hyerin

2017-01-01

Molecular adaptations to chronic neurohormonal stress, including sarcomeric protein cleavage and phosphorylation, provide a mechanism to increase ventricular contractility and enhance cardiac output, yet the link between sarcomeric protein modifications and changes in myocardial function remains unclear. To examine the effects of neurohormonal stress on posttranslational modifications of sarcomeric proteins, mice were administered combined α- and β-adrenergic receptor agonists (isoproterenol and phenylephrine, IPE) for 14 days using implantable osmotic pumps. In addition to significant cardiac hypertrophy and increased maximal ventricular pressure, IPE treatment accelerated pressure development and relaxation (74% increase in dP/dtmax and 14% decrease in τ), resulting in a 52% increase in cardiac output compared with saline (SAL)-treated mice. Accelerated pressure development was maintained when accounting for changes in heart rate and preload, suggesting that myocardial adaptations contribute to enhanced ventricular contractility. Ventricular myocardium isolated from IPE-treated mice displayed a significant reduction in troponin I (TnI) and myosin-binding protein C (MyBP-C) expression and a concomitant increase in the phosphorylation levels of the remaining TnI and MyBP-C protein compared with myocardium isolated from saline-treated control mice. Skinned myocardium isolated from IPE-treated mice displayed a significant acceleration in the rate of cross-bridge (XB) detachment (46% increase) and an enhanced magnitude of XB recruitment (43% increase) at submaximal Ca2+ activation compared with SAL-treated mice but unaltered myofilament Ca2+ sensitivity of force generation. These findings demonstrate that sarcomeric protein modifications during neurohormonal stress are molecular adaptations that enhance in vivo ventricular contractility through accelerated XB kinetics to increase cardiac output. NEW & NOTEWORTHY Posttranslational modifications to sarcomeric regulatory proteins provide a mechanism to modulate cardiac function in response to stress. In this study, we demonstrate that neurohormonal stress produces modifications to myosin-binding protein C and troponin I, including a reduction in protein expression within the sarcomere and increased phosphorylation of the remaining protein, which serve to enhance cross-bridge kinetics and increase cardiac output. These findings highlight the importance of sarcomeric regulatory protein modifications in modulating ventricular function during cardiac stress. PMID:27909224

Sarcomeric protein modification during adrenergic stress enhances cross-bridge kinetics and cardiac output.

PubMed

Gresham, Kenneth S; Mamidi, Ranganath; Li, Jiayang; Kwak, Hyerin; Stelzer, Julian E

2017-03-01

Molecular adaptations to chronic neurohormonal stress, including sarcomeric protein cleavage and phosphorylation, provide a mechanism to increase ventricular contractility and enhance cardiac output, yet the link between sarcomeric protein modifications and changes in myocardial function remains unclear. To examine the effects of neurohormonal stress on posttranslational modifications of sarcomeric proteins, mice were administered combined α- and β-adrenergic receptor agonists (isoproterenol and phenylephrine, IPE) for 14 days using implantable osmotic pumps. In addition to significant cardiac hypertrophy and increased maximal ventricular pressure, IPE treatment accelerated pressure development and relaxation (74% increase in dP/d t max and 14% decrease in τ), resulting in a 52% increase in cardiac output compared with saline (SAL)-treated mice. Accelerated pressure development was maintained when accounting for changes in heart rate and preload, suggesting that myocardial adaptations contribute to enhanced ventricular contractility. Ventricular myocardium isolated from IPE-treated mice displayed a significant reduction in troponin I (TnI) and myosin-binding protein C (MyBP-C) expression and a concomitant increase in the phosphorylation levels of the remaining TnI and MyBP-C protein compared with myocardium isolated from saline-treated control mice. Skinned myocardium isolated from IPE-treated mice displayed a significant acceleration in the rate of cross-bridge (XB) detachment (46% increase) and an enhanced magnitude of XB recruitment (43% increase) at submaximal Ca 2+ activation compared with SAL-treated mice but unaltered myofilament Ca 2+ sensitivity of force generation. These findings demonstrate that sarcomeric protein modifications during neurohormonal stress are molecular adaptations that enhance in vivo ventricular contractility through accelerated XB kinetics to increase cardiac output. NEW & NOTEWORTHY Posttranslational modifications to sarcomeric regulatory proteins provide a mechanism to modulate cardiac function in response to stress. In this study, we demonstrate that neurohormonal stress produces modifications to myosin-binding protein C and troponin I, including a reduction in protein expression within the sarcomere and increased phosphorylation of the remaining protein, which serve to enhance cross-bridge kinetics and increase cardiac output. These findings highlight the importance of sarcomeric regulatory protein modifications in modulating ventricular function during cardiac stress. Copyright © 2017 the American Physiological Society.

Increased Th1 and Th2 allergen-induced cytokine responses in children with atopic disease.

PubMed

Smart, J M; Kemp, A S

2002-05-01

Polyclonal cytokine responses following stimulation of T cells with mitogens or superantigens provides information on cytokine production from a wide range of T cells. Alternatively allergen-induced T cell responses can provide information on cytokine production by allergen-reactive T cells. While there is evidence of increased Th2 and reduced Th1 cytokine production following T cell stimulation with non-specific mitogens and superantigens, the evidence that Th1 cytokine production to allergens is decreased in line with a postulated imbalance in Th1/Th2 responses is unclear, with studies finding decreased, no difference or increased IFN-gamma responses to allergens in atopic subjects. To examine childhood polyclonal and allergen-induced cytokine responses in parallel to evaluate cytokine imbalances in childhood atopic disease. PBMC cytokine responses were examined in response to a polyclonal stimulus, staphylococcal superantigen (SEB), in parallel with two inhalant allergens, house dust mite (HDM) and rye grass pollen (RYE), and an ingested allergen, ovalbumin (OVA), in (a) 35 healthy children (non-atopic) and (b) 36 children with atopic disease (asthma, eczema and/or rhinitis) (atopic). Atopic children had significantly reduced IFN-gamma and increased IL-4 and IL-5 but not IL13 production to SEB superantigen stimulation when compared with non-atopic children. HDM and RYE allergens stimulated significantly increased IFN-gamma, IL-5 and IL-13, while OVA stimulated significantly increased IFN-gamma production in atopic children. We show that a polyclonal stimulus induces a reduced Th1 (IFN-gamma) and increased Th2 (IL-4 and IL-5) cytokine pattern. In contrast, the allergen-induced cytokine responses in atopic children were associated with both increased Th1 (INF-gamma) and Th2 (IL-5 and IL-13) cytokine production. The increased Th1 response to allergen is likely to reflect prior sensitization and indicates that increases in both Th1 and Th2 cytokine production to allergens exists concomitantly with a decreased Th1 response to a polyclonal stimulus in atopic children.

Learning to Improve: Using Writing to Increase Critical Thinking Performance in General Education Biology

PubMed Central

Kurtz, Martha J.

2007-01-01

Increasingly, national stakeholders express concern that U.S. college graduates cannot adequately solve problems and think critically. As a set of cognitive abilities, critical thinking skills provide students with tangible academic, personal, and professional benefits that may ultimately address these concerns. As an instructional method, writing has long been perceived as a way to improve critical thinking. In the current study, the researchers compared critical thinking performance of students who experienced a laboratory writing treatment with those who experienced traditional quiz-based laboratory in a general education biology course. The effects of writing were determined within the context of multiple covariables. Results indicated that the writing group significantly improved critical thinking skills whereas the nonwriting group did not. Specifically, analysis and inference skills increased significantly in the writing group but not the nonwriting group. Writing students also showed greater gains in evaluation skills; however, these were not significant. In addition to writing, prior critical thinking skill and instructor significantly affected critical thinking performance, whereas other covariables such as gender, ethnicity, and age were not significant. With improved critical thinking skill, general education biology students will be better prepared to solve problems as engaged and productive citizens. PMID:17548876

Improved vitamin D supplementation in hospitalized breastfed infants through electronic order modification and targeted provider education.

PubMed

Watnick, Caroline S; Binns, Helen J; Greenberg, Robert S

2015-03-01

To examine effectiveness of an intervention promoting vitamin D supplementation in hospitalized breastfed infants. Our urban tertiary care hospital instituted a 2-part intervention: brief education for providers on vitamin D guidelines and insertion of an opt-in order for vitamin D supplements into electronic admission order sets. Data downloads on admissions of patients aged <1 year were obtained. We excluded those not breastfed, with a dietary restriction, or admitted to intensive care. Intervention effects were compared from 6 months postintervention to the 6 same months 1 year earlier. We applied χ2 and logistic regression, including the patient as a random effect to adjust for repeated admissions. Data on 471 exclusively or partially breastfed admissions (441 infants) were analyzed (221 preintervention, 250 postintervention). Admission characteristics did not differ by period: 55.0% boys; 40.6% Medicaid; 63.7% hospitalized ≤2 days; 72.0% on a general medical service; 16.6% received nutritionist consultation. In-hospital vitamin D prescribing rates significantly increased postintervention (19.5% vs 44.4%; P<.001). Postintervention admissions were more than twice as likely to receive vitamin D supplementation (adjusted odds ratio 2.3, 95% confidence interval 1.6-3.2). Other associated factors included vitamin D as a medication used before admission (adjusted odds ratio 14.3, 95% confidence interval 4.9-41.6), nutritionist consultation during admission, hospitalization≥3 days, and admission to a general medical service. Prescribing of vitamin D at discharge increased significantly (9.0% vs 19.6%; P<.001). Medical provider education and modification of electronic ordering templates significantly increased use of vitamin D supplementation in hospitalized breastfed infants. Copyright © 2015 by the American Academy of Pediatrics.

Does Intervening in Childcare Settings Impact Fundamental Movement Skill Development?

PubMed

Adamo, Kristi B; Wilson, Shanna; Harvey, Alysha L J; Grattan, Kimberly P; Naylor, Patti-Jean; Temple, Viviene A; Goldfield, Gary S

2016-05-01

Knowing that motor skills will not develop to their full potential without opportunities to practice in environments that are stimulating and supportive, we evaluated the effect of a physical activity (PA)-based intervention targeting childcare providers on fundamental movement skills (FMS) in preschoolers attending childcare centers. In this two-arm cluster-randomized controlled trial, six licensed childcare centers in Ottawa, Canada, were randomly allocated into one of two groups (three controls, n = 43; three interventions, n = 40). Participants were between the ages of 3 and 5 yr. Childcare providers in the experimental condition received two 3-h workshops and a training manual at program initiation aimed at increasing PA through active play and several in-center "booster" sessions throughout the 6-month intervention. Control childcare centers implemented their standard curriculum. FMS were measured at baseline and 6 months using the Test of Gross Motor Development-2. Groups did not differ on sociodemographic variables. Compared with control, children in the intervention group demonstrated significantly greater improvement in their standardized gross motor quotient (score, 5.70; 95% confidence interval [95% CI], 0.74-10.67; P = 0.025 and gross motor quotient percentile, 13.33; 95% CI, 2.17-24.49; P = 0.020). Over the 6-month study period, the intervention group showed a significantly greater increase in locomotor skills score (1.20; 95% CI, 0.18-2.22; P = 0.022) than the control group. There was a significant decrease in the object control scores in the control group over the study period. A childcare provider-led PA-based intervention increased the FMS in preschoolers, driven by the change in locomotor skills. The childcare environment may represent a viable public health approach for promoting motor skill development to support future engagement in PA.

Ovarian Cancer Knowledge in Women and Providers Following Education with Inside Knowledge Campaign Materials.

PubMed

Puckett, Mary C; Townsend, Julie S; Gelb, Cynthia A; Hager, Polly; Conlon, Amy; Stewart, Sherri L

2017-06-24

Because no effective methods for preventing or screening for ovarian cancer exist, symptom recognition is integral to its early detection. The Centers for Disease Control and Prevention's Inside Knowledge: Get the Facts about Gynecologic Cancer campaign was developed to raise awareness and educate women and providers about risk factors, symptoms, recommended screening, and prevention strategies for the five main gynecologic cancers, including ovarian cancer. Inside Knowledge campaign materials were utilized by CDC's National Comprehensive Cancer Control Program grantees to educate women and providers about gynecologic cancer from 2014 to 2015. Grantees recruited participants and held educational sessions using Inside Knowledge materials. Questionnaires were given before and after the sessions to assess changes in awareness, confidence, and behavioral intentions around gynecologic cancer information and analyzed in 2016. This analysis focused on an assessment of changes related to ovarian cancer information. Participants' knowledge increased after educational sessions. Among women, there were increases in correctly identifying that the Papanicolaou (Pap) test does not screen for ovarian cancer (89.2%) and that genetic testing is available (77.9%). There was a lower increase in knowledge that HPV is not a cause of ovarian cancer (56.4%). Providers and women reported significant increases in their confidence in their ability to talk to each other about gynecologic cancer post-session. Ovarian cancer awareness, confidence, and related behaviors increased in participants exposed to Inside Knowledge materials. Using these materials to increase knowledge could lead to more empowered patients, better provider-patient communications, and improved care for gynecologic cancers, including ovarian cancer.

Transition Readiness in Adolescents and Emerging Adults with Diabetes: The Role of Patient-Provider Communication

PubMed Central

Hilliard, Marisa; Sweenie, Rachel; Riekert, Kristin

2013-01-01

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care. PMID:24014075

Dynamic visualization techniques for high consequence software

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

Pollock, G.M.

1998-02-01

This report documents a prototype tool developed to investigate the use of visualization and virtual reality technologies for improving software surety confidence. The tool is utilized within the execution phase of the software life cycle. It provides a capability to monitor an executing program against prespecified requirements constraints provided in a program written in the requirements specification language SAGE. The resulting Software Attribute Visual Analysis Tool (SAVAnT) also provides a technique to assess the completeness of a software specification. The prototype tool is described along with the requirements constraint language after a brief literature review is presented. Examples of howmore » the tool can be used are also presented. In conclusion, the most significant advantage of this tool is to provide a first step in evaluating specification completeness, and to provide a more productive method for program comprehension and debugging. The expected payoff is increased software surety confidence, increased program comprehension, and reduced development and debugging time.« less

Effects of an educational intervention on female biomedical scientists' research self-efficacy.

PubMed

Bakken, Lori L; Byars-Winston, Angela; Gundermann, Dawn M; Ward, Earlise C; Slattery, Angela; King, Andrea; Scott, Denise; Taylor, Robert E

2010-05-01

Women and people of color continue to be underrepresented among biomedical researchers to an alarming degree. Research interest and subsequent productivity have been shown to be affected by the research training environment through the mediating effects of research self-efficacy. This article presents the findings of a study to determine whether a short-term research training program coupled with an efficacy enhancing intervention for novice female biomedical scientists of diverse racial backgrounds would increase their research self-efficacy beliefs. Forty-three female biomedical scientists were randomized into a control or intervention group and 15 men participated as a control group. Research self-efficacy significantly increased for women who participated in the self-efficacy intervention workshop. Research self-efficacy within each group also significantly increased following the short-term research training program, but cross-group comparisons were not significant. These findings suggest that educational interventions that target sources of self-efficacy and provide domain-specific learning experiences are effective at increasing research self-efficacy for women and men. Further studies are needed to determine the longitudinal outcomes of this effort.

Hyperaccumulator straw improves the cadmium phytoextraction efficiency of emergent plant Nasturtium officinale.

PubMed

Li, Keqiang; Lin, Lijin; Wang, Jin; Xia, Hui; Liang, Dong; Wang, Xun; Liao, Ming'an; Wang, Li; Liu, Li; Chen, Cheng; Tang, Yi

2017-08-01

With the development of economy, the heavy metal contamination has become an increasingly serious problem, especially the cadmium (Cd) contamination. The emergent plant Nasturtium officinale R. Br. is a Cd-accumulator with low phytoremediation ability. To improve Cd phytoextraction efficiency of N. officinale, the straw from Cd-hyperaccumulator plants Youngia erythrocarpa, Galinsoga parviflora, Siegesbeckia orientalis, and Bidens pilosa was applied to Cd-contaminated soil and N. officinale was then planted; the study assessed the effect of hyperaccumulator straw on the growth and Cd accumulation of N. officinale. The results showed that application of hyperaccumulator species straws increased the biomass and photosynthetic pigment content and reduced the root/shoot ratio of N. officinale. All straw treatments significantly increased Cd content in roots, but significantly decreased Cd content in shoots of N. officinale. Applying hyperaccumulator straw significantly increased the total Cd accumulation in the roots, shoots, and whole plants of N. officinale. Therefore, application of straw from four hyperaccumulator species promoted the growth of N. officinale and improved the phytoextraction efficiency of N. officinale in Cd-contaminated paddy field soil; the straw of Y. erythrocarpa provided the most improvement.

Effects of an Educational Intervention on Female Biomedical Scientists’ Research Self-Efficacy

PubMed Central

Bakken, Lori L.; Byars-Winston, Angela; Gundermann, Dawn M.; Ward, Earlise C.; Slattery, Angela; King, Andrea; Scott, Denise; Taylor, Robert E.

2009-01-01

Women and people of color continue to be underrepresented among biomedical researchers to an alarming degree. Research interest and subsequent productivity have been shown to be affected by the research training environment through the mediating effects of research self-efficacy. This article presents the findings of a study to determine whether a short-term research training program coupled with an efficacy enhancing intervention for novice female biomedical scientists of diverse racial backgrounds would increase their research self-efficacy beliefs. Forty-three female biomedical scientists were randomized into a control or intervention group and 15 men participated as a control group. Research self-efficacy significantly increased for women who participated in the self-efficacy intervention workshop. Research self-efficacy within each group also significantly increased following the short-term research training program, but cross-group comparisons were not significant. These findings suggest that educational interventions that target sources of self-efficacy and provide domain-specific learning experiences are effective at increasing research self-efficacy for women and men. Further studies are needed to determine the longitudinal outcomes of this effort. PMID:19774477

Effects of Surface Roughness, Oxidation, and Temperature on the Emissivity of Reactor Pressure Vessel Alloys

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

King, J. L.; Jo, H.; Tirawat, R.

Thermal radiation will be an important mode of heat transfer in future high-temperature reactors and in off-normal high-temperature scenarios in present reactors. In this work, spectral directional emissivities of two reactor pressure vessel (RPV) candidate materials were measured at room temperature after exposure to high-temperature air. In the case of SA508 steel, significant increases in emissivity were observed due to oxidation. In the case of Grade 91 steel, only very small increases were observed under the tested conditions. Effects of roughness were also investigated. To study the effects of roughening, unexposed samples of SA508 and Grade 91 steel were roughenedmore » via one of either grinding or shot-peening before being measured. Significant increases were observed only in samples having roughness exceeding the roughness expected of RPV surfaces. While the emissivity increases for SA508 from oxidation were indeed significant, the measured emissivity coefficients were below that of values commonly used in heat transfer models. Based on the observed experimental data, recommendations for emissivity inputs for heat transfer simulations are provided.« less

Effectiveness of the Lunch is in the Bag program on communication between the parent, child and child-care provider around fruits, vegetables and whole grain foods: a group-randomized controlled trial

PubMed Central

Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cindy; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M.

2015-01-01

Objective To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). Method A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011–2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at p<0.05. Results At baseline, parent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β = 0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β = 0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Conclusion Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. PMID:26190371

A quality improvement program in pediatric practices to increase tailored injury prevention counseling and assess self-reported changes made by families.

PubMed

Gittelman, Michael A; Carle, Adam C; Denny, Sarah; Anzeljc, Samantha; Arnold, Melissa Wervey

2018-04-10

Many pediatric providers struggle to screen families for the majority of age-appropriate injury risks and educate them when appropriate. Standardized tools have helped physicians provide effective, more purposeful counseling. In this study, pediatricians utilized a standardized, injury prevention screening tool to increase targeted discussions and families were re-screened at subsequent visits to determine changes in their behavior. Pediatric practices, recruited from the Ohio Chapter, American Academy of Pediatrics database, self-selected to participate in a quality improvement program. Two screening tools, for children birth-4 month and 6-12 month, with corresponding talking points, were to be implemented into every well child visit. During the 7-month collaborative, screening results and pediatrician counseling for reported unsafe behaviors were calculated. Patients who completed a screening tool at subsequent visits were followed up at a later visit to determine self-reported behavior changes. We examined statistically significant differences in frequencies using the X 2 test. Providers received maintenance of certification IV credit for participation. Seven practices (39 providers) participated. By the second month, participating providers discussed 75% of all inappropriate responses for birth-4 month screenings and 87% for 6-12 months. Of the 386 families who received specific counseling and had a follow-up visit, 65% (n = 94/144) of birth-4 month and 65% (n = 59/91) of 6-12 month families made at least one behavior change. The X 2 test showed that families who received counseling versus those that did not were significantly more likely to change inappropriate behaviors (p < 0.05). Overall, of all the risks identified, 45% (136) of birth-4 month and 42% (91) of 6-12 month behaviors reportedly changed after a practitioner addressed the topic area. Participation in a quality improvement program within pediatric offices can increase screening for injury risks and encourage tailored injury prevention discussions during an office encounter. As a result, significantly more families reported to practice safer behaviors at later visits.

The Effectiveness of Health Education on Maternal Anxiety, Circumcision Knowledge, and Nursing Hours: A Quasi-Experimental Study.

PubMed

Chang, Shu-Fang; Hung, Chich-Hsiu; Hsu, Yu-Yun; Liu, Yi; Wang, Tsu-Nai

2017-08-01

Many studies have shown that providing health education before surgery may significantly increase health knowledge and decrease anxiety in both patients and their family members. However, few studies have compared the effects on pediatric outpatient surgery outcomes of different health education instruction modes. This study compares the effects of two health education delivery modes on maternal knowledge and anxiety, the number of unexpected early hospital follow-up visits, and the time spent by nurses on health education. A quasi-experimental design with pretest and posttest was used to compare the effect on the outcomes of pediatric circumcision of a multimedia compact disc (CD) and a printed material.Seventy mothers of children who underwent Plastibell circumcision participated in this study. Both the printed material and the multimedia CD significantly increased the knowledge and reduced the anxiety levels of the participants. However, no significant differences in unscheduled early hospital follow-up visits postsurgery were found between the two modes of instruction. Furthermore, we found that significantly fewer hours were spent by nurses on health education for the multimedia CD group in comparison with the printed material group. In the current clinical environment of common staffing shortages, information tools may be used to cost-effectively assist and simplify nursing work. The findings of this study may provide a reference to medical centers that are working to reduce the time spent by nurses on health education for outpatient surgery patients. Furthermore, audiovisual health education tools are recommended to increase nursing effectiveness and save nursing time.

Emergency Department Expansion Versus Patient Flow Improvement: Impact on Patient Experience of Care.

PubMed

Sayah, Assaad; Lai-Becker, Melisa; Kingsley-Rocker, Lisa; Scott-Long, Tasha; O'Connor, Kelly; Lobon, Luis F

2016-02-01

Most strategies used to help improve the patient experience of care and ease emergency department (ED) crowding and diversion require additional space and personnel resources, major process improvement interventions, or a combination of both. To compare the impact of ED expansion vs. patient flow improvement and the establishment of a rapid assessment unit (RAU) on the patient experience of care in a medium-size safety net ED. This paper describes a study of a single ED wherein the department first undertook a physical expansion (2006 Q2 to 2007 Q2) followed by a reorganization of patient flow and establishment of an RAU (2009 Q2) by the use of an interrupted time series analysis. In the time period after ED expansion, significant negative trends were observed: decreasing Press Ganey percentiles (-4.1 percentile per quarter), increasing door-to-provider time (+4.9 minutes per quarter), increasing duration of stay (+13.2 minutes per quarter), and increasing percent of patients leaving without being seen (+0.11 per quarter). After the RAU was established, significant immediate impacts were observed for door-to-provider time (-25.8 minutes) and total duration of stay (-66.8 minutes). The trends for these indicators further suggested the improvements continued to be significant over time. Furthermore, the negative trends for the Press Ganey outcomes observed after ED expansion were significantly reversed and in the positive direction after the RAU. Our results demonstrate that the impact of process improvement and rapid assessment implementation is far greater than the impact of renovation and facility expansion. Copyright © 2016 Elsevier Inc. All rights reserved.

Nitrosative Stress and Nitrated Proteins in Trichloroethene-Mediated Autoimmunity

PubMed Central

Wang, Gangduo; Wang, Jianling; Luo, Xuemei; Ansari, G. A. Shakeel; Khan, M. Firoze

2014-01-01

Exposure to trichloroethene (TCE), a ubiquitous environmental contaminant, has been linked to a variety of autoimmune diseases (ADs) including SLE, scleroderma and hepatitis. Mechanisms involved in the pathogenesis of ADs are largely unknown. Earlier studies from our laboratory in MRL+/+ mice suggested the contribution of oxidative/nitrosative stress in TCE-induced autoimmunity, and N-acetylcysteine (NAC) supplementation provided protection by attenuating oxidative stress. This study was undertaken to further evaluate the contribution of nitrosative stress in TCE-mediated autoimmunity and to identify proteins susceptible to nitrosative stress. Groups of female MRL +/+ mice were given TCE, NAC or TCE + NAC for 6 weeks (TCE, 10 mmol/kg, i.p., every 4th day; NAC, ∼250 mg/kg/day via drinking water). TCE exposure led to significant increases in serum anti-nuclear and anti-histone antibodies together with significant induction of iNOS and increased formation of nitrotyrosine (NT) in sera and livers. Proteomic analysis identified 14 additional nitrated proteins in the livers of TCE-treated mice. Furthermore, TCE exposure led to decreased GSH levels and increased activation of NF-κB. Remarkably, NAC supplementation not only ameliorated TCE-induced nitrosative stress as evident from decreased iNOS, NT, nitrated proteins, NF-κB p65 activation and increased GSH levels, but also the markers of autoimmunity, as evident from decreased levels of autoantibodies in the sera. These findings provide support to the role of nitrosative stress in TCE-mediated autoimmune response and identify specific nitrated proteins which could have autoimmune potential. Attenuation of TCE-induced autoimmunity in mice by NAC provides an approach for designing therapeutic strategies. PMID:24892995

Fixed Access Network Sharing

NASA Astrophysics Data System (ADS)

Cornaglia, Bruno; Young, Gavin; Marchetta, Antonio

2015-12-01

Fixed broadband network deployments are moving inexorably to the use of Next Generation Access (NGA) technologies and architectures. These NGA deployments involve building fiber infrastructure increasingly closer to the customer in order to increase the proportion of fiber on the customer's access connection (Fibre-To-The-Home/Building/Door/Cabinet… i.e. FTTx). This increases the speed of services that can be sold and will be increasingly required to meet the demands of new generations of video services as we evolve from HDTV to "Ultra-HD TV" with 4k and 8k lines of video resolution. However, building fiber access networks is a costly endeavor. It requires significant capital in order to cover any significant geographic coverage. Hence many companies are forming partnerships and joint-ventures in order to share the NGA network construction costs. One form of such a partnership involves two companies agreeing to each build to cover a certain geographic area and then "cross-selling" NGA products to each other in order to access customers within their partner's footprint (NGA coverage area). This is tantamount to a bi-lateral wholesale partnership. The concept of Fixed Access Network Sharing (FANS) is to address the possibility of sharing infrastructure with a high degree of flexibility for all network operators involved. By providing greater configuration control over the NGA network infrastructure, the service provider has a greater ability to define the network and hence to define their product capabilities at the active layer. This gives the service provider partners greater product development autonomy plus the ability to differentiate from each other at the active network layer.

Guidelines and mHealth to Improve Quality of Hypertension and Type 2 Diabetes Care for Vulnerable Populations in Lebanon: Longitudinal Cohort Study

PubMed Central

Paik, Kenneth E; Hei Tam, Hok; Fahed, Zeina; Winkler, Eric; Kontunen, Kaisa; Mkanna, Abdalla; Burnham, Gilbert

2017-01-01

Background Given the protracted nature of the crisis in Syria, the large noncommunicable disease (NCD) caseload of Syrian refugees and host Lebanese, and the high costs of providing NCD care, the implications for Lebanon’s health system are vast. Objective The aim of this study was to evaluate the effectiveness of treatment guidelines and a mobile health (mHealth) app on quality of care and health outcomes in primary care settings in Lebanon. Methods A longitudinal cohort study was implemented from January 2015 to August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth app on quality of care and health outcomes for Syrian and Lebanese patients in Lebanese primary health care (PHC) facilities. Results Compared with baseline record extraction, recording of blood pressure (BP) readings (−11.4%, P<.001) and blood sugar measurements (−6.9%, P=.03) significantly decreased following the implementation of treatment guidelines. Recording of BP readings also decreased after the mHealth phase as compared with baseline (−8.4%, P=.001); however, recording of body mass index (BMI) reporting increased at the end of the mHealth phase from baseline (8.1%, P<.001) and the guidelines phase (7.7%, P<.001). There were a great proportion of patients for whom blood sugar, BP, weight, height, and BMI were recorded using the tablet compared with in paper records; however, only differences in BMI were statistically significant (31.6% higher in app data as compared with paper records; P<.001). Data extracted from the mHealth app showed that a higher proportion of providers offered lifestyle counseling compared with the counseling reported in patients’ paper records (health diet counseling; 77.3% in app data vs 8.8% in paper records, P<.001 and physical activity counseling and 59.7% in app vs 7.1% in paper records, P<.001). There were statistically significant increases in all four measures of patient-provider interaction across study phases. Provider inquiry of medical history increased by 16.6% from baseline following guideline implementation and by 28.2% from baseline to mHealth implementation (P<.001). From baseline, patient report of provider inquiry regarding medication complications increased in the guidelines and mHealth phases by 12.9% and 59.6%, respectively, (P<.001). The proportion of patients reporting that providers asked other questions relevant to their illness increased from baseline through guidelines implementation by 27.8% and to mHealth implementation by 66.3% (P<.001). Follow-up scheduling increased from baseline to the guidelines phase by 20.6% and the mHealth phase by 39.8% (P<.001). Conclusions Results from this study of an mHealth app in 10 PHC facilities in Lebanon indicate that the app has potential to improve adherence to guidelines and quality of care. Further studies are necessary to determine the effects of patient-controlled health record apps on provider adherence to treatment guidelines, as well as patients’ long-term medication and treatment adherence and disease control. PMID:29046266

Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.

PubMed

Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami

2018-03-01

The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education-providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. A large discrepancy was found between GHSF nurses' practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident's preferences concerning EOL care.

Human engineering and habitability: the critical challenges for the International Space Station.

PubMed

Novak, J B

2000-09-01

As the duration of spaceflight increases, the impact of habitability on mission success becomes significant. Habitability is based on the qualities and capabilities of an environment that enable people to work and live. Poor habitability can impact productivity, safety, well-being, and performance. The International Space Station (ISS) Operational Habitability Project has been established to address the increased role of habitability for ISS. The primary objective of the project is to establish a pool of data from which opinions and decisions for judging and improving habitability on ISS will be generated. The main activities of the project are to: 1) collect and interpret data related to habitability on ISS; 2) identify Operational Habitability Lessons Learned; and 3) provide data summaries, judgments, and recommendations for the improvement of habitability. As an example, the ISS Operational Habitability Project has provided significant inputs to a current ISS issue regarding stowage. In this situation, a lack of prioritization on habitability resulted in a less than ideal situation. Operational Habitability data from previous missions was identified and summarized to provide inputs to assist in working the issues toward a resolution that supports habitability on ISS.

Report on Technology Horizons: A Vision for Air Force Science and Technology During 2010-2030. Volume 1

DTIC Science & Technology

2010-05-15

flow and decision processes across the air and space domains. It thus comprises traditional wired and fiber-optic computer networks based on...dual flow path design allow high volumetric efficiency, and high cruise speed provides significantly increased survivability. Vertical takeoff...emerging “third-stream engine architectures” can enable for constant mass flow engines that can provide further reductions in fuel consumption. A wide

Investigating the Nature of and Methods for Managing Metroplex Operations

NASA Technical Reports Server (NTRS)

Atkins, Stephen; Capozzi, Brian; Hinkey, Jim; Idris, Husni; Kaiser, Kent

2011-01-01

A combination of traffic demand growth, Next Generation Air Transportation System (NextGen) technologies and operational concepts, and increased utilization of regional airports is expected to increase the occurrence and severity of coupling between operations at proximate airports. These metroplex phenomena constrain the efficiency and/or capacity of airport operations and, in NextGen, have the potential to reduce safety and prevent environmental benefits. Without understanding the nature of metroplexes and developing solutions that provide efficient coordination of operations between closely-spaced airports, the use of NextGen technologies and distribution of demand to regional airports may provide little increase in the overall metroplex capacity. However, the characteristics and control of metroplex operations have not received significant study. This project advanced the state of knowledge about metroplexes by completing three objectives: 1. developed a foundational understand of the nature of metroplexes; 2. provided a framework for discussing metroplexes; 3. suggested and studied an approach for optimally managing metroplexes that is consistent with other NextGen concepts

Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi clinic, Namibia: A descriptive survey.

PubMed

Bikinesi, Leonard T; Mash, Robert; Joyner, Kate

2017-12-06

Intimate partner violence (IPV) is a significant and largely hidden public health problem for all women and, during pregnancy, can have significant effects on the health of both mother and the unborn baby. Previous Namibian studies suggest rates of IPV as high as 36%, although few studies have been conducted in primary care. To determine the prevalence of IPV amongst women attending antenatal care. Outapi primary care clinic, Namibia. A descriptive survey administering a validated questionnaire to 386 consecutive participants. The mean age of the participants was 27.5 years (standard deviation = 6.8), 335 (86.8%) were unmarried, 215 (55.7%) had only primary school education and 237 (61.4%) were in their third trimester. Overall, 51 participants (13.2%) had HIV and 44 (11.4%) had teenage pregnancies. The reported lifetime prevalence of IPV was 39 (10.1%), the 12-month prevalence was 35 (9.1%) and the prevalence during pregnancy was 31 (8.0%). Emotional abuse was the commonest type of abuse in 27 (7.0%). The commonest specific abusive behaviour was refusing to provide money to run the house or look after the children whilst the partner spent money on his priorities (4.9%). Increased maternal age was associated with an increase in the occurrence of IPV. The reported lifetime prevalence of IPV was 10.1%, with emotional abuse being the commonest type of abuse. Increased age was associated with an increase in reported IPV. IPV is significant enough to warrant that healthcare providers develop guidelines to assist women affected by IPV in Namibia.

Students’ Use of Optional Online Reviews and Its Relationship to Summative Assessment Outcomes in Introductory Biology

PubMed Central

Carpenter, Shana K.; Rahman, Shuhebur; Lund, Terry J. S.; Armstrong, Patrick I.; Lamm, Monica H.; Reason, Robert D.; Coffman, Clark R.

2017-01-01

Retrieval practice has been shown to produce significant enhancements in student learning of course information, but the extent to which students make use of retrieval to learn information on their own is unclear. In the current study, students in a large introductory biology course were provided with optional online review questions that could be accessed as Test questions (requiring students to answer the questions before receiving feedback) or as Read questions (providing students with the question and correct answer up-front). Students more often chose to access the questions as Test compared with Read, and students who used the Test questions scored significantly higher on subsequent exams compared with students who used Read questions or did not access the questions at all. Following an in-class presentation of superior exam performance following use of the Test questions, student use of Test questions increased significantly for the remainder of the term. These results suggest that practice questions can be an effective tool for enhancing student achievement in biology and that informing students about performance-based outcomes coincides with increased use of retrieval practice. PMID:28408408

Quantifying uncertainty of remotely sensed topographic surveys for ephemeral gully channel monitoring

USDA-ARS?s Scientific Manuscript database

Spatio-temporal measurements of landform evolution provide the basis for process-based theory formulation and validation. Overtime, field measurement of landforms has increased significantly worldwide, driven primarily by the availability of new surveying technologies. However, there is not a standa...

Microcomputers in Library Automation.

ERIC Educational Resources Information Center

Simpson, George A.

As librarians cope with reduced budgets, decreased staff, and increased demands for services, microcomputers will take a significant role in library automation by providing low-cost systems, solving specific library problems, and performing in distributed systems. This report presents an introduction to the technology of this low-cost, miniature…

Quantifying tetracycline resistance genes in swine waste anaerobic digester over a period of 100 days

USDA-ARS?s Scientific Manuscript database

Unregulated use of growth promoting antibiotics like Tetracyclines in agricultural feeds is becoming an increasing problem in antibiotic resistance. Undigested antibiotics leads to significant concentrations in livestock waste. These concentrations provide continuous selection pressure for the devel...

Teacher Stress: Issues and Intervention.

ERIC Educational Resources Information Center

Jenkins, Susan; Calhoun, James F.

1991-01-01

Examined methods of assisting public school teachers with managing stress by assigning 124 female teachers to either individualized training method or global approach training method. Individual training participants did significantly increase time spent on managing stress. Results also provided data on types of stress experienced, sources of…

School-Based Practices for Asperger Syndrome: A Canadian Perspective

ERIC Educational Resources Information Center

McCrimmon, Adam W.; Altomare, Alyssa A.; Matchullis, Ryan L.; Jitlina, Katia

2012-01-01

Educators face increasing demands to provide quality education in their classrooms, particularly to students with exceptional needs. Students with Asperger syndrome (AS) represent a population experiencing significant nonacademic barriers to learning (e.g., social, emotional, and behavioural needs). However, educational policies that identify and…

Measuring user acceptance of and willingness-to-pay for CVI technology : final research report.

DOT National Transportation Integrated Search

2016-09-30

The increased prevalence of Connected Vehicles (CVs) is expected to provide significant safety : benefits to roadway users. Estimates indicate that the use of CVs will reduce non-impaired driver : crashes by 80 percent. To ensure that the full benefi...

To Be Continued...

ERIC Educational Resources Information Center

Poliniak, Susan

2010-01-01

Professional growth, like personal growth, comes only through an investment of effort, but it can provide significant returns. Music educators--indeed, most serious musicians--are naturally curious and intensely interested in opportunities for continuing education. If music educators are looking for ways to increase the level of knowledge they…

Internationalizing Teacher Education in the United States

ERIC Educational Resources Information Center

Shaklee, Beverly D., Ed.; Baily, Supriya, Ed.

2012-01-01

As countries become increasingly interdependent, student populations in the United States are becoming more culturally diverse. These students' transnational perspectives present significant challenges to teachers, but a disconnect exists between the skills teachers need and those provided to them by colleges of education. As teacher preparation…

Cadmium stress alters the redox reaction and hormone balance in oilseed rape (Brassica napus L.) leaves.

PubMed

Yan, Hui; Filardo, Fiona; Hu, Xiaotao; Zhao, Xiaomin; Fu, DongHui

2016-02-01

In order to understand the physiological response of oilseed rape (Brassica napus L.) leaves to cadmium (Cd) stress and exploit the physiological mechanisms involved in Cd tolerance, macro-mineral and chlorophyll concentrations, reactive oxygen species (ROS) accumulation, activities of enzymatic antioxidants, nonenzymatic compounds metabolism, endogenous hormonal changes, and balance in leaves of oilseed rape exposed to 0, 100, or 200 μM CdSO4 were investigated. The results showed that under Cd exposure, Cd concentrations in the leaves continually increased while macro-minerals and chlorophyll concentrations decreased significantly. Meanwhile, with increased Cd stress, superoxide anion (O2(• -)) production rate and hydrogen peroxide (H2O2) concentrations in the leaves increased significantly, which caused malondialdehyde (MDA) accumulation and oxidative stress. For scavenging excess accumulated ROS and alleviating oxidative injury in the leaves, the activity of enzymatic antioxidants, such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT), was increased significantly at certain stress levels. However, with increased Cd stress, the antioxidant enzyme activities all showed a trend towards reduction. The nonenzymatic antioxidative compounds, such as proline and total soluble sugars, accumulated continuously with increased Cd stress to play a long-term role in scavenging ROS. In addition, ABA levels also increased continuously with Cd stress while ZR decreased and the ABA/ZR ratio increased, which might also be providing a protective role against Cd toxicity.

Expanded interleaved solid-state memory for a wide bandwidth transient waveform recorder

NASA Technical Reports Server (NTRS)

Thomas, R. M., Jr.

1980-01-01

An interleaved, solid state expanded memory for a 100 MHz bandwidth waveform recorder is described. The memory development resulted in a significant increase in the storage capacity of a commercially available recorder. The motivation for the memory expansion of the waveform recorder, which is used to support in-flight measurement of the electromagnetic characteristics of lightning discharges, was the need for a significantly longer data window than that provided by the commercially available unit. The expanded recorder provides a data window that is 128 times longer than the commercial unit, while maintaining the same time resolution, by increasing the storage capacity from 1024 to 131 072 data samples. The expanded unit operates at sample periods as small as 10 ns. Sampling once every 10 ns, the commercial unit records for about 10 microseconds before the memory is filled, whereas, the expanded unit records for about 1300 microseconds. A photo of the expanded waveform recorder is shown.

Use of Advanced Solar Cells for Commercial Communication Satellites

NASA Technical Reports Server (NTRS)

Bailey, Sheila G.; Landis, Geoffrey A.

1995-01-01

The current generation of communications satellites are located primarily in geosynchronous Earth orbit (GEO). Over the next decade, however, a new generation of communications satellites will be built and launched, designed to provide a world-wide interconnection of portable telephones. For this mission, the satellites must be positioned in lower polar and near-polar orbits. To provide complete coverage, large numbers of satellites will be required. Because the required number of satellites decreases as the orbital altitude is increased, fewer satellites would be required if the orbit chosen were raised from low to intermediate orbit. However, in intermediate orbits, satellites encounter significant radiation due to trapped electrons and protons. Radiation tolerant solar cells may be necessary to make such satellites feasible. We analyze the amount of radiation encountered in low and intermediate polar orbits at altitudes of interest to next-generation communication satellites, calculate the expected degradation for silicon, GaAs, and InP solar cells, and show that the lifetimes can be significantly increased by use of advanced solar cells.

Use of advanced solar cells for commerical communication satellites

NASA Astrophysics Data System (ADS)

Landis, Geoffrey A.; Bailey, Sheila G.

1995-01-01

The current generation of communications satellites are located primarily in geosynchronous Earth orbit (GEO). Over the next decade, however, a new generation of communications satellites will be built and launched, designed to provide a world-wide interconnection of portable telephones. For this mission, the satellites must be positioned in lower polar- and near-polar orbits. To provide complete coverage, large numbers of satellites will be required. Because of the required number of satellites decreases as the orbital altitude is increased, fewer satellites would be required if the orbit chosen were raised from Low to intermediate orbit. However, in intermediate orbits, satellites encounter significant radiation due to trapped electrons and protons. Radiation tolerant solar cells may be necessary to make such satellites feasible. We analyze the amount of radiation encountered in low and intermediate polar orbits at altitudes of interest to next-generation communication satellites, calculate the expected degradation for silicon, GaAs, and InP solar cells, and show that the lifetimes can be significantly increased by use of advanced solar cells.

Use of advanced solar cells for commercial communication satellites

NASA Astrophysics Data System (ADS)

Bailey, Sheila G.; Landis, Geoffrey A.

1995-03-01

The current generation of communications satellites are located primarily in geosynchronous Earth orbit (GEO). Over the next decade, however, a new generation of communications satellites will be built and launched, designed to provide a world-wide interconnection of portable telephones. For this mission, the satellites must be positioned in lower polar and near-polar orbits. To provide complete coverage, large numbers of satellites will be required. Because the required number of satellites decreases as the orbital altitude is increased, fewer satellites would be required if the orbit chosen were raised from low to intermediate orbit. However, in intermediate orbits, satellites encounter significant radiation due to trapped electrons and protons. Radiation tolerant solar cells may be necessary to make such satellites feasible. We analyze the amount of radiation encountered in low and intermediate polar orbits at altitudes of interest to next-generation communication satellites, calculate the expected degradation for silicon, GaAs, and InP solar cells, and show that the lifetimes can be significantly increased by use of advanced solar cells.

Parasite infection accelerates age polyethism in young honey bees

PubMed Central

Lecocq, Antoine; Jensen, Annette Bruun; Kryger, Per; Nieh, James C.

2016-01-01

Honey bees (Apis mellifera) are important pollinators and their health is threatened worldwide by persistent exposure to a wide range of factors including pesticides, poor nutrition, and pathogens. Nosema ceranae is a ubiquitous microsporidian associated with high colony mortality. We used lab micro-colonies of honey bees and video analyses to track the effects of N. ceranae infection and exposure on a range of individual and social behaviours in young adult bees. We provide detailed data showing that N. ceranae infection significantly accelerated the age polyethism of young bees, causing them to exhibit behaviours typical of older bees. Bees with high N. ceranae spore counts had significantly increased walking rates and decreased attraction to queen mandibular pheromone. Infected bees also exhibited higher rates of trophallaxis (food exchange), potentially reflecting parasite manipulation to increase colony infection. However, reduction in queen contacts could help bees limit the spread of infection. Such accelerated age polyethism may provide a form of behavioural immunity, particularly if it is elicited by a wide variety of pathogens. PMID:26912310

Parasite infection accelerates age polyethism in young honey bees.

PubMed

Lecocq, Antoine; Jensen, Annette Bruun; Kryger, Per; Nieh, James C

2016-02-25

Honey bees (Apis mellifera) are important pollinators and their health is threatened worldwide by persistent exposure to a wide range of factors including pesticides, poor nutrition, and pathogens. Nosema ceranae is a ubiquitous microsporidian associated with high colony mortality. We used lab micro-colonies of honey bees and video analyses to track the effects of N. ceranae infection and exposure on a range of individual and social behaviours in young adult bees. We provide detailed data showing that N. ceranae infection significantly accelerated the age polyethism of young bees, causing them to exhibit behaviours typical of older bees. Bees with high N. ceranae spore counts had significantly increased walking rates and decreased attraction to queen mandibular pheromone. Infected bees also exhibited higher rates of trophallaxis (food exchange), potentially reflecting parasite manipulation to increase colony infection. However, reduction in queen contacts could help bees limit the spread of infection. Such accelerated age polyethism may provide a form of behavioural immunity, particularly if it is elicited by a wide variety of pathogens.

Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior?

PubMed

Kisker, E E; Brown, R S

1996-05-01

The purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers. The outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status. The health centers increased students' access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant. School-based health centers can increase students' health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

Rapid control and feedback rates enhance neuroprosthetic control

PubMed Central

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms. PMID:28059065

Rapid control and feedback rates enhance neuroprosthetic control

NASA Astrophysics Data System (ADS)

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms.

Implementation of a Thick-Film Composite Li-Ion Microcathode Using Carbon Nanotubes as the Conductive Filler

NASA Technical Reports Server (NTRS)

Lin, Qian; Harb, John N.

2004-01-01

This paper describes the development of a thick-film microcathode for use in Li-ion microbatteries in order to provide increased power and energy per area. These cathodes take advantage of a composite porous electrode structure, utilizing carbon nanotubes (CNT) as the conductive filler. The use of carbon nanotubes was found to significantly reduce the measured resistance of the electrodes, increase active material accessibility, and improve electrode performance. In particular, the cycling and power performance of the thick-film cathodes was significantly improved, and the need for compression was eliminated. Cathode thickness and CNT content were optimized to maximize capacity and power performance. Power capability of >50 mW/sq cm (17 mA/sq cm) with discharge capacity of >0.17 mAh/sq cm was demonstrated. The feasibility of fabricating thick-film microcathodes capable of providing the power and capacity needed for use in autonomous microsensor systems was also demonstrated.

Infection control guidelines for prevention of health care-associated transmission of hepatitis B and C viruses.

PubMed

Michelin, Angela; Henderson, David K

2010-02-01

Viral hepatitis was first identified as an occupational hazard for health care workers more than 60 years ago. For the past few decades, hepatitis B has been one of the most significant occupational infectious risks for health care providers. With the increasing prevalence of hepatitis C infections around the world, occupational transmission of this flavivirus from infected patients to their providers has also become a significant concern. Several factors influence the risk for occupational blood-borne hepatitis infection among health care providers, among them: the prevalence of infection among the population served, the infection status of the patients to whom workers are exposed (ie, the source patient's circulating viral burden), the types and frequencies of parenteral and mucosal exposures to blood and blood-containing body fluids, and whether the patient or provider has been immunized with the hepatitis B vaccine. This article reviews patient-to-provider, patient-to-patient, and provider-to-patient transmission of hepatitis B and C in the health care setting. Current prevention strategies, precautions, and guidelines are discussed. (c) 2010. Published by Elsevier Inc.

The impact of increased weekend physiotherapy service provision in critical care: a mixed methods study.

PubMed

Duncan, Catharine; Hudson, Megan; Heck, Carol

2015-01-01

At the hospital studied, weekend physiotherapy (WEPT) is routinely provided and in 2013 WEPT was increased from one (PRE) to three (POST) physiotherapists (PTs) to cover intensive care and ward patients. (1) To evaluate the impact of increased WEPT on patient volumes, treatments provided and conditions treated in critical care and wards; and (2) to understand the PTs' perspectives on the new coverage model. A mixed methods design was utilized. The quantitative component consisted of retrospective document reviews of all weekend patients treated January 1-May 5 (PRE) and May 11-December 31 (POST). The qualitative component used a questionnaire to collect staff feedback. PRE-POST comparisons were conducted using χ(2) or Mann-Whitney U tests. Significant (p = 0.00) increases POST were seen in number of patients treated, number of mobility treatments provided and number of post-surgical patients seen in both clinical areas. The majority of survey respondents reported feeling adequately trained, but had concerns regarding the impact of increased WEPT on work-life balance. PTs perceived enhanced service was beneficial for continuity of weekday care and improved patient function. Future studies need to focus on measuring the effect of increased weekend provision on outcomes, preventing complications and length of stay.

Shock outcome prediction before and after CPR: a comparative study of manual and automated active compression-decompression CPR.

PubMed

Box, M S; Watson, J N; Addison, P S; Clegg, G R; Robertson, C E

2008-09-01

We report on a study designed to compare the relative efficacy of manual CPR (M-CPR) and automated mechanical CPR (ACD-CPR) provided by an active compression-decompression (ACD) device. The ECG signals of out-of-hospital cardiac arrest patients of cardiac aetiology were analysed just prior to, and immediately after, cardiopulmonary resuscitation (CPR) to assess the likelihood of successful defibrillation at these time points. The cardioversion outcome prediction (COP) measure previously developed by our group was used to quantify the probability of return of spontaneous circulation (ROSC) after counter-shock and was used as a measure of the efficacy of CPR. An initial validation study using COP to predict shock outcome from the patient data set resulted in a performance of 60% specificity achieved at 100% sensitivity on a blind test of the data. This is comparable with previous studies and provided confidence in the robustness of the technique across hardware platforms. Significantly, the COP marker also displayed an ability to stratify according to outcomes: asystole, ventricular fibrillation (VF), pulseless electrical activity (PEA), normal sinus rhythm (NSR). We then used the validated COP marker to analyse the ECG data record just prior to and immediately after the chest compression segments. This was initially performed for 87 CPR segments where VF was both the pre- and post-CPR waveform. An increase in the mean COP values was found for both CPR types. A signed rank sum test found the increase due to manual CPR not to be significant (p>0.05) whereas the automated CPR was found to be significant (p<0.05). This increase was larger for the automated CPR (1.26, p=0.024) than for the manual CPR (0.99, p=0.124). These results indicate that the application of CPR does indeed provide beneficial preparation of the heart prior to defibrillation therapy whether manual or automated CPR is applied. The COP marker shows promise as a definitive, quantitative determinant of the immediate positive effect of both types of CPR regardless of the details of use. In work of a more exploratory nature we then used the validated COP marker to analyse the ECG pre- and post-CPR for all rhythm types (212 traces). We show a significant increase in the COP measure (p<0.001 in both cases) as indicated by a shift in the median COP marker distribution values. This increase was more pronounced for automated ACD-CPR than for manual CPR. However, a detailed statistical analysis carried out between the groups adjusted for pre-CPR value showed no significant difference between the two methods of CPR (p=0.20). Similarly, adjusting for length of CPR showed no significant difference between the groups. Secondary, subgroup analysis of the ECG according to the length of time for which CPR was performed showed that both types of CPR led to an increase in the likelihood of successful defibrillation after increasing durations of CPR, however results were less reliable after longer periods of continuous CPR.

Automated detection of physiologic deterioration in hospitalized patients.

PubMed

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-03-01

Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Nurses reported the positive predictive value of alerts was 91-100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before-after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Awareness of symptoms and risk factors of ovarian cancer in a population of women and healthcare providers.

PubMed

Goldstein, Carol L; Susman, Ellen; Lockwood, Suzy; Medlin, Erin E; Behbakht, Kian

2015-04-01

Awareness of ovarian cancer among women and healthcare providers is understudied. An early awareness of ovarian cancer may lead to early detection and treatment of ovarian cancer. The purpose of this study was to determine the level of that awareness among a sample of women and providers. Written surveys were developed by the authors based on available literature and were administered to women (n = 857) and healthcare providers (n = 188) attending or volunteering at a community health fair. Chi-square tests for independence and z tests were used for analysis. Healthcare providers were significantly more likely to identify the symptoms and risk factors for ovarian cancer. Forty percent of women reported being at least slightly familiar with the symptoms of ovarian cancer. Women who were familiar with symptoms were significantly more likely to identify symptoms and risk factors correctly and to report symptoms immediately to a provider. Identification of symptoms among healthcare providers ranged from 59%-93%. Identification of ovarian cancer symptoms and risk factors is poor among women, and knowledge deficits are present in providers. Increasing familiarity and awareness could lead to improvements in early diagnosis.

Cost-benefit analysis of different air change rates in an operating room environment.

PubMed

Gormley, Thomas; Markel, Troy A; Jones, Howard; Greeley, Damon; Ostojic, John; Clarke, James H; Abkowitz, Mark; Wagner, Jennifer

2017-12-01

Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry. Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables. Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Capacity value assessments of wind power: Capacity value assessments of wind power

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

Milligan, Michael; Frew, Bethany; Ibanez, Eduardo

This article describes some of the recent research into the capacity value of wind power. With the worldwide increase in wind power during the past several years, there is increasing interest and significance regarding its capacity value because this has a direct influence on the amount of other (nonwind) capacity that is needed. We build on previous reviews from IEEE and IEA Wind Task 25a and examine recent work that evaluates the impact of multiple-year data sets and the impact of interconnected systems on resource adequacy. We also provide examples that explore the use of alternative reliability metrics for windmore » capacity value calculations. We show how multiple-year data sets significantly increase the robustness of results compared to single-year assessments. Assumptions regarding the transmission interconnections play a significant role. To date, results regarding which reliability metric to use for probabilistic capacity valuation show little sensitivity to the metric.« less

Topical treatment with coenzyme Q10-containing formulas improves skin's Q10 level and provides antioxidative effects.

PubMed

Knott, Anja; Achterberg, Volker; Smuda, Christoph; Mielke, Heiko; Sperling, Gabi; Dunckelmann, Katja; Vogelsang, Alexandra; Krüger, Andrea; Schwengler, Helge; Behtash, Mojgan; Kristof, Sonja; Diekmann, Heike; Eisenberg, Tanya; Berroth, Andreas; Hildebrand, Janosch; Siegner, Ralf; Winnefeld, Marc; Teuber, Frank; Fey, Sven; Möbius, Janne; Retzer, Dana; Burkhardt, Thorsten; Lüttke, Juliane; Blatt, Thomas

2015-01-01

Ubiquinone (coenzyme Q10, Q10) represents an endogenously synthesized lipid-soluble antioxidant which is crucial for cellular energy production but is diminished with age and under the influence of external stress factors in human skin. Here, it is shown that topical Q10 treatment is beneficial with regard to effective Q10 replenishment, augmentation of cellular energy metabolism, and antioxidant effects. Application of Q10-containing formulas significantly increased the levels of this quinone on the skin surface. In the deeper layers of the epidermis the ubiquinone level was significantly augmented indicating effective supplementation. Concurrent elevation of ubiquinol levels suggested metabolic transformation of ubiquinone resulting from increased energy metabolism. Incubation of cultured human keratinocytes with Q10 concentrations equivalent to treated skin showed a significant augmentation of energy metabolism. Moreover, the results demonstrated that stressed skin benefits from the topical Q10 treatment by reduction of free radicals and an increase in antioxidant capacity. © 2015 International Union of Biochemistry and Molecular Biology.

Caesarean section rate and cost control effectiveness of case payment reform in the new cooperative medical scheme for delivery: evidence from Xi County, China.

PubMed

Liu, Shuang; Wang, Jing; Zhang, Liang; Zhang, Xiang

2018-03-09

In China, increases in both the caesarean section (CS) rates and delivery costs have raised questions regarding the reform of the medical insurance payment system. Case payment is useful for regulating the behaviour of health providers and for controlling the CS rates and excessive increases in medical expenses. New Cooperative Medical Scheme (NCMS) agencies in Xi County in Henan Province piloted a case payment reform (CPR) in delivery for inpatients. We aimed to observe the changes in the CS rates, compare the changes in delivery-related variables, and identify variables related to delivery costs before and after the CPR in Xi County. Overall, 28,314 cases were selected from the Xi County NCMS agency from 2009 to 2010 and from 2014 to 2015. One-way ANOVA and chi-square tests were used to compare the distributions of CS and vaginal delivery (VD) before and after the CPR under different indicators. We applied multivariate linear regressions for the total medical cost of the VD and CS groups and total samples to identify the relationships between medical expenses and variables. The CS rates in Xi County increased from 26.1% to 32.5% after the CPR. The length of stay (LOS), total medical cost, and proportion of county hospitals increased in the CS and VD groups after the CPR, which had significant differences. The total medical cost in the CS and VD groups as well as the total samples was significantly influenced by inpatient age, LOS, and hospital type, and had a significant correlation with the CPR in the VD group and the total samples. The CPR might fail to control the growth of unreasonable medical expenses and regulate the behaviour of providers, which possibly resulted from the unreasonable compensation standard of case payments, prolonged LOS, and the increasing proportion of county hospitals. The NCMS should modify the case payment standard of delivery to inhibit providers' motivation to render CS services. The LOS should be controlled by implementing clinical guidelines, and a reference system should be established to guide patients in choosing reasonable hospitals.

Impact of Large Scale Energy Efficiency Programs On Consumer Tariffs and Utility Finances in India

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

Abhyankar, Nikit; Phadke, Amol

2011-01-20

Large-scale EE programs would modestly increase tariffs but reduce consumers' electricity bills significantly. However, the primary benefit of EE programs is a significant reduction in power shortages, which might make these programs politically acceptable even if tariffs increase. To increase political support, utilities could pursue programs that would result in minimal tariff increases. This can be achieved in four ways: (a) focus only on low-cost programs (such as replacing electric water heaters with gas water heaters); (b) sell power conserved through the EE program to the market at a price higher than the cost of peak power purchase; (c) focusmore » on programs where a partial utility subsidy of incremental capital cost might work and (d) increase the number of participant consumers by offering a basket of EE programs to fit all consumer subcategories and tariff tiers. Large scale EE programs can result in consistently negative cash flows and significantly erode the utility's overall profitability. In case the utility is facing shortages, the cash flow is very sensitive to the marginal tariff of the unmet demand. This will have an important bearing on the choice of EE programs in Indian states where low-paying rural and agricultural consumers form the majority of the unmet demand. These findings clearly call for a flexible, sustainable solution to the cash-flow management issue. One option is to include a mechanism like FAC in the utility incentive mechanism. Another sustainable solution might be to have the net program cost and revenue loss built into utility's revenue requirement and thus into consumer tariffs up front. However, the latter approach requires institutionalization of EE as a resource. The utility incentive mechanisms would be able to address the utility disincentive of forgone long-run return but have a minor impact on consumer benefits. Fundamentally, providing incentives for EE programs to make them comparable to supply-side investments is a way of moving the electricity sector toward a model focused on providing energy services rather than providing electricity.« less

Divergent Binding and Transactivation by Two Related Steroid Receptors at the Same Response Element*

PubMed Central

Tesikova, Martina; Dezitter, Xavier; Nenseth, Hatice Z.; Klokk, Tove I.; Mueller, Florian; Hager, Gordon L.; Saatcioglu, Fahri

2016-01-01

Transcription factor (TF) recruitment to chromatin is central to activation of transcription. TF-chromatin interactions are highly dynamic, which are evaluated by recovery half time (t1/2) in seconds, determined by fluorescence recovery experiments in living cells, and chromatin immunoprecipitation (ChIP) analysis, measured in minutes. These two states are related: the larger the t1/2, the longer the ChIP occupancy resulting in increased transcription. Here we present data showing that this relationship does not always hold. We found that histone deacetylase inhibitors (HDACis) significantly increased t1/2 of green fluorescent protein (GFP) fused androgen receptor (AR) on a tandem array of positive hormone response elements (HREs) in chromatin. This resulted in increased ChIP signal of GFP-AR. Unexpectedly, however, transcription was inhibited. In contrast, the GFP-fused glucocorticoid receptor (GR), acting through the same HREs, displayed a profile consistent with current models. We provide evidence that these differences are mediated, at least in part, by HDACs. Our results provide insight into TF action in living cells and show that very closely related TFs may trigger significantly divergent outcomes at the same REs. PMID:27056330

Disruptive staff interactions: a serious source of inter-provider conflict and stress in health care settings.

PubMed

Stecker, Mona; Stecker, Mark M

2014-07-01

This study sought to explore the prevalence of workplace stress, gender differences, and the relationship of workplace incivility to the experience of stress. Effects of stress on performance have been explored for many years. Work stress has been at the root of many physical and psychological problems and has even been linked to medical errors and suboptimal patient outcomes. In this study, 617 respondents completed a Provider Conflict Questionnaire (PCQ) as well as a ten-item stress survey. Work was the main stressor according to 78.2% of respondents. The stress index was moderately high, ranging between 10 and 48 (mean = 25.5). Females demonstrated a higher stress index. Disruptive behavior showed a significant positive correlation with increased stress. This study concludes that employees of institutions with less disruptive behavior exhibited lower stress levels. This finding is important in improving employee satisfaction and reducing medical errors. It is difficult to retain experienced nurses, and stress is a significant contributor to job dissatisfaction. Moreover, workplace conflict and its correlation to increased stress levels must be managed as a strategy to reduce medical errors and increase job satisfaction.

Reduced bone breakage and increased bone strength in free range laying hens fed omega-3 polyunsaturated fatty acid supplemented diets.

PubMed

Tarlton, John F; Wilkins, Lindsay J; Toscano, Michael J; Avery, Nick C; Knott, Lynda

2013-02-01

The omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) are the immediate precursors to a number of important mediators of immunity, inflammation and bone function, with products of omega-6 generally thought to promote inflammation and favour bone resorption. Western diets generally provide a 10 to 20-fold deficit in omega-3 PUFAs compared with omega-6, and this is thought to have contributed to the marked rise in incidence of disorders of modern human societies, such as heart disease, colitis and perhaps osteoporosis. Many of our food production animals, fed on grains rich in omega-6, are also exposed to a dietary deficit in omega-3, with perhaps similar health consequences. Bone fragility due to osteoporotic changes in laying hens is a major economic and welfare problem, with our recent estimates of breakage rates indicating up to 95% of free range hens suffer breaks during lay. Free range hens housed in full scale commercial systems were provided diets supplemented with omega-3 alpha linolenic acid, and the skeletal benefits were investigated by comparison to standard diets rich in omega-6. There was a significant 40-60% reduction in keel bone breakage rate, and a corresponding reduction in breakage severity in the omega-3 supplemented hens. There was significantly greater bone density and bone mineral content, alongside increases in total bone and trabecular volumes. The mechanical properties of the omega-3 supplemented hens were improved, with strength, energy to break and stiffness demonstrating significant increases. Alkaline phosphatase (an osteoblast marker) and tartrate-resistant acid phosphatase (an osteoclast marker) both showed significant increases with the omega-3 diets, indicating enhanced bone turnover. This was corroborated by the significantly lower levels of the mature collagen crosslinks, hydroxylysyl pyridinoline, lysyl pyridinoline and histidinohydroxy-lysinonorleucine, with a corresponding significant shift in the mature:immature crosslink ratio. The improved skeletal health in laying hens corresponds to as many as 68million fewer hens suffering keel fractures in the EU each year. The biomechanical and biochemical evidence suggests that increased bone turnover has enhanced the bone mechanical properties, and that this may suggest potential benefits for human osteoporosis. Copyright © 2012 Elsevier Inc. All rights reserved.

Benford analysis of quantum critical phenomena: First digit provides high finite-size scaling exponent while first two and further are not much better

NASA Astrophysics Data System (ADS)

Bera, Anindita; Mishra, Utkarsh; Singha Roy, Sudipto; Biswas, Anindya; Sen(De), Aditi; Sen, Ujjwal

2018-06-01

Benford's law is an empirical edict stating that the lower digits appear more often than higher ones as the first few significant digits in statistics of natural phenomena and mathematical tables. A marked proportion of such analyses is restricted to the first significant digit. We employ violation of Benford's law, up to the first four significant digits, for investigating magnetization and correlation data of paradigmatic quantum many-body systems to detect cooperative phenomena, focusing on the finite-size scaling exponents thereof. We find that for the transverse field quantum XY model, behavior of the very first significant digit of an observable, at an arbitrary point of the parameter space, is enough to capture the quantum phase transition in the model with a relatively high scaling exponent. A higher number of significant digits do not provide an appreciable further advantage, in particular, in terms of an increase in scaling exponents. Since the first significant digit of a physical quantity is relatively simple to obtain in experiments, the results have potential implications for laboratory observations in noisy environments.

Multiphoton microscopy, fluorescence lifetime imaging and optical spectroscopy for the diagnosis of neoplasia

NASA Astrophysics Data System (ADS)

Skala, Melissa Caroline

2007-12-01

Cancer morbidity and mortality is greatly reduced when the disease is diagnosed and treated early in its development. Tissue biopsies are the gold standard for cancer diagnosis, and an accurate diagnosis requires a biopsy from the malignant portion of an organ. Light, guided through a fiber optic probe, could be used to inspect regions of interest and provide real-time feedback to determine the optimal tissue site for biopsy. This approach could increase the diagnostic accuracy of current biopsy procedures. The studies in this thesis have characterized changes in tissue optical signals with carcinogenesis, increasing our understanding of the sensitivity of optical techniques for cancer detection. All in vivo studies were conducted on the dimethylbenz[alpha]anthracene treated hamster cheek pouch model of epithelial carcinogenesis. Multiphoton microscopy studies in the near infrared wavelength region quantified changes in tissue morphology and fluorescence with carcinogenesis in vivo. Statistically significant morphological changes with precancer included increased epithelial thickness, loss of stratification in the epithelium, and increased nuclear diameter. Fluorescence changes included a statistically significant decrease in the epithelial fluorescence intensity per voxel at 780 nm excitation, a decrease in the fluorescence lifetime of protein-bound nicotinamide adenine dinucleotide (NADH, an electron donor in oxidative phosphorylation), and an increase in the fluorescence lifetime of protein-bound flavin adenine dinucleotide (FAD, an electron acceptor in oxidative phosphorylation) with precancer. The redox ratio (fluorescence intensity of FAD/NADH, a measure of the cellular oxidation-reduction state) did not significantly change with precancer. Cell culture experiments (MCF10A cells) indicated that the decrease in protein-bound NADH with precancer could be due to increased levels of glycolysis. Point measurements of diffuse reflectance and fluorescence spectra in the ultraviolet to visible wavelength range indicated that the most diagnostic optical signals originate from sub-surface tissue layers. Optical properties extracted from these spectroscopy measurements showed a significant decrease in the hemoglobin saturation, absorption coefficient, reduced scattering coefficient and fluorescence intensity (at 400 nm excitation) in neoplastic compared to normal tissues. The results from these studies indicate that multiphoton microscopy and optical spectroscopy can non-invasively provide information on tissue structure and function in vivo that is related to tissue pathology.

A demographic survey of unwanted horses in Ireland 2005-2010

PubMed Central

2012-01-01

Background The Irish Horse Industry expanded during the Celtic Tiger boom years, then contracted in the current economic recession. High value horses were traditionally controlled through sale at public auction, private sales and sales to dealers; these are now also being reduced by decreases in production (> 40%), and increases in retirement, re-homing, euthanasia and disposal through Category 2 plants and abattoirs. The absence or banning of horse abattoirs has been shown to have very significant welfare social and economic consequences in the USA. This study described the currently available data on the demographics of unwanted horses in Ireland from 2005 to 2010. Results The majority of horses euthanised by practicing veterinarians are destroyed on medical grounds but the number euthanised at the request of welfare groups and the state, as well as welfare related calls and the number of horses involved in these calls and subsequent visits is increasing reflecting the increasing involvement of the veterinary profession in equine welfare. Welfare groups have limited resources and do not have a tradition of recording data, but they too have reported increasing calls, visits and numbers of horses per visit. Welfare groups provide significant service to equine welfare and the community. Local Authorities report similar trends. Over 300 horses were found dead or required immediate or subsequent euthanasia following welfare group and local authority visits in 2010, which is of national concern. The majority of local authority interfaces with unwanted horses are with urban (60%) rather than rural (40%) horses. Mortality figures are poor indicators of non-fatal neglect. More horses were admitted into the care of local authorities than welfare groups, reflecting significant state and taxpayer investment in the control of low value horses. Category 2 plants and abattoirs represent a significant state investment in licensing and control in the national interest. Abattoirs provide an increasingly important and essential service for the disposal of unwanted horses. Despite the increase in unwanted horses, Ireland is a minority contributor to the EU slaughter total. Conclusions There is a need for annual demographic data compilation and review of the numbers of unwanted horses and ponies within the horse industry to assist policy makers and legislators. PMID:22385906

Improving eating disorders mental health literacy: a preliminary evaluation of the "Should I say something?" workshop.

PubMed

Gratwick-Sarll, Kassandra; Bentley, Caroline

2014-01-01

A repeated measures, uncontrolled, preliminary evaluation of a single 3-hour workshop-"Should I Say Something?"-aimed at improving eating disorders mental health literacy, was conducted in a sample of 177 university undergraduates. Following participation in the workshop, significant increases in eating disorder recognition and knowledge, and significant decreases in stigmatizing attitudes, were reported by participants. Moreover, 85% of participants reported that they provided assistance to someone whom they suspected had a mental health condition, including an eating disorder, during the 3-month follow-up period. This study provides preliminary evidence that "Should I Say Something?" may be effective in improving the mental health literacy of young people.

Acculturation and dietary change among Chinese immigrant women in the United States

PubMed Central

Tseng, Marilyn; Wright, David J.; Fang, Carolyn Y

2014-01-01

Background US Chinese immigrants undergo a transition to increased chronic disease risk commonly attributed to acculturative and dietary changes. Longitudinal data to confirm this are lacking. Methods We examined acculturation and diet over time in 312 Chinese immigrant women in Philadelphia, recruited October 2005 to April 2008 and followed with interviews and dietary recalls until April 2010. Associations were modeled using generalized estimating equations to account for repeated measures over time. Results Increasing length of US residence was associated with a small (~1%/year) but significant increase in acculturation score (p<0.0001), which in turn was significantly associated with increased energy density of the diet, percent of energy from fat, and sugar intake, and lower dietary moderation score. Discussion These findings provide longitudinal evidence that acculturation increases with length of US residence and is accompanied by dietary changes. However, the changes were small enough that their health impact is unclear. Factors besides acculturation that affect immigrant health and that affect the acculturation trajectory itself warrant investigation. PMID:25281323

FY2015 Energy Storage R&D Annual Progress Report

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

None, None

The Energy Storage research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush.

Updated epidemiological study of workers at two California petroleum refineries, 1950–95

PubMed Central

Satin, K; Bailey, W; Newton, K; Ross, A; Wong, O

2002-01-01

Objectives: To further assess the potential role of occupational exposures on mortality, a second update of a cohort study of workers at two petroleum refineries in California was undertaken. Methods: Mortality analyses were based on standardised mortality ratios (SMRs) and 95% confidence intervals (95% CIs) using the general population of California as a reference. Additional analyses of lymphatic and haematopoietic cancer deaths and diseases related to asbestos were undertaken. Results: The update consisted of 18 512 employees, who contributed 456 425 person-years of observation between 1950 and 1995. Both overall mortality and total cancer mortality were significantly lower than expected, as were several site specific cancers and non-malignant diseases. In particular, no significant increases were reported for leukaemia cell types or non-Hodgkin's lymphoma. Mortality excess from multiple myeloma was marginally significant. The excess was confined to employees enrolled before 1949. Furthermore, there was no significant upward trend based on duration of employment, which argues against a causal interpretation relative to employment or exposures at the refineries. No increase was found for diseases related to asbestos: pulmonary fibrosis; lung cancer; or malignant mesothelioma. There was no significant increase in mortality from any other cancers or non-malignant diseases. Conclusion: This second update provides additional reassurance that employment at these two refineries is not associated with increased risk of mortality. PMID:11934952

The influence of a low air pressure environment on human metabolic rate during short-term (< 2 h) exposures.

PubMed

Cui, W; Wang, H; Wu, T; Ouyang, Q; Hu, S; Zhu, Y

2017-03-01

Passengers in aircraft cabins are exposed to low-pressure environments. One of the missing links in the research on thermal comfort under cabin conditions is the influence of low air pressure on the metabolic rate. In this research, we simulated the cabin pressure regime in a chamber in which the pressure level could be controlled. Three pressure levels (101/85/70 kPa) were tested to investigate how metabolic rate changed at different pressure levels. The results show that as pressure decreased, the respiratory flow rate (RFR) at standard condition (STPD: 0°C, 101 kPa) significantly decreased. Yet the oxygen (O 2 ) consumption and carbon dioxide (CO 2 ) production significantly increased, as reflected in the larger concentration difference between inhaled and exhaled air. A significant increase in the respiratory quotient (RQ) was also observed. For metabolic rate, no significant increase (P > 0.05) was detected when pressure decreased from 101 kPa to 85 kPa; however, the increase associated with a pressure decrease from 85 kPa to 70kPa was significant (P < 0.05). Empirical equations describing the above parameters are provided, which can be helpful for thermal comfort assessment in short-haul flights. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Provider payment methods and health worker motivation in community-based health insurance: a mixed-methods study.

PubMed

Robyn, Paul Jacob; Bärnighausen, Till; Souares, Aurélia; Traoré, Adama; Bicaba, Brice; Sié, Ali; Sauerborn, Rainer

2014-05-01

In a community-based health insurance (CBHI) introduced in 2004 in Nouna health district, Burkina Faso, poor perceived quality of care by CBHI enrollees has been a key factor in observed high drop-out rates. The poor quality perceptions have been previously attributed to health worker dissatisfaction with the provider payment method used by the scheme and the resulting financial risk of health centers. This study applied a mixed-methods approach to investigate how health workers working in facilities contracted by the CBHI view the methods of provider payment used by the CBHI. In order to analyze these relationships, we conducted 23 in-depth interviews and a quantitative survey with 98 health workers working in the CBHI intervention zone. The qualitative in-depth interviews identified that insufficient levels of capitation payments, the infrequent schedule of capitation payment, and lack of a payment mechanism for reimbursing service fees were perceived as significant sources of health worker dissatisfaction and loss of work-related motivation. Combining qualitative interview and quantitative survey data in a mixed-methods analysis, this study identified that the declining quality of care due to the CBHI provider payment method was a source of significant professional stress and role strain for health workers. Health workers felt that the following five changes due to the provider payment methods introduced by the CBHI impeded their ability to fulfill professional roles and responsibilities: (i) increased financial volatility of health facilities, (ii) dissatisfaction with eligible costs to be covered by capitation; (iii) increased pharmacy stock-outs; (iv) limited financial and material support from the CBHI; and (v) the lack of mechanisms to increase provider motivation to support the CBHI. To address these challenges and improve CBHI uptake and health outcomes in the targeted populations, the health care financing and delivery model in the study zone should be reformed. We discuss concrete options for reform based on the study findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Promoting the Shared-Care Model for Adolescent and Young Adults With Cancer: Optimizing Referrals and Care Coordination With Primary Care Providers.

PubMed

Kinahan, Karen E; Kircher, Sheetal; Altman, Jessica; Rademaker, Alfred; Salsman, John M; Didwania, Aarati; O'Brien, Bridget; Patel, Alpa C; Sanford, Stacy D

2017-01-01

The "shared-care model" for patients with cancer involves care coordination between primary care providers (PCPs) and oncologists, with the goal of optimizing survivorship care. However, a high proportion of adolescent and young adult (AYA) cancer survivors do not have a PCP. Study objectives were to increase the percentage of AYAs with a PCP documented in the electronic medical record (EMR) via the use of a best practice advisory (BPA) or "stopgap" intervention; to increase communication between providers by the number of routed clinic notes; and to assess oncology providers' attitudes/beliefs about the model and intervention. Data were collected for the 6 months before implementation of the BPA to determine the percentage of AYAs with a PCP and the number of notes routed to providers (time point 1 [T1]). The same data were collected at time point 2 (T2) after the BPA had been implemented for 6 months. Oncology providers participated in an education video module and an online survey at T1 and a survey at T2. At T1, 47.1% of 756 AYAs had a documented PCP in the EMR. At T2, the percentage increased to 55.1% (P<.002). The number of routed notes did not change significantly from T1 to T2. Providers that completed the intervention survey agreed/strongly agreed that the shared-care model is a desirable model of care (T1 = 86%; T2 = 93%) and that a BPA is useful for facilitating PCP referrals (T1 = 76%; T2 = 39%). This BPA is feasible for increasing the percentage of AYAs with a PCP documented in the EMR and could potentially lead to increased PCP referral and communication among providers for the benefit of long-term survivorship care. Providers generally agree with the shared-care model; however, the BPA implementation requires modification. Copyright © 2017 by the National Comprehensive Cancer Network.

Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study.

PubMed

Varghese, Beena; Krishnamurthy, Jayanna; Correia, Blaze; Panigrahi, Ruchika; Washington, Maryann; Ponnuswamy, Vinotha; Mony, Prem

2016-12-23

The majority of the maternal and perinatal deaths are preventable through improved emergency obstetric and newborn care at facilities. However, the quality of such care in India has significant gaps in terms of provider skills and in their preparedness to handle emergencies. We tested the feasibility, acceptability, and effectiveness of a "skills and drills" intervention, implemented between July 2013 and September 2014, to improve emergency obstetric and newborn care in the state of Karnataka, India. Emergency drills through role play, conducted every 2 months, combined with supportive supervision and a 2-day skills refresher session were delivered across 4 sub-district, secondary-level government facilities by an external team of obstetric and pediatric specialists and nurses. We evaluated the intervention through a quasi-experimental design with 4 intervention and 4 comparison facilities, using delivery case sheet reviews, pre- and post-knowledge tests among providers, objective structured clinical examinations (OSCEs), and qualitative in-depth interviews. Primary outcomes consisted of improved diagnosis and management of selected maternal and newborn complications (postpartum hemorrhage, pregnancy-induced hypertension, and birth asphyxia). Secondary outcomes included knowledge and skill levels of providers and acceptability and feasibility of the intervention. Knowledge scores among providers improved significantly in the intervention facilities; in obstetrics, average scores between the pre- and post-test increased from 49% to 57% (P=.006) and in newborn care, scores increased from 48% to 56% (P=.03). Knowledge scores in the comparison facilities were similar but did not improve significantly over time. Skill levels were significantly higher among providers in intervention facilities than comparison facilities (mean objective structured clinical examination scores for obstetric skills: 55% vs. 46%, respectively; for newborn skills: 58% vs. 48%, respectively; P<.001 for both obstetric and newborn), along with their confidence in managing complications. However, this did not result in significant differences in correct diagnosis and management of complications between intervention and comparison facilities. Shortage of trained nurses and doctors along with unavailability of a consistent supply chain was cited by most providers as major health systems barriers affecting provision of care. Improvements in knowledge, skills, and confidence levels of providers as a result of the skills and drills intervention was not sufficient to translate into improved diagnosis and management of maternal and newborn complications. System-level changes including adequate in-service training may also be necessary to improve maternal and newborn outcomes. © Varghese et al.

Adherence to the Otitis Media with Effusion Clinical Practice Guideline By Providers in a United States Air Force Medical Treatment Facility

DTIC Science & Technology

1999-03-18

In the United States, office visits for otitis media increased by 150 percent between 1975 and 1990, to 24.5 million (annually), with children under...visits for otitis media , they also had the greatest increase in number of visits between 1975 and 1990: 224 percent. Of significance, is the increase in...expenditure. Gates (1996) estimated the costs to be about five billion dollars annually. Cost is not the only factor important in the management of otitis media with

Is there a Link Between Foreclosure and Health?

PubMed Central

Currie, Janet

2016-01-01

We investigate the relationship between foreclosures and hospital visits using data on all foreclosures and all hospital and emergency room visits from four states that were among the hardest hit by the foreclosure crisis. We find that living in a neighborhood with a spike in foreclosures is associated with significant increases in urgent unscheduled visits, including increases in visits for preventable conditions. The estimated relationships cannot be accounted for by increasing unemployment, declines in housing prices, migration, or by people switching from out-patient providers to hospitals. PMID:27390614

Analysis of Mineral Elements, Metabolism, and Inflammation Indexes in the Plasma of Dairy Cows Suffering from Different Degrees of Lameness.

PubMed

Sun, Dongbo; Li, Chunqiu; Gu, Cheng; Chen, Jianfei; Qu, Yongli; Wang, Xinyu; Gao, Jing; Wei, Shan; Wang, Jianfa; Wu, Rui; Guo, Donghua

2015-12-01

In the plasma of dairy cows with 1-5 points of lameness, the mineral elements [calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), iodine (I), selenium (Se), molybdenum (Mo), and chromium (Cr)], the energy metabolic indicators [triglyceride (TG), glucose (Glu), total cholesterol (CHO), nonesterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), lactate (LA), and blood urea nitrogen (BUN)], and inflammatory indexes [bovine haptoglobin (BoHp), histamine (HIS), and immunoglobulin G (IgG)] were measured, respectively. Furthermore, the correlations of the measured indicators with the degrees of lameness were analyzed. The results showed that in the plasma of dairy cows with 2/3-5 points of lameness, for the mineral elements' levels, Ca, Cu, I, Se, and Fe significantly decreased, Cr significantly increased, and Mo showed a decreasing trend; for levels of the energy metabolism indicators, NEFA and BHBA significantly decreased, BUN and LA significantly increased, and Glu, CHO, and TG showed an increasing trend; for inflammation indexes, the concentrations of HIS, BoHp, and IgG all significantly increased; and further analysis indicated that the Mo, Fe, NEFA, BUN, BHBA, IgG, Ca, and Se had a significant correlation with the degrees of lameness. Resulting data revealed the changes of mineral elements, metabolism, and inflammation indexes in the plasma of dairy cows suffering from different degrees of lameness, which will provided basic knowledge for in-depth understanding of lameness in dairy cows.

Tassel Removal Positively Affects Biomass Production Coupled with Significantly Increasing Stem Digestibility in Switchgrass

PubMed Central

Zhao, Chunqiao; Fan, Xifeng; Hou, Xincun; Zhu, Yi; Yue, Yuesen; Zhang, Shuang; Wu, Juying

2015-01-01

In this study, tassels of Cave-in-Rock (upland) and Alamo (lowland) were removed at or near tassel emergence to explore its effects on biomass production and quality. Tassel-removed (TR) Cave-in-Rock and Alamo both exhibited a significant (P<0.05) increase in plant heights (not including tassel length), tiller number, and aboveground biomass dry weight (10% and 12%, 30% and 13%, 13% and 18%, respectively by variety) compared to a control (CK) treatment. Notably, total sugar yields of TR Cave-in-Rock and Alamo stems increased significantly (P<0.05 or 0.01) by 19% and 19%, 21% and 14%, 52% and 18%, respectively by variety, compared to those of control switchgrass under 3 treatments by direct enzymatic hydrolysis (DEH), enzymatic hydrolysis after 1% NaOH pretreatment (EHAL) and enzymatic hydrolysis after 1% H2SO4 pretreatment (EHAC). These differences were mainly due to significantly (P<0.05 or 0.01) higher cellulose content, lower cellulose crystallinity indexes (CrI) caused by higher arabinose (Ara) substitution in xylans, and lower S/G ratio in lignin. However, the increases of nitrogen (N) and sulphur (S) concentration negatively affects the combustion quality of switchgrass aboveground biomass. This work provides information for increasing biomass production and quality in switchgrass and also facilitates the inhibition of gene dispersal of switchgrass in China. PMID:25849123

Influenza vaccination of pregnant women: attitudes and behaviors of Oregon physician prenatal care providers.

PubMed

Arao, Robert F; Rosenberg, Kenneth D; McWeeney, Shannon; Hedberg, Katrina

2015-04-01

In spite of increased risk of influenza complications during pregnancy, only half of US pregnant women get influenza vaccination. We surveyed physician prenatal care providers in Oregon to assess their knowledge and behaviors regarding vaccination of pregnant women. From September through November 2011, a state-wide survey was mailed to a simple random sample (n = 1,114) of Oregon obstetricians and family physicians. The response rate was 44.5 %. Of 496 survey respondents, 187 (37.7 %) had provided prenatal care within the last 12 months. Of these, 88.5 % reported that they routinely recommended influenza vaccine to healthy pregnant patients. No significant differences in vaccine recommendation were found by specialty, practice location, number of providers in their practice, physician gender or years in practice. In multivariable regression analysis, routinely recommending influenza vaccine was significantly associated with younger physician age [adjusted odds ratio (AOR) 2.01, 95 % confidence interval (CI) 1.29-3.13] and greater number of pregnant patients seen per week (AOR 1.95, 95 % CI 1.25-3.06). Among rural physicians, fewer obstetricians (90.3 %) than family physicians (98.5 %) had vaccine-appropriate storage units (p = 0.001). Most physician prenatal care providers understand the importance of influenza vaccination during pregnancy. To increase influenza vaccine coverage among pregnant women, it will be necessary to identify and address patient barriers to receiving influenza vaccination during pregnancy.

[Efficiency of teeth local anesthesia by articaine-containing formulation with adrenaline and clonidine in pediatric dentistry].

PubMed

Mel'nikova, A V; Shugaĭlov, I A; Garus, Ia N

2014-01-01

The study evaluated duration and depth of the local infiltration anesthesia by articaine with different combinations of epinephrine and clonidine : articaine (4%) + epinephrine (1: 200 000), articaine (4%) + clonidine (1:100 000), articaine (4%) + epinephrine (1:200 000) + clonidine (1:100 000), articaine (4%) + epinephrine (1: 400 000) + clonidine (1:100, 000) in pediatric dental practice. It was revealed that the replacement of the vasoconstrictor epinephrine on clonidine associated with reduced depth and duration of analgesia. This increased efficiency is provided by inclusion of epinephrine (1:200 000), and clonidine (1:100 000) into anesthetic solution, which provided statistically significant increase in depth and duration of anesthesia.

Patient-Centered Technological Assessment and Monitoring of Depression for Low-Income Patients

PubMed Central

Wu, Shinyi; Vidyanti, Irene; Liu, Pai; Hawkins, Caitlin; Ramirez, Magaly; Guterman, Jeffrey; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Ell, Kathleen

2014-01-01

Depression is a significant challenge for ambulatory care because it worsens health status and outcomes, increases health care utilizations and costs, and elevates suicide risk. An automatic telephonic assessment (ATA) system that links with tasks and alerts to providers may improve quality of depression care and increase provider productivity. We used ATA system in a trial to assess and monitor depressive symptoms of 444 safety-net primary care patients with diabetes. We assessed system properties, evaluated preliminary clinical outcomes, and estimated cost savings. The ATA system is feasible, reliable, valid, safe, and likely cost-effective for depression screening and monitoring for low-income primary care population. PMID:24525531

Impact of Flexibility Options on Grid Economic Carrying Capacity of Solar and Wind: Three Case Studies

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

Denholm, Paul; Novacheck, Joshua; Jorgenson, Jennie

In this study, we attempt to quantify the benefits of various options of grid flexibility by measuring their impact on two measures: economic carrying capacity and system costs. Flexibility can increase ECC and reduce overall system costs. In some cases, options that provide a limited increase in ECC can provide significant operational savings, thus demonstrating the need to evaluate flexibility options using multiple metrics. The value of flexibility options varies regionally due to different generation mixes and types of renewables. The more rapid decline in PV value compared to wind makes PV more dependent on adding flexibility options, including transmissionmore » and energy storage.« less

Nanoparticles and nanofibers for topical drug delivery

PubMed Central

Goyal, Ritu; Macri, Lauren K.; Kaplan, Hilton M.; Kohn, Joachim

2016-01-01

This review provides the first comprehensive overview of the use of both nanoparticles and nanofibers for topical drug delivery. Researchers have explored the use of nanotechnology, specifically nanoparticles and nanofibers, as drug delivery systems for topical and transdermal applications. This approach employs increased drug concentration in the carrier, in order to increase drug flux into and through the skin. Both nanoparticles and nanofibers can be used to deliver hydrophobic and hydrophilic drugs and are capable of controlled release for a prolonged period of time. The examples presented provide significant evidence that this area of research has—and will continue to have — a profound impact on both clinical outcomes and the development of new products. PMID:26518723

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

Muir, Ryan D.; Sullivan, Shane Z.; Oglesbee, Robert A.

Digital lock-in amplification (LIA) with synchronous digitization (SD) is shown to provide significant signal to noise (S/N) and linear dynamic range advantages in beam-scanning microscopy measurements using pulsed laser sources. Direct comparisons between SD-LIA and conventional LIA in homodyne second harmonic generation measurements resulted in S/N enhancements consistent with theoretical models. SD-LIA provided notably larger S/N enhancements in the limit of low light intensities, through the smooth transition between photon counting and signal averaging developed in previous work. Rapid beam scanning instrumentation with up to video rate acquisition speeds minimized photo-induced sample damage. The corresponding increased allowance for higher lasermore » power without sample damage is advantageous for increasing the observed signal content.« less

Effects of hypercapnia and hypoxia on the cardiovascular system: vascular capacitance and aortic chemoreceptors.

PubMed

Rothe, C F; Maass-Moreno, R; Flanagan, A D

1990-09-01

Aortic chemoreceptor influences on vascular capacitance after changes in blood carbon dioxide and oxygen were studied in mongrel dogs anesthetized with methoxyflurane and nitrous oxide. The mean circulatory filling pressure (Pmcf), measured during transient cardiac fibrillation, provided a measure of capacitance vessel tone. Hypercapnia, hypoxia, and hypoxic hypercapnia significantly increased most variables, except that hypercapnia caused the total peripheral resistance (TPR) to decrease. Hypocapnia caused a significant decrease in mean systemic (Psa) and pulmonary (Ppa) arterial blood pressures, cardiac output (CO), and central blood volume and an increase in TPR and heart rate. The changes in Pmcf on changing blood gas tensions could be described by the equation delta Pmcf = -1.60 + 0.036 (arterial PCO2) + 50.8/arterial PO2. Thus a 10 mmHg increase in arterial PCO2 caused a 0.36 mmHg increase in Pmcf with receptors intact. Cold block (2 degrees C) of the cervical vagosympathetic trunks did not significantly influence the measured variables at control. During severe hypercapnia, vagal cooling caused a small but significant decrease in Pmcf, Psa, Ppa, and CO but not TPR. During hypoxia, vagal cooling caused the Pmcf, Psa, and TPR to decrease. We conclude that although hypercapnia or hypoxia acts reflexly to increase the capacitance vessel tone (an increase in Pmcf), the aortic and cardiopulmonary chemoreceptors with afferents in the vagi have only a small influence on the capacitance system, accounting for only approximately 25% of the total body response.

Effect of regional climate warming on the phenology of butterflies in boreal forests in Manitoba, Canada.

PubMed

Westwood, A R; Blair, D

2010-08-01

We examined the effect of regional climate warming on the phenology of butterfly species in boreal forest ecosystems in Manitoba, Canada. For the period 1971-2004, the mean monthly temperatures in January, September, and December increased significantly, as did the mean temperatures for several concurrent monthly periods. The mean annual temperature increased ≈ 0.05°C/yr over the study period. The annual number of frost-free days and degree-day accumulations increased as well. We measured the response of 19 common butterfly species to these temperature changes with the date of first appearance, week of peak abundance, and the length of flight period over the 33-yr period of 1972-2004. Although adult butterfly response was variable for spring and summer months, 13 of 19 species showed a significant (P < 0.05) increase in flight period extending longer into the autumn. Flight period extensions increased by 31.5 ± 13.9 (SD) d over the study period for 13 butterfly species significantly affected by the warming trend. The early autumn and winter months warmed significantly, and butterflies seem to be responding to this warming trend with a change in the length of certain life stages. Two species, Junonia coenia and Euphydryas phaeton, increased their northerly ranges by ≈ 150 and 70 km, respectively. Warmer autumns and winters may be providing opportunities for range extensions of more southerly butterfly species held at bay by past climatic conditions.

Resistance Training Combined With Diet Decreases Body Fat While Preserving Lean Mass Independent of Resting Metabolic Rate: A Randomized Trial.

PubMed

Miller, Todd; Mull, Stephanie; Aragon, Alan Albert; Krieger, James; Schoenfeld, Brad Jon

2018-01-01

The purpose of this study was to determine the effects of resistance training only (RT; n = 10), dietary intervention only (DIET; n = 10), resistance training plus diet (RT+DIET; n = 10), and control (CON; n = 10) on body composition and resting metabolic rate (RMR) in a cohort of 40 premenopausal female volunteers. Subjects in DIET and RT+DIET were provided with daily macronutrient and calorie goals based on DXA and RMR tests, with protein maintained at 3.1 g/kg/day. Subjects in the RT and RT+DIET groups performed a supervised progressive RT program consisting of exercises for all the major muscle groups of the body. Results showed a significant month-by-group interaction for change in fat mass with no significant linear trend for control. The three treatment groups all showed significant linear decreases in fat mass, but the slope of the decrease became progressively steeper from the RT, to DIET, to RT+DIET. A significant linear increase for lean mass was seen for resistance training only. There was a nonsignificant increase in RMR in all groups from Month 0 to Month 4 but no significant month by group interaction. In conclusion, significant reductions in fat mass were achieved by all experimental groups, but results were maximized by RT+DIET. Only the RT group showed significant increases in lean mass.

Analytical Characterization of Internet Security Attacks

ERIC Educational Resources Information Center

Sellke, Sarah H.

2010-01-01

Internet security attacks have drawn significant attention due to their enormously adverse impact. These attacks includes Malware (Viruses, Worms, Trojan Horse), Denial of Service, Packet Sniffer, and Password Attacks. There is an increasing need to provide adequate defense mechanisms against these attacks. My thesis proposal deals with analytical…

A New Vision for Distance Learning and Continuing Medical Education

ERIC Educational Resources Information Center

Harden, Ronald M.

2005-01-01

Increasing demands on continuing medical education (CME) are taking place at a time of significant developments in educational thinking and new learning technologies. Such developments allow today's CME providers to better meet the CRISIS criteria for effective continuing education: convenience, relevance, individualization, self-assessment,…

SIGNIFICANCE OF INCORPORATING MEASURES OF SPERM PRODUCTION AND FUNCTION INTO RAT TOXICOLOGY STUDIES

EPA Science Inventory

The rat is the preferred species for reproductive toxicity testing. The inclusion of measures of rat sperm quality, such as motility and morphology, into reproductive test protocols often increases the sensitivity of the test to detect effects, and provides the toxicologist and ...

An Overview of the Energy Crisis

ERIC Educational Resources Information Center

Walters, Edward A.; Wewerka, Eugene M.

1975-01-01

Concludes that coal will be the major U.S. energy source in the near future despite the significant problems associated with an increase in coal consumption. Provides advantages and disadvantages for the four major long-term energy sources: nuclear fission, nuclear fusion, geothermal sources, and solar energy. (MLH)

HBCUs and Chemical Engineering: Analysis of Baccalaureate Programs

ERIC Educational Resources Information Center

Reeves, Sheena; Thompson, Audie

2018-01-01

Historically Black Colleges and Universities (HBCUs) provide significant STEM degrees to African Americans. Initiatives toward increasing diversity in STEM fields have been implemented by government and industry leaders. HBCUs annually award over 20% of all African American baccalaureate chemical engineering degrees. This speaks volume to the…

Integrating Writing into Science through Student-Made Field Guides

ERIC Educational Resources Information Center

Gaither, Elizabeth; Scott, Catherine Marie

2016-01-01

In our experience, providing students with opportunities to explore outdoors has benefited them greatly in appreciating the outdoors and learning more about the environment. Similarly, researchers recognize that participants of outdoor schoolyard instruction have a more significant increase in cognitive understanding of ecological science concepts…

Identifying physiological gains in the historic Midwest soybean germplasm

USDA-ARS?s Scientific Manuscript database

Soybean yields in the US have steadily increased throughout the past century due to advances made in breeding and management practices. Despite these historical gains, producers will face a significant challenge to provide sufficient food, fiber, and fuel to supply a growing world population, which ...

Clotting Factor Changes during the First Cycle of Oral Contraceptive Use

PubMed Central

Westhoff, Carolyn L.; Eisenberger, Andrew; Tang, Rosalind; Cremers, Serge; Grossman, Lisa V.; Pike, Malcolm C.

2016-01-01

Objectives The risk of venous thromboembolism (VTE) is highest during the initial months of oral contraceptive (OC) use. We sought to evaluate the extent of hemostatic variable changes during the initial OC cycle and if such changes are related to systemic ethinyl estradiol (EE2) exposure. Study Design Participants provided multiple blood samples during a 21-day OC cycle (30 mcg EE2; 150 mcg levonorgestrel) and after a single dose following a wash-out period. Analytes included D-dimer, factor VIII activity, protein C total antigen and the hepatic proteins corticosteroid- and sex-hormone-binding globulins (CBG and SHBG). EE2 pharmacokinetic analyses related to the 24 hours after the first OC tablet (OC1) and at steady state (OC21). Results Seventeen women completed the study. D-dimer more than doubled by OC6 (p = 0.013) and remained elevated at OC21 (p=0.012). D-dimer levels within women varied widely from day-to-day. Factor VIII increased 27% by OC2 (p < 0.001), but declined to a 9% increase by OC21. Protein C increased only 6%. EE2 steady-state area-under-the-curve ranged from 488 to 1103 pg·h/mL; higher levels were not correlated with greater increases in clotting variables. CBG and SHBG increased significantly, but were not significantly correlated with levels of EE2 or with the hemostatic variables. Conclusions D-dimer increases during the first OC cycle were at least as great as increases seen with longer OC use. These results provide support for the increased VTE risk during initial OC use. The extreme variability in D-dimer levels may be an important component of this risk. PMID:26452328

Effects of Wastes from the Brewing Industry in Lightweight Aggregates Manufactured with Clay for Green Roofs.

PubMed

Farías, Romina D; Martínez García, Carmen; Cotes Palomino, Teresa; Martínez Arellano, Myriam

2017-05-15

This study investigates the effects of sieved wastes generated from the brewing industry on lightweight aggregates manufactured with clay. Sludge from a wastewater treatment plant, bagasse and diatomaceous earth were used to obtain the samples. These wastes are usually dumped in landfills, but the current increase in restrictions on dumping and interest in improving the environment make our proposal for gaining value from these wastes a significant contribution. Laboratory tests show that the new aggregate has low bulk density and increased water absorption and porosity. The thermographic camera results provide evidence that new aggregates have significant insulating properties and are suitable for use on green roofs.

Equity in the Medicaid Program: Changes in the Latter 1980s

PubMed Central

Adams, E. Kathleen

1995-01-01

The possibility of health care reform has helped focus attention on equity in the receipt of health care. This is a particular issue for the Medicaid program, as State variations in eligibility and payment policies have historically created inequity. This study examines equity for Medicaid beneficiaries and State taxpayers during the latter 1980s. Findings indicate that federally mandated expansions significantly increased equity in the coverage of the poor, but inequality in real resources per enrollee remained significant. Although equity improved from 1984 through 1991, the increased use of provider-specific tax and voluntary donation (T&D) programs by traditionally high-spending States played an important role in the 1992 figures. PMID:10142581

Effects of Wastes from the Brewing Industry in Lightweight Aggregates Manufactured with Clay for Green Roofs

PubMed Central

Farías, Romina D.; Martínez García, Carmen; Cotes Palomino, Teresa; Martínez Arellano, Myriam

2017-01-01

This study investigates the effects of sieved wastes generated from the brewing industry on lightweight aggregates manufactured with clay. Sludge from a wastewater treatment plant, bagasse and diatomaceous earth were used to obtain the samples. These wastes are usually dumped in landfills, but the current increase in restrictions on dumping and interest in improving the environment make our proposal for gaining value from these wastes a significant contribution. Laboratory tests show that the new aggregate has low bulk density and increased water absorption and porosity. The thermographic camera results provide evidence that new aggregates have significant insulating properties and are suitable for use on green roofs. PMID:28772892

Can training in empathetic validation improve medical students' communication with patients suffering pain? A test of concept.

PubMed

Linton, Steven J; Flink, Ida K; Nilsson, Emma; Edlund, Sara

2017-05-01

Patient-centered, empathetic communication has been recommended as a means for improving the health care of patients suffering pain. However, a problem has been training health care providers since programs may be time-consuming and difficult to learn. Validation, a form of empathetic response that communicates that what a patient experiences is accepted as true, has been suggested as an appropriate method for improving communication with patients suffering pain. We study the immediate effects of providing medical students with a 2-session (45-minute duration each) program in validation skills on communication. A one group, pretest vs posttest design was employed with 22 volunteer medical students. To control patient variables, actors simulated 1 of 2 patient scenarios (randomly provided at pretest and posttest). Video recordings were blindly evaluated. Self-ratings of validation and satisfaction were also employed. Observed validation responses increased significantly after training and corresponded to significant reductions in invalidating responses. Both the patient simulators and the medical students were significantly more satisfied after the training. We demonstrated that training empathetic validation results in improved communication thus extending previous findings to a medical setting with patients suffering pain. Our results suggest that it would be feasible to provide validation training for health care providers and this warrants further investigation in controlled studies.

Effect of Rhythmic Auditory Stimulation on Hemiplegic Gait Patterns.

PubMed

Shin, Yoon-Kyum; Chong, Hyun Ju; Kim, Soo Ji; Cho, Sung-Rae

2015-11-01

The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system. Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

Donor-Site Morbidity After DIEAP Flap Breast Reconstruction—A 2-Year Postoperative Computed Tomography Comparison

PubMed Central

Bosse, Gerhard; Mynarek, Georg Karl; Berg, Thomas; Tindholdt, Tyge Tind; Tønseth, Kim Alexander

2017-01-01

Background: The study was undertaken to provide a more complete picture of donor-site morbidity following the deep inferior epigastric artery perforator (DIEAP) flap harvest in breast reconstruction. Most studies evaluating this subject have been performed using ultrasonography. Computed tomography (CT) might provide valuable information. Methods: In 14 patients who were reconstructed with a DIEAP flap, donor-site morbidity was assessed by comparing routine preoperative CT abdomen with CT abdomen performed 2 years postoperatively. The anteroposterior diameter and transverse diameter (TD) of the rectus muscle were measured bilaterally within 4 standardized zones. Diastasis recti abdominis (DRA) was measured in the same zones. The abdominal wall was assessed for hernias, bulging, and seromas. Results: The operated rectus muscle had a significantly increased anteroposterior diameter in 2 zones and decreased TD in 1 zone compared with preoperative measurements. Comparing the operated and nonoperated rectus muscles, the former had a significantly decreased TD in 1 zone. Supraumbilical DRA was significantly decreased with surgery, whereas infraumbilical DRA was significantly increased. No new hernias or bulging were found. Two patients had seroma formation in the abdominal wall. Conclusions: Symmetry of the 2 hemiabdomens is well preserved after DIEAP flap harvest; however, significant changes to the rectus muscles and DRA were observed. Hernia formation does not seem to be a postoperative complication of importance. The study indicates that DIEAP flaps result in limited donor-site morbidity, which for most patients does not outweigh the benefits of free perforator flap breast reconstruction. PMID:28831346

Hospitalized children's mood differences during play and music therapy.

PubMed

Hendon, C; Bohon, L M

2008-03-01

Paediatric hospitals are concerned with both the physical and social well-being of their young patients. These institutions often provide play and music therapy to enhance the child's sense of normality. The purpose of this study was to test whether children in a hospital were happier during music rather than play therapy. Sixty children were observed either during play or music therapy. Happiness was operationally defined as the frequency of smiles during a 3 minute period. The results showed that music therapy (M = 12.43, SD = 4.83) led to significantly more smiles than did play therapy (M = 5.83, SD = 3.10). Increasing the amount of time hospitals provide music therapy for child patients may be a way to increase positive effect and ultimately to increase mental and physical well-being in hospitalized children.

Macroeconomic and household-level impacts of HIV/AIDS in Botswana.

PubMed

Jefferis, Keith; Kinghorn, Anthony; Siphambe, Happy; Thurlow, James

2008-07-01

To measure the impact of HIV/AIDS on economic growth and poverty in Botswana and estimate how providing treatment can mitigate its effects. Demographic and financial projections were combined with economic simulation models, including a macroeconomic growth model and a macro-microeconomic computable general equilibrium and microsimulation model. HIV/AIDS significantly reduces economic growth and increases household poverty. The impact is now severe enough to be affecting the economy as a whole, and threatens to pull some of the uninfected population into poverty. Providing antiretroviral therapy can partly offset this negative effect. Treatment increases health's share of government expenditure only marginally, because it increases economic growth and because withholding treatment raises the cost of other health services. Botswana's treatment programme is appropriate from a macroeconomic perspective. Conducting macroeconomic impact assessments is important in countries where prevalence rates are particularly high.

Exploring the potential uses of value-added metrics in the context of postgraduate medical education.

PubMed

Gregory, Simon; Patterson, Fiona; Baron, Helen; Knight, Alec; Walsh, Kieran; Irish, Bill; Thomas, Sally

2016-10-01

Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education. We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons. We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection. Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.

Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.

PubMed

Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho

2016-01-01

This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations.

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

PubMed

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

Development and evaluation of a palliative care curriculum for cystic fibrosis healthcare providers.

PubMed

Linnemann, Rachel W; O'Malley, Patricia J; Friedman, Deborah; Georgiopoulos, Anna M; Buxton, David; Altstein, Lily L; Sicilian, Leonard; Lapey, Allen; Sawicki, Gregory S; Moskowitz, Samuel M

2016-01-01

Primary palliative care refers to basic skills that all healthcare providers can employ to improve quality of life for patients at any stage of disease. Training in these core skills is not commonly provided to clinicians caring for cystic fibrosis (CF) patients. The objective of this study was to assess change in comfort with core skills among care team members after participation in CF-specific palliative care training focused on management of burdensome symptoms and difficult conversations. A qualitative needs assessment was performed to inform the development of an 18-hour curriculum tailored to the chronicity and complexity of CF care. A 32-question pre- and post-course survey assessed CF provider comfort with the targeted palliative care skills in 5 domains using a 5-point Likert scale (1=very uncomfortable, 3=neutral, 5=very comfortable). Among course participants (n=16), mean overall comfort score increased by 0.9, from 3 (neutral) to 3.9 (comfortable) (p<0.001). Mean comfort level increased significantly (range 0.8 to 1.4) in each skill domain: use of supportive care resources, pain management, non-pain symptom management, communication, and psychosocial skills. CF-specific palliative care training was well received by participants and significantly improved self-assessed comfort with core skills. Copyright © 2015 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Effect of a topical vasodilator on tumor hypoxia and tumor oxygen guided radiotherapy using EPR oximetry.

PubMed

Hou, Huagang; Abramovic, Zrinka; Lariviere, Jean P; Sentjurc, Marjeta; Swartz, Harold; Khan, Nadeem

2010-05-01

We sought to reduce tumor hypoxia by topical application of a vasodilator, benzyl nicotinate (BN), and investigated its effect on the growth of tumors irradiated at times when tumor pO(2) increased. EPR oximetry was used to follow the changes in the tissue pO(2) of subcutaneous radiation-induced fibrosarcoma (RIF-1) tumors during topical applications of 1.25-8% BN formulations for 5 consecutive days. The RIF-1 tumors were hypoxic with a tissue pO(2) of 4.6-7.0 mmHg. A significant increase in tumor pO(2) occurred 10-30 min after BN application. The formulation with the minimal BN concentration that produced a significant increase in tumor pO(2) was used for the radiation study. The tumors were irradiated (4 Gy x 5) at the time of the maximum increase in pO(2) observed with the 2.5% BN formulation. The tumors with an increase in pO(2) of greater than 2 mmHg from the baseline after application of BN on day 1 had a significant growth inhibition compared to the tumors with an increase in pO(2) of less than 2 mmHg. The results indicate that the irradiation of tumors at the time of an increase in pO(2) after the topical application of the 2.5% BN formulation led to a significant growth inhibition. EPR oximetry provided dynamic information on the changes in tumor pO(2), which could be used to identify responders and non-responders and schedule therapy during the experiments.

Public and private prenatal care providers in urban Mexico: how does their quality compare?

PubMed

Barber, Sarah L

2006-08-01

To evaluate variations in prenatal care quality by public and private clinical settings and by household wealth. The study uses 2003 data detailing retrospective reports of 12 prenatal care procedures received that correspond to clinical guidelines. The 12 procedures are summed up, and prenatal care quality is described as the average procedures received by clinical setting, provider qualifications, and household wealth. Low-income communities in 17 states in urban Mexico. A total of 1253 women of reproductive age who received prenatal care within 1 year of the survey. The mean of the 12 prenatal care procedures received, reported as unadjusted and adjusted for individual, household, and community characteristics. Women received significantly more procedures in public clinical settings [80.7, 95% confidence interval (CI) = 79.3-82.1; P < or = 0.05] compared with private (60.2, 95% CI = 57.8-62.7; P < or = 0.05). Within private clinical settings, an increase in household wealth is associated with an increase in procedures received. Care from medical doctors is associated with significantly more procedures (78.8, 95% CI = 77.5-80.1; P < or = 0.05) compared with non-medical doctors (50.3, 95% CI = 46.7-53.9; P < or = 0.05). These differences are independent of individual, household, and community characteristics that affect health-seeking behavior. Significant differences in prenatal care quality exist across clinical settings, provider qualifications, and household wealth in urban Mexico. Strategies to improve quality include quality reporting, training, accreditation, regulation, and franchising.

Involvement of opioid peptides in the regulation of reproduction in the prawn Penaeus indicus

NASA Astrophysics Data System (ADS)

Sreenivasula Reddy, P.

The possible involvement of an endogenous opioid system in the regulation of ovarian development in the prawn Penaeus indicus was investigated. Injection of leucine-enkephalin significantly increased the ovarian index and oocyte diameter in a dose-dependent manner. In contrast, injection of methionine-enkephalin significantly decreased the ovarian index and oocyte diameters. These results provide evidence to support the hypothesis that an opioid system is involved in the regulation of reproduction in crustaceans.

The effect of exercise, resveratrol or their combination on Sarcopenia in aged rats via regulation of AMPK/Sirt1 pathway.

PubMed

Liao, Zhi-Yin; Chen, Jin-Liang; Xiao, Ming-Han; Sun, Yue; Zhao, Yu-Xing; Pu, Die; Lv, An-Kang; Wang, Mei-Li; Zhou, Jing; Zhu, Shi-Yu; Zhao, Ke-Xiang; Xiao, Qian

2017-11-01

Sarcopenia is an age-related syndrome characterized by progressive loss of muscle mass and function. Exercise is an important strategy to prolong life and increase muscle mass, and resveratrol has been shown a variety beneficial effects on skeletal muscle. In the present study, we investigated the potential efficacy of using short-term exercise (six weeks), resveratrol (150mg/kg/day), or combined exercise+resveratrol (150mg/kg/day) on gastrocnemius muscle mass, grip strength, cross-sectional area and microscopic morphology in aged rats, and explored the potential mechanism at the apoptosis level. Six months old SD rats were used as young control group and 24months old SD rats were adopted as aged group. After six weeks intervention, the data provide evidence that exercise, resveratrol or their combination significantly increase the relative grip strength and muscle mass in aged rats (P<0.05). Electron microscopy discovered a significant increase in sarcomere length, I-band and H-zone in aged rats (P<0.05), and exercise, resveratrol or their combination significantly reduced the increasement (P<0.05). Moreover, light microscopy revealed a significant increase on Feret's diameter and cross-sectional area (CSA) in aged rats (P<0.05), but exercise and resveratrol did not show significant effects on them (P>0.05). Furthermore, exercise, resveratrol or their combination significantly increased the expression of p-AMPK and SIRT1, decreased the expression of acetyl P53 and Bax/Bcl-2 ratio in aged rats (P<0.05). These findings show that aged rats show significant changes in gastrocnemius muscle morphology and ultrastructure, and the protective effects of exercise, resveratrol and their combination are probably associated with anti-apoptotic signaling pathways through activation of AMPK/Sirt1. Copyright © 2017 Elsevier Inc. All rights reserved.

Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma Population.

PubMed

Morris, Brent J; Zumsteg, Justin W; Archer, Kristin R; Cash, Brian; Mir, Hassan R

2014-08-06

The negative consequences of narcotic use and diversion for nonmedical use are on the rise. A growing number of narcotic abusers obtain narcotic prescriptions from multiple providers ("doctor shopping"). This study sought to determine the effects of multiple postoperative narcotic providers on the number of narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day in the orthopaedic trauma population. Our prospective cohort study used the state-controlled substance monitoring database to identify all narcotic prescriptions filled three months prior to admission and six months following discharge for enrolled patients. Patients were assigned into two groups: a single narcotic provider group with prescriptions only from the treating surgeon (or extenders) or a multiple narcotic provider group with prescriptions from both the treating surgeon and an additional provider or providers. Complete data were available for 130 of 151 eligible patients. Preoperative narcotic use, defined by three or more narcotic prescriptions within three months of admission, was noted in 8.5% of patients. Overall, 20.8% of patients sought multiple narcotic providers postoperatively. There were significant increases in postoperative narcotic prescriptions (p < 0.001) between the single narcotic provider group (two prescriptions) and the multiple narcotic provider group (seven prescriptions), in duration of postoperative narcotic use (p < 0.001) between the single narcotic provider group (twenty-eight days) and the multiple narcotic provider group (110 days), and in morphine equivalent dose per day (p = 0.002) between the single narcotic provider group (26 mg) and the multiple narcotic provider group (43 mg). Patients with a high school education or less were 3.2 times more likely to seek multiple providers (p = 0.02), and patients with a history of preoperative narcotic use were 4.5 times more likely to seek multiple providers (p < 0.001). There is a 20.8% prevalence of postoperative doctor shopping in the orthopaedic trauma population. Patients with multiple postoperative narcotic providers had a significant increase in postoperative narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Rapid Perturbation in Viremia Levels Drives Increases in Functional Avidity of HIV-specific CD8 T Cells

PubMed Central

Viganò, Selena; Bellutti Enders, Felicitas; Miconnet, Isabelle; Cellerai, Cristina; Savoye, Anne-Laure; Rozot, Virginie; Perreau, Matthieu; Faouzi, Mohamed; Ohmiti, Khalid; Cavassini, Matthias; Bart, Pierre-Alexandre; Pantaleo, Giuseppe; Harari, Alexandre

2013-01-01

The factors determining the functional avidity and its relationship with the broad heterogeneity of antiviral T cell responses remain partially understood. We investigated HIV-specific CD8 T cell responses in 85 patients with primary HIV infection (PHI) or chronic (progressive and non-progressive) infection. The functional avidity of HIV-specific CD8 T cells was not different between patients with progressive and non-progressive chronic infection. However, it was significantly lower in PHI patients at the time of diagnosis of acute infection and after control of virus replication following one year of successful antiretroviral therapy. High-avidity HIV-specific CD8 T cells expressed lower levels of CD27 and CD28 and were enriched in cells with an exhausted phenotype, i.e. co-expressing PD-1/2B4/CD160. Of note, a significant increase in the functional avidity of HIV-specific CD8 T cells occurred in early-treated PHI patients experiencing a virus rebound after spontaneous treatment interruption. This increase in functional avidity was associated with the accumulation of PD-1/2B4/CD160 positive cells, loss of polyfunctionality and increased TCR renewal. The increased TCR renewal may provide the mechanistic basis for the generation of high-avidity HIV-specific CD8 T cells. These results provide insights on the relationships between functional avidity, viremia, T-cell exhaustion and TCR renewal of antiviral CD8 T cell responses. PMID:23853580

Fructose impairs glucose-induced hepatic triglyceride synthesis

PubMed Central

2011-01-01

Obesity, type 2 diabetes and hyperlipidemia frequently coexist and are associated with significantly increased morbidity and mortality. Consumption of refined carbohydrate and particularly fructose has increased significantly in recent years and has paralled the increased incidence of obesity and diabetes. Human and animal studies have demonstrated that high dietary fructose intake positively correlates with increased dyslipidemia, insulin resistance, and hypertension. Metabolism of fructose occurs primarily in the liver and high fructose flux leads to enhanced hepatic triglyceride accumulation (hepatic steatosis). This results in impaired glucose and lipid metabolism and increased proinflammatory cytokine expression. Here we demonstrate that fructose alters glucose-stimulated expression of activated acetyl CoA carboxylase (ACC), pSer hormone sensitive lipase (pSerHSL) and adipose triglyceride lipase (ATGL) in hepatic HepG2 or primary hepatic cell cultures in vitro. This was associated with increased de novo triglyceride synthesis in vitro and hepatic steatosis in vivo in fructose- versus glucose-fed and standard-diet fed mice. These studies provide novel insight into the mechanisms involved in fructose-mediated hepatic hypertriglyceridemia and identify fructose-uptake as a new potential therapeutic target for lipid-associated diseases. PMID:21261970

High Resolution Topography of Age-Related Changes in Non-Rapid Eye Movement Sleep Electroencephalography

PubMed Central

Sprecher, Kate E.; Riedner, Brady A.; Smith, Richard F.; Tononi, Giulio; Davidson, Richard J.; Benca, Ruth M.

2016-01-01

Sleeping brain activity reflects brain anatomy and physiology. The aim of this study was to use high density (256 channel) electroencephalography (EEG) during sleep to characterize topographic changes in sleep EEG power across normal aging, with high spatial resolution. Sleep was evaluated in 92 healthy adults aged 18–65 years old using full polysomnography and high density EEG. After artifact removal, spectral power density was calculated for standard frequency bands for all channels, averaged across the NREM periods of the first 3 sleep cycles. To quantify topographic changes with age, maps were generated of the Pearson’s coefficient of the correlation between power and age at each electrode. Significant correlations were determined by statistical non-parametric mapping. Absolute slow wave power declined significantly with increasing age across the entire scalp, whereas declines in theta and sigma power were significant only in frontal regions. Power in fast spindle frequencies declined significantly with increasing age frontally, whereas absolute power of slow spindle frequencies showed no significant change with age. When EEG power was normalized across the scalp, a left centro-parietal region showed significantly less age-related decline in power than the rest of the scalp. This partial preservation was particularly significant in the slow wave and sigma bands. The effect of age on sleep EEG varies substantially by region and frequency band. This non-uniformity should inform the design of future investigations of aging and sleep. This study provides normative data on the effect of age on sleep EEG topography, and provides a basis from which to explore the mechanisms of normal aging as well as neurodegenerative disorders for which age is a risk factor. PMID:26901503

Understanding and predicting social media use among community health center patients: a cross-sectional survey.

PubMed

Hanson, Carl L; West, Josh; Thackeray, Rosemary; Barnes, Michael D; Downey, Jordan

2014-11-26

The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. The aim was to determine the use and factors predicting the use of social media for health care-related purposes among medically underserved primary care patients. A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Understanding use and factors predicting use can increase adoption and utilization of social media for health care-related purposes among underserved patients in community health centers.

Public reaction to direct-to-consumer online genetic tests: Comparing attitudes, trust and intentions across commercial and conventional providers.

PubMed

Critchley, Christine; Nicol, Dianne; Otlowski, Margaret; Chalmers, Don

2015-08-01

The success of personalised medicine depends upon the public's embracing genetic tests. Tests that claim to predict an individual's future health can now be accessed via online companies outside of conventional health regulations. This research assessed the extent to which the public embrace direct-to-consumer (DTC) genetic tests relative to those obtained by a conventional medical practitioner (MP). It also examined the reasons for differences across providers using a randomised experimental telephone survey of 1000 Australians. Results suggest that people were significantly less likely to approve of, and order a DTC genetic test administered by a company compared to a MP because they were less trusting of companies' being able to protect their privacy and provide them with access to genetic expertise and counselling. Markets for DTC genetic tests provided by companies would therefore significantly increase if trust in privacy protection and access to expertise are enhanced through regulation. © The Author(s) 2014.

Simulation training for medical emergencies in the dental setting using an inexpensive software application.

PubMed

Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

2017-11-09

Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P < .01). For the item "I can treat vasovagal syncope/anaphylaxis adequately," the percentage responding "Strongly agree" or "Agree" increased from 14% to 56% for vasovagal syncope and from 6% to 42% for anaphylaxis with simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of acute care surgery to departmental productivity.

PubMed

Barnes, Stephen L; Cooper, Christopher J; Coughenour, Jeffrey P; MacIntyre, Allan D; Kessel, James W

2011-10-01

The face of trauma surgery is rapidly evolving with a paradigm shift toward acute care surgery (ACS). The formal development of ACS has been viewed by some general surgeons as a threat to their practice. We sought to evaluate the impact of a new division of ACS to both departmental productivity and provider satisfaction at a University Level I Trauma Center. Two-year retrospective analysis of annual work relative value unit (wRVU) productivity, operative volume, and FTEs before and after establishment of an ACS division at a University Level I trauma center. Provider satisfaction was measured using a 10-point scale. Analysis completed using Microsoft Excel with a p value less than 0.05 significant. The change to an ACS model resulted in a 94% increase in total wRVU production (78% evaluation and management, 122% operative; p<0.05) for ACS, whereas general surgery wRVU production increased 8% (-15% evaluation and management, 14% operative; p<0.05). Operative productivity was substantial after transition to ACS, with 129% and 44% increases (p<0.05) in operative and elective case load, respectively. Decline in overall general surgery operative volume was attributed to reduction in emergent cases. Establishment of the ACS model necessitated one additional FTE. Job satisfaction substantially improved with the ACS model while allowing general surgery a more focused practice. The ACS practice model significantly enhances provider productivity and job satisfaction when compared with trauma alone. Fears of a productivity impact to the nontrauma general surgeon were not realized.

Enhanced thermal conductivity oxide nuclear fuels by co-sintering with BeO: II. Fuel performance and neutronics

NASA Astrophysics Data System (ADS)

McCoy, Kevin; Mays, Claude

2008-04-01

The fuel rod performance and neutronics of enhanced thermal conductivity oxide (ECO) nuclear fuel with BeO have been compared to those of standard UO 2 fuel. The standards of comparison were that the ECO fuel should have the same infinite neutron-multiplication factor kinf at end of life and provide the same energy extraction per fuel assembly over its lifetime. The BeO displaces some uranium, so equivalence with standard UO 2 fuel was obtained by increasing the burnup and slightly increasing the enrichment. The COPERNIC fuel rod performance code was adapted to account for the effect of BeO on thermal properties. The materials considered were standard UO 2, UO 2 with 4.0 vol.% BeO, and UO 2 with 9.6 vol.% BeO. The smaller amount of BeO was assumed to provide increases in thermal conductivity of 0, 5, or 10%, whereas the larger amount was assumed to provide an increase of 50%. A significant improvement in performance was seen, as evidenced by reduced temperatures, internal rod pressures, and fission gas release, even with modest (5-10%) increases in thermal conductivity. The benefits increased monotonically with increasing thermal conductivity. Improvements in LOCA initialization performance were also seen. A neutronic calculation considered a transition from standard UO 2 fuel to ECO fuel. The calculation indicated that only a small increase in enrichment is required to maintain the kinf at end of life. The smallness of the change was attributed to the neutron-multiplication reaction of Be with fast neutrons and the moderating effect of BeO. Adoption of ECO fuel was predicted to provide a net reduction in uranium cost. Requirements for industrial hygiene were found to be comparable to those for processing of UO 2.

The impact of tailored interventions on a community health center population.

PubMed

Rimer, B K; Conaway, M; Lyna, P; Glassman, B; Yarnall, K S; Lipkus, I; Barber, L T

1999-06-01

We conducted a 4-year randomized study in a community health center that serves primarily low income Blacks in Durham, North Carolina. Patients (1318 at baseline) were assigned randomly to one of three study groups: provider prompting intervention alone, provider prompting and tailored print materials or the previous group and tailored telephone counseling. The purpose of the study was to determine whether increasingly intensive, tailored print and telephone interventions also were increasingly effective in promoting adherence to mammograms, Pap tests and overall cancer screening compliance. Thus, the combination of tailored print interventions (print and telephone) should have been more effective than the provider prompting intervention alone, or the print intervention and prompting combination. This is one of the few studies to examine a measure of overall cancer screening compliance and to assess the benefit of combinations of tailored interventions in promoting adherence to cancer screening. Patients gave extremely high ratings to the interventions. At the bivariate level, we found a significant effect of the most intensive group (provider prompting intervention, tailored print communications and tailored telephone counseling) on Pap test compliance (P = 0.05) and borderline significance at the multivariate level (P = 0.06) as well on overall screening compliance (P = 0.06). There was not a significant effect on mammography, probably because a majority of the patients were receiving regular mammograms. We also found some important subgroup differences. For example, a larger proportion of women reported Pap tests in the tailored print and counseling group when they believed the materials were 'meant for me.' These results show that a combination of tailored interventions may have potential for reaching the women who have too often been labeled the 'hard to reach.'

[Estimation on value of water and soil conservation of agricultural ecosystems in Xi' an metropolitan, Northwest China].

PubMed

Yang, Wen-yan; Zhou, Zhong-xue

2014-12-01

With the urban eco-environment increasingly deteriorating, the ecosystem services provided by modern urban agriculture are exceedingly significant to maintain and build more suitable environment in a city. Taking Xi' an metropolitan as the study area, based on remote sensing data, DEM data and the economic and social statistics data, the water and soil conservation service of the agricultural ecosystems was valued employing the remote sensing and geographic information system method, covering the reduction values on land waste, soil fertility loss and sediment loss from 2000 to 2011, and analyzed its changes in time and space. The results showed that during the study period, the total value of water and soil conservation service provided by agricultural systems in Xi' an metropolitan was increased by 46,086 and 33.008 billion yuan respectively from period of 2000 to 2005 and from 2005 to 2011. The cultivated land (including grains, vegetables and other farming land), forest (including orchard) and grassland provided higher value on the water and soil conservation service than waters and other land use. Ecosystem service value of water and soil conserva- tion provided by agriculture was gradually decreasing from the southern to the northern in Xi' an metropolitan. There were significantly positive relationship between the ecosystem service value and the vegetation coverage. Forest, orchard and grassland distributed intensively in the southern which had higher vegetation coverage than in northern where covered by more cultivated land, sparse forest and scattered orchard. There were significantly negative correlation between the urbanization level and the value of water and soil conservation. The higher level of urbanization, the lower value there was from built-up area to suburban and to countryside within Xi' an metropolitan.

I've got a mobile phone too! Hard and soft assistive technology customization and supportive call centres for people with disability.

PubMed

Darcy, Simon; Green, Jenny; Maxwell, Hazel

2017-05-01

The purpose of this article is to examine the use of a mobile technology platform, software customization and technical support services by people with disability. The disability experience is framed through the participants' use of the technology, their social participation. A qualitative and interpretive research design was employed using a three-stage process of observation and semi-structured interviews of people with disability, a significant other and their service provider. Transcripts were analyzed to examine the research questions through the theoretical framework of PHAATE - Policy, Human, Activity, Assistance and Technology and Environment. The analysis revealed three emergent themes: 1. Engagement and activity; 2. Training, support and customization; and 3. Enablers, barriers and attitudes. The findings indicate that for the majority of users, the mobile technology increased the participants' communication and social participation. However, this was not true for all members of the pilot with variations due to disability type, support needs and availability of support services. Most participants, significant others and service providers identified improvements in confidence, security, safety and independence of those involved. Yet, the actions and attitudes of some of the significant others and service providers acted as a constraint to the adoption of the technology. Implications for Rehabilitation Customized mobile technology can operate as assistive technology providing a distinct benefit in terms of promoting disability citizenship. Mobile technology used in conjunction with a supportive call centre can lead to improvements in confidence, safety and independence for people experiencing disability. Training and support are critical in increasing independent use of mobile technology for people with disability. The enjoyment, development of skills and empowerment gained through the use of mobile technology facilitate the social inclusion of people with disability.

Effectiveness of the Lunch is in the Bag program on communication between the parent, child and child-care provider around fruits, vegetables and whole grain foods: A group-randomized controlled trial.

PubMed

Sharma, Shreela V; Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cynthia; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M

2015-12-01

To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at p<0.05. At baseline, parent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β=0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β=0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. Copyright © 2015 Elsevier Inc. All rights reserved.

A Prospective Test of Cognitive Vulnerability Models of Depression with Adolescent Girls

ERIC Educational Resources Information Center

Bohon, Cara; Stice, Eric; Burton, Emily; Fudell, Molly; Nolen-Hoeksema, Susan

2008-01-01

This study sought to provide a more rigorous prospective test of two cognitive vulnerability models of depression with longitudinal data from 496 adolescent girls. Results supported the cognitive vulnerability model in that stressors predicted future increases in depressive symptoms and onset of clinically significant major depression for…

Electronic-nose devices - Potential for noninvasive early disease-detection applications

Treesearch

Alphus Dan Wilson

2017-01-01

Significant progress in the development of portable electronic devices is showing considerable promise to facilitate clinical diagnostic processes. The increasing global trend of shifts in healthcare policies and priorities toward shortening and improving the effectiveness of diagnostic procedures by utilizing non-invasive methods should provide multiple benefits of...

Public/Private Partnerships in Child Care.

ERIC Educational Resources Information Center

Sonnier, Catherine

1988-01-01

The amount of state legislation dealing with child care issues has significantly increased in the last 5 years. This report focuses on state strategies for expanding and improving the child care system through incentives and support for employers and providers. State policymakers are exploring partnerships of public and private resources for…

Measurement Of Crossflow Vortex Structure

NASA Technical Reports Server (NTRS)

Maddalon, Dal V.; Agarwal, Navel K.

1994-01-01

Method developed for measuring wavelengths of crossflow vortices by using surface-mounted, microthin, multielement hot-film sensors. Provides direct and true value of wavelength of crossflow vortices at various spanwise locations without localized flow disturbances. Attainment of laminar airflow on aircraft wings has significant potential for reducing drag and increasing fuel efficiency.

75 FR 4684 - Fisheries off West Coast States; Pacific Coast Groundfish Fishery; Data Collection for the Trawl...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

... Coast groundfish fishery. The trawl rationalization program is intended to increase net economic benefits, create individual economic stability, provide full utilization of the trawl sector allocation... one time reporting will have a significant economic impact on small entities, as the estimated...

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

Rich, B.L.

Measurements of beta and/or nonpenetrating exposure results is complicated and past techniques and capabilities have resulted in significant inaccuracies in recorded results. Current developments have resulted in increased capabilities which make the results more accurate and should result in less total exposure to the work force. Continued development of works in progress should provide equivalent future improvements.

Conflict, Militarization, and Their After-Effects: Key Challenges for TESOL

ERIC Educational Resources Information Center

Nelson, Cynthia D.; Appleby, Roslyn

2015-01-01

Skyrocketing military spending, ongoing military conflicts, and human displacement worldwide have significant consequences for the teaching and learning of English. TESOL increasingly requires a robust research base that can provide informed, critical guidance in preparing English language teachers for work in and near conflict zones, for teaching…

Food for Thought: Expanding School Breakfast to NJ Students

ERIC Educational Resources Information Center

Allen-Kyle, Portia; Parello, Nancy

2011-01-01

This brief marks the start of "Advocates for Children of New Jersey's Food for Thought School Breakfast Campaign", which seeks to expand innovative approaches to serving school breakfast and significantly increase students' participation rates. This report provides a closer look at the data, including identifying districts that have high…

Vascular structure determines pulmonary blood flow distribution

NASA Technical Reports Server (NTRS)

Hlastala, M. P.; Glenny, R. W.

1999-01-01

Scientific knowledge develops through the evolution of new concepts. This process is usually driven by new methodologies that provide observations not previously available. Understanding of pulmonary blood flow determinants advanced significantly in the 1960s and is now changing rapidly again, because of increased spatial resolution of regional pulmonary blood flow measurements.

Teaching about America's Fiscal Future in the University's Core Curriculum

ERIC Educational Resources Information Center

Galatas, Steven; Pressley, Cindy

2010-01-01

Civic engagement is increasingly recognized as a significant function of public universities. The university provides a variety of opportunities for civic engagement, including co-curricular activities, service learning opportunities, and specific majors and minors. This article reviews the attempt to embed civic engagement and civic education…

The Role of Problem Solving in Complex Intraverbal Repertoires

ERIC Educational Resources Information Center

Sautter, Rachael A.; LeBlanc, Linda A.; Jay, Allison A.; Goldsmith, Tina R.; Carr, James E.

2011-01-01

We examined whether typically developing preschoolers could learn to use a problem-solving strategy that involved self-prompting with intraverbal chains to provide multiple responses to intraverbal categorization questions. Teaching the children to use the problem-solving strategy did not produce significant increases in target responses until…

Using Online Delivery for Workplace Training in Healthcare

ERIC Educational Resources Information Center

Bryce, Elizabeth; Choi, Peter; Landstrom, Margaret; LoChang, Justin

2008-01-01

The potential impact of on-line learning in health care is significant. By providing access to educational material from an internet-connected computer anytime and anywhere, healthcare workers (HCWs), whose workload demands are often changing and somewhat unpredictable, have increased ability to self-educate. For example, the growing recognition…

Modular Access and Progression Routes: Support Issues and Student Directed Learning.

ERIC Educational Resources Information Center

Ward, Jill

1995-01-01

The effects of modularizing Access Courses provided by the University of Derby were examined for 299 adult students. No significant differences appeared in retention, but the modular approach had increased recruitment/retention of unskilled and lower achieving students. Students with lower entry qualifications had higher achievement than similar…

Theoretically Based Pedagogical Strategies Leading to Deep Learning in Asynchronous Online Gerontology Courses

ERIC Educational Resources Information Center

Majeski, Robin; Stover, Merrily

2007-01-01

Online learning has enjoyed increasing popularity in gerontology. This paper presents instructional strategies grounded in Fink's (2003) theory of significant learning designed for the completely asynchronous online gerontology classroom. It links these components with the development of mastery learning goals and provides specific guidelines for…

Project Invest: Instructional Network for Vocational Education and Specialized Training.

ERIC Educational Resources Information Center

Borba, Craig E.; Guzicki, Joseph A.

1980-01-01

An evaluation of the effects on attendance of Project Invest, a program providing career education to special education students, was undertaken with 20 students participating in the project and a control group of 20 nonparticipating students. Results showed a significant increase in attendance among the experimental Ss. (PHR)

Reciprocity and Social Capital in Sibling Relationships of People with Disabilities

ERIC Educational Resources Information Center

Kramer, John; Hall, Allison; Heller, Tamar

2013-01-01

Sibling relationships are some of the longest-lasting relationships people experience, providing ample opportunities to build connections across the life span. For siblings and people with intellectual and developmental disabilities (IDD), these connections take on an increased significance as their families age and parents can no longer provide…

Future assessment activities

Treesearch

Toral Patel-Weynand

2012-01-01

Scientific literature on the effects of climatic variability and change on forest ecosystems has increased significantly over the past decade, providing a foundation for establishing forest-climate relationships and projecting the effects of continued warming on a wide range of forest resources and ecosystem services. In addition, certainty about the nature of some of...

Improving scientific knowledge

Treesearch

James M. Vose; David L. Peterson

2012-01-01

Scientific literature on the effects of climatic variability and change on forest ecosystems has increased significantly over the past decade, providing a foundation for establishing forest-climate relationships and projecting the effects of continued warming on a wide range of forest resources and ecosystem services. In addition, certainty about the nature of some of...

CARDIOVASCULAR RESPONSES IN UNRESTRAINED WKY-RATS TO INHALED ULTRAFINE CARBON PARTICLES

EPA Science Inventory

Abstract
This study provides evidence for adverse cardiac effects of inhaled ultrafine particles (UFPs) in healthy WKY rats. Short term exposure (24 h) with carbon UFPs (180 ?g?m ?) induced a moderate but significant heart rate increase of 18 bpm (4.8 %) in association with a ...

Flipping Introduction to MIS for a Connected World

ERIC Educational Resources Information Center

Law, Wai K.

2014-01-01

It has been increasingly challenging to provide an introductory coverage of the rapidly expanding fields in Information Systems (IS). The task has been further complicated by the popularity of web resources and cloud services. A new generation of technically savvy learners, while recognizing the significance of information systems, expects…

Educational Implications of Costello Syndrome: The Team Approach

ERIC Educational Resources Information Center

Murdick, Nikki L.; Gartin, Barbara C.

2014-01-01

Since the 1990s the number of children with disabilities placed within the general education classroom has steadily increased. Many of these children are provided special education services under the generic disability title "intellectual disability." Over the past decade, there has been a significant amount of research concerning rare…

Teachers' Knowledge of Education Law

ERIC Educational Resources Information Center

Littleton, Mark

2008-01-01

The knowledge base of education-related law is growing at a rapid pace. The increase in federal and state statutes is rising commensurate with litigation that directs teachers on curricular, professional, and social matters. At the same time, numerous studies provide significant evidence that teachers lack an adequate level of knowledge of…

76 FR 44462 - Statement of General Policy or Interpretation; Commentary on the Fair Credit Reporting Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... collection, assembly, and use of consumer report information and provides the framework for the credit... increased the obligations of users of consumer reports, particularly employers. Most significantly, the 1996... transferred authority to issue interpretive guidance under the FCRA to the Consumer Financial Protection...

A Guide to Involving English Language Learners in School to Career Initiatives.

ERIC Educational Resources Information Center

Allen, Lili; DiBona, Natanya; Reilly, Michael Chavez

This guidebook provides suggestions and directions for increasing and improving English language learners' involvement in school-to-career initiatives across the country. It describes model career initiatives that either target or include significant numbers of English language learners, and it analyzes some school restructuring issues raised by…

The Determinant of US Consumers Attitudes toward Solar Energy

ERIC Educational Resources Information Center

Lu, Chao-Lin

2016-01-01

Solar energy provides several significant advantages, such as reduction of the CO[subscript 2] emissions, increase of energy supply diversification, security of energy, and regional/national energy independence. Due to the reduced installation cost and the rapid advances in solar energy technology, the installed capacity of solar power has been…

MODELING THE IMPACTS OF FIRE FLOWS ON DISTRIBUTION SYSTEM WATER QUALITY, DESIGN AND OPERATION

EPA Science Inventory

In most water distribution systems, a significant amount of the piping and storage capacity is used to provide adequate quantities of water during fire conditions. This increased capacity results in higher capital costs and potential negative impacts on water quality due to longe...

Feeding a hungry world: the challenge of developing safe and effective methods of food preservation

USDA-ARS?s Scientific Manuscript database

Preventing the loss of harvested commodities due to either postharvest diseases or physiological breakdown (uncontrolled ripening) offers a significant approach to providing the increased yields of food that will be needed to feed the world population in the 21st century (Wilson 2013). Activities ...

Are Immigrants Healthier? The Case of Depression among Filipino Americans

ERIC Educational Resources Information Center

Mossakowski, Krysia N.

2007-01-01

Immigration has fundamentally changed American society by increasing racial and ethnic diversity. Yet, our knowledge of the relationship between immigrant status and mental health remains limited. This study provides evidence that Filipino American immigrants have significantly lower levels of depressive symptoms than Filipinos born in the United…

The impact of coaches providing healthy snacks at junior sport training.

PubMed

Belski, Regina; Staley, Kiera; Keenan, Stephen; Skiadopoulos, Anne; Randle, Erica; Donaldson, Alex; O'Halloran, Paul; Kappelides, Pam; O'Neil, Stacey; Nicholson, Matthew

2017-12-01

Sports clubs provide an opportunity to tackle childhood obesity rates through targeted interventions. Our study aimed to investigate if coaches providing healthy snacks to participants before junior netball sessions at five clubs in Melbourne, Australia, increased consumption of healthy foods and influenced coach perceptions of participants' attention/participation levels. Coaches provided healthy snacks to participants before each netball session for one school term. Children's food consumption was observed at one session before, during and after the intervention. Parents attending the observed session completed pre- and post-intervention questionnaires. Coaches rated participants' attention/participation at the observed sessions before and during the intervention, and completed a questionnaire post-intervention. Baseline: Ice cream and cake were the most frequently consumed snacks. During intervention: Fruit, cheese and crackers and vegetables were the most frequently consumed snacks. Coaches ratings of participants' attention/participation increased significantly (baseline: 6.4 ± 0.17, intervention: 7.5 ± 0.36; p=0.02) where the same coach undertook ratings at both time points. Coaches providing healthy snacks before sessions at sports clubs increased consumption of nutrient-dense foods at the session, and may have positively affected participants' attention/participation. Implications for public health: This study highlights how a simple intervention could improve the diet of Australian children. © 2017 The Authors.

The influence of a powered knee-ankle-foot orthosis on walking in poliomyelitis subjects: A pilot study.

PubMed

Arazpour, Mokhtar; Moradi, Alireza; Samadian, Mohammad; Bahramizadeh, Mahmood; Joghtaei, Mahmoud; Ahmadi Bani, Monireh; Hutchins, Stephen W; Mardani, Mohammad A

2016-06-01

Traditionally, the anatomical knee joint is locked in extension when walking with a conventional knee-ankle-foot orthosis. A powered knee-ankle-foot orthosis was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait. The purpose of this study was to determine differences of the powered knee-ankle-foot orthosis compared to a locked knee-ankle-foot orthosis in kinematic data and temporospatial parameters during ambulation. Quasi-experimental design. Subjects with poliomyelitis (n = 7) volunteered for this study and undertook gait analysis with both the powered and the conventional knee-ankle-foot orthoses. Three trials per orthosis were collected while each subject walked along a 6-m walkway using a calibrated six-camera three-dimensional video-based motion analysis system. Walking with the powered knee-ankle-foot orthosis resulted in a significant reduction in both walking speed and step length (both 18%), but a significant increase in stance phase percentage compared to walking with the conventional knee-ankle-foot orthosis. Cadence was not significantly different between the two test conditions (p = 0.751). There was significantly higher knee flexion during swing phase and increased hip hiking when using the powered orthosis. The new powered orthosis permitted improved knee joint kinematic for knee-ankle-foot orthosis users while providing knee support in stance and active knee motion in swing in the gait cycle. Therefore, the new powered orthosis provided more natural knee flexion during swing for orthosis users compared to the locked knee-ankle-foot orthosis. This orthosis has the potential to improve knee joint kinematics and gait pattern in poliomyelitis subjects during walking activities. © The International Society for Prosthetics and Orthotics 2015.

A national cross-sectional study on effects of fluoride-safe water supply on the prevalence of fluorosis in China.

PubMed

Wang, Cheng; Gao, Yanhui; Wang, Wei; Zhao, Lijun; Zhang, Wei; Han, Hepeng; Shi, Yuxia; Yu, Guangqian; Sun, Dianjun

2012-01-01

To assess the effects of provided fluoride-safe drinking-water for the prevention and control of endemic fluorosis in China. A national cross-sectional study in China. In 1985, randomly selected villages in 27 provinces (or cities and municipalities) in 5 geographic areas all over China. Involved 81 786 children aged from 8 to 12 and 594 698 adults aged over 16. The prevalence of dental fluorosis and clinical skeletal fluorosis, the fluoride concentrations in the drinking-water in study villages and in the urine of subjects. The study showed that in the villages where the drinking-water fluoride concentrations were higher than the government standard of 1.2 mg/l, but no fluoride-safe drinking-water supply scheme was provided (FNB areas), the prevalence rate and index of dental fluorosis in children, and prevalence rate of clinical skeletal fluorosis in adults were all significantly higher than those in the historical endemic fluorosis villages after the fluoride-safe drinking-water were provided (FSB areas). Additionally, the prevalence rate of dental fluorosis as well as clinical skeletal fluorosis, and the concentration of fluoride in urine were found increased with the increase of fluoride concentration in drinking-water, with significant positive correlations in the FNB areas. While, the prevalence rate of dental fluorosis and clinical skeletal fluorosis in different age groups and their degrees of prevalence were significantly lower in the FSB areas than those in the FNB areas. The provision of fluoride-safe drinking-water supply schemes had significant effects on the prevention and control of dental fluorosis and skeletal fluorosis. The study also indicated that the dental and skeletal fluorosis is still prevailing in the high-fluoride drinking-water areas in China.

Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study.

PubMed

Bogenschutz, Michael P; Forcehimes, Alyssa A; Pommy, Jessica A; Wilcox, Claire E; Barbosa, P C R; Strassman, Rick J

2015-03-01

Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants' responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p < 0.05). Gains were largely maintained at follow-up to 36 weeks. The intensity of effects in the first psilocybin session (at week 4) strongly predicted change in drinking during weeks 5-8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. NCT02061293. © The Author(s) 2015.

Long-acting follicle-stimulating hormone analogs containing N-linked glycosylation exhibited increased bioactivity compared with o-linked analogs in female rats.

PubMed

Weenen, C; Peña, J E; Pollak, S V; Klein, J; Lobel, L; Trousdale, R K; Palmer, S; Lustbader, E G; Ogden, R T; Lustbader, J W

2004-10-01

The effects of altering the number and type of additional carbohydrate moieties on the pharmacokinetic and pharmacodynamic properties of FSH were examined in this report. A series of single-chain follitropins, containing variable numbers of additional N- (or O-) linked carbohydrates, were designed and expressed in Chinese hamster ovary cells. Proper folding, efficient receptor binding, and signal transduction were confirmed by in vitro assays. Pharmacokinetic and pharmacodynamic parameters were evaluated in immature female Sprague Dawley rats. Increasing the number of glycosylation sites with either N- (or O-) linked moieties extended the elimination half-life as much as 2-fold compared with recombinant human FSH (rhFSH). However, there was a maximum elimination half-life such that further glycosylation provided no additional lengthening of the half-life. Conversely, biopotency, as assessed by inhibin A levels 74 h post injection, and follicle production were significantly higher for the N-linked analogs. Rats stimulated with the longest acting analogs (either N- or O-linked) showed significantly higher ovarian weights than rats receiving a single injection of rhFSH. The analog containing four additional N-linked sites (rhFSH-N4) had the greatest number of large, preovulatory follicles. Although the half-life of rhFSH-N4 displayed no further enhancement beyond the other longest acting analogs, this analog exhibited significantly increased biopotency in rats. This work provides the basis for the generation of a series of reagents potentially useful for therapeutic applications.

Training Employers to Implement Health Promotion Programs: Results From the CDC Work@Health® Program.

PubMed

Cluff, Laurie A; Lang, Jason E; Rineer, Jennifer R; Jones-Jack, Nkenge H; Strazza, Karen M

2018-05-01

Centers for Disease Control and Prevention (CDC) initiated the Work@Health Program to teach employers how to improve worker health using evidence-based strategies. Program goals included (1) determining the best way(s) to deliver employer training, (2) increasing employers' knowledge of workplace health promotion (WHP), and (3) increasing the number of evidence-based WHP interventions at employers' worksites. This study is one of the few to examine the effectiveness of a program designed to train employers how to implement WHP programs. Pre- and posttest design. Training via 1 of 3 formats hands-on, online, or blended. Two hundred six individual participants from 173 employers of all sizes. Eight-module training curriculum to guide participants through building an evidence-based WHP program, followed by 6 to 10 months of technical assistance. The CDC Worksite Health ScoreCard and knowledge, attitudes, and behavior survey. Descriptive statistics, paired t tests, and mixed linear models. Participants' posttraining mean knowledge scores were significantly greater than the pretraining scores (61.1 vs 53.2, P < .001). A year after training, employers had significantly increased the number of evidence-based interventions in place (47.7 vs 35.5, P < .001). Employers' improvements did not significantly differ among the 3 training delivery formats. The Work@Health Program provided employers with knowledge to implement WHP interventions. The training and technical assistance provided structure, practical guidance, and tools to assess needs and select, implement, and evaluate interventions.

Peptide YY, neuropeptide Y and corticotrophin-releasing factor modulate gastrointestinal motility and food intake during acute stress.

PubMed

Forbes, Sarah C; Cox, Helen M

2014-11-01

Peripheral neuropeptide Y (NPY) provides protection against the endocrine, feeding and gastrointestinal (GI) responses to stress; however, it is not yet established how it interacts with corticotrophin-releasing factor (CRF) to mediate these effects. Peptide YY (PYY) also has significant roles in GI motility and food intake but little is known about its role in stress responses. Upper GI transit, fecal pellet output (FPO) and feeding responses, and the role of CRF1 receptors, during restraint or a novel environment stress, were ascertained in PYY-/-, NPY-/- and wild type (WT) mice, with CRF and the CRF1 antagonist, antalarmin, injected intraperitoneally. Upper GI transit and FPO were significantly increased in PYY-/- mice during restraint stress. Exogenous CRF increased defecation during placement in a novel environment in WT mice through CRF1 , while CRF1 blockade reduced defecation in WT and NPY-/- mice but had no effect in PYY-/- mice. In addition, CRF1 blockade had no effect on upper GI transit in WT mice, or on food intake in PYY-/- or NPY-/- mice, but it significantly increased food intake in WT mice. Endogenous NPY appears to inhibit the colonic motor response induced by CRF1 activation, unlike PYY, while both peptides are required for CRF1 modulation of feeding behavior during stress. Overall, these results provide new insights into the mechanism by which PYY and NPY affect stress responses. © 2014 John Wiley & Sons Ltd.

Compressing Aviation Data in XML Format

NASA Technical Reports Server (NTRS)

Patel, Hemil; Lau, Derek; Kulkarni, Deepak

2003-01-01

Design, operations and maintenance activities in aviation involve analysis of variety of aviation data. This data is typically in disparate formats making it difficult to use with different software packages. Use of a self-describing and extensible standard called XML provides a solution to this interoperability problem. XML provides a standardized language for describing the contents of an information stream, performing the same kind of definitional role for Web content as a database schema performs for relational databases. XML data can be easily customized for display using Extensible Style Sheets (XSL). While self-describing nature of XML makes it easy to reuse, it also increases the size of data significantly. Therefore, transfemng a dataset in XML form can decrease throughput and increase data transfer time significantly. It also increases storage requirements significantly. A natural solution to the problem is to compress the data using suitable algorithm and transfer it in the compressed form. We found that XML-specific compressors such as Xmill and XMLPPM generally outperform traditional compressors. However, optimal use of Xmill requires of discovery of optimal options to use while running Xmill. This, in turn, depends on the nature of data used. Manual disc0ver.y of optimal setting can require an engineer to experiment for weeks. We have devised an XML compression advisory tool that can analyze sample data files and recommend what compression tool would work the best for this data and what are the optimal settings to be used with a XML compression tool.

Hypertension and hyperlipidemia management in patients treated at community health centers.

PubMed

Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

2008-01-01

OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at <140/90 mm Hg, p=0.02). Hypertension control for persons with diabetes, renal failure and heart failure increased (16% vs. 28% controlled at <130/85 mm Hg, p=0.006). LDL control increased significantly for patients with 2 or more risk factors (39% vs. 58% controlled at <130 mg/dl, p=0.008). Other clinical subgroups showed trends toward better control, although there was insufficient power to detect significant differences for these groups. CONCLUSION: Hypertension and hyperlipidemia outcomes improved for some risk groups; however, ongoing QI is necessary.

Influenza vaccination among cancer survivors: disparities in prevalence between blacks and whites.

PubMed

Stafford, Kristen A; Sorkin, John D; Steinberger, Eileen K

2013-06-01

Cancer survivors are at increased risk for influenza-related complications. Racial disparities in preventive health services have not been extensively studied among cancer survivors. Our objective is to compare influenza vaccination prevalence among black and white cancer survivors We performed a secondary data analysis of 41,346 white and black cancer survivors (excluding non-melanoma skin cancer) from the 2009 Behavioral Risk Factor Surveillance System survey. Respondents were asked whether they had received an influenza vaccination in the previous year. Multivariable logistic regression was used to estimate the odds of having influenza vaccine by race. Sixty-five percent of whites reported receiving the vaccine in the last year compared to 50 % of blacks. Blacks had significantly lower odds of vaccination after controlling for covariates significantly associated with the odds of influenza vaccination. Higher education, having health insurance, having a primary care provider, and having a routine check-up in the last year increased the odds of receiving an influenza vaccine. Our analysis supports that racial disparities in vaccine coverage persist among cancer survivors, a group strongly recommended to receive annual influenza vaccine, even when predictors significantly associated with increased vaccination are controlled for. As a nationally representative survey with a large sample size, our study provides a picture of self-reported vaccine coverage among cancer survivors in the USA and the disparity that exists between blacks and whites in this population. Care teams can use these findings to better target follow-up care for cancer survivors.

Distribution of Peripheral Memory T Follicular Helper Cells in Patients with Schistosomiasis Japonica

PubMed Central

Chen, Xiaojun; Li, Wei; Zhang, Yang; Song, Xian; Xu, Lei; Xu, Zhipeng; Zhou, Sha; Zhu, Jifeng; Jin, Xin; Liu, Feng; Chen, Gengxin; Su, Chuan

2015-01-01

Background Schistosomiasis is a helminthic disease that affects more than 200 million people. An effective vaccine would be a major step towards eliminating the disease. Studies suggest that T follicular helper (Tfh) cells provide help to B cells to generate the long-term humoral immunity, which would be a crucial component of successful vaccines. Thus, understanding the biological characteristics of Tfh cells in patients with schistosomiasis, which has never been explored, is essential for vaccine design. Methodology/Principal Findings In this study, we investigated the biological characteristics of peripheral memory Tfh cells in schistosomiasis patients by flow cytometry. Our data showed that the frequencies of total and activated peripheral memory Tfh cells in patients were significantly increased during Schistosoma japonicum infection. Moreover, Tfh2 cells, which were reported to be a specific subpopulation to facilitate the generation of protective antibodies, were increased more greatly than other subpopulations of total peripheral memory Tfh cells in patients with schistosomiasis japonica. More importantly, our result showed significant correlations of the percentage of Tfh2 cells with both the frequency of plasma cells and the level of IgG antibody. In addition, our results showed that the percentage of T follicular regulatory (Tfr) cells was also increased in patients with schistosomiasis. Conclusions/Significance Our report is the first characterization of peripheral memory Tfh cells in schistosomasis patients, which not only provides potential targets to improve immune response to vaccination, but also is important for the development of vaccination strategies to control schistosomiasis. PMID:26284362

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed Central

Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005–2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of “how-to” information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007–2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for “carbon monoxide poisoning” for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries. PMID:29284015

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed

Paul, Elise; Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005-2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of "how-to" information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007-2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for "carbon monoxide poisoning" for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries.

Alcohol prices, beverage quality, and the demand for alcohol: quality substitutions and price elasticities.

PubMed

Gruenewald, Paul J; Ponicki, William R; Holder, Harold D; Romelsjö, Anders

2006-01-01

Although the published literature on alcohol beverage taxes, prices, sales, and related problems treats alcoholic beverages as a simple good, alcohol is a complex good composed of different beverage types (i.e., beer, wine, and spirits) and quality brands (e.g., high-, medium-, and low-quality beers). As a complex good, consumers may make substitutions between purchases of different beverage types and brands in response to price increases. For this reason, the availability of a broad range of beverage prices provides opportunities for consumers to mitigate the effects of average price increases through quality substitutions; a change in beverage choice in response to price increases to maintain consumption. Using Swedish price and sales data provided by Systembolaget for the years 1984 through 1994, this study assessed the relationships between alcohol beverage prices, beverage quality, and alcohol sales. The study examined price effects on alcohol consumption using seemingly unrelated regression equations to model the impacts of price increases within 9 empirically defined quality classes across beverage types. The models enabled statistical assessments of both own-price and cross-price effects between types and classes. The results of these analyses showed that consumers respond to price increases by altering their total consumption and by varying their brand choices. Significant reductions in sales were observed in response to price increases, but these effects were mitigated by significant substitutions between quality classes. The findings suggest that the net impacts of purposeful price policy to reduce consumption will depend on how such policies affect the range of prices across beverage brands.

Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans

PubMed Central

Stanhope, Kimber L.; Schwarz, Jean Marc; Keim, Nancy L.; Griffen, Steven C.; Bremer, Andrew A.; Graham, James L.; Hatcher, Bonnie; Cox, Chad L.; Dyachenko, Artem; Zhang, Wei; McGahan, John P.; Seibert, Anthony; Krauss, Ronald M.; Chiu, Sally; Schaefer, Ernst J.; Ai, Masumi; Otokozawa, Seiko; Nakajima, Katsuyuki; Nakano, Takamitsu; Beysen, Carine; Hellerstein, Marc K.; Berglund, Lars; Havel, Peter J.

2009-01-01

Studies in animals have documented that, compared with glucose, dietary fructose induces dyslipidemia and insulin resistance. To assess the relative effects of these dietary sugars during sustained consumption in humans, overweight and obese subjects consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Although both groups exhibited similar weight gain during the intervention, visceral adipose volume was significantly increased only in subjects consuming fructose. Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption. In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption. Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle–triglyceride and –cholesterol significantly increased during fructose but not glucose consumption. In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose. These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults. PMID:19381015

Increased Science Instrumentation Funding Strengthens Mars Program

NASA Technical Reports Server (NTRS)

Graham, Lee D.; Graff, T. G.

2012-01-01

As the strategic knowledge gaps mature for the exploration of Mars, Mars sample return (MSR), and Phobos/Deimos missions, one approach that becomes more probable involves smaller science instrumentation and integrated science suites. Recent technological advances provide the foundation for a significant evolution of instrumentation; however, the funding support is currently too small to fully utilize these advances. We propose that an increase in funding for instrumentation development occur in the near-term so that these foundational technologies can be applied. These instruments would directly address the significant knowledge gaps for humans to Mars orbit, humans to the Martian surface, and humans to Phobos/ Deimos. They would also address the topics covered by the Decadal Survey and the Mars scientific goals, objectives, investigations and priorities as stated by the MEPAG. We argue that an increase of science instrumentation funding would be of great benefit to the Mars program as well as the potential for human exploration of the Mars system. If the total non-Earth-related planetary science instrumentation budget were increased 100% it would not add an appreciable amount to the overall NASA budget and would provide the real potential for future breakthroughs. If such an approach were implemented in the near-term, NASA would benefit greatly in terms of science knowledge of the Mars, Phobos/Deimos system, exploration risk mitigation, technology development, and public interest.

Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance.

PubMed

Schlund, Michael W; Cataldo, Michael F; Siegle, Greg J; Ladouceur, Cecile D; Silk, Jennifer S; Forbes, Erika E; McFarland, Ashley; Iyengar, Satish; Dahl, Ronald E; Ryan, Neal D

2011-05-06

Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI) research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population. In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 9-13 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N=120). Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress. Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations. We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks. The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols.

Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance

PubMed Central

2011-01-01

Background Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI) research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population. Method In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 9-13 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N = 120). Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress. Results Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations. Discussion We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks Conclusion The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols. PMID:21548928

Imaging Bone–Cartilage Interactions in Osteoarthritis Using [18F]-NaF PET-MRI

PubMed Central

Pedoia, Valentina; Seo, Youngho; Yang, Jaewon; Bucknor, Matt; Franc, Benjamin L.; Majumdar, Sharmila

2016-01-01

Purpose: Simultaneous positron emission tomography–magnetic resonance imaging (PET-MRI) is an emerging technology providing both anatomical and functional images without increasing the scan time. Compared to the traditional PET/computed tomography imaging, it also exposes the patient to significantly less radiation and provides better anatomical images as MRI provides superior soft tissue characterization. Using PET-MRI, we aim to study interactions between cartilage composition and bone function simultaneously, in knee osteoarthritis (OA). Procedures: In this article, bone turnover and remodeling was studied using [18F]-sodium fluoride (NaF) PET data. Quantitative MR-derived T1ρ relaxation times characterized the biochemical cartilage degeneration. Sixteen participants with early signs of OA of the knee received intravenous injections of [18F]-NaF at the onset of PET-MR image acquisition. Regions of interest were identified, and kinetic analysis of dynamic PET data provided the rate of uptake (Ki) and the normalized uptake (standardized uptake value) of [18F]-NaF in the bone. Morphological MR images and quantitative voxel-based T1ρ maps of cartilage were obtained using an atlas-based registration technique to segment cartilage automatically. Voxel-by-voxel statistical parameter mapping was used to investigate the relationship between bone and cartilage. Results: Increases in cartilage T1ρ, indicating degenerative changes, were associated with increased turnover in the adjoining bone but reduced turnover in the nonadjoining compartments. Associations between pain and increased bone uptake were seen in the absence of morphological lesions in cartilage, but the relationship was reversed in the presence of incident cartilage lesions. Conclusion: This study shows significant cartilage and bone interactions in OA of the knee joint using simultaneous [18F]-NaF PET-MR, the first in human study. These observations highlight the complex biomechanical and biochemical interactions in the whole knee joint in OA, which potentially could help assess therapeutic targets in treating OA. PMID:28654417

The impaired anesthesiologist: what you should know about substance abuse.

PubMed

Samuelson, Stefan T; Bryson, Ethan O

2017-02-01

Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life. Physicians and other healthcare professionals are not immune to the disease of addiction and are just as prone to developing SUD as laypersons. Even so, the risk of mortality is significantly increased because of access to potent and highly addictive anesthetic agents with a narrow therapeutic index when self-administered. Also, the number of anesthesia residents who are identified as having SUD is currently increasing. Due to the considerable morbidity and mortality associated with the abuse of anesthetic agents as well as the continuous increase in the rate of substance abuse by anesthesia providers, it is essential for anesthesia care providers to become familiar with the presenting signs and symptoms of substance abuse and impairment.

Dance clubbing on MDMA and during abstinence from Ecstasy/MDMA: prospective neuroendocrine and psychobiological changes.

PubMed

Parrott, A C; Lock, J; Conner, A C; Kissling, C; Thome, J

2008-01-01

The present study is the first to prospectively compare a group of recreational Ecstasy users when dance clubbing on 3,4-methylenedioxymethamphetamine (MDMA) and when clubbing during abstinence from Ecstasy/MDMA. Twelve normal healthy volunteers (mean age = 23.2 years) were assessed at a Saturday night dance club under self-administered MDMA. On the other weekend they went to the same dance club without taking MDMA (order counterbalanced). Both conditions involved 5 test sessions conducted at similar times: pre-drug baseline, 1 h post-drug clubbing, 2.5 h post-drug clubbing, and 2 and 4 days later. The assessments included body and ambient temperature, physical activity (pedometer), as well as self-ratings for mood state, physical activity, thermal comfort and thirst. Saliva samples were analyzed for MDMA, cortisol and testosterone. The cortisol levels increased significantly by 800% when dance clubbing on MDMA, while testosterone increased significantly by 75%; neither neuroendocrine measure was altered during abstinence. Saliva analyses confirmed the presence of MDMA when dancing on Ecstasy and its absence when dancing off Ecstasy. The pedometer values and self-rated levels of dancing were similar at both weekends. Hot and cold flushes and feeling hot increased significantly under MDMA. The mean body temperature did not change significantly, although there was a borderline trend for increased values after MDMA. Feelings of happiness and excitement increased under MDMA, although they were not significantly greater than when clubbing during abstinence. Neurohormonal release may be an important part of the acute MDMA experience. The large cortisol increase provides further data on the bioenergetic stress model of recreational Ecstasy/MDMA. Copyright 2008 S. Karger AG, Basel.

Dance Clubbing on MDMA and during Abstinence from Ecstasy/MDMA: Prospective Neuroendocrine and Psychobiological Changes

PubMed Central

Parrott, A.C.; Lock, J.; Conner, A.C.; Kissling, C.; Thome, J.

2013-01-01

Background/Aims The present study is the first to prospectively compare a group of recreational Ecstasy users when dance clubbing on 3,4-methylenedioxymethamphetamine (MDMA) and when clubbing during abstinence from Ecstasy/MDMA. Methods Twelve normal healthy volunteers (mean age = 23.2 years) were assessed at a Saturday night dance club under self-administered MDMA. On the other weekend they went to the same dance club without taking MDMA (order counterbalanced). Both conditions involved 5 test sessions conducted at similar times: pre-drug baseline, 1 h post-drug clubbing, 2.5 h post-drug clubbing, and 2 and 4 days later. The assessments included body and ambient temperature, physical activity (pedometer), as well as self-ratings for mood state, physical activity, thermal comfort and thirst. Saliva samples were analyzed for MDMA, cortisol and testosterone. Results The cortisol levels increased significantly by 800% when dance clubbing on MDMA, while testosterone increased significantly by 75%; neither neuroendocrine measure was altered during abstinence. Saliva analyses confirmed the presence of MDMA when dancing on Ecstasy and its absence when dancing off Ecstasy. The pedometer values and self-rated levels of dancing were similar at both weekends. Hot and cold flushes and feeling hot increased significantly under MDMA. The mean body temperature did not change significantly, although there was a borderline trend for increased values after MDMA. Feelings of happiness and excitement increased under MDMA, although they were not significantly greater than when clubbing during abstinence. Conclusions Neurohormonal release may be an important part of the acute MDMA experience. The large cortisol increase provides further data on the bioenergetic stress model of recreational Ecstasy/MDMA. PMID:18654086

Primary adrenal insufficiency is associated with impaired natural killer cell function: a potential link to increased mortality.

PubMed

Bancos, Irina; Hazeldine, Jon; Chortis, Vasileios; Hampson, Peter; Taylor, Angela E; Lord, Janet M; Arlt, Wiebke

2017-04-01

Mortality in patients with primary adrenal insufficiency (PAI) is significantly increased, with respiratory infections as a major cause of death. Moreover, patients with PAI report an increased rate of non-fatal infections. Neutrophils and natural killer (NK) cells are innate immune cells that provide frontline protection against invading pathogens. Thus, we compared the function and phenotype of NK cells and neutrophils isolated from PAI patients and healthy controls to ascertain whether altered innate immune responses could be a contributory factor for the increased susceptibility of PAI patients to infection. We undertook a cross-sectional study of 42 patients with PAI due to autoimmune adrenalitis ( n =  37) or bilateral adrenalectomy ( n =  5) and 58 sex- and age-matched controls. A comprehensive screen of innate immune function, consisting of measurements of neutrophil phagocytosis, reactive oxygen species production, NK cell cytotoxicity (NKCC) and NK cell surface receptor expression, was performed on all subjects. Neutrophil function did not differ between PAI and controls. However, NKCC was significantly reduced in PAI (12.0 ± 1.5% vs 21.1 ± 2.6%, P  < 0.0001). Phenotypically, the percentage of NK cells expressing the activating receptors NKG2D and NKp46 was significantly lower in PAI, as was the surface density of NKG2D (all P  < 0.0001). Intracellular granzyme B expression was significantly increased in NK cells from PAI patients ( P  < 0.01). Adrenal insufficiency is associated with significantly decreased NKCC, thereby potentially compromising early recognition and elimination of virally infected cells. This potential impairment in anti-viral immune defense may contribute to the increased rate of respiratory infections and ultimately mortality in PAI. © 2017 The authors.