Teacher Evaluation in Practice: Year 3 Teacher and Administrator Perceptions of REACH. Research Brief

ERIC Educational Resources Information Center

Sporte, Susan E.; Jiang, Jennie Y.

2016-01-01

Three years after the launch of Chicago's redesigned teacher evaluation system, Recognizing Educators Advancing Chicago Students (REACH) Students, most teachers and administrators continue to report they believe REACH has the potential to improve instruction and student learning, and they remain negative about the use of student growth in…

Adoption, reach, implementation, and maintenance of a behavioral and mental health assessment in primary care.

PubMed

Krist, Alex H; Phillips, Siobhan M; Sabo, Roy T; Balasubramanian, Bijal A; Heurtin-Roberts, Suzanne; Ory, Marcia G; Johnson, Sallie Beth; Sheinfeld-Gorin, Sherri N; Estabrooks, Paul A; Ritzwoller, Debra P; Glasgow, Russell E

2014-01-01

Guidelines recommend screening patients for unhealthy behaviors and mental health concerns. Health risk assessments can systematically identify patient needs and trigger care. This study seeks to evaluate whether primary care practices can routinely implement such assessments into routine care. As part of a cluster-randomized pragmatic trial, 9 diverse primary care practices implemented My Own Health Report (MOHR)-an electronic or paper-based health behavior and mental health assessment and feedback system paired with counseling and goal setting. We observed how practices integrated MOHR into their workflows, what additional practice staff time it required, and what percentage of patients completed a MOHR assessment (Reach). Most practices approached (60%) agreed to adopt MOHR. How they implemented MOHR depended on practice resources, informatics capacity, and patient characteristics. Three practices mailed patients invitations to complete MOHR on the Web, 1 called patients and completed MOHR over the telephone, 1 had patients complete MOHR on paper in the office, and 4 had staff help patients complete MOHR on the Web in the office. Overall, 3,591 patients were approached and 1,782 completed MOHR (Reach = 49.6%). Reach varied by implementation strategy with higher reach when MOHR was completed by staff than by patients (71.2% vs 30.2%, P <.001). No practices were able to sustain the complete MOHR assessment without adaptations after study completion. Fielding MOHR increased staff and clinician time an average of 28 minutes per visit. Primary care practices can implement health behavior and mental health assessments, but counseling patients effectively requires effort. Practices will need more support to implement and sustain assessments. © 2014 Annals of Family Medicine, Inc.

Hydraulic alterations resulting from hydropower development in the Bonneville Reach of the Columbia River

USGS Publications Warehouse

Hatten, James R.; Batt, Thomas R.

2010-01-01

We used a two-dimensional (2D) hydrodynamic model to simulate and compare the hydraulic characteristics in a 74-km reach of the Columbia River (the Bonneville Reach) before and after construction of Bonneville Dam. For hydrodynamic modeling, we created a bathymetric layer of the Bonneville Reach from single-beam and multi-beam echo-sounder surveys, digital elevation models, and navigation surveys. We calibrated the hydrodynamic model at 100 and 300 kcfs with a user-defined roughness layer, a variable-sized mesh, and a U.S. Army Corps of Engineers backwater curve. We verified the 2D model with acoustic Doppler current profiler (ADCP) data at 14 transects and three flows. The 2D model was 88% accurate for water depths, and 77% accurate for velocities. We verified a pre-dam 2D model run at 126 kcfs using pre-dam aerial photos from September 1935. Hydraulic simulations indicated that mean water depths in the Bonneville Reach increased by 34% following dam construction, while mean velocities decreased by 58%. There are numerous activities that would benefit from data output from the 2D model, including biological sampling, bioenergetics, and spatially explicit habitat modeling.

27 CFR 8.52 - Practices which result in exclusion.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Practices which result in..., DEPARTMENT OF THE TREASURY ALCOHOL EXCLUSIVE OUTLETS Exclusion § 8.52 Practices which result in exclusion. The practices specified in this section result in exclusion under section 105(a) of the Act. The...

27 CFR 8.52 - Practices which result in exclusion.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Practices which result in..., DEPARTMENT OF THE TREASURY ALCOHOL EXCLUSIVE OUTLETS Exclusion § 8.52 Practices which result in exclusion. The practices specified in this section result in exclusion under section 105(a) of the Act. The...

27 CFR 8.52 - Practices which result in exclusion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Practices which result in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.52 Practices which result in exclusion. The practices specified in this section result in exclusion under section 105(a) of the Act. The...

27 CFR 8.52 - Practices which result in exclusion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Practices which result in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.52 Practices which result in exclusion. The practices specified in this section result in exclusion under section 105(a) of the Act. The...

27 CFR 8.52 - Practices which result in exclusion.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Practices which result in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.52 Practices which result in exclusion. The practices specified in this section result in exclusion under section 105(a) of the Act. The...

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific

Project Career REACH: Marketing Strategies for Effective Guidance Programs.

ERIC Educational Resources Information Center

Bollendorf, Marsha; And Others

1990-01-01

Outlines the practical marketing strategies used to implement Project Career REACH, a career development program for high school freshmen. Marketing basics for guidance programs are discussed, including mission analysis, market analysis, resource analysis, strategic planning, and evaluation. (TE)

Our Global Reach: UNESCO and ICAE as Catalysts

ERIC Educational Resources Information Center

Boucouvalas, Marcie

2012-01-01

Globalization has become a household word, permeating workplaces and communities, while internationalizing the curriculum has become common practice, not just in higher education, but also reaching into the primary grades and outward into program planning efforts in the non-formal sector. Few fields, however, can claim two international bodies…

27 CFR 8.53 - Practice not resulting in exclusion.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Practice not resulting in..., DEPARTMENT OF THE TREASURY ALCOHOL EXCLUSIVE OUTLETS Exclusion § 8.53 Practice not resulting in exclusion. The practice specified in this section is deemed not to result in exclusion under section 105(a) of...

27 CFR 8.53 - Practice not resulting in exclusion.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Practice not resulting in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.53 Practice not resulting in exclusion. The practice specified in this section is deemed not to result in exclusion under section 105(a) of...

27 CFR 8.53 - Practice not resulting in exclusion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Practice not resulting in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.53 Practice not resulting in exclusion. The practice specified in this section is deemed not to result in exclusion under section 105(a) of...

27 CFR 8.53 - Practice not resulting in exclusion.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Practice not resulting in..., DEPARTMENT OF THE TREASURY ALCOHOL EXCLUSIVE OUTLETS Exclusion § 8.53 Practice not resulting in exclusion. The practice specified in this section is deemed not to result in exclusion under section 105(a) of...

27 CFR 8.53 - Practice not resulting in exclusion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Practice not resulting in..., DEPARTMENT OF THE TREASURY LIQUORS EXCLUSIVE OUTLETS Exclusion § 8.53 Practice not resulting in exclusion. The practice specified in this section is deemed not to result in exclusion under section 105(a) of...

Reaching the hard-to-reach.

PubMed

Valdes, C

1992-01-01

Guatemala's family planning (FP) programs are innovative but contraceptive use is only 23%. Total fertility is 5.3 children/woman, and the 9.5 million population will double in 23 years. The problem is poverty and illiteracy among rural residents removed from health services. 80% live in poverty and 80% are illiterate. Government effort is devoted to combating diseases such as diarrhea so there are few funds for implementing a comprehensive population policy. There is support within the national government but FP lacks priority status. APROFAM's goals are to use innovative marketing methods to inform the rural population who lack access to and knowledge about FP. Service delivery is constrained by the difficulty in reaching remote areas where 4 out of 10 indigenous Guatemalans live. Infant mortality can reach as high as 200/1000 live births. Population growth has slowed, and APROFAM plans to reach 16,000 more in the future. Promotions are conducted in several languages and aired on radio, television, and in the print media. It has been found that market research is the most effective strategy in reaching indigenous families. APROFAM has also been effective in upgrading service facilities through training, client surveys, and setting improved clinic standards. Breastfeeding, training, and voluntary sterilization programs contribute to the primary care effort. The example is given of Paulina Lebron from a very poor area who has learned how to space her children and thus improve the standard of living for her family. Eventually, she convinced herself and her family that sterilization was necessary, and now the couple enjoy the bliss of newlyweds without fear of pregnancy.

Reaching quantum limits for phase-shift detection with semiclassical states

NASA Astrophysics Data System (ADS)

Luis, Alfredo

2004-01-01

We present two measuring strategies reaching the Heisenberg limit for phase-shift measurements using semiclassical coherent states exclusively. We examine their performance by assuming practical experimental conditions such as losses and nonideal detectors.

EFNEP Reaches Refugee Youth Using a Mobile Van

ERIC Educational Resources Information Center

Gossett, Linda S.

2012-01-01

New groups of refugees settled in apartments far from city services. Their children lacked access to organized after-school activities and the opportunity to practice English. The Expanded Food and Nutrition Education Program (EFNEP) wanted to reach and teach the young refugees but lacked the staff and budget to do so. This article discusses how…

Reaching Boys: An International Study of Effective Teaching Practices

ERIC Educational Resources Information Center

Reichert, Michael; Hawley, Richard

2010-01-01

Despite a continuing stream of concern on the part of researchers, demographers, and cultural pundits about a crisis in boys' social development and schooling, surprisingly little attention has been paid to what is perhaps the richest pool of data: current, observable teaching practices that clearly work with boys. In schools of all types in all…

An official multi-society statement: the role of clinical research results in the practice of critical care medicine.

PubMed

Tonelli, Mark R; Curtis, J Randall; Guntupalli, Kalpalatha K; Rubenfeld, Gordon D; Arroliga, Alejandro C; Brochard, Laurent; Douglas, Ivor S; Gutterman, David D; Hall, Jesse R; Kavanagh, Brian P; Mancebo, Jordi; Misak, Cheryl J; Simpson, Steven Q; Slutsky, Arthur S; Suffredini, Anthony F; Thompson, B Taylor; Ware, Lorraine B; Wheeler, Arthur P; Levy, Mitchell M

2012-05-15

While the results of clinical research are clearly valuable in the care of critically ill patients, the limitations of such information and the role of other forms of medical knowledge for clinical decision making have not been carefully examined. The leadership of three large professional societies representing critical care practitioners convened a diverse group representing a wide variety of views regarding the role of clinical research results in clinical practice to develop a document to serve as a basis for agreement and a framework for ongoing discussion. Consensus was reached on several issues. While the results of rigorous clinical research are important in arriving at the best course of action for an individual critically ill patient, other forms of medical knowledge, including clinical experience and pathophysiologic reasoning, remain essential. No single source of knowledge is sufficient to guide clinical decisions, nor does one kind of knowledge always take precedence over others. Clinicians will find clinical research compelling for a variety of reasons that go beyond study design. While clinical practice guidelines and protocols based upon clinical research may improve care and decrease variability in practice, clinicians must be able to understand and articulate the rationale as to why a particular protocol or guideline is used or why an alternative approach is taken. Making this clinical reasoning explicit is necessary to understand practice variability. Understanding the strengths and weaknesses of different kinds of medical knowledge for clinical decision making and factors beyond study design that make clinical research compelling to clinicians can provide a framework for understanding the role of clinical research in practice.

Reaching consensus on communication of critical laboratory results using a collective intelligence method.

PubMed

Llovet, Maria Isabel; Biosca, Carmen; Martínez-Iribarren, Alicia; Blanco, Aurora; Busquets, Glòria; Castro, María José; Llopis, Maria Antonia; Montesinos, Mercè; Minchinela, Joana; Perich, Carme; Prieto, Judith; Ruiz, Rosa; Serrat, Núria; Simón, Margarita; Trejo, Alex; Monguet, Josep Maria; López-Pablo, Carlos; Ibarz, Mercè

2018-02-23

There is no consensus in the literature about what analytes or values should be informed as critical results and how they should be communicated. The main aim of this project is to establish consensual standards of critical results for the laboratories participating in the study. Among the project's secondary objectives, establishing consensual procedures for communication can be highlighted. Consensus was reached among all participating laboratories establishing the basis for the construction of the initial model put forward for consensus in conjunction with the clinicians. A real-time Delphi, methodology "health consensus" (HC), with motivating and participative questions was applied. The physician was expected to choose a numeric value within a scale designed for each analyte. The medians of critical results obtained represent the consensus on critical results for outpatient and inpatient care. Both in primary care and in hospital care a high degree of consensus was observed for critical values proposed in the analysis of creatinine, digoxin, phosphorus, glucose, international normalized ratio (INR), leukocytes, magnesium, neutrophils, chloride, sodium, calcium and lithium. For the rest of critical results the degree of consensus obtained was "medium high". The results obtained showed that in 72% of cases the consensual critical value coincided with the medians initially proposed by the laboratories. The real-time Delphi has allowed obtaining consensual standards for communication of critical results among the laboratories participating in the study, which can serve as a basis for other organizations.

Contextual Factors Related to Implementation and Reach of a Pragmatic Multisite Trial– The My Own Health Report (MOHR) Study

PubMed Central

Balasubramanian, Bijal A.; Heurtin-Roberts, Suzanne; Krasny, Sarah; Rohweder, Catherine; Fair, Kayla; Olmos, Tanya; Stange, Kurt C.; Gorin, Sherri Sheinfeld

2018-01-01

Background Contextual factors relevant to health care improvement studies are important for translating findings to other settings; however, these are rarely collected systematically and reported. This study articulates a prospective method for assessing contextual factors and describes factors related to implementation and patient reach of a pragmatic multisite trial conducted in nine primary care practices. Methods In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematically conducting health risk assessments and goal setting for unhealthy behaviors and behavioral health in primary care. Data were collected prospectively at baseline, mid-point, and end of intervention using a template that guided conduct of interviews and observations at practice sites. A multidisciplinary team used an iterative process to summarize themes describing contextual factors related to intervention implementation and patient reach, calculated by dividing the number of patients who completed the MOHR assessment by the number of patients offered MOHR. Results Contextual factors operational both within and external to the practice environment influenced implementation and patient reach over time. These included practice members’ motivations towards the MOHR intervention, practice staff capacity to take on additional responsibilities for implementation, practice information system capacity, external resources to support quality improvement, linkages with community resources, and fit of implementation strategy to patient populations. Conclusions Systematic assessment of contextual factors throughout implementation of quality improvement initiatives is needed to meaningfully interpret findings and translate lessons learned to other health care settings. Thus, knowledge of contextual factors is essential for scaling up of effective improvement strategies. PMID:28484066

Reach-scale effects of riparian forest cover on urban stream ecosystems

USGS Publications Warehouse

Roy, A.H.; Faust, C.L.; Freeman, Mary C.; Meyer, J.L.

2005-01-01

We compared habitat and biota between paired open and forested reaches within five small streams (basin area 10?20 km2) in suburban catchments (9%?49% urban land cover) in the Piedmont of Georgia, USA. Stream reaches with open canopies were narrower than forested reaches (4.1 versus 5.0 m, respectively). There were no differences in habitat diversity (variation in velocity, depth, or bed particle size) between open and forested reaches. However, absence of local forest cover corresponded to decreased large wood and increased algal chlorophyll a standing crop biomass. These differences in basal food resources translated into higher densities of fishes in open (9.0 individuals?m?2) versus forested (4.9 individuals?m?2) reaches, primarily attributed to higher densities of the herbivore Campostoma oligolepis. Densities of terrestrial invertebrate inputs were higher in open reaches; however, trends suggested higher biomass of terrestrial inputs in forested reaches and a corresponding higher density of terrestrial prey consumed by water column feeding fishes. Reach-scale biotic integrity (macroinvertebrates, salamanders, and fishes) was largely unaffected by differences in canopy cover. In urbanizing areas where catchment land cover drives habitat and biotic quality, management practices that rely exclusively on forested riparian areas for stream protection are unlikely to be effective at maintaining ecosystem integrity.

Common elements of adolescent prevention programs: minimizing burden while maximizing reach.

PubMed

Boustani, Maya M; Frazier, Stacy L; Becker, Kimberly D; Bechor, Michele; Dinizulu, Sonya M; Hedemann, Erin R; Ogle, Robert R; Pasalich, Dave S

2015-03-01

A growing number of evidence-based youth prevention programs are available, but challenges related to dissemination and implementation limit their reach and impact. The current review identifies common elements across evidence-based prevention programs focused on the promotion of health-related outcomes in adolescents. We reviewed and coded descriptions of the programs for common practice and instructional elements. Problem-solving emerged as the most common practice element, followed by communication skills, and insight building. Psychoeducation, modeling, and role play emerged as the most common instructional elements. In light of significant comorbidity in poor outcomes for youth, and corresponding overlap in their underlying skills deficits, we propose that synthesizing the prevention literature using a common elements approach has the potential to yield novel information and inform prevention programming to minimize burden and maximize reach and impact for youth.

The long reach of Alzheimer's disease: patients, practice, and policy.

PubMed

Bynum, Julie P W

2014-04-01

The impact of Alzheimer's disease and related dementias reaches well beyond the health care needs of the person with dementia. As dementia inexorably progresses, the patient becomes increasingly dependent on others for basic daily care and routine tasks, a physically safe environment, and protection from exploitation or abuse. Addressing the diverse medical and social care needs of the burgeoning US population with Alzheimer's disease and related dementias requires the adoption of a broad-based policy framework and agenda that explicitly acknowledge the complex and unique needs of people with dementia and the impacts of dementia on caregivers and society at large. Public policies related to social service providers, agencies that provide appropriate housing, financial and legal services, and law enforcement must complement other policies focused on prevention and risk reduction, effective treatment development, and efficient health care delivery.

Good practices and health policy analysis in European sports stadia: results from the 'Healthy Stadia' project.

PubMed

Drygas, Wojciech; Ruszkowska, Joanna; Philpott, Matthew; Björkström, Olav; Parker, Mike; Ireland, Robin; Roncarolo, Federico; Tenconi, Maria

2013-06-01

Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles. Fast food, alcohol and tobacco are commonly advertized, served and consumed during sports games giving the spectators and TV fans contradictory messages concerning healthy choices. As part of a wider programme of work part-funded by the European Union, a study was therefore designed to explore current 'good practice' relating to positive health interventions in sports stadia across a number of European countries. Using a specially designed questionnaire, information about health policies and good practices relating to food offerings in stadia, physical activity promotion among local communities, tobacco policy, positive mental health initiatives, environmental sustainability practices and social responsibility policies were collected in 10 European countries (England and Northern Ireland, Finland, Georgia, Greece, Ireland, Italy, Latvia, Poland, Spain and Sweden) involving 88 stadia. The audit results show that stadia health policies differ considerably between specific countries and sports. Based on the literature analysed, the examples of good practices collected through the study, and the subsequent instigation of a European Healthy Stadia Network, it shows that there is considerable potential for stadia to become health promoting settings.

Reach-scale land use drives the stress responses of a resident stream fish.

PubMed

Blevins, Zachary W; Wahl, David H; Suski, Cory D

2014-01-01

Abstract To date, relatively few studies have tried to determine the practicality of using physiological information to help answer complex ecological questions and assist in conservation actions aimed at improving conditions for fish populations. In this study, the physiological stress responses of fish were evaluated in-stream between agricultural and forested stream reaches to determine whether differences in these responses can be used as tools to evaluate conservation actions. Creek chub Semotilus atromaculatus sampled directly from forested and agricultural stream segments did not show differences in a suite of physiological indicators. When given a thermal challenge in the laboratory, creek chub sampled from cooler forested stream reaches had higher cortisol levels and higher metabolic stress responses to thermal challenge than creek chub collected from warmer and more thermally variable agricultural reaches within the same stream. Despite fish from agricultural and forested stream segments having different primary and secondary stress responses, fish were able to maintain homeostasis of other physiological indicators to thermal challenge. These results demonstrate that local habitat conditions within discrete stream reaches may impact the stress responses of resident fish and provide insight into changes in community structure and the ability of tolerant fish species to persist in agricultural areas.

Detection of self-paced reaching movement intention from EEG signals.

PubMed

Lew, Eileen; Chavarriaga, Ricardo; Silvoni, Stefano; Millán, José Del R

2012-01-01

Future neuroprosthetic devices, in particular upper limb, will require decoding and executing not only the user's intended movement type, but also when the user intends to execute the movement. This work investigates the potential use of brain signals recorded non-invasively for detecting the time before a self-paced reaching movement is initiated which could contribute to the design of practical upper limb neuroprosthetics. In particular, we show the detection of self-paced reaching movement intention in single trials using the readiness potential, an electroencephalography (EEG) slow cortical potential (SCP) computed in a narrow frequency range (0.1-1 Hz). Our experiments with 12 human volunteers, two of them stroke subjects, yield high detection rates prior to the movement onset and low detection rates during the non-movement intention period. With the proposed approach, movement intention was detected around 500 ms before actual onset, which clearly matches previous literature on readiness potentials. Interestingly, the result obtained with one of the stroke subjects is coherent with those achieved in healthy subjects, with single-trial performance of up to 92% for the paretic arm. These results suggest that, apart from contributing to our understanding of voluntary motor control for designing more advanced neuroprostheses, our work could also have a direct impact on advancing robot-assisted neurorehabilitation.

Mechanisms of Short-Term Training-Induced Reaching Improvement in Severely Hemiparetic Stroke Patients: A TMS Study

PubMed Central

Harris-Love, Michelle L.; Morton, Susanne M.; Perez, Monica A.; Cohen, Leonardo G.

2011-01-01

Background The neurophysiological mechanisms underlying improved upper-extremity motor skills have been partially investigated in patients with good motor recovery but are poorly understood in more impaired individuals, the majority of stroke survivors. Objective The authors studied changes in primary motor cortex (M1) excitability (motor evoked potentials [MEPs], contralateral and ipsilateral silent periods [CSPs and ISPs] using transcranial magnetic stimulation [TMS]) associated with training-induced reaching improvement in stroke patients with severe arm paresis (n = 11; Upper-Extremity Fugl-Meyer score (F-M) = 27 ± 6). Methods All patients underwent a single session of reaching training focused on moving the affected hand from a resting site to a target placed at 80% of maximum forward reaching amplitude in response to a visual “GO” cue. Triceps contribute primarily as agonist and biceps primarily as antagonist to the trained forward reaching movement. Response times were recorded for each reaching movement. Results Preceding training (baseline), greater interhemispheric inhibition (measured by ISP) in the affected triceps muscle, reflecting inhibition from the nonlesioned to the lesioned M1, was observed in patients with lower F-M scores (more severe motor impairment). Training-induced improvements in reaching were greater in patients with slower response times at baseline. Increased MEP amplitudes and decreased ISPs and CSPs were observed in the affected triceps but not in the biceps muscle after training. Conclusion These results indicate that along with training-induced motor improvements, training-specific modulation of intrahemispheric and interhemispheric mechanisms occurs after reaching practice in chronic stroke patients with substantial arm impairment. PMID:21343522

37 CFR 1.47 - Filing when an inventor refuses to sign or cannot be reached.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reached. (a) If a joint inventor refuses to join in an application for patent or cannot be found or reached after diligent effort, the application may be made by the other inventor on behalf of himself or... PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES National...

Impact of the REACH II and REACH VA Dementia Caregiver Interventions on Healthcare Costs.

PubMed

Nichols, Linda O; Martindale-Adams, Jennifer; Zhu, Carolyn W; Kaplan, Erin K; Zuber, Jeffrey K; Waters, Teresa M

2017-05-01

Examine caregiver and care recipient healthcare costs associated with caregivers' participation in Resources for Enhancing Alzheimer's Caregivers Health (REACH II or REACH VA) behavioral interventions to improve coping skills and care recipient management. RCT (REACH II); propensity-score matched, retrospective cohort study (REACH VA). Five community sites (REACH II); 24 VA facilities (REACH VA). Care recipients with Alzheimer's disease and related dementias (ADRD) and their caregivers who participated in REACH II study (analysis sample of 110 caregivers and 197 care recipients); care recipients whose caregivers participated in REACH VA and a propensity matched control group (analysis sample of 491). Previously collected data plus Medicare expenditures (REACH II) and VA costs plus Medicare expenditures (REACH VA). There was no increase in VA or Medicare expenditures for care recipients or their caregivers who participated in either REACH intervention. For VA care recipients, REACH was associated with significantly lower total VA costs of care (33.6%). VA caregiver cost data was not available. In previous research, both REACH II and REACH VA have been shown to provide benefit for dementia caregivers at a cost of less than $5/day; however, concerns about additional healthcare costs may have hindered REACH's widespread adoption. Neither REACH intervention was associated with additional healthcare costs for caregivers or patients; in fact, for VA patients, there were significantly lower healthcare costs. The VA costs savings may be related to the addition of a structured format for addressing the caregiver's role in managing complex ADRD care to an existing, integrated care system. These findings suggest that behavioral interventions are a viable mechanism to support burdened dementia caregivers without additional healthcare costs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Test result communication in primary care: a survey of current practice

PubMed Central

Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

2015-01-01

Background The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. Methods We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Results Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. Conclusions The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for

Test result communication in primary care: a survey of current practice.

PubMed

Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

2015-11-01

The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the

Reach-scale stream restoration in agricultural streams of southern Minnesota alters structural and functional responses of macroinvertebrates

USGS Publications Warehouse

Dolph, Christine L.; Eggert, Susan L.; Magner, Joe; Ferrington, Leonard C.; Vondracek, Bruce C.

2015-01-01

Recent studies suggest that stream restoration at the reach scale may not increase stream biodiversity, raising concerns about the utility of this conservation practice. We examined whether reach-scale restoration in disturbed agricultural streams was associated with changes in macroinvertebrate community structure (total macroinvertebrate taxon richness, total macroinvertebrate density, Ephemeroptera, Plecoptera, Trichoptera [EPT] taxon richness, % abundance of EPT taxa) or secondary production (macroinvertebrate biomass over time). We collected macroinvertebrate samples over the course of 1 y from restored and unrestored reaches of 3 streams in southern Minnesota and used generalized least-square (GLS) models to assess whether measures of community structure were related to reach type, stream site, or sampling month. After accounting for effects of stream site and time, we found no significant difference in total taxon richness or % abundance of EPT taxa between restored and unrestored reaches. However, the number of EPT taxa and macroinvertebrate density were significantly higher in restored than in unrestored reaches. We compared secondary production estimates among study reaches based on 95th-percentile confidence intervals generated via bootstrapping. In each study stream, secondary production was significantly (2–3×) higher in the restored than in the unrestored reach. Higher productivity in the restored reaches was largely a result of the disproportionate success of a few dominant, tolerant taxa. Our findings suggest that reach-scale restoration may have ecological effects that are not detected by measures of total taxon richness alone.

Pacific lamprey artificial propogation and rearing investigations: Rocky Reach Lamprey Management Plan

USGS Publications Warehouse

,; ,; ,; ,; ,

2011-01-01

The impetus for developing this document is through implementing the Rocky Reach Pacific Lamprey Management Plan (PLMP), a component of the Rocky Reach Comprehensive Settlement Agreement, both of which are discussed more thoroughly in Section 1.2. The ultimate goal of the PLMP is to achieve No Net Impact (NNI) to Pacific lamprey of ongoing operations of the Rocky Reach Hydroelectric Project. Conducting artificial propagation of Pacific lamprey was considered by the state and federal fishery agencies and Tribes that are parties to the Settlement Agreement as a potential Protection, Mitigation, and Enhancement measure (PME) for achieving NNI during the term of the current Rocky Reach license. This document is intended to provide guidance as to the feas ibility of culturing Pacific lamprey, the associated facilities necessary for culture practices, and identifying uncertainties for monitoring culture efficacy and rationale for implementing Pacific lamprey artificial propagation

Numerical model of the lowermost Mississippi River as an alluvial-bedrock reach: preliminary results

NASA Astrophysics Data System (ADS)

Viparelli, E.; Nittrouer, J. A.; Mohrig, D. C.; Parker, G.

2012-12-01

Recent field studies reveal that the river bed of the Lower Mississippi River is characterized by a transition from alluvium (upstream) to bedrock (downstream). In particular, in the downstream 250 km of the river, fields of actively migrating bedforms alternate with deep zones where a consolidated substratum is exposed. Here we present a first version of a one-dimensional numerical model able to capture the alluvial-bedrock transition in the lowermost Mississippi River, defined herein as the 500-km reach between the Old River Control Structure and the Gulf of Mexico. The flow is assumed to be steady, and the cross-section is divided in two regions, the river channel and the floodplain. The streamwise variation of channel and floodplain geometry is described with synthetic relations derived from field observations. Flow resistance in the river channel is computed with the formulation for low-slope, large sand bed rivers due to Wright and Parker, while a Chezy-type formulation is implemented on the floodplain. Sediment is modeled in terms of bed material and wash load. Suspended load is computed with the Wright-Parker formulation. This treatment allows either uniform sediment or a mixture of different grain sizes, and accounts for stratification effects. Bedload transport rates are estimated with the relation for sediment mixtures of Ashida and Michiue. Previous work documents reasonable agreement between these load relations and field measurements. Washload is routed through the system solving the equation of mass conservation of sediment in suspension in the water column. The gradual transition from the alluvial reach to the bedrock reach is modeled in terms of a "mushy" layer of specified thickness overlying the non-erodible substrate. In the case of a fully alluvial reach, the channel bed elevation is above this mushy layer, while in the case of partial alluvial cover of the substratum, the channel bed elevation is within the mushy layer. Variations in base

Planning Guide to Statewide Implementation, Scale-Up, and Sustainability of Recommended Practices. RP[superscript 2]: Reaching Potentials through Recommended Practices

ERIC Educational Resources Information Center

Smith, Barbara J.; Fox, Lise; Dunlap, Glen; Strain, Phil; Trivette, Carol M.; Perez Binder, Denise; Bovey, Ted; McCullough, Katy; Blase, Karen

2015-01-01

This document is a guide for implementing widespread use of evidence-based practices for improving the outcomes for young children with or at-risk for delays or disabilities and their families. The evidence-based practices are selected practices from the Division for Early Childhood (DEC) Recommended Practices (RPs). The guide is written for…

'Before reaching the last mile'- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study.

PubMed

Singh, Akash Ranjan; Pakhare, Abhijit; Kokane, Arun M; Shewade, Hemant Deepak; Chauhan, Ashish; Singh, Abhishek; Gangwar, Arti; Thakur, Prahlad Singh

2017-12-01

Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers. Mixed-methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision. 'Adequate knowledge' and 'satisfactory practice' related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT. Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Tennessee advanced practice nurse compensation survey results 2006-2007.

PubMed

Arnold, Kimberly

2007-01-01

In 2006, representatives from Middle Tennessee Advanced Practice Nurses (MTAPN), Greater Memphis Area Advanced Practice Nurses (GMAAPN), and Northeast Tennessee Nurse Practitioners Association (NETNPA) decided to poll APNs in Tennessee to compare data with the most recent results from the Advance for Nurse Practitioners national NP survey. Every other year, Advance for Nurse Practitioners publishes salary survey results from their survey. Most recently, in January 2006, an average nationwide salary for all APNs was reported at $74,812, with Tennessee's average at $71,068.

Comparing REACH Chemical Safety Assessment information with practice-a case-study of polymethylmethacrylate (PMMA) in floor coating in The Netherlands.

PubMed

Spee, Ton; Huizer, Daan

2017-10-01

On June 1st, 2007 the European regulation on Registration, Evaluation and Restriction of Chemical substances (REACH) came into force. Aim of the regulation is safe use of chemicals for humans and for the environment. The core element of REACH is chemical safety assessment of chemicals and communication of health and safety hazards and risk management measures throughout the supply chain. Extended Safety Data Sheets (Ext-SDS) are the primary carriers of health and safety information. The aim of our project was to find out whether the actual exposure to methyl methacrylate (MMA) during the application of polymethylmethacrylate (PMMA) in floor coatings as assessed in the chemical safety assessment, reflect the exposure situations as observed in the Dutch building practice. Use of PMMA flooring and typical exposure situations during application were discussed with twelve representatives of floor laying companies. Representative situations for exposure measurements were designated on the basis of this inventory. Exposure to MMA was measured in the breathing zone of the workers at four construction sites, 14 full shift samples and 14 task based samples were taken by personal air sampling. The task-based samples were compared with estimates from the Targeted Risk Assessment Tool (v3.1) of the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC-TRA) as supplied in the safety assessment from the manufacturer. For task-based measurements, in 12 out of 14 (86%) air samples measured exposure was higher than estimated exposure. Recalculation with a lower ventilation rate (50% instead of 80%) together with a higher temperature during mixing (40°C instead of 20°C) in comparison with the CSR, reduced the number of underestimated exposures to 10 (71%) samples. Estimation with the EMKG-EXPO-Tool resulted in unsafe exposure situations for all scenarios, which is in accordance with the measurement outcomes. In indoor situations, 5 out of 8 full shift exposures (62

Postural responses to unexpected perturbations of balance during reaching

PubMed Central

Trivedi, Hari; Leonard, Julia A.; Ting, Lena H.; Stapley, Paul J.

2014-01-01

To study the interaction between feedforward and feedback modes of postural control, we investigated postural responses during unexpected perturbations of the support surface that occurred during forward reaching in a standing position. We examined postural responses in lower limb muscles of 9 human subjects. Baseline measures were obtained when subjects executed reaching movements to a target placed in front of them (R condition) and during postural responses to forward and backward support-surface perturbations (no reaching, P condition) during quiet stance. Perturbations were also given at different delays after the onset of reaching movements (RP conditions) as well as with the arm extended in the direction of the target, but not reaching (P/AE condition). Results showed that during perturbations to reaching (RP), the initial automatic postural response, occurring around 100 ms after the onset of perturbations, was relatively unchanged in latency or amplitude compared to control conditions (P and P/AE). However, longer latency postural responses were modulated to aid in the reaching movements during forward perturbations but not during backward perturbations. Our results suggest that the nervous system prioritizes the maintenance of a stable postural base during reaching, and that later components of the postural responses can be modulated to ensure the performance of the voluntary task. PMID:20035321

Reach Address Database (RAD)

EPA Pesticide Factsheets

The Reach Address Database (RAD) stores the reach address of each Water Program feature that has been linked to the underlying surface water features (streams, lakes, etc) in the National Hydrology Database (NHD). (A reach is the portion of a stream between two points of confluence. A confluence is the location where two or more streams flow together.)

Reaching for Rigor: Identifying Practices of Effective High Schools. Research Report

ERIC Educational Resources Information Center

Cannata, Marisa; Haynes, Katherine Taylor; Smith, Thomas M.

2013-01-01

What distinguishes high schools that "beat the odds" for students from traditionally lower-performing groups from schools that struggle to improve the achievement and graduation rates of these student populations? What types of programs, practices, and processes support better than expected outcomes for students at risk of failure? How…

Reach Out for Health: A Church-Based Pilot Breast Cancer Education Program.

ERIC Educational Resources Information Center

Allen, Jennifer Dacey; Peterson, Karen; Stoddard, Anne M.; Colditz, Graham; Sorensen, Gloria

2002-01-01

Describes the development and testing of Reach Out For Health, a peer-led, church-based breast cancer education program for African American and Hispanic communities. Pretest-posttest evaluation of screening practices and attitudes among women over age 40 indicated that the intervention was associated with improved attitudes toward mammography,…

Metasurface holograms reaching 80% efficiency.

PubMed

Zheng, Guoxing; Mühlenbernd, Holger; Kenney, Mitchell; Li, Guixin; Zentgraf, Thomas; Zhang, Shuang

2015-04-01

Surfaces covered by ultrathin plasmonic structures--so-called metasurfaces--have recently been shown to be capable of completely controlling the phase of light, representing a new paradigm for the design of innovative optical elements such as ultrathin flat lenses, directional couplers for surface plasmon polaritons and wave plate vortex beam generation. Among the various types of metasurfaces, geometric metasurfaces, which consist of an array of plasmonic nanorods with spatially varying orientations, have shown superior phase control due to the geometric nature of their phase profile. Metasurfaces have recently been used to make computer-generated holograms, but the hologram efficiency remained too low at visible wavelengths for practical purposes. Here, we report the design and realization of a geometric metasurface hologram reaching diffraction efficiencies of 80% at 825 nm and a broad bandwidth between 630 nm and 1,050 nm. The 16-level-phase computer-generated hologram demonstrated here combines the advantages of a geometric metasurface for the superior control of the phase profile and of reflectarrays for achieving high polarization conversion efficiency. Specifically, the design of the hologram integrates a ground metal plane with a geometric metasurface that enhances the conversion efficiency between the two circular polarization states, leading to high diffraction efficiency without complicating the fabrication process. Because of these advantages, our strategy could be viable for various practical holographic applications.

Validity of the modified back-saver sit-and-reach test: a comparison with other protocols.

PubMed

Hui, S S; Yuen, P Y

2000-09-01

Studies have shown that the classical sit-and-reach (CSR) test, the modified sit-and-reach (MSR), and the newly developed back-saver sit-and-reach (BS) test have poor criterion-related validity in estimating low-back flexibility but yielded moderate criterion-related validity in hamstring flexibility. The V sit-and-reach (VSR) test was found to be practical but the validity has not been established. The purpose of this study was to propose a modified back-saver sit-and-reach (MBS) test, which incorporated all advantages of the various protocols, and to compare the criterion-related validity and reliability of all these tests. 158 college students (F = 96, and M = 62; age = 20.77 +/- 2.51) performed CSR, VSR, BS (left and right leg), and MBS (left and right leg) tests in a randomized order. Scores from each test were then correlated with the criterion measures. For all sit-reach tests, intraclass reliability (single trial) was very high (r = 0.89-0.98). MBS yielded significant and highest r with low-back and hamstring criterion for men (r = 0.47-0.67) and women (r = 0.23-0.54). The low-back and right hamstring validity of MBS for men were significantly (P < 0.01) higher than those from BS and CSR, whereas no differences in criterion-related validity were found between the MBS and other protocols in women. The ratings of perceived comfort among the sit-and-reach protocols were significantly different (P < 0.001) from each other. The rating for MBS was observed the most comfortable test as compared with other protocols. The MBS test is not only a reliable test for hamstring and low-back flexibility, it is also a more practical with improved validity for hamstring and low-back flexibility in men than previous protocols.

Dentists’ practice patterns regarding caries prevention: results from a dental practice-based research network

PubMed Central

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V

2013-01-01

Objective The purposes of this study were to (1) quantify dentists' practice patterns regarding caries prevention and (2) test the hypothesis that certain dentists' characteristics are associated with these practice patterns. Design The study used a cross-sectional study design consisting of a questionnaire survey. Participants The study queried dentists who worked in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan, which seeks to engage dentists in investigating research questions and sharing experiences and expertise (n=282). Measurement Dentists were asked about their practice patterns regarding caries preventive dentistry. Background data on patients, practice and dentist were also collected. Results 38% of dentists (n=72) provided individualised caries prevention to more than 50% of their patients. Overall, 10% of the time in daily practice was spent on caries preventive dentistry. Dentists who provided individualised caries prevention to more than 50% of their patients spent significantly more time on preventive care and less time on removable prosthetics treatment, compared to dentists who did not provide individualised caries prevention. Additionally, they provided oral hygiene instruction, patient education, fluoride recommendations, intraoral photographs taken and diet counselling to their patients significantly more often than dentists who did not provide individualised caries prevention. Multiple logistic regression analysis suggested that the percentage of patients interested in caries prevention and the percentage of patients who received hygiene instruction, were both associated with the percentage of patients who receive individualised caries prevention. Conclusions We identified substantial variation in dentists' practice patterns regarding preventive dentistry. Individualised caries prevention was significantly related to provision of other preventive services and to having a higher percentage

27 CFR 10.53 - Practices not resulting in exclusion. [Reserved

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Practices not resulting in exclusion. [Reserved] 10.53 Section 10.53 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS COMMERCIAL BRIBERY Exclusion § 10.53 Practices not...

Reaching English Language Learners in Every Classroom: Energizers for Teaching and Learning

ERIC Educational Resources Information Center

Arechiga, Debbie

2012-01-01

Reach all of your English language learners with the effective and engaging approaches in this book. It's filled with practical tools, strategies, and real-world vignettes that will help you teach reading and writing to a diverse student population. The book features "Mental Energizers," aptitudes that will help sustain your commitment as you work…

Perceiver as polar planimeter: Direct perception of jumping, reaching, and jump-reaching affordances for the self and others.

PubMed

Thomas, Brandon J; Hawkins, Matthew M; Nalepka, Patrick

2017-03-30

Runeson (Scandanavian Journal of Psychology 18:172-179, 1977) suggested that the polar planimeter might serve as an informative model system of perceptual mechanism. The key aspect of the polar planimeter is that it registers a higher order property of the environment without computational mediation on the basis of lower order properties, detecting task-specific information only. This aspect was posited as a hypothesis for the perception of jumping and reaching affordances for the self and another person. The findings supported this hypothesis. The perception of reaching while jumping significantly differed from an additive combination of jump-without-reaching and reach-without-jumping perception. The results are consistent with Gibson's (The senses considered as perceptual systems, Houghton Mifflin, Boston, MA; Gibson, The senses considered as perceptual systems, Houghton Mifflin, Boston, MA, 1966; The ecological approach to visual perception, Houghton Mifflin, Boston, MA; Gibson, The ecological approach to visual perception, Houghton Mifflin, Boston, MA, 1979) theory of information-that aspects of the environment are specified by patterns in energetic media.

Reaching Hard-to-Reach Individuals: Nonselective Versus Targeted Outbreak Response Vaccination for Measles

PubMed Central

Minetti, Andrea; Hurtado, Northan; Grais, Rebecca F.; Ferrari, Matthew

2014-01-01

Current mass vaccination campaigns in measles outbreak response are nonselective with respect to the immune status of individuals. However, the heterogeneity in immunity, due to previous vaccination coverage or infection, may lead to potential bias of such campaigns toward those with previous high access to vaccination and may result in a lower-than-expected effective impact. During the 2010 measles outbreak in Malawi, only 3 of the 8 districts where vaccination occurred achieved a measureable effective campaign impact (i.e., a reduction in measles cases in the targeted age groups greater than that observed in nonvaccinated districts). Simulation models suggest that selective campaigns targeting hard-to-reach individuals are of greater benefit, particularly in highly vaccinated populations, even for low target coverage and with late implementation. However, the choice between targeted and nonselective campaigns should be context specific, achieving a reasonable balance of feasibility, cost, and expected impact. In addition, it is critical to develop operational strategies to identify and target hard-to-reach individuals. PMID:24131555

SU-F-E-07: Web-Based Training for Radiosurgery: Methods and Metrics for Global Reach

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

Schulz, R; Thomas, E; Popple, R

Purpose: Webinars have become an evolving tool with greater or lesser success in reaching health care providers (HCPs). This study seeks to assess best practices and metrics for success in webinar deployment for optimal global reach. Methods: Webinars have been developed and launched to reach practicing health care providers in the field of radiation oncology and radiosurgery. One such webinar was launched in early February 2016. “Multiple Brain Metastases & Volumetric Modulated Arc Radiosurgery: Refining the Single-Isocenter Technique to Benefit Surgeons and Patients” presented by Drs. Fiveash and Thomas from UAB was submitted to and accredited by the Institute formore » Medical Education as qualifying for CME as well as MDCB for educational credit for dosimetrists, in order to encourage participation. MedicalPhysicsWeb was chosen as the platform to inform attendees regarding the webinar. Further IME accredited the activity for 1 AMA PRA Category 1 credit for physicians & medical physicists. The program was qualified by the ABR in meeting the criteria for self-assessment towards fulfilling MOC requirements. Free SAMs credits were underwritten by an educational grant from Varian Medical Systems. Results: The webinar in question attracted 992 pre-registrants from 66 countries. Outside the US and Canada; 11 were from the Americas; 32 were from Europe; 9 from the Middle East and Africa. Australasia and the Indian subcontinent represented the remaining 14 countries. Pre-registrants included 423 Medical Physicists, 225 Medical Dosimetrists, 24 Radiation Therapists, 66 Radiation Oncologists & other. Conclusion: The effectiveness of CME and SAM-CME programs such as this can be gauged by the high rate of respondents who state an intention to change practice habits, a primary goal of continuing medical education and self-assessment. This webinar succeeded in being the most successful webinar on Medical Physics Web as measured by pre-registration, participation and

"Reaching Every Student" with a Pyramid of Intervention Approach: One District's Journey

ERIC Educational Resources Information Center

Howery, Kathy; McClellan, Tony; Pedersen-Bayus, Karen

2013-01-01

This paper presents a description of ongoing work of an Alberta school district that is working to support and enhance effective inclusive practices that reach and teach every student. The district is implementing a Pyramid of Supports model that is built upon four critical elements: a belief in social justice and the value of every child, a…

Population targeting amid complex mental health programming: Are California's Full Service Partnerships reaching underserved children?

PubMed

Cordell, Katharan D; Snowden, Lonnie R

2017-01-01

California's Mental Health Services Act (MHSA) created Full Service Partnership programs (FSPs) targeting socially and economically vulnerable children with mental illness who are underserved by counties' public mental health treatment system. To determine whether FSPs reach a distinctive group of children, this study compares indicators of FSP-targeted underservice for FSP entrants (n = 15,598) versus everyone treated in the counties' public mental health systems (n = 282,178) and for FSP entrants versus entrants in the most intensive Medicaid delivered program in California, Therapeutic Behavioral Services (TBS, n = 11,993). Results identify that, despite first encountering mental health services systems at earlier ages, FSP clients had fewer months of treatment and were less likely to have been treated in the prior 6 months, except for crisis care, as compared to all other children served, after considering clinical severity and indicators of service need. FSP entrants also had more substance abuse and trauma-related problems. Although less seriously ill than TBS served children, FSP served children were significantly underserved. The results indicate that, amid overlapping policies and programs, carving out and reaching a distinctly underserved population can be achieved in practice, and that specialized programs, such as the FSP program, which target underserved children, have the potential to augment a system's ability to reach the underserved. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Applying attachment theory to effective practice with hard-to-reach youth: the AMBIT approach.

PubMed

Bevington, Dickon; Fuggle, Peter; Fonagy, Peter

2015-01-01

Adolescent Mentalization-Based Integrative Treatment (AMBIT) is a developing approach to working with "hard-to-reach" youth burdened with multiple co-occurring morbidities. This article reviews the core features of AMBIT, exploring applications of attachment theory to understand what makes young people "hard to reach," and provide routes toward increased security in their attachment to a worker. Using the theory of the pedagogical stance and epistemic ("pertaining to knowledge") trust, we show how it is the therapeutic worker's accurate mentalizing of the adolescent that creates conditions for new learning, including the establishment of alternative (more secure) internal working models of helping relationships. This justifies an individual keyworker model focused on maintaining a mentalizing stance toward the adolescent, but simultaneously emphasizing the critical need for such keyworkers to remain well connected to their wider team, avoiding activation of their own attachment behaviors. We consider the role of AMBIT in developing a shared team culture (shared experiences, shared language, shared meanings), toward creating systemic contexts supportive of such relationships. We describe how team training may enhance the team's ability to serve as a secure base for keyworkers, and describe an innovative approach to treatment manualization, using a wiki format as one way of supporting this process.

Best Practices for Reduction of Uncertainty in CFD Results

NASA Technical Reports Server (NTRS)

Mendenhall, Michael R.; Childs, Robert E.; Morrison, Joseph H.

2003-01-01

This paper describes a proposed best-practices system that will present expert knowledge in the use of CFD. The best-practices system will include specific guidelines to assist the user in problem definition, input preparation, grid generation, code selection, parameter specification, and results interpretation. The goal of the system is to assist all CFD users in obtaining high quality CFD solutions with reduced uncertainty and at lower cost for a wide range of flow problems. The best-practices system will be implemented as a software product which includes an expert system made up of knowledge databases of expert information with specific guidelines for individual codes and algorithms. The process of acquiring expert knowledge is discussed, and help from the CFD community is solicited. Benefits and challenges associated with this project are examined.

REACH – an overview

PubMed Central

Čihák, Rostislav

2009-01-01

An outline of the new European policy in the management of chemicals is given. This new system is known under the acronym REACH which stands for Registration, Evaluation and Authorisation of Chemicals. The background, objectives, requirements and the operation of REACH are briefly explained. PMID:21217844

Cultural democracy: the way forward for primary care of hard to reach New Zealanders.

PubMed

Finau, Sitaleki A; Finau, Eseta

2007-09-01

The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.

Home-based Reach-to-Grasp training for people after stroke is feasible: a pilot randomised controlled trial.

PubMed

Turton, A J; Cunningham, P; van Wijck, F; Smartt, Hjm; Rogers, C A; Sackley, C M; Jowett, S; Wolf, S L; Wheatley, K; van Vliet, P

2017-07-01

To determine feasibility of a randomised controlled trial (RCT) of home-based Reach-to-Grasp training after stroke. single-blind parallel group RCT. Residual arm deficit less than 12 months post-stroke. Reach-to-Grasp training in 14 one-hour therapist's visits over 6 weeks, plus one hour self-practice per day (total 56 hours). Usual care. Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), pre-randomisation, 7, 12, 24 weeks post-randomisation. Forty-seven participants (Reach-to-Grasp=24, usual care=23) were randomised over 17 months. Reach-to-Grasp participants received a median (IQR) 14 (13,14) visits, and performed 157 (96,211) repetitions per visit; plus 30 minutes (22,45) self-practice per day. Usual care participants received 10.5 (5,14) therapist visits, comprising 38.6 (30,45) minutes of arm therapy with 16 (6,24) repetitions of functional tasks per visit. Median ARAT scores in the reach-to-grasp group were 8.5 (3.0,24.0) at baseline and 14.5 (3.5,26.0) at 24 weeks compared to median of 4 at both time points (IQR: baseline (3.0,14.0), 24 weeks (3.0,30.0)) in the usual-care group. Median WMFT tasks completed at baseline and 24 weeks were 6 (3.0,11.5) and 8.5 (4.5,13.5) respectively in the reach-to-grasp group and 4 (3.0,10.0), 6 (3.0,14.0) in the usual care group. Incidence of arm pain was similar between groups. The study was stopped before 11 patients reached the 24 weeks assessment. An RCT of home-based Reach-to-Grasp training after stroke is feasible and safe. With ARAT being our preferred measure it is estimated that 240 participants will be needed for a future two armed trial.

Medical Simulation Practices 2010 Survey Results

NASA Technical Reports Server (NTRS)

McCrindle, Jeffrey J.

2011-01-01

Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

Environmental Degradation, Disproportionality, and the Double Diversion: Reaching out, Reaching ahead, and Reaching beyond

ERIC Educational Resources Information Center

Freudenburg, William R.

2006-01-01

Rather than seeking ivory-tower isolation, members of the Rural Sociological Society have always been distinguished by a willingness to work with specialists from a broad range of disciplines, and to work on some of the world's most challenging problems. What is less commonly recognized is that the willingness to reach beyond disciplinary…

Reaching with cerebral tunnel vision.

PubMed

Rizzo, M; Darling, W

1997-01-01

We studied reaching movements in a 48-year-old man with bilateral lesions of the calcarine cortex which spared the foveal representation and caused severe tunnel vision. Three-dimensional (3D) reconstruction of brain MR images showed no evidence of damage beyond area 18. The patient could not see his hand during reaching movements, providing a unique opportunity to test the role of peripheral visual cues in limb control. Optoelectronic recordings of upper limb movements showed normal hand paths and trajectories to fixated extrinsic targets. There was no slowing, tremor, or ataxia. Self-bound movements were also preserved. Analyses of limb orientation at the endpoints of reaches showed that the patient could transform an extrinsic target's visual coordinates to an appropriate upper limb configuration for target acquisition. There was no disadvantage created by blocking the view of the reaching arm. Moreover, the patient could not locate targets presented in the hemianopic fields by pointing. Thus, residual nonconscious vision or 'blindsight' in the aberrant fields was not a factor in our patient's reaching performance. The findings in this study show that peripheral visual cues on the position and velocity of the moving limb are not critical to the control of goal directed reaches, at least not until the hand is close to target. Other cues such as kinesthetic feedback can suffice. It also appears that the visuomotor transformations for reaching do not take place before area 19 in humans.

The role of domain-specific practice, handedness, and starting age in chess.

PubMed

Gobet, Fernand; Campitelli, Guillermo

2007-01-01

The respective roles of the environment and innate talent have been a recurrent question for research into expertise. The authors investigated markers of talent, environment, and critical period for the acquisition of expert performance in chess. Argentinian chess players (N = 104), ranging from weak amateurs to grandmasters, completed a questionnaire measuring variables including individual and group practice, starting age, and handedness. The study reaffirms the importance of practice for reaching high levels of performance, but it also indicates a large variability: The slower player needed 8 times as much practice to reach master level than the faster player. Additional results show a correlation between skill and starting age and indicate that players are more likely to be mixed-handed than individuals in the general population; however, there was no correlation between handedness and skill within the sample of chess players. Together, these results suggest that practice is a necessary but not sufficient condition for the acquisition of expertise, that some additional factors may differentiate chessplayers and nonchessplayers, and that starting age of practice is important. Copyright 2006 APA, all rights reserved.

27 CFR 10.53 - Practices not resulting in exclusion. [Reserved

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Practices not resulting in exclusion. [Reserved] 10.53 Section 10.53 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... resulting in exclusion. [Reserved] ...

27 CFR 10.53 - Practices not resulting in exclusion. [Reserved

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Practices not resulting in exclusion. [Reserved] 10.53 Section 10.53 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... resulting in exclusion. [Reserved] ...

Infrastructure for Reaching Disadvantaged Consumers

PubMed Central

Hovenga, Evelyn J. S.; Hovel, Joe; Klotz, Jeanette; Robins, Patricia

1998-01-01

Both consumers and health service providers need access to up-to-date information, including patient and practice guidelines, that allows them to make decisions in partnership about individual and public health in line with the primary health care model of health service delivery. Only then is it possible for patient preferences to be considered while the health of the general population is improved. The Commonwealth Government of Australia has allocated $250 million over five years, starting July 1, 1997, to support activities and projects designed to meet a range of telecommunication needs in regional, rural, and remote Australia. This paper defines rural and remote communities, then reviews rural and remote health services, information, and telecommunication technology infrastructures and their use in Australia to establish the current state of access to information tools by rural and remote communities and rural health workers in Australia today. It is argued that a suitable telecommunication infrastructure is needed to reach disadvantaged persons in extremely remote areas and that intersectoral support is essential to build this infrastructure. In addition, education will make its utilization possible. PMID:9609497

Reaching Consensus on Essential Biomedical Science Learning Objectives in a Dental Curriculum.

PubMed

Best, Leandra; Walton, Joanne N; Walker, Judith; von Bergmann, HsingChi

2016-04-01

This article describes how the University of British Columbia Faculty of Dentistry reached consensus on essential basic biomedical science objectives for DMD students and applied the information to the renewal of its DMD curriculum. The Delphi Method was used to build consensus among dental faculty members and students regarding the relevance of over 1,500 existing biomedical science objectives. Volunteer panels of at least three faculty members (a basic scientist, a general dentist, and a dental specialist) and a fourth-year dental student were formed for each of 13 biomedical courses in the first two years of the program. Panel members worked independently and anonymously, rating each course objective as "need to know," "nice to know," "irrelevant," or "don't know." Panel members were advised after each round which objectives had not yet achieved a 75% consensus and were asked to reconsider their ratings. After a maximum of three rounds to reach consensus, a second group of faculty experts reviewed and refined the results to establish the biomedical science objectives for the renewed curriculum. There was consensus on 46% of the learning objectives after round one, 80% after round two, and 95% after round three. The second expert group addressed any remaining objectives as part of its review process. Only 47% of previous biomedical science course objectives were judged to be essential or "need to know" for the general dentist. The consensus reached by participants in the Delphi Method panels and a second group of faculty experts led to a streamlined, better integrated DMD curriculum to prepare graduates for future practice.

Inhalation toxicity studies: OECD guidelines in relation to REACH and scientific developments.

PubMed

Arts, Josje H E; Muijser, H; Jonker, D; van de Sandt, J J M; Bos, P M J; Feron, V J

2008-06-01

The OECD Health Effects Test Guidelines (TGs) provide guidance concerning the use of methods for the identification and characterization of hazards from chemical substances. These TGs are largely based on tests in routine use for many years and are known to yield information relevant to various types of toxicity. They have proven their value in practice and will remain of paramount importance for decades to come. However, the TGs describe mostly animal assays, and there is an increasingly strong urge to reduce animal testing on ethical grounds. In addition, assessment procedures are generally considered too slow and too rigid, which has resulted in elaborate testing of a relatively small number of chemicals, while virtually nothing is known about the vast majority of compounds. The major objectives of Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) are to improve the knowledge about the properties and use of chemicals and to speed up the procedure of risk assessment. The REACH text contains information requirements that can be met by OECD TGs but REACH also provides rules for adaptation of the standard testing regime. Also, various components of "Intelligent Testing Strategies" are described in order to limit animal testing. This paper briefly describes the OECD TGs for inhalation toxicity studies, including those in preparation, and their role in future hazard identification. This will be discussed in relation to the evaluation of the safety of thousands of chemicals in a relatively short period of time and scientific developments, including the use of alternatives to animal testing.

Do working environment interventions reach shift workers?

PubMed

Nabe-Nielsen, Kirsten; Jørgensen, Marie Birk; Garde, Anne Helene; Clausen, Thomas

2016-01-01

Shift workers are exposed to more physical and psychosocial stressors in the working environment as compared to day workers. Despite the need for targeted prevention, it is likely that workplace interventions less frequently reach shift workers. The aim was therefore to investigate whether the reach of workplace interventions varied between shift workers and day workers and whether such differences could be explained by the quality of leadership exhibited at different times of the day. We used questionnaire data from 5361 female care workers in the Danish eldercare sector. The questions concerned usual working hours, quality of leadership, and self-reported implementation of workplace activities aimed at stress reduction, reorganization of the working hours, and participation in improvements of working procedures or qualifications. Compared with day workers, shift workers were less likely to be reached by workplace interventions. For example, night workers less frequently reported that they had got more flexibility (OR 0.5; 95 % CI 0.3-0.7) or that they had participated in improvements of the working procedures (OR 0.6; 95 % CI 0.5-0.8). Quality of leadership to some extent explained the lack of reach of interventions especially among fixed evening workers. In the light of the evidence of shift workers' stressful working conditions, we suggest that future studies focus on the generalizability of results of the present study and on how to reach this group and meet their needs when designing and implementing workplace interventions.

Professionally Responsible Disclosure of Genomic Sequencing Results in Pediatric Practice

PubMed Central

Brothers, Kyle B.; Chung, Wendy K.; Joffe, Steven; Koenig, Barbara A.; Wilfond, Benjamin; Yu, Joon-Ho

2015-01-01

Genomic sequencing is being rapidly introduced into pediatric clinical practice. The results of sequencing are distinctive for their complexity and subsequent challenges of interpretation for generalist and specialist pediatricians, parents, and patients. Pediatricians therefore need to prepare for the professionally responsible disclosure of sequencing results to parents and patients and guidance of parents and patients in the interpretation and use of these results, including managing uncertain data. This article provides an ethical framework to guide and evaluate the professionally responsible disclosure of the results of genomic sequencing in pediatric practice. The ethical framework comprises 3 core concepts of pediatric ethics: the best interests of the child standard, parental surrogate decision-making, and pediatric assent. When recommending sequencing, pediatricians should explain the nature of the proposed test, its scope and complexity, the categories of results, and the concept of a secondary or incidental finding. Pediatricians should obtain the informed permission of parents and the assent of mature adolescents about the scope of sequencing to be performed and the return of results. PMID:26371191

Action Sounds Modulate Arm Reaching Movements

PubMed Central

Tajadura-Jiménez, Ana; Marquardt, Torsten; Swapp, David; Kitagawa, Norimichi; Bianchi-Berthouze, Nadia

2016-01-01

Our mental representations of our body are continuously updated through multisensory bodily feedback as we move and interact with our environment. Although it is often assumed that these internal models of body-representation are used to successfully act upon the environment, only a few studies have actually looked at how body-representation changes influence goal-directed actions, and none have looked at this in relation to body-representation changes induced by sound. The present work examines this question for the first time. Participants reached for a target object before and after adaptation periods during which the sounds produced by their hand tapping a surface were spatially manipulated to induce a representation of an elongated arm. After adaptation, participants’ reaching movements were performed in a way consistent with having a longer arm, in that their reaching velocities were reduced. These kinematic changes suggest auditory-driven recalibration of the somatosensory representation of the arm morphology. These results provide support to the hypothesis that one’s represented body size is used as a perceptual ruler to measure objects’ distances and to accordingly guide bodily actions. PMID:27695430

The Reach Address Database (RAD)

EPA Pesticide Factsheets

The Reach Address Database (RAD) stores reach address information for each Water Program feature that has been linked to the underlying surface water features (streams, lakes, etc) in the National Hydrology Database (NHD) Plus dataset.

The linking of the upper-middle and lower reaches of the Yellow River as a result of fluvial entrenchment

NASA Astrophysics Data System (ADS)

Hu, ZhenBo; Pan, BaoTian; Bridgland, David; Vandenberghe, Jef; Guo, LianYong; Fan, YunLong; Westaway, Rob

2017-06-01

The upper-middle Yellow River flows through the Fenwei graben, a structure resulting from extensional tectonism that was formed and repeatedly extended during the Cenozoic. The drainage system within this graben was formerly isolated from the lower reaches of the Yellow River system by the Xiaoshan mountains, an actively growing ∼ NW-SE trending range. The modern course of the Yellow River takes it through this range along the Sanmen gorge, the formation of which was of great significance in that it initiated through-going drainage between the upper-middle and lower reaches of the system. The timing of this event, which was clearly a critical point in the evolution of the Yellow River, can be established by dating the terraces in the gorge. Intermittent deepening of this gorge by the Yellow River from a high-level planation surface capping the mountain range has resulted in the formation of five terraces. Magnetostratigraphic records from aeolian deposits accumulated on these surfaces provide a geochronological sequence for this geomorphic archive, in which the ages of the planation surface and of terraces T5, T4, T3, T2, and T1 have been determined as ∼3.63 Ma, ∼1.24 Ma, ∼0.86 Ma, ∼0.62 Ma, ∼129 ka, and ∼12 ka, respectively. Under the constraint of this chronological framework, a model for landscape evolution is proposed here. Uplift of the inner Fenwei graben and of the surrounding mountain ranges led to dissection of the 3.63 Ma old planation surface in conjunction with the formation of the Sanmen gorge. Drainage of the lake previously occupying the basin would have promoted incision into the fluvio-lacustrine graben sediments; indeed, gorge formation through the Xiaoshan may have been initiated or intensified by lake overflow. The ages obtained for the planation surface and uppermost terrace suggest that the formation of the Sanmen gorge and the initiation of the through-going eastward drainage of the Yellow River occurred between 3.63 and 1.24 Ma

Referent control and motor equivalence of reaching from standing

PubMed Central

Tomita, Yosuke; Feldman, Anatol G.

2016-01-01

Motor actions may result from central changes in the referent body configuration, defined as the body posture at which muscles begin to be activated or deactivated. The actual body configuration deviates from the referent configuration, particularly because of body inertia and environmental forces. Within these constraints, the system tends to minimize the difference between these configurations. For pointing movement, this strategy can be expressed as the tendency to minimize the difference between the referent trajectory (RT) and actual trajectory (QT) of the effector (hand). This process may underlie motor equivalent behavior that maintains the pointing trajectory regardless of the number of body segments involved. We tested the hypothesis that the minimization process is used to produce pointing in standing subjects. With eyes closed, 10 subjects reached from a standing position to a remembered target located beyond arm length. In randomly chosen trials, hip flexion was unexpectedly prevented, forcing subjects to take a step during pointing to prevent falling. The task was repeated when subjects were instructed to intentionally take a step during pointing. In most cases, reaching accuracy and trajectory curvature were preserved due to adaptive condition-specific changes in interjoint coordination. Results suggest that referent control and the minimization process associated with it may underlie motor equivalence in pointing. NEW & NOTEWORTHY Motor actions may result from minimization of the deflection of the actual body configuration from the centrally specified referent body configuration, in the limits of neuromuscular and environmental constraints. The minimization process may maintain reaching trajectory and accuracy regardless of the number of body segments involved (motor equivalence), as confirmed in this study of reaching from standing in young healthy individuals. Results suggest that the referent control process may underlie motor equivalence in

Practice activities of privately-practicing nurse practitioners: Results from an Australian survey.

PubMed

Currie, Jane; Chiarella, Mary; Buckley, Thomas

2018-03-01

To facilitate expansion of privately-practicing nurse practitioners in community and primary care settings, a legislative amendment in 2010 made privately-practicing nurse practitioners eligible to provide services subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme. To evaluate their practice activities, a national survey of privately-practicing nurse practitioners in Australia was conducted, and data analysed using descriptive statistics and thematic analysis (n = 73). As part of their role, 96% (n = 70) participants reported undertaking direct patient care, 95% (n = 69) patient education and health promotion, 95% (n = 69) prescribed medications, 92% (n = 67) referred patients for diagnostic investigations, and 88% (n = 64) reported making a diagnosis. Over 50% of participants saw up to 15 patients daily, and 80% (n = 58) treated the same patients on a regular basis. Of the participants, 59% (n = 43) perceived that they worked to their full scope of practice. The mainstay of privately-practicing nurse practitioner services is provision of direct patient care in community and primary healthcare settings, suggesting they have emerging potential in addressing the ever-increasing demand for healthcare in Australia. © 2017 John Wiley & Sons Australia, Ltd.

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Neural coordination during reach-to-grasp

PubMed Central

Vaidya, Mukta; Kording, Konrad; Saleh, Maryam; Takahashi, Kazutaka

2015-01-01

When reaching to grasp, we coordinate how we preshape the hand with how we move it. To ask how motor cortical neurons participate in this coordination, we examined the interactions between reach- and grasp-related neuronal ensembles while monkeys reached to grasp a variety of different objects in different locations. By describing the dynamics of these two ensembles as trajectories in a low-dimensional state space, we examined their coupling in time. We found evidence for temporal compensation across many different reach-to-grasp conditions such that if one neural trajectory led in time the other tended to catch up, reducing the asynchrony between the trajectories. Granger causality revealed bidirectional interactions between reach and grasp neural trajectories beyond that which could be attributed to the joint kinematics that were consistently stronger in the grasp-to-reach direction. Characterizing cortical coordination dynamics provides a new framework for understanding the functional interactions between neural populations. PMID:26224773

Task-dependent vestibular feedback responses in reaching.

PubMed

Keyser, Johannes; Medendorp, W Pieter; Selen, Luc P J

2017-07-01

When reaching for an earth-fixed object during self-rotation, the motor system should appropriately integrate vestibular signals and sensory predictions to compensate for the intervening motion and its induced inertial forces. While it is well established that this integration occurs rapidly, it is unknown whether vestibular feedback is specifically processed dependent on the behavioral goal. Here, we studied whether vestibular signals evoke fixed responses with the aim to preserve the hand trajectory in space or are processed more flexibly, correcting trajectories only in task-relevant spatial dimensions. We used galvanic vestibular stimulation to perturb reaching movements toward a narrow or a wide target. Results show that the same vestibular stimulation led to smaller trajectory corrections to the wide than the narrow target. We interpret this reduced compensation as a task-dependent modulation of vestibular feedback responses, tuned to minimally intervene with the task-irrelevant dimension of the reach. These task-dependent vestibular feedback corrections are in accordance with a central prediction of optimal feedback control theory and mirror the sophistication seen in feedback responses to mechanical and visual perturbations of the upper limb. NEW & NOTEWORTHY Correcting limb movements for external perturbations is a hallmark of flexible sensorimotor behavior. While visual and mechanical perturbations are corrected in a task-dependent manner, it is unclear whether a vestibular perturbation, naturally arising when the body moves, is selectively processed in reach control. We show, using galvanic vestibular stimulation, that reach corrections to vestibular perturbations are task dependent, consistent with a prediction of optimal feedback control theory. Copyright © 2017 the American Physiological Society.

Environmental stressors afflicting tailwater stream reaches across the United States

USGS Publications Warehouse

Miranda, Leandro E.; Krogman, R. M.

2014-01-01

The tailwater is the reach of a stream immediately below an impoundment that is hydrologically, physicochemically and biologically altered by the presence and operation of a dam. The overall goal of this study was to gain a nationwide awareness of the issues afflicting tailwater reaches in the United States. Specific objectives included the following: (i) estimate the percentage of reservoirs that support tailwater reaches with environmental conditions suitable for fish assemblages throughout the year, (ii) identify and quantify major sources of environmental stress in those tailwaters that do support fish assemblages and (iii) identify environmental features of tailwater reaches that determine prevalence of key fish taxa. Data were collected through an online survey of fishery managers. Relative to objective 1, 42% of the 1306 reservoirs included in this study had tailwater reaches with sufficient flow to support a fish assemblage throughout the year. The surface area of the reservoir and catchment most strongly delineated reservoirs maintaining tailwater reaches with or without sufficient flow to support a fish assemblage throughout the year. Relative to objective 2, major sources of environmental stress generally reflected flow variables, followed by water quality variables. Relative to objective 3, zoogeography was the primary factor discriminating fish taxa in tailwaters, followed by a wide range of flow and water quality variables. Results for objectives 1–3 varied greatly among nine geographic regions distributed throughout the continental United States. Our results provide a large-scale view of the effects of reservoirs on tailwater reaches and may help guide research and management needs.

Practice and professional development plans (PPDPs): results of a feasibility study

PubMed Central

Elwyn, Glyn; Carlisle, Sandra; Hocking, Paul; Smail, Simon

2001-01-01

Background Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Aims Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Design Qualitative observational study. Study sample All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Method Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Results Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. Conclusions This work supports the view that organisational development has considerable

Reaching beyond an Online/Offline Divide: Invoking the Rhizome in Higher Education Course Design

ERIC Educational Resources Information Center

Jones, Angela; Bennett, Rebecca

2017-01-01

In the rush to digitise aspects of higher education to cater to an increasingly diverse and wide-ranging university market, there is a concern that best-practice teaching and learning based on sound pedagogy may be left behind. This article addresses this concern by offering a conceptual reimagining of the learning space that reaches beyond a…

How to Reach and Teach Children with ADD/ADHD: Practical Techniques, Strategies, and Interventions. Third Edition

ERIC Educational Resources Information Center

Rief, Sandra F.

2016-01-01

The third edition of "How to Reach and Teach Children and Teens with ADD/ADHD" has been completely revised to offer the most updated and comprehensive guidance to everyone engaged in the positive education of children and teens who have been diagnosed with ADHD or show signs and symptoms of the disorder. This valuable resource contains…

Context Matters: Team and Organizational Factors Associated with Reach of Evidence-Based Psychotherapies for PTSD in the Veterans Health Administration.

PubMed

Sayer, Nina A; Rosen, Craig S; Bernardy, Nancy C; Cook, Joan M; Orazem, Robert J; Chard, Kathleen M; Mohr, David C; Kehle-Forbes, Shannon M; Eftekhari, Afsoon; Crowley, Jill; Ruzek, Josef I; Smith, Brandy N; Schnurr, Paula P

2017-11-01

Evidence-based psychotherapies for PTSD are often underused. The objective of this mixed-method study was to identify organizational and clinic factors that promote high levels of reach of evidence-based psychotherapies for PTSD 10 years into their dissemination throughout the Veterans Health Administration. We conducted 96 individual interviews with staff from ten outpatient PTSD teams at nine sites that differed in reach of evidence-based psychotherapies for PTSD. Major themes associated with reach included clinic mission, clinic leader and staff engagement, clinic operations, staff perceptions, and the practice environment. Strategies to improve reach of evidence-based psychotherapies should attend to organizational and team-level factors.

Transfer Paths of Research Results to the Practice: Observations From the Receiving End

NASA Astrophysics Data System (ADS)

Findikakis, A. N.

2005-12-01

A non-scientific poll of fellow practicing professionals suggests that there is a range of opinions regarding the effectiveness of different ways of becoming acquainted with and using the results of academic research in their practice. Journal articles remain the dominant path for transferring research results to the profession, even though accessing them is becoming more difficult with time. Driven primarily by cost considerations personal and corporate subscriptions seem to be on the decline. Libraries are one of the first victims of cost cutting measures in the industry. Even though the availability of journal articles in electronic form facilitates their availability, their prices are prohibitive. This is especially true during when a professional is searching for a solution to a problem and may have to review several papers on the subject. One colleague suggested that the professional organizations and other publishers of research articles could learn from the experience of the music industry, by lowering the cost of downloading individual papers to something like a dollar per article, recovering thus their production costs through the increase in the volume of purchased articles. The posting on the internet of special reports and dissertations by research institutions is viewed as very useful by those working in practice. The distribution through the internet of reports by federal organizations conducting or sponsoring research, such as the U.S. Geological Survey and the U.S. Environmental Protection Agency is greatly appreciated by the practicing professionals. The use of leading researchers as consultants provides a direct path for bringing research results to the practice, but it is limited to a small number of cases where bringing in a consultant can be justified. Short courses are viewed as an effective way of familiarizing professionals with the latest research findings on specific subjects. The notes distributed in such courses are considered

REACH: impact on the US cosmetics industry?

PubMed

Pouillot, Anne; Polla, Barbara; Polla, Ada

2009-03-01

The Registration, Evaluation, Authorization and restriction of Chemicals (REACH) is a recent European regulation on chemical substances meant to protect human health and the environment. REACH imposes the "precautionary principle" where additional data and definitive action are required when uncertainty is identified. The cosmetics industry is only partially concerned by REACH: while the stages of registration and evaluation apply to cosmetics, those of authorization and restriction most likely will not, as cosmetic ingredients are already subject to regulation by various agencies and directives. REACH has potential benefits to the industry including the possibility of reassuring consumers and improving their image of chemicals and cosmetics. However, REACH also has potential disadvantages, mainly with regard to impeding innovation. The American cosmetics industry will be affected by REACH, because all US manufacturers who export substances to Europe will have to fully comply with REACH.

Do children perceive postural constraints when estimating reach or action planning?

PubMed

Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

2009-03-01

Estimation of whether an object is reachable from a specific body position constitutes an important aspect in effective motor planning. Researchers who estimate reachability by way of motor imagery with adults consistently report the tendency to overestimate, with some evidence of a postural effect (postural stability hypothesis). This idea suggests that perceived reaching limits depend on an individual's perceived postural constraints. Based on previous work with adults, the authors expected a significant postural effect with the Reach 2 condition, as evidenced by reduced overestimation. Furthermore, the authors hypothesized that the postural effect would be greater in younger children. They then tested these propositions among children aged 7, 9, and 11 years by asking them to estimate reach while seated (Reach 1) and in the more demanding posture of standing on 1 foot and leaning forward (Reach 2). Results indicated no age or condition difference, therefore providing no support for a postural effect. When the authors compared these data to a published report of adults, a developmental difference emerged. That is, adults recognize the perceived postural constraint of the standing position resulting in under- rather than overestimation, as displayed in the seated condition. Although preliminary, these observations suggest that estimates of reach (action planning) continue to be refined between late childhood and young adulthood.

Interpreting REACH guidance in the determination of the derived no effect level (DNEL).

PubMed

Kreider, Marisa L; Spencer Williams, E

2010-11-01

Under the new European chemicals regulation, REACH, a new safety value, the Derived No Effect Level (DNEL) must be established for all chemicals manufactured, imported or used in the EU in quantities greater than 10 metric tonnes per year. The DNEL is to be calculated for all relevant exposure pathways, exposure populations, and endpoints of toxicity. The EU has published guidance on how to derive the DNEL, but this guidance has yet to be put into practice and is in some places not prescriptive. Using the Agency for Toxic Substances and Disease Registry (ATSDR) dataset, we have determined inhalation DNELs for styrene. In doing so, we considered what effect key decisions would have on the calculated DNEL. The resulting DNELs were then compared to existing risk criteria values or occupational exposure limits. General population DNELs were generally more conservative than analogous risk criteria (ranging from approximately 0.05 to 2.5 ppm). Worker DNELs are lower than existing occupational standards (ranging from approximately 0.4 to 20 ppm). To our knowledge, this work represents the first rigorous application and interpretation of the EU guidance for determination of a DNEL and will prove useful as a model for determination of other DNELs under REACH. Copyright © 2010 Elsevier Inc. All rights reserved.

Effect of a gravity-compensating orthosis on reaching after stroke: evaluation of the Therapy Assistant WREX.

PubMed

Iwamuro, Bridget T; Cruz, Erik G; Connelly, Lauri L; Fischer, Heidi C; Kamper, Derek G

2008-11-01

Within-subjects repeated-measures design evaluating reaching with and without the Therapy Assistant Wilmington Robotic Exoskeleton (WREX). Laboratory. Stroke survivors (N=10) with chronic upper-extremity hemiparesis. Not applicable. Arm movement kinematics (Optotrak Certus motion detection system), muscle activity for biceps, triceps, anterior deltoid, and brachioradialis muscles (bipolar surface electromyography). Significant improvements of reaching distance occurred for all subjects across all targets (P<.001) when using the Therapy Assistant WREX. While the self-selected peak speed of hand movement during the reach decreased significantly with the Therapy Assistant WREX (P<.001), use of the Therapy Assistant WREX led to improved quality of movement as signified by a decrease in jerk (P<.001) and a shift in the timing of the peak speed to an earlier point in the movement (P<.001). Electromyographic muscle activity analysis showed that use of the Therapy Assistant WREX led to a reduction in biceps activity across all targets during the reach (P<.05), in conjunction with a marginally significant reduction in activity of the anterior deltoid (P<.055). No changes were observed in triceps (P=.47) or brachioradialis activity (P=.28). By reducing requirements for shoulder activation, the Therapy Assistant WREX improved reaching performance among stroke survivors compared with free reaching, thereby potentially facilitating practice of functional tasks.

Decoding natural reach-and-grasp actions from human EEG

NASA Astrophysics Data System (ADS)

Schwarz, Andreas; Ofner, Patrick; Pereira, Joana; Ioana Sburlea, Andreea; Müller-Putz, Gernot R.

2018-02-01

Objective. Despite the high number of degrees of freedom of the human hand, most actions of daily life can be executed incorporating only palmar, pincer and lateral grasp. In this study we attempt to discriminate these three different executed reach-and-grasp actions utilizing their EEG neural correlates. Approach. In a cue-guided experiment, 15 healthy individuals were asked to perform these actions using daily life objects. We recorded 72 trials for each reach-and-grasp condition and from a no-movement condition. Main results. Using low-frequency time domain features from 0.3 to 3 Hz, we achieved binary classification accuracies of 72.4%, STD  ±  5.8% between grasp types, for grasps versus no-movement condition peak performances of 93.5%, STD  ±  4.6% could be reached. In an offline multiclass classification scenario which incorporated not only all reach-and-grasp actions but also the no-movement condition, the highest performance could be reached using a window of 1000 ms for feature extraction. Classification performance peaked at 65.9%, STD  ±  8.1%. Underlying neural correlates of the reach-and-grasp actions, investigated over the primary motor cortex, showed significant differences starting from approximately 800 ms to 1200 ms after the movement onset which is also the same time frame where classification performance reached its maximum. Significance. We could show that it is possible to discriminate three executed reach-and-grasp actions prominent in people’s everyday use from non-invasive EEG. Underlying neural correlates showed significant differences between all tested conditions. These findings will eventually contribute to our attempt of controlling a neuroprosthesis in a natural and intuitive way, which could ultimately benefit motor impaired end users in their daily life actions.

Education, training, and practice among nordic neuropsychologists. Results from a professional practices survey.

PubMed

Norup, A; Egeland, J; Løvstad, M; Nybo, T; Persson, B A; Rivera, D; Schanke, A-K; Sigurdardottir, S; Arango-Lasprilla, J C

2017-01-01

To investigate sociodemographic characteristics, clinical and academic training, work setting and salary, clinical activities, and salary and job satisfaction among practicing neuropsychologists in four Nordic countries. 890 neuropsychologists from Denmark, Finland, Norway, and Sweden participated in an internet-based survey between December 2013 and June 2015. Three-fourths (76%) of the participants were women, with a mean age of 47 years (range 24-79). In the total sample, 11% earned a PhD and 42% were approved as specialists in neuropsychology (equivalent to board certification in the U.S.). Approximately 72% worked full-time, and only 1% were unemployed. Of the participants, 66% worked in a hospital setting, and 93% had conducted neuropsychological assessments during the last year. Attention deficit hyperactivity disorder, learning disability, and intellectual disability were the most common conditions seen by neuropsychologists. A mean income of 53,277 Euros was found. Neuropsychologists expressed greater job satisfaction than income satisfaction. Significant differences were found between the Nordic countries. Finnish neuropsychologists were younger and worked more hours every week. Fewer Swedish neuropsychologists had obtained specialist approval and fewer worked full-time in neuropsychology positions. Danish and Norwegian neuropsychologists earned more money than their Nordic colleagues. This is the first professional practice survey of Nordic neuropsychologists to provide information about sociodemographic characteristics and work setting factors. Despite the well-established guidelines for academic and clinical education, there are relevant differences between the Nordic countries. The results of the study offer guidance for refining the development of organized and highly functioning neuropsychological specialty practices in Nordic countries.

Muscle activation patterns in acceleration-based phases during reach-to-grasp movement.

PubMed

Tokuda, Keisuke; Lee, Bumsuk; Shiihara, Yasufumi; Takahashi, Kazuhiro; Wada, Naoki; Shirakura, Kenji; Watanabe, Hideomi

2016-11-01

[Purpose] An earlier study divided reaching activity into characteristic phases based on hand velocity profiles. By synchronizing muscle activities and the acceleration profile, a phasing approach for reaching movement, based on hand acceleration profiles, was attempted in order to elucidate the roles of individual muscle activities in the different phases of the acceleration profile in reaching movements. [Subjects and Methods] Ten healthy volunteer subjects participated in this study. The aim was to electromyographically evaluate muscles around the shoulder, the upper trapezius, the anterior deltoid, the biceps brachii, and the triceps brachii, most of which have been used to evaluate arm motion, as well as the acceleration of the upper limb during simple reaching movement in the reach-to-grasp task. [Results] Analysis showed the kinematic trajectories of the acceleration during a simple biphasic profile of the reaching movement could be divided into four phases: increasing acceleration (IA), decreasing acceleration (DA), increasing deceleration (ID), and decreasing deceleration (DD). Muscles around the shoulder showed different activity patterns, which were closely associated with these acceleration phases. [Conclusion] These results suggest the important role of the four phases, derived from the acceleration trajectory, in the elucidation of the muscular mechanisms which regulate and coordinate the muscles around the shoulder in reaching movements.

Primary health care registered nurses' types in implementation of health promotion practices.

PubMed

Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele

2016-09-01

Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed

Sure start: voices of the 'hard-to-reach'.

PubMed

Coe, C; Gibson, A; Spencer, N; Stuttaford, M

2008-07-01

This research aimed to look in depth at the factors affecting the ability of four Sure Start local programmes, based in a multicultural Midlands city, to engage with 'hard-to-reach' populations. A variety of research strategies and methods were employed. Geographical information systems, participatory research methods and interviews were used in order to understand the extent of the challenge, and hear first hand, why parents may not get involved with Sure Start. The mapping exercise involved collation and mapping of postcode data with respect to boundaries and potential and actual users of Sure Start services. This made possible the identification of any geographical patterning in the distribution of service users and non-users. Participatory research methods were used with parents, enabling them to conduct short interviews within their own communities and make sense of the data collected. Interviews were also conducted with 70 parents across the city, recruited through local schools. The results indicate that parental decisions regarding Sure Start are the product of a complex interaction between numerous factors which may act as either barriers or facilitators to service utilization. The results suggest that a multi-method approach to data collection is useful and appropriate in gaining access to those parents who are non-users of the Sure Start services and enabling their voices to be heard. These findings offer some explanations and insight into the apparent ambivalent attitudes of some families toward Sure Start services. Implications for future practice are discussed.

Teaching interpersonal skills in family practice: results of a national survey.

PubMed

Kahn, G; Cohen, B; Jason, H

1979-02-01

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.

REACH. Major Appliance.

ERIC Educational Resources Information Center

English, Charles; And Others

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of major appliances. The instructional units focus on installation of appliances, troubleshooting washing machines, troubleshooting electric dryers,…

REACH. Refrigeration Units.

ERIC Educational Resources Information Center

Snow, Rufus; And Others

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of refrigeration. The instructional units focus on refrigeration fundamentals, tubing and pipe, refrigerants, troubleshooting, window air conditioning, and…

Do older adults perceive postural constraints for reach estimation?

PubMed

Cordova, Alberto; Gabbard, Carl

2014-01-01

BACKGROUND/STUDY CONTEXT: Recent evidence indicates that older persons have difficulty mentally representing intended movements. Furthermore, in an estimation of reach paradigm using motor imagery, a form of mental representation, older persons significantly overestimated their ability compared with young adults. The authors tested the notion that older adults may also have difficulty perceiving the postural constraints associated with reach estimation. The authors compared young (Mage = 22 years) and older (Mage = 67) adults on reach estimation while seated and in a more postural demanding standing and leaning forward position. The expectation was a significant postural effect with the standing condition, as evidenced by reduced overestimation. Whereas there was no difference between groups in the seated condition (both overestimated), older adults underestimated whereas the younger group once again overestimated in the standing condition. From one perspective, these results show that older adults do perceive postural constraints in light of their own physical capabilities. That is, that group perceived greater postural demands with the standing posture and elected to program a more conservative strategy, resulting in underestimation.

Distance Reached in the Anteromedial Reach Test as a Function of Learning and Leg Length

ERIC Educational Resources Information Center

Bent, Nicholas P.; Rushton, Alison B.; Wright, Chris C.; Batt, Mark E.

2012-01-01

The Anteromedial Reach Test (ART) is a new outcome measure for assessing dynamic knee stability in anterior cruciate ligament-injured patients. The effect of learning and leg length on distance reached in the ART was examined. Thirty-two healthy volunteers performed 15 trials of the ART on each leg. There was a moderate correlation (r = 0.44-0.50)…

Pilot study to test effectiveness of video game on reaching performance in stroke.

PubMed

Acosta, Ana Maria; Dewald, Hendrik A; Dewald, Jules P A

2011-01-01

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject's success rate increases.

Pilot study to test effectiveness of video game on reaching performance in stroke

PubMed Central

Acosta, Ana Maria; Dewald, Hendrik A.; Dewald, Jules P. A.

2012-01-01

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject’s success rate increases. PMID:21674392

Reach and get capability in a computing environment

DOEpatents

Bouchard, Ann M [Albuquerque, NM; Osbourn, Gordon C [Albuquerque, NM

2012-06-05

A reach and get technique includes invoking a reach command from a reach location within a computing environment. A user can then navigate to an object within the computing environment and invoke a get command on the object. In response to invoking the get command, the computing environment is automatically navigated back to the reach location and the object copied into the reach location.

Reach Adaptation: What Determines Whether We Learn an Internal Model of the Tool or Adapt the Model of Our Arm?

PubMed Central

Kluzik, JoAnn; Diedrichsen, Jörn; Shadmehr, Reza; Bastian, Amy J.

2008-01-01

We make errors when learning to use a new tool. However, the cause of error may be ambiguous: is it because we misestimated properties of the tool or of our own arm? We considered a well-studied adaptation task in which people made goal-directed reaching movements while holding the handle of a robotic arm. The robot produced viscous forces that perturbed reach trajectories. As reaching improved with practice, did people recalibrate an internal model of their arm, or did they build an internal model of the novel tool (robot), or both? What factors influenced how the brain solved this credit assignment problem? To investigate these questions, we compared transfer of adaptation between three conditions: catch trials in which robot forces were turned off unannounced, robot-null trials in which subjects were told that forces were turned off, and free-space trials in which subjects still held the handle but watched as it was detached from the robot. Transfer to free space was 40% of that observed in unannounced catch trials. We next hypothesized that transfer to free space might increase if the training field changed gradually, rather than abruptly. Indeed, this method increased transfer to free space from 40 to 60%. Therefore although practice with a novel tool resulted in formation of an internal model of the tool, it also appeared to produce a transient change in the internal model of the subject's arm. Gradual changes in the tool's dynamics increased the extent to which the nervous system recalibrated the model of the subject's own arm. PMID:18596187

Reach distance but not judgment error is associated with falls in older people.

PubMed

Butler, Annie A; Lord, Stephen R; Fitzpatrick, Richard C

2011-08-01

Reaching is a vital action requiring precise motor coordination and attempting to reach for objects that are too far away can destabilize balance and result in falls and injury. This could be particularly important for many elderly people with age-related loss of sensorimotor function and a reduced ability to recover balance. Here, we investigate the interaction between reaching ability, errors in judging reach, and the incidence of falling (retrospectively and prospectively) in a large cohort of older people. Participants (n = 415, 70-90 years) had to estimate the furthest distance they could reach to retrieve a broomstick hanging in front of them. In an iterative dialog with the experimenter, the stick was moved until it was at the furthest distance they estimated to be reached successfully. At this point, participants were asked to attempt to retrieve the stick. Actual maximal reach was then measured. The difference between attempted reach and actual maximal reach provided a measure of judgment error. One-year retrospective fall rates were obtained at initial assessment and prospective falls were monitored by monthly calendar. Participants with poor maximal reach attempted shorter reaches than those who had good reaching ability. Those with the best reaching ability most accurately judged their maximal reach, whereas poor performers were dichotomous and either underestimated or overestimated their reach with few judging exactly. Fall rates were significantly associated with reach distance but not with reach judgment error. Maximal reach but not error in perceived reach is associated with falls in older people.

Memory-guided reaching in a patient with visual hemiagnosia.

PubMed

Cornelsen, Sonja; Rennig, Johannes; Himmelbach, Marc

2016-06-01

The two-visual-systems hypothesis (TVSH) postulates that memory-guided movements rely on intact functions of the ventral stream. Its particular importance for memory-guided actions was initially inferred from behavioral dissociations in the well-known patient DF. Despite of rather accurate reaching and grasping movements to visible targets, she demonstrated grossly impaired memory-guided grasping as much as impaired memory-guided reaching. These dissociations were later complemented by apparently reversed dissociations in patients with dorsal damage and optic ataxia. However, grasping studies in DF and optic ataxia patients differed with respect to the retinotopic position of target objects, questioning the interpretation of the respective findings as a double dissociation. In contrast, the findings for reaching errors in both types of patients came from similar peripheral target presentations. However, new data on brain structural changes and visuomotor deficits in DF also questioned the validity of a double dissociation in reaching. A severe visuospatial short-term memory deficit in DF further questioned the specificity of her memory-guided reaching deficit. Therefore, we compared movement accuracy in visually-guided and memory-guided reaching in a new patient who suffered a confined unilateral damage to the ventral visual system due to stroke. Our results indeed support previous descriptions of memory-guided movements' inaccuracies in DF. Furthermore, our data suggest that recently discovered optic-ataxia like misreaching in DF is most likely caused by her parieto-occipital and not by her ventral stream damage. Finally, multiple visuospatial memory measurements in HWS suggest that inaccuracies in memory-guided reaching tasks in patients with ventral damage cannot be explained by visuospatial short-term memory or perceptual deficits, but by a specific deficit in visuomotor processing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practice and professional development plans (PPDPs): results of a feasibility study.

PubMed

Elwyn, G; Carlisle, S; Hocking, P; Smail, S

2001-01-01

Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Qualitative observational study. All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. This work supports the view that organisational development has considerable potential for bringing about effective change, and individual

Management of diabetes in Morocco: results of the International Diabetes Management Practices Study (IDMPS) – wave 5

PubMed Central

Chadli, Asmae; El Aziz, Siham; El Ansari, Nawal; Ajdi, Farida; Seqat, Mehdi; Latrech, Hanane; Belmejdoub, Ghizlaine

2016-01-01

Objectives: The International Diabetes Mellitus Practice Study (IDMPS) is a 5-year survey documenting changes in diabetes treatment practices in developing countries. The primary objective of this survey was to assess the therapeutic management of type 2 diabetes mellitus (T2DM) in real-life medical practice. The secondary objectives were to evaluate the clinical management of type 1 diabetes mellitus (T1DM) and to assess the proportion of all diabetic patients failing to reach the glycated haemoglobin (HbA1c) <7% target. Methods: Data were analysed for 738 patients (240 with T1DM and 498 with T2DM) included in wave 5 of the IDMPS in Morocco in 2011. Results: Nearly two-thirds (61%) of T2DM patients were treated with oral glucose-lowering drugs (OGLDs) alone, 13.1% were treated with insulin alone and 23.3% were treated with OGLDs plus insulin. Insulin use was less frequent, was initiated later and involved a greater use of premixes versus basal/prandial schedules compared to other populations evaluated in the IDMPS. The majority (92.5%) of T1DM patients were treated with insulin alone and the remainder received insulin plus an OGLD. Insulin protocols included basal + prandial dosing (37.5%) and premix preparations (41.3%). The recommended target of HbA1c <7% was achieved by only 22.2% of T1DM patients and 26.8% of T2DM patients. More macrovascular but fewer microvascular complications were reported in T2DM compared to T1DM patients. Late complications increased with disease duration so that 20 years after diagnosis, 75.7% of T2DM patients were found to have at least one late complication. Conclusions: The clinical burden of diabetes is high in Morocco and the majority of patients do not achieve the recommended glycaemia target, suggesting that there is a huge gap between evidence-based diabetic management and real-life practice. Better education of patients and improved compliance with international recommendations are necessary to deliver a better quality of

From reaching to reach-to-grasp: the arm posture difference and its implications on human motion control strategy.

PubMed

Li, Zhi; Milutinović, Dejan; Rosen, Jacob

2017-05-01

Reach-to-grasp arm postures differ from those in pure reaching because they are affected by grasp position/orientation, rather than simple transport to a position during a reaching motion. This paper investigates this difference via an analysis of experimental  data collected on reaching and reach-to-grasp motions. A seven-degree-of-freedom (DOFs) kinematic arm model with the swivel angle is used for the motion analysis. Compared to a widely used anatomical arm model, this model distinguishes clearly the four grasping-relevant DOFs (GR-DOFs) that are affected by positions and orientations of the objects to be grasped. These four GR-DOFs include the swivel angle that measures the elbow rotation about the shoulder-wrist axis, and three wrist joint angles. For each GR-DOF, we quantify position vs orientation task-relevance bias that measures how much the DOF is affected by the grasping position vs orientation. The swivel angle and forearm supination have similar bias, and the analysis of their motion suggests two hypotheses regarding the synergistic coordination of the macro- and micro-structures of the human arm (1) DOFs with similar task-relevance are synergistically coordinated; and (2) such synergy breaks when a task-relevant DOF is close to its joint limit without necessarily reaching the limit. This study provides a motion analysis method to reduce the control complexity for reach-to-grasp tasks, and suggests using dynamic coupling to coordinate the hand and arm of upper-limb exoskeletons.

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke.

PubMed

Levin, Mindy F; Liebermann, Dario G; Parmet, Yisrael; Berman, Sigal

2016-08-01

Background The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. Objectives To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion. Methods Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed. Results Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. Conclusions The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke. © The Author(s) 2015.

Evaluation of a hydrological model based on Bidirectional Reach (BReach)

NASA Astrophysics Data System (ADS)

Van Eerdenbrugh, Katrien; Van Hoey, Stijn; Verhoest, Niko E. C.

2016-04-01

Evaluation and discrimination of model structures is crucial to ensure an appropriate use of hydrological models. When evaluating model results by aggregating their quality in (a subset of) individual observations, overall results of this analysis sometimes conceal important detailed information about model structural deficiencies. Analyzing model results within their local (time) context can uncover this detailed information. In this research, a methodology called Bidirectional Reach (BReach) is proposed to evaluate and analyze results of a hydrological model by assessing the maximum left and right reach in each observation point that is used for model evaluation. These maximum reaches express the capability of the model to describe a subset of the evaluation data both in the direction of the previous (left) and of the following data (right). This capability is evaluated on two levels. First, on the level of individual observations, the combination of a parameter set and an observation is classified as non-acceptable if the deviation between the accompanying model result and the measurement exceeds observational uncertainty. Second, the behavior in a sequence of observations is evaluated by means of a tolerance degree. This tolerance degree expresses the condition for satisfactory model behavior in a data series and is defined by the percentage of observations within this series that can have non-acceptable model results. Based on both criteria, the maximum left and right reaches of a model in an observation represent the data points in the direction of the previous respectively the following observations beyond which none of the sampled parameter sets both are satisfactory and result in an acceptable deviation. After assessing these reaches for a variety of tolerance degrees, results can be plotted in a combined BReach plot that show temporal changes in the behavior of model results. The methodology is applied on a Probability Distributed Model (PDM) of the river

REACH. Heating Units.

ERIC Educational Resources Information Center

Stanfield, Carter; And Others

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized units in the area of heating. The instructional units focus on electric heating systems, gas heating systems, and oil burning systems. Each unit follows a typical format that includes a unit…

Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study.

PubMed

Biswas, Animesh; Dalal, Koustuv; Abdullah, Abu Sayeed Md; Gifford, Mervyn; Halim, M A

2016-01-01

Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions:  The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.

Clinical Practices and Outcomes in Elderly Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

PubMed Central

Tong, Lin; Tentori, Francesca; Akiba, Takashi; Karaboyas, Angelo; Gillespie, Brenda; Akizawa, Tadao; Pisoni, Ronald L.; Bommer, Juergen; Port, Friedrich K.

2011-01-01

Summary Background and objectives Demand for hemodialysis among elderly patients is increasing worldwide. Although clinical care of this high-risk group is complex and challenging, no guidelines exist to inform hemodialysis practices. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to assess dialysis practices and associated outcomes among elderly versus younger patients on chronic in-center hemodialysis in 12 countries. Design, setting, participants, & measurements Clinical characteristics, dialysis practices, and outcomes of elderly versus younger patients were compared among participants in four DOPPS regions in 2005 through 2007. Results Although participant mean age increased over time in all DOPPS countries, the percentage of elderly varied widely. Overall, comorbidities and malnutrition were more common in the elderly. Fistulae were used less frequently among elderly versus younger patients in Europe and North America but not in Australia, New Zealand, and Japan. No difference in treatment time was observed between elderly and younger patients after normalizing for body weight. In all regions, ultrafiltration rates were lower among elderly patients. Elderly patients reported poorer quality of life with respect to the physical but not mental component scores. Mortality risk was three- to sixfold higher in the elderly group, whereas causes of death overall were similar for elderly and younger patients. Conclusions Elderly patients represent a different proportion of DOPPS participants across countries, possibly reflecting differences in policies and clinical practices. In general, hemodialysis practices in the elderly reflected each region's clinical patterns, with some variation by age group depending upon the practice. PMID:21734085

The acceptance of in silico models for REACH: Requirements, barriers, and perspectives

PubMed Central

2011-01-01

In silico models have prompted considerable interest and debate because of their potential value in predicting the properties of chemical substances for regulatory purposes. The European REACH legislation promotes innovation and encourages the use of alternative methods, but in practice the use of in silico models is still very limited. There are many stakeholders influencing the regulatory trajectory of quantitative structure-activity relationships (QSAR) models, including regulators, industry, model developers and consultants. Here we outline some of the issues and challenges involved in the acceptance of these methods for regulatory purposes. PMID:21982269

How infants' reaches reveal principles of sensorimotor decision making

NASA Astrophysics Data System (ADS)

Dineva, Evelina; Schöner, Gregor

2018-01-01

In Piaget's classical A-not-B-task, infants repeatedly make a sensorimotor decision to reach to one of two cued targets. Perseverative errors are induced by switching the cue from A to B, while spontaneous errors are unsolicited reaches to B when only A is cued. We argue that theoretical accounts of sensorimotor decision-making fail to address how motor decisions leave a memory trace that may impact future sensorimotor decisions. Instead, in extant neural models, perseveration is caused solely by the history of stimulation. We present a neural dynamic model of sensorimotor decision-making within the framework of Dynamic Field Theory, in which a dynamic instability amplifies fluctuations in neural activation into macroscopic, stable neural activation states that leave memory traces. The model predicts perseveration, but also a tendency to repeat spontaneous errors. To test the account, we pool data from several A-not-B experiments. A conditional probabilities analysis accounts quantitatively how motor decisions depend on the history of reaching. The results provide evidence for the interdependence among subsequent reaching decisions that is explained by the model, showing that by amplifying small differences in activation and affecting learning, decisions have consequences beyond the individual behavioural act.

Physical Demand but Not Dexterity Is Associated with Motor Flexibility during Rapid Reaching in Healthy Young Adults

PubMed Central

Greve, Christian; Hortobàgyi, Tibor; Bongers, Raoul M.

2015-01-01

Healthy humans are able to place light and heavy objects in small and large target locations with remarkable accuracy. Here we examine how dexterity demand and physical demand affect flexibility in joint coordination and end-effector kinematics when healthy young adults perform an upper extremity reaching task. We manipulated dexterity demand by changing target size and physical demand by increasing external resistance to reaching. Uncontrolled manifold analysis was used to decompose variability in joint coordination patterns into variability stabilizing the end-effector and variability de-stabilizing the end-effector during reaching. Our results demonstrate a proportional increase in stabilizing and de-stabilizing variability without a change in the ratio of the two variability components as physical demands increase. We interpret this finding in the context of previous studies showing that sensorimotor noise increases with increasing physical demands. We propose that the larger de-stabilizing variability as a function of physical demand originated from larger sensorimotor noise in the neuromuscular system. The larger stabilizing variability with larger physical demands is a strategy employed by the neuromuscular system to counter the de-stabilizing variability so that performance stability is maintained. Our findings have practical implications for improving the effectiveness of movement therapy in a wide range of patient groups, maintaining upper extremity function in old adults, and for maximizing athletic performance. PMID:25970465

Aligning Theory and Design: The Development of an Online Learning Intervention to Teach Evidence-based Practice for Maximal Reach

PubMed Central

Vihstadt, Corrie; Evans, Roni

2015-01-01

Background: Online educational interventions to teach evidence-based practice (EBP) are a promising mechanism for overcoming some of the barriers to incorporating research into practice. However, attention must be paid to aligning strategies with adult learning theories to achieve optimal outcomes. Methods: We describe the development of a series of short self-study modules, each covering a small set of learning objectives. Our approach, informed by design-based research (DBR), involved 6 phases: analysis, design, design evaluation, redesign, development/implementation, and evaluation. Participants were faculty and students in 3 health programs at a complementary and integrative educational institution. Results: We chose a reusable learning object approach that allowed us to apply 4 main learning theories: events of instruction, cognitive load, dual processing, and ARCS (attention, relevance, confidence, satisfaction). A formative design evaluation suggested that the identified theories and instructional approaches were likely to facilitate learning and motivation. Summative evaluation was based on a student survey (N=116) that addressed how these theories supported learning. Results suggest that, overall, the selected theories helped students learn. Conclusion: The DBR approach allowed us to evaluate the specific intervention and theories for general applicability. This process also helped us define and document the intervention at a level of detail that covers almost all the proposed Guideline for Reporting Evidence-based practice Educational intervention and Teaching (GREET) items. This thorough description will facilitate the interpretation of future research and implementation of the intervention. Our approach can also serve as a model for others considering online EBP intervention development. PMID:26421233

Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

PubMed

Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

2016-01-01

Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

The Social Competency Program of the Reach Out to Schools Project. Project Report, 1991-92. No. 3.

ERIC Educational Resources Information Center

Krasnow, Jean H.; And Others

This document presents outcomes of the Social Competency Program: Reach Out to Schools Project, a program designed to help elementary students learn and practice interpersonal and problem-solving skills. It is based on the understanding that positive peer relationships and a supportive, caring classroom community are essential to students' social…

Expanding the chronic care framework to improve diabetes management: the REACH case study.

PubMed

Jenkins, Carolyn; Pope, Charlene; Magwood, Gayenell; Vandemark, Lisa; Thomas, Virginia; Hill, Karen; Linnen, Florene; Beck, Lorna Shelton; Zapka, Jane

2010-01-01

Reducing the burden of chronic conditions among minorities requires novel approaches to prevent and manage disease. This paper describes the expansion of the Chronic Care Model (CCM) to include a community focus for improving diabetes self-management and reducing health disparities. The literature review assesses the concept of "community" in improving outcomes as viewed by proponents of the CCM for chronic disease. The CCM was then modified and informed by experiences of a major community-based participatory action initiative to improve diabetes outcomes, the Racial and Ethnic Approaches to Community Health (REACH) Charleston and Georgetown Diabetes Coalition. Based on our experiences with community-based and health systems diabetes interventions, we present examples of improvements within both health delivery practice sites and other community systems that are essential for improving diabetes outcomes and reducing disparities. Building on the Centers for Disease Control and Prevention's (CDC) principles of community involvement, our coalition activities provide examples of working with community partners to frame this enhanced ecologically grounded Community CCM (CCCM). The resulting CCCM integrates expanded conceptual frameworks, evidence-based practice, community-based evidence and participatory actions, and highlights the possibilities and challenges for improving chronic disease outcomes and reducing disparities via community programs that foster individual, systems, community, and policy change.

Calibrating Reach Distance to Visual Targets

ERIC Educational Resources Information Center

Mon-Williams, Mark; Bingham, Geoffrey P.

2007-01-01

The authors investigated the calibration of reach distance by gradually distorting the haptic feedback obtained when participants grasped visible target objects. The authors found that the modified relationship between visually specified distance and reach distance could be captured by a straight-line mapping function. Thus, the relation could be…

Quartermaster Reach Restoration Project

EPA Pesticide Factsheets

Information about the SFBWQP Quartermaster Reach Restoration Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

Impacts on industry of Europe's emerging chemicals policy REACh.

PubMed

Angerer, Gerhard; Nordbeck, Ralf; Sartorius, Christian

2008-03-01

For Europe, a new regime in chemicals regulation is about to start. After the proposal of the European Commission concerning the Registration, Evaluation and Authorization of Chemicals (REACh) passed its readings in the European Parliament and some differences with the European Council of Ministers were resolved, the regulation will come into force in June 2007. This paper is focused on the question how serious the cost burdens for industry induced by REACh will be, and whether the New European Member States (NMS) which joined the European Union in May 2004 will be able to cope with the regulation. This evaluation has been done by assessing the legislative, administrative and economic framework in New Member States and by analysing real business cases in companies. The empirical showcase business impact studies are at the same time of interest for companies of EU-15 states, other European countries who may implement the regulation, and even for exporters of raw materials and chemicals outside Europe, who will also have to comply with REACh if they market in the European Community. The results give no indications that REACh adoption will bring significant drawbacks to companies in the NMS. The emerging regulation will bring challenges for individual companies, especially for small and medium-sized ones, but for the European chemical industry as a whole, there is no question that it will be able to cope with REACh burdens without losing its global competitiveness.

Reliability Prediction Analysis: Airborne System Results and Best Practices

NASA Astrophysics Data System (ADS)

Silva, Nuno; Lopes, Rui

2013-09-01

This article presents the results of several reliability prediction analysis for aerospace components, made by both methodologies, the 217F and the 217Plus. Supporting and complementary activities are described, as well as the differences concerning the results and the applications of both methodologies that are summarized in a set of lessons learned that are very useful for RAMS and Safety Prediction practitioners.The effort that is required for these activities is also an important point that is discussed, as is the end result and their interpretation/impact on the system design.The article concludes while positioning these activities and methodologies in an overall process for space and aeronautics equipment/components certification, and highlighting their advantages. Some good practices have also been summarized and some reuse rules have been laid down.

Teratology testing under REACH.

PubMed

Barton, Steve

2013-01-01

REACH guidelines may require teratology testing for new and existing chemicals. This chapter discusses procedures to assess the need for teratology testing and the conduct and interpretation of teratology tests where required.

Effects of virtual reality training on functional reaching movements in people with Parkinson's disease: a randomized controlled pilot trial.

PubMed

Ma, Hui-Ing; Hwang, Wen-Juh; Fang, Jing-Jing; Kuo, Jui-Kun; Wang, Ching-Yi; Leong, Iat-Fai; Wang, Tsui-Ying

2011-10-01

To investigate whether practising reaching for virtual moving targets would improve motor performance in people with Parkinson's disease. Randomized pretest-posttest control group design. A virtual reality laboratory in a university setting. Thirty-three adults with Parkinson's disease. The virtual reality training required 60 trials of reaching for fast-moving virtual balls with the dominant hand. The control group had 60 practice trials turning pegs with their non-dominant hand. Pretest and posttest required reaching with the dominant hand to grasp real stationary balls and balls moving at different speeds down a ramp. Success rates and kinematic data (movement time, peak velocity and percentage of movement time for acceleration phase) from pretest and posttest were recorded to determine the immediate transfer effects. Compared with the control group, the virtual reality training group became faster (F = 9.08, P = 0.005) and more forceful (F = 9.36, P = 0.005) when reaching for real stationary balls. However, there was no significant difference in success rate or movement kinematics between the two groups when reaching for real moving balls. A short virtual reality training programme improved the movement speed of discrete aiming tasks when participants reached for real stationary objects. However, the transfer effect was minimal when reaching for real moving objects.

Project Reach 1988-89. OREA Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Lista, Carlos A.

Project Reach, serving 390 students of limited English proficiency at William H. Taft high school in New York, was fully implemented in 1988-89. Project Reach endeavored to help students develop their English and native language skills and make academic progress through bilingual content area courses. During the school year, participating students…

Has Corpus-Based Instruction Reached a Tipping Point? Practical Applications and Pointers for Teachers

ERIC Educational Resources Information Center

Huang, Li-Shih

2017-01-01

This article provides an easy introduction into corpus-based instruction by explaining what the approach entails. It also presents key terms and discusses key theoretical concepts drawn from the literature; from these, practical applications and pointers are offered for those practitioners wishing to use corpus data or implement corpus-based…

Contemporary training practices in elite British powerlifters: survey results from an international competition.

PubMed

Swinton, Paul A; Lloyd, Ray; Agouris, Ioannis; Stewart, Arthur

2009-03-01

The primary objective of this study was to investigate current powerlifting training methods in light of anecdotal evidence purporting increased similarity with the explosive training practices of weightlifters. The study also assessed the prevalence of contemporary training practices frequently recommended for powerlifters in the popular literature. A 20-item survey was distributed to 32 elite British powerlifters at an International competition. The subject group included multiple national, international, and commonwealth champions and record holders. Based on 2007 competition results, the average Wilks score of the group was 450.26 +/- 34.7. The response rate for the surveys was 88% (28 of 32). The survey was sectioned into 6 areas of inquiry: a) repetition speed, b) explosive training load, c) resistance materials used, d) adjunct power training methods, e) exercise selection, and f) training organization. The results demonstrate that the majority of powerlifters train with the intention to explosively lift maximal and submaximal loads (79 and 82%, respectively). Results revealed that 39% of the lifters regularly used elastic bands and that 57% incorporated chains in their training. Evidence for convergence of training practices between powerlifters and weightlifters was found when 69% of the subjects reported using the Olympic lifts or their derivatives as part of their powerlifting training. Collectively, the results demonstrate that previous notions of how powerlifters train are outdated. Contemporary powerlifters incorporate a variety of training practices that are focused on developing both explosive and maximal strength.

Interrupted object-based updating of reach program leads to a negative compatibility effect.

PubMed

Vainio, Lari

2009-07-01

The author investigated how the motor program elicited by an object's orientation is updated by object-based information while a participant reaches for the object. Participants selected the hand of response according to the thickness of the graspable object and then reached toward the location in which the object appeared. Reach initiation times decreased when the handle of the object was oriented toward the responding hand. This positive compatibility effect turned into a negative compatibility effect (NCE) during reach execution when the object was removed from the display 300 ms after object onset or replaced with a mask at movement onset. The results demonstrate that interrupted object-based updating of an ongoing reach movement triggers the NCE.

Survey of Sterile Admixture Practices in Canadian Hospital Pharmacies: Part 1. Methods and Results

PubMed Central

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W.

2009-01-01

Background: The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its “General Chapter <797> Pharmaceutical Compounding—Sterile Preparations”, which set a more rigorous and enforceable standard for sterile compounding in the United States. Objectives: To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. Methods: An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. Results: A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. Part 1 of this series reports the survey methods and results

REACH: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Sibieta, Luke

2016-01-01

REACH is a targeted reading support programme designed to improve reading accuracy and comprehension in pupils with reading difficulties in Years 7 and 8. It is based on research by the Centre for Reading and Language at York and is delivered by specially trained teaching assistants (TAs). This evaluation tested two REACH interventions, one based…

Global reach and engagement

NASA Astrophysics Data System (ADS)

2016-09-01

Popular culture reflects both the interests of and the issues affecting the general public. As concerns regarding climate change and its impacts grow, is it permeating into popular culture and reaching that global audience?

Opportunities-to-Learn at Home: Profiles of Students With and Without Reaching Science Proficiency

NASA Astrophysics Data System (ADS)

Liu, Xiufeng; Whitford, Melinda

2011-08-01

This study examines the relationship between opportunity-to-learn (OTL) at home and students' attainment of science proficiency. The data set used was the 2006 PISA science US national sample. Data mining was used to create patterns of association between home OTL variables and student attainment of science proficiency. It was found that students who failed to reach science proficiency are characterized by having fewer than 100 books at home; these students are also found to take out-of-school individual or group lessons with their teachers or with other teachers. On the other hands, students who reached science proficiency are characterized by having more than 100 books at home, not taking any out-of-school lessons, and having a highest parent level of graduate education. In addition to the above common characteristics, other home characteristics (e.g. computer and internet at home and language spoke at home) are also identified in profiles of students who have reached science proficiency. We explain the above findings in terms of current social-cultural theories. We finally discuss implications of the above findings for future studies and for improving science education policy and practice.

School Furniture Dimensions: Standing and Reaching.

ERIC Educational Resources Information Center

Department of Education and Science, London (England).

Performance of school children in regard to their standing and reach postures are described with dimensions given on the limits of their performance only. The facts of task performances are presented for the following tasks--(1) seeing into a shelf, (2) reaching into a shelf, (3) drawing on a vertical surface, (4) sitting or standing while…

Channel morphodynamics in four reaches of the Lower Missouri River, 2006-07

USGS Publications Warehouse

Elliott, Caroline M.; Reuter, Joanna M.; Jacobson, Robert B.

2009-01-01

Channel morphodynamics in response to flow modifications from Gavins Point Dam are examined in four reaches of the Lower Missouri River. Measures include changes in channel morphology and indicators of sediment transport in four 6 kilometer long reaches located downstream from Gavins Point Dam, near Yankton, South Dakota, Kenslers Bend, Nebraska, Little Sioux, Iowa, and Miami, Missouri. Each of the four reaches was divided into 300 transects with a 20-meter spacing and surveyed during the summer in 2006 and 2007. A subset of 30 transects was randomly selected and surveyed 7-10 times in 2006-07 over a wide range of discharges including managed and natural flow events. Hydroacoustic mapping used a survey-grade echosounder and a Real Time Kinematic Global Positioning System to evaluate channel change. Acoustic Doppler current profiler measurements were used to evaluate bed-sediment velocity. Results indicate varying amounts of deposition, erosion, net change, and sediment transport in the four Lower Missouri River reaches. The Yankton reach was the most stable over monthly and annual time-frames. The Kenslers Bend and Little Sioux reaches exhibited substantial amounts of deposition and erosion, although net change was generally low in both reaches. Total, or gross geomorphic change was greatest in the Kenslers Bend reach. The Miami reach exhibited varying rates of deposition and erosion, and low net change. The Yankton, Kenslers Bend, and Miami reaches experienced net erosion during the time period that bracketed the managed May 2006 spring rise event from Gavins Point Dam.

Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?

PubMed

Fagnan, Lyle J; Walunas, Theresa L; Parchman, Michael L; Dickinson, Caitlin L; Murphy, Katrina M; Howell, Ross; Jackson, Kathryn L; Madden, Margaret B; Ciesla, James R; Mazurek, Kathryn D; Kho, Abel N; Solberg, Leif I

2018-04-01

The methods and costs to enroll small primary care practices in large, regional quality improvement initiatives are unknown. We describe the recruitment approach, cost, and resources required to recruit and enroll 500 practices in the Northwest and Midwest regional cooperatives participating in the Agency for Healthcare Research and Quality (AHRQ)-funded initiative, EvidenceNOW: Advancing Heart Health in Primary Care. The project management team of each cooperative tracked data on recruitment methods used for identifying and connecting with practices. We developed a cost-of-recruitment template and used it to record personnel time and associated costs of travel and communication materials. A total of 3,669 practices were contacted during the 14- to 18-month recruitment period, resulting in 484 enrolled practices across the 6 states served by the 2 cooperatives. The average number of interactions per enrolled practice was 7, with a total of 29,100 hours and a total cost of $2.675 million, or $5,529 per enrolled practice. Prior partnerships predicted recruiting almost 1 in 3 of these practices as contrasted to 1 in 20 practices without a previous relationship or warm hand-off. Recruitment of practices for large-scale practice quality improvement transformation initiatives is difficult and costly. The cost of recruiting practices without existing partnerships is expensive, costing 7 times more than reaching out to familiar practices. Investigators initiating and studying practice quality improvement initiatives should budget adequate funds to support high-touch recruitment strategies, including building trusted relationships over a long time frame, for a year or more. © 2018 Annals of Family Medicine, Inc.

The Challenges Never Stop! Two Decades of Reaching for the Best in Clinical Practice

ERIC Educational Resources Information Center

Field, Bruce E.; Van Scoy, Irma J.

2014-01-01

The University of South Carolina Professional Development School (USC PDS) Network has been engaged in designing and redesigning school-university partnerships for more than 20 years with a focus on ensuring that school-based practice lies at the heart of candidate preparation. In 2012-2013, the USC PDS Network once again reexamined their program…

Contemporary practice patterns of dynamic psychiatrists--survey results.

PubMed

Alfonso, César A; Olarte, Silvia W

2011-01-01

The authors examine the practice characteristics of dynamic psychiatrists, including the combined use of medication and psychotherapy, and adherence by self-report to psychodynamic, supportive, and cognitive behavioral therapy theoretical principles and techniques. Survey of 555 members of the American Academy of Psychoanalysis and Dynamic Psychiatry conducted in 2009. 24.1% response rate; 75% of respondents were between 61 and 80 years old, 61% had over 30 years of experience; 89% have a private practice but work on an average of 1.6 settings; 39% teach. Most respondents treat patients with complex comorbidities; 92.6% prescribe psychotropic medication. The preferred mode of practice is individual psychotherapy and the preferred frequency once a week; 94.5% of sessions are 45-60 minutes. Using Plakun's Y-model framework, psychoanalysts and dynamic psychiatrist subgroups equally support all core psychotherapy and psychodynamic features, with lesser emphasis but substantial endorsement of cognitive-behavioral psychotherapy features. Dynamic psychiatrists are committed to see most patients once a week for 45-60 minute sessions and use a variety of conceptual frameworks to guide their treatment plans. They endorse supportive and psychodynamic practice elements more than cognitive-behavioral principles.

Expectation affects verbal judgments but not reaches to visually perceived egocentric distances.

PubMed

Pagano, Christopher C; Isenhower, Robert W

2008-04-01

Two response measures for reporting visually perceived egocentric distances-verbal judgments and blind manual reaches-were compared using a within-trial methodology. The expected range of possible target distances was manipulated by instructing the subjects that the targets would be between .50 and 1.00 of their maximum arm reach in one session and between .25 and .90 in another session. The actual range of target distances was always .50-.90. Verbal responses varied as a function of the range of expected distances, whereas simultaneous reaches remained unaffected. These results suggest that verbal responses are subject to a cognitive influence that does not affect actions. It is suggested that action responses are indicative of absolute perception, whereas cognitive responses may reflect only relative perception. The results also indicate that the dependant variable utilized for the study of depth perception will influence the obtained results.

Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study

PubMed Central

Biswas, Animesh; Dalal, Koustuv; Abdullah, Abu Sayeed Md; Gifford, Mervyn; Halim, MA

2016-01-01

Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions:  The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths. PMID:27853517

Increasing reach by offering choices: Results from an innovative model for statewide services for smoking cessation.

PubMed

Keller, Paula A; Schillo, Barbara A; Kerr, Amy N; Lien, Rebecca K; Saul, Jessie; Dreher, Marietta; Lachter, Randi B

2016-10-01

Although state quitlines provide free telephone counseling and often include nicotine replacement therapy (NRT), reach remains limited (1-2% in most states). More needs to be done to engage all smokers in the quitting process. A possible strategy is to offer choices of cessation services through quitlines and to reduce registration barriers. In March 2014, ClearWay Minnesota SM implemented a new model for QUITPLAN® Services, the state's population-wide cessation services. Tobacco users could choose the QUITPLAN® Helpline or one or more Individual QUITPLAN® Services (NRT starter kit, text messaging, email program, or quit guide). The program website was redesigned, online enrollment was added, and a new advertising campaign was created and launched. In 2014-2015, we evaluated whether these changes increased reach. We also assessed quit attempts, quit outcomes, predictors of 30-day abstinence, and average cost per quit via a seven-month follow-up survey. Between March 2014-February 2015, 15,861 unique tobacco users registered, which was a 169% increase over calendar year 2013. The majority of participants made a quit attempt (83.7%). Thirty-day point prevalence abstinence rates (responder rates) were 26.1% for QUITPLAN Services overall, 29.6% for the QUITPLAN Helpline, and 25.5% for Individual QUITPLAN Services. Several variables predicted quit outcomes, including receiving only one call from the Helpline and using both the Helpline and the NRT starter kit. Providing greater choice of cessation services and reducing registration barriers have the potential to engage more tobacco users, foster more quit attempts, and ultimately lead to long-term cessation and reductions in prevalence. Copyright © 2016 Elsevier Inc. All rights reserved.

Introducing a drug formulary to general practice — effects on practice prescribing costs

PubMed Central

Beardon, P.H.G.; Brown, S.V.; Mowat, D.A.E.; Grant, J.A.; McDevitt, D.G.

1987-01-01

A drug formulary comprising 249 preparations of 132 drugs and drug combinations was prepared by the partners in a three-doctor general practice serving more than 5000 patients. No attempt was made to change to generic prescribing nor were repeat prescription drugs altered. Introduction of the formulary in September 1981 was followed by an increase in the proportion of prescriptions containing drugs from the formulary from about 55% to more than 60% for both repeat and non-repeat prescriptions. The proportion of formulary drugs on non-repeat prescriptions reached a maximum of 78% within the first year with the additional influence of information feedback. Over the first year the level of formulary drugs used for both repeat and nonrepeat prescribing levelled off at about 62%. Even with these modest changes, when compared with the costs of general practice prescribing in Scotland as a whole, the introduction of the formulary resulted in savings of approximately 10% within the practice for the mean ingredient costs both per patient and per prescription. PMID:3449632

Simulation of Columbia River Floods in the Hanford Reach

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

Waichler, Scott R.; Serkowski, John A.; Perkins, William A.

Columbia River water elevations and flows in the Hanford Reach affect the environment and facilities along the shoreline, including movement of contaminants in groundwater, fish habitat, and infrastructure subject to flooding. This report describes the hydraulic simulation of hypothetical flood flows using the best available topographic and bathymetric data for the Hanford Reach and the Modular Aquatic Simulation System in 1 Dimension (MASS1) hydrodynamic model. The MASS1 model of the Hanford Reach was previously calibrated to field measurements of water surface elevations. The current model setup can be used for other studies of flow, water levels, and temperature in themore » Reach. The existing MASS1 channel geometry and roughness and other model configuration inputs for the Hanford Reach were used for this study, and previous calibration and validation results for the model are reprinted here for reference. The flood flows for this study were simulated by setting constant flow rates obtained from the U.S. Army Corps of Engineers (USACE) for the Columbia, Snake, and Yakima Rivers, and a constant water level at McNary Dam, and then running the model to steady state. The discharge levels simulated were all low-probability events; for example, a 100-year flood is one that would occur on average every 100 years, or put another way, in any given year there is a 1% chance that a discharge of that level or higher will occur. The simulated floods and their corresponding Columbia River discharges were 100-year (445,000 cfs), 500-year (520,000 cfs), and the USACE-defined Standard Project Flood (960,000 cfs). The resulting water levels from the steady-state floods can be viewed as “worst case” outcomes for the respective discharge levels. The MASS1 output for water surface elevations was converted to the North American Vertical Datum of 1988 and projected across the channel and land surface to enable mapping of the floodplain for each scenario. Floodplain maps show

ERF1 -- Enhanced River Reach File 1.2

USGS Publications Warehouse

Alexander, Richard B.; Brakebill, John W.; Brew, Robert E.; Smith, Richard A.

1999-01-01

U.S. Environmental Protection Agency's River Reach File 1 (RF1) to ensure the hydrologic integrity of the digital reach traces and to quantify the mean water time of travel in river reaches and reservoirs [see USEPA (1996) for a description of the original RF1].

Napa River Restoration Project: Rutherford Reach Completion and Oakville to Oak Knoll Reach

EPA Pesticide Factsheets

Information about the SFBWQP Napa River Restoration Project: Rutherford Reach Completion/Oakville to Oak Knoll, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

Concepts Within Reach: Action Performance Predicts Action Language Processing in Stroke

PubMed Central

Desai, Rutvik H.; Herter, Troy; Riccardi, Nicholas; Rorden, Chris; Fridriksson, Julius

2015-01-01

The relationship between the brain’s conceptual or semantic and sensory-motor systems remains controversial. Here, we tested manual and conceptual abilities of 41 chronic stroke patients in order to examine their relationship. Manual abilities were assed through a reaching task using an exoskeleton robot. Semantic abilities were assessed with implicit as well as explicit semantic tasks, for both verbs and nouns. The results show that that the degree of selective impairment for action word processing was predicted by the degree of impairment in reaching performance. Moreover, the implicit semantic measures showed a correlation with a global reaching parameter, while the explicit semantic similarity judgment task predicted performance in action initiation. These results indicate that action concepts are dynamically grounded through motoric simulations, and that more details are simulated for more explicit semantic tasks. This is evidence for a close and causal relationship between sensory-motor and conceptual systems of the brain. PMID:25858602

Effect of Visual Field Presentation on Action Planning (Estimating Reach) in Children

ERIC Educational Resources Information Center

Gabbard, Carl; Cordova, Alberto

2012-01-01

In this article, the authors examined the effects of target information presented in different visual fields (lower, upper, central) on estimates of reach via use of motor imagery in children (5-11 years old) and young adults. Results indicated an advantage for estimating reach movements for targets placed in lower visual field (LoVF), with all…

Transformational leadership practices of nurse leaders in professional nursing associations.

PubMed

Ross, Erin J; Fitzpatrick, Joyce J; Click, Elizabeth R; Krouse, Helene J; Clavelle, Joanne T

2014-04-01

This study describes the transformational leadership (TL) practices of nurse leaders in professional nursing associations (PNAs). Professional nursing associations are vehicles to provide educational opportunities for nurses as well as leadership opportunities for members. Little has been published about the leadership practices of PNA members. E-mail surveys of 448 nurse leaders in PNAs were conducted in 2013 using the Leadership Practices Inventory (LPI). The top 2 TL practices of these nurse leaders were enabling others to act and encouraging the heart. Respondents with more leadership training reported higher TL practices. This is the 1st study to describe TL practices of nurse leaders in PNAs. Results of this study show that nurse leaders of PNAs emulate practices of TL. Transformational leaders can mobilize and direct association members in reaching shared values, objectives, and outcomes. Understanding TL practices of nurse leaders in PNAs are important to the future of nursing in order to enable nurses to lead change and advance health through these organizations.

Allocentric information is used for memory-guided reaching in depth: A virtual reality study.

PubMed

Klinghammer, Mathias; Schütz, Immo; Blohm, Gunnar; Fiehler, Katja

2016-12-01

Previous research has demonstrated that humans use allocentric information when reaching to remembered visual targets, but most of the studies are limited to 2D space. Here, we study allocentric coding of memorized reach targets in 3D virtual reality. In particular, we investigated the use of allocentric information for memory-guided reaching in depth and the role of binocular and monocular (object size) depth cues for coding object locations in 3D space. To this end, we presented a scene with objects on a table which were located at different distances from the observer and served as reach targets or allocentric cues. After free visual exploration of this scene and a short delay the scene reappeared, but with one object missing (=reach target). In addition, the remaining objects were shifted horizontally or in depth. When objects were shifted in depth, we also independently manipulated object size by either magnifying or reducing their size. After the scene vanished, participants reached to the remembered target location on the blank table. Reaching endpoints deviated systematically in the direction of object shifts, similar to our previous results from 2D presentations. This deviation was stronger for object shifts in depth than in the horizontal plane and independent of observer-target-distance. Reaching endpoints systematically varied with changes in object size. Our results suggest that allocentric information is used for coding targets for memory-guided reaching in depth. Thereby, retinal disparity and vergence as well as object size provide important binocular and monocular depth cues. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reach Trajectories Characterize Tactile Localization for Sensorimotor Decision Making.

PubMed

Brandes, Janina; Heed, Tobias

2015-10-07

Spatial target information for movement planning appears to be coded in a gaze-centered reference frame. In touch, however, location is initially coded with reference to the skin. Therefore, the tactile spatial location must be derived by integrating skin location and posture. It has been suggested that this recoding is impaired when the limb is placed in the opposite hemispace, for example, by limb crossing. Here, human participants reached toward visual and tactile targets located at uncrossed and crossed feet in a sensorimotor decision task. We characterized stimulus recoding by analyzing the timing and spatial profile of hand reaches. For tactile targets at crossed feet, skin-based information implicates the incorrect side, and only recoded information points to the correct location. Participants initiated straight reaches and redirected the hand toward a target presented in midflight. Trajectories to visual targets were unaffected by foot crossing. In contrast, trajectories to tactile targets were redirected later with crossed than uncrossed feet. Reaches to crossed feet usually continued straight until they were directed toward the correct tactile target and were not biased toward the skin-based target location. Occasional, far deflections toward the incorrect target were most likely when this target was implicated by trial history. These results are inconsistent with the suggestion that spatial transformations in touch are impaired by limb crossing, but are consistent with tactile location being recoded rapidly and efficiently, followed by integration of skin-based and external information to specify the reach target. This process may be implemented in a bounded integrator framework. How do you touch yourself, for instance, to scratch an itch? The place you need to reach is defined by a sensation on the skin, but our bodies are flexible, so this skin location could be anywhere in 3D space. The movement toward the tactile sensation must therefore be specified

Reach a nonlinear consensus for MAS via doubly stochastic quadratic operators

NASA Astrophysics Data System (ADS)

Abdulghafor, Rawad; Turaev, Sherzod; Zeki, Akram; Al-Shaikhli, Imad

2018-06-01

This technical note addresses the new nonlinear protocol class of doubly stochastic quadratic operators (DSQOs) for coordination of consensus problem in multi-agent systems (MAS). We derive the conditions for ensuring that every agent reaches consensus on a desired rate of the group's decision where the group decision value in its agent's initial statuses varies. Besides that, we investigate a nonlinear protocol sub-class of extreme DSQO (EDSQO) to reach a consensus for MAS to a common value with nonlinear low-complexity rules and fast time convergence if the interactions for each agent are not selfish. In addition, to extend the results to reach a consensus and to avoid the selfish case we specify a general class of DSQO for reaching a consensus under any given case of initial states. The case that MAS reach a consensus by DSQO is if each member of the agent group has positive interactions of DSQO (PDSQO) with the others. The convergence of both EDSQO and PDSQO classes is found to be directed towards the centre point. Finally, experimental simulations are given to support the analysis from theoretical aspect.

Gingival displacement: Survey results of dentists' practice procedures.

PubMed

Ahmed, Sumitha N; Donovan, Terry E

2015-07-01

A high percentage of fixed prosthodontic restorations require a subgingival margin placement, which requires the practice of gingival displacement or a deflection procedure to replicate the margins in impression. The purpose of this study was to learn the different gingival displacement techniques that are currently used by dentists in their practice and to compare the current concepts of gingival displacement with previously published articles. A survey of questions pertaining to gingival deflection methods was distributed as part of continuing education (CE) course material to dentists attending CE meetings in 7 states in the U.S. and 1 Canadian province. Question topics included initial patient assessment procedures, gingival displacement methods, dentist's knowledge and assessment of systemic manifestations, and brand names of materials used. Ninety-four percent of the participants were general practitioners with 24.11 ± 12.5 years of experience. Ninety-two percent used gingival displacement cords, while 20.2% used a soft tissue laser and 32% used electrosurgery as an adjunct. Sixty percent of the dentists used displacement cords impregnated with a medicament. Of the preimpregnated cords, 29% were impregnated with epinephrine, 13% with aluminum chloride, and 18% with aluminum potassium sulfate. The study showed a steady decrease compared with results of previously published articles in the use of epinephrine as a gingival deflection medicament. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Adaptive mixed reality rehabilitation improves quality of reaching movements more than traditional reaching therapy following stroke.

PubMed

Duff, Margaret; Chen, Yinpeng; Cheng, Long; Liu, Sheng-Min; Blake, Paul; Wolf, Steven L; Rikakis, Thanassis

2013-05-01

Adaptive mixed reality rehabilitation (AMRR) is a novel integration of motion capture technology and high-level media computing that provides precise kinematic measurements and engaging multimodal feedback for self-assessment during a therapeutic task. We describe the first proof-of-concept study to compare outcomes of AMRR and traditional upper-extremity physical therapy. Two groups of participants with chronic stroke received either a month of AMRR therapy (n = 11) or matched dosing of traditional repetitive task therapy (n = 10). Participants were right handed, between 35 and 85 years old, and could independently reach to and at least partially grasp an object in front of them. Upper-extremity clinical scale scores and kinematic performances were measured before and after treatment. Both groups showed increased function after therapy, demonstrated by statistically significant improvements in Wolf Motor Function Test and upper-extremity Fugl-Meyer Assessment (FMA) scores, with the traditional therapy group improving significantly more on the FMA. However, only participants who received AMRR therapy showed a consistent improvement in kinematic measurements, both for the trained task of reaching to grasp a cone and the untrained task of reaching to push a lighted button. AMRR may be useful in improving both functionality and the kinematics of reaching. Further study is needed to determine if AMRR therapy induces long-term changes in movement quality that foster better functional recovery.

REACH. Air Conditioning Units.

ERIC Educational Resources Information Center

Garrison, Joe; And Others

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of air conditioning. The instructional units focus on air conditioning fundamentals, window air conditioning, system and installation, troubleshooting and…

Extending earthquakes' reach through cascading.

PubMed

Marsan, David; Lengliné, Olivier

2008-02-22

Earthquakes, whatever their size, can trigger other earthquakes. Mainshocks cause aftershocks to occur, which in turn activate their own local aftershock sequences, resulting in a cascade of triggering that extends the reach of the initial mainshock. A long-lasting difficulty is to determine which earthquakes are connected, either directly or indirectly. Here we show that this causal structure can be found probabilistically, with no a priori model nor parameterization. Large regional earthquakes are found to have a short direct influence in comparison to the overall aftershock sequence duration. Relative to these large mainshocks, small earthquakes collectively have a greater effect on triggering. Hence, cascade triggering is a key component in earthquake interactions.

SVHC in imported articles: REACH authorisation requirement justified under WTO rules.

PubMed

Schenten, Julian; Führ, Martin

2016-01-01

The purpose of the REACH Regulation is to ensure a high level of protection of human health and the environment as well as the free circulation of substances on the internal market while enhancing competitiveness and innovation. To this end, REACH introduces, among other instruments, the authorisation regime for substances of very high concern (SVHC) that are listed on Annex XIV of the regulation. After expiration of the transitional period for each Annex XIV-SVHC, articles, such as most products of daily use, produced in the European Economic Area (EEA) may not contain such substances unless an authorisation was granted for the specific use or this use falls within the scope of an exemption from the authorisation requirement. The authorisation scheme does, however, only apply to SVHC used in the EEA. As a consequence, REACH does not regulate SVHC entering the European market as part of imported articles which burden human health and the environment. Moreover, from an economic perspective, domestic articles are subject to stricter requirements than those which are produced abroad, putting actors from within the EEA at competitive disadvantage and thus impeding the intention of REACH to enhance competitiveness and innovation. One option to close this regulatory gap could be to extend the authorisation requirement to SVHC present in imported articles. A legal appraisal on behalf of the German Environment Agency (UBA) assesses whether such option would be in accordance with the specifications of WTO world trade law. It concludes that, measured by the standards of the WTO dispute settlement practice, such an extended authorisation scheme would neither violate the principles of national treatment and most-favoured nation treatment. Also, such regulation would not constitute an unnecessary obstacle to trade, since the extended authorisation requirement would pursue a legitimate objective covered by the regulatory autonomy of the EU and, furthermore, the regulation would

Association between imagined and actual functional reach (FR): a comparison of young and older adults.

PubMed

Gabbard, Carl; Cordova, Alberto

2013-01-01

Recent studies indicate that the ability to mentally represent action using motor imagery declines with advanced age (>64 years). As the ability to represent action declines, the elderly may experience increasing difficulty with movement planning and execution. Here, we determined the association between estimation of reach via use of motor imagery and actual FR. Young adults (M=22 years) and older adults (M=66 years) estimated reach while standing with targets randomly presented in peripersonal (within actual reach) and extrapersonal (beyond reach) space. Imagined responses were compared to the individual's scaled maximum reach. FR, also while standing, was assessed using the standardized Functional Reach Test (FRT). Results for total score estimation accuracy showed that there was no difference for age; however, results for mean bias and distribution of error revealed that the older group underestimated while the younger group overestimated. In reference to FR, younger adults outperformed older adults (30 versus 14in.) and most prominent, only the younger group showed a significant relationship between estimation and FR. In addition to gaining insight to the effects of advanced age on the ability to mentally represent action and its association with movement execution, these results although preliminary, may have clinical implications based on the question of whether motor imagery training could improve movement estimations and how that might affect actual reach. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Outcomes of senior reach gatekeeper referrals: comparison of the Spokane gatekeeper program, Colorado Senior Reach, and Mid-Kansas Senior Outreach.

PubMed

Bartsch, David A; Rodgers, Vicki K; Strong, Don

2013-01-01

Outcomes of older adults referred for care management and mental health services through the senior reach gatekeeper model of case finding were examined in this study and compared with the Spokane gatekeeper model Colorado Senior Reach and the Mid-Kansas Senior Outreach (MKSO) programs are the two Senior Reach Gatekeeper programs modeled after the Spokane program, employing the same community education and gatekeeper model and with mental health treatment for elderly adults in need of support. The three mature programs were compared on seniors served isolation, and depression ratings. Nontraditional community gatekeepers were trained and referred seniors in need. Findings indicate that individuals served by the two Senior Reach Gatekeeper programs demonstrated significant improvements. Isolation indicators such as social isolation decreased and depression symptoms and suicide ideation also decreased. These findings for two Senior Reach Gatekeeper programs demonstrate that the gatekeeper approach to training community partners worked in referring at-risk seniors in need in meeting their needs, and in having a positive impact on their lives.

Whisker and Nose Tactile Sense Guide Rat Behavior in a Skilled Reaching Task

PubMed Central

Parmiani, Pierantonio; Lucchetti, Cristina; Franchi, Gianfranco

2018-01-01

Skilled reaching is a complex movement in which a forelimb is extended to grasp food for eating. Video-recordings analysis of control rats enables us to distinguish several components of skilled reaching: Orient, approaching the front wall of the reaching box and poking the nose into the slot to locate the food pellet; Transport, advancing the forelimb through the slot to reach-grasp the pellet; and Withdrawal of the grasped food to eat. Although food location and skilled reaching is guided by olfaction, the importance of whisker/nose tactile sense in rats suggests that this too could play a role in reaching behavior. To test this hypothesis, we studied skilled reaching in rats trained in a single-pellet reaching task before and after bilateral whisker trimming and bilateral infraorbital nerve (ION) severing. During the task, bilaterally trimmed rats showed impaired Orient with respect to controls. Specifically, they detected the presence of the wall by hitting it with their nose (rather than their whiskers), and then located the slot through repetitive nose touches. The number of nose touches preceding poking was significantly higher in comparison to controls. On the other hand, macrovibrissae trimming resulted in no change in reaching/grasping or withdrawal components of skilled reaching. Bilaterally ION-severed rats, displayed a marked change in the structure of their skilled reaching. With respect to controls, in ION-severed rats: (a) approaches to the front wall were significantly reduced at 3–5 and 6–8 days; (b) nose pokes were significantly reduced at 3–5 days, and the slot was only located after many repetitive nose touches; (c) the reaching-grasping-retracting movement never appeared at 3–5 days; (d) explorative paw movements, equal to zero in controls, reached significance at 9–11 days; and (e) the restored reaching-grasping-retracting sequence was globally slower than in controls, but the success rate was the same. These findings strongly

Adaptation of reach-to-grasp movement in response to force perturbations.

PubMed

Rand, M K; Shimansky, Y; Stelmach, G E; Bloedel, J R

2004-01-01

reaching arm is perturbed or not. In addition, the results of the predictable perturbations showed that the time from movement onset to the onset of grip aperture closure changed as adaptation occurred. However, the spatial location where the onset of finger closure occurred showed minimum changes with perturbation. These data suggest that the onset of finger closure is dependent upon distance to target rather than the temporal relationship of the grasp relative to the transport phase of the movement.

Hydraulic characterization of the middle reach of the Congo River

NASA Astrophysics Data System (ADS)

O'Loughlin, F.; Trigg, M. A.; Schumann, G. J.-P.; Bates, P. D.

2013-08-01

The middle reach of the Congo remains one of the most difficult places to access, with ongoing conflicts and a lack of infrastructure. This has resulted in the Congo being perhaps the least understood large river hydraulically, particularly compared to the Amazon, Nile, or Mississippi. Globally the Congo River is important; it is the largest river in Africa and the basin contains some of the largest areas of tropical forests and wetlands in the world, which are important to both the global carbon and methane cycles. This study produced the first detailed hydraulic characterization of the middle reach, utilizing mostly remotely sensed data sets. Using Landsat imagery, a 30 m resolution water-mask was created for the middle reach, from which effective river widths and the number of channels and islands were determined. Water surface slopes were determined using ICESat observations for three different periods during the annual flood pulse, and while the overall slope calculated was similar to previous estimates, greater spatial variability was identified. We find that the water surface slope varies markedly in space but relatively little in time and that this appears to contrast with the Amazon where previous studies indicate that time and spatial variations are of equal magnitude. Five key hydraulic constraints were also identified, which play an important role in the overall dynamics of the Congo. Finally, backwater lengths were approximated for four of these constraints, with the results showing that at high water, over a third of the middle reach is affected by backwater effects.

The role of vision on hand preshaping during reach to grasp.

PubMed

Winges, Sara A; Weber, Douglas J; Santello, Marco

2003-10-01

During reaching to grasp objects with different shapes hand posture is molded gradually to the object's contours. The present study examined the extent to which the temporal evolution of hand posture depends on continuous visual feedback. We asked subjects to reach and grasp objects with different shapes under five vision conditions (VCs). Subjects wore liquid crystal spectacles that occluded vision at four different latencies from onset of the reach. As a control, full-vision trials (VC5) were interspersed among the blocked vision trials. Object shapes and all VCs were presented to the subjects in random order. Hand posture was measured by 15 sensors embedded in a glove. Linear regression analysis, discriminant analysis, and information theory were used to assess the effect of removing vision on the temporal evolution of hand shape. We found that reach duration increased when vision was occluded early in the reach. This was caused primarily by a slower approach of the hand toward the object near the end of the reach. However, vision condition did not have a significant effect on the covariation patterns of joint rotations, indicating that the gradual evolution of hand posture occurs in a similar fashion regardless of vision. Discriminant analysis further supported this interpretation, as the extent to which hand posture resembled object shape and the rate at which hand posture discrimination occurred throughout the movement were similar across vision conditions. These results extend previous observations on memory-guided reaches by showing that continuous visual feedback of the hand and/or object is not necessary to allow the hand to gradually conform to object contours.

The Validity of the Modified Sit-and-Reach Test in College-Age Students.

ERIC Educational Resources Information Center

Minkler, Sharin; Patterson, Patricia

1994-01-01

Reports a study that examined the criterion-related validity of the modified sit-and-reach test against criterion measures of hamstring and low back flexibility in college students. Results indicated the modified sit-and-reach test moderately related to hamstring flexibility, but its relation to low back flexibility was low. (SM)

Effects of Anisometropic Amblyopia on Visuomotor Behavior, Part 2: Visually Guided Reaching

PubMed Central

Niechwiej-Szwedo, Ewa; Goltz, Herbert C.; Chandrakumar, Manokaraananthan; Hirji, Zahra; Crawford, J. Douglas; Wong, Agnes M. F.

2016-01-01

Purpose The effects of impaired spatiotemporal vision in amblyopia on visuomotor skills have rarely been explored in detail. The goal of this study was to examine the influences of amblyopia on visually guided reaching. Methods Fourteen patients with anisometropic amblyopia and 14 control subjects were recruited. Participants executed reach-to-touch movements toward targets presented randomly 5° or 10° to the left or right of central fixation in three viewing conditions: binocular, monocular amblyopic eye, and monocular fellow eye viewing (left and right monocular viewing for control subjects). Visual feedback of the target was removed on 50% of the trials at the initiation of reaching. Results Reaching accuracy was comparable between patients and control subjects during all three viewing conditions. Patients’ reaching responses were slightly less precise during amblyopic eye viewing, but their precision was normal during binocular or fellow eye viewing. Reaching reaction time was not affected by amblyopia. The duration of the acceleration phase was longer in patients than in control subjects under all viewing conditions, whereas the duration of the deceleration phase was unaffected. Peak acceleration and peak velocity were also reduced in patients. Conclusions Amblyopia affects both the programming and the execution of visually guided reaching. The increased duration of the acceleration phase, as well as the reduced peak acceleration and peak velocity, might reflect a strategy or adaptation of feedforward/feedback control of the visuomotor system to compensate for degraded spatiotemporal vision in amblyopia, allowing patients to optimize their reaching performance. PMID:21051723

Survey of Sterile Admixture Practices in Canadian Hospital Pharmacies: Part 2. More Results and Discussion

PubMed Central

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-01-01

Background: The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its “General Chapter <797> Pharmaceutical Compounding—Sterile Preparations”, which set a more rigorous and enforceable standard for sterile compounding in the United States. Objectives: To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. Methods: An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. Results: A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. The survey methods for this study and results relating to

REACH. Electricity Units. Secondary.

ERIC Educational Resources Information Center

Smith, Gene; Sappe, Hoyt

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of electricity. The instructional units focus on electricity fundamentals and electric motors. Each unit follows a typical format that includes a unit sheet,…

Survey of sterile admixture practices in canadian hospital pharmacies: part 1. Methods and results.

PubMed

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-03-01

The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter <797> Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. Part 1 of this series reports the survey methods and results relating to policies, personnel, raw materials

Records Reaching Recording Data Technologies

NASA Astrophysics Data System (ADS)

Gresik, G. W. L.; Siebe, S.; Drewello, R.

2013-07-01

The goal of RECORDS (Reaching Recording Data Technologies) is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

A Newsletter/Text Message Intervention Promoting Beverage-Related Parenting Practices: Pilot Test Results.

PubMed

Zahid, Arwa; Reicks, Marla

2018-06-01

Positive beverage parenting practices may reduce sugar-sweetened beverage consumption by children and prevent potential health problems. An online newsletter/text message intervention was conducted with parents of children 6 to 12 years to improve beverage parenting practices. Newsletters and text messages were sent weekly over a 4-week period providing gain-framed messages encouraging parenting practices including role modeling and controlling home beverage availability. Pre-post surveys included measures of home availability of beverages and parent beverage intake as an indication of parenting practices. Parents were primarily White, well-educated, and female. About one third lived in rural areas. Results from 100 parents with pre-post data from baseline to 4 weeks showed decreased reported home availability of regular soda pop (p = .008), decreased parent intake of sweetened beverages (p = .004), and decreased parent-reported child intake of regular soft drinks (p = .001), and sweetened juice drink beverages (p < .0001). Most parents (82%) reported reading all three newsletters and indicated that the information provided was relevant (93%). A brief newsletter/text message intervention may be a positive and convenient approach to promote positive beverage parenting practices.

"Brown's" Far Reaching Impact

ERIC Educational Resources Information Center

Chinn, Philip C.

2004-01-01

Although the 1954 "Brown v. Board of Education" U.S. Supreme Court decision changed the face of American education forever, few individuals at that time could have fully realized its far-reaching implications. Certainly, the National Association for the Advancement of Colored People Legal Director Thurgood Marshall in his arguments was…

Motor imagery in reaching: is there a left-hemispheric advantage?

PubMed

Gabbard, Carl; Ammar, Diala; Rodrigues, Luis

2005-06-01

The study of motor imagery affords an attractive approach in the quest to identify the specific aspects of cognitive and neuromotor mechanisms and relationship involved in action processing. Here, the authors investigated the recently reported finding that compared to the left-hemisphere, the right brain is at a significant disadvantage for mentally simulating reaching movements. The authors investigated this observation with strong right-handers that were asked to estimate the imagined reachability of visual targets (presented at 150 ms) at multiple points at midline, right- and left visual field; responses were compared to actual maximum reaching distance. Results indicated that individuals are relatively accurate at imagined reachability, with no significant distinction between visual field responses. Therefore, these data provide no evidence to support the claim that the right hemisphere is significantly inferior to the left hemisphere in estimations of motor imagery for reaching. The authors do acknowledge differences in the experimental task and subject characteristics compared to earlier work using split-brain and stroke patients.

Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: reaching the vision by scaling up, scaling down, and reaching out

PubMed Central

2014-01-01

This report summarizes the 7th meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF), Washington DC, November 18–19, 2012. The theme, “A Future Free of Lymphatic Filariasis: Reaching the Vision by Scaling Up, Scaling Down and Reaching Out”, emphasized new strategies and partnerships necessary to reach the 2020 goal of elimination of lymphatic filariasis (LF) as a public-health problem. PMID:24450283

Climate Resilience: Outreach and Engagement with Hard to Reach Communities

NASA Astrophysics Data System (ADS)

Baja, K.

2017-12-01

Baltimore faces a unique combination of shocks and stresses that cut across social, economic, and environmental sectors. Like many postindustrial cities, Baltimore has experienced a decline in its population - resulting in a lower tax base. These trends have had deleterious effects on the city's ability to attend to much needed infrastructure improvements and human services. Furthermore, Baltimore has an unfortunate history of deliberate racial segregation that is directly responsible for many of the economic and social challenges the City faces today. In addition to considerable social and economic issues, the city is already experiencing negative impacts from climate change. Baltimore is vulnerable to many natural hazards including heavy precipitation, sea level rise, storm surge, and extreme heat. Impacts from hazards and the capacity to adapt to them is not equal across all populations. Low-income residents and communities of color are most vulnerable and lack access to the resources to effectively plan, react and recover. They are also less likely to engage in government processes or input sessions, either due to distrust or ineffective outreach efforts by government employees and partners. This session is focused on sharing best practices and lessons learned from Baltimore's approach to community outreach and engagement as well as its focus on power shifting and relationship building with hard-to-reach communities. Reducing neighborhood vulnerability and strengthening the fabric that holds systems together requires a large number of diverse stakeholders coordinated around resiliency efforts. With the history of deliberate segregation and current disparities it remains critical to build trust, shift power from government to residents, and focus on relationship building. Baltimore City utilized this approach in planning, implementation and evaluation of resiliency work. This session will highlight two plan development processes, several projects, and innovative

Practical results from a mathematical analysis of guard patrols

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

Indusi, Joseph P.

1978-12-01

Using guard patrols as a primary detection mechanism is not generally viewed as a highly efficient detection method when compared to electronic means. Many factors such as visibility, alertness, and the space-time coincidence of guard and adversary presence all have an effect on the probability of detection. Mathematical analysis of the guard patrol detection problem is related to that of classical search theory originally developed for naval search operations. The results of this analysis tend to support the current practice of using guard forces to assess and respond to previously detected intrusions and not as the primary detection mechanism. 6more » refs.« less

Characterization of streamflow, water quality, and instantaneous dissolved solids, selenium, and uranium loads in selected reaches of the Arkansas River, southeastern Colorado, 2009-2010

USGS Publications Warehouse

Ivahnenko, Tamara; Ortiz, Roderick F.; Stogner, Sr., Robert W.

2013-01-01

As a result of continued water-quality concerns in the Arkansas River, including metal contamination from historical mining practices, potential effects associated with storage and movement of water, point- and nonpoint-source contamination, population growth, storm-water flows, and future changes in land and water use, the Arkansas River Basin Regional Resource Planning Group (RRPG) developed a strategy to address these issues. As such, a cooperative strategic approach to address the multiple water-quality concerns within selected reaches of the Arkansas River was developed to (1) identify stream reaches where stream-aquifer interactions have a pronounced effect on water quality and (or) where reactive transport, and physical and (or) chemical alteration of flow during conveyance, is occurring, (2) quantify loading from point sources, and (3) determine source areas and mass loading for selected constituents. (To see the complete abstract, open Report PDF.)

Peer Support for the Hardly Reached: A Systematic Review.

PubMed

Sokol, Rebeccah; Fisher, Edwin

2016-07-01

Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems. To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used. Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015. Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support. We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach. Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions

Comparison of current Shuttle and pre-Challenger flight suit reach capability during launch accelerations

NASA Technical Reports Server (NTRS)

Bagian, James P.; Schafer, Lauren E.

1992-01-01

The Challenger accident prompted the creation of a crew escape system which replaced the former Launch Entry Helmet (LEH) ensemble with the current Launch Entry Suit (LES). However, questions were raised regarding the impact of this change on crew reach capability. This study addressed the question of reach capability and its effects on realistic ground-based training for Space Shuttle missions. Eleven subjects performed reach sweeps in both the LEH and LES suits during 1 and 3 Gx acceleration trials in the Brooks AFB centrifuge. These reach sweeps were recorded on videotape and subsequently analyzed using a 3D motion analysis system. The ANOVA procedure of the Statistical Analysis System program was used to evaluate differences in forward and overhead reach. The results showed that the LES provided less reach capability than its predecessor, the LEH. This study also demonstrated that, since there was no substantial difference between 1 and 3 Gx reach sweeps in the LES, realistic Shuttle launch training may be accomplished in ground based simulators.

Locations of serial reach targets are coded in multiple reference frames.

PubMed

Thompson, Aidan A; Henriques, Denise Y P

2010-12-01

Previous work from our lab, and elsewhere, has demonstrated that remembered target locations are stored and updated in an eye-fixed reference frame. That is, reach errors systematically vary as a function of gaze direction relative to a remembered target location, not only when the target is viewed in the periphery (Bock, 1986, known as the retinal magnification effect), but also when the target has been foveated, and the eyes subsequently move after the target has disappeared but prior to reaching (e.g., Henriques, Klier, Smith, Lowy, & Crawford, 1998; Sorrento & Henriques, 2008; Thompson & Henriques, 2008). These gaze-dependent errors, following intervening eye movements, cannot be explained by representations whose frame is fixed to the head, body or even the world. However, it is unknown whether targets presented sequentially would all be coded relative to gaze (i.e., egocentrically/absolutely), or if they would be coded relative to the previous target (i.e., allocentrically/relatively). It might be expected that the reaching movements to two targets separated by 5° would differ by that distance. But, if gaze were to shift between the first and second reaches, would the movement amplitude between the targets differ? If the target locations are coded allocentrically (i.e., the location of the second target coded relative to the first) then the movement amplitude should be about 5°. But, if the second target is coded egocentrically (i.e., relative to current gaze direction), then the reaches to this target and the distances between the subsequent movements should vary systematically with gaze as described above. We found that requiring an intervening saccade to the opposite side of 2 briefly presented targets between reaches to them resulted in a pattern of reaching error that systematically varied as a function of the distance between current gaze and target, and led to a systematic change in the distance between the sequential reach endpoints as predicted by

Reaching Black Men. Commentary

ERIC Educational Resources Information Center

Gassman, Marybeth

2010-01-01

Journalist Elizabeth Redden brings to the surface several salient issues in her article entitled, "Reaching Black Men." First, she illuminates that fact that access is not enough when it comes to educating African American men. Second, she points to the importance of having campus-wide initiatives to support the success of Black men. And…

Aligning Theory and Design: The Development of an Online Learning Intervention to Teach Evidence-based Practice for Maximal Reach.

PubMed

Delagran, Louise; Vihstadt, Corrie; Evans, Roni

2015-09-01

Online educational interventions to teach evidence-based practice (EBP) are a promising mechanism for overcoming some of the barriers to incorporating research into practice. However, attention must be paid to aligning strategies with adult learning theories to achieve optimal outcomes. We describe the development of a series of short self-study modules, each covering a small set of learning objectives. Our approach, informed by design-based research (DBR), involved 6 phases: analysis, design, design evaluation, redesign, development/implementation, and evaluation. Participants were faculty and students in 3 health programs at a complementary and integrative educational institution. We chose a reusable learning object approach that allowed us to apply 4 main learning theories: events of instruction, cognitive load, dual processing, and ARCS (attention, relevance, confidence, satisfaction). A formative design evaluation suggested that the identified theories and instructional approaches were likely to facilitate learning and motivation. Summative evaluation was based on a student survey (N=116) that addressed how these theories supported learning. Results suggest that, overall, the selected theories helped students learn. The DBR approach allowed us to evaluate the specific intervention and theories for general applicability. This process also helped us define and document the intervention at a level of detail that covers almost all the proposed Guideline for Reporting Evidence-based practice Educational intervention and Teaching (GREET) items. This thorough description will facilitate the interpretation of future research and implementation of the intervention. Our approach can also serve as a model for others considering online EBP intervention development.

Single trial prediction of self-paced reaching directions from EEG signals.

PubMed

Lew, Eileen Y L; Chavarriaga, Ricardo; Silvoni, Stefano; Millán, José Del R

2014-01-01

Early detection of movement intention could possibly minimize the delays in the activation of neuroprosthetic devices. As yet, single trial analysis using non-invasive approaches for understanding such movement preparation remains a challenging task. We studied the feasibility of predicting movement directions in self-paced upper limb center-out reaching tasks, i.e., spontaneous movements executed without an external cue that can better reflect natural motor behavior in humans. We reported results of non-invasive electroencephalography (EEG) recorded from mild stroke patients and able-bodied participants. Previous studies have shown that low frequency EEG oscillations are modulated by the intent to move and therefore, can be decoded prior to the movement execution. Motivated by these results, we investigated whether slow cortical potentials (SCPs) preceding movement onset can be used to classify reaching directions and evaluated the performance using 5-fold cross-validation. For able-bodied subjects, we obtained an average decoding accuracy of 76% (chance level of 25%) at 62.5 ms before onset using the amplitude of on-going SCPs with above chance level performances between 875 to 437.5 ms prior to onset. The decoding accuracy for the stroke patients was on average 47% with their paretic arms. Comparison of the decoding accuracy across different frequency ranges (i.e., SCPs, delta, theta, alpha, and gamma) yielded the best accuracy using SCPs filtered between 0.1 to 1 Hz. Across all the subjects, including stroke subjects, the best selected features were obtained mostly from the fronto-parietal regions, hence consistent with previous neurophysiological studies on arm reaching tasks. In summary, we concluded that SCPs allow the possibility of single trial decoding of reaching directions at least 312.5 ms before onset of reach.

Reach-to-grasp movement as a minimization process.

PubMed

Yang, Fang; Feldman, Anatol G

2010-02-01

It is known that hand transport and grasping are functionally different but spatially coordinated components of reach-to-grasp (RTG) movements. As an extension of this notion, we suggested that body segments involved in RTG movements are controlled as a coherent ensemble by a global minimization process associated with the necessity for the hand to reach the motor goal. Different RTG components emerge following this process without pre-programming. Specifically, the minimization process may result from the tendency of neuromuscular elements to diminish the spatial gap between the actual arm-hand configuration and its virtual (referent) configuration specified by the brain. The referent configuration is specified depending on the object shape, localization, and orientation. Since the minimization process is gradual, it can be interrupted and resumed following mechanical perturbations, at any phase during RTG movements, including hand closure. To test this prediction of the minimization hypothesis, we asked subjects to reach and grasp a cube placed within the reach of the arm. Vision was prevented during movement until the hand returned to its initial position. As predicted, by arresting wrist motion at different points of hand transport in randomly selected trials, it was possible to halt changes in hand aperture at any phase, not only during hand opening but also during hand closure. Aperture changes resumed soon after the wrist was released. Another test of the minimization hypothesis was made in RTG movements to an object placed beyond the reach of the arm. It has previously been shown (Rossi et al. in J Physiol 538:659-671, 2002) that in such movements, the trunk motion begins to contribute to hand transport only after a critical phase when the shifts in the referent arm configuration have finished (at about the time when hand velocity is maximal). The minimization rule suggests that when the virtual contribution of the arm to hand transport is completed

Reaching to multiple targets when standing: the spatial organization of feedforward postural adjustments.

PubMed

Leonard, Julia A; Brown, Ryan H; Stapley, Paul J

2009-04-01

We examined the spatial organization of feedforward postural adjustments produced prior to and during voluntary arm reaching movements executed while standing. We sought to investigate whether the activity of postural muscles before and during reaching was directionally tuned and whether a strategy of horizontal force constraint could be observed. To this end, eight human subjects executed self-paced reach-to-point movements on the random illumination of one of 13 light targets placed within a 180 degrees array centered along the midline of the body. Analysis was divided into two periods: a first corresponding to the 250 ms preceding the onset of the reaching movements (termed pPA period) and a second 250-ms period immediately preceding target attainment (the aPA period). For both periods, electromyographic activity of the lower limb muscles revealed a clear directional tuning, with groups of muscles being activated for similar directions of reach. Analysis of horizontal ground reaction forces supported the existence of a force constraint strategy only for the pPA period, however, with those in the aPA period being more widely dispersed. We suggest that the strategy adopted for feedforward pPAs is one where the tuned muscle synergies constrain the forces diagonally away from the center of mass (CoM) to move it within the support base. However, the need to control for final finger and body position for each target during the aPA phase resulted in a distribution of vectors across reaching directions. Overall, our results would support the idea that endpoint limb force during postural tasks depends on the use of functional muscle synergies, which are used to displace the CoM or decelerate the body at the end of the reach.

Current practice patterns in conservative thumb CMC joint care: survey results.

PubMed

O'Brien, Virginia H; McGaha, Jamie L

2014-01-01

Cross-sectional descriptive survey Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Not applicable. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

PubMed

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Poor shape perception is the reason reaches-to-grasp are visually guided online.

PubMed

Lee, Young-Lim; Crabtree, Charles E; Norman, J Farley; Bingham, Geoffrey P

2008-08-01

Both judgment studies and studies of feedforward reaching have shown that the visual perception of object distance, size, and shape are inaccurate. However, feedback has been shown to calibrate feedfoward reaches-to-grasp to make them accurate with respect to object distance and size. We now investigate whether shape perception (in particular, the aspect ratio of object depth to width) can be calibrated in the context of reaches-to-grasp. We used cylindrical objects with elliptical cross-sections of varying eccentricity. Our participants reached to grasp the width or the depth of these objects with the index finger and thumb. The maximum grasp aperture and the terminal grasp aperture were used to evaluate perception. Both occur before the hand has contacted an object. In Experiments 1 and 2, we investigated whether perceived shape is recalibrated by distorted haptic feedback. Although somewhat equivocal, the results suggest that it is not. In Experiment 3, we tested the accuracy of feedforward grasping with respect to shape with haptic feedback to allow calibration. Grasping was inaccurate in ways comparable to findings in shape perception judgment studies. In Experiment 4, we hypothesized that online guidance is needed for accurate grasping. Participants reached to grasp either with or without vision of the hand. The result was that the former was accurate, whereas the latter was not. We conclude that shape perception is not calibrated by feedback from reaches-to-grasp and that online visual guidance is required for accurate grasping because shape perception is poor.

Reaching for the Stars

ERIC Educational Resources Information Center

Terry, Dorothy Givens

2012-01-01

Dr. Mae Jemison is the world's first woman astronaut of color who continues to reach for the stars. Jemison was recently successful in leading a team that has secured a $500,000 federal grant to make interstellar space travel a reality. The Dorothy Jemison Foundation for Excellence (named after Jemison's mother) was selected in June by the Defense…

Quantitative model of transport-aperture coordination during reach-to-grasp movements.

PubMed

Rand, Miya K; Shimansky, Y P; Hossain, Abul B M I; Stelmach, George E

2008-06-01

It has been found in our previous studies that the initiation of aperture closure during reach-to-grasp movements occurs when the hand distance to target crosses a threshold that is a function of peak aperture amplitude, hand velocity, and hand acceleration. Thus, a stable relationship between those four movement parameters is observed at the moment of aperture closure initiation. Based on the concept of optimal control of movements (Naslin 1969) and its application for reach-to-grasp movement regulation (Hoff and Arbib 1993), it was hypothesized that the mathematical equation expressing that relationship can be generalized to describe coordination between hand transport and finger aperture during the entire reach-to-grasp movement by adding aperture velocity and acceleration to the above four movement parameters. The present study examines whether this hypothesis is supported by the data obtained in experiments in which young adults performed reach-to-grasp movements in eight combinations of two reach-amplitude conditions and four movement-speed conditions. It was found that linear approximation of the mathematical model described the relationship among the six movement parameters for the entire aperture-closure phase with very high precision for each condition, thus supporting the hypothesis for that phase. Testing whether one mathematical model could approximate the data across all the experimental conditions revealed that it was possible to achieve the same high level of data-fitting precision only by including in the model two additional, condition-encoding parameters and using a nonlinear, artificial neural network-based approximator with two hidden layers comprising three and two neurons, respectively. This result indicates that transport-aperture coordination, as a specific relationship between the parameters of hand transport and finger aperture, significantly depends on the condition-encoding variables. The data from the aperture-opening phase also fit a

Hand synergies during reach-to-grasp.

PubMed

Mason, C R; Gomez, J E; Ebner, T J

2001-12-01

An emerging viewpoint is that the CNS uses synergies to simplify the control of the hand. Previous work has shown that static hand postures for mimed grasps can be described by a few principal components in which the higher order components explained only a small fraction of the variance yet provided meaningful information. Extending that earlier work, this study addressed whether the entire act of grasp can be described by a small number of postural synergies and whether these synergies are similar for different grasps. Five right-handed adults performed five types of reach-to-grasps including power grasp, power grasp with a lift, precision grasp, and mimed power grasp and mimed precision grasp of 16 different objects. The object shapes were cones, cylinders, and spindles, systematically varied in size to produce a large range of finger joint angle combinations. Three-dimensional reconstructions of 21 positions on the hand and wrist throughout the reach-to-grasp were obtained using a four-camera video system. Singular value decomposition on the temporal sequence of the marker positions was used to identify the common patterns ("eigenpostures") across the 16 objects for each task and their weightings as a function of time. The first eigenposture explained an average of 97.3 +/- 0.89% (mean +/- SD) of the variance of the hand shape, and the second another 1.9 +/- 0.85%. The first eigenposture was characterized by an open hand configuration that opens and closes during reach. The second eigenposture contributed to the control of the thumb and long fingers, particularly in the opening of the hand during the reach and the closing in preparation for object grasp. The eigenpostures and their temporal evolutions were similar across subjects and grasps. The higher order eigenpostures, although explaining only small amounts of the variance, contributed to the movements of the fingers and thumb. These findings suggest that much of reach-to-grasp is effected using a base

The European Union's REACH regulation: a review of its history and requirements.

PubMed

Williams, E Spencer; Panko, Julie; Paustenbach, Dennis J

2009-01-01

In 2006, the European Union (EU) promulgated a monumental regulatory initiative for the Registration, Evaluation, Authorization, and Restriction of Chemicals (REACH). To date, several thousand pages of text have been needed to describe the expectations of this regulation. There were numerous reasons for the promulgation of REACH, but, by and large, it is an extension of the global desire to produce fewer industrial chemicals, to understand the possible human and ecological hazards of those that are produced, and to insure that any major threat is anticipated, as well as prevented. Most industry-related groups consider it the most wide-ranging and costly regulatory initiatives related to health risk assessment ever to be promulgated. This review presents a description of REACH that should inform scientists, managers, and others about its objectives and the means to satisfy them. Registration is required for all chemicals manufactured or imported into the EU, unless specifically exempted. Registration is expected to be a collaborative process among companies, which will generate a dossier containing data on physicochemical characteristics, as well as toxicological and ecotoxicological properties. Though the magnitude of the gaps in the data required for registration is uncertain at this point, it is clear that basic toxicology testing will have to be conducted for many chemical substances that have not undergone formal review up to this point. For many chemicals, an examination of hazards and risks arising from the use of these substances will also be required in the form of a chemical safety report (CSR). Beginning with the dual processes of dossier and substance evaluation, the European Chemicals Agency (ECHA), the Member States of the EU, and the European Commission will identify chemicals that may pose unacceptable hazards to human health and/or the environment, and will curtail or restrict their usage. The implementation of REACH will expand and deepen the

Sliding Mode Control of Dynamic Voltage Restorer by Using a New Adaptive Reaching Law

NASA Astrophysics Data System (ADS)

Pandey, Achala; Agrawal, Rekha; Mandloi, Ravindra S.; Sarkar, Biswaroop

2017-12-01

This paper presents a new kind of adaptive reaching law for sliding mode control of Dynamic Voltage Restorer (DVR). Such an adaptive reaching law follows under-damped sinusoidal nature that causes the initial state to reach the sliding regime in extremely less time with negligible chattering. Moreover, it is robust in the sense the trajectory does not deviate from the sliding surface. This new approach is developed and successfully applied to DVR. The simulation results are presented that show its robustness.

Value gaps in dental practice: understanding how differences in core values can adversely affect the practice.

PubMed

Newsome, Philip; Wolfe, Ira S

2003-11-01

The authors explore the importance of human values in dental practice, an area often overlooked as we struggle to deal with the everyday demands of treating patients and managing staff members. Such values are, however, fundamental to the success of any practice; therefore, it is important to understand their significance. Problems arise in dental practices when gaps develop between the values held by the various players involved (that is, between the entire dental team and patients, the dentist/owner's personal values and business goals, the dentist/owner and staff members, and the dental practice and any third-party funding organizations). By understanding the potentially damaging consequences of value gaps for practice viability, dental practice owners and managers can take steps to create a more harmonious workplace in which all parties strive to reach common goals.

Reach and speed of judgment propagation in the laboratory.

PubMed

Moussaïd, Mehdi; Herzog, Stefan M; Kämmer, Juliane E; Hertwig, Ralph

2017-04-18

In recent years, a large body of research has demonstrated that judgments and behaviors can propagate from person to person. Phenomena as diverse as political mobilization, health practices, altruism, and emotional states exhibit similar dynamics of social contagion. The precise mechanisms of judgment propagation are not well understood, however, because it is difficult to control for confounding factors such as homophily or dynamic network structures. We introduce an experimental design that renders possible the stringent study of judgment propagation. In this design, experimental chains of individuals can revise their initial judgment in a visual perception task after observing a predecessor's judgment. The positioning of a very good performer at the top of a chain created a performance gap, which triggered waves of judgment propagation down the chain. We evaluated the dynamics of judgment propagation experimentally. Despite strong social influence within pairs of individuals, the reach of judgment propagation across a chain rarely exceeded a social distance of three to four degrees of separation. Furthermore, computer simulations showed that the speed of judgment propagation decayed exponentially with the social distance from the source. We show that information distortion and the overweighting of other people's errors are two individual-level mechanisms hindering judgment propagation at the scale of the chain. Our results contribute to the understanding of social-contagion processes, and our experimental method offers numerous new opportunities to study judgment propagation in the laboratory.

Reach and speed of judgment propagation in the laboratory

PubMed Central

Herzog, Stefan M.; Kämmer, Juliane E.; Hertwig, Ralph

2017-01-01

In recent years, a large body of research has demonstrated that judgments and behaviors can propagate from person to person. Phenomena as diverse as political mobilization, health practices, altruism, and emotional states exhibit similar dynamics of social contagion. The precise mechanisms of judgment propagation are not well understood, however, because it is difficult to control for confounding factors such as homophily or dynamic network structures. We introduce an experimental design that renders possible the stringent study of judgment propagation. In this design, experimental chains of individuals can revise their initial judgment in a visual perception task after observing a predecessor’s judgment. The positioning of a very good performer at the top of a chain created a performance gap, which triggered waves of judgment propagation down the chain. We evaluated the dynamics of judgment propagation experimentally. Despite strong social influence within pairs of individuals, the reach of judgment propagation across a chain rarely exceeded a social distance of three to four degrees of separation. Furthermore, computer simulations showed that the speed of judgment propagation decayed exponentially with the social distance from the source. We show that information distortion and the overweighting of other people’s errors are two individual-level mechanisms hindering judgment propagation at the scale of the chain. Our results contribute to the understanding of social-contagion processes, and our experimental method offers numerous new opportunities to study judgment propagation in the laboratory. PMID:28373540

Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh.

PubMed

Moinuddin, Md; Christou, Aliki; Hoque, Dewan Md Emdadul; Tahsina, Tazeen; Salam, Shumona Sharmin; Billah, Sk Masum; Kuppens, Lianne; Matin, Md Ziaul; Arifeen, Shams El

2017-01-01

Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh. To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices. A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis. Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6). Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low

Mechanical energy expenditures and movement efficiency in full body reaching movements.

PubMed

Sha, Daohang; France, Christopher R; Thomas, James S

2010-02-01

The effect of target location, speed, and handedness on the average total mechanical energy and movement efficiency is studied in 15 healthy subjects (7 males and 8 females with age 22.9 +/- 1.79 years old) performing full body reaching movements. The average total mechanical energy is measured as the time average of integration of joint power, potential energy, and kinetic energy respectively. Movement efficiency is calculated as the ratio of total kinetic energy to the total joint power and potential energy. Results show that speed and target location have significant effects on total mechanical energy and movement efficiency, but reaching hand only effects kinetic energy. From our findings we conclude that (1) efficiency in whole body reaching is dependent on whether the height of the body center of mass is raised or lowered during the task; (2) efficiency is increased as movement speed is increased, in part because of greater changes in potential energy; and (3) the CNS does not appear to use movement efficiency as a primary planning variable in full body reaching. It may be dependent on a combination of other factors or constraints.

Bimanual reach to grasp movements after cervical spinal cord injury.

PubMed

Britten, Laura; Coats, Rachel; Ichiyama, Ronaldo; Raza, Wajid; Jamil, Firas; Astill, Sarah

2017-01-01

Injury to the cervical spinal cord results in bilateral deficits in arm/hand function reducing functional independence and quality of life. To date little research has been undertaken to investigate control strategies of arm/hand movements following cervical spinal cord injury (cSCI). This study aimed to investigate unimanual and bimanual coordination in patients with acute cSCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together (symmetrical task), and compare this to the movement patterns of uninjured younger and older adults. Eighteen adults with a cSCI (mean 61.61 years) with lesions at C4-C8, with an American Spinal Injury Association (ASIA) grade B to D and 16 uninjured younger adults (mean 23.68 years) and sixteen uninjured older adults (mean 70.92 years) were recruited. Participants with a cSCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants. These differences were exacerbated during bimanual reach-to-grasp tasks. Maximal grasp aperture was no different between groups, but reached earlier by people with cSCI. Participants with a cSCI were less synchronous than younger and older adults but all groups used the deceleration phase for error correction to end the movement in a synchronous fashion. Overall, this study suggests that after cSCI a level of bimanual coordination is retained. While there seems to be a greater reliance on feedback to produce both the reach to grasp, we observed minimal disruption of the more impaired limb on the less impaired limb. This suggests that bimanual movements should be integrated into therapy.

Is there a hard-to-reach audience?

PubMed Central

Freimuth, V S; Mettger, W

1990-01-01

The "hard-to-reach" label has been applied to many different audiences. Persons who have a low socioeconomic status (SES), members of ethnic minorities, and persons who have a low level of literacy often are tagged as "hard-to-reach." The authors identify reasons why these groups have been labelled "hard-to-reach," discuss preconceptions associated with the "hard-to-reach" label, propose alternative conceptualizations of these audiences, and present implications of such conceptualizations for health communication campaigns. Pejorative labels and preconceptions about various groups may lead to depicting these audiences as powerless, apathetic, and isolated. The authors discuss alternative conceptualizations, which highlight the strengths of different audience segments and encourage innovative approaches to the communication process. These alternative conceptualizations emphasize interactive communication, a view of society in which individuals are seen as members of equivalent--albeit different--cultures, and a shift of responsibility for health problems from individuals to social systems. Recommendations for incorporating these alternative concepts into health campaigns include formative research techniques that create a dialogue among participants, more sophisticated segmentation techniques to capture audience diversity, and new roles for mass media that are more interactive and responsive to individual needs. PMID:2113680

Phenomena and characteristics of barrier river reaches in the middle and lower Yangtze River, China

NASA Astrophysics Data System (ADS)

You, Xingying; Tang, Jinwu

2017-06-01

Alluvial river self-adjustment describes the mechanism whereby a river that was originally in an equilibrium state of sediment transport encounters some disturbance that destroys the balance and results in responses such as riverbed deformation. A systematic study of historical and recent aerial photographs and topographic maps in the Middle and Lower Reaches of the Yangtze River (MLYR) shows that river self-adjustment has the distinguishing feature of transferring from upstream to downstream, which may affect flood safety, waterway morphology, bank stability, and aquatic environmental safety over relatively long reaches downstream. As a result, it is necessary to take measures to control or block this transfer. Using the relationship of the occurrence time of channel adjustments between the upstream and downstream, 34 single-thread river reaches in the MLYR were classified into four types: corresponding, basically corresponding, basically not corresponding, not corresponding. The latter two types, because of their ability to prevent upstream channel adjustment from transferring downstream, are called barrier river reaches in this study. Statistics indicate that barrier river reaches are generally single thread and slightly curved, with a narrow and deep cross-sectional morphology, and without flow deflecting nodes in the upper and middle parts of reaches. Moreover, in the MLYR, barrier river reaches have a hydrogeometric coefficient of {<}{4}, a gradient {>}1.2‱, a silty clay content of the concave bank {>}{9.5}%, and a median diameter of the bed sediment {>}{0.158} mm. The barrier river reach mechanism lies in that can effectively centralise the planimetric position of the main stream from different upstream directions, meaning that no matter how the upper channel adjusts, the main stream shows little change, providing relatively stable inflow conditions for the lower reaches. Regarding river regulation, it is necessary to optimise the benefits of barrier river

Assessment of Rapid-Blood-Culture-Identification Result Interpretation and Antibiotic Prescribing Practices

PubMed Central

Campbell, W. Scott; Lyden, Elizabeth; Van Schooneveld, Trevor C.

2017-01-01

ABSTRACT Rapid pathogen identification can alter antibiotic prescribing practices if interpreted correctly. Microbiology reporting can be difficult to understand, and new technology has made it more challenging. Nebraska Medicine recently implemented the BioFire FilmArray blood culture identification panel (BCID) coupled with stewardship-based education on interpretation. Physician BCID result interpretation and prescribing were assessed via an electronic survey, with a response rate of 40.8% (156/382 surveys). Seven questions required respondents to interpret BCID results, identify the most likely pathogen, and then choose therapy based on the results. The tallied correct responses resulted in a knowledge score. General linear models evaluated the effect of role, specialty, and utilization of the BCID interpretation guide on the mean knowledge score. The specialties of the respondents included 55.7% internal medicine, 19.7% family medicine, and 24.6% other. Roles included 41.1% residents, 5.0% fellows, and 53.9% faculty. Most reported that they reviewed antimicrobial susceptibility results (89.4%) and adjusted therapy accordingly (81.6%), while only 60% stated that they adjusted therapy based on BCID results. The correct response rates ranged from 52 to 86% for the interpretation questions. The most common errors included misinterpretation of Enterobacteriaceae and Staphylococcus genus results. Neither role nor specialty was associated with total knowledge score in multivariate analysis (P = 0.13 and 0.47, respectively). In conclusion, physician interpretation of BCID results is suboptimal and can result in ineffective treatment or missed opportunity to narrow therapy. With the implementation of new technology, improved reporting practices of BCID results with clinical decision support tools providing interpretation guidance available at the point of care is recommended. PMID:28250000

Endorsing the Practical Endorsement? OCR's Approach to Practical Assessment in Science A-Levels

ERIC Educational Resources Information Center

Evans, Steve; Wade, Neil

2015-01-01

This article summarises the practical requirements for new science A-levels in biology, chemistry and physics for first teaching from September 2015. It discusses the background to how the new approach was reached and how OCR has seen this taking shape in our assessment models. The opportunities presented by this new approach to practical…

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

PubMed

Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

2016-02-01

Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

III-V-on-silicon solar cells reaching 33% photoconversion efficiency in two-terminal configuration

NASA Astrophysics Data System (ADS)

Cariou, Romain; Benick, Jan; Feldmann, Frank; Höhn, Oliver; Hauser, Hubert; Beutel, Paul; Razek, Nasser; Wimplinger, Markus; Bläsi, Benedikt; Lackner, David; Hermle, Martin; Siefer, Gerald; Glunz, Stefan W.; Bett, Andreas W.; Dimroth, Frank

2018-04-01

Silicon dominates the photovoltaic industry but the conversion efficiency of silicon single-junction solar cells is intrinsically constrained to 29.4%, and practically limited to around 27%. It is possible to overcome this limit by combining silicon with high-bandgap materials, such as III-V semiconductors, in a multi-junction device. Significant challenges associated with this material combination have hindered the development of highly efficient III-V/Si solar cells. Here, we demonstrate a III-V/Si cell reaching similar performances to standard III-V/Ge triple-junction solar cells. This device is fabricated using wafer bonding to permanently join a GaInP/GaAs top cell with a silicon bottom cell. The key issues of III-V/Si interface recombination and silicon's weak absorption are addressed using poly-silicon/SiOx passivating contacts and a novel rear-side diffraction grating for the silicon bottom cell. With these combined features, we demonstrate a two-terminal GaInP/GaAs//Si solar cell reaching a 1-sun AM1.5G conversion efficiency of 33.3%.

Timing variability of reach trajectories in left versus right hemisphere stroke.

PubMed

Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

2011-10-24

This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial's acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand's warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. Copyright © 2011

TIMING VARIABILITY OF REACH TRAJECTORIES IN LEFT VERSUS RIGHT HEMISPHERE STROKE

PubMed Central

Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

2011-01-01

This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial’s acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand’s warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. PMID:21920508

Motives of former interns in general practice for speciality-choice − Results of a cross-sectional study among graduates 2007 to 2012

PubMed Central

Abendroth, Jens; Schnell, Ute; Lichte, Thomas; Oemler, Matthias; Klement, Andreas

2014-01-01

Background: The influence of a final-year elective internship in general practice (IGP) on motives affecting graduates’ choice of specialty is the object of great public interest, yet still insufficiently evaluated. Longitudinal studies show the influence of numerous motives (e.g. work-life balance), but not following the IGP experience itself. Thus, we performed a cross-sectional questionnaire study of all graduates who completed the IGP in Saxony-Anhalt during 2007-2012 regarding their motives for choosing a speciality. Method: A standardized questionnaire was sent to 109 former interns in general practice. The questionnaire contained 29 items addressing three topics (personal attitudes, concept of personal and professional life, motives for speciality choice) and used single-choice and multiple-choice answers, as well as Likert scales. Correlation analysis was carried out by means of Kendall's tau. Results: The questionnaire reached 97 former interns, of which 45 (46%) responded. In the overall ranking of motives for speciality choice, family (71%), leisure time (66%) and job opportunities (48%) rated as more important than income (36%), mentoring (20%), status or scientific work (20%). Only 29% of the respondents stated that their speciality choice was changed by the IGP. If the speciality choice was already established before the IGP, the influence of the IGP on speciality choice was significantly low (r=-.5; p<.01). However, if the IGP had an influence on speciality choice, it was correlated with a new perception of general practice (r=.36; p<.01). This new perception was associated with a positive influence of the medical teacher during the IGP. Conclusion: The final-year IGP is an opportunity to change the perception of general practice in students who are still undecided. This can lead to different speciality choices in a subgroup. Personal attitudes and concepts of personal life and career were also important factors affecting speciality choice. The

An assessment of the impact of upland afforestation on lowland river reaches: the Afon Trannon, mid-Wales

NASA Astrophysics Data System (ADS)

Mount, N. J.; Sambrook Smith, G. H.; Stott, T. A.

2005-01-01

Upland afforestation in the UK was the largest rural land-use change last century. As a consequence, the bed load yields of upland catchments increased substantially. Circumstantial evidence suggests that, when this increased load reaches the lowland catchment, it is deposited, triggering flow diversion and channel instability. However, despite the widespread adoption of this theory, it remains to be properly tested. This paper uses aerial photograph analysis and contemporary channel digital terrain models (DTMs) to assess this concept on the Afon Trannon, mid-Wales, the upper catchment of which was afforested between 1948 and 1978. Construction of a sediment budget demonstrates that upland catchment bed load yields are only equivalent to localized inputs of gravel from bank erosion and are therefore unlikely to be totally responsible for producing the high rates of channel change observed in some lowland reaches. Channel instability appears to be more related to the nature of the local bank input as those reaches where gravel is not present in the bank material are stable. Additionally, flood magnitude and frequency are shown to have increased since 1988, a factor of at least equal importance to that of bed load yields from either upland catchments or local bank erosion. It is concluded that, in contrast to previous work, afforestation in the uplands has only a minor influence on downstream reaches of the Afon Trannon. Situations where upland afforestation may have a greater impact on downstream reaches are discussed and the implications for best management practice explored.

RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH (REACH)

EPA Science Inventory

Racial and Ethnic Approaches to Community Health (REACH) 2010 is the cornerstone of CDC's efforts to eliminate racial and ethnic disparities in health. Launched in 1999, REACH 2010 is designed to eliminate disparities in the following six priority areas: cardiovascular disease, i...

Survey of sterile admixture practices in canadian hospital pharmacies: part 2. More results and discussion.

PubMed

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-05-01

The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter <797> Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. The survey methods for this study and results relating to policies, personnel, raw materials, storage and

Kangaroo care: research results, and practice implications and guidelines.

PubMed

Ludington-Hoe, S M; Thompson, C; Swinth, J; Hadeed, A J; Anderson, G C

1994-02-01

Results of two studies of the effects of 2 to 3 hours of kangaroo care (KC), one a randomized trial of 25 premature infants in open-air cribs and the other a pilot of 6 premature infants who were at least 24 hours postextubation, who were cared for in incubators are reviewed. Both studies incorporated a pretest/posttest control group design. Heart rate and abdominal skin temperature rose for KC infants during KC. Heat loss did not occur during KC, and infants slept more during KC. Kangaroo care had a comforting effect on infants and their mothers. Apnea and periodic breathing episodes dropped during KC for incubator infants. Suggestions and guidelines for selection of infants and practice based on these studies are presented.

Spatial eye–hand coordination during bimanual reaching is not systematically coded in either LIP or PRR

PubMed Central

Snyder, Lawrence H.

2018-01-01

We often orient to where we are about to reach. Spatial and temporal correlations in eye and arm movements may depend on the posterior parietal cortex (PPC). Spatial representations of saccade and reach goals preferentially activate cells in the lateral intraparietal area (LIP) and the parietal reach region (PRR), respectively. With unimanual reaches, eye and arm movement patterns are highly stereotyped. This makes it difficult to study the neural circuits involved in coordination. Here, we employ bimanual reaching to two different targets. Animals naturally make a saccade first to one target and then the other, resulting in different patterns of limb–gaze coordination on different trials. Remarkably, neither LIP nor PRR cells code which target the eyes will move to first. These results suggest that the parietal cortex plays at best only a permissive role in some aspects of eye–hand coordination and makes the role of LIP in saccade generation unclear. PMID:29610356

Unified communication to reach vulnerable mothers.

PubMed

Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

2011-01-01

The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

Self-Esteem and Narcissism: Implications for Practice. ERIC Digest.

ERIC Educational Resources Information Center

Katz, Lilian G.

While the development of children's self-esteem is a worthwhile goal in early education, many practices designed to reach this goal may instead be encouraging narcissism. Such practices include those that direct children's attention to their own inner gratifications, or encourage children to believe their specialness is dependent on trivial…

Putting Public Health Into Practice: A Model for Assessing the Relationship Between Local Health Departments and Practicing Physicians

PubMed Central

Perlman, Sharon E.; Koppaka, Ram; Greene, Carolyn M.

2012-01-01

The New York City (NYC) Department of Health and Mental Hygiene (Health Department) surveyed practicing NYC physicians to quantify Health Department resource use. Although the Health Department successfully reaches most physicians, and information is valued in practice, knowledge of several key resources was low. Findings suggested 3 recommendations for all local health departments seeking to enhance engagement with practicing physicians: (1) capitalize on physician interest, (2) engage physicians early and often, and (3) make interaction with the health department easy. Also, older physicians may require targeted outreach. PMID:22690968

Bimanual reach to grasp movements after cervical spinal cord injury

PubMed Central

Raza, Wajid; Jamil, Firas

2017-01-01

Injury to the cervical spinal cord results in bilateral deficits in arm/hand function reducing functional independence and quality of life. To date little research has been undertaken to investigate control strategies of arm/hand movements following cervical spinal cord injury (cSCI). This study aimed to investigate unimanual and bimanual coordination in patients with acute cSCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together (symmetrical task), and compare this to the movement patterns of uninjured younger and older adults. Eighteen adults with a cSCI (mean 61.61 years) with lesions at C4-C8, with an American Spinal Injury Association (ASIA) grade B to D and 16 uninjured younger adults (mean 23.68 years) and sixteen uninjured older adults (mean 70.92 years) were recruited. Participants with a cSCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants. These differences were exacerbated during bimanual reach-to-grasp tasks. Maximal grasp aperture was no different between groups, but reached earlier by people with cSCI. Participants with a cSCI were less synchronous than younger and older adults but all groups used the deceleration phase for error correction to end the movement in a synchronous fashion. Overall, this study suggests that after cSCI a level of bimanual coordination is retained. While there seems to be a greater reliance on feedback to produce both the reach to grasp, we observed minimal disruption of the more impaired limb on the less impaired limb. This suggests that bimanual movements should be integrated into therapy. PMID:28384247

REACH. Electricity Units, Post-Secondary.

ERIC Educational Resources Information Center

Smith, Gene; And Others

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this postsecondary student manual contains individualized instructional units in the area of electricity. The instructional units focus on electricity fundamentals, electric motors, electrical components, and controls and installation.…

Patterns of arm muscle activation involved in octopus reaching movements.

PubMed

Gutfreund, Y; Flash, T; Fiorito, G; Hochner, B

1998-08-01

The extreme flexibility of the octopus arm allows it to perform many different movements, yet octopuses reach toward a target in a stereotyped manner using a basic invariant motor structure: a bend traveling from the base of the arm toward the tip (Gutfreund et al., 1996a). To study the neuronal control of these movements, arm muscle activation [electromyogram (EMG)] was measured together with the kinematics of reaching movements. The traveling bend is associated with a propagating wave of muscle activation, with maximal muscle activation slightly preceding the traveling bend. Tonic activation was occasionally maintained afterward. Correlation of the EMG signals with the kinematic variables (velocities and accelerations) reveals that a significant part of the kinematic variability can be explained by the level of muscle activation. Furthermore, the EMG level measured during the initial stages of movement predicts the peak velocity attained toward the end of the reaching movement. These results suggest that feed-forward motor commands play an important role in the control of movement velocity and that simple adjustment of the excitation levels at the initial stages of the movement can set the velocity profile of the whole movement. A simple model of octopus arm extension is proposed in which the driving force is set initially and is then decreased in proportion to arm diameter at the bend. The model qualitatively reproduces the typical velocity profiles of octopus reaching movements, suggesting a simple control mechanism for bend propagation in the octopus arm.

Priming of Reach and Grasp Actions by Handled Objects

ERIC Educational Resources Information Center

Masson, Michael E. J.; Bub, Daniel N.; Breuer, Andreas T.

2011-01-01

Pictures of handled objects such as a beer mug or frying pan are shown to prime speeded reach and grasp actions that are compatible with the object. To determine whether the evocation of motor affordances implied by this result is driven merely by the physical orientation of the object's handle as opposed to higher-level properties of the object,…

Reaching the hard to reach.

PubMed

Bhiwandi, P; Campbell, M; Potts, M

1994-01-01

The 1994 International Conference on Population and Development proposed increasing contraceptive couple protection from 550 million in 1995 to 880 million in 2015. The task for family planning (FP) programs is to provide access to services for, sometimes, inaccessible rural populations. FP need based on desire for no more children has ranged from under 20% in Senegal to almost 80% in Peru. Socioeconomic development was found not to be a prerequisite for fertility change. Gender inequalities in education and social autonomy must be changed. FP access is very important among women with a disadvantaged background or among women unsure about FP. Bangladesh is a good example of a country with increased contraceptive prevalence despite low income. The rule of thumb is that contraception increases of 15% contribute to a drop in family size of about one child. Program effectiveness is related to a variety of factors: contraceptive availability at many locations, acceptable price of contraception, delivery of the oral contraceptives without prescriptions, and other strategies. FP is a service not a medical treatment. A range of methods must be promoted and available from a range of facilities. Contraceptive use is dependent on the woman's stage in her lifecycle and is dependent on informed choice. Community-based distribution systems are effective, whereas free distribution by poorly-trained field workers is not always very effective because patient payment of all or part of the cost assures quality and freedom of choice. Effective programs for underprivileged groups involve aggressive, easy to manage programs that can be replicated rapidly. FP serves a useful function in depressing maternal mortality among the poor in Africa, who have no access to quality health services. Social marketing is an effective strategy for reaching remote areas. Political will and robust management are necessary commodities.

Prism adaptation speeds reach initiation in the direction of the prism after-effect.

PubMed

Striemer, Christopher L; Borza, Carley A

2017-10-01

Damage to the temporal-parietal cortex in the right hemisphere often leads to spatial neglect-a disorder in which patients are unable to attend to sensory input from their contralesional (left) side. Neglect has been associated with both attentional and premotor deficits. That is, in addition to having difficulty with attending to the left side, patients are often slower to initiate leftward vs. rightward movements (i.e., directional hypokinesia). Previous research has indicated that a brief period of adaptation to rightward shifting prisms can reduce symptoms of neglect by adjusting the patient's movements leftward, toward the neglected field. Although prism adaptation has been shown to reduce spatial attention deficits in patients with neglect, very little work has examined the effects of prisms on premotor symptoms. In the current study, we examined this in healthy individuals using leftward shifting prisms to induce a rightward shift in the egocentric reference frame, similar to neglect patients prior to prism adaptation. Specifically, we examined the speed with which healthy participants initiated leftward and rightward reaches (without visual feedback) prior to and following adaptation to either 17° leftward (n = 16) or 17° rightward (n = 15) shifting prisms. Our results indicated that, following adaptation, participants were significantly faster to initiate reaches towards targets located in the direction opposite the prism shift. That is, participants were faster to initiate reaches to right targets following leftward prism adaptation and were faster to initiate reaches to left targets following rightward prism adaptation. Overall, these results are consistent with the idea that prism adaptation can influence the speed with which a reach can be initiated toward a target in the direction opposite the prism shift, possibly through altering activity in neural circuits involved in reach planning.

Kinematics of reaching and implications for handedness in rhesus monkey infants

PubMed Central

Nelson, Eliza L.; Konidaris, George D.; Berthier, Neil E.; Braun, Maurine C.; Novak, Matthew F.S.X.; Suomi, Stephen J.; Novak, Melinda A.

2014-01-01

Kinematic studies of reaching in human infants using two-dimensional (2-D) and three-dimensional (3-D) recordings have complemented behavioral studies of infant handedness by providing additional evidence of early right asymmetries. Right hand reaches have been reported to be straighter and smoother than left hand reaches during the first year. Although reaching has been a popular measure of handedness in primates, there has been no systematic comparison of left and right hand reach kinematics. We investigated reaching in infant rhesus monkeys using the 2-D motion analysis software MaxTRAQ Lite+ (Innovision Systems). Linear mixed-effects models revealed that left hand reaches were smoother, but not straighter, than right hand reaches. An early left bias matches previous findings of a left hand preference for reaching in adult rhesus monkeys. Additional work using this kind of kinematic approach will extend our understanding of primate handedness beyond traditional studies measuring only frequency or bouts of hand use. PMID:22031459

Factors associated with reaching or not reaching target HbA1c after initiation of basal or premixed insulin in patients with type 2 diabetes.

PubMed

Scheen, A J; Schmitt, H; Jiang, H H; Ivanyi, T

2017-02-01

To evaluate factors associated with reaching or not reaching target glycated haemoglobin (HbA 1c ) levels by analysing the respective contributions of fasting hyperglycaemia (FHG), also referred to as basal hyperglycaemia, vs postprandial hyperglycaemia (PHG) before and after initiation of a basal or premixed insulin regimen in patients with type 2 diabetes. This post-hoc analysis of insulin-naïve patients in the DURABLE study randomised to receive either insulin glargine or insulin lispro mix 25 evaluated the percentages of patients achieving a target HbA 1c of <7.0% (<53mmol/mol) per baseline HbA 1c quartiles, and the effect of each insulin regimen on the relative contributions of PHG and FHG to overall hyperglycaemia. Patients had comparable demographic characteristics and similar HbA 1c and FHG values at baseline in each HbA 1c quartile regardless of whether they reached the target HbA 1c . The higher the HbA 1c quartile, the greater was the decrease in HbA 1c , but also the smaller the percentage of patients achieving the target HbA 1c . HbA 1c and FHG decreased more in patients reaching the target, resulting in significantly lower values at endpoint in all baseline HbA 1c quartiles with either insulin treatment. Patients not achieving the target HbA 1c had slightly higher insulin doses, but lower total hypoglycaemia rates. Smaller decreases in FHG were associated with not reaching the target HbA 1c , suggesting a need to increase basal or premixed insulin doses to achieve targeted fasting plasma glucose and improve patient response before introducing more intensive prandial insulin regimens. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effective Practices in Community Based Family Literacy: Results of a National Research and Evaluation Project.

ERIC Educational Resources Information Center

Association for Community Based Education, Washington, DC.

A field evaluation of 14 community-based family and intergenerational literacy programs identified the most effective strategies, structures, and approaches to reach and teach the "hardest to reach." Information was collected through 90-minute telephone surveys with program coordinators and/or executive directors. Although different in structural…

The Caregiver Vigilance Scale: application and validation in the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project.

PubMed

Mahoney, Diane Feeney; Jones, Richard N; Coon, David W; Mendelsohn, Aaron B; Gitlin, Laura N; Ory, Marcia

2003-01-01

This article reports on the measurement properties of Caregiver Vigilance, a four-item caregiver self-report of perceived oversight demand for Alzheimer's disease and related disorders family caregiving. The self-report uses data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project, a multisite National Institutes of Health (NIH) sponsored study of over 1,200 family caregivers. Results indicate that the items were clearly understood by the racially/ethnically diverse respondents; and, when responses were transformed into a summary scale and analyzed, unidimensionality was evident and internal consistency reliability favorably demonstrated. We suggest using the Caregiver Vigilance Scale in conjunction with traditional burden measures to systematically include the caregiving time associated with protectively watching over care recipients and the daily duration of this responsibility. We also highlight the practical utility of selected items for potential use in the caregiver assessment process.

Cerebellar inactivation impairs memory of learned prism gaze-reach calibrations.

PubMed

Norris, Scott A; Hathaway, Emily N; Taylor, Jordan A; Thach, W Thomas

2011-05-01

Three monkeys performed a visually guided reach-touch task with and without laterally displacing prisms. The prisms offset the normally aligned gaze/reach and subsequent touch. Naive monkeys showed adaptation, such that on repeated prism trials the gaze-reach angle widened and touches hit nearer the target. On the first subsequent no-prism trial the monkeys exhibited an aftereffect, such that the widened gaze-reach angle persisted and touches missed the target in the direction opposite that of initial prism-induced error. After 20-30 days of training, monkeys showed long-term learning and storage of the prism gaze-reach calibration: they switched between prism and no-prism and touched the target on the first trials without adaptation or aftereffect. Injections of lidocaine into posterolateral cerebellar cortex or muscimol or lidocaine into dentate nucleus temporarily inactivated these structures. Immediately after injections into cortex or dentate, reaches were displaced in the direction of prism-displaced gaze, but no-prism reaches were relatively unimpaired. There was little or no adaptation on the day of injection. On days after injection, there was no adaptation and both prism and no-prism reaches were horizontally, and often vertically, displaced. A single permanent lesion (kainic acid) in the lateral dentate nucleus of one monkey immediately impaired only the learned prism gaze-reach calibration and in subsequent days disrupted both learning and performance. This effect persisted for the 18 days of observation, with little or no adaptation.

Cerebellar inactivation impairs memory of learned prism gaze-reach calibrations

PubMed Central

Hathaway, Emily N.; Taylor, Jordan A.; Thach, W. Thomas

2011-01-01

Three monkeys performed a visually guided reach-touch task with and without laterally displacing prisms. The prisms offset the normally aligned gaze/reach and subsequent touch. Naive monkeys showed adaptation, such that on repeated prism trials the gaze-reach angle widened and touches hit nearer the target. On the first subsequent no-prism trial the monkeys exhibited an aftereffect, such that the widened gaze-reach angle persisted and touches missed the target in the direction opposite that of initial prism-induced error. After 20–30 days of training, monkeys showed long-term learning and storage of the prism gaze-reach calibration: they switched between prism and no-prism and touched the target on the first trials without adaptation or aftereffect. Injections of lidocaine into posterolateral cerebellar cortex or muscimol or lidocaine into dentate nucleus temporarily inactivated these structures. Immediately after injections into cortex or dentate, reaches were displaced in the direction of prism-displaced gaze, but no-prism reaches were relatively unimpaired. There was little or no adaptation on the day of injection. On days after injection, there was no adaptation and both prism and no-prism reaches were horizontally, and often vertically, displaced. A single permanent lesion (kainic acid) in the lateral dentate nucleus of one monkey immediately impaired only the learned prism gaze-reach calibration and in subsequent days disrupted both learning and performance. This effect persisted for the 18 days of observation, with little or no adaptation. PMID:21389311

Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel nonrobotic device: a randomized clinical trial.

PubMed

Barker, Ruth N; Brauer, Sandra G; Carson, Richard G

2008-06-01

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting stroke survivors with severe paresis to practice a constrained reaching task. A single-blind, randomized clinical trial was conducted with 42 stroke survivors with severe and chronic paresis. Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electromyography-triggered electrical stimulation, 13 received training using the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 1-hour sessions over 4 weeks. The primary outcome measure was "upper arm function," item 6 of the Motor Assessment Scale. Secondary outcome measures included impairment measures; triceps muscle strength, reaching force, modified Ashworth scale; and activity measures: reaching distance and Motor Assessment Scale. Assessments were administered before (0 weeks) and after training (4 weeks) and at 2 months follow-up (12 weeks). Both SMART Arm groups demonstrated significant improvements in all impairment and activity measures after training and at follow-up. There was no significant difference between these 2 groups. There was no change in the control group. Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis, highlighting the benefits of intensive task-oriented practice, even in the context of severe paresis.

Where Is Medical Practice In India Heading?

PubMed Central

Pandya, Sunil K.

2006-01-01

Medical practice is based on teaching, learning and examples set by seniors. Past and present practices are briefly analysed. Current trends do not justify optimism. The poor patient is likely to be sidelined as doctors reach out to the rich and powerful in this country and those bringing in American dollars from abroad. While corrective steps are possible, it is unlikely that they will be implemented. PMID:22013332

Probing the reaching-grasping network in humans through multivoxel pattern decoding.

PubMed

Di Bono, Maria Grazia; Begliomini, Chiara; Castiello, Umberto; Zorzi, Marco

2015-11-01

The quest for a putative human homolog of the reaching-grasping network identified in monkeys has been the focus of many neuropsychological and neuroimaging studies in recent years. These studies have shown that the network underlying reaching-only and reach-to-grasp movements includes the superior parieto-occipital cortex (SPOC), the anterior part of the human intraparietal sulcus (hAIP), the ventral and the dorsal portion of the premotor cortex, and the primary motor cortex (M1). Recent evidence for a wider frontoparietal network coding for different aspects of reaching-only and reach-to-grasp actions calls for a more fine-grained assessment of the reaching-grasping network in humans by exploiting pattern decoding methods (multivoxel pattern analysis--MVPA). Here, we used MPVA on functional magnetic resonance imaging (fMRI) data to assess whether regions of the frontoparietal network discriminate between reaching-only and reach-to-grasp actions, natural and constrained grasping, different grasp types, and object sizes. Participants were required to perform either reaching-only movements or two reach-to-grasp types (precision or whole hand grasp) upon spherical objects of different sizes. Multivoxel pattern analysis highlighted that, independently from the object size, all the selected regions of both hemispheres contribute in coding for grasp type, with the exception of SPOC and the right hAIP. Consistent with recent neurophysiological findings on monkeys, there was no evidence for a clear-cut distinction between a dorsomedial and a dorsolateral pathway that would be specialized for reaching-only and reach-to-grasp actions, respectively. Nevertheless, the comparison of decoding accuracy across brain areas highlighted their different contributions to reaching-only and grasping actions. Altogether, our findings enrich the current knowledge regarding the functional role of key brain areas involved in the cortical control of reaching-only and reach-to-grasp actions

Assessment of Suited Reach Envelope in an Underwater Environment

NASA Technical Reports Server (NTRS)

Kim, Han; Benson, Elizabeth; Bernal, Yaritza; Jarvis, Sarah; Meginnis, Ian; Rajulu, Sudhakar

2017-01-01

Predicting the performance of a crewmember in an extravehicular activity (EVA) space suit presents unique challenges. The kinematic patterns of suited motions are difficult to reproduce in gravity. Additionally, 3-D suited kinematics have been practically and technically difficult to quantify in an underwater environment, in which crewmembers are commonly trained and assessed for performance. The goal of this study is to develop a hardware and software system to predictively evaluate the kinematic mobility of suited crewmembers, by measuring the 3-D reach envelope of the suit in an underwater environment. This work is ultimately aimed at developing quantitative metrics to compare the mobility of the existing Extravehicular Mobility Unit (EMU) to newly developed space suit, such as the Z-2. The EMU has been extensively used at NASA since 1981 for EVA outside the Space Shuttle and International Space Station. The Z-2 suit is NASA's newest prototype space suit. The suit is comprised of new upper torso and lower torso architectures, which were designed to improve test subject mobility.

REACH. Residential Electrical Wiring Units.

ERIC Educational Resources Information Center

Ansley, Jimmy; Ennis, Mike

As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of residential electrical wiring. The instructional units focus on grounded outlets, service entrance, and blueprint reading. Each unit follows a typical format…

Reaching All Students with Mathematics.

ERIC Educational Resources Information Center

Cuevas, Gilbert, Ed.; Driscoll, Mark, Ed.

The National Council of Teachers of Mathematics'"Curriculum and Evaluation Standards for School Mathematics" and "Professional Standards for Teaching Mathematics" reflect the belief that all students can learn a significant core of high-quality mathematics. Recognizing the magnitude of the task of reaching all students, this…

Concept of REACH and impact on evaluation of chemicals.

PubMed

Foth, H; Hayes, Aw

2008-01-01

Industrial chemicals have been in use for many decades and new products are regularly invented and introduced to the market. Also for decades, many different chemical laws have been introduced to regulate safe handling of chemicals in different use patterns. The patchwork of current regulation in the European Union is to be replaced by the new regulation on industrial chemical control, REACH. REACH stands for registration, evaluation, and authorization of chemicals. REACH entered force on June 1, 2007. REACH aims to overcome limitations in testing requirements of former regulation on industrial chemicals to enhance competitiveness and innovation with regard to manufacture safer substances and to promote the development of alternative testing methods. A main task of REACH is to address data gaps regarding the properties and uses of industrial chemicals. Producers, importers, and downstream users will have to compile and communicate standard information for all chemicals. Information sets to be prepared include safety data sheets (SDS), chemical safety reports (CSR), and chemical safety assessments (CSA). These are designed to guarantee adequate handling in the production chain, in transport and in use and to prevent the substances from being released to and distributed within the environment. Another important aim is to identify the most harmful chemicals and to set incentives to substitute them with safer alternatives. On one hand, REACH will have substantial impact on the basic understanding of the evaluation of chemicals. However, the toxicological sciences can also substantially influence the workability of REACH that supports the transformation of data to the information required to understand and manage acceptable and non acceptable risks in the use of industrial chemicals. The REACH regulation has been laid down in the main document and 17 Annexes of more than 849 pages. Even bigger technical guidance documents will follow and will inform about the rules for

Reaching Girls

ERIC Educational Resources Information Center

Jacobs, Charlotte E.; Kuriloff, Peter J.; Cox, Amanda B.

2014-01-01

If educators want to engage girls in learning, they must align teaching practices with girls' specific needs. In a study modeled after Reichert and Hawley's study of boys, the authors learned that lessons with hands-on learning, elements of creativity, multimodal projects, and class discussions all worked to stimulate girls'…

Managing Appalachian hardwood stands using four regeneration practices--34 year results

Treesearch

H. Clay Smith; Gary W. Miller

1987-01-01

Adjacent Appalachian hardwood stands in West Virginia established on excellent growing sites were managed for a 34-year period using four regeneration practices. These practices included a commercial clearcut, 15.5-in diameter-limit, and two single-tree selection practices. An uncut area was maintained as a control. Stand development, growth response, and some stumpage...

Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium†

PubMed Central

Kennedy, Ann B.; Cambron, Jerrilyn A.; Sharpe, Patricia A.; Travillian, Ravensara S.; Saunders, Ruth P.

2016-01-01

Background Massage therapists are at times unclear about the definition of massage therapy, which creates challenges for the profession. It is important to investigate the current definitions and to consider the field as a whole in order to move toward clarity on what constitutes the constructs within the profession. Purpose To determine how a sample of experts understand and describe the field of massage therapy as a step toward clarifying definitions for massage and massage therapy, and framing the process of massage therapy practice. Setting A two-day symposium held in 2010 with the purpose of gathering knowledge to inform and aid in the creation of massage therapy best practice guidelines for stress and low back pain. Participants Thirty-two experts in the field of massage therapy from the United States, Europe, and Canada. Design Qualitative analysis of secondary cross-sectional data using a grounded theory approach. Results Three over-arching themes were identified: 1) What is massage?; 2) The multidimensional nature of massage therapy; and 3) The influencing factors on massage therapy practice. Discussion The data offered clarifying definitions for massage and massage therapy, as well as a framework for the context for massage therapy practice. These clarifications can serve as initial steps toward the ultimate goal of creating new theory for the field of massage therapy, which can then be applied in practice, education, research, and policy. Conclusions Foundational research into how experts in the profession understand and describe the field of massage therapy is limited. Understanding the potential differences between the terms massage and massage therapy could contribute to a transformation in the profession in the areas of education, practice, research, policy and/or regulation. Additionally, framing the context for massage therapy practice invites future discussions to further clarify practice issues. PMID:27648109

Evaluating the User Experience of Exercising Reaching Motions With a Robot That Predicts Desired Movement Difficulty.

PubMed

Shirzad, Navid; Van der Loos, H F Machiel

2016-01-01

The notion of an optimal difficulty during practice has been articulated in many areas of cognitive psychology: flow theory, the challenge point framework, and desirable difficulties. Delivering exercises at a participant's desired difficulty has the potential to improve both motor learning and users' engagement in therapy. Motivation and engagement are among the contributing factors to the success of exercise programs. The authors previously demonstrated that error amplification can be used to introduce levels of challenge into a robotic reaching task, and that machine-learning algorithms can dynamically adjust difficulty to the desired level with 85% accuracy. Building on these findings, we present the results of a proof-of-concept study investigating the impacts of practicing under desirable difficulty conditions. A control condition with a predefined random order for difficulty levels was deemed more suitable for this study (compared to constant or continuously increasing difficulty). By practicing the task at their desirable difficulties, participants in the experimental group perceived their performance at a significantly higher level and reported lower required effort to complete the task, in comparison to a control group. Moreover, based on self-reports, participants in the experimental group were willing, on average, to continue the training session for 4.6 more training blocks (∼45 min) compared to the control group's average. This study demonstrates the efficiency of delivering the exercises at the user's desired difficulty level to improve the user's engagement in exercise tasks. Future work will focus on clinical feasibility of this approach in increasing stroke survivors' engagement in their therapy programs.

An impact of environmental changes on flows in the reach scale under a range of climatic conditions

NASA Astrophysics Data System (ADS)

Karamuz, Emilia; Romanowicz, Renata J.

2016-04-01

The present paper combines detection and adequate identification of causes of changes in flow regime at cross-sections along the Middle River Vistula reach using different methods. Two main experimental set ups (designs) have been applied to study the changes, a moving three-year window and low- and high-flow event based approach. In the first experiment, a Stochastic Transfer Function (STF) model and a quantile-based statistical analysis of flow patterns were compared. These two methods are based on the analysis of changes of the STF model parameters and standardised differences of flow quantile values. In the second experiment, in addition to the STF-based also a 1-D distributed model, MIKE11 was applied. The first step of the procedure used in the study is to define the river reaches that have recorded information on land use and water management changes. The second task is to perform the moving window analysis of standardised differences of flow quantiles and moving window optimisation of the STF model for flow routing. The third step consists of an optimisation of the STF and MIKE11 models for high- and low-flow events. The final step is to analyse the results and relate the standardised quantile changes and model parameter changes to historical land use changes and water management practices. Results indicate that both models give consistent assessment of changes in the channel for medium and high flows. ACKNOWLEDGEMENTS This research was supported by the Institute of Geophysics Polish Academy of Sciences through the Young Scientist Grant no. 3b/IGF PAN/2015.

Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

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

Jhaveri, Pavan M.; Sun Zhuyi; Ballas, Leslie

2012-09-01

Purpose: Integrated urology-radiation oncology (RO) practices have been advocated as a means to improve community-based prostate cancer care by joining urologic and radiation care in a single-practice environment. However, little is known regarding the scope and actual physical integration of such practices. We sought to characterize the emergence of such practices in Texas, their extent of physical integration, and their potential effect on patient travel times for radiation therapy. Methods and Materials: A telephone survey identified integrated urology-RO practices, defined as practices owned by urologists that offer RO services. Geographic information software was used to determine the proximity of integratedmore » urology-RO clinic sites with respect to the state's population. We calculated patient travel time and distance from each integrated urology-RO clinic offering urologic services to the RO treatment facility owned by the integrated practice and to the nearest nonintegrated (independent) RO facility. We compared these times and distances using the Wilcoxon-Mann-Whitney test. Results: Of 229 urology practices identified, 12 (5%) offered integrated RO services, and 182 (28%) of 640 Texas urologists worked in such practices. Approximately 53% of the state population resides within 10 miles of an integrated urology-RO clinic site. Patients with a diagnosis of prostate cancer at an integrated urology-RO clinic site travel a mean of 19.7 miles (26.1 min) from the clinic to reach the RO facility owned by the integrated urology-RO practice vs 5.9 miles (9.2 min) to reach the nearest nonintegrated RO facility (P<.001). Conclusions: Integrated urology-RO practices are common in Texas and are generally clustered in urban areas. In most integrated practices, the urology clinics and the integrated RO facilities are not at the same location, and driving times and distances from the clinic to the integrated RO facility exceed those from the clinic to the nearest

Examining the reach of a brief alcohol intervention service in routine practice at a level 1 trauma center.

PubMed

Turner, Brianna J; McCann, Barbara S; Dunn, Christopher W; Darnell, Doyanne A; Beam, Christopher R; Kleiber, Blair; Nelson, Kimberly M; Fukunaga, Rena

2017-08-01

The American College of Surgeons requires Level I and II trauma centers to provide brief intervention services to traumatically injured patients who screen positive for alcohol. Despite evidence supporting substantial cost savings and reduced re-injury associated with these services, brief interventions may not be uniformly delivered owing to a variety of demographic, clinical and operational characteristics. To inform service adjustments that may improve the reach of such services, we compared trauma patients who did and did not receive brief alcohol intervention services during their hospitalizations. Electronic medical records of injured patients admitted to a Level I trauma center between September 27, 2013 and March 11, 2014 with a positive blood alcohol concentration (N=189) were coded for demographic and clinical variables. Records of those who did not receive a brief intervention during their admission were reviewed for possible reasons why interventions were not delivered. Of the total sample, 115 patients (60.8%) received brief interventions. Patients who did and did not receive brief interventions did not differ on age, sex, race, blood alcohol concentration at admission, or mechanism of injury, indicating that patient characteristics were unlikely to bias service delivery. Instead, common features of patients who were referred but did not receive SBIRT interventions included admissions lasting fewer than two working days (12.7%) and persistent cognitive impairment following injury (9.0%). These findings align with previous studies suggesting that service reach could be improved by promoting dedicated and flexible staffing and adapting services to allow for SBIRT delivery in follow-up care settings. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessing Restoration Effects on River Hydromorphology Using the Process-based Morphological Quality Index in Eight European River Reaches

NASA Astrophysics Data System (ADS)

Belletti, B.; Nardi, L.; Rinaldi, M.; Poppe, M.; Brabec, K.; Bussettini, M.; Comiti, F.; Gielczewski, M.; Golfieri, B.; Hellsten, S.; Kail, J.; Marchese, E.; Marcinkowski, P.; Okruszko, T.; Paillex, A.; Schirmer, M.; Stelmaszczyk, M.; Surian, N.

2018-01-01

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach.

Assessing Restoration Effects on River Hydromorphology Using the Process-based Morphological Quality Index in Eight European River Reaches.

PubMed

Belletti, B; Nardi, L; Rinaldi, M; Poppe, M; Brabec, K; Bussettini, M; Comiti, F; Gielczewski, M; Golfieri, B; Hellsten, S; Kail, J; Marchese, E; Marcinkowski, P; Okruszko, T; Paillex, A; Schirmer, M; Stelmaszczyk, M; Surian, N

2018-01-01

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach.

Ramucirumab as Second-Line Treatment in Patients With Advanced Hepatocellular Carcinoma: Analysis of REACH Trial Results by Child-Pugh Score.

PubMed

Zhu, Andrew X; Baron, Ari David; Malfertheiner, Peter; Kudo, Masatoshi; Kawazoe, Seiji; Pezet, Denis; Weissinger, Florian; Brandi, Giovanni; Barone, Carlo A; Okusaka, Takuji; Wada, Yoshiyuki; Park, Joon Oh; Ryoo, Baek-Yeol; Cho, Jae Yong; Chung, Hyun Cheol; Li, Chung-Pin; Yen, Chia-Jui; Lee, Kuan-Der; Chang, Shao-Chun; Yang, Ling; Abada, Paolo B; Chau, Ian

2016-09-22

incidence of grade 3 or higher treatment-emergent adverse events, including ascites and asthenia, and special-interest events, including liver injury and/or failure and bleeding, compared with patients with Child-Pugh scores of 5 or 6. In unselected patients, a trend for ramucirumab survival benefit was observed only for patients with a Child-Pugh score of 5. In patients with baseline αFP levels of 400 ng/mL or more, a ramucirumab survival benefit was observed for Child-Pugh scores of 5 and 6. Ramucirumab had a manageable toxic effect profile. These results support the ongoing REACH-2 study of ramucirumab in patients with advanced HCC with underlying Child-Pugh A cirrhosis and baseline αFP levels of 400 ng/mL or more. clinicaltrials.gov Identifier: NCT01140347.

Interlimb Differences in Coordination of Unsupported Reaching Movements

PubMed Central

Schaffer, Jacob E.; Sainburg, Robert L.

2017-01-01

Previous research suggests that interlimb differences in coordination associated with handedness might result from specialized control mechanisms that are subserved by different cerebral hemispheres. Based largely on the results of horizontal plane reaching studies, we have proposed that the hemisphere contralateral to the dominant arm is specialized for predictive control of limb dynamics, while the non-dominant hemisphere is specialized for controlling limb impedance. The current study explores interlimb differences in control of 3-D unsupported reaching movements. While the task was presented in the horizontal plane, participant’s arms were unsupported and free to move within a range of the vertical axis, which was redundant to the task plane. Results indicated significant dominant arm advantages for both initial direction accuracy and final position accuracy. The dominant arm showed greater excursion along a redundant axis that was perpendicular to the task, and parallel to gravitational forces. In contrast, the non-dominant arm better impeded motion out of the task-plane. Nevertheless, left arm task errors varied substantially more with shoulder rotation excursion than did dominant arm task errors. These findings suggest that the dominant arm controller was able to take advantage of the redundant degrees of freedom of the task, while non-dominant task errors appeared enslaved to motion along the redundant axis. These findings are consistent with a dominant controller that is specialized for intersegmental coordination, and a non-dominant controller that is specialized for impedance control. However, the findings are inconsistent with previously documented conclusions from planar tasks, in which non-dominant control leads to greater final position accuracy. PMID:28344068

GAP-REACH

PubMed Central

Lewis-Fernández, Roberto; Raggio, Greer A.; Gorritz, Magdaliz; Duan, Naihua; Marcus, Sue; Cabassa, Leopoldo J.; Humensky, Jennifer; Becker, Anne E.; Alarcón, Renato D.; Oquendo, María A.; Hansen, Helena; Like, Robert C.; Weiss, Mitchell; Desai, Prakash N.; Jacobsen, Frederick M.; Foulks, Edward F.; Primm, Annelle; Lu, Francis; Kopelowicz, Alex; Hinton, Ladson; Hinton, Devon E.

2015-01-01

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-itemGAP-REACH© checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article. PMID:24080673

Reaching the Next Generation of Marine Scientists

NASA Astrophysics Data System (ADS)

Joyce, J.

2009-04-01

The next generation of marine scientists are today at primary school, secondary school or at college. To encourage them in their career, and to introduce those who are as yet undecided to the wonders of marine science, the Irish Marine Institute has devised a series of three overlapping outreach programmes to reach children at all three levels. Beginning at primary school, the "Explorers" programme offers a range of resources to teachers to enable them to teach marine-related examples as part of the science or geography modules of the SESE curriculum. These include teacher training, expert visits to schools, the installation and stocking of aquaria, field trips and downloadable lesson plans. For older pupils, the "Follow the Fleet" programme is a web-based education asset that allows users to track individual merchant ships and research vessels across the world, to interact with senior crew members of ships and to learn about their cargoes, the ports they visit and the sea conditions along the way. Finally, the "Integrated Marine Exploration Programme (IMEP)" takes secondary school pupils and university students to sea aboard the Marine Institute's research vessels to give them a taste of life as a marine scientist or to educate them in the practical day-to-day sampling and data processing tasks that make up a marine scientist's job.

Visual cortex activation in kinesthetic guidance of reaching.

PubMed

Darling, W G; Seitz, R J; Peltier, S; Tellmann, L; Butler, A J

2007-06-01

The purpose of this research was to determine the cortical circuit involved in encoding and controlling kinesthetically guided reaching movements. We used (15)O-butanol positron emission tomography in ten blindfolded able-bodied volunteers in a factorial experiment in which arm (left/right) used to encode target location and to reach back to the remembered location and hemispace of target location (left/right side of midsagittal plane) varied systematically. During encoding of a target the experimenter guided the hand to touch the index fingertip to an external target and then returned the hand to the start location. After a short delay the subject voluntarily moved the same hand back to the remembered target location. SPM99 analysis of the PET data contrasting left versus right hand reaching showed increased (P < 0.05, corrected) neural activity in the sensorimotor cortex, premotor cortex and posterior parietal lobule (PPL) contralateral to the moving hand. Additional neural activation was observed in prefrontal cortex and visual association areas of occipital and parietal lobes contralateral and ipsilateral to the reaching hand. There was no statistically significant effect of target location in left versus right hemispace nor was there an interaction of hand and hemispace effects. Structural equation modeling showed that parietal lobe visual association areas contributed to kinesthetic processing by both hands but occipital lobe visual areas contributed only during dominant hand kinesthetic processing. This visual processing may also involve visualization of kinesthetically guided target location and use of the same network employed to guide reaches to visual targets when reaching to kinesthetic targets. The present work clearly demonstrates a network for kinesthetic processing that includes higher visual processing areas in the PPL for both upper limbs and processing in occipital lobe visual areas for the dominant limb.

Priming of reach trajectory when observing actions: Hand-centred effects

PubMed Central

Griffiths, Debra; Tipper, Steven P.

2009-01-01

When another person's actions are observed it appears that these actions are simulated, such that similar motor processes are triggered in the observer. Much evidence suggests that such simulation concerns the achievement of behavioural goals, such as grasping a particular object, and is less concerned with the specific nature of the action, such as the path the hand takes to reach the goal object. We demonstrate that when observing another person reach around an obstacle, an observer's subsequent reach has an increased curved trajectory, reflecting motor priming of reach path. This priming of reach trajectory via action observation can take place under a variety of circumstances: with or without a shared goal, and when the action is seen from a variety of perspectives. However, of most importance, the reach path priming effect is only evoked if the obstacle avoided by another person is within the action (peripersonal) space of the observer. PMID:19731190

[The REACH legislation: the consumer and environment protection perspective].

PubMed

Gundert-Remy, Ursula

2008-12-01

REACH has been initiated with the aim of improving existing legislation. In order to assist in the interpretation of the REACH legislation, guidance documents have been developed, which have only lately become available. According to the REACH annexes and supported by guidance documents, waiving of test requirements will be possible, thus, opening the possibility that under REACH no new (eco)toxicological data will be required. Concerning products, a guidance document was released in April 2008 stating that the substance concentration threshold of 0.1 % (w/w) applies to the article as produced or imported and it does not relate to the homogeneous materials or parts of an article, but relates to the article as such (i.e., as produced or imported). Hence, notification will not be required for many products containing chemicals with properties which place them on the candidate list for authorization. In summary, it is at present not foreseeable whether the expected benefit of the REACH legislation will materialise for the environment and for the health of consumers and at the work place.

[ANALYSIS USING AN EXPERT PANEL OF ACTIVITIES AND COMPETENCIES WHICH NURSING CLINICAL PRACTICE TUTORS IN THE COMUNIDAD AUTÓNOMA DE MADRID SHOULD POSSESS].

PubMed

Argüello López, María Teresa; Palmar Santos, Ana María; Sellán Soto, Carmen

2015-01-01

Although practical training has always been important in Nursing, it has reached a new dimension in the European Higher Education Area. This has involved adapting the syllabus, where one of the new features is considering clinical practice as an independent subject and also including the concept of competence as a result of the students' learning. The figure of the tutor becomes one of the key factors and therefore their activities and competencies must be defined. To enumerate and prioritize, by agreement, the main activities and competences by the tutor of clinical practices in the Comunidad Autónoma de Madrid should posses. METHODOLOGY. Quantitative focus, analysis by group of experts between 2010 and 2013. RESULTS. A total of 510 nurses have participated, 17 panels of experts have met and consensus has been reached on 22 competencies and 12 activities. The description of activities and competencies can be extremely useful for selecting, evaluating and developing nursing clinical practice tutors, becoming a baseline and reducing the subjectivity in the development of tutors according to the new demands of the European Higher Education Area.

Practice-Based Evidence: Intelligent Action Inquiry for Complex Problems

ERIC Educational Resources Information Center

Eppley, Karen; Shannon, Patrick

2017-01-01

We have two goals for this article: to question the efficacy of evidence-based practice as the foundation of reading education policy and to propose practice-based evidence as a viable, more socially just alternative. In order to reach these goals, we describe the limits of reading policies of the last half century and argue for the possibilities…

Delays in using chromatic and luminance information to correct rapid reaches.

PubMed

Kane, Adam; Wade, Alex; Ma-Wyatt, Anna

2011-09-07

People can use feedback to make online corrections to movements but only if there is sufficient time to integrate the new information and make the correction. A key variable in this process is therefore the speed at which the new information about the target location is coded. Conduction velocities for chromatic signals are lower than for achromatic signals so it may take longer to correct reaches to chromatic stimuli. In addition to this delay, the sensorimotor system may prefer achromatic information over the chromatic information as delayed information may be less valuable when movements are made under time pressure. A down-weighting of chromatic information may result in additional latencies for chromatically directed reaches. In our study, participants made online corrections to reaches to achromatic, (L-M)-cone, and S-cone stimuli. Our chromatic stimuli were carefully adjusted to minimize stimulation of achromatic pathways, and we equated stimuli both in terms of detection thresholds and also by their estimated neural responses. Similar stimuli were used throughout the subjective adjustments and final reaching experiment. Using this paradigm, we found that responses to achromatic stimuli were only slightly faster than responses to (L-M)-cone and S-cone stimuli. We conclude that the sensorimotor system treats chromatic and achromatic information similarly and that the delayed chromatic responses primarily reflect early conduction delays.

Exploring REACH as a potential data source for characterizing ecotoxicity in life cycle assessment.

PubMed

Müller, Nienke; de Zwart, Dick; Hauschild, Michael; Kijko, Gaël; Fantke, Peter

2017-02-01

Toxicity models in life cycle impact assessment (LCIA) currently only characterize a small fraction of marketed substances, mostly because of limitations in the underlying ecotoxicity data. One approach to improve the current data situation in LCIA is to identify new data sources, such as the European Registration, Evaluation, Authorisation, and Restriction of Chemicals (REACH) database. The present study explored REACH as a potential data source for LCIA based on matching reported ecotoxicity data for substances that are currently also included in the United Nations Environment Programme/Society for Environmental Toxicology and Chemistry (UNEP/SETAC) scientific consensus model USEtox for characterizing toxicity impacts. Data are evaluated with respect to number of data points, reported reliability, and test duration, and are compared with data listed in USEtox at the level of hazardous concentration for 50% of the covered species per substance. The results emphasize differences between data available via REACH and in USEtox. The comparison of ecotoxicity data from REACH and USEtox shows potential for using REACH ecotoxicity data in LCIA toxicity characterization, but also highlights issues related to compliance of submitted data with REACH requirements as well as different assumptions underlying regulatory risk assessment under REACH versus data needed for LCIA. Thus, further research is required to address data quality, pre-processing, and applicability, before considering data submitted under REACH as a data source for use in LCIA, and also to explore additionally available data sources, published studies, and reports. Environ Toxicol Chem 2017;36:492-500. © 2016 SETAC. © 2016 SETAC.

Trip Staff Training Practices: Survey and Discussion Results.

ERIC Educational Resources Information Center

Zwaagstra, Lynn

A discussion group and survey examined trip-staff training practices among outdoor and adventure recreation/education programs. Of the 40 participants, 80 percent worked with university noncredit programs, with the remaining participants representing university for-credit, military recreation, nonprofit, and for-profit programs. Although the…

ReachScan - an Exposure Assessment Model

EPA Pesticide Factsheets

ReachScan estimates surface water concentrations downstream from industrial sites to assess impacts on the aquatic environment and potential dose rates for humans exposed via ingestion of drinking water and fish.

Object permanence and method of disappearance: looking measures further contradict reaching measures.

PubMed

Charles, Eric P; Rivera, Susan M

2009-11-01

Piaget proposed that understanding permanency, understanding occlusion events, and forming mental representations were synonymous; however, accumulating evidence indicates that those concepts are not unified in development. Infants reach for endarkened objects at younger ages than for occluded objects, and infants' looking patterns suggest that they expect occluded objects to reappear at younger ages than they reach for them. We reaffirm the latter finding in 5- to 6-month-olds and find similar responses to faded objects, but we fail to find that pattern in response to endarkened objects. This suggests that looking behavior and reaching behavior are both sensitive to method of disappearance, but with opposite effects. Current cognition-oriented (i.e. representation-oriented) explanations of looking behavior cannot easily accommodate these results; neither can perceptual-preference explanations, nor the traditional ecological reinterpretations of object permanence. A revised ecological hypothesis, invoking affordance learning, suggests how these differences could arise developmentally.

5 CFR 315.703 - Employees formerly reached on a register.

Code of Federal Regulations, 2011 CFR

2011-01-01

... coverage. An employee who was serving in a position when his or her name was within reach for career or... verifies that the employee would have been within reach; (2) The register was being used for career and... within reach and available for appointment. (b) Tenure on conversion. An employee whose appointment is...

';Best' Practices for Aggregating Subset Results from Archived Datasets

NASA Astrophysics Data System (ADS)

Baskin, W. E.; Perez, J.

2013-12-01

In response to the exponential growth in science data analysis and visualization capabilities Data Centers have been developing new delivery mechanisms to package and deliver large volumes of aggregated subsets of archived data. New standards are evolving to help data providers and application programmers deal with growing needs of the science community. These standards evolve from the best practices gleaned from new products and capabilities. The NASA Atmospheric Sciences Data Center (ASDC) has developed and deployed production provider-specific search and subset web applications for the CALIPSO, CERES, TES, and MOPITT missions. This presentation explores several use cases that leverage aggregated subset results and examines the standards and formats ASDC developers applied to the delivered files as well as the implementation strategies for subsetting and processing the aggregated products. The following topics will be addressed: - Applications of NetCDF CF conventions to aggregated level 2 satellite subsets - Data-Provider-Specific format requirements vs. generalized standards - Organization of the file structure of aggregated NetCDF subset output - Global Attributes of individual subsetted files vs. aggregated results - Specific applications and framework used for subsetting and delivering derivative data files

Exploring the use of Storybooks to Reach Mothers of Preschoolers with Nutrition and Physical Activity Messages

PubMed Central

Bellows, Laura; Spaeth, Amanda; Lee, Victoria; Anderson, Jennifer

2013-01-01

Objectives To assess perceptions stay-at-home mothers have about their preschoolers’ eating and physical activity behaviors and to explore the feasibility of utilizing storybooks in home-based nutrition and activity programming. Methods Focus groups were conducted with 24 mothers; intercept interviews with 30 parents; and a storybook prototype was developed and pretested in 8 preschool classrooms. Results Mothers acknowledged picky eating as an issue and were less likely to identify issues with physical activity but were interested in information on gross motor development. Mothers strongly supported storybooks as a modality to convey and reinforce health messages at home. The storybook prototype was well liked by parents, teachers and preschoolers. Conclusions and Implications Storybooks are a practical method to reach mothers and preschoolers and have the potential to elicit changes in eating and activity behaviors. Understanding mothers’ perceptions of healthy eating and physical activity is essential to ensure that storybook messages resonate with this audience. PMID:23415760

Abnormal ovarian cancer screening test result: women's informational, psychological and practical needs.

PubMed

Ryan, Patricia Y; Graves, Kristi D; Pavlik, Edward J; Andrykowski, Michael A

2007-01-01

Considerable effort has been devoted to the identification of cost-effective approaches to screening for ovarian cancer (OC). Transvaginal ultrasound (TVS) is one such screening approach. Approximately 5-7% of routine TVS screening tests yield abnormal results. Some women experience significant distress after receipt of an abnormal TVS screening test. Four focus groups provided in-depth, qualitative data regarding the informational, psychological, and practical needs of women after the receipt of an abnormal TVS result. Through question and content analytic procedures, we identified four themes: anticipation, emotional response, role of the screening technician, and impact of prior cancer experiences. Results provide initial guidance toward development of interventions to promote adaptive responses after receipt of an abnormal cancer screening test result.

Practice Architectures and Sustainable Curriculum Renewal

ERIC Educational Resources Information Center

Goodyear, Victoria A.; Casey, Ashley; Kirk, David

2017-01-01

While there are numerous pedagogical innovations and varying forms of professional learning to support change, teachers rarely move beyond the initial implementation of new ideas and policies and few innovations reach the institutionalized stage. Building on both site ontologies and situated learning in communities of practice perspectives, this…

Impact of LSP character on Slepton reach at the LHC

NASA Astrophysics Data System (ADS)

Eckel, Jonathan; Ramsey-Musolf, Michael J.; Shepherd, William; Su, Shufang

2014-11-01

Searches for supersymmetry at the Large Hadron Collider (LHC) have significantly constrained the parameter space associated with colored superpartners, whereas the constraints on color-singlet superpartners are considerably less severe. In this study, we investigate the dependence of slepton decay branching fractions on the nature of the lightest supersymmetric particle (LSP). In particular, in the Higgsino-like LSP scenarios, both decay branching fractions of and depend strongly on the sign and value of M 1 /M 2, which has strong implications for the reach of dilepton plus [InlineMediaObject not available: see fulltext.] searches for slepton pair production. We extend the experimental results for same flavor, opposite sign dilepton plus [InlineMediaObject not available: see fulltext.] searches at the 8TeV LHC to various LSP scenarios. We find that the LHC bounds on sleptons are strongly enhanced for a non-Bino-like LSP: the 95% C.L. limit for extends from 300 GeV for a Bino-like LSP to about 370 GeV for a Wino-like LSP. The bound for with a Higgsino-like LSP is the strongest (˜ 490 GeV) for M 1 /M 2 ˜ - tan2 θ W and is the weakest (˜ 220 GeV) for M 1 /M 2 ˜ tan2 θ W . We also calculate prospective slepton search reaches at the 14 TeV LHC. With 100 fb-1 integrated luminosity, the projected 95% C.L. mass reach for the left-handed slepton varies from 550 (670) GeV for a Bino-like (Winolike) LSP to 900 (390) GeV for a Higgsino-like LSP under the most optimistic (pessimistic) scenario. The reach for the right-handed slepton is about 440 GeV. The corresponding 5 σ discovery sensitivity is about 100 GeV smaller. For 300 fb-1 integrated luminosity, the reach is about 50 - 100 GeV higher.

[Legal aspects of the REACH regulation. The control system of the REACH regulation--new approaches in the EU chemical legislation].

PubMed

Pache, Eckhard

2008-12-01

The REACH regulation from 2006 shall overcome the deficiencies of the previously existing inconsistent legal system of chemicals and build an efficient and innovative regulation for industrial chemicals in the EU. For this purpose, the REACH regulation is not inventing a completely new legislation for chemical substances, but refers to the existing rules, regulates and structures them in a new manner and complements them. With REACH a consistent control system for chemicals in Europe has been created, which basically is managed and coordinated by the newly established European Chemicals Agency (ECHA). In the first phases of the REACH system, information about chemicals is generated and afterwards evaluated. Then this information is used in a process of authorization and restriction, to ensure adequate proliferation and safe exposure to chemical substances. Numerous duties to furnish information complement the readjustment's procedural steps, particularly with regard to the supply chain and down to the consumer. It is mainly affected by the abrogation of the determination between new and existing substances, the principle of substitution and is based on the idea that industry itself is best suited to ensure that the substances it manufactures and places on the market in the EU do not adversely affect human health or the environment.

Thumb Reach of Indonesian Young Adult When Interacting with Touchscreen of Single-Handed Device: A Preliminary Study

NASA Astrophysics Data System (ADS)

Umami, M. K.

2018-01-01

This study is a preliminary survey on thumb reach of Indonesian population when interacting with single-handed device. This study was aimed to know the thumb reach envelope on the screen of mobile phone. The correlation between the thumb reach vs. the hand length and thumb length was also identified. Thirty young adults participated in the study. All participants had normal body stature and were right-handed person. In the observational phase, the participant was asked to colour the canvas area on the screen of the mobile phone by using his/her thumb. The participant had to complete the task by applying the single hand interaction. The participant should grab the mobile phone as he/she use it normally in his/her daily activities. The thumb reach envelope of participants was identified from the coloured area of the canvas. The results of this study found that participants with a large hand length and thumb length tend to have a large thumb reach. The results of this study also show the thumb reach area of the participants is forming an elliptical shape that runs from the northeast to southwest on the device screen.

Reach and its Impact: NASA and US Aerospace Communities

NASA Technical Reports Server (NTRS)

Rothgeb, Matthew J.

2011-01-01

REACH is a European law that threatens to impact materials used within the US aerospace communities, including NASA. The presentation briefly covers REACH and generally, its perceived impacts to NASA and the aerospace community within the US.

Classification of brain signals associated with imagination of hand grasping, opening and reaching by means of wavelet-based common spatial pattern and mutual information.

PubMed

Amanpour, Behzad; Erfanian, Abbas

2013-01-01

An important issue in designing a practical brain-computer interface (BCI) is the selection of mental tasks to be imagined. Different types of mental tasks have been used in BCI including left, right, foot, and tongue motor imageries. However, the mental tasks are different from the actions to be controlled by the BCI. It is desirable to select a mental task to be consistent with the desired action to be performed by BCI. In this paper, we investigated the detecting the imagination of the hand grasping, hand opening, and hand reaching in one hand using electroencephalographic (EEG) signals. The results show that the ERD/ERS patterns, associated with the imagination of hand grasping, opening, and reaching are different. For classification of brain signals associated with these mental tasks and feature extraction, a method based on wavelet packet, regularized common spatial pattern (CSP), and mutual information is proposed. The results of an offline analysis on five subjects show that the two-class mental tasks can be classified with an average accuracy of 77.6% using proposed method. In addition, we examine the proposed method on datasets IVa from BCI Competition III and IIa from BCI Competition IV.

Neural correlates of target selection for reaching movements in superior colliculus

PubMed Central

McPeek, Robert M.

2014-01-01

We recently demonstrated that inactivation of the primate superior colliculus (SC) causes a deficit in target selection for arm-reaching movements when the reach target is located in the inactivated field (Song JH, Rafal RD, McPeek RM. Proc Natl Acad Sci USA 108: E1433–E1440, 2011). This is consistent with the notion that the SC is part of a general-purpose target selection network beyond eye movements. To understand better the role of SC activity in reach target selection, we examined how individual SC neurons in the intermediate layers discriminate a reach target from distractors. Monkeys reached to touch a color oddball target among distractors while maintaining fixation. We found that many SC neurons robustly discriminate the goal of the reaching movement before the onset of the reach even though no saccade is made. To identify these cells in the context of conventional SC cell classification schemes, we also recorded visual, delay-period, and saccade-related responses in a delayed saccade task. On average, SC cells that discriminated the reach target from distractors showed significantly higher visual and delay-period activity than nondiscriminating cells, but there was no significant difference in saccade-related activity. Whereas a majority of SC neurons that discriminated the reach target showed significant delay-period activity, all nondiscriminating cells lacked such activity. We also found that some cells without delay-period activity did discriminate the reach target from distractors. We conclude that the majority of intermediate-layer SC cells discriminate a reach target from distractors, consistent with the idea that the SC contains a priority map used for effector-independent target selection. PMID:25505107

5 Ways to Reach (and Maintain!) a Healthy Weight

MedlinePlus

... Staying Safe Videos for Educators Search English Español 5 Ways to Reach a Healthy Weight KidsHealth / For ... formas de alcanzar (¡y mantener!) un peso saludable 5 Ways to Reach (and Maintain!) a Healthy Weight ...

Are condom-promotion interventions reaching internal migrants in China? Integrated evidence from two cross-sectional surveys.

PubMed

Liu, Xiaona; Erasmus, Vicki; van Genugten, Lenneke; Sun, Xinying; Tan, Jingguang; Richardus, Jan Hendrik

2016-09-01

Behavioral interventions containing behavior change techniques (BCTs) that do not reach the target populations sufficiently will fail to accomplish their desired outcome. To guide sexually transmitted infection prevention policy for internal migrants in China, this study examines the extent to which BCTs aiming at increasing condom use reach the migrants and investigates the preference of the target population for these techniques among 364 migrants and 44 healthcare workers (HCWs) in Shenzhen, China. The results show that condom-promotion techniques that had been offered by HCWs to internal migrants reached a limited proportion of the population (range of reach ratio: 17.6-55.0%), although there appears to be a good match between what is offered and what is preferred by Chinese internal migrants regarding condom-promotion techniques (rank difference ≤ 1). Our findings highlight the need to increase the reach of condom-promotion techniques among Chinese internal migrants, and suggest techniques that are likely to reach the target population and match their preferred health education approaches.

Expanding the Reach of Continuing Educational Offerings Through a Web-Based Virtual Network: The Experience of InspireNet.

PubMed

Frisch, Noreen C; Atherton, Pat; Borycki, Elizabeth M; Mickelson, Grace; Black, Agnes; Novak Lauscher, Helen; Cordeiro, Jennifer

2017-01-01

Virtual platforms using webinars, e-posters, e-newsletters, wikis and blogs connect people who have common interests in new ways. When those individuals are healthcare providers, a professional network that operates on a virtual platform can support their needs for learning, professional development and information currency. The practice of e-learning for continuing professional development is emerging , particularly in nursing where shift work shift inhibits their ability to attend conferences and classes. This article reports the experience of the InspireNet network that provided e-learning models to: 1) provide opportunities for healthcare providers to organize themselves into learning communities through development of electronic communities of practice; 2) support learning on demand; and 3) dramatically increase the reach of educational offerings.

A Sediment Transport Based Geomorphic Analysis of the Skykomish River Braided Reach to Identify "Restoration" Opportunities

NASA Astrophysics Data System (ADS)

Devries, P.; Aldrich, R.; Brunzell, S.; Purser, M.

2004-12-01

A study is underway to assess the driving sediment transport and hydraulic processes influencing channel changes in a braided reach of the Skykomish River, Washington. The reach is located below a steeper, confined section of the river and has likely been geomorphically active since the last glaciation. Bankfull widths range between roughly 100-350 m within, and drainage area is 1,500 km2 above, the study reach. Analyses have been conducted at the reach scale, and include development of a sediment transport model, historical photograph and survey overlays, and an accounting of where sediment deposition, channel shifts and avulsions, and side channel connection are most and least likely to occur over reasonable design life spans (e.g., between 10 and 50 years). The ultimate goal of the analysis is to identify suitable locations for projects that will enhance, restore, or protect fish habitat as well as protect infrastructure, while considering constraints posed by channel hydraulic, sediment transport/deposition, and stability characteristics. Our strategy is to determine what types of projects are best suited for different locations in the reach based on the analysis results. The results can then be used to prioritize and estimate costs for project alternatives.

Addressing disappointment in veterinary practice.

PubMed

O'Connell, Daniel; Bonvicini, Kathleen A

2007-01-01

Disappointing experiences are not uncommon in the increasingly complex setting of veterinary practice. Managing these situations requires that health care teams be sensitive to client disappointments; accept responsibility for engaging with clients to resolve them; and act ethically, sensitively, and flexibly to reach the best resolutions possible while learning from the experience to reduce the potential for recurrence. The reward for their efforts is an enhanced capability to rebuild rapport, trust, credibility, and loyalty after disappointments and adverse outcomes. Success should translate into a more satisfying practice that builds and maintains its client base and minimizes its liability risks.

Intra-reach headwater fish assemblage structure

USGS Publications Warehouse

McKenna, James E.

2017-01-01

Large-scale conservation efforts can take advantage of modern large databases and regional modeling and assessment methods. However, these broad-scale efforts often assume uniform average habitat conditions and/or species assemblages within stream reaches.

General Overview of Psychotherapeutic Practice in Poland. Results from a Nationwide Survey.

PubMed

Suszek, Hubert; Grzesiuk, Lidia; Styła, Rafał; Krawczyk, Krzysztof

2017-09-01

A total of 1196 persons conducting psychotherapy in Poland fully completed a nationwide online survey (or, alternatively, a paper and pencil enquiry) concerning their education, training, experience, and clinical work (professional environment, patients treated). The results are described in detail and compared with findings of similar studies from other countries. Among the primary findings were: (1) psychotherapy in Poland is conducted mostly by women (80 %); (2) almost all participants have an MA degree (91 %), including 75.2 % having graduated in psychology; (3) the therapists are well trained (mean number of training hours is above 942) and established (average experience is about 9.8 years), however, more than half of the therapists have no type of certificate; (4) 54 % of respondents identify with the integrative or eclectic orientation and, simultaneously, for 48.6 % of the therapists the most important approach is either psychodynamic or psychoanalytic; (5) the most common form of therapy is individual psychotherapy in private practice; (6) the majority of the therapists treat adult patients with anxiety or personality disorders. In sum, the results show that psychotherapeutic practice is well established in Poland and many indices are similar to those found in Western countries.

Effect of Reinforcement History on Hand Choice in an Unconstrained Reaching Task

PubMed Central

Stoloff, Rebecca H.; Taylor, Jordan A.; Xu, Jing; Ridderikhoff, Arne; Ivry, Richard B.

2011-01-01

Choosing which hand to use for an action is one of the most frequent decisions people make in everyday behavior. We developed a simple reaching task in which we vary the lateral position of a target and the participant is free to reach to it with either the right or left hand. While people exhibit a strong preference to use the hand ipsilateral to the target, there is a region of uncertainty within which hand choice varies across trials. We manipulated the reinforcement rates for the two hands, either by increasing the likelihood that a reach with the non-dominant hand would successfully intersect the target or decreasing the likelihood that a reach with the dominant hand would be successful. While participants had minimal awareness of these manipulations, we observed an increase in the use of the non-dominant hand for targets presented in the region of uncertainty. We modeled the shift in hand use using a Q-learning model of reinforcement learning. The results provided a good fit of the data and indicate that the effects of increasing and decreasing the rate of positive reinforcement are additive. These experiments emphasize the role of decision processes for effector selection, and may point to a novel approach for physical rehabilitation based on intrinsic reinforcement. PMID:21472031

Real-time evaluation of a noninvasive neuroprosthetic interface for control of reach.

PubMed

Corbett, Elaine A; Körding, Konrad P; Perreault, Eric J

2013-07-01

Injuries of the cervical spinal cord can interrupt the neural pathways controlling the muscles of the arm, resulting in complete or partial paralysis. For individuals unable to reach due to high-level injuries, neuroprostheses can restore some of the lost function. Natural, multidimensional control of neuroprosthetic devices for reaching remains a challenge. Electromyograms (EMGs) from muscles that remain under voluntary control can be used to communicate intended reach trajectories, but when the number of available muscles is limited control can be difficult and unintuitive. We combined shoulder EMGs with target estimates obtained from gaze. Natural gaze data were integrated with EMG during closed-loop robotic control of the arm, using a probabilistic mixture model. We tested the approach with two different sets of EMGs, as might be available to subjects with C4- and C5-level spinal cord injuries. Incorporating gaze greatly improved control of reaching, particularly when there were few EMG signals. We found that subjects naturally adapted their eye-movement precision as we varied the set of available EMGs, attaining accurate performance in both tested conditions. The system performs a near-optimal combination of both physiological signals, making control more intuitive and allowing a natural trajectory that reduces the burden on the user.

Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

PubMed

André, Beate; Aune, Anne G; Brænd, Jorunn A

2016-05-01

Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of Recruitment Strategy on the Reach and Effect of a Web-Based Multiple Tailored Smoking Cessation Intervention among Dutch Adult Smokers

ERIC Educational Resources Information Center

Smit, Eline Suzanne; Hoving, Ciska; Cox, Vincent Cornelis Maria; de Vries, Hein

2012-01-01

This study investigated the influence of two different recruitment strategies on the reach and effect of a web-based multiple tailored smoking cessation program. From May 2009 until June 2010, Dutch adult smokers were recruited via mass media or general practices. Those who completed the baseline questionnaire were followed up during 6 weeks (two…

Geriatric screening in first opinion practice - results from 45 dogs.

PubMed

Davies, M

2012-09-01

To evaluate and report the results of screening geriatric dogs in a first opinion practice. A prospective health screen of dogs over nine-years-old involving history taking, physical examination and urinalysis. At least one previously unrecognised problem was identified in 80% of 45 dogs and 353 findings (mean 7·8 per dog) were recorded. Owners often failed to recognise and report serious signs of age-related disease. However, they most often reported increased sleeping (31%), loss of hearing (29%) or sight (20%), stiffness or lameness (22%) and "slowing down" (20%). Increased lens opacity (64%), increased thirst (58%), pain (24%), increased frequency of urination (24%), signs of osteoarthritis (24%) and dental disease (22%) were most frequently identified at the time of consultation. Potentially, life-threatening findings included respiratory distress, palpable abdominal masses and metastatic lung disease. Screening resulted in 29 further diagnostic procedures, including 10 dental procedures, seven medical treatments, two surgical procedures and euthanasia of two dogs. Screening elderly dogs identified unrecognised and unreported health risk factors resulting in lifestyle modification and ongoing monitoring, as well as signs of age-related diseases resulting in diagnostic investigations, early diagnoses and surgical and medical interventions to improve quality of life. © 2012 British Small Animal Veterinary Association.

The profile of attention differs between locations orthogonal to and in line with reach direction.

PubMed

Stewart, Emma E M; Ma-Wyatt, Anna

2017-11-01

People make movements in a variety of directions when interacting with the world around them. It has been well documented that attention shifts to the goal of an upcoming movement, whether the movement is a saccade or a reach. However, recent evidence suggests that the direction of a movement may influence the spatial spread of attention (Stewart & Ma-Wyatt, 2015, Journal of Vision, 15(5), 10). We investigated whether the spatiotemporal profile of attention differs depending on where that location is situated relative to the direction of movement, and if this pattern is consistent across different movement effectors. We compared attentional facilitation at locations in line with or orthogonal to the movement, for reach-only, reach-plus-saccade, and saccade-only conditions. Results show that the spatiotemporal profile of attention differs across different movement combinations, and is also different at target locations orthogonal to and in line with the movement direction. Specifically, when a reach alone was made, there was a general decrease in attention at all locations during the movement and a general increase in attention at all locations with a saccade only. However, the concurrent reach and saccade condition showed a premovement attentional facilitation at locations orthogonal to movement direction, but not those in line with the movement direction. These results suggest attentional guidance may be more important at differing time points, depending on the type of movement.

Consistency assessment of rating curve data in various locations using Bidirectional Reach (BReach)

NASA Astrophysics Data System (ADS)

Van Eerdenbrugh, Katrien; Van Hoey, Stijn; Coxon, Gemma; Freer, Jim; Verhoest, Niko E. C.

2017-10-01

When estimating discharges through rating curves, temporal data consistency is a critical issue. In this research, consistency in stage-discharge data is investigated using a methodology called Bidirectional Reach (BReach), which departs from a (in operational hydrology) commonly used definition of consistency. A period is considered to be consistent if no consecutive and systematic deviations from a current situation occur that exceed observational uncertainty. Therefore, the capability of a rating curve model to describe a subset of the (chronologically sorted) data is assessed in each observation by indicating the outermost data points for which the rating curve model behaves satisfactorily. These points are called the maximum left or right reach, depending on the direction of the investigation. This temporal reach should not be confused with a spatial reach (indicating a part of a river). Changes in these reaches throughout the data series indicate possible changes in data consistency and if not resolved could introduce additional errors and biases. In this research, various measurement stations in the UK, New Zealand and Belgium are selected based on their significant historical ratings information and their specific characteristics related to data consistency. For each country, regional information is maximally used to estimate observational uncertainty. Based on this uncertainty, a BReach analysis is performed and, subsequently, results are validated against available knowledge about the history and behavior of the site. For all investigated cases, the methodology provides results that appear to be consistent with this knowledge of historical changes and thus facilitates a reliable assessment of (in)consistent periods in stage-discharge measurements. This assessment is not only useful for the analysis and determination of discharge time series, but also to enhance applications based on these data (e.g., by informing hydrological and hydraulic model

Neurons in Primary Motor Cortex Encode Hand Orientation in a Reach-to-Grasp Task.

PubMed

Ma, Chaolin; Ma, Xuan; Fan, Jing; He, Jiping

2017-08-01

It is disputed whether those neurons in the primary motor cortex (M1) that encode hand orientation constitute an independent channel for orientation control in reach-to-grasp behaviors. Here, we trained two monkeys to reach forward and grasp objects positioned in the frontal plane at different orientation angles, and simultaneously recorded the activity of M1 neurons. Among the 2235 neurons recorded in M1, we found that 18.7% had a high correlation exclusively with hand orientation, 15.9% with movement direction, and 29.5% with both movement direction and hand orientation. The distributions of neurons encoding hand orientation and those encoding movement direction were not uniform but coexisted in the same region. The trajectory of hand rotation was reproduced by the firing patterns of the orientation-related neurons independent of the hand reaching direction. These results suggest that hand orientation is an independent component for the control of reaching and grasping activity.

Automated River Reach Definition Strategies: Applications for the Surface Water and Ocean Topography Mission

NASA Astrophysics Data System (ADS)

Frasson, Renato Prata de Moraes; Wei, Rui; Durand, Michael; Minear, J. Toby; Domeneghetti, Alessio; Schumann, Guy; Williams, Brent A.; Rodriguez, Ernesto; Picamilh, Christophe; Lion, Christine; Pavelsky, Tamlin; Garambois, Pierre-André

2017-10-01

The upcoming Surface Water and Ocean Topography (SWOT) mission will measure water surface heights and widths for rivers wider than 100 m. At its native resolution, SWOT height errors are expected to be on the order of meters, which prevent the calculation of water surface slopes and the use of slope-dependent discharge equations. To mitigate height and width errors, the high-resolution measurements will be grouped into reaches (˜5 to 15 km), where slope and discharge are estimated. We describe three automated river segmentation strategies for defining optimum reaches for discharge estimation: (1) arbitrary lengths, (2) identification of hydraulic controls, and (3) sinuosity. We test our methodologies on 9 and 14 simulated SWOT overpasses over the Sacramento and the Po Rivers, respectively, which we compare against hydraulic models of each river. Our results show that generally, height, width, and slope errors decrease with increasing reach length. However, the hydraulic controls and the sinuosity methods led to better slopes and often height errors that were either smaller or comparable to those of arbitrary reaches of compatible sizes. Estimated discharge errors caused by the propagation of height, width, and slope errors through the discharge equation were often smaller for sinuosity (on average 8.5% for the Sacramento and 6.9% for the Po) and hydraulic control (Sacramento: 7.3% and Po: 5.9%) reaches than for arbitrary reaches of comparable lengths (Sacramento: 8.6% and Po: 7.8%). This analysis suggests that reach definition methods that preserve the hydraulic properties of the river network may lead to better discharge estimates.

Cost-effectiveness of possible future smoking cessation strategies in Hungary: results from the EQUIPTMOD.

PubMed

Németh, Bertalan; Józwiak-Hagymásy, Judit; Kovács, Gábor; Kovács, Attila; Demjén, Tibor; Huber, Manuel B; Cheung, Kei-Long; Coyle, Kathryn; Lester-George, Adam; Pokhrel, Subhash; Vokó, Zoltán

2018-01-25

To evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary. The EQUIPTMOD, a Markov-based economic model, was used to assess the cost-effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group-based behavioural support therapies and proactive telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Life-time costs and quality-adjusted life years (QALYs) were calculated from a health-care perspective. The analyses used various return on investment (ROI) estimates, including incremental cost-effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values. Introducing a social marketing campaign resulted in an increase of 0.3014 additional quitters per 1 000 smokers, translating to health-care cost-savings of €0.6495 per smoker compared with current practice. When the value of QALY gains was considered, cost-savings increased to €14.1598 per smoker. Doubling the reach of existing group-based behavioural support therapies and proactive telephone support resulted in health-care savings of €0.2539 per smoker (€3.9620 with the value of QALY gains), compared with current practice. The respective figures for the combined scenario were €0.8960 and €18.0062. Results were sensitive to model input values. According to the EQUIPTMOD modelling tool, it would be cost-effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group-based behavioural support therapies and proactive telephone support. Such policies would more than pay for themselves in the long term. © 2018 The Authors

Microgravity Science Glovebox - Interior Reach

NASA Technical Reports Server (NTRS)

1997-01-01

This photo shows the interior reach in the Microgravity Science Glovebox (MSG) being developed by the European Space Agency (ESA) and NASA for use aboard the International Space Station (ISS). Scientists will use the MSG to carry out multidisciplinary studies in combustion science, fluid physics and materials science. The MSG is managed by NASA's Marshall Space Flight Center (MSFC). Photo Credit: NASA/MSFC

Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa.

PubMed

Akoojee, Yusuf; Mash, Robert

2017-05-26

Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training. A Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians. Consensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills. The findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

Networks of conforming or nonconforming individuals tend to reach satisfactory decisions.

PubMed

Ramazi, Pouria; Riehl, James; Cao, Ming

2016-11-15

Binary decisions of agents coupled in networks can often be classified into two types: "coordination," where an agent takes an action if enough neighbors are using that action, as in the spread of social norms, innovations, and viral epidemics, and "anticoordination," where too many neighbors taking a particular action causes an agent to take the opposite action, as in traffic congestion, crowd dispersion, and division of labor. Both of these cases can be modeled using linear-threshold-based dynamics, and a fundamental question is whether the individuals in such networks are likely to reach decisions with which they are satisfied. We show that, in the coordination case, and perhaps more surprisingly, also in the anticoordination case, the agents will indeed always tend to reach satisfactory decisions, that is, the network will almost surely reach an equilibrium state. This holds for every network topology and every distribution of thresholds, for both asynchronous and partially synchronous decision-making updates. These results reveal that irregular network topology, population heterogeneity, and partial synchrony are not sufficient to cause cycles or nonconvergence in linear-threshold dynamics; rather, other factors such as imitation or the coexistence of coordinating and anticoordinating agents must play a role.

A solution to the online guidance problem for targeted reaches: proportional rate control using relative disparity tau.

PubMed

Anderson, Joe; Bingham, Geoffrey P

2010-09-01

We provide a solution to a major problem in visually guided reaching. Research has shown that binocular vision plays an important role in the online visual guidance of reaching, but the visual information and strategy used to guide a reach remains unknown. We propose a new theory of visual guidance of reaching including a new information variable, tau(alpha) (relative disparity tau), and a novel control strategy that allows actors to guide their reach trajectories visually by maintaining a constant proportion between tau(alpha) and its rate of change. The dynamical model couples the information to the reaching movement to generate trajectories characteristic of human reaching. We tested the theory in two experiments in which participants reached under conditions of darkness to guide a visible point either on a sliding apparatus or on their finger to a point-light target in depth. Slider apparatus controlled for a simple mapping from visual to proprioceptive space. When reaching with their finger, participants were forced, by perturbation of visual information used for feedforward control, to use online control with only binocular disparity-based information for guidance. Statistical analyses of trajectories strongly supported the theory. Simulations of the model were compared statistically to actual reaching trajectories. The results supported the theory, showing that tau(alpha) provides a source of information for the control of visually guided reaching and that participants use this information in a proportional rate control strategy.

Engaging All Americans: Innovative Strategies for Reaching the Public with Climate and Environmental Information

NASA Astrophysics Data System (ADS)

Espinoza, S.

2014-12-01

From extensive drought and heat waves to floods, tornadoes and Superstorm Sandy, extreme weather and climate events provide teachable moments to help communities prepare for and respond to related environmental, economic and health impacts. The National Environmental Education Foundation (www.neefusa.org) works with the American Meteorological Society, the media and other trusted messengers to provide weather, climate and environmental information to the public in accessible and widely used formats, whether via TV, radio or social media. NEEF will provide an overview of innovative partnerships and projects that are engaging Americans in understanding and using climate and environmental information to make the best choices in their daily lives and improve the health of their communities, including: Assessing knowledge, attitudes and behaviors: NEEF will share results from its national survey research and targeted focus groups on current attitudes and practices relating to our nation's environment. Simplifying and amplifying key messages: NEEF provides a national network of more than 350 meteorologists, radio broadcasters and journalists with the science-based information and resources they need to present climate and environmental topics to their viewers on-air, online and in community outreach. Engaging television viewers in citizen science: Eyes on Central PA, a pilot project of NEEF, Project Noah and WTAJ-TV, harnesses Project Noah's citizen science platform to collect and display photos of wildlife from WTAJ-TV viewers. NEEF and WTAJ provide regular blogs and on-air stories that highlight viewers' photos and link them to local weather conditions and climate trends. Expanding the conversation: NEEF's multimedia strategy in the Mid-Atlantic U.S. is reaching Spanish-speaking audiences with climate and environmental information through regular radio and television broadcasts. We are also exploring ways to reach other non-traditional audiences, including faith

Classification of ephemeral, intermittent, and perennial stream reaches using a TOPMODEL-based approach

USGS Publications Warehouse

Williamson, Tanja N.; Agouridis, Carmen T.; Barton, Christopher D.; Villines, Jonathan A.; Lant, Jeremiah G.

2015-01-01

Whether a waterway is temporary or permanent influences regulatory protection guidelines, however, classification can be subjective due to a combination of factors, including time of year, antecedent moisture conditions, and previous experience of the field investigator. Our objective was to develop a standardized protocol using publically available spatial information to classify ephemeral, intermittent, and perennial streams. Our hypothesis was that field observations of flow along the stream channel could be compared to results from a hydrologic model, providing an objective method of how these stream reaches can be identified. Flow-state sensors were placed at ephemeral, intermittent, and perennial stream reaches from May to December 2011 in the Appalachian coal basin of eastern Kentucky. This observed flow record was then used to calibrate the simulated saturation deficit in each channel reach based on the topographic wetness index used by TOPMODEL. Saturation deficit values were categorized as flow or no-flow days, and the simulated record of streamflow was compared to the observed record. The hydrologic model was more accurate for simulating flow during the spring and fall seasons. However, the model effectively identified stream reaches as intermittent and perennial in each of the two basins.

Congenitally blind individuals rapidly adapt to coriolis force perturbations of their reaching movements

NASA Technical Reports Server (NTRS)

DiZio, P.; Lackner, J. R.

2000-01-01

Reaching movements made to visual targets in a rotating room are initially deviated in path and endpoint in the direction of transient Coriolis forces generated by the motion of the arm relative to the rotating environment. With additional reaches, movements become progressively straighter and more accurate. Such adaptation can occur even in the absence of visual feedback about movement progression or terminus. Here we examined whether congenitally blind and sighted subjects without visual feedback would demonstrate adaptation to Coriolis forces when they pointed to a haptically specified target location. Subjects were tested pre-, per-, and postrotation at 10 rpm counterclockwise. Reaching to straight ahead targets prerotation, both groups exhibited slightly curved paths. Per-rotation, both groups showed large initial deviations of movement path and curvature but within 12 reaches on average had returned to prerotation curvature levels and endpoints. Postrotation, both groups showed mirror image patterns of curvature and endpoint to the per-rotation pattern. The groups did not differ significantly on any of the performance measures. These results provide compelling evidence that motor adaptation to Coriolis perturbations can be achieved on the basis of proprioceptive, somatosensory, and motor information in the complete absence of visual experience.

Gravitoinertial force background level affects adaptation to coriolis force perturbations of reaching movements

NASA Technical Reports Server (NTRS)

Lackner, J. R.; Dizio, P.

1998-01-01

We evaluated the combined effects on reaching movements of the transient, movement-dependent Coriolis forces and the static centrifugal forces generated in a rotating environment. Specifically, we assessed the effects of comparable Coriolis force perturbations in different static force backgrounds. Two groups of subjects made reaching movements toward a just-extinguished visual target before rotation began, during 10 rpm counterclockwise rotation, and after rotation ceased. One group was seated on the axis of rotation, the other 2.23 m away. The resultant of gravity and centrifugal force on the hand was 1.0 g for the on-center group during 10 rpm rotation, and 1.031 g for the off-center group because of the 0.25 g centrifugal force present. For both groups, rightward Coriolis forces, approximately 0.2 g peak, were generated during voluntary arm movements. The endpoints and paths of the initial per-rotation movements were deviated rightward for both groups by comparable amounts. Within 10 subsequent reaches, the on-center group regained baseline accuracy and straight-line paths; however, even after 40 movements the off-center group had not resumed baseline endpoint accuracy. Mirror-image aftereffects occurred when rotation stopped. These findings demonstrate that manual control is disrupted by transient Coriolis force perturbations and that adaptation can occur even in the absence of visual feedback. An increase, even a small one, in background force level above normal gravity does not affect the size of the reaching errors induced by Coriolis forces nor does it affect the rate of reacquiring straight reaching paths; however, it does hinder restoration of reaching accuracy.

Evaluating adequacy of the representative stream reach used in invertebrate monitoring programs

USGS Publications Warehouse

Rabeni, C.F.; Wang, N.; Sarver, R.J.

1999-01-01

Selection of a representative stream reach is implicitly or explicitly recommended in many biomonitoring protocols using benthic invertebrates. We evaluated the adequacy of sampling a single stream reach selected on the basis of its appearance. We 1st demonstrated the precision of our within-reach sampling. Then we sampled 3 or 4 reaches (each ~20x mean width) within an 8-16 km segment on each of 8 streams in 3 ecoregions and calculated 4 common metrics: 1) total taxa; 2) Ephemeroptera, Plecoptera, and Trichoptera taxa; 3) biotic index; and 4) Sharmon's diversity index. In only 6% of possible cases was the coefficient of variation for any of the metrics reduced >10% by sampling additional reaches. Sampling a 2nd reach on a stream improved the ability to detect impairment by an average of only 9.3%. Sampling a 3rd reach on a stream additionally improved ability to detect impairment by only 4.5%. We concluded that a single well-chosen reach, if adequately sampled, can be representative of an entire stream segment, and sampling additional reaches within a segment may not be cost effective.

Researching effective approaches to cleaning in hospitals: protocol of the REACH study, a multi-site stepped-wedge randomised trial.

PubMed

Hall, Lisa; Farrington, Alison; Mitchell, Brett G; Barnett, Adrian G; Halton, Kate; Allen, Michelle; Page, Katie; Gardner, Anne; Havers, Sally; Bailey, Emily; Dancer, Stephanie J; Riley, Thomas V; Gericke, Christian A; Paterson, David L; Graves, Nicholas

2016-03-24

The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (i

Cross-sectional study to examine evidence-based practice skills and behaviors of physical therapy graduates: is there a knowledge-to-practice gap?

PubMed

Manns, Patricia J; Norton, Amy V; Darrah, Johanna

2015-04-01

Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. A cross-sectional study with 4 graduating cohorts was conducted. Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1-15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. This study used a convenience sample of therapists who agreed to volunteer for the study. The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings. © 2015 American Physical Therapy Association.

Beliefs, identities and educational practice: a Q methodology study of general practice supervisors.

PubMed

Dory, Valérie; Audétat, Marie-Claude; Rees, Charlotte

2015-03-01

Quality of supervisory practices varies. According to the integrative model of behaviour prediction, supervisors' beliefs may influence practice. This study aimed to examine the belief profiles of general practice supervisors, and their potential relationship with supervisory practice. A cross-sectional study was conducted using Q-methodology to explore supervisors' beliefs and the Maastricht Clinical Teaching Questionnaire to measure self-reported supervisory practice. One-hundred and thirty-nine supervisors took part (76%). The most common belief profile (36.7%) comprised a proactive view of supervisors' roles, strong self-efficacy beliefs and awareness of university norms. It revealed merged identities as clinicians and teachers. The second profile (18.0%) included a belief that supervision essentially involved sharing one's experience, uncertainty about the impact of supervision and about university norms. This profile was consistent with a pre-eminence of supervisors' identities as clinicians. Supervisors with merged identities were more likely to have more experience as supervisors and to engage in other teaching activities. Differences in self-reported supervisory practice were observed but did not reach statistical significance (P = 0.053). Supervisors' beliefs reveal differences in the way they manage their multiple professional identities. Further research should be conducted into whether these differences are developmental and if so how development occurs.

Expanding your gay and lesbian patient base: what savvy medical practices know.

PubMed

Kahn, Ellen; Sullivan, Tom

2008-01-01

Many medical practices are looking at options to reach out to the gay, lesbian, bisexual, and transgender community as a means of expanding business and improving quality of care. This article sets out steps that any practice can take to market to this community and improve its cultural competence.

Modeling Effects of Lability on Microbial Uptake of DOM in River Reaches

NASA Astrophysics Data System (ADS)

Li, A.; Drummond, J. D.; Bowen, J. C.; Cory, R. M.; Kaplan, L.; Packman, A. I.

2017-12-01

Rivers are hotspots for biological degradation of dissolved organic matter (DOM), contributing to 1.8 petagrams of carbon emissions per year. DOM represents approximately 60% of the total mass of organic carbon transported within river networks, fueling stream ecosystem metabolism. Not all DOM is biodegradable, biodegradation rates vary based on lability, and lability decreases with reaction time. Fluorescent fractions of DOM (FDOM) are often used as proxies of DOM lability. Humic-like FDOM, previously considered recalcitrant and thought to contribute minimally to the biodegradable DOM pools, has recently been shown to contribute more than 50% to DOM uptake in bioreactor columns colonized by bacteria in stream water. Protein-like FDOM, a proxy for the biodegradable DOM pool, also contributes to the recalcitrant DOM pool in bioreactors. However, the contribution of different lability pools to DOM uptake at the reach scale remains elusive. Here we combine local-scale results from a bioreactor study and measures of stream geomorphology parameters to model reach-scale DOM uptake in White Clay Creek, a Pennsylvania piedmont stream with an intact, forested riparian zone and inputs from upland agriculture. Steady state modeling of a point-source, continuous injection of FDOM shows that humic-like FDOM contributes up to 80% of the total removal of FDOM at the reach scale, suggesting its importance to in-stream DOM uptake. Tryptophan-like FDOM, a protein-like FDOM, contributes to 80% of the remaining fraction of FDOM at the reach scale that incorporates longer timescales of transport and retention. This is consistent with recent local-scale findings that the lability of tryptophan-like FDOM decreases substantially with reaction time in bioreactors, such that it becomes much more recalcitrant as it travels downstream. Steady state modeling of a distributed source, continuous injection of FDOM shows that contributing sources distribute differently along the river reach for

Children's Visual Processing of Egocentric Cues in Action Planning for Reach

ERIC Educational Resources Information Center

Cordova, Alberto; Gabbard, Carl

2011-01-01

In this study the authors examined children's ability to code visual information into an egocentric frame of reference for planning reach movements. Children and adults estimated reach distance via motor imagery in immediate and response-delay conditions. Actual maximum reach was compared to estimates in multiple locations in peripersonal and…

5 CFR 330.505 - Nonapplicability to persons within reach on registers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Nonapplicability to persons within reach... Principles § 330.505 Nonapplicability to persons within reach on registers. The restrictions in this subpart do not apply to a person who is within reach on a register for competitive appointment to the...

5 CFR 330.505 - Nonapplicability to persons within reach on registers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Nonapplicability to persons within reach... Principles § 330.505 Nonapplicability to persons within reach on registers. The restrictions in this subpart do not apply to a person who is within reach on a register for competitive appointment to the...

Hyporheic invertebrate assemblages at reach scale in a Neotropical stream in Brazil.

PubMed

Mugnai, R; Messana, G; Di Lorenzo, T

2015-11-01

In the Neotropical Region, information concerning hyporheic communities is virtually non-existent. We carried out a sampling survey in the hyporheic zone of the Tijuca River, in the Tijuca National Park, located in the urban area of the city of Rio de Janeiro. Biological samples from the hyporheic zone were collected in three different stream reaches, in June 2012. The main objectives were: 1) to describe the structure of invertebrate assemblages in the hyporheic zone of a neotropical stream; 2) to apply a reach-scale approach in order to investigate spatial patterns of the hyporheic assemblages in relation to hydrology, depth and microhabitat typology. A total of 1460 individuals were collected and identified in 31 taxa belonging to Nematoda, Annelida, Crustacea, Hydrachnidia and Insecta. The class Insecta dominated the upper layer of the hyporheic zone. Copepods were the most abundant taxon among crustaceans and occurred mostly in the upwelling areas of the reaches. The results of this study represent one of the few contributions so far about hyporheic invertebrate assemblages of the Neotropical Region.

Evaluation of a noninvasive command scheme for upper-limb prostheses in a virtual reality reach and grasp task.

PubMed

Kaliki, Rahul R; Davoodi, Rahman; Loeb, Gerald E

2013-03-01

C5/C6 tetraplegic patients and transhumeral amputees may be able to use voluntary shoulder motion as command signals for a functional electrical stimulation system or transhumeral prosthesis. Stereotyped relationships, termed "postural synergies," among the shoulder, forearm, and wrist joints emerge during goal-oriented reaching and transport movements as performed by able-bodied subjects. Thus, the posture of the shoulder can potentially be used to infer the desired posture of the elbow and forearm joints during reaching and transporting movements. We investigated how well able-bodied subjects could learn to use a noninvasive command scheme based on inferences from these postural synergies to control a simulated transhumeral prosthesis in a virtual reality task. We compared the performance of subjects using the inferential command scheme (ICS) with subjects operating the simulated prosthesis in virtual reality according to complete motion tracking of their actual arm and hand movements. Initially, subjects performed poorly with the ICS but improved rapidly with modest amounts of practice, eventually achieving performance only slightly less than subjects using complete motion tracking. Thus, inferring the desired movement of distal joints from voluntary shoulder movements appears to be an intuitive and noninvasive approach for obtaining command signals for prostheses to restore reaching and grasping functions.

Classification of different reaching movements from the same limb using EEG

NASA Astrophysics Data System (ADS)

Shiman, Farid; López-Larraz, Eduardo; Sarasola-Sanz, Andrea; Irastorza-Landa, Nerea; Spüler, Martin; Birbaumer, Niels; Ramos-Murguialday, Ander

2017-08-01

Objective. Brain-computer-interfaces (BCIs) have been proposed not only as assistive technologies but also as rehabilitation tools for lost functions. However, due to the stochastic nature, poor spatial resolution and signal to noise ratio from electroencephalography (EEG), multidimensional decoding has been the main obstacle to implement non-invasive BCIs in real-live rehabilitation scenarios. This study explores the classification of several functional reaching movements from the same limb using EEG oscillations in order to create a more versatile BCI for rehabilitation. Approach. Nine healthy participants performed four 3D center-out reaching tasks in four different sessions while wearing a passive robotic exoskeleton at their right upper limb. Kinematics data were acquired from the robotic exoskeleton. Multiclass extensions of Filter Bank Common Spatial Patterns (FBCSP) and a linear discriminant analysis (LDA) classifier were used to classify the EEG activity into four forward reaching movements (from a starting position towards four target positions), a backward movement (from any of the targets to the starting position and rest). Recalibrating the classifier using data from previous or the same session was also investigated and compared. Main results. Average EEG decoding accuracy were significantly above chance with 67%, 62.75%, and 50.3% when decoding three, four and six tasks from the same limb, respectively. Furthermore, classification accuracy could be increased when using data from the beginning of each session as training data to recalibrate the classifier. Significance. Our results demonstrate that classification from several functional movements performed by the same limb is possible with acceptable accuracy using EEG oscillations, especially if data from the same session are used to recalibrate the classifier. Therefore, an ecologically valid decoding could be used to control assistive or rehabilitation mutli-degrees of freedom (DoF) robotic devices

Health spending in the 1980's: Integration of clinical practice patterns with management

PubMed Central

Freeland, Mark S.; Schendler, Carol E.

1984-01-01

Health care spending in the United States more than tripled between 1972 and 1982, increasing from $94 billion to $322 billion. This growth substantially outpaced overall growth in the economy. National health expenditures are projected to reach approximately $690 billion in 1990 and consume roughly 12 percent of the gross national product. Government spending for health care is projected to reach $294 billion by 1990, with the Federal Government paying 72 percent. The Medicare prospective payment system and increasing competition in the health services sector are providing incentives to integrate clinical practice patterns with improved management practices. PMID:10310595

Thermal Profiles for Selected River Reaches in the Yakima River Basin, Washington

USGS Publications Warehouse

Vaccaro, J.J.; Keys, M.E.; Julich, R.J.; Welch, W.B.

2008-01-01

Thermal profiles (data sets of longitudinal near-streambed temperature) that provide information on areas of potential ground-water discharge and salmonid habitat for 11 river reaches in the Yakima River basin, Washington, are available as Microsoft Excel? files that can be downloaded from the Internet. Two reaches were profiled twice resulting in 13 profiles. Data were collected for all but one thermal profile during 2001. Data consist of date and time (Pacific Daylight), near-streambed water temperature, and latitude and longitude collected concurrently using a temperature probe and a Global Positioning System. The data were collected from a watercraft towing the probe with an internal datalogger while moving downstream in a Lagrangian framework.

Morphological adjustments in a meandering reach of the middle Yangtze River caused by severe human activities

NASA Astrophysics Data System (ADS)

Zhou, Meirong; Xia, Junqiang; Lu, Jinyou; Deng, Shanshan; Lin, Fenfen

2017-05-01

In the past 50 years, the Shishou reach in the middle Yangtze River underwent significant channel evolution owing to the implementation of an artificial cutoff, the construction of bank revetment works and the operation of the Three Gorges Project (TGP). Based on the measured hydrological data and topographic data, the processes of channel evolution in this reach were investigated mainly from the adjustments in planform and cross-sectional geometries. The variation in planform geometry obtained in this study indicates that (i) the artificial cutoff at Zhongzhouzi caused the river regime to adjust drastically, with the mean rate of thalweg migration at reach scale of 42.0 m/a over the period 1966-1975; (ii) then the effect of this artificial cutoff reduced gradually, with the mean migration rate decreasing to < 30 m/a in 1975-1993, while it increased to > 40 m/a owing to the occurrence of high water levels in 1993-1998; and (iii) the average annual rate of thalweg migration decreased to 29.3 m/a because of the impacts of various bank protection engineering and the TGP operation during the period 2002-2015. However, remarkable thalweg migration processes still occurred in local regions after the TGP operation, which resulted in significant bankline migration in local reaches of Beimenkou, Shijiatai, and Tiaoxiankou. In addition, the adjustments of bankfull channel geometry were investigated at section and reach scales after the TGP operation. Calculated results show that lateral channel migration in this reach was restricted by various river regulation works and that channel evolution was mainly characterized by an increase in bankfull depth and cross-sectional area. Empirical relationships were developed between the reach-scale bankfull dimensions (depth and area), the bankfull widths at specified sections, and the previous 5-year average fluvial erosion intensity during flood seasons, with high correlation degrees between them being obtained.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.

PubMed

Mattison, Marian

2012-07-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

Efficacy of REACH Forgiveness across cultures.

PubMed

Lin, Yin; Worthington, Everett L; Griffin, Brandon J; Greer, Chelsea L; Opare-Henaku, Annabella; Lavelock, Caroline R; Hook, Joshua N; Ho, Man Yee; Muller, Holly

2014-09-01

This study investigates the efficacy of the 6-hour REACH Forgiveness intervention among culturally diverse undergraduates. Female undergraduates (N = 102) and foreign extraction (46.2%) and domestic (43.8%) students in the United States were randomly assigned to immediate treatment or waitlist conditions. Treatment efficacy and the effect of culture on treatment response were assessed using measures of emotional and decisional forgiveness across 3 time periods. Students in the treatment condition reported greater improvement in emotional forgiveness, but not decisional forgiveness, relative to those in the waitlist condition. Gains were maintained at a 1-week follow-up. Although culture did not moderate the effect of treatment, a main effect of culture on emotional forgiveness and marginally significant interaction effect of culture on decisional forgiveness were found. The REACH Forgiveness intervention was efficacious for college students from different cultural backgrounds when conducted in the United States. However, some evidence may warrant development of culturally adapted forgiveness interventions. © 2014 Wiley Periodicals, Inc.

Quality Assurance and Foreign Languages--Reflecting on Oral Assessment Practices in Two University Spanish Language Programs in Australia

ERIC Educational Resources Information Center

Díaz, Adriana R.; Hortiguera, Hugo; Espinoza Vera, Marcia

2015-01-01

In the era of quality assurance (QA), close scrutiny of assessment practices has been intensified worldwide across the board. However, in the Australian context, trends in QA efforts have not reached the field of modern/foreign languages. This has largely resulted in leaving the establishment of language proficiency benchmarking up to individual…

Do clinical practice education groups result in sustained change in GP prescribing?

PubMed

Richards, Dee; Toop, Les; Graham, Patrick

2003-04-01

Concern has been expressed at the poor uptake of evidence into clinical practice. This is despite the fact that continuing education is an embedded feature of quality assurance in general practice. There are a variety of clinical practice education methods available for dissemination of new evidence. Recent systematic reviews indicate that the effectiveness of these different strategies is extremely variable. Our aim was to determine whether a peer-led small group education pilot programme used to promote rational GP prescribing is an effective tool in changing practice when added to prescribing audit and feedback, academic detailing and educational bulletins, and to determine whether any effect seen decays over time. A retrospective analysis of a controlled trial of a small group education strategy with 24 month follow-up was carried out. The setting was an independent GPs association (IPA) of 230 GPs in the Christchurch New Zealand urban area. All intervention and control group GPs were already receiving prescribing audit and feedback, academic detailing and educational bulletins. The intervention group were the first 52 GPs to respond to an invitation to pilot the project. Two control groups were used, one group who joined the pilot later and a second group which included all other GPs in the IPA. The main outcome measures were targeted prescribing data for 12 months before and 24 months after each of four education sessions. An effect in the expected direction was seen in six of the eight key messages studied. This effect was statistically significant for five of the eight messages studied. The effect size varied between 7 and 40%. Where a positive effect was seen, the effect decayed with time but persisted to a significant level for 6-24 months of observation. The results support a positive effect of the education strategy on prescribing behaviour in the intervention group for most outcomes measured. The effect seen is statistically significant, sustained and

Mental Health Practice Guidelines for Child Welfare

ERIC Educational Resources Information Center

Annie E. Casey Foundation, 2009

2009-01-01

The guidelines and supporting rationale presented in this paper were developed from the October 2007 "Best Practices for Mental Health in Child Welfare Consensus Conference" sponsored by Casey Family Programs, the Annie E. Casey Foundation and the REACH Institute (REsource for Advancing Children's Health). The purpose of the conference was to…

Improvement in Diagnosis and Treat-to-Target Management of Hyperuricemia in Gout: Results from the GEMA-2 Transversal Study on Practice.

PubMed

Perez Ruiz, Fernando; Sanchez-Piedra, Carlos A; Sanchez-Costa, Jesus T; Andrés, Mariano; Diaz-Torne, Cesar; Jimenez-Palop, Mercedes; De Miguel, Eugenio; Moragues, Carmen; Sivera, Francisca

2018-06-01

The objective of the study was to evaluate changes regarding main European League Against Rheumatism (EULAR) recommendations on diagnosis and treatment of gout compared to a previous assessment. The GEMA-2 (Gout Evaluation and MAnagement) is a transversal assessment of practice for gout by rheumatologists. Main outcome variables were improvement of the previous GEMA assessment regarding the rate of crystal-proven diagnosis and that reaching therapeutic serum urate target below 6 mg/dl at last visit. Other management variables (prophylaxis, treatment of flares, lifestyle change advice) were also evaluated along with general characteristics. The sample was powered to include at least 483 patients for up to 50% change. Data on management of 506 patients were retrieved from 38 out of 41 rheumatology units that participated in the previous GEMA audit. Crystal-proved diagnosis rate increased from 26% to 32% (31% improvement) and was higher in gout-dedicated practices; ultrasonography contributed to diagnosis in less than 1% of cases. Therapeutic serum urate at last visit improved from 41% to 64% of all patients (66% of patients on urate-lowering medications), in any case over 50% improvement from the previous assessment. The use of any urate-lowering medication available was not prescribed as per label dosing in patients who failed to achieve target serum urate. Clinical inertia to increase doses of either allopurinol or febuxostat was still present in clinical practice. Over 50% improvement in targeting therapeutic serum urate has been observed, but clinical inertia is still present. Diagnosis is still mostly clinically based, ultrasonography not being commonly contributive. Menarini España.

Scaling up Evidence-Based Practices: Strategies from Investing in Innovation (i3)

ERIC Educational Resources Information Center

DeWire, Tom; McKithen, Clarissa; Carey, Rebecca

2017-01-01

What can the Investing in Innovation (i3) grantees tell us about scaling innovative educational practices? The newly released white paper "Scaling Up Evidence-Based Practices: Strategies from Investing in Innovation (i3)" captures the experiences of nine grantees whose projects collectively have reached over 1.2 million students across…

Predicting losing and gaining river reaches in lowland New Zealand based on a statistical methodology

NASA Astrophysics Data System (ADS)

Yang, Jing; Zammit, Christian; Dudley, Bruce

2017-04-01

The phenomenon of losing and gaining in rivers normally takes place in lowland where often there are various, sometimes conflicting uses for water resources, e.g., agriculture, industry, recreation, and maintenance of ecosystem function. To better support water allocation decisions, it is crucial to understand the location and seasonal dynamics of these losses and gains. We present a statistical methodology to predict losing and gaining river reaches in New Zealand based on 1) information surveys with surface water and groundwater experts from regional government, 2) A collection of river/watershed characteristics, including climate, soil and hydrogeologic information, and 3) the random forests technique. The surveys on losing and gaining reaches were conducted face-to-face at 16 New Zealand regional government authorities, and climate, soil, river geometry, and hydrogeologic data from various sources were collected and compiled to represent river/watershed characteristics. The random forests technique was used to build up the statistical relationship between river reach status (gain and loss) and river/watershed characteristics, and then to predict for river reaches at Strahler order one without prior losing and gaining information. Results show that the model has a classification error of around 10% for "gain" and "loss". The results will assist further research, and water allocation decisions in lowland New Zealand.

Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

PubMed

Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

2012-02-06

Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

The Performance of Left-Handed Participants on a Preferential Reaching Test

ERIC Educational Resources Information Center

Mamolo, Carla M.; Roy, Eric A.; Bryden, Pamela J.; Rohr, Linda E.

2005-01-01

Previous research in our laboratory has examined the distribution of preferred hand (PH) reaches in working space with right-handed participants. In one study, we examined the effects of tool position and task demands on the frequency of PH reaches with right-handers (Mamolo, Roy, Bryden, & Rohr, 2004). We found that PH reaches were at a maximum…

What Determines Limb Selection for Reaching?

ERIC Educational Resources Information Center

Helbig, Casi Rabb; Gabbard, Carl

2004-01-01

While motor dominance appears to drive limb selection for reaching movements at the midline and ipsilateral (dominant) side, this study examined the possible determinants associated with what drives the programming of movements in response to stimuli presented in contralateral space. Experiment 1 distinguished between object proximity and a…

Braking reaching movements: a test of the constant tau-dot strategy under different viewing conditions.

PubMed

Hopkins, Brian; Churchill, Andrew; Vogt, Stefan; Rönnqvist, Louise

2004-03-01

Following F. Zaal and R. J. Bootsma (1995), the authors studied whether the decelerative phase of a reaching movement could be modeled as a constant tau-dot strategy resulting in a soft collision with the object. Specifically, they investigated whether that strategy is sustained over different viewing conditions. Participants (N = 11) were required to reach for 15- and 50-mm objects at 2 different distances under 3 conditions in which visual availability of the immediate environment and of the reaching hand were varied. Tau-dot estimates and goodness-of-fit were highly similar across the 3 conditions. Only within-participant variability of tau-dot estimates was increased when environmental cues were removed. That finding suggests that the motor system uses a tau-dot strategy involving the intermodal (i.e., visual, proprioceptive, or both) specification of information to regulate the decelerative phase of reaching under restricted viewing conditions. The authors provide recommendations for improving the derivation of tau;(x) estimates and stress the need for further research on how time-to-contact information is used in the regulation of the dynamics of actions such as reaching.

Hydraulic characterization of the middle reach of the Congo River

NASA Astrophysics Data System (ADS)

O'Loughlin, F.; Trigg, M.; Schumann, G.; Bates, P. D.

2012-12-01

Little is known about the hydraulics of the Congo River compared to other large rivers, such as the Amazon, Nile and Mississippi, despite it draining an area greater than 3.7 million square kilometers and being the seconded largest river in terms of discharge. While there has been some study of the Congo Basin, most of these concentrate on ecology or the human aspects, but few look at the either the hydrology or hydraulic characteristics of the river. Of the published hydrology/hydraulic research, most concentrates on the hydrology of the Congo Basin aiming to alleviate some of the issues relating to a sparse river gauging network that currently exists. Even fewer studies have looked at hydraulics of the Congo, and usually over a relatively small area of the basin. To undertake a larger study area requires more details on the characteristics of the Congo River. The Congo River can be divided into three distinct reaches; the upper, middle and lower reaches. We concentrate on the middle reach which starts upstream at Boyoma falls, just south of Kisangani, and ends downstream at Livingstone Falls, at Kinshasa (DRC), Brazzaville (Congo) and the Pool Malebo. From Kisangani to Kinshasa, the middle Congo crosses the equator twice and is join by two large tributaries (Ubangi, Kasai) and is highly braided. The middle reach of the Congo is especially important as its still largely undisturbed wetlands are the seconded largest tropical wetlands globally. It is also the main transportation link between Kisangani and Kinshasa, the two largest cities in the DRC. By utilizing remotely sensed Landsat and Icesat datasets, we present the first detailed study on the hydraulic characterization of the middle reach of the Congo River. With these datasets we identify the main control points of flow in the middle reach, investigate how the water surface slope, channel width, islands and braids vary between high and low flows and spatially along the reach. We compare the middle reach of

[Beat therapeutic inertia in dyslipidemic patient management: A challenge in daily clinical practice] [corrected].

PubMed

Morales, Clotilde; Mauri, Marta; Vila, Lluís

2014-01-01

Beat therapeutic inertia in dyslipidemic patient management: a challenge in daily clinical practice. In patients with dyslipidemia, there is the need to reach the therapeutic goals in order to get the maximum benefit in the cardiovascular events risk reduction, especially myocardial infarction. Even having guidelines and some powerful hypolipidemic drugs, the goals of low-density lipoprotein-cholesterol (LDL-c) are often not reached, being of special in patients with a high cardiovascular risk. One of the causes is the therapeutic inertia. There are tools to plan the treatment and make the decisions easier. One of the challenges in everyday clinical practice is to know the needed percentage of reduction in LDL-c. Moreover: it is hard to know which one is the treatment we should use in the beginning of the treatment but also when the desired objective is not reached. This article proposes a practical method that can help solving these questions. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

Nanosafety practices: results from a national survey at research facilities

NASA Astrophysics Data System (ADS)

Díaz-Soler, Beatriz María; López-Alonso, Mónica; Martínez-Aires, María Dolores

2017-05-01

The exposure to engineered nanomaterials (ENMs) is a new emerging risk at work due to an increase in the number of workers potentially exposed to them and the current lack of data on their health and safety risks. This paper reports the findings of a survey designed to study the safety practices employed by workers in Spanish research facilities performing tasks involving the use of ENMs at research level. A questionnaire pretested and validated by an expert panel was sent by e-mail to the target audience. The 425 surveys completed show that most of the respondents handled up to 5 different ENMs, in suspension, in small amounts during short periods of exposure. The implementation of common hygienic practices, such as the use of protection for hands and the implementation of fume hoods, is widely indicated. The selection of the preventive and protective measures does not depend on the characteristics of ENMs handled. Also, the risks posed by ENMs are widely ignored. Besides the performance of risk assessment, hygienic monitoring and the conducting of a specific health surveillance are practically non-existent although some accidents relating to ENMs were identified. In conclusion, workers' exposure to ENMs seems to be low. Even though the best practices and preventive and protective measures reported were employed, most of the respondents could not be correctly protected. Moreover, workers do not associate the measures implemented with the nanorisks. Finally, there is a lack of proactive action underway to protect the workers, and concerns about safety are weakly evidenced.

Geriatric screening in first opinion practice – results from 45 dogs

PubMed Central

Davies, M

2012-01-01

Objectives To evaluate and report the results of screening geriatric dogs in a first opinion practice. Methods A prospective health screen of dogs over nine-years-old involving history taking, physical examination and urinalysis. Results At least one previously unrecognised problem was identified in 80% of 45 dogs and 353 findings (mean 7·8 per dog) were recorded. Owners often failed to recognise and report serious signs of age-related disease. However, they most often reported increased sleeping (31%), loss of hearing (29%) or sight (20%), stiffness or lameness (22%) and “slowing down” (20%). Increased lens opacity (64%), increased thirst (58%), pain (24%), increased frequency of urination (24%), signs of osteoarthritis (24%) and dental disease (22%) were most frequently identified at the time of consultation. Potentially, life-threatening findings included respiratory distress, palpable abdominal masses and metastatic lung disease. Screening resulted in 29 further diagnostic procedures, including 10 dental procedures, seven medical treatments, two surgical procedures and euthanasia of two dogs. Clinical Significance Screening elderly dogs identified unrecognised and unreported health risk factors resulting in lifestyle modification and ongoing monitoring, as well as signs of age-related diseases resulting in diagnostic investigations, early diagnoses and surgical and medical interventions to improve quality of life. PMID:22835038

Installing a Practical Research Project and Interpreting Research Results

Treesearch

Kasten R. Dumroese; David L. Wenny

2003-01-01

The basic concepts of the scientific method and research process are reviewed. An example from a bareroot nursery demonstrates how a practical research project can be done at any type of nursery, meshing sound statistical principles with the limitations of busy nursery managers.

Effect of visual field presentation on action planning (estimating reach) in children.

PubMed

Gabbard, Carl; Cordova, Alberto

2012-01-01

In this article, the authors examined the effects of target information presented in different visual fields (lower, upper, central) on estimates of reach via use of motor imagery in children (5-11 years old) and young adults. Results indicated an advantage for estimating reach movements for targets placed in lower visual field (LoVF), with all groups having greater difficulty in the upper visual field (UpVF) condition, especially 5- and 7-year-olds. Complementing these results was an overall age-related increase in accuracy. Based in part on the equivalence hypothesis suggesting that motor imagery and motor planning and execution are similar, the findings support previous work of executed behaviors showing that there is a LoVF bias for motor skill actions of the hand. Given that previous research hints that the UpVF may be bias for visuospatial (perceptual) qualities, research in that area and its association with visuomotor processing (LoVF) should be considered.

Scientific governance and the process for exposure scenario development in REACH.

PubMed

Money, Chris D; Van Hemmen, Joop J; Vermeire, Theo G

2007-12-01

The primary process established by the European Commission to address the science needed to define key REACH concepts and to help rationally implement REACH's ambitions is enshrined in a series of activities known as the REACH Implementation Projects (RIPs). These are projects that aim to define the methodology that could be used, and present the basis for guidance on the actual principles and procedures that may be (are proposed to be) followed in the development of the required documentation that ensures the safe use of chemicals. In order to develop soundly based and equitable regulation, it is necessary that science governance using established and accepted scientific principles must take a leading role. The extent to which such governance is embraced will be determined by many factors, but notably the process adopted to enable scientific discussion to take place. This article addresses the issues of science as they have impacted on the exemplification of the Exposure Scenario concept under REACH. The current RIP activities have created a non-adversarial process in which the key stakeholders are able to discuss the key REACH challenges. But the RIP activities will be finalised before REACH comes into force. A suitable mechanism should perhaps now be identified to ensure that this positive spirit of scientific discussion and collaboration can continue to benefit REACH and those that it serves well into the future.

C, N, P export regimes from headwater catchments to downstream reaches

NASA Astrophysics Data System (ADS)

Dupas, R.; Musolff, A.; Jawitz, J. W.; Rao, P. S.; Jaeger, C. G.; Fleckenstein, J. H.; Rode, M.; Borchardt, D.

2017-12-01

Excessive amounts of nutrients and dissolved organic matter in freshwater bodies affect aquatic ecosystems. In this study, the spatial and temporal variability in nitrate (NO3), dissolved organic carbon (DOC) and soluble reactive phosphorus (SRP) was analyzed in the Selke river continuum from headwaters draining 1 - 3 km² catchments to downstream reaches representing spatially integrated signals from 184 - 456 km² catchments (part of TERENO - Terrestrial Environmental Observatories, in Germany). Three headwater catchments were selected as archetypes of the main landscape units (land use x lithology) present in the Selke catchment. Export regimes in headwater catchments were interpreted in terms of NO3, DOC and SRP land-to-stream transfer processes. Headwater signals were subtracted from downstream signals, with the differences interpreted in terms of in-stream processes and contribution of point-source emissions. The seasonal dynamics for NO3 were opposite those of DOC and SRP in all three headwater catchments, and spatial differences also showed NO3 contrasting with DOC and SRP. These dynamics were interpreted as the result of the interplay of hydrological and biogeochemical processes, for which riparian zones were hypothesized to play a determining role. In the two downstream reaches, NO3 was transported almost conservatively, whereas DOC was consumed and produced in the upper and lower river sections, respectively. The natural export regime of SRP in the three headwater catchments mimicked a point-source signal, which may lead to overestimation of domestic contributions in the downstream reaches. Monitoring the river continuum from headwaters to downstream reaches proved effective to investigate jointly land-to-stream and in-stream transport and transformation processes.

Development of reaching during mid-childhood from a Developmental Systems perspective.

PubMed

Golenia, Laura; Schoemaker, Marina M; Otten, Egbert; Mouton, Leonora J; Bongers, Raoul M

2018-01-01

Inspired by the Developmental Systems perspective, we studied the development of reaching during mid-childhood (5-10 years of age) not just at the performance level (i.e., endpoint movements), as commonly done in earlier studies, but also at the joint angle level. Because the endpoint position (i.e., the tip of the index finger) at the reaching target can be achieved with multiple joint angle combinations, we partitioned variability in joint angles over trials into variability that does not (goal-equivalent variability, GEV) and that does (non-goal-equivalent variability, NGEV) influence the endpoint position, using the Uncontrolled Manifold method. Quantifying this structure in joint angle variability allowed us to examine whether and how spatial variability of the endpoint at the reaching target is related to variability in joint angles and how this changes over development. 6-, 8- and 10-year-old children and young adults performed reaching movements to a target with the index finger. Polynomial trend analysis revealed a linear and a quadratic decreasing trend for the variable error. Linear decreasing and cubic trends were found for joint angle standard deviations at movement end. GEV and NGEV decreased gradually with age, but interestingly, the decrease of GEV was steeper than the decrease of NGEV, showing that the different parts of the joint angle variability changed differently over age. We interpreted these changes in the structure of variability as indicating changes over age in exploration for synergies (a family of task solutions), a concept that links the performance level with the joint angle level. Our results suggest changes in the search for synergies during mid-childhood development.

Livestock First Reached Southern Africa in Two Separate Events.

PubMed

Sadr, Karim

2015-01-01

After several decades of research on the subject, we now know when the first livestock reached southern Africa but the question of how they got there remains a contentious topic. Debate centres on whether they were brought with a large migration of Khoe-speakers who originated from East Africa; or whether the livestock were traded down-the-line among hunter-gatherer communities; or indeed whether there was a long history of diverse small scale population movements in this part of the world, one or more of which 'infiltrated' livestock into southern Africa. A new analysis of the distribution of stone toolkits from a sizeable sample of sub-equatorial African Later Stone Age sites, coupled with existing knowledge of the distribution of the earliest livestock remains and ceramics vessels, has allowed us to isolate two separate infiltration events that brought the first livestock into southern Africa just over 2000 years ago; one infiltration was along the Atlantic seaboard and another entered the middle reaches of the Limpopo River Basin. These findings agree well with the latest results of genetic research which together indicate that multiple, small-scale infiltrations probably were responsible for bringing the first livestock into southern Africa.

Family physician practice visits arising from the Alberta Physician Achievement Review

PubMed Central

2013-01-01

Background Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. PMID:24010980

Steady-state LPO is not always reached in high-strain shear zones

NASA Astrophysics Data System (ADS)

Kumamoto, K. M.; Warren, J. M.

2017-12-01

Seismic anisotropy in the upper mantle results from the alignment of olivine crystal lattices during flow by dislocation creep. Experiments on the evolution of olivine lattice preferred orientation (LPO) as a function of shear strain have found that high strains (>10) are necessary to achieve a steady-state LPO (i.e., the dominant slip system does not change appreciably with further strain) when a pre-existing LPO is present. At lower strain ( 2), a pseudo-steady-state fabric is reached, in which the [100] axes of olivine reach a steady orientation relative to the deformation kinematics, but the [010] and [001] axes continue to evolve (e.g. Hansen et al., 2014). To constrain LPO evolution at mantle conditions, we looked at the LPO variation across three high temperature mantle shear zones in the Josephine Peridotite of SW Oregon. These shear zones provide a rare opportunity to examine LPO evolution in natural samples as a function of shear strain, due to the presence of a pyroxene foliation that serves as a strain marker. Observations of two of these shear zones are consistent with experimental observations (Warren et al., 2008; Skemer et al., 2010). Shear Zone G reaches a steady-state LPO at a strain of >20. Shear Zone P reaches a pseudo-steady-state LPO, with a consistent [100] axis orientation, at a strain of 3.5. However, a steady-state orientation is not reached in the [010] or [001] axes at the maximum strain of 5.25. The third shear zone, Shear Zone A, does not appear to reach even a pseudo-steady-state LPO, despite reaching strains >20 at its center. Instead, the dominant slip plane switches back and forth between the (010) and (001) planes with increasing strain, while the [100] axis orientations continue to evolve. Unusually, at peak strain, the [100] axes are oriented 40° past the shear plane. In contrast, the other two shear zones, along with other natural and experimental examples, have the [100] axes oriented approximately parallel to the shear

Installing a practical research project and interpreting research results

Treesearch

R. Kasten Dumroese; David L. Weny

2002-01-01

We review the basic concepts of science and research and the scientific process. Using an example from a bareroot nursery, we show how a practical research project can be done at any type of nursery, meshing sound statistical principles with limitations of busy nursery managers.

Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

PubMed Central

Akizawa, Tadao; Pisoni, Ronald L.; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K.; Kurokawa, Kiyoshi

2008-01-01

Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia management practices and outcomes for Japanese HD patients. Results. From 1999 to 2006, patient mean Hb increased from 9.7 g/dl to 10.4 g/dl, and the percentage of facilities with median Hb ≥10 g/dl increased from 27% to 75%. Hb was measured in the supine position for 90% of patients, resulting in substantially lower reported Hb values than those seen in other countries. As of 2006, erythropoietin (Epo) was prescribed to 83% of HD patients; mean Epo dose was 5231 units/week; intravenous (IV) iron use was 33% and median IV iron dose was 160 mg/month. Many patient- and facility-level factors were significantly related to higher Hb. A consistent overall pattern of lower mortality risk with higher baseline Hb levels was seen (RR = 0.89 per 1 g/dl higher Hb, P = 0.003). Facilities with median Hb ≥10.4 displayed a lower mortality risk (RR = 0.77, P = 0.03) versus facility median Hb <10.4 g/dl. Lower Hb levels were not significantly related to hospitalization risk, but were associated with lower QoL scores. Conclusions. These results provide detailed information on anaemia management practices in Japan and the relationships of anaemia control with outcomes, with implications of anaemia management worldwide. PMID:18577535

Reaching the Overlooked Student in Physical Education

ERIC Educational Resources Information Center

Esslinger, Keri; Esslinger, Travis; Bagshaw, Jarad

2015-01-01

This article describes the use of live action role-playing, or "LARPing," as a non-traditional activity that has the potential to reach students who are not interested in traditional physical education.

Coordinated turn-and-reach movements. II. Planning in an external frame of reference

NASA Technical Reports Server (NTRS)

Pigeon, Pascale; Bortolami, Simone B.; DiZio, Paul; Lackner, James R.

2003-01-01

most subjects, indicating that subjects used different patterns of interjoint coordination in slow and fast movements while nevertheless preserving the shape of their finger trajectory. Higher movement speeds did not disrupt the arm joint rotations despite the larger interaction torques generated. Rather, subjects used the redundant degrees of freedom of the arm/trunk system to achieve similar finger trajectories with differing joint configurations. We examined finger movement patterns and velocity profiles to determine the frame of reference in which turn-and-reach movements could be most simply described. Finger trajectories of turn-and-reach movements had much larger curvatures and their velocity profiles were less smooth and less bell-like in trunk-based coordinates than in external coordinates. Taken together, these results support the conclusion that turn-and-reach movements are controlled in an external frame of reference.

Surprising results: HIV testing and changes in contraceptive practices among young women in Malawi

PubMed Central

Sennott, Christie; Yeatman, Sara

2015-01-01

This study uses eight waves of data from the population-based Tsogolo la Thanzi study (2009–2011) in rural Malawi to examine changes in young women’s contraceptive practices, including the use of condoms, non-barrier contraceptive methods, and abstinence, following positive and negative HIV tests. The analysis factors in women’s prior perceptions of their HIV status that may already be shaping their behaviour and separates surprise HIV test results from those that merely confirm what was already believed. Fixed effects logistic regression models show that HIV testing frequently affects the contraceptive practices of young Malawian women, particularly when the test yields an unexpected result. Specifically, women who are surprised to test HIV positive increase their condom use and are more likely to use condoms consistently. Following an HIV negative test (whether a surprise or expected), women increase their use of condoms and decrease their use of non-barrier contraceptives; the latter may be due to an increase in abstinence following a surprise negative result. Changes in condom use following HIV testing are robust to the inclusion of potential explanatory mechanisms including fertility preferences, relationship status, and the perception that a partner is HIV positive. The results demonstrate that both positive and negative tests can influence women’s sexual and reproductive behaviours, and emphasise the importance of conceptualizing of HIV testing as offering new information only insofar as results deviate from prior perceptions of HIV status. PMID:26160156

Improved guideline adherence to pharmacotherapy of chronic systolic heart failure in general practice--results from a cluster-randomized controlled trial of implementation of a clinical practice guideline.

PubMed

Peters-Klimm, Frank; Müller-Tasch, Thomas; Remppis, Andrew; Szecsenyi, Joachim; Schellberg, Dieter

2008-10-01

Clinical practice guidelines (CPG) reflect the evidence of effective pharmacotherapy of chronic (systolic) heart failure (CHF) which needs to be implemented. This study aimed to evaluate the effect of a new, multifaceted intervention (educational train-the-trainer course plus pharmacotherapy feedback = TTT) compared with standard education on guideline adherence (GA) in general practice. Thirty-seven participating general practitioners (GPs) were randomized (18 vs. 19) and included 168 patients with ascertained symptomatic CHF [New York Heart Association (NYHA) II-IV]. Groups received CPG, the TTT intervention consisted of four interactive educational meetings and a pharmacotherapy feedback, while the control group received a usual lecture (Standard). Outcome measure was GA assessed by prescription rates and target dosing of angiotensin converting enzyme (ACE) inhibitors (ACE-I) or angiotensin receptor blockers (ARB), beta-blockers (BB) and aldosterone antagonists (AA) at baseline and 7-month follow-up. Group comparisons at follow-up were adjusted to GA, sex, age and NYHA stage at baseline. Prescription rates at baseline (n = 168) were high (ACE-I/ARB 90, BB 79 and AA 29%) in both groups. At follow up (n = 146), TTT improved compared with Standard regarding AA (43% vs. 23%, P = 0.04) and the rates of reached target doses of ACE-I/ARB (28% vs. 15%, P = 0.04). TTT group achieved significantly higher mean percentages of daily target dose (52% vs. 42%, mean difference 10.3%, 95% CI 0.84-19.8, P = 0.03). Despite of pre-existing high GA in both groups and an active control group, the multifaceted intervention was effective in quality of care measured by GA. Further research is needed on the choice of interventions in different provider populations.

Reaching their potential: Perceived impact of a collaborative academic-clinical partnership programme for early career nurses in New Zealand.

PubMed

McKillop, Ann; Doughty, Lesley; Atherfold, Cheryl; Shaw, Kathy

2016-01-01

The dynamic nature of healthcare ensures that early career nurses enter an uncertain and complex world of practice and consequently require support to develop their practice, build confidence and reach their potential. The New Zealand Nurse Entry to Practice programme for registered nurses in their first year of practice has been operating since 2005 to enable safe and confident practice, improve the quality of care, and positively impact on recruitment and retention. This academic and clinical programme was offered as a partnership between a university and a clinical provider with postgraduate academic credits gained. The aim of this study was to explore the perceived impact of postgraduate university education for early career nurses in one regional health area of New Zealand. Participants were registered nurses who had completed the early career nurse programme and their clinical preceptors. The research was conducted via an online survey of 248 nurses and three focus groups to explore how the programme was experienced and its impact on knowledge and practice. Early career nurses and their preceptors found that the programme enables improved knowledge and skills of patient assessment, application of critical thinking to clinical practice, perceived improvement in patient care delivery and outcomes, enhanced interprofessional communication and knowledge sharing, and had a positive impact on professional awareness and career planning. This clinical-academic partnership positively impacted on the clinical practice and transition experience of early career nurses and was closely aligned to an organization's strategic plan for nursing workforce development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparative effectiveness research and its utility in In-clinic practice

PubMed Central

Dang, Amit; Kaur, Kirandeep

2016-01-01

One of the important components of patient-centered healthcare is comparative effectiveness research (CER), which aims at generating evidence from the real-life setting. The primary purpose of CER is to provide comparative information to the healthcare providers, patients, and policy makers about the standard of care available. This involves research on clinical questions unanswered by the explanatory trials during the regulatory approval process. Main methods of CER involve randomized controlled trials and observational methods. The limitations of these two methods have been overcome with the help of new statistical methods. After the evidence generation, it is equally important to communicate the results to all the interested organizations. CER is beginning to have its impact in the clinical practice as its results become part of the clinical practice guidelines. CER will have far-reaching scientific and financial impact. CER will make both the treating physician and the patient equally responsible for the treatment offered. PMID:26955571

ERF1_2 -- Enhanced River Reach File 2.0

USGS Publications Warehouse

Nolan, Jacqueline V.; Brakebill, John W.; Alexander, Richard B.; Schwarz, Gregory E.

2003-01-01

The digital segmented network based on watershed boundaries, ERF1_2, includes enhancements to the U.S. Environmental Protection Agency's River Reach File 1 (RF1) (USEPA, 1996; DeWald and others, 1985) to support national and regional-scale surface water-quality modeling. Alexander and others (1999) developed ERF1, which assessed the hydrologic integrity of the digital reach traces and calculated the mean water time-of-travel in river reaches and reservoirs. ERF1_2 serves as the foundation for SPARROW (Spatially Referenced Regressions (of nutrient transport) on Watershed) modeling. Within the context of a Geographic Information System, SPARROW estimates the proportion of watersheds in the conterminous U.S. with outflow concentrations of several nutrients, including total nitrogen and total phosphorus, (Smith, R.A., Schwarz, G.E., and Alexander, R.B., 1997). This version of the network expands on ERF1 (Version 1.2; Alexander, et al., 1999) and includes the incremental and total drainage area derived from 1-kilometer (km) elevation data for North America. Previous estimates of the water time-of-travel were recomputed for reaches with water-quality monitoring sites that included two reaches. The mean flow and velocity estimates for these split reaches are based on previous estimation methods (Alexander et al., 1999) and are unchanged in ERF1_2. Drainage area calculations provide data used to estimate the contribution of a given nutrient to the outflow. Data estimates depend on the accuracy of node connectivity. Reaches split at water-quality or pesticide-monitoring sites indicate the source point for estimating the contribution and transport of nutrients and their loads throughout the watersheds. The ERF1_2 coverage extends the earlier drainage area founded on the 1-kilometer data for North America (Verdin, 1996; Verdin and Jenson, 1996). A 1-kilometer raster grid of ERF1_2 projected to Lambert Azimuthal Equal Area, NAD 27 Datum (Snyder, 1987), was merged with the

Bridging the Research-to-Practice Gap: A Review of the Literature Focusing on Inclusive Education

ERIC Educational Resources Information Center

Grima-Farrell, Christine R.; Bain, Alan; McDonagh, Sarah H.

2011-01-01

Despite advances in our knowledge of evidence-based inclusive educational practice, much of this knowledge does not reach routine classroom practice. There remains a significant gap between our accumulated knowledge about what can work in classrooms and the extent to which evidence-based practice is used in sustainable ways. This inability to…

Adaptive upstream rate adjustment by RSOA-ONU depending on different injection power of seeding light in standard-reach and long-reach PON systems

NASA Astrophysics Data System (ADS)

Yeh, C. H.; Chow, C. W.; Shih, F. Y.; Pan, C. L.

2012-08-01

The wavelength division multiplexing-time division multiplexing (WDM-TDM) passive optical network (PON) using reflective semiconductor optical amplifier (RSOA)-based colorless optical networking units (ONUs) is considered as a promising candidate for the realization of fiber-to-the-home (FTTH). And this architecture is actively considered by Industrial Technology Research Institute (ITRI) for the realization of FTTH in Taiwan. However, different fiber distances and optical components would introduce different power budgets to different ONUs in the PON. Besides, due to the aging of optical transmitter (Tx), the power decay of the distributed optical carrier from the central office (CO) could also reduce the injection power into each ONU. The situation will be more severe in the long-reach (LR) PON, which is considered as an option for the future access. In this work, we investigate a WDM-TDM PON using RSOA-based ONU for upstream data rate adjustment depending on different continuous wave (CW) injection powers. Both standard-reach (25 km) and LR (100 km) transmissions are evaluated. Moreover, a detail analysis of the upstream signal bit-error rate (BER) performances at different injection powers, upstream data rates, PON split-ratios under stand-reach and long-reach is presented.

Assessment of adnexal masses using ultrasound: a practical review

PubMed Central

Smorgick, Noam; Maymon, Ron

2014-01-01

Pelvic ultrasound is commonly used as part of the routine gynecologic exams, resulting in diagnosis of adnexal masses, the majority of which are functional or benign. However, due to the possible complications involving benign adnexal cysts (ie, adnexal torsion, pelvic pain) and the utmost importance of early diagnosis and treatment of ovarian cancer, the correct ultrasound diagnosis of adnexal masses is essential in clinical practice. This review will describe the typical ultrasound appearance of the common physiologic, benign, and malignant adnexal masses with the aim of aiding the clinician to reach the correct diagnosis. PMID:25285023

Generic exposure scenarios: their development, application, and interpretation under REACH.

PubMed

Money, Chris; Margary, Alison; Noij, Dook; Hommes, Kees

2011-06-01

The European Union Registration, Evaluation, Authorization, and Restriction of Chemicals (REACH) Regulation (EC 1907/2006) places significant new obligations on the manufacturers or importers (M/Is) of chemicals in Europe. It also places new responsibilities on downstream users (DUs) of these chemicals i.e. those that purchase and use chemical products. In particular, for registered classified substances, the M/I is expected to communicate how any substance can be safely used without risk to man or the environment. This communication is in the form of an exposure scenario (ES), which is included in an Annex to the REACH extended safety data sheet. DUs then have certain obligations relating to adopting the control conditions described in the ES. The REACH Technical Guidance Documents lay down the expectations for the process of risk assessment that M/Is should adopt when developing ESs. But with many thousands of chemicals in daily commerce, it is also necessary to ensure that what is communicated to DUs not only meets the requirements of REACH but is also understandable to these groups, as well as being consistent across different chemical suppliers and supply chains. In cooperation with relevant DU groups, the European solvents industry has developed generic approaches for describing how solvents are commonly used, in order that these can subsequently be used as the basis for REACH registrations and related safety data sheet communications on health risk control. The utility of these approaches (termed 'generic exposure scenarios') is acknowledged under REACH and they are now publicly available for use both by M/Is and DUs.

Effects of turbulent hyporheic mixing on reach-scale solute transport

NASA Astrophysics Data System (ADS)

Roche, K. R.; Li, A.; Packman, A. I.

2017-12-01

Turbulence rapidly mixes solutes and fine particles into coarse-grained streambeds. Both hyporheic exchange rates and spatial variability of hyporheic mixing are known to be controlled by turbulence, but it is unclear how turbulent mixing influences mass transport at the scale of stream reaches. We used a process-based particle-tracking model to simulate local- and reach-scale solute transport for a coarse-bed stream. Two vertical mixing profiles, one with a smooth transition from in-stream to hyporheic transport conditions and a second with enhanced turbulent transport at the sediment-water interface, were fit to steady-state subsurface concentration profiles observed in laboratory experiments. The mixing profile with enhanced interfacial transport better matched the observed concentration profiles and overall mass retention in the streambed. The best-fit mixing profiles were then used to simulate upscaled solute transport in a stream. Enhanced mixing coupled in-stream and hyporheic solute transport, causing solutes exchanged into the shallow subsurface to have travel times similar to the water column. This extended the exponential region of the in-stream solute breakthrough curve, and delayed the onset of the heavy power-law tailing induced by deeper and slower hyporheic porewater velocities. Slopes of observed power-law tails were greater than those predicted from stochastic transport theory, and also changed in time. In addition, rapid hyporheic transport velocities truncated the hyporheic residence time distribution by causing mass to exit the stream reach via subsurface advection, yielding strong exponential tempering in the in-stream breakthrough curves at the timescale of advective hyporheic transport through the reach. These results show that strong turbulent mixing across the sediment-water interface violates the conventional separation of surface and subsurface flows used in current models for solute transport in rivers. Instead, the full distribution of

Implementation of study results in guidelines and adherence to guidelines in clinical practice.

PubMed

Waldfahrer, Frank

2016-01-01

Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF). Since increasing digitalization has made access to scientific publications quicker and simpler, relevant study results can be incorporated in guidelines more easily today than in the analog world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines.

Olefins and chemical regulation in Europe: REACH.

PubMed

Penman, Mike; Banton, Marcy; Erler, Steffen; Moore, Nigel; Semmler, Klaus

2015-11-05

REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the European Union's chemical regulation for the management of risk to human health and the environment (European Chemicals Agency, 2006). This regulation entered into force in June 2007 and required manufacturers and importers to register substances produced in annual quantities of 1000 tonnes or more by December 2010, with further deadlines for lower tonnages in 2013 and 2018. Depending on the type of registration, required information included the substance's identification, the hazards of the substance, the potential exposure arising from the manufacture or import, the identified uses of the substance, and the operational conditions and risk management measures applied or recommended to downstream users. Among the content developed to support this information were Derived No-Effect Levels or Derived Minimal Effect Levels (DNELs/DMELs) for human health hazard assessment, Predicted No Effect Concentrations (PNECs) for environmental hazard assessment, and exposure scenarios for exposure and risk assessment. Once registered, substances may undergo evaluation by the European Chemicals Agency (ECHA) or Member State authorities and be subject to requests for additional information or testing as well as additional risk reduction measures. To manage the REACH registration and related activities for the European olefins and aromatics industry, the Lower Olefins and Aromatics REACH Consortium was formed in 2008 with administrative and technical support provided by Penman Consulting. A total of 135 substances are managed by this group including 26 individual chemical registrations (e.g. benzene, 1,3-butadiene) and 13 categories consisting of 5-26 substances. This presentation will describe the content of selected registrations prepared for 2010 in addition to the significant post-2010 activities. Beyond REACH, content of the registrations may also be relevant to other European activities, for

Scene Configuration and Object Reliability Affect the Use of Allocentric Information for Memory-Guided Reaching

PubMed Central

Klinghammer, Mathias; Blohm, Gunnar; Fiehler, Katja

2017-01-01

-relevancy. Moreover, when solely task-relevant objects were shifted incoherently, the variability of reaching endpoints increased compared to coherent shifts of task-relevant objects. Our results suggest that the use of allocentric information for coding targets for memory-guided reaching depends on the scene configuration, in particular the average distance of the reach target to task-relevant objects, and the reliability of task-relevant allocentric information. PMID:28450826

Scene Configuration and Object Reliability Affect the Use of Allocentric Information for Memory-Guided Reaching.

PubMed

Klinghammer, Mathias; Blohm, Gunnar; Fiehler, Katja

2017-01-01

-relevancy. Moreover, when solely task-relevant objects were shifted incoherently, the variability of reaching endpoints increased compared to coherent shifts of task-relevant objects. Our results suggest that the use of allocentric information for coding targets for memory-guided reaching depends on the scene configuration, in particular the average distance of the reach target to task-relevant objects, and the reliability of task-relevant allocentric information.

On the time needed to reach an equilibrium structure of the radiation belts

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

Ripoll, J. -F.; Loran, V.; Cunningham, Gregory Scott

In this paper, we complement the notion of equilibrium states of the radiation belts with a discussion on the dynamics and time needed to reach equilibrium. We solve for the equilibrium states obtained using 1D radial diffusion with recently developed hiss and chorus lifetimes at constant values of Kp = 1, 3 and 6. We find that the equilibrium states at moderately low Kp, when plotted vs L-shell (L) and energy (E), display the same interesting S-shape for the inner edge of the outer belt as recently observed by the Van Allen Probes. The S-shape is also produced as themore » radiation belts dynamically evolve toward the equilibrium state when initialized to simulate the buildup after a massive dropout or to simulate loss due to outward diffusion from a saturated state. Physically, this shape, intimately linked with the slot structure, is due to the dependence of electron loss rate (originating from wave-particle interactions) on both energy and L-shell. Equilibrium electron flux profiles are governed by the Biot number (τ Diffusion/τ loss), with large Biot number corresponding to low fluxes and low Biot number to large fluxes. The time it takes for the flux at a specific (L, E) to reach the value associated with the equilibrium state, starting from these different initial states, is governed by the initial state of the belts, the property of the dynamics (diffusion coefficients), and the size of the domain of computation. Its structure shows a rather complex scissor form in the (L, E) plane. The equilibrium value (phase space density or flux) is practically reachable only for selected regions in (L, E) and geomagnetic activity. Convergence to equilibrium requires hundreds of days in the inner belt for E > 300 keV and moderate Kp (≤3). It takes less time to reach equilibrium during disturbed geomagnetic conditions (Kp ≥ 3), when the system evolves faster. Restricting our interest to the slot region, below L = 4, we find that only small regions in (L, E) space

On the time needed to reach an equilibrium structure of the radiation belts

DOE PAGES

Ripoll, J. -F.; Loran, V.; Cunningham, Gregory Scott; ...

2016-08-01

In this paper, we complement the notion of equilibrium states of the radiation belts with a discussion on the dynamics and time needed to reach equilibrium. We solve for the equilibrium states obtained using 1D radial diffusion with recently developed hiss and chorus lifetimes at constant values of Kp = 1, 3 and 6. We find that the equilibrium states at moderately low Kp, when plotted vs L-shell (L) and energy (E), display the same interesting S-shape for the inner edge of the outer belt as recently observed by the Van Allen Probes. The S-shape is also produced as themore » radiation belts dynamically evolve toward the equilibrium state when initialized to simulate the buildup after a massive dropout or to simulate loss due to outward diffusion from a saturated state. Physically, this shape, intimately linked with the slot structure, is due to the dependence of electron loss rate (originating from wave-particle interactions) on both energy and L-shell. Equilibrium electron flux profiles are governed by the Biot number (τ Diffusion/τ loss), with large Biot number corresponding to low fluxes and low Biot number to large fluxes. The time it takes for the flux at a specific (L, E) to reach the value associated with the equilibrium state, starting from these different initial states, is governed by the initial state of the belts, the property of the dynamics (diffusion coefficients), and the size of the domain of computation. Its structure shows a rather complex scissor form in the (L, E) plane. The equilibrium value (phase space density or flux) is practically reachable only for selected regions in (L, E) and geomagnetic activity. Convergence to equilibrium requires hundreds of days in the inner belt for E > 300 keV and moderate Kp (≤3). It takes less time to reach equilibrium during disturbed geomagnetic conditions (Kp ≥ 3), when the system evolves faster. Restricting our interest to the slot region, below L = 4, we find that only small regions in (L, E) space

Recommendations for Internet-Based Qualitative Health Research With Hard-to-Reach Populations

PubMed Central

Wilkerson, J. Michael; Iantaffi, Alex; Grey, Jeremy A.; Bockting, Walter O.; Simon Rosser, B. R.

2014-01-01

Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team’s response to various situations. Our recommendations direct researchers’ reflection on these considerations. PMID:24623662

Assessment of skin sensitization under REACH: A case report on vehicle choice in the LLNA and its crucial role preventing false positive results.

PubMed

Watzek, Nico; Berger, Franz; Kolle, Susanne Noreen; Kaufmann, Tanja; Becker, Matthias; van Ravenzwaay, Bennard

2017-04-01

In the EU, chemicals with a production or import volume in quantities of one metric ton per year or more have to be tested for skin sensitizing properties under the REACH regulation. The murine Local Lymph Node Assay (LLNA) and its modifications are widely used to fulfil the data requirement, as it is currently considered the first-choice method for in vivo testing to cover this endpoint. This manuscript describes a case study highlighting the importance of understanding the chemistry of the test material during testing for 'skin sensitization' of MCDA (mixture of 2,4- and 2,6-diamino-methylcyclohexane) with particular focus on the vehicle used. While the BrdU-ELISA modification of the LLNA using acetone/olive oil (AOO) as vehicle revealed expectable positive results. However, the concentration control analysis unexpectedly revealed an instability of MCDA in the vehicle AOO. Further studies on the reactivity showed MCDA to rapidly react with AOO under formation of various imine structures, which might have caused the positive LLNA result. The repetition of the LLNA using propylene glycol (PG) as vehicle did not confirm the positive results of the LLNA using AOO. Finally, a classification of MCDA as skin sensitizer according to the Globally Harmonized System (GHS) was not justified. Copyright © 2017 Elsevier Inc. All rights reserved.

Selective reaching in macaques: evidence for action-centred attention.

PubMed

Bulgheroni, Maria; Camperio-Ciani, Andrea; Straulino, Elisa; Sartori, Luisa; D'Amico, Enrico; Castiello, Umberto

2017-03-01

When a monkey selects a piece of food lying on the ground from among other viable objects in the near vicinity, only the desired item governs the particular pattern and direction of the animal's reaching action. It would seem then that selection is an important component controlling the animal's action. But, we may ask, is the selection process in such cases impervious to the presence of other objects that could constitute potential obstacles to or constraints on movement execution? And if it is, in fact, pervious to other objects, do they have a direct influence on the organization of the response? The kinematics of macaques' reaching movements were examined by the current study that analysed some exemplars as they selectively reached to grasp a food item in the absence as well as in the presence of potential obstacles (i.e., stones) that could affect the arm trajectory. Changes in movement parameterization were noted in temporal measures, such as movement time, as well as in spatial ones, such as paths of trajectory. Generally speaking, the presence of stones in the vicinity of the acting hand stalled the reaching movement and affected the arm trajectory as the hand veered away from the stone even when it was not a physical obstacle. We concluded that nearby objects evoke a motor response in macaques, and the attentional mechanisms that allow for a successful action selection are revealed in the reaching path. The data outlined here concur with human studies indicating that potential obstacles are internally represented, a finding implying basic cognitive operations allowing for action selection in macaques.

Toward a Science of Character Education: Frameworks for Identifying and Implementing Effective Practices

ERIC Educational Resources Information Center

Berkowitz, Marvin W.; Bier, Melinda C.; McCauley, Brian

2017-01-01

A growing body of research on character education offers the opportunity to derive lessons on effective practice. While there is little focused research on the effectiveness of specific practices, reviews of effective programs have been mined for well over a decade to reach conclusions about "what works in character education." More…

[Psychosocial counselling in gynecological practices : Results from a nationwide, representative survey of gynecologists in Germany].

PubMed

Metzner, Franka; Siefert, Sönke; Pawils, Silke

2017-02-01

Due to their high social acceptance gynecologists provide ideal conditions for approaching families. Psychosocial stress (PSS), e. g. in the context of partnership conflicts, poverty or social isolation can be identified and support can be initiated. The aim of the study was to capture attitudes and engagement of gynecologists dealing with patients with PSS in gynecological practices in Germany. Out of 3000 randomly selected gynecologists in private practices, 1034 (response rate: 35%) took part in a Germany-wide questionnaire study on gynecologists' sense of responsibility, procedures and barriers when dealing with women with PSS. Ninety-six percent of the surveyed gynecologists felt responsible for patients with PSS. On average, gynecologists assumed PSS in 23% of their patients. Most of the gynecologists counseled patients with PSS and referral into the regional help system often occurred. When asked about the German early intervention system, 74% responded that they could imagine their own practice participating in this system. A need for improvement was observed in networking and financing. Significant differences in screening and interventions were found mainly in terms of professional experience, old vs. new federal states as well as between single and joint practices. Surprisingly, openness and engagement for patients with PSS were found in gynecological practices. The majority of gynecologists already offered psychosocial interventions. It may be deduced from these results that gynecologists in practices would contribute to the psychosocial aid network if key basic conditions including the financing were fulfilled.

Local field potential spectral tuning in motor cortex during reaching.

PubMed

Heldman, Dustin A; Wang, Wei; Chan, Sherwin S; Moran, Daniel W

2006-06-01

In this paper, intracortical local field potentials (LFPs) and single units were recorded from the motor cortices of monkeys (Macaca fascicularis) while they preformed a standard three-dimensional (3-D) center-out reaching task. During the center-out task, the subjects held their hands at the location of a central target and then reached to one of eight peripheral targets forming the corners of a virtual cube. The spectral amplitudes of the recorded LFPs were calculated, with the high-frequency LFP (HF-LFP) defined as the average spectral amplitude change from baseline from 60 to 200 Hz. A 3-D linear regression across the eight center-out targets revealed that approximately 6% of the beta LFPs (18-26 Hz) and 18% of the HF-LFPs were tuned for velocity (p-value < 0.05), while 10% of the beta LFPs and 15% of the HF-LFPs were tuned for position. These results suggest that a multidegree-of-freedom brain-machine interface is possible using high-frequency LFP recordings in motor cortex.

Target: Alcohol Abuse in the Hard-to-Reach Work Force. Ideas and Resources for Responding to Problems of the Hard-to-Reach Work Force.

ERIC Educational Resources Information Center

Informatics, Inc., Rockville, MD.

This guide is designed as a source of ideas and information for individuals and organizations interested in occupational alcoholism programs for the hard-to-reach work force. Following a brief overview of the problem and a report on progress in occupational alcoholism programming, a working definition of the hard-to-reach work force is offered;…

Determining Exercise Strength Requirements for Astronaut Critical Mission Tasks: Reaching Under G-Load

NASA Technical Reports Server (NTRS)

Schaffner, Grant; Bentley, Jason

2008-01-01

The critical mission tasks assessments effort seeks to determine the physical performance requirements that astronauts must meet in order to safely and successfully accomplish lunar exploration missions. These assessments will determine astronaut preflight strength, fitness, and flexibility requirements, and the extent to which exercise and other countermeasures must prevent the physical deconditioning associated with prolonged weightlessness. The purpose is to determine the flexibility and strength that crewmembers must possess in order to reach Crew Exploration Vehicle controls during maneuvers that result in sustained acceleration levels ranging from 3.7G to 7.8G. An industry standard multibody dynamics application was used to create human models representing a 5th percentile female, a 50th percentile male, and a 95th percentile male. The additional mass of a space suit sleeve was added to the reaching arm to account for the influence of the suit mass on the reaching effort. The human model was merged with computer models of a pilot seat and control panel for the Crew Exploration Vehicle. Three dimensional paths were created that guided the human models hand from a starting position alongside its thigh to three control targets: a joystick, a keyboard, and an overhead switch panel. The reaching motion to each target was repeated under four vehicle acceleration conditions: nominal ascent (3.7G), two ascent aborts (5.5G and 7.8G) and lunar reentry (4.6G). Elbow and shoulder joint angular excursions were analyzed to assess range of motion requirements. Mean and peak elbow and shoulder joint torques were determined and converted to equivalent resistive exercise loads to assess strength requirements. Angular excursions for the 50th and 95th percentile male models remained within joint range of motion limits. For the 5th percentile female, both the elbow and the shoulder exceeded range of motion limits during the overhead reach. Elbow joint torques ranged from 10 N

Translating the REACH Caregiver Intervention for Use by Area Agency on Aging Personnel: the REACH OUT Program

ERIC Educational Resources Information Center

Burgio, Louis D.; Collins, Irene B.; Schmid, Bettina; Wharton, Tracy; McCallum, Debra; DeCoster, Jamie

2009-01-01

Purpose: The aim of this study was to translate the evidence-based Resources for Enhancing Alzheimer's Caregiver Health (REACH) II intervention for use in 4 Area Agencies on Aging (AAAs). A secondary aim was to examine possible moderators of treatment outcome. Design and Methods: We used a quasi-experimental pre-post treatment design with no…

Functional anatomy of nonvisual feedback loops during reaching: a positron emission tomography study.

PubMed

Desmurget, M; Gréa, H; Grethe, J S; Prablanc, C; Alexander, G E; Grafton, S T

2001-04-15

Reaching movements performed without vision of the moving limb are continuously monitored, during their execution, by feedback loops (designated nonvisual). In this study, we investigated the functional anatomy of these nonvisual loops using positron emission tomography (PET). Seven subjects had to "look at" (eye) or "look and point to" (eye-arm) visual targets whose location either remained stationary or changed undetectably during the ocular saccade (when vision is suppressed). Slightly changing the target location during gaze shift causes an increase in the amount of correction to be generated. Functional anatomy of nonvisual feedback loops was identified by comparing the reaching condition involving large corrections (jump) with the reaching condition involving small corrections (stationary), after subtracting the activations associated with saccadic movements and hand movement planning [(eye-arm-jumping minus eye-jumping) minus (eye-arm-stationary minus eye-stationary)]. Behavioral data confirmed that the subjects were both accurate at reaching to the stationary targets and able to update their movement smoothly and early in response to the target jump. PET difference images showed that these corrections were mediated by a restricted network involving the left posterior parietal cortex, the right anterior intermediate cerebellum, and the left primary motor cortex. These results are consistent with our knowledge of the functional properties of these areas and more generally with models emphasizing parietal-cerebellar circuits for processing a dynamic motor error signal.

A Robotics-Based Approach to Modeling of Choice Reaching Experiments on Visual Attention

PubMed Central

Strauss, Soeren; Heinke, Dietmar

2012-01-01

The paper presents a robotics-based model for choice reaching experiments on visual attention. In these experiments participants were asked to make rapid reach movements toward a target in an odd-color search task, i.e., reaching for a green square among red squares and vice versa (e.g., Song and Nakayama, 2008). Interestingly these studies found that in a high number of trials movements were initially directed toward a distractor and only later were adjusted toward the target. These “curved” trajectories occurred particularly frequently when the target in the directly preceding trial had a different color (priming effect). Our model is embedded in a closed-loop control of a LEGO robot arm aiming to mimic these reach movements. The model is based on our earlier work which suggests that target selection in visual search is implemented through parallel interactions between competitive and cooperative processes in the brain (Heinke and Humphreys, 2003; Heinke and Backhaus, 2011). To link this model with the control of the robot arm we implemented a topological representation of movement parameters following the dynamic field theory (Erlhagen and Schoener, 2002). The robot arm is able to mimic the results of the odd-color search task including the priming effect and also generates human-like trajectories with a bell-shaped velocity profile. Theoretical implications and predictions are discussed in the paper. PMID:22529827

Neuronal Correlates of Functional Coupling between Reach- and Grasp-Related Components of Muscle Activity

PubMed Central

Geed, Shashwati; McCurdy, Martha L.; van Kan, Peter L. E.

2017-01-01

neuronal correlates showed invariant spatiotemporal coupling. Clinical and lesion studies have reported disruption of coupling between reach and grasp following cerebellar damage; the present results expand on those studies by identifying a neuronal mechanism that may underlie cerebellar contributions to spatiotemporal coordination of distal and proximal limb muscles during reaching to grasp. We conclude that finding similar functional units of behavior expressed at multiple levels of information processing along interposito-rubrospinal pathways and forelimb muscles supports the hypothesis that functionally related populations of NI and RNm neurons act synergistically in the control of complex coordinated motor behaviors. PMID:28270752

Spatial and Temporal Eye–Hand Coordination Relies on the Parietal Reach Region

PubMed Central

Hauschild, Markus; Wilke, Melanie; Andersen, Richard A.

2014-01-01

Coordinated eye movements are crucial for precision control of our hands. A commonly believed neural mechanism underlying eye–hand coordination is interaction between the neural networks controlling each effector, exchanging, and matching information, such as movement target location and onset time. Alternatively, eye–hand coordination may result simply from common inputs to independent eye and hand control pathways. Thus far, it remains unknown whether and where either of these two possible mechanisms exists. A candidate location for the former mechanism, interpathway communication, includes the posterior parietal cortex (PPC) where distinct effector-specific areas reside. If the PPC were within the network for eye–hand coordination, perturbing it would affect both eye and hand movements that are concurrently planned. In contrast, if eye–hand coordination arises solely from common inputs, perturbing one effector pathway, e.g., the parietal reach region (PRR), would not affect the other effector. To test these hypotheses, we inactivated part of PRR in the macaque, located in the medial bank of the intraparietal sulcus encompassing the medial intraparietal area and area 5V. When each effector moved alone, PRR inactivation shortened reach but not saccade amplitudes, compatible with the known reach-selective activity of PRR. However, when both effectors moved concurrently, PRR inactivation shortened both reach and saccade amplitudes, and decoupled their reaction times. Therefore, consistent with the interpathway communication hypothesis, we propose that the planning of concurrent eye and hand movements causes the spatial information in PRR to influence the otherwise independent eye control pathways, and that their temporal coupling requires an intact PRR. PMID:25232123

Job satisfaction among primary care physicians: results of a survey.

PubMed

Behmann, Mareike; Schmiemann, Guido; Lingner, Heidrun; Kühne, Franziska; Hummers-Pradier, Eva; Schneider, Nils

2012-03-01

A shortage of primary care physicians (PCPs) seems likely in Germany in the near future and already exists in some parts of the country. Many currently practicing PCPs will soon reach retirement age, and recruiting young physicians for family practice is difficult. The attractiveness of primary care for young physicians depends on the job satisfaction of currently practicing PCPs. We studied job satisfaction among PCPs in Lower Saxony, a large federal state in Germany. In 2009, we sent a standardized written questionnaire on overall job satisfaction and on particular aspects of medical practice to 3296 randomly chosen PCPs and internists in family practice in Lower Saxony (50% of the entire target population). 1106 physicians (34%) responded; their mean age was 52, and 69% were men. 64% said they were satisfied or very satisfied with their job overall. There were particularly high rates of satisfaction with patient contact (91%) and working atmosphere (87% satisfied or very satisfied). In contrast, there were high rates of dissatisfaction with administrative tasks (75% dissatisfied or not at all satisfied). The results were more indifferent concerning payment and work life balance. Overall, younger PCPs and physicians just entering practice were more satisfied than their older colleagues who had been in practice longer. PCPs are satisfied with their job overall. However, there is significant dissatisfaction with administrative tasks. Improvements in this area may contribute to making primary care more attractive to young physicians.

A neural network simulating human reach-grasp coordination by continuous updating of vector positioning commands.

PubMed

Ulloa, Antonio; Bullock, Daniel

2003-10-01

We developed a neural network model to simulate temporal coordination of human reaching and grasping under variable initial grip apertures and perturbations of object size and object location/orientation. The proposed model computes reach-grasp trajectories by continuously updating vector positioning commands. The model hypotheses are (1) hand/wrist transport, grip aperture, and hand orientation control modules are coupled by a gating signal that fosters synchronous completion of the three sub-goals. (2) Coupling from transport and orientation velocities to aperture control causes maximum grip apertures that scale with these velocities and exceed object size. (3) Part of the aperture trajectory is attributable to an aperture-reducing passive biomechanical effect that is stronger for larger apertures. (4) Discrepancies between internal representations of targets partially inhibit the gating signal, leading to movement time increases that compensate for perturbations. Simulations of the model replicate key features of human reach-grasp kinematics observed under three experimental protocols. Our results indicate that no precomputation of component movement times is necessary for online temporal coordination of the components of reaching and grasping.

Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke

PubMed Central

2012-01-01

This study, conducted in a group of nine chronic patients with right-side hemiparesis after stroke, investigated the effects of a robotic-assisted rehabilitation training with an upper limb robotic exoskeleton for the restoration of motor function in spatial reaching movements. The robotic assisted rehabilitation training was administered for a period of 6 weeks including reaching and spatial antigravity movements. To assess the carry-over of the observed improvements in movement during training into improved function, a kinesiologic assessment of the effects of the training was performed by means of motion and dynamic electromyographic analysis of reaching movements performed before and after training. The same kinesiologic measurements were performed in a healthy control group of seven volunteers, to determine a benchmark for the experimental observations in the patients’ group. Moreover degree of functional impairment at the enrolment and discharge was measured by clinical evaluation with upper limb Fugl-Meyer Assessment scale (FMA, 0–66 points), Modified Ashworth scale (MA, 0–60 pts) and active ranges of motion. The robot aided training induced, independently by time of stroke, statistical significant improvements of kinesiologic (movement time, smoothness of motion) and clinical (4.6 ± 4.2 increase in FMA, 3.2 ± 2.1 decrease in MA) parameters, as a result of the increased active ranges of motion and improved co-contraction index for shoulder extension/flexion. Kinesiologic parameters correlated significantly with clinical assessment values, and their changes after the training were affected by the direction of motion (inward vs. outward movement) and position of target to be reached (ipsilateral, central and contralateral peripersonal space). These changes can be explained as a result of the motor recovery induced by the robotic training, in terms of regained ability to execute single joint movements and of improved interjoint coordination of

The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

PubMed

Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

2017-04-27

The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety

In silico models for predicting ready biodegradability under REACH: a comparative study.

PubMed

Pizzo, Fabiola; Lombardo, Anna; Manganaro, Alberto; Benfenati, Emilio

2013-10-01

REACH (Registration Evaluation Authorization and restriction of Chemicals) legislation is a new European law which aims to raise the human protection level and environmental health. Under REACH all chemicals manufactured or imported for more than one ton per year must be evaluated for their ready biodegradability. Ready biodegradability is also used as a screening test for persistent, bioaccumulative and toxic (PBT) substances. REACH encourages the use of non-testing methods such as QSAR (quantitative structure-activity relationship) models in order to save money and time and to reduce the number of animals used for scientific purposes. Some QSAR models are available for predicting ready biodegradability. We used a dataset of 722 compounds to test four models: VEGA, TOPKAT, BIOWIN 5 and 6 and START and compared their performance on the basis of the following parameters: accuracy, sensitivity, specificity and Matthew's correlation coefficient (MCC). Performance was analyzed from different points of view. The first calculation was done on the whole dataset and VEGA and TOPKAT gave the best accuracy (88% and 87% respectively). Then we considered the compounds inside and outside the training set: BIOWIN 6 and 5 gave the best results for accuracy (81%) outside training set. Another analysis examined the applicability domain (AD). VEGA had the highest value for compounds inside the AD for all the parameters taken into account. Finally, compounds outside the training set and in the AD of the models were considered to assess predictive ability. VEGA gave the best accuracy results (99%) for this group of chemicals. Generally, START model gave poor results. Since BIOWIN, TOPKAT and VEGA models performed well, they may be used to predict ready biodegradability. Copyright © 2013 Elsevier B.V. All rights reserved.

"El Alfabetismo Y Las Familias Latinas": A Critical Perspective on the Literacy Values and Practices of Latino Families with Young Children

ERIC Educational Resources Information Center

Billings, Elsa S.

2009-01-01

This study investigated literacy values and practices among Latino families with preschool-age children. Results are part of a larger study that looked at the efficacy of a pediatric-based early literacy promotion program called Reach Out and Read (ROR). Participants included families participating in a ROR program in which…

Motives of former interns in general practice for speciality-choice--results of a cross-sectional study among graduates 2007 to 2012.

PubMed

Abendroth, Jens; Schnell, Ute; Lichte, Thomas; Oemler, Matthias; Klement, Andreas

2014-01-01

The influence of a final-year elective internship in general practice (IGP) on motives affecting graduates' choice of specialty is the object of great public interest, yet still insufficiently evaluated. Longitudinal studies show the influence of numerous motives (e.g., work-life balance), but not following the IGP experience itself. Thus, we performed a cross-sectional questionnaire study of all graduates who completed the IGP in Saxony-Anhalt during 2007-2012 regarding their motives for choosing a speciality. A standardized questionnaire was sent to 109 former interns in general practice. The questionnaire contained 29 items addressing three topics (personal attitudes, concept of personal and professional life, motives for speciality choice) and used single-choice and multiple-choice answers, as well as Likert scales. Correlation analysis was carried out by means of Kendall's tau. The questionnaire reached 97 former interns, of which 45 (46%) responded. In the overall ranking of motives for speciality choice, family (71%), leisure time (66%) and job opportunities (48%) rated as more important than income (36%), mentoring (20%), status or scientific work (20%). Only 29% of the respondents stated that their speciality choice was changed by the IGP. If the speciality choice was already established before the IGP, the influence of the IGP on speciality choice was significantly low (r = -.5; p < .01). However, if the IGP had an influence on speciality choice, it was correlated with a new perception of general practice (r = .36; p<.01). This new perception was associated with a positive influence of the medical teacher during the IGP. The final-year IGP is an opportunity to change the perception of general practice in students who are still undecided. This can lead to different speciality choices in a subgroup. Personal attitudes and concepts of personal life and career were also important factors affecting speciality choice. The aspects of the positive influence

Faculty Promotion and Attrition: The Importance of Coauthor Network Reach at an Academic Medical Center.

PubMed

Warner, Erica T; Carapinha, René; Weber, Griffin M; Hill, Emorcia V; Reede, Joan Y

2016-01-01

Business literature has demonstrated the importance of networking and connections in career advancement. This is a little-studied area in academic medicine. To examine predictors of intra-organizational connections, as measured by network reach (the number of first- and second-degree coauthors), and their association with probability of promotion and attrition. Prospective cohort study between 2008 and 2012. Academic medical center. A total of 5787 Harvard Medical School (HMS) faculty with a rank of assistant professor or full-time instructor as of January 1, 2008. Using negative binomial models, multivariable-adjusted predictors of continuous network reach were assessed according to rank. Poisson regression was used to compute relative risk (RR) and 95 % confidence intervals (CI) for the association between network reach (in four categories) and two outcomes: promotion or attrition. Models were adjusted for demographic, professional and productivity metrics. Network reach was positively associated with number of first-, last- and middle-author publications and h-index. Among assistant professors, men and whites had greater network reach than women and underrepresented minorities (p < 0.001). Compared to those in the lowest category of network reach in 2008, instructors in the highest category were three times as likely to have been promoted to assistant professor by 2012 (RR: 3.16, 95 % CI: 2.60, 3.86; p-trend <0.001) after adjustment for covariates. Network reach was positively associated with promotion from assistant to associate professor (RR: 1.82, 95 % CI: 1.32, 2.50; p-trend <0.001). Those in the highest category of network reach in 2008 were 17 % less likely to have left HMS by 2012 (RR: 0.83, 95 % CI 0.70, 0.98) compared to those in the lowest category. These results demonstrate that coauthor network metrics can provide useful information for understanding faculty advancement and retention in academic medicine. They can and should be investigated at

The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

PubMed

Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

1998-07-01

birth center and $5,535 for the traditional care group. Final results based on the full study sample (full data available February 1998) details of payor costs such as provider, facility, NICU, and ancillary along with costs from the health care system perspective and patient satisfaction results will be presented.Conclusion: Current results suggest similar morbidity and mortality between the birth center program and traditional care groups, with less resource utilization translating to lower costs in the collaborative practice model. Results suggest that collaborative practice using a freestanding birth center as an adjunct to an integrated perinatal health care system may provide a quality, lower-cost alternative for the provision of perinatal services.

The VERB campaign's strategy for reaching African-American, Hispanic, Asian, and American Indian children and parents.

PubMed

Huhman, Marian; Berkowitz, Judy M; Wong, Faye L; Prosper, Erika; Gray, Michael; Prince, David; Yuen, Jeannie

2008-06-01

The VERB campaign promoted physical activity to U.S. children aged 9-13 years (tweens) by surrounding them with appealing messages that were associated with the VERB brand and tag line It's what you do! To maximize the impact of the campaign, VERB had a two-level strategy for its marketing. One level was designed to reach a general audience of tweens (i.e., most tweens who use mainstream media). The second level was designed specifically to reach four racial or ethnic audiences: African Americans, Hispanics, Asian Americans, and American Indians as an augmentation to the first level. This article focuses on VERB's market segmentation strategy and reports how messages for the general audience were adapted to reach specific racial or ethnic segments of the U.S. population. Findings are reported from qualitative studies conducted with tweens and the parents of tweens from these ethnic groups, and the marketing strategies used to reach each ethnic group and the results of evaluations of those strategies are also described.

Practice-audit-publish: A practice reflection.

PubMed

Ferrari, Robert

2016-12-01

Practice audits are useful opportunities to improve practice efficiency and effectiveness, reduce clinical errors, demonstrate quality care to stakeholders, promote high standards of practice, lower the risk of liability, and foster practice change. However, a benefit that is usually overlooked is the possibility of publication of the results of a practice audit. Publication (research) has a number of benefits for the clinician, including skill development as a scholar, communicator, professional, and collaborator. A practice audit is beneficial to an individual physician; furthermore, publication of the audit results could be beneficial for many others such as health care providers, patients, and other stakeholders in a health care system. The problem is that practice audits often begin without a clear plan. The important steps in planning and carrying out a practice audit can be captured by thinking about how a research publication evolves. Thus, a good researcher is a good practice auditor. This paper reviews the author's experience and provides examples and directions of the process of practice-audit-publish.

Practice-audit-publish: A practice reflection

PubMed Central

Ferrari, Robert

2016-01-01

Practice audits are useful opportunities to improve practice efficiency and effectiveness, reduce clinical errors, demonstrate quality care to stakeholders, promote high standards of practice, lower the risk of liability, and foster practice change. However, a benefit that is usually overlooked is the possibility of publication of the results of a practice audit. Publication (research) has a number of benefits for the clinician, including skill development as a scholar, communicator, professional, and collaborator. A practice audit is beneficial to an individual physician; furthermore, publication of the audit results could be beneficial for many others such as health care providers, patients, and other stakeholders in a health care system. The problem is that practice audits often begin without a clear plan. The important steps in planning and carrying out a practice audit can be captured by thinking about how a research publication evolves. Thus, a good researcher is a good practice auditor. This paper reviews the author’s experience and provides examples and directions of the process of practice-audit-publish. PMID:28149662

Reaching Year 12 in Victoria, Australia: Student and School Influences

ERIC Educational Resources Information Center

Marks, Gary

2014-01-01

This paper examines student and school influences on reaching Year 12, the final year of schooling in Victoria, Australia. It analyses data from the population of students who were in Year 9 in 2008. Male, English-speaking background, government school, and especially Indigenous students were less likely to reach Year 12 than comparison groups.…

Workforce characteristics of privately practicing nurse practitioners in Australia: Results from a national survey.

PubMed

Currie, Jane; Chiarella, Mary; Buckley, Thomas

2016-10-01

Australian private practice nurse practitioner (PPNP) services have grown since legislative changes in 2010 enabled eligible nurse practitioners (NPs) to access reimbursement for care delivered through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). This article provides data from a national survey on the workforce characteristics of PPNPs in Australia. PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. There were 73 completed surveys. One of the intentions of expanding access to MBS and PBS for patients treated by NPs was to increase patients' access to health care through greater flexibility in the healthcare workforce. The results of this survey confirm that the workforce characteristics of PPNPs provide a potentially untapped resource to meet current primary healthcare demand. The findings of this study allow us to understand the characteristics of PPNP services, which are significant for workforce planning. The focus of PPNP practice is toward primary health care with PPNPs working predominantly in general practice settings. The largest age group of PPNPs is over 50 years and means a proportion will be retiring in the next 15 years. ©2016 American Association of Nurse Practitioners.

Effects of land use types on surface water quality across an anthropogenic disturbance gradient in the upper reach of the Hun River, Northeast China.

PubMed

Wang, Ruizhao; Xu, Tianle; Yu, Lizhong; Zhu, Jiaojun; Li, Xiaoyu

2013-05-01

Surface water quality is vulnerable to pollution due to human activities. The upper reach of the Hun River is an important water source that supplies 52 % of the storage capacity of the Dahuofang Reservoir, the largest reservoir for drinking water in Northeast China, which is suffering from various human-induced changes in land use, including deforestation, reclamation/farming, urbanization and mine exploitation. To investigate the impacts of land use types on surface water quality across an anthropogenic disturbance gradient at a local scale, 11 physicochemical parameters (pH, dissolved oxygen [DO], turbidity, oxygen redox potential, conductivity, biochemical oxygen demand [BOD5], chemical oxygen demand [COD], total nitrogen [TN], total phosphorus [TP], NO(3)(-)N, and NH(4)(+)-N) of water from 12 sampling sites along the upper reach of the Hun River were monitored monthly during 2009-2010. The sampling sites were classified into four groups (natural, near-natural, more disturbed, and seriously disturbed). The water quality exhibited distinct spatial and temporal characteristics; conductivity, TN, and NO(3)(-)-N were identified as key parameters indicating the water quality variance. The forest and farmland cover types played significant roles in determining the surface water quality during the low-flow, high-flow, and mean-flow periods based on the results of a stepwise linear regression. These results may provide incentive for the local government to consider sustainable land use practices for water conservation.

Magnitude and extent of flooding at selected river reaches in western Washington, January 2009

USGS Publications Warehouse

Mastin, M.C.; Gendaszek, A.S.; Barnas, C.R.

2010-01-01

A narrow plume of warm, moist tropical air produced prolonged precipitation and melted snow in low-to-mid elevations throughout western Washington in January 2009. As a result, peak-of-record discharges occurred at many long-term streamflow-gaging stations in the region. A disaster was declared by the President for eight counties in Washington State and by May 2009, aid payments by the Federal Emergency Management Agency (FEMA) had exceeded $17 million. In an effort to document the flood and to obtain flood information that could be compared with simulated flood extents that are commonly prepared in conjunction with flood insurance studies by FEMA, eight stream reaches totaling 32.6 miles were selected by FEMA for inundation mapping. The U.S. Geological Survey?s Washington Water Science Center used a survey-grade global positioning system (GPS) the following summer to survey high-water marks (HWMs) left by the January 2009 flood at these reaches. A Google Maps (copyright) application was developed to display all HWM data on an interactive mapping tool on the project?s web site soon after the data were collected. Water-surface profiles and maps that display the area and depth of inundation were produced through a geographic information system (GIS) analysis that combined surveyed HWM elevations with Light Detection and Ranging (LiDAR)-derived digital elevation models of the study reaches and surrounding terrain. In several of the reaches, floods were well confined in their flood plains and were relatively straightforward to map. More common, however, were reaches with more complicated hydraulic geometries where widespread flooding resulted in flows that separated from the main channel. These proved to be more difficult to map, required subjective hydrologic judgment, and relied on supplementary information, such as aerial photographs and descriptions of the flooding from local landowners and government officials to obtain the best estimates of the extent of flooding.

Laterality effects in motor learning by mental practice in right-handers.

PubMed

Gentili, R J; Papaxanthis, C

2015-06-25

Converging evidences suggest that mental movement simulation and actual movement production share similar neurocognitive and learning processes. Although a large body of data is available in the literature regarding mental states involving the dominant arm, examinations for the nondominant arm are sparse. Does mental training, through motor-imagery practice, with the dominant arm or the nondominant arm is equally efficient for motor learning? In the current study, we investigated laterality effects in motor learning by motor-imagery practice. Four groups of right-hander adults mentally and physically performed as fast and accurately as possible (speed/accuracy trade-off paradigm) successive reaching movements with their dominant or nondominant arm (physical-training-dominant-arm, mental-training-dominant-arm, physical-training-nondominant-arm, and mental-training-nondominant-arm groups). Movement time was recorded and analyzed before, during, and after the training sessions. We found that physical and mental practice had a positive effect on the motor performance (i.e., decrease in movement time) of both arms through similar learning process (i.e., similar exponential learning curves). However, movement time reduction in the posttest session was significantly higher after physical practice than motor-imagery practice for both arms. More importantly, motor-imagery practice with the dominant arm resulted in larger and more robust improvements in movement speed compared to motor-imagery practice with the nondominant arm. No such improvements were observed in the control group. Our results suggest a superiority of the dominant arm in motor learning by mental practice. We discussed these findings from the perspective of the internal models theory. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Adherence to best practice consensus guidelines for implant-based breast reconstruction: Results from the iBRA national practice questionnaire survey.

PubMed

Mylvaganam, Senthurun; Conroy, Elizabeth J; Williamson, Paula R; Barnes, Nicola L P; Cutress, Ramsey I; Gardiner, Matthew D; Jain, Abhilash; Skillman, Joanna M; Thrush, Steven; Whisker, Lisa J; Blazeby, Jane M; Potter, Shelley; Holcombe, Christopher

2018-05-01

The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study. A questionnaire developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Simple summary statistics were calculated for each survey item to assess compliance with current best-practice guidelines. 81 units from 79 NHS Trusts completed the questionnaire. Marked variation was observed in adherence to guidelines, especially those relating to clinical governance and infection prevention strategies. Less than half (n = 28, 47%) of units obtained local clinical governance board approval prior to offering new mesh-based techniques and prospective audit of the clinical, cosmetic and patient-reported outcomes of surgery was infrequent. Most units screened for methicillin-resistant staphylococcus aureus prior to surgery but fewer than 1 in 3 screened for methicillin-sensitive strains. Laminar-flow theatres (recommended for IBBR) were not widely-available with less than 1 in 5 units having regular access. Peri-operative antibiotics were widely-used, but the type and duration were highly-variable. The iBRA national practice questionnaire has demonstrated variation in reported practice and adherence to IBBR guidelines. High-quality evidence is urgently required to inform best practice. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementation of study results in guidelines and adherence to guidelines in clinical practice

PubMed Central

Waldfahrer, Frank

2016-01-01

Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF). Since increasing digitalization has made access to scientific publications quicker and simpler, relevant study results can be incorporated in guidelines more easily today than in the analog world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:28025601

Dynamic push-pull characteristics at three hand-reach envelopes: applications for the workplace.

PubMed

Calé-Benzoor, Maya; Dickstein, Ruth; Arnon, Michal; Ayalon, Moshe

2016-01-01

Pushing and pulling are common tasks in the workplace. Overexertion injuries related to manual pushing and pulling are often observed, and therefore the understanding of work capacity is important for efficient and safe workstation design. The purpose of the present study was to describe workloads obtained during different reach envelopes during a seated push-pull task. Forty-five women performed an isokinetic push-pull sequence at two velocities. Strength, work and agonist/antagonist muscle ratio were calculated for the full range of motion (ROM). We then divided the ROM into three reach envelopes - neutral, medium, and maximum reach. The work capacity for each direction was determined and the reach envelope work data were compared. Push capability was best at medium reach envelope and pulling was best at maximum reach envelope. Push/pull strength ratio was approximately 1. A recommendation was made to avoid strenuous push-pull tasks at neutral reach envelopes. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Infants' Knowledge of the Path that Animals Take to Reach a Goal

ERIC Educational Resources Information Center

Rakison, David H.; Cicchino, Jessica B.; Hahn, Erin R.

2007-01-01

Two experiments with the inductive generalization procedure tested whether 16- and 20-month-old infants understand that animals and not vehicles follow a rational path to reach a goal. Infants were tested with four different events and the model exemplar was either an animal or ambiguous block. Results showed that infants at 20 months of age, but…

Core Practices for Teaching History: The Results of a Delphi Panel Survey

ERIC Educational Resources Information Center

Fogo, Bradley

2014-01-01

Recent education literature and research has focused on identifying effective core teaching practices to inform and help shape teacher education and professional development. Although a rich literature on the teaching and learning of history has continued to develop over the past decade, core practice research has largely overlooked…

Evidence-practice gap for dental sealant application: results from a dental practice-based research network in Japan.

PubMed

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V

2016-12-01

The study aims were: (i) to examine dentist practice patterns regarding treatment recommendations for dental sealants; and (ii) to identify characteristics associated with this recommendation. The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (n = 282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface of a mandibular first molar were presented, portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants, and dentist, patient and practice characteristics. Responses were obtained from 189 dentists (response rate = 67%). In the hypothetical scenarios, dentists' recommendations for sealants for the 12-year-old patient varied from 16% to 26% across the three hypothetical clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants. Dentist practice patterns for sealant treatment recommendation show changes that are dependent on caries severity. The dentists' recommendations for sealants for the 12-year-old patient were low for all three selected scenarios, based on indications for sealants in the American Dental Association guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment. © 2016 FDI World Dental Federation.

Multimodal decoding and congruent sensory information enhance reaching performance in subjects with cervical spinal cord injury.

PubMed

Corbett, Elaine A; Sachs, Nicholas A; Körding, Konrad P; Perreault, Eric J

2014-01-01

Cervical spinal cord injury (SCI) paralyzes muscles of the hand and arm, making it difficult to perform activities of daily living. Restoring the ability to reach can dramatically improve quality of life for people with cervical SCI. Any reaching system requires a user interface to decode parameters of an intended reach, such as trajectory and target. A challenge in developing such decoders is that often few physiological signals related to the intended reach remain under voluntary control, especially in patients with high cervical injuries. Furthermore, the decoding problem changes when the user is controlling the motion of their limb, as opposed to an external device. The purpose of this study was to investigate the benefits of combining disparate signal sources to control reach in people with a range of impairments, and to consider the effect of two feedback approaches. Subjects with cervical SCI performed robot-assisted reaching, controlling trajectories with either shoulder electromyograms (EMGs) or EMGs combined with gaze. We then evaluated how reaching performance was influenced by task-related sensory feedback, testing the EMG-only decoder in two conditions. The first involved moving the arm with the robot, providing congruent sensory feedback through their remaining sense of proprioception. In the second, the subjects moved the robot without the arm attached, as in applications that control external devices. We found that the multimodal-decoding algorithm worked well for all subjects, enabling them to perform straight, accurate reaches. The inclusion of gaze information, used to estimate target location, was especially important for the most impaired subjects. In the absence of gaze information, congruent sensory feedback improved performance. These results highlight the importance of proprioceptive feedback, and suggest that multi-modal decoders are likely to be most beneficial for highly impaired subjects and in tasks where such feedback is unavailable.

Using Technology to Develop a High School Career Awareness Workshop: The REACH Program

ERIC Educational Resources Information Center

Friery, Kathleen; Nelson, J. Gordon

2004-01-01

This article describes a collaborative project between business and industry, local school systems and Jacksonville State University (Jacksonville, Alabama). This project resulted in a new education and business/industry partnership called Readiness Education for Achieving Career Heights (REACH). The Calhoun County Chamber of Commerce saw a need…

Governance implications of nanomaterials companies' inconsistent risk perceptions and safety practices

NASA Astrophysics Data System (ADS)

Engeman, Cassandra D.; Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D.; Satterfield, Terre A.; Holden, Patricia A.; Harthorn, Barbara Herr

2012-03-01

Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders' perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated "lack of information" as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders' reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

Reorganization of muscle synergies during multidirectional reaching in the horizontal plane with experimental muscle pain

PubMed Central

Muceli, Silvia; Falla, Deborah

2014-01-01

Muscle pain induces a complex reorganization of the motor strategy which cannot be fully explained by current theories. We tested the hypothesis that the neural control of muscles during reaching in the presence of nociceptive input is determined by a reorganization of muscle synergies with respect to control conditions. Muscle pain was induced by injection of hypertonic saline into the anterior deltoid muscle of eight men. Electromyographic (EMG) signals were recorded from 12 upper limb muscles as subjects performed a reaching task before (baseline) and after the injection of hypertonic (pain) saline, and after the pain sensation vanished. The EMG envelopes were factorized in muscle synergies, and activation signals extracted for each condition. Nociceptive stimulation resulted in a complex muscle reorganization without changes in the kinematic output. The anterior deltoid muscle activity decreased in all subjects while the changes in other muscles were subject specific. Three synergies sufficed to describe the EMG patterns in each condition, suggesting that reaching movements remain modular in the presence of experimental pain. Muscle reorganization in all subjects was accompanied by a change in the activation signals compatible with a change in the central drive to muscles. One, two or three synergies were shared between the baseline and painful conditions, depending on the subject. These results indicate that nociceptive stimulation may induce a reorganization of modular control in reaching. We speculate that such reorganization may be due to the recruitment of synergies specific to the painful condition. PMID:24453279

When Outcome Definition Determines the Result in Impact Evaluations: An Illustration Using the Swedish Work-Practice Programme

ERIC Educational Resources Information Center

Månsson, Jonas; Lundin, Christofer

2017-01-01

In this paper we investigate the effect of difference in outcome definitions on the result of impact evaluations. The Swedish workplace practice programme is evaluated, using matching methods. The key findings are that changing how the outcome is defined has a considerable influence on the results of the impact assessment. From the results of this…

Decoding Grasping Movements from the Parieto-Frontal Reaching Circuit in the Nonhuman Primate.

PubMed

Nelissen, Koen; Fiave, Prosper Agbesi; Vanduffel, Wim

2018-04-01

Prehension movements typically include a reaching phase, guiding the hand toward the object, and a grip phase, shaping the hand around it. The dominant view posits that these components rely upon largely independent parieto-frontal circuits: a dorso-medial circuit involved in reaching and a dorso-lateral circuit involved in grasping. However, mounting evidence suggests a more complex arrangement, with dorso-medial areas contributing to both reaching and grasping. To investigate the role of the dorso-medial reaching circuit in grasping, we trained monkeys to reach-and-grasp different objects in the dark and determined if hand configurations could be decoded from functional magnetic resonance imaging (MRI) responses obtained from the reaching and grasping circuits. Indicative of their established role in grasping, object-specific grasp decoding was found in anterior intraparietal (AIP) area, inferior parietal lobule area PFG and ventral premotor region F5 of the lateral grasping circuit, and primary motor cortex. Importantly, the medial reaching circuit also conveyed robust grasp-specific information, as evidenced by significant decoding in parietal reach regions (particular V6A) and dorsal premotor region F2. These data support the proposed role of dorso-medial "reach" regions in controlling aspects of grasping and demonstrate the value of complementing univariate with more sensitive multivariate analyses of functional MRI (fMRI) data in uncovering information coding in the brain.

Channel evolution under changing hydrological regimes in anabranching reaches downstream of the Three Gorges Dam

NASA Astrophysics Data System (ADS)

Han, Jianqiao; Zhang, Wei; Yuan, Jing; Fan, Yongyang

2018-03-01

Elucidating the influence of dams on fluvial processes can benefit river protection and basin management. Based on hydrological and topographical data, we analyzed channel evolution in anabranching reaches under changing hydrological regimes influenced by the Three Gorges Dam. The main conclusions are as follows: 1) the channels of specific anabranching reaches were defined as flood trend channels or low-flow trend channels according to the distribution of their flow characteristics. The anabranching reaches were classified as T1 or T2. The former is characterized by the correspondence between the flood trend and branch channels, and the latter is characterized by the correspondence between the flood trend and main channels; 2) on the basis of the new classification, the discrepant patterns of channel evolution seen in anabranching reaches were unified into a pattern that showed flood trend channels shrinking and low-flow trend channels expanding; 3) flood abatement and the increased duration of moderate flow discharges are the main factors that affect channel adjustments in anabranching reaches after dam construction; and 4) in the next few decades, the pattern of channel evolution will remain the same as that of the Three Gorges Dam operation. That is, the morphology will fully adapt to a flow with a low coefficient of variation. Our results are of interest in the management of the Yangtze River and other rivers influenced by dams.

Clarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior.

PubMed

Gevers, D W M; Kremers, S P J; de Vries, N K; van Assema, P

2014-08-01

Inconsistencies in measurements of food parenting practices continue to exist. Fundamental to this problem is the lack of clarity about what is understood by different concepts of food parenting practices. The purpose of this study was to clarify food parenting practice concepts related to snacking. A three round Delphi study among an international group of experts (n = 63) was conducted. In the first round, an open-ended survey was used to collect food parenting practice descriptions and concept labels associated with those practices. In the second round, participants were asked to match up descriptions with the appropriate concept labels. The third and final round allowed participants to reconsider how descriptions and concept labels were matched, taking into account the opinions expressed in round two. Round one produced 408 descriptions of food parenting practices and 110 different concept names. Round two started with 116 descriptions of food parenting practices and 20 concept names. On 40 descriptions, consensus regarding the underlying concept name was reached in round two. Of the remaining 76 descriptions, consensus on 47 descriptions regarding the underlying concept name was reached in round three. The present study supports the essential process of consensus development with respect to food parenting practices concepts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of underestimating the kinematics of trunk rotation on simultaneous reaching movements: predictions of a biomechanical model

PubMed Central

2013-01-01

Background Rotation of the torso while reaching produces torques (e.g., Coriolis torque) that deviate the arm from its planned trajectory. To ensure an accurate reaching movement, the brain may take these perturbing torques into account during movement planning or, alternatively, it may correct hand trajectory during movement execution. Irrespective of the process selected, it is expected that an underestimation of trunk rotation would likely induce inaccurate shoulder and elbow torques, resulting in hand deviation. Nonetheless, it is still undetermined to what extent a small error in the perception of trunk rotations, translating into an inappropriate selection of motor commands, would affect reaching accuracy. Methods To investigate, we adapted a biomechanical model (J Neurophysiol 89: 276-289, 2003) to predict the consequences of underestimating trunk rotations on right hand reaching movements performed during either clockwise or counter clockwise torso rotations. Results The results revealed that regardless of the degree to which the torso rotation was underestimated, the amplitude of hand deviation was much larger for counter clockwise rotations than for clockwise rotations. This was attributed to the fact that the Coriolis and centripetal joint torques were acting in the same direction during counter clockwise rotation yet in opposite directions during clockwise rotations, effectively cancelling each other out. Conclusions These findings suggest that in order to anticipate and compensate for the interaction torques generated during torso rotation while reaching, the brain must have an accurate prediction of torso rotation kinematics. The present study proposes that when designing upper limb prostheses controllers, adding a sensor to monitor trunk kinematics may improve prostheses control and performance. PMID:23758968

REACH: Real-Time Data Awareness in Multi-Spacecraft Missions

NASA Technical Reports Server (NTRS)

Maks, Lori; Coleman, Jason; Obenschain, Arthur F. (Technical Monitor)

2002-01-01

Missions have been proposed that will use multiple spacecraft to perform scientific or commercial tasks. Indeed, in the commercial world, some spacecraft constellations already exist. Aside from the technical challenges of constructing and flying these missions, there is also the financial challenge presented by the tradition model of the flight operations team (FOT) when it is applied to a constellation mission. Proposed constellation missions range in size from three spacecraft to more than 50. If the current ratio of three-to-five FOT personnel per spacecraft is maintained, the size of the FOT becomes cost prohibitive. The Advanced Architectures and Automation Branch at the Goddard Space Flight Center (GSFC Code 588) saw the potential to reduce the cost of these missions by creating new user interfaces to the ground system health-and-safety data. The goal is to enable a smaller FOT to remain aware and responsive to the increased amount of ground system information in a multi-spacecraft environment. Rather than abandon the tried and true, these interfaces were developed to run alongside existing ground system software to provide additional support to the FOT. These new user interfaces have been combined in a tool called REACH. REACH-the Real-time Evaluation and Analysis of Consolidated Health-is a software product that uses advanced visualization techniques to make spacecraft anomalies easy to spot, no matter how many spacecraft are in the constellation. REACH reads a real-time stream of data from the ground system and displays it to the FOT such that anomalies are easy to pick out and investigate. Data visualization has been used in ground system operations for many years. To provide a unique visualization tool, we developed a unique source of data to visualize: the REACH Health Model Engine. The Health Model Engine is rule-based software that receives real-time telemetry information and outputs "health" information related to the subsystems and spacecraft that

Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

PubMed Central

Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

2015-01-01

Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the

An Investigation of Software Scaffolds Supporting Modeling Practices

NASA Astrophysics Data System (ADS)

Fretz, Eric B.; Wu, Hsin-Kai; Zhang, Baohui; Davis, Elizabeth A.; Krajcik, Joseph S.; Soloway, Elliot

2002-08-01

Modeling of complex systems and phenomena is of value in science learning and is increasingly emphasised as an important component of science teaching and learning. Modeling engages learners in desired pedagogical activities. These activities include practices such as planning, building, testing, analysing, and critiquing. Designing realistic models is a difficult task. Computer environments allow the creation of dynamic and even more complex models. One way of bringing the design of models within reach is through the use of scaffolds. Scaffolds are intentional assistance provided to learners from a variety of sources, allowing them to complete tasks that would otherwise be out of reach. Currently, our understanding of how scaffolds in software tools assist learners is incomplete. In this paper the scaffolds designed into a dynamic modeling software tool called Model-It are assessed in terms of their ability to support learners' use of modeling practices. Four pairs of middle school students were video-taped as they used the modeling software for three hours, spread over a two week time frame. Detailed analysis of coded videotape transcripts provided evidence of the importance of scaffolds in supporting the use of modeling practices. Learners used a variety of modeling practices, the majority of which occurred in conjunction with scaffolds. The use of three tool scaffolds was assessed as directly as possible, and these scaffolds were seen to support a variety of modeling practices. An argument is made for the continued empirical validation of types and instances of tool scaffolds, and further investigation of the important role of teacher and peer scaffolding in the use of scaffolded tools.

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

Intrarater and interrater reliability of the Anteromedial Reach Test in healthy participants

PubMed Central

Bent, Nicholas P; Rushton, Alison B; Wright, Chris C; Petherick, Emma-Jane; Batt, Mark E

2014-01-01

Background The Anteromedial Reach Test is a performance-based outcome measure for evaluating dynamic knee stability in patients with anterior cruciate ligament injury. No previously published study has adequately evaluated intrarater or interrater reliability of the Anteromedial Reach Test, so the purpose of this study was to assess these measurement properties in healthy participants prior to their investigation in patients with anterior cruciate ligament injury. Methods Two raters (A and B) tested 39 healthy university staff and students (20 men, 19 women). For the intrarater reliability investigation, rater A tested participants on three separate test occasions (days 1, 2, and 3) at the same time of day. For the interrater reliability investigation, raters A and B independently tested participants on the same test occasion (day 3). Results There was no significant systematic bias between test occasions or raters. Values of the intraclass correlation coefficient (2,1) were 0.96 for intrarater reliability of both the dominant leg and nondominant leg and 0.97 (dominant leg) and 0.98 (nondominant leg) for interrater reliability. Values for the standard error of measurement were 1.46 (dominant leg) and 1.62 (nondominant leg) for the intrarater investigation, and 1.26 (dominant leg) and 1.04 (nondominant leg) for the interrater investigation. At the 90% confidence level, the minimum detectable change was 3.8% and the error in an individual’s score at a given point in time was ±2.7%. Conclusion The Anteromedial Reach Test demonstrated excellent intrarater and interrater reliability in healthy participants. This provides a basis for future investigation of the measurement properties of the Anteromedial Reach Test in patients with anterior cruciate ligament injury. PMID:24648776

Suspended-sediment trapping in the tidal reach of an estuarine tributary channel

USGS Publications Warehouse

Downing-Kunz, Maureen; Schoellhamer, David H.

2015-01-01

Evidence of decreasing sediment supply to estuaries and coastal oceans worldwide illustrates the need for accurate and updated estimates. In the San Francisco Estuary (Estuary), recent research suggests a decrease in supply from its largest tributaries, implying the increasing role of smaller, local tributaries in sediment supply to this estuary. Common techniques for estimating supply from tributaries are based on gages located above head of tide, which do not account for trapping processes within the tidal reach. We investigated the effect of a tidal reach on suspended-sediment discharge for Corte Madera Creek, a small tributary of the Estuary. Discharge of water (Q) and suspended-sediment (SSD) were observed for 3 years at two locations along the creek: upstream of tidal influence and at the mouth. Comparison of upstream and mouth gages showed nearly 50 % trapping of upstream SSD input within the tidal reach over this period. At the storm time scale, suspended-sediment trapping efficiency varied greatly (range −31 to 93 %); storms were classified as low- or high-yield based on upstream SSD. As upstream peak Q increased, high-yield storms exhibited significantly decreased trapping. Tidal conditions at the mouth—ebb duration and peak ebb velocity—during storms had a minor effect on sediment trapping, suggesting fluvial processes dominate. Comparison of characteristic fluvial and tidal discharges at the storm time scale demonstrated longitudinal differences in the regulating process for SSD. These results suggest that SSD from gages situated above head of tide overestimate sediment supply to the open waters beyond tributary mouths and thus trapping processes within the tidal reach should be considered.

Bedrock channel reaches morphology: examples from the Northern Marche Region (Italy)

NASA Astrophysics Data System (ADS)

Tiberi, V.; di Agostino, V.; Troiani, F.; Nesci, O.; Savelli, D.

2009-04-01

The Northern Marche rivers, on account of a significant variability of their catchment geology, geodynamics and geomorphology, can be regarded as excellent natural laboratories for the study of the morphology, dynamics and evolution of bedrock channel reaches. Hence a geomorphologic study has been carried on in order to map and describe -from qualitative and quantitative point of view- some bedrock channel types of this area, to detect morphological controls at different scales (from the local scale up to the catchment one), and to assess human perturbations on the drainage systems. The study is based on detailed field surveying concerning channel shape and dynamics, floodplain configurations, slope geomorphologic processes, bedrock structure and composition. In addiction, a good aero photograph documentation dating back to the 1955 allowed a reliable reconstruction of the main evolution trends of bedrock channel reaches in the latest past. In the reported rivers the bedrock channel reaches vary in length from a few tens to hundreds of meters, and alternate with alluvial and mixed bedrock-alluvial channel reaches. In many cases specific numerical relations among geometric parameters of bedrock channels have been discovered and some similarities in both morphology and dynamics of rock-cut channels with alluvial channel reaches have been pointed out. Specifically, with regard of their morphologic arrangement, geometric parameters, and flow dynamics several bedrock channels are quite similar to step pool channels found along gravelly channel reaches. Nonetheless, along a given segment of the hydrographical network where an individual alluvial-channel pattern (e.g. a wandering) is found both upstream and downstream a rock-cut channel reach, the occurrence of this latter (e.g. planar bedrock-floored channel) simply breaks the along-stream continuity of the alluvial-bed morphology.

International reach of tobacco marketing among young children.

PubMed

Borzekowski, Dina L G; Cohen, Joanna E

2013-10-01

Prosmoking messages, delivered through marketing and the media, can reach very young children and influence attitudes and behaviors around smoking. This study examined the reach of tobacco marketing to 5 and 6 year olds in 6 low- and middle-income countries. Researchers worked one-on-one with 5 and 6 year olds in Brazil, China, India, Nigeria, Pakistan, and Russia (N = 2423). The children were asked to match logos with pictures of products, including 8 logos for cigarette brands. Analyses examined, overall and by country, whether gender, age, location, household use of tobacco, and knowledge of media characters were associated with awareness of cigarette brand logos. Additional analyses considered the relationship between cigarette brand logo awareness and intentions to smoke. Overall, 68% of 5 and 6 year olds could identify at least 1 cigarette brand logo, ranging from 50% in Russia to 86% in China. Across countries, being slightly older and having someone in the household who used tobacco, were significantly associated with greater odds of being able to identify at least 1 cigarette brand logo. The majority of young children from low- and middle-income countries are familiar with cigarette brands. This study's findings suggest that more effective measures are needed to restrict the reach of tobacco marketing.

Effects of Resistance Training on the Sit-and-Reach Test in Elderly Women.

ERIC Educational Resources Information Center

Barbosa, Aline Rodrigues; Santarem Jose Maria; Filho, Wilson Jacob; Marucci, Maria de Fatima Nunes

2002-01-01

Examined the effects of a 10-week resistance training program on older women's flexibility (evaluated through the sit- and-reach test performed before and after the training program). Participants were compared to inactive older women. The training program resulted in significant increases in participants' flexibility, suggesting that weight…

Reach-Scale Channel Adjustments to Channel Network Geometry in Mountain Bedrock Streams

NASA Astrophysics Data System (ADS)

Plitzuweit, S. J.; Springer, G. S.

2008-12-01

Channel network geometry (CNG) is a critical determinant of hydrological response and may significantly affect incision processes within the Appalachian Plateau near Richwood, West Virginia. The Williams, Cherry, and Cranberry Rivers share drainage divides and their lower reaches flow atop resistant, quartz-rich sandstones. The lower two-thirds of the Cranberry and Williams Rivers display linear profiles atop the sandstones; whereas the Cherry is concave upwards atop the sandstones. Because lithologies and geological structures are similar among the watersheds, we tested whether differences in CNGs explain the profile shapes and reach-scale channel properties. Specifically, we quantified CNG by calculating reach- specific area-distance functions using DEMs. The area-distance functions were then converted into synthetic hydrographs to model hydrological responses. The Cherry River exhibits a classic dendritic drainage pattern, producing peaked hydrographs and low interval transit times. The Cranberry River displays a trellis-like drainage pattern, which produces attenuated hydrographs and high interval transit times. The upstream reaches of the Williams River have a dendritic drainage pattern, but the lower two-thirds of the watershed transitions into an elongated basin with trellis-like CNG. Reach gradients are steeper in the lower reaches of the Williams and Cranberry Rivers where hydrographs are attenuated. In contrast, peaked hydrographs within the Cherry River are associated with lower reach gradients despite resistant sandstone channel beds. Trellis-like CNG may restrict the ability of downstream reaches within the Williams and Cranberry Rivers to achieve the critical discharge needed to cause incision during floods (all other things being equal). If so, increased reach gradients may be hydraulic adjustments that compensate for comparatively low discharges. We are now applying the synthetic hydrographs to HEC-RAS flow models generated from field channel

Theorizing Collaborative Mathematics Teacher Learning in Communities of Practice

ERIC Educational Resources Information Center

Bannister, Nicole A.

2018-01-01

Persistent disconnects within and among education research, practice, and policy are limiting the reach of professional mathematics teacher communities, one of the most promising levers for humanizing mathematics teaching and learning in schools. An overarching goal of this commentary is to convince the field of mathematics education to broaden…

Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

PubMed

Klaess, Cynthia C; Jungquist, Carla R

2018-06-01

Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Update in outpatient general internal medicine: practice-changing evidence published in 2014.

PubMed

Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

2015-10-01

The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving the Slepton Reach through Cascade Decay at the LHC

NASA Astrophysics Data System (ADS)

Eckel, Jonathan; Su, Shufang; Shepherd, William

2011-10-01

LHC studies on the slepton sector have mostly been focused on direct slepton Drell-Yan pair production. We analyzed the case when the left-handed sleptons are lighter than winos and can appear in the on-shell decay of those particles. The invariant mass of the lepton pairs, Mll, from the neutralino decay has a distinctive triangle shape with a sharp cutoff. We discuss the utilization of the triangle shape in the Mll distribution to identify the slepton signal. We studied the trilepton signal and obtained the σxBR xacceptance that is needed for a 5 σ discovery as a function of the cutoff mass for the LHC with center of mass energy 14 TeV and 100 fb-1 integrated luminosity. Our results are model independent such that they could be applied to other models with similar decay topology. When applied to the MSSM case, it is found that with 30 (100) fb-1, the left-handed slepton mass of about 500 (600) GeV could be reached, which extends far beyond the slepton mass reach in the usual Drell-Yan study.

Influence of Pedagogical Supervisors' Practices and Perceptions on the Use of Results-Based Management

ERIC Educational Resources Information Center

April, Daniel; Bouchamma, Yamina

2017-01-01

In the province of Québec, Canada, school principals are obligated by law to ensure pedagogical supervision. This law, the Public Education Act (Government of Québec, 2017), also advocates a contractual Results-Based Management approach (RBM). We examined how the practices and perceptions of these supervisors influence the implementation of this…

What Is Evidence-Based Practice? Research-to-Results Brief. Publication #2007-14

ERIC Educational Resources Information Center

Metz, Allison J. R.; Espiritu, Rachele; Moore, Kristin A.

2007-01-01

This brief represents part 1 in a series on fostering the adoption of evidence-based practices in out-of-school time programs. The lag between discovering effective practices and using them "on the ground" can be unnecessarily long, sometimes taking 15 to 20 years! The purpose of this brief is to provide practitioners with a better understanding…

Dry Stream Reaches in Carbonate Terranes: Surface Indicators of Ground-Water Reservoirs

USGS Publications Warehouse

Brahana, J.V.; Hollyday, E.F.

1988-01-01

In areas where dry stream reaches occur, subsurface drainage successfully competes with surface drainage, and sheet-like dissolution openings have developed parallel to bedding creating the ground-water reservoir. Union Hollow in south-central Tennessee is the setting for a case study that illustrates the application of the dry stream reach technique. In this technique, dry stream reach identification is based on two types of readily acquired information: remotely sensed black and white infrared aerial photography; and surface reconnaissance of stream channel characteristics. Test drilling in Union Hollow subsequent to identification of the dry reach proved that a localized ground-water reservoir was present.

Male Body Practices.

PubMed

Lefkowich, Maya; Oliffe, John L; Hurd Clarke, Laura; Hannan-Leith, Madeline

2017-03-01

The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels "pitches," "purchases," and "performativities" were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. "Pitches" distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. "Purchases" refer to men's diverse buy-in to dominant discourses about acceptable male bodies and practices. "Performativities" chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men's diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field.

Male Body Practices

PubMed Central

Lefkowich, Maya; Oliffe, John L.; Hurd Clarke, Laura; Hannan-Leith, Madeline

2016-01-01

The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels “pitches,” “purchases,” and “performativities” were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. “Pitches” distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. “Purchases” refer to men’s diverse buy-in to dominant discourses about acceptable male bodies and practices. “Performativities” chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men’s diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field. PMID:27645513

A Community-Responsive Adaptation to Reach and Engage Latino Families Affected by Maternal Depression.

PubMed

Valdez, Carmen R; Ramirez Stege, Alyssa; Martinez, Elizabeth; D'Costa, Stephanie; Chavez, Thomas

2017-07-23

As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community. We describe a cultural adaptation framework that is responsive to the unique opportunities and challenges of identifying and recruiting vulnerable families through community partnerships, and of addressing the needs of families by incorporating multiple community perspectives. Specifically, we apply these principles to the cultural adaptation of an intervention originally developed for low-income African American and White families facing maternal depression. The new intervention, Fortalezas Familiares (Family Strengths), was targeted to Latino immigrant families whose mothers were in treatment for depression in mental health and primary care clinics. We conclude with key recommendations and directions for how family researchers and practitioners can design the cultural adaptation of interventions to be responsive to the practices, preferences, and needs of underserved communities, including families and service providers. © 2017 Family Process Institute.

Redesigning Schools to Reach Every Student with Excellent Teachers: Change Management--Key Theories to Consider when Extending Reach

ERIC Educational Resources Information Center

Barrett, Sharon Kebschull

2012-01-01

As schools, their teachers, and outside facilitators redesign jobs and incorporate technology to extend the reach of excellent teachers to more students and develop an Opportunity Culture for all, choosing the right school models is just one part of the task. The human experience--and experience in education--says that even perfect design will not…

Reaching to Throw Compared to Reaching to Place: A Comparison across Individuals with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Wilmut, Kate; Byrne, Maia; Barnett, Anna L.

2013-01-01

When picking up an object, adults show a longer deceleration phase when the onward action has a greater precision requirement. Tailoring action in this way is thought to need forward modelling in order to predict the consequences of movement. Some evidence suggests that young children also tailor reaching in this way; however, how this skill…

How Does Stroop Interference Change with Practice? A Reappraisal from the Musical Stroop Paradigm

ERIC Educational Resources Information Center

Grégoire, Laurent; Perruchet, Pierre; Poulin-Charronnat, Bénédicte

2015-01-01

Most earlier studies investigating the evolution of the Stroop effect with the amount of reading practice have reported data consistent with an inverted U-shaped curve, whereby the Stroop effect appears early during reading acquisition, reaches a peak after 2 or 3 years of practice, and then continuously decreases until adulthood. The downward…

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

Estimation of reach in peripersonal and extrapersonal space: a developmental view.

PubMed

Gabbard, Carl; Cordova, Alberto; Ammar, Diala

2007-01-01

This study explored the developmental nature of action processing via estimation of reach in peripersonal and extrapersonal space. Children 5 to 11 years of age and adults were tested for estimates of reach to targets presented randomly at seven midline locations. Target distances were scaled to the individual based on absolute maximum reach. While there was no difference between age groups for total error, a significant distinction emerged in reference to space. With children, significantly more error was exhibited in extrapersonal space; no difference was found with adults. The groups did not differ in peripersonal space; however, adults were substantially more accurate with extrapersonal targets. Furthermore, children displayed a greater tendency to overestimate. In essence, these data reveal a body-scaling problem in children in estimating reach in extrapersonal space. Future work should focus on possible developmental differences in use of visual information and state of confidence.

Has publication of the results of the ORACLE Children Study changed practice in the UK?

PubMed

Kenyon, S; Pike, K; Jones, D; Brocklehurst, P; Marlow, N; Salt, A; Taylor, D

2010-10-01

  To investigate whether publication of the results of the ORACLE Children's Study, a 7-year follow-up of the ORACLE trial, changed practice with regard to the routine prescription of antibiotics to women with preterm rupture of membranes or spontaneous preterm labour (intact membranes).   A comparative questionnaire survey of clinical practice in November 2007 (before publication) and March 2009 (after publication).   Lead obstetricians for labour wards of all maternity units in the UK.   Self-administered questionnaires requested information about the routine prescription of antibiotics to women with either preterm rupture of membranes or spontaneous preterm labour (intact membranes).   Change in practice for prescription of antibiotics.   The response rate was 166/214 (78%) in 2007 and 158/209 (76%) in 2009. In total, 120 maternity units responded on both occasions. For women with preterm rupture of membranes, 162/214 (98%) in 2007 and 151/158 (96%) in 2009 maternity units reported that they prescribed antibiotics, with the majority using erythromycin (98%). For women with spontaneous preterm labour (intact membranes), 35/166 (21%) in 2007 and 25/158 (16%) in 2009 maternity units reported that they routinely prescribed antibiotics. The findings from units who responded on both occasions are similar.   There has been little change in the reported prescription of antibiotics to women with either preterm rupture of membranes or spontaneous preterm labour following publication of the ORACLE Children's Study. This suggests that current practice may require updated guidance.

The landscape for diabetes education: results of the 2012 AADE National Diabetes Education Practice Survey.

PubMed

Martin, Annette Lenzi; Warren, Joshua P; Lipman, Ruth D

2013-01-01

The National Member Practice Survey (NPS) of the American Association of Diabetes Educators (AADE) is conducted biannually to describe the current diabetes education practice in the United States and identify trends, opportunities, and areas for improvement. The 2012 NPS contained 49 questions about diabetes education providers, patients, and programs. The survey, sent electronically to approximately 13,000 AADE members, was completed by 3644 members. Testing was completed using a significance level of .05 or 95% confidence. While nurses and dietitians continued to comprise the majority of diabetes educators in 2012, a significant increase from 2010 occurred in the respondents identified as pharmacists (5% vs. 4%). Individuals holding the certified diabetes educator (CDE) credential decreased slightly in 2012 from 2010. Practice settings for diabetes education increased significantly in 2012 versus 2010 for hospital outpatient/clinic (44% vs. 37%) and hospital inpatient (20% vs. 15%) settings. Prediabetes education was provided by 78% of respondents. Nearly 53% of educators indicated they devoted more than 4 hours per week to data entry, significantly higher than any other amount of time. Collection of clinical and behavioral outcomes increased significantly in 2012 from 2010. Results of the 2012 NPS provide evidence that the practice of diabetes education is continuing to adapt to evolving models of health care in the United States by expanding the mix of practitioners providing education, engaging in necessary system support activities, and broadening the range of patients seen to include individuals at risk of developing diabetes.

Encoding of Both Reaching and Grasping Kinematics in Dorsal and Ventral Premotor Cortices

PubMed Central

Best, Matthew D.

2017-01-01

Classically, it has been hypothesized that reach-to-grasp movements arise from two discrete parietofrontal cortical networks. As part of these networks, the dorsal premotor cortex (PMd) has been implicated in the control of reaching movements of the arm, whereas the ventral premotor cortex (PMv) has been associated with the control of grasping movements of the hand. Recent studies have shown that such a strict delineation of function along anatomical boundaries is unlikely, partly because reaching to different locations can alter distal hand kinematics and grasping different objects can affect kinematics of the proximal arm. Here, we used chronically implanted multielectrode arrays to record unit-spiking activity in both PMd and PMv simultaneously while rhesus macaques engaged in a reach-to-grasp task. Generalized linear models were used to predict the spiking activity of cells in both areas as a function of different kinematic parameters, as well as spike history. To account for the influence of reaching on hand kinematics and vice versa, we applied demixed principal components analysis to define kinematics synergies that maximized variance across either different object locations or grip types. We found that single cells in both PMd and PMv encode the kinematics of both reaching and grasping synergies, suggesting that this classical division of reach and grasp in PMd and PMv, respectively, does not accurately reflect the encoding preferences of cells in those areas. SIGNIFICANCE STATEMENT For reach-to-grasp movements, the dorsal premotor cortex (PMd) has been implicated in the control of reaching movements of the arm, whereas the ventral premotor cortex (PMv) has been associated with the control of grasping movements of the hand. We recorded unit-spiking activity in PMd and PMv simultaneously while macaques performed a reach-to-grasp task. We modeled the spiking activity of neurons as a function of kinematic parameters and spike history. We applied demixed

Geomorphic effects, flood power, and channel competence of a catastrophic flood in confined and unconfined reaches of the upper Lockyer valley, southeast Queensland, Australia

NASA Astrophysics Data System (ADS)

Thompson, Chris; Croke, Jacky

2013-09-01

Flooding is a persistent natural hazard, and even modest changes in future climate are believed to lead to large increases in flood magnitude. Previous studies of extreme floods have reported a range of geomorphic responses from negligible change to catastrophic channel change. This paper provides an assessment of the geomorphic effects of a rare, high magnitude event that occurred in the Lockyer valley, southeast Queensland in January 2011. The average return interval of the resulting flood was ~ 2000 years in the upper catchment and decreased to ~ 30 years downstream. A multitemporal LiDAR-derived DEM of Difference (DoD) is used to quantify morphological change in two study reaches with contrasting valley settings (confined and unconfined). Differences in geomorphic response between reaches are examined in the context of changes in flood power, channel competence and degree of valley confinement using a combination of one-dimensional (1-D) and two-dimensional (2-D) hydraulic modelling. Flood power peaked at 9800 W m- 2 along the confined reach and was 2-3 times lower along the unconfined reach. Results from the DoD confirm that the confined reach was net erosional, exporting ~ 287,000 m3 of sediment whilst the unconfined reach was net depositional gaining ~ 209,000 m3 of sediment, 70% of the amount exported from the upstream, confined reach. The major sources of eroded sediment in the confined reach were within channel benches and macrochannel banks resulting in a significant increase of channel width. In the unconfined reach, the benches and floodplains were the major loci for deposition, whilst the inner channel exhibited minor width increases. The presence of high stream power values, and resultant high erosion rates, within the confined reach is a function of the higher energy gradient of the steeper channel that is associated with knickpoint development. Dramatic differences in geomorphic responses were observed between the two adjacent reaches of

Reaching older people with PA delivered in football clubs: the reach, adoption and implementation characteristics of the Extra Time Programme.

PubMed

Parnell, Daniel; Pringle, Andy; McKenna, Jim; Zwolinsky, Stephen; Rutherford, Zoe; Hargreaves, Jackie; Trotter, Lizzie; Rigby, Michael; Richardson, David

2015-03-05

Older adults (OA) represent a core priority group for physical activity and Public Health policy. As a result, significant interest is placed on how to optimise adherence to interventions promoting these approaches. Extra Time (ET) is an example of a national programme of physical activity interventions delivered in professional football clubs for OA aged 55+ years. This paper aims to examine the outcomes from ET, and unpick the processes by which these outcomes were achieved. This paper represents a secondary analysis of data collected during the evaluation of ET. From the 985 OA reached by ET, n=486 adopted the programme and completed post-intervention surveys (typically 12 weeks). We also draw on interview data with 18 ET participants, and 7 staff who delivered the programme. Data were subject to thematic analysis to generate overarching and sub themes. Of the 486 participants, the majority 95%, (n= 462) were White British and 59.7% (n=290) were female. Most adopters (65.4%/n=318) had not participated in previous interventions in the host clubs. Social interaction was the most frequently reported benefit of participation (77.2%, n=375). While the reach of the club badge was important in letting people know about the programme, further work enhanced adoption and satisfaction. These factors included (i) listening to participants, (ii) delivering a flexible age-appropriate programme of diverse physical and social activities, (iii) offering activities which satisfy energy drives and needs for learning and (iv) extensive opportunities for social engagement. Findings emerging from this study indicate that physical activity and health interventions delivered through professional football clubs can be effective for engaging OA.

Useful properties of spinal circuits for learning and performing planar reaches

NASA Astrophysics Data System (ADS)

Tsianos, George A.; Goodner, Jared; Loeb, Gerald E.

2014-10-01

Objective. We developed a detailed model of the spinal circuitry plus musculoskeletal system (SC + MS) for the primate arm and investigated its role in sensorimotor control, learning and storing of movement repertoires. Approach. Recently developed models of spinal circuit connectivity, neurons and muscle force/energetics were integrated and in some cases refined to construct the most comprehensive model of the SC + MS to date. The SC + MS’s potential contributions to center-out reaching movement were assessed by employing an extremely simple model of the brain that issued only step commands. Main results. The SC + MS was able to generate physiological muscle dynamics underlying reaching across different directions, distances, speeds, and even in the midst of strong dynamic perturbations (i.e. viscous curl field). For each task, there were many different combinations of brain inputs that generated physiological performance. Natural patterns of recruitment and low metabolic cost emerged for about half of the learning trials when a purely kinematic cost function was used and for all of the trials when an estimate of metabolic energy consumption was added to the cost function. Solutions for different tasks could be interpolated to generate intermediate movement and the range over which interpolation was successful was consistent with experimental reports. Significance. This is the first demonstration that a realistic model of the SC + MS is capable of generating the required dynamics of center-out reaching. The interpolability observed is important for the feasibility of storing motor programs in memory rather than computing them from internal models of the musculoskeletal plant. Successful interpolation of command programs required them to have similar muscle recruitment patterns, which are thought by many to arise from hard-wired muscle synergies rather than learned as in our model system. These properties of the SC + MS along with its tendency to generate

[Obstacles perceived by nurses for evidence-based practice: a qualitative study].

PubMed

Sánchez-García, Inmaculada; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L

2013-01-01

To examine the obstacles perceived by nurses to implement an evidence-based clinical practice. A qualitative study through semi-structured interviews conducted in 2010-2011 including 11 nurses purposively selected from public hospitals and community centres in Jaén and Córdoba (Spain). A content analysis was performed, using Miles and Huberman as a reference and comprising the following steps: data reduction, data presentation, and data conclusion/verification. Data saturation was reached in these categories (obstacles). The obstacles perceived by nurses to introduce an evidence-based clinical practice (EBCP) were grouped into 3 major categories: obstacles related with professionals (routine-based practice, unwilling and stagnant attitudes, and lack of training in EBCP), obstacles related to the social context (reluctance from other professionals and from patients or families), and obstacles related to the organization (obsolete cultures that do not promote innovation in nursing care). This study highlights the persistence of various factors that hinder the use of research findings in clinical practice. The results underline the need to change the culture of healthcare organizations, to motivate professionals, and to break some of the resistance attitudes that hinder the implementation of evidence-based practice. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Control of aperture closure during reach-to-grasp movements in Parkinson's disease.

PubMed

Rand, M K; Smiley-Oyen, A L; Shimansky, Y P; Bloedel, J R; Stelmach, G E

2006-01-01

This study examined whether the pattern of coordination between arm-reaching toward an object (hand transport) and the initiation of aperture closure for grasping is different between PD patients and healthy individuals, and whether that pattern is affected by the necessity to quickly adjust the reach-to-grasp movement in response to an unexpected shift of target location. Subjects reached for and grasped a vertical dowel, the location of which was indicated by illuminating one of the three dowels placed on a horizontal plane. In control conditions, target location was fixed during the trial. In perturbation conditions, target location was shifted instantaneously by switching the illumination to a different dowel during the reach. The hand distance from the target at which the subject initiated aperture closure (aperture closure distance) was similar for both the control and perturbation conditions within each group of subjects. However, that distance was significantly closer to the target in the PD group than in the control group. The timing of aperture closure initiation varied considerably across the trials in both groups of subjects. In contrast, aperture closure distance was relatively invariant, suggesting that aperture closure initiation was determined by spatial parameters of arm kinematics rather than temporal parameters. The linear regression analysis of aperture closure distance showed that the distance was highly predictable based on the following three parameters: the amplitude of maximum grip aperture, hand velocity, and hand acceleration. This result implies that a control law, the arguments of which include the above parameters, governs the initiation of aperture closure. Further analysis revealed that the control law was very similar between the subject groups under each condition as well as between the control and perturbation conditions for each group. Consequently, the shorter aperture closure distance observed in PD patients apparently is a

The future of optometric practice? The results of a survey of optometrists and optometry students.

PubMed

Silverman, Morton W; Woodruff, Chris; Hardigan, Patrick C

2004-10-01

There is an apparent increase in the number of private optometry practices that are closing due to a lack of interested buyers. We examined some of the factors that influence the market for optometry practices in a survey of practicing optometrists and third- and fourth-year optometry students. Optometrists in six states, and students at four schools and colleges of optometry, completed a mailed or faxed survey regarding attitudes toward optometric practice, including fair/reasonable compensation for a new optometrist, the value of optometric practices, and preferred mode of practice on graduation. Doctors and students differed significantly in the amount of money they reported as fair/reasonable compensation for a recently graduated optometrist joining a practice. Comparing students to doctors in specific categories of compensation, students chose a higher fair/reasonable compensation compared to doctors. Students were more likely than doctors to choose >$70,000 as fair/reasonable compensation, while doctors were more likely than students to choose $40,000 to $69,000. Doctors tended to overvalue their practices for the purpose of selling the practice when using percentage of gross income as a valuation method. Students' choices for mode of practice changed dramatically from their ideal when taking their current financial situation into consideration. Students were more likely to choose corporate practice as their preferred practice mode when considering their current financial situation than when not restricted. There are many factors that affect the value and marketability of an optometric practice. In order to sell a practice, the owner must consider the effects of the needs and desires of recently graduated optometrists.