Science.gov

Sample records for reached practical results

  1. Teacher Evaluation in Practice: Implementing Chicago's REACH Students

    ERIC Educational Resources Information Center

    Sporte, Susan E.; Stevens, W. David; Healey, Kaleen; Jiang, Jennie; Hart, Holly

    2013-01-01

    This report focuses on the perceptions and experiences of teachers and administrators during the first year of REACH implementation, which was in many ways a particularly demanding year. These experiences can be helpful to Chicago Public Schools (CPS) and to other districts across the country as they work to restructure and transform teacher…

  2. 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…

  3. Global Reach and Local Practice: The Promise of MOOCs

    ERIC Educational Resources Information Center

    Godwin-Jones, Robert

    2014-01-01

    Robert Goodwin-Jones opens his discussion with the thought "If you want to attract attention to a new online course, the foolproof strategy today is to label it a MOOC, a massive open online course." The hype surrounding MOOCs has resulted in substantial interest--from the general public to university presidents--in online learning, as…

  4. How to Reach and Teach English Language Learners: Practical Strategies to Ensure Success

    ERIC Educational Resources Information Center

    Syrja, Rachel Carrillo

    2011-01-01

    This book provides practical strategies and tools for assessing and teaching even the most hard to reach English language learners across the content areas. Syrja offers educators the latest information on working with ELLs (including using formative assessments) and provides a wealth of classroom-tested models and measures. These tools have…

  5. Preparing Every Teacher to Reach English Learners: A Practical Guide for Teacher Educators

    ERIC Educational Resources Information Center

    Nutta, Joyce W., Ed.; Mokhtari, Kouider, Ed.; Strebel, Carine, Ed.

    2012-01-01

    "Preparing Every Teacher to Reach English Learners" presents a practical, flexible model for infusing English learner (EL) instruction into teacher education courses. The editors outline the key steps involved in this approach--winning faculty support, assessing needs, and developing capacity--and share strategies for avoiding pitfalls. The…

  6. Taking a Multi-pronged Approach to Expand the Reach of Climate Research Results

    NASA Astrophysics Data System (ADS)

    Hauser, R.; Unger, M.; Eastburn, T.; Rockwell, A.; Laursen, K. K.; National CenterAtmospheric Research

    2011-12-01

    Recognizing the importance of tailoring content to a variety of audiences, the National Center for Atmospheric Research (NCAR) takes a multi-pronged approach to expand the reach of climate research results. The center's communications and education and outreach teams leverage Web 1.0 and 2.0 functionality - Google searches, Twitter, Facebook, YouTube - as well as face-to-face interactions and traditional media outlets to ensure climate change messages effectively connect with multiple audiences. Key to these efforts, NCAR seeks to frame messages that emphasize cultural cognition, that is, in a manner that recognizes and resonates with different audiences' values and thus their identities. Among the basic communications approaches NCAR uses to engage the public are one-on-one interactions with the visiting public, which ranges from school children and tourists, to dignitaries and journalists. As an example, the NCAR Journalism Fellowship brings a competitively selected group of internatoinal journalists to NCAR. During a week-long visit and ongoing contact, journalists are provided with a close-up, nuanced view of the science and individuals working on the bigger-picture research that drives climate-related sound bites reported by the press. NCAR provides media training for its scientists, giving them tools and practice in effectively handling interviews for print, Web and radio outlets. The institution hosts public events like "Super Science Saturday," and NCAR staff participate in external activities such as school science fairs, community events and continuing education sessions. In addition to interactive displays that allow the public to "experience" science directly and informally, NCAR develops educational programs and curricula targeted to specific age groups and levels of expertise. We will explore the importance of analogies, images and anecdotes in explaining complicated subjects to such a varied set of audiences, and identify key concepts in simplifying

  7. Reaching out for patients: public relations and events with real results.

    PubMed

    Kuechel, Marie Czenko

    2010-02-01

    In today's market, the aesthetic physician needs to connect with patients using methods that are personal, educational, and that will glean the interest of prospective patients whose attention and dollars are sought by countless facial plastic surgery competitors near and far. Public relations, or reaching your prospective patient without a direct solicitation (advertising) for services, are traditional means that include media relations and charitable and social events. With the added component of social media, today the opportunities to reach out for new patients and garner real results are more varied and more affordable than ever before.

  8. Promoting early literacy in pediatric practice: twenty years of reach out and read.

    PubMed

    Zuckerman, Barry

    2009-12-01

    Reach Out and Read (ROR) is the first pediatric, evidence-based strategy to prevent problems of early childhood development and learning. With a start in a single clinic in Boston City Hospital in 1989, doctors working in >4000 clinics and practices gave approximately 5.7 million new books to >3.5 million children in all 50 states in 2008. ROR also has become a model for a different way of thinking about parent education during primary care encounters, based less on telling and more on creating real-time learning experiences. ROR flourished because of (1) the growth of pediatric interest in child development, (2) local leadership of pediatric champions as well as nonmedical supporters, coordinators, and volunteers, (3) evidence of effectiveness, and (4) public financial support attributable to strong bipartisan support in Congress, led by Senator Edward Kennedy. Since ROR started, an increasing amount of research confirms the importance of reading aloud for the development of language and other emergent literacy skills, which in turn helps children get ready for school and leads to later success in reading. Future goals include continued growth until all low-income children are reached with pediatric advice and books, a national campaign led by physicians encouraging all parents to read to their children every day, additional evidence-based, parent information to increase the effectiveness of parents reading to children, quality-improvement efforts to achieve the full potential, and global expansion.

  9. Act on the Registration and Evaluation of Chemicals (K-REACH) and replacement, reduction or refinement best practices

    PubMed Central

    2016-01-01

    Objectives Korea’s Act on the Registration and Evaluation of Chemicals (K-REACH) was enacted for the protection of human health and the environment in 2015. Considering that about 2000 new substances are introduced annually across the globe, the extent of animal testing requirement could be overwhelming unless regulators and companies work proactively to institute and enforce global best practices to replace, reduce or refine animal use. In this review, the way to reduce the animal use for K-REACH is discussed. Methods Background of the enforcement of the K-REACH and its details was reviewed along with the papers and regulatory documents regarding the limitation of animal experiments and its alternatives in order to discuss the regulatory adoption of alternative tests. Results Depending on the tonnage of the chemical used, the data required ranges from acute and other short-term studies for a single exposure route to testing via multiple exposure routes and costly, longer-term studies such as a full two-generation reproducibility toxicity. The European Registration, Evaluation, Authorization and Restriction of Chemicals regulation provides for mandatory sharing of vertebrate test data to avoid unnecessary duplication of animal use and test costs, and obligation to revise data requirements and test guidelines “as soon as possible” after relevant, validated replacement, reduction or refinement (3R) methods become available. Furthermore, the Organization for Economic Cooperation and Development actively accepts alternative animal tests and 3R to chemical toxicity tests. Conclusions Alternative tests which are more ethical and efficient than animal experiments should be widely used to assess the toxicity of chemicals for K-REACH registration. The relevant regulatory agencies will have to make efforts to actively adopt and uptake new alternative tests and 3R to K-REACH. PMID:28118702

  10. A Practical Genome Scan for Population-Specific Strong Selective Sweeps That Have Reached Fixation

    PubMed Central

    Kimura, Ryosuke; Fujimoto, Akihiro; Tokunaga, Katsushi; Ohashi, Jun

    2007-01-01

    Phenotypic divergences between modern human populations have developed as a result of genetic adaptation to local environments over the past 100,000 years. To identify genes involved in population-specific phenotypes, it is necessary to detect signatures of recent positive selection in the human genome. Although detection of elongated linkage disequilibrium (LD) has been a powerful tool in the field of evolutionary genetics, current LD-based approaches are not applicable to already fixed loci. Here, we report a method of scanning for population-specific strong selective sweeps that have reached fixation. In this method, genome-wide SNP data is used to analyze differences in the haplotype frequency, nucleotide diversity, and LD between populations, using the ratio of haplotype homozygosity between populations. To estimate the detection power of the statistics used in this study, we performed computer simulations and found that these tests are relatively robust against the density of typed SNPs and demographic parameters if the advantageous allele has reached fixation. Therefore, we could determine the threshold for maintaining high detection power, regardless of SNP density and demographic history. When this method was applied to the HapMap data, it was able to identify the candidates of population-specific strong selective sweeps more efficiently than the outlier approach that depends on the empirical distribution. This study, confirming strong positive selection on genes previously reported to be associated with specific phenotypes, also identifies other candidates that are likely to contribute to phenotypic differences between human populations. PMID:17356696

  11. 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…

  12. 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.

  13. 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.

  14. Defining Best Practices in Boating, Fishing, and Stewardship Education: Challenges and Opportunities for Reaching Diverse Audiences.

    ERIC Educational Resources Information Center

    Floyd, Myron F.

    Minority groups encounter barriers to participation in boating and fishing and may not have equal access to these activities. Racial and ethnic influences on outdoor recreation participation are viewed from four theoretical perspectives. For each perspective, practices are presented that would remove or lessen socioeconomic barriers that constrain…

  15. 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…

  16. Reaching the Adult Learner: Teaching Information Technology Infrastructure Library (ITIL) to Practicing Technology Managers

    ERIC Educational Resources Information Center

    Adade, Anthony Kwasi

    2012-01-01

    A great deal has been written about adult learning in terms of approaches and strategies. However, very little has been published on best practices for teaching Information Technology Infrastructure Library ® (ITIL) certification course to IT professionals. This dearth of research, along with five years of experience teaching the course sparked my…

  17. Nitrate reduction by denitrifying anaerobic methane oxidizing microorganisms can reach a practically useful rate.

    PubMed

    Cai, Chen; Hu, Shihu; Guo, Jianhua; Shi, Ying; Xie, Guo-Jun; Yuan, Zhiguo

    2015-12-15

    Methane in biogas has been proposed to be an electron donor to facilitate complete nitrogen removal using denitrifying anaerobic methane oxidizing (DAMO) microorganisms in an anaerobic ammonium oxidation (anammox) reactor, by reducing the nitrate produced. However, the slow growth and the low activity of DAMO microorganisms cast a serious doubt about the practical usefulness of such a process. In this study, a previously established lab-scale membrane biofilm reactor (MBfR), with biofilms consisting of a coculture of DAMO and anammox microorganisms, was operated to answer if the DAMO reactor can achieve a nitrate reduction rate that can potentially be applied for wastewater treatment. Through progressively increasing nitrate and ammonium loading rates to the reactor, a nitrate removal rate of 684 ± 10 mg-N L(-1) d(-1) was achieved after 453 days of operation. This rate is, to our knowledge, by far the highest reported for DAMO reactors, and far exceeds what is predicted to be required for nitrate removal in a sidestream (5.6-135 mg-N L(-1) d(-1)) or mainstream anammox reactor (3.2-124 mg-N L(-1) d(-1)). Mass balance analysis showed that the nitrite produced by nitrate reduction was jointly reduced by anammox bacteria at a rate of 354 ± 3 mg-N L(-1) d(-1), accompanied by an ammonium removal rate of 268 ± 2 mg-N L(-1) d(-1), and DAMO bacteria at a rate of 330 ± 9 mg-N L(-1) d(-1). This study shows that the nitrate reduction rate achieved by the DAMO process can be high enough for removing nitrate produced by anammox process, which would enable complete nitrogen removal from wastewater.

  18. Cognitive and Kidney Function: Results from a British Birth Cohort Reaching Retirement Age

    PubMed Central

    Silverwood, Richard J.; Richards, Marcus; Pierce, Mary; Hardy, Rebecca; Sattar, Naveed; Ferro, Charles; Savage, Caroline; Kuh, Diana; Nitsch, Dorothea

    2014-01-01

    Background Previous studies have found associations between cognitive function and chronic kidney disease. We aimed to explore possible explanations for this association in the Medical Research Council National Survey of Health and Development, a prospective birth cohort representative of the general British population. Methods Cognitive function at age 60–64 years was quantified using five measures (verbal memory, letter search speed and accuracy, simple and choice reaction times) and glomerular filtration rate (eGFR) at the same age was estimated using cystatin C. The cross-sectional association between cognitive function and eGFR was adjusted for background confounding factors (socioeconomic position, educational attainment), prior cognition, and potential explanations for any remaining association (smoking, diabetes, hypertension, inflammation, obesity). Results Data on all the analysis variables were available for 1306–1320 study members (depending on cognitive measure). Verbal memory and simple and choice reaction times were strongly associated with eGFR. For example, the lowest quartile of verbal memory corresponded to a 4.1 (95% confidence interval 2.0, 6.2) ml/min/1.73 m2 lower eGFR relative to the highest quartile. Some of this association was explained by confounding due to socioeconomic factors, but very little of it by prior cognition. Smoking, diabetes, hypertension, inflammation and obesity explained some but not all of the remaining association. Conclusions These analyses support the notion of a shared pathophysiology of impaired cognitive and kidney function at older age, which precedes clinical disease. The implications of these findings for clinical care and research are important and under-recognised, though further confirmatory studies are required. PMID:24482683

  19. 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

  20. Infection control practice across Europe: results of the EPD.

    PubMed

    De Vos, J Y; Elseviers, M; Harrington, M; Zampieron, A; Vlaminck, H; Ormandy, P; Kafkia, T

    2006-01-01

    The European Practice Database (EPD) project, developed by the EDTNA/ERCA Research Board, collects data on renal practice at centre level in different European countries. Results presented in this paper focus on infection control practice in haemodialysis centres from 8 different European countries or regions following data collection from 2002 up to 2004. The prevalence of hepatitis B (HBV), hepatitis C (HCV), human immune deficiency (HIV) and methicillin-resistant staphylococcus Aureus (MRSA) was studied as well as the use of screening and preventive actions. These results will enable international comparison in practice and will stimulate further research and the development of new practice recommendations.

  1. 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

  2. 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…

  3. REACH Presentation.

    ERIC Educational Resources Information Center

    Bucklee, Joanne

    In an effort to provide support for employees and their families, Red Deer College (RDC) developed the Resources, Employees, Assistance, Counselling, and Health (REACH) program. The program is administered by a committee of five people who represent the five major employee groups at the college (i.e., senior administration, middle administration,…

  4. A Practical Method of Monitoring the Results of Health Care

    PubMed Central

    Daugharty, G. D.

    1979-01-01

    To meet our goal of improving health care through more productive use of the data we are collecting about the delivery of health care we need to define our concepts of health and quality. The WHO definition of health allows the design of useful functional outcome criteria which give us measurable standards for the outcome of the health care. By recording, retrieving, and reviewing pertinent information from the structure and the process of health care for a valid comparison with its outcome, the most effective and efficient health care is identified. A practical system is presented which identifies the better methods of management and produces the motivation for change that results in improved care. The successful use of this system in a private practice supports its universal adaptability for health care providers. The initial encouraging results suggest that future trials in other types of practices will be even more encouraging.

  5. 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.

  6. 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'…

  7. Professionally Responsible Disclosure of Genomic Sequencing Results in Pediatric Practice.

    PubMed

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

    2015-10-01

    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.

  8. Evaluation of the Effects of Chromium to Fall Chinook Salmon in the Hanford Reach of the Columbia River: Integration of Recent Toxicity Test Results

    SciTech Connect

    Dauble, Dennis D. ); Patton, Gregory W. ); Poston, Ted M. ); Peterson, Robert E. )

    2003-05-01

    The objective of this report was to summarize results of a series of recent laboratory studies conducted to evaluate the effects of chromium on chinook salmon. Individual studies focused on determining the relationship between exposure concentration and toxicological response for a range of life stages including fertilization, egg through swim-up (early life history), parr health, and avoidance-preference of juveniles. Study designs were representative of possible exposure scenarios in the Hanford Reach of the Columbia River.

  9. [Psychological care demand in clinical practice: treatment and results].

    PubMed

    Labrador, Francisco Javier; Estupiñá, Francisco José; García Vera, María Paz

    2010-11-01

    With the aim of describing the usual clinical context as opposed to the academic or research context, the characteristics of patients and psychological treatments applied in a sample of 856 patients from the Clinic of Psychology of the Complutense University is analyzed. The disorders that require attention, the characteristics of the therapists and their interventions are identified. Out of the total patients, 24.3% withdrew from treatment; 68.3% of the patients who started treatment completed it with therapeutic success. 83% of patients were assessed in 4 sessions or fewer (median=4). 75.3% of patients who finished the treatment received 18 or fewer treatment sessions (median=11). The generalization of the results and their implications for professional clinical practice and for training clinical psychologists are discussed.

  10. ';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

  11. [Eslicarbazepine acetate in clinical practice. Efficacy and safety results].

    PubMed

    Serrano-Castro, Pedro J; Payán-Ortiz, Manuel; Cimadevilla, José M; Quiroga-Subirana, Pablo; Fernández-Pérez, Javier

    2013-03-16

    INTRODUCTION. Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED) licensed in Spain in February 2011 as an adjunctive therapy in adults with partial seizures with or without secondary generalization. Clinical trials with ESL have demonstrated acceptable efficacy and safety. AIM. To evaluate the results of ESL in our epilepsy unit during its first year of clinical experience with this AED. PATIENTS AND METHODS. We included all patients who started treatment with ESL at our epilepsy unit from March 2011 to May 2012. We collected the following variables: gender, aetiology of epilepsy, epileptogenic area, reason for switch to ESL, clinical response after initiation of ESL, adverse effects of ESL, refractoriness criteria and treatment discontinuation. A bivariate factor-to-factor correlation study was carried out to establish associations between the independent variables and the clinical response. RESULTS. We recruited 105 patients (51.4% male). 20,7% of patients remained seizure-free and 58.4% showed > 50% improvement after introduction of ESL. At 6 months, 18.1% had experienced some type of side effect, with cognitive disorders being the most common, and 11.5% had discontinued treatment. Combination with lacosamide proved to be significantly less effective in the control of seizures. Combination of ESL with the rest of sodium channel inhibitors was similar in efficacy to others combinations. CONCLUSIONS. ESL is a well-tolerated and effective AED when is used as adjunctive treatment with most of other AED in clinical practice.

  12. 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.

  13. 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…

  14. 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.

  15. 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.

  16. Conducting Outreach to Transition-Aged Youth: Strategies for Reaching out to Youth with Disabilities, Their Families, and Agencies that Serve Them. Policy and Practice Brief

    ERIC Educational Resources Information Center

    Sheldon, James R., Jr.; Golden, Thomas P.

    2012-01-01

    The purpose of this policy and practice brief is to provide readers with a resource for planning outreach to transition-aged youth, their parents, and the service providers who work with them (i.e., the authors' "target group"). The authors will first provide a summary of the laws governing how three key agencies--school districts, state…

  17. EPA Reaches Settlement with Two N.H. Companies for Failure to Disclose Lead Paint Information or Follow Lead-Safe Work Practices at Residential Property in Manchester

    EPA Pesticide Factsheets

    The U.S. EPA finalized a settlement agreement with two N.H. companies for their alleged failure to follow lead-safe work practices and provide proper lead paint disclosure to tenants at a residential property in Manchester, N.H.

  18. CBOs: Reaching the Hardest to Reach.

    ERIC Educational Resources Information Center

    BCEL Newsletter for the Business Community, 1986

    1986-01-01

    The agents most successful in reaching and teaching those most in need of basic skills instruction are the community-based organizations (CBOs). They come into being in response to social and economic problems faced by their constituents--disadvantaged minorities, the poor, the unemployed, and the alienated. Because of their close ties to the…

  19. Increased Uptake of HCV Testing through a Community-Based Educational Intervention in Difficult-to-Reach People Who Inject Drugs: Results from the ANRS-AERLI Study

    PubMed Central

    Roux, Perrine; Rojas Castro, Daniela; Ndiaye, Khadim; Debrus, Marie; Protopopescu, Camélia; Le Gall, Jean-Marie; Haas, Aurélie; Mora, Marion; Spire, Bruno; Suzan-Monti, Marie; Carrieri, Patrizia

    2016-01-01

    Aims The community-based AERLI intervention provided training and education to people who inject drugs (PWID) about HIV and HCV transmission risk reduction, with a focus on drug injecting practices, other injection-related complications, and access to HIV and HCV testing and care. We hypothesized that in such a population where HCV prevalence is very high and where few know their HCV serostatus, AERLI would lead to increased HCV testing. Methods The national multisite intervention study ANRS-AERLI consisted in assessing the impact of an injection-centered face-to-face educational session offered in volunteer harm reduction (HR) centers (“with intervention”) compared with standard HR centers (“without intervention”). The study included 271 PWID interviewed on three occasions: enrolment, 6 and 12 months. Participants in the intervention group received at least one face-to-face educational session during the first 6 months. Measurements The primary outcome of this analysis was reporting to have been tested for HCV during the previous 6 months. Statistical analyses used a two-step Heckman approach to account for bias arising from the non-randomized clustering design. This approach identified factors associated with HCV testing during the previous 6 months. Findings Of the 271 participants, 127 and 144 were enrolled in the control and intervention groups, respectively. Of the latter, 113 received at least one educational session. For the present analysis, we selected 114 and 88 participants eligible for HCV testing in the control and intervention groups, respectively. In the intervention group, 44% of participants reported having being tested for HCV during the previous 6 months at enrolment and 85% at 6 months or 12 months. In the control group, these percentages were 51% at enrolment and 78% at 12 months. Multivariable analyses showed that participants who received at least one educational session during follow-up were more likely to report HCV testing

  20. Factors affecting outcomes in patients reaching end-stage kidney disease worldwide: differences in access to renal replacement therapy, modality use, and haemodialysis practices.

    PubMed

    Robinson, Bruce M; Akizawa, Tadao; Jager, Kitty J; Kerr, Peter G; Saran, Rajiv; Pisoni, Ronald L

    2016-07-16

    More than 2 million people worldwide are being treated for end-stage kidney disease (ESKD). This Series paper provides an overview of incidence, modality use (in-centre haemodialysis, home dialysis, or transplantation), and mortality for patients with ESKD based on national registry data. We also present data from an international cohort study to highlight differences in haemodialysis practices that affect survival and the experience of patients who rely on this therapy, which is both life-sustaining and profoundly disruptive to their quality of life. Data illustrate disparities in access to renal replacement therapy of any kind and in the use of transplantation or home dialysis, both of which are widely considered preferable to in-centre haemodialysis for many patients with ESKD in settings where infrastructure permits. For most patients with ESKD worldwide who are treated with in-centre haemodialysis, overall survival is poor, but longer in some Asian countries than elsewhere in the world, and longer in Europe than in the USA, although this gap has reduced. Commendable haemodialysis practice includes exceptionally high use of surgical vascular access in Japan and in some European countries, and the use of longer or more frequent dialysis sessions in some countries, allowing for more effective volume management. Mortality is especially high soon after ESKD onset, and improved preparation for ESKD is needed including alignment of decision making with the wishes of patients and families.

  1. 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

  2. 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

  3. Pediatric nurse practitioner salary and practice: results of a Midwest metropolitan area survey.

    PubMed

    Loman, Deborah G; Hung, Shu-Ling

    2007-01-01

    The St. Louis Association of Pediatric Nurse Practitioners has conducted a local biennial salary, practice, and benefits survey since the mid 1990s. This cross-sectional, descriptive study investigated demographic characteristics, salary, benefits, and practice patterns of pediatric nurse practitioners (PNPs) in the St. Louis area in fall, 2005. The survey was sent to 199 PNPs who lived within 100 miles of Saint Louis, with a return rate of 60%. The mean salary for full time PNPs engaged in practice was $72,788, which was a 6.3% increase from the 2003 survey results. PNPs with more years of experience received significantly higher salaries than those with less experience; however, there was no difference in salary based on type of practice (primary versus specialty care) or type of practice setting. Increasing numbers of PNPs are reporting their practice focus as specialty care (53%) rather than primary care (47%) in this region, with 70% of full time PNPs indicating specialty care. PNPs with less than 3 years experience were working equally in primary and specialty care. Practice challenges such as reimbursement and prescriptive issues were identified. Only 37% of PNPs indicated that they were credentialed by insurance plans. Nurse practitioners may find a local survey helpful as they negotiate changes in their salaries and benefits. Members of advance practice nursing organizations and educators may find the survey process useful as they observe local practice trends over time. It is essential that nursing education and continuing education conferences address the basic and continuing education needs of PNPs in both primary care and common specialty practices.

  4. Towards Harmonisation of Critical Laboratory Result Management - Review of the Literature and Survey of Australasian Practices

    PubMed Central

    Campbell, CA; Horvath, AR

    2012-01-01

    Timely release and communication of critical test results may have significant impact on medical decisions and subsequent patient outcomes. Laboratories therefore have an important responsibility and contribution to patient safety. Certification, accreditation and regulatory bodies also require that laboratories follow procedures to ensure patient safety, but there is limited guidance on best practices. In Australasia, no specific requirements exist in this area and critical result reporting practices have been demonstrated to be heterogeneous worldwide. Recognising the need for agreed standards and critical limits, the AACB started a quality initiative to harmonise critical result management throughout Australasia. The first step toward harmonisation is to understand current laboratory practices. Fifty eight Australasian laboratories responded to a survey and 36 laboratories shared their critical limits. Findings from this survey are compared to international practices reviewed in various surveys conducted elsewhere. For the successful operation of a critical result management system, critical tests and critical limits must be defined in collaboration with clinicians. Reporting procedures must include how critical results are identified; who can report and who can receive critical results; what is an acceptable timeframe within which results must be delivered or, if reporting fails, what escalation procedures should follow; what communication channels or systems should be used; what should be recorded and how; and how critical result procedures should be maintained and evaluated to assess impact on outcomes. In this paper we review the literature of current standards and recommendations for critical result management. Key elements of critical result reporting are discussed in view of the findings of various national surveys on existing laboratory practices, including data from our own survey in Australasia. Best practice recommendations are made that laboratories

  5. 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.

  6. 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?

  7. Statutory Reform is Associated with Improved Court Practice: Results of a Tri-State Comparison

    PubMed Central

    Moye, Jennifer; Wood, Erica; Edelstein, Barry; Wood, Stacey; Bower, Emily H.; Harrison, Julie A.; Armesto, Jorge C.

    2016-01-01

    Purpose This study investigates the impact of statutory reform in adult guardianship on court practice. Methods Case files for 298 cases of adult guardianship were reviewed in three states with varying degrees of statutory reform: MA (no reform), PA (major amendments in 1992), and CO (full re-enactment of statute per UGPPA in 2000). Five court practices associated with progressive statutory reform were studied: (1) diversion to less restrictive alternatives; (2) minimal and appropriate use of emergency procedures; (3) presence of the alleged incapacitated person at the hearing; (4) use of functional evaluation; (5) use of limited orders. Results CO more frequently utilized all five practices, whereas PA used diversion to less restrictive alternatives and less frequent emergency procedures, but not other practices. MA files rarely showed evidence for use of any of these reforms. Implications Statutory reform may improve court practice. More study of the effects of reform on court practices, and the vulnerable adults served by these courts, is needed. PMID:17506075

  8. 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

  9. 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.

  10. Some results and problems encountered in the practical implementation of a Shack-Fizeau interferometer

    NASA Astrophysics Data System (ADS)

    Garcia-Marquez, Jorge L.; Malacara-Hernandez, Daniel; Malacara-Doblado, Daniel

    1995-06-01

    A Shack-Fizeau interferometer has been designed and constructed to test concave conical telescope mirrors. Many interesting practical problems and results were found on the way. Some of these problems are, for example, the design of each optical element and the imaging of the interference pattern on the detector, etc. Here, we describe the design parameters with some detail.

  11. 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…

  12. Reaching for the Stars.

    ERIC Educational Resources Information Center

    Roper-Davis, Sharon

    1999-01-01

    Describes "Reaching for the Stars," a program which develops teaming and mentoring skills in senior physics students. Phase 1 requires student pairs to design a rocket; Phase 2 pairs seniors with gifted second graders who build the rocket from written instructions; and in Phase 3, pairs of seniors create a children's storybook explaining…

  13. 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…

  14. 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,…

  15. 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…

  16. 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…

  17. "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…

  18. A Standards-Based Professional Development Program and the Resulting Impact on Two Sixth Grade Teachers' Classroom Practices

    NASA Astrophysics Data System (ADS)

    Bereki, Debra Lynn

    In 2000, California introduced science content standards as part of an across the curriculum reform. This presented a special challenge for elementary teachers due to an increased emphasis on math and language arts, and limited science background and resources. This two year qualitative study looks at a professional development program that resulted from collaboration between a university and an elementary school district. The program brought sixth grade elementary teachers together with scientists (geologists) and a science educator to develop a quality sixth grade science curriculum aligned to the California content standards. This multiple-case embedded study included an analysis of how these standards were addressed during the program, and the impact of this professional development on two teachers' classroom practices. The results of this study indicate that the geologists and the science educator played different but complementary roles in the professional development program. Furthermore, the professional development disproportionately focused on the Earth science standards, and this correlated to a disproportionate focus on these standards in the classrooms of the two teachers studied. Finally, the results indicate that as these two teachers implemented their new science units, they progressed through the initial stages of teacher change as outlined by change models described in the literature. However, they did not reach the final stage of change that involves complete confidence in their knowledge and being satisfied with the implementation of their science units.

  19. How similar are the changes in neural activity resulting from mindfulness practice in contrast to spiritual practice?

    PubMed

    Barnby, Joseph M; Bailey, Neil W; Chambers, Richard; Fitzgerald, Paul B

    2015-11-01

    Meditation and spiritual practices are conceptually similar, eliciting similar subjective experiences, and both appear to provide similar benefits to the practicing individuals. However, no research has examined whether the mechanism of action leading to the beneficial effects is similar in both practices. This review examines the neuroimaging research that has focused on groups of meditating individuals, groups who engage in religious/spiritual practices, and research that has examined groups who perform both practices together, in an attempt to assess whether this may be the case. Differences in the balance of activity between the parietal and prefrontal cortical activation were found between the three groups. A relative prefrontal increase was reflective of mindfulness, which related to decreased anxiety and improved well-being. A relative decrease in activation of the parietal cortex, specifically the inferior parietal cortex, appears to be reflective of spiritual belief, whether within the context of meditation or not. Because mindful and spiritual practices differ in focus regarding the 'self' or 'other' (higher being), these observations about neurological components that reflect spirituality may continue work towards understanding how the definition of 'self' and 'other' is represented in the brain, and how this may be reflected in behaviour. Future research can begin to use cohorts of participants in mindfulness studies which are controlled for using the variable of spirituality to explicitly examine how functional and structural similarities and differences may arise.

  20. Translating research into practice: criteria for applying literature search results to your work.

    PubMed

    Foster, Margaret; Shurtz, Suzanne; Smith, Matthew Lee

    2014-03-01

    Evidence-based practices in the fields of health education and health promotion require evaluating the validity and reliability of relevant and timely research. Skills associated with effectively assessing and applying research findings are essential when researchers and practitioners are developing a new program, writing a grant, or completing a research project. This Tool outlines steps and resources with which health educators and health promotion specialists can critically appraise the literature before deciding to apply a concept or practice. It also includes descriptions of "levels of evidence" for determining level of academic rigor, and questions to guide critical appraisals of published literature and other resources for determining their relevance to the work at hand. Assessing the evidence involves two steps: synthesizing selected articles and then applying their content to a certain situation, population, or need. This Tool is intended to advance the profession by offering tips for assessing and applying the results of literature searches, which involves evaluating the quality of the articles and determining how to best put the research into practice.

  1. Proprioceptive Body Illusions Modulate the Visual Perception of Reaching Distance

    PubMed Central

    Petroni, Agustin; Carbajal, M. Julia; Sigman, Mariano

    2015-01-01

    The neurobiology of reaching has been extensively studied in human and non-human primates. However, the mechanisms that allow a subject to decide—without engaging in explicit action—whether an object is reachable are not fully understood. Some studies conclude that decisions near the reach limit depend on motor simulations of the reaching movement. Others have shown that the body schema plays a role in explicit and implicit distance estimation, especially after motor practice with a tool. In this study we evaluate the causal role of multisensory body representations in the perception of reachable space. We reasoned that if body schema is used to estimate reach, an illusion of the finger size induced by proprioceptive stimulation should propagate to the perception of reaching distances. To test this hypothesis we induced a proprioceptive illusion of extension or shrinkage of the right index finger while participants judged a series of LEDs as reachable or non-reachable without actual movement. Our results show that reach distance estimation depends on the illusory perceived size of the finger: illusory elongation produced a shift of reaching distance away from the body whereas illusory shrinkage produced the opposite effect. Combining these results with previous findings, we suggest that deciding if a target is reachable requires an integration of body inputs in high order multisensory parietal areas that engage in movement simulations through connections with frontal premotor areas. PMID:26110274

  2. 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.

  3. Impact of agricultural management practices on DOC leaching - results of a long-term lysimeter study

    NASA Astrophysics Data System (ADS)

    Wagner, A.; Ollesch, G.; Seeger, J.; Meißner, R.; Rode, M.

    2009-04-01

    Dissolved organic carbon (DOC) fluxes are recently increasing in surface waters of humid climate regions. Due to its substantial importance for leaching processes, aquatic foodwebs, and drinking water purification a better understanding of sources and pathways of DOC is needed. Therefore this study aims to analyse and simulate DOC fluxes in agricultural ecosystems with selected crop rotations. A data set of 24 lysimeters of the UFZ Lysimeter station at Falkenberg (Saxony-Anhalt) covering nine years of DOC investigation has been selected and examined. The data set covers a wide range of climatic conditions with deviating management practices for grasslands and agricultural crop rotations. The monthly DOC concentrations assessed in the leached water range from 2.4 to 34.1 mg /l. DOC concentrations depend on temperature, precipitation and discharge. The type of crop grown on the lysimeter is an important trigger for DOC leaching - especially lysimeters used as pasture, or planted with rape and carrots exhibit high DOC concentrations. Management practices and fertilizer application modify the leaching of DOC and offer potentials to reduce DOC losses. The results form the basis of further process simulation studies and upscaling of the results to the small catchment scale.

  4. Infants and adults reaching in the dark.

    PubMed

    Babinsky, Erin; Braddick, Oliver; Atkinson, Janette

    2012-03-01

    It has been shown that infants over the age of 6 months will reach for an object in complete darkness. This experiment measured the reaching movements of 9- to 16-month-old infants and adults under several different conditions of illumination to investigate the role of vision and stored visual representations in reach control. In one condition, participants reached for an object with the lights on. In a second condition, participants reached for an object glowing in the dark (glowing condition). This allowed us to measure the effects of vision of the arm and vision of the reach space. We also looked at the effect of removing vision of the object on reach control: in the final two conditions, participants reached for an object in complete darkness (0-s dark) and in complete darkness after a 4-s delay (4-s dark). We compared the kinematics of a reach (e.g. average speed, reach straightness) between the four illumination conditions. The results showed that infants reached faster and decelerated for a shorter period of time in the dark (0- and 4-s dark) than in the light. By comparison, adults reached slower and decelerated for a longer period of time in the dark (0- and 4-s dark) than in the light. We did not find any effect of the glowing condition compared to full vision on infant reaching movements. These results suggest that infant reaching movements only become compromised when the target is not visible, whereas vision of the hand and the reach space are less significant. Without online visual feedback, an infant reach in the dark appears to be driven by feedforward mechanisms and control may be affected by an immature ability to form and/or retain visual spatial memory.

  5. Europe reaches the Moon

    NASA Astrophysics Data System (ADS)

    2004-11-01

    A complex package of tests on new technologies was successfully performed during the cruise to the Moon, while the spacecraft was getting ready for the scientific investigations which will come next. These technologies pave the way for future planetary missions. SMART-1 reached its closest point to the lunar surface so far - its first ‘perilune’ - at an altitude of about 5000 kilometres at 18:48 Central European Time (CET) on 15 November. Just hours before that, at 06:24 CET, SMART-1’s solar-electric propulsion system (or ‘ion engine’) was started up and is now being fired for the delicate manoeuvre that will stabilise the spacecraft in lunar orbit. During this crucial phase, the engine will run almost continuously for the next four days, and then for a series of shorter burns, allowing SMART-1 to reach its final operational orbit by making ever-decreasing loops around the Moon. By about mid-January, SMART-1 will be orbiting the Moon at altitudes between 300 kilometres (over the lunar south pole) and 3000 kilometres (over the lunar north pole), beginning its scientific observations. The main purpose of the first part of the SMART-1 mission, concluding with the arrival at the Moon, was to demonstrate new spacecraft technologies. In particular, the solar-electric propulsion system was tested over a long spiralling trip to the Moon of more than 84 million kilometres. This is a distance comparable to an interplanetary cruise. For the first time ever, gravity-assist manoeuvres, which use the gravitational pull of the approaching Moon, were performed by an electrically-propelled spacecraft. The success of this test is important to the prospects for future interplanetary missions using ion engines. SMART-1 has demonstrated new techniques for eventually achieving autonomous spacecraft navigation. The OBAN experiment tested navigation software on ground computers to determine the exact position and velocity of the spacecraft using images of celestial objects taken

  6. Practice-Based Research Priorities for Palliative Care: Results From a Research-to-Practice Consensus Workshop.

    PubMed

    Pillemer, Karl; Chen, Emily K; Riffin, Catherine; Prigerson, Holly; Reid, M C

    2015-11-01

    We employed the research-to-practice consensus workshop (RTP; workshops held in New York City and Tompkins County, New York, in 2013) model to merge researcher and practitioner views of translational research priorities in palliative care. In the RTP approach, a diverse group of frontline providers generates a research agenda for palliative care in collaboration with researchers. We have presented the major workshop recommendations and contrasted the practice-based research priorities with those of previous consensus efforts. We uncovered notable differences and found that the RTP model can produce unique insights into research priorities. Integrating practitioner-identified needs into research priorities for palliative care can contribute to addressing palliative care more effectively as a public health issue.

  7. Control of a Shunt Active Power Filter with Neural Networks—Theory and Practical Results

    NASA Astrophysics Data System (ADS)

    Villalva, Marcelo G.; Filho, Ernesto Ruppert

    This paper presents theoretical studies and practical results obtained with a four-wire shunt active power filter fully controlled with neural networks. The paper is focused on a current compensation method based on adaptive linear elements (adalines), which are powerful and easy-to-use neural networks. The reader will find here an introduction about these networks, an explanatory section about the achievement of Fourier series with adalines, and the full description of an adaline-based selective current compensator. The paper also brings a quick discussion about the use of a feedforward neural network in the current controller of the active filter, as well as simulation and experimental results obtained with the prototype of an active power filter.

  8. Reaching Beyond The Stars

    NASA Astrophysics Data System (ADS)

    Baker, Mariah; Rosenthal, L.; Gaughan, A.; Hopkins, E.

    2014-01-01

    Strawbridge Observatory at Haverford College is home to a undergraduate-led public observing program. Our program holds ~once monthly public events throughout the academic year that take advantage of eyepiece observing on our 16-inch and 12-inch telescopes as well as of the classroom, library, and projection system. These resources allow us to organize a variety of astronomy related activities that are engaging for individuals of all ages: accessible student talks, current film screenings and even arts and crafts for the families who attend with young children. These events aim to spark curiosity in others about scientific discovery and about the remarkable nature of the world in which we live. In addition to exciting local families about astronomy, this program has excited Haverford students from a range of disciplines about both science and education. Being entirely student led means that we are able to take the initiative in planning, coordinating and running all events, fostering an atmosphere of collaboration, experimentation and commitment amongst our volunteers. Additionally, this program is one of the few at Haverford that regularly reaches beyond the campus walls to promote and build relationships with the outside community. In light of this, our program presents a distinctive and enlightening opportunity for student volunteers: we get to use our scientific backgrounds to educate a general audience, while also learning from them about how to communicate and inspire in others the excitement we feel about the subject of astronomy. The work on this project has been supported by NSF AST-1151462.

  9. Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices

    PubMed Central

    Begaud, Bernard; Lert, France; Rouillon, Frederic; Massol, Jacques; Guillemot, Didier; Avouac, Bernard; Duru, Gerard; Magnier, Anne-Marie; Rossignol, Michel; Abenhaim, Lucien

    2011-01-01

    Objective To assess the burden of diseases and quality of life (QOL) of patients for a large variety of diseases within general practice. Design In a representative nationwide cross-sectional study, a total of 825 general practitioners (GPs) were randomly selected from across France. Independent investigators recruited 8559 patients attending the GPs' practices. Data on QOL (12-Item Short Form questionnaire) and other individual characteristics were documented by the independent investigators for all participants in the waiting room. Medical information was recorded by GPs. Sampling was calibrated to national standards using the CALMAR (CALage sur MARges) weighting procedure. Associations of lower scores (ie, below vs above the first quartile) of physical and mental component scores (physical component summary score (PCS) and mental component summary score (MCS), respectively) with main diseases and patients characteristics were estimated using multivariate logistic regression. Weighted morbidity rates, PCS and MCS were computed for 100 diagnoses using the International Classification of Diseases (9th version). Results Overall mental impairment was observed among patients in primary care with an average MCS of 41.5 (SD 8.6), ranging from 33.0 for depressive disorders to 45.3 for patients exhibiting fractures or sprains. Musculoskeletal diseases were found to have the most pronounced effect on impaired physical health (OR=2.31; 95% CI 2.08 to 2.57) with the lowest PCS (45.6 (SD 8.8)) and ranked first (29.0%) among main diagnoses experienced by patients followed by cardiovascular diseases (26.7%) and psychological disorders (22.0%). When combining both prevalence and QOL, musculoskeletal diseases represented the heaviest burden in general practice. Conclusions Etude épidémiologique de l'Impact de santé public sur 3 groupes de pathologies (EPI3) is the first study to provide reference figures for burden of disease in general practice across a wide range of

  10. 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

  11. Information preferences and practices among people living with HIV/AIDS: results from a nationwide survey

    PubMed Central

    Hogan, Timothy P.; Palmer, Carole L.

    2005-01-01

    Objectives: This study was designed to reach many segments of the diverse HIV/AIDS community and broaden understanding of how information can better assist people living with HIV/AIDS. Methods: Data were collected through a self-administered mail survey distributed nationwide at clinics, drug treatment centers, and other AIDS service organizations. Results: The 662 respondents preferred getting information from people—including health professionals, family, and friends—and considered people the most trustworthy, useful, understandable, and available information sources. Forty-three percent selected doctors as their most preferred source. The Internet was not rated highly overall but was preferred by those with more education or living in metropolitan areas. Seventy-two percent said they actively search for HIV/AIDS-related information, and 80% said they give advice or tell others where to get such information. However, 71% agreed that it is easy to feel overwhelmed by information, and 31% agreed that not seeking information can be beneficial. Conclusions: Overall, information seeking is an important activity for this sample of people living with HIV/AIDS. Many sources are widely available to them but, together, can be overwhelming. They rely on health professionals far more than print or media sources and receive encouragement and support from family and friends. PMID:16239938

  12. Practices and perspectives on building integrated data repositories: results from a 2010 CTSA survey

    PubMed Central

    Wyatt, Matt C; Schuff, Robert; Tenenbaum, Jessica D; Anderson, Nick

    2012-01-01

    Clinical integrated data repositories (IDRs) are poised to become a foundational element of biomedical and translational research by providing the coordinated data sources necessary to conduct retrospective analytic research and to identify and recruit prospective research subjects. The Clinical and Translational Science Award (CTSA) consortium's Informatics IDR Group conducted a survey of 2010 consortium members to evaluate recent trends in IDR implementation and use to support research between 2008 and 2010. A web-based survey based in part on a prior 2008 survey was developed and deployed to 46 national CTSA centers. A total of 35 separate organizations completed the survey (74%), representing 28 CTSAs and the National Institutes of Health Clinical Center. Survey results suggest that individual organizations are progressing in their approaches to the development, management, and use of IDRs as a means to support a broad array of research. We describe the major trends and emerging practices below. PMID:22437072

  13. [New techniques in childbirth assistance. Experience and results of theoretical and practical training].

    PubMed

    Surico, N; Grimaldi, G

    2001-02-01

    In 1995, the Course on Integrated Obstetrical and Gynaecological Techniques was added to the training program of the Obstetrics and Gynaecology Clinic and to the Midwife Diploma School, at the Faculty of Medicine of the A. Avogadro University of East Piemonte. This addition was due to the demand to create a service to train young medical doctors and student midwives on the basis of the requirements of the World Health Organisation, concerning a more natural way of giving birth. In this paper the results obtained after a four years practical application of these clinical techniques are presented. The factors considered were the type of assistance offered in correlation with different outcomes for both mother and child. The study demonstrates a general improvement in the quality of assistance and a decrease of costs for the National Health Service. The data have been compared with those of the neighbour Hospital Division, where deliveries are assisted with traditional techniques.

  14. 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.

  15. An analysis of current pharmaceutical industry practices for making clinical trial results publicly accessible.

    PubMed

    Viereck, Christopher; Boudes, Pol

    2009-07-01

    We compared the clinical trial transparency practices of US/European pharma by analyzing the publicly-accessible clinical trial results databases of major drugs (doripenem, varenicline, lapatinib, zoledronic acid, adalimumab, insulin glargine, raltegravir, gefitinib). We evaluated their accessibility and utility from the perspective of the lay public. We included databases on company websites, http://www.clinicalstudyresults.org, http://www.clinicaltrials.gov and http://clinicaltrials.ifpma.org. Only 2 of 8 company homepages provide a direct link to the results. While the use of common terms on company search engines led to results for 5 of the 8 drugs following 2-4 clicks, no logical pathway was identified. The number of clinical trials in the databases was inconsistent: 0 for doripenem to 45 for insulin glargine. Results from all phases of clinical development were provided for 2 (insulin glargine and gefitinib) of the 8 drugs. Analyses of phase III reports revealed that most critical elements of the International Conference of Harmonization E3 Structure and Content of Synopses for Clinical Trial Reports were provided for 2 (varenicline, lapatinib) of the 8 drugs. For adalimumab and zoledronic acid, only citations were provided, which the lay public would be unable to access. None of the clinical trial reports was written in lay language. User-friendly support, when provided, was of marginal benefit. Only 1 of the databases (gefitinib) permitted the user to find the most recently updated reports. None of the glossaries included explanations for adverse events or statistical methodology. In conclusion, our study indicates that the public faces significant hurdles in finding and understanding clinical trial results databases.

  16. 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.

  17. 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…

  18. Practices that Support the Transition to Public Preschool Programs: Results from a National Survey

    ERIC Educational Resources Information Center

    Rous, Beth; Hallam, Rena; McCormick, Katherine; Cox, Megan

    2010-01-01

    The number of children participating in public school preschool programs has steadily increased over the last two decades. While the use of specific practices to support the transition to kindergarten has received a great deal of attention, there are little data on the use of transition practices by public school preschool teachers to support…

  19. Implementation Integrity of Practice-Based Coaching: Preliminary Results from the BEST in CLASS Efficacy Trial

    ERIC Educational Resources Information Center

    Sutherland, Kevin S.; Conroy, Maureen A.; Vo, Abigail; Ladwig, Crystal

    2015-01-01

    The purpose of this article is to describe the practice-based coaching model used in BEST in CLASS, a Tier-2 classroom-based intervention comprised of evidence-based instructional practices designed to prevent and ameliorate the chronic problem behaviors of young children at risk for the development of emotional/behavioral disorders. Following a…

  20. Credit for Prior Learning Practices: Results of the AACRAO December 2014 60 Second Survey

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2015

    2015-01-01

    The American Association of Collegiate Registrars and Admissions Officers (AACRAO) initiated a series of surveys designed to capture member institutional practice snapshots in 60 seconds or less. The December 2014 "AACRAO 60 Second Survey" asked respondents to indicate their institutions' credit for prior learning practices (CPL). To…

  1. Daylighting practices of the architectural industry (baseline results of a national survey)

    SciTech Connect

    Hattrup, M.P.

    1990-05-01

    A national survey of over 300 commercial design architects was conducted to develop baseline information on their knowledge, perceptions, and use of daylighting in commercial building designs. Pacific Northwest Laboratory conducted the survey for the US Department of Energy's (DOE) Office of Building and Community Systems (BCS). In the survey daylighting was defined as the intentional use of natural light as a partial substitute for artificially generated light. The results suggested that architects need to be educated about the true benefits of daylighting and the impacts it can have on a building's energy performance. Educational programs that will increase the architects' understanding and awareness of modern daylighting technologies and practices should be developed by utilities, stage agencies, and the federal government. If more architects can be made aware of the true effectiveness and positive attributes of daylighting systems and technologies, daylighting may be used in more commercial buildings. The results of the survey show that the more familiar architects feel they are with daylighting, the more they use daylighting. 3 refs., 19 tabs.

  2. Summarising and validating test accuracy results across multiple studies for use in clinical practice.

    PubMed

    Riley, Richard D; Ahmed, Ikhlaaq; Debray, Thomas P A; Willis, Brian H; Noordzij, J Pieter; Higgins, Julian P T; Deeks, Jonathan J

    2015-06-15

    Following a meta-analysis of test accuracy studies, the translation of summary results into clinical practice is potentially problematic. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of a test may differ substantially from the average meta-analysis findings, because of heterogeneity. Clinicians thus need more guidance: given the meta-analysis, is a test likely to be useful in new populations, and if so, how should test results inform the probability of existing disease (for a diagnostic test) or future adverse outcome (for a prognostic test)? We propose ways to address this. Firstly, following a meta-analysis, we suggest deriving prediction intervals and probability statements about the potential accuracy of a test in a new population. Secondly, we suggest strategies on how clinicians should derive post-test probabilities (PPV and NPV) in a new population based on existing meta-analysis results and propose a cross-validation approach for examining and comparing their calibration performance. Application is made to two clinical examples. In the first example, the joint probability that both sensitivity and specificity will be >80% in a new population is just 0.19, because of a low sensitivity. However, the summary PPV of 0.97 is high and calibrates well in new populations, with a probability of 0.78 that the true PPV will be at least 0.95. In the second example, post-test probabilities calibrate better when tailored to the prevalence in the new population, with cross-validation revealing a probability of 0.97 that the observed NPV will be within 10% of the predicted NPV.

  3. 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.

  4. [Results of a structural diagnosis of patients with chronic dyspnoea recruited from two cardiological practices].

    PubMed

    Ewert, R; Obst, A; Bahr, C; Weirich, C; Henschel, F; Rink, A

    2013-01-01

    While well validated algorithms exist for the diagnosis of patients with acute dyspnoea, such generally valid procedural instructions are lacking for patients with chronic dyspnoea. The diagnostic approach presented here is based on investigations of 246 patients with chronic dyspnoea recruited from two cardiological practices using a self-developed multi-level procedure. Besides anamnestic and clinical examinations, different diagnostic procedures, available in the ambulant range, are included. The results suggest that in over 50 % of the cases the cause of chronic dyspnoea can be determined from anamnestic and clinical examinations as well as from electrocardiogram and echocardiography. Additional inclusion of lung function and capillary blood gas analysis permitted a sufficient clarification in over 80 % of the cases. In a further step, cardiopulmonary exercise testing clarified the reasons for chronic dyspnoea in approximately 10 % of the remaining patients. Threshold values of lung function parameters as used for the differentiation of acute dyspnoea, do not seem suitable for the diagnosis of patients with chronic dyspnoea. By means of a simple step-wise diagnostic algorithm, applicable under ambulant conditions, the cause of chronic dyspnoea could sufficiently be clarified in more than 95 % of the cases.

  5. Pelvic floor complaints in gastroenterology practice: results of a survey in the netherlands

    PubMed Central

    Nicolai, Melianthe P J; Fidder, Herma H; Bekker, Milou D; Putter, Hein; Pelger, Rob C M; Elzevier, Henk W

    2012-01-01

    Objective The pelvic floor is an integrated structure; dysfunctions may lead to a wide range of symptoms, involving voiding, defecation and sexual functioning (SF). Functional symptoms such as constipation and lower abdominal pain are often caused by pelvic floor dysfunction (PFD), and they highly impact the quality of life. Multiple specialists are responsible for a specific part of the pelvic floor, but its treatment asks for a holistic approach. The authors are still unaware of gastroenterologists' knowledge on PFD or whether they are addressing pelvic floor complaints in their daily practice. Design A 42-itemed anonymous questionnaire was mailed to all 402 members of the Dutch Society of Gastroenterology (gastroenterologists and residents-in-training). Results 169 (42%) questionnaires were analysed. Most gastroenterologists address lower urinary tract symptoms in their history-taking, 92% in female patients and 84% in male patients. When patients indicate irritable bowel syndrome-like complaints, more than 60% of the physicians inquire about SF to their female patients, compared with 38% inquiries to male patients (p<0.001). A reason not to inquire about SF is a lack of knowledge about female and male sexuality (19% and 23%, respectively). Forty-six per cent of the respondents regard it rather important to receive more training on PFD in male patients versus 61% in female patients. Conclusion Awareness of PFD is not yet routinely integrated into the history taken by gastroenterologists. PMID:24124626

  6. Design considerations &practical results with long duration systems for manned flight: cryogenic helium and superpressure balloons.

    NASA Astrophysics Data System (ADS)

    Nott, J.

    The paper will describe two manned flights made in polyethylene zero pressure balloons with liquid helium carried to provide all in-flight buoyancy adjustment. These balloons were of 1,600 and 8,000 cubic meter volumes. Two flights have been made, both lasting 24 hours. The first flight cruised and flew through the sunset at 18,000 feet / 5,500 meters. The second flight using a pressurized cabin included flying through the night at about 32,000 feet / 10,000 meters. These flights highlight a wide range of theoretical and practical design concerns. For a craft carrying a crew, structural integrity and manageability &control in flight are naturally important. These flights demonstrated the complete feasibility of this system which will be described in detail. In addition the author constructed a 1,600 cubic meter pumpkin balloon used for a two day fight across Australia with a crew of two. Considerable problems were discovered during construction with distortion of the balloon. Although this work was done some time ago, the results have not been published in detail. The reason for publications at this time is that the work is very relevant to the problems recently encountered with the ULDB pumpkin design. The author, who is a physicist as well as a member of the Society of Experimental Test Pilots, was the principal desig ner as well as pilot of these craft. Ends...

  7. Levodopa therapy with entacapone in daily clinical practice: results of a post-marketing surveillance study.

    PubMed

    Kupsch, Andreas; Trottenberg, Thomas; Bremen, Dirk

    2004-01-01

    The catechol-O-methyl transferase inhibitor entacapone is given in combination with levodopa/dopa decarboxylase inhibitor for Parkinson's disease (PD) patients experiencing end-of-dose wearing-off. This 4-week post-marketing surveillance study was undertaken to assess patients' responses to levodopa combined with entacapone in a real clinical practice setting. Overall, 466 patients with idiopathic PD treated with levodopa and experiencing symptoms of wearing-off were recruited. Both physicians and patients recorded the response to therapy, including improvements and side-effects. Following initiation of entacapone treatment, the average daily levodopa dose was reduced from 510 to 453 mg. Physician assessment of entacapone efficacy was judged to be "very good" or "good" in 77.6% of the patients, and tolerability was considered to be "very good" or "good" in 92.4% of patients, with only 12 patients (2.6%) withdrawing from the study. Compared with baseline, there was a decrease in the mean duration of daily 'off' time from 3.0 to 1.3 h per day during the treatment period. Adverse events were in line with those previously reported, with diarrhoea being the most frequent event. The percentage of patients suffering from dyskinesia decreased from 46 to 34%, and of those patients still suffering from dyskinesia, the average daily duration of dyskinesia was reduced from 2.2 to 1.7 h. The use of adjunct dopamine agonists decreased from 67 to 59%. At study end, the percentage of patients who rated their quality of life (QoL) as "very good" or "good" increased from 12.1 to 51.7% and the percentage of patients who rated their QoL as "bad" or "very bad" decreased from 40 to 10.7%. In summary, the results of this survey conducted in real clinical practice support the findings of previous clinical trials demonstrating the efficacy and tolerability of entacapone, as well as the benefits of improved QoL, for patients achieved with entacapone.

  8. Instructional Practices in Introductory Geoscience Courses: Results of a National Faculty Survey

    NASA Astrophysics Data System (ADS)

    MacDonald, R.; Manduca, C. A.; Mogk, D. W.; Tewksbury, B. J.

    2004-12-01

    The NAGT professional development program "On the Cutting Edge" recently surveyed 7000 geoscience faculty in the United States to develop a snapshot of current instructional practices in undergraduate geoscience courses, faculty strategies for learning new content and new teaching approaches, and faculty involvement in the geoscience education community. Over 2200 faculty responded to the survey which was conducted by the American Institute of Physics. Results for introductory courses (814 responses) indicate that lecture is the most common teaching strategy used in courses of all sizes. Many faculty incorporate some interactive activities in their courses. Most commonly, they use questioning, demonstrations, discussions, and in-class exercises. Less common, but not rare, are small group discussion or think-pair-share and classroom debates or role-playing. Activities involving problem solving, using quantitative skills, working with data and primarily literature, and structured collaboration are incorporated by many faculty in introductory courses, suggesting efforts to teach the process of science. Activities in which students address a problem of national or local interest, analyze their own data, or address problems of their own design are less common but not rare. Field experiences are common but not ubiquitous for students in introductory courses. A wide variety of assessment strategies are used in introductory courses of all sizes, including exams, quizzes, problem sets, papers, oral presentations, and portfolios. While papers are used for assessment more extensively in small classes, a significant number of faculty use papers in large classes (greater than 81 students). A majority of faculty use rubrics in grading. Faculty report that in the past two years, approximately one-third have made changes in the content of their introductory courses while just under half have changed the teaching methods they use. While faculty learn about both new content and

  9. Bioactive maca (Lepidium meyenii) alkamides are a result of traditional Andean postharvest drying practices.

    PubMed

    Esparza, Eliana; Hadzich, Antonella; Kofer, Waltraud; Mithöfer, Axel; Cosio, Eric G

    2015-08-01

    Maca, Lepidium meyenii Walpers (Brassicaceae), is an annual herbaceous plant native to the high plateaus of the Peruvian central Andes. Its underground storage hypocotyls have been a traditional medicinal agent and dietary staple since pre-Columbian times. Reported properties include energizing and fertility-enhancing effects. Published reports have focused on the benzylalkamides (macamides) present in dry hypocotyls as one of the main bioactive components. Macamides are secondary amides formed by benzylamine and a fatty acid moiety, with varying hydrocarbon chain lengths and degree of unsaturation. Although it has been assumed that they are usually present in fresh undamaged tissues, analyses show them to be essentially absent from them. However, hypocotyls dried by traditional Andean postharvest practices or industrial oven drying contain up to 800μgg(-1) dry wt (2.3μmolg(-1) dry wt) of macamides. In this study, the generation of macamides and their putative precursors were studied during nine-week traditional drying trials at 4200m altitude and in ovens under laboratory conditions. Freeze-thaw cycles in the open field during drying result in tissue maceration and release of free fatty acids from storage and membrane lipids up to levels of 1200μgg(-1) dry wt (4.3μmolg(-1) dry wt). Endogenous metabolism of the isothiocyanates generated from glucosinolate hydrolysis during drying results in maximal benzylamine values of 4300μgg(-1) dry wt (40.2μmolg(-1) dry wt). Pearson correlation coefficients of the accumulation profiles of benzylamine and free fatty acid to that of macamides showed good values of 0.898 and 0.934, respectively, suggesting that both provide sufficient substrate for amide synthesis during the drying process.

  10. Oncolytic virotherapy reaches adolescence.

    PubMed

    Hammill, Adrienne M; Conner, Joseph; Cripe, Timothy P

    2010-12-15

    Lytic viruses kill cells as a consequence of their normal replication life cycle. The idea of harnessing viruses to kill cancer cells arose over a century ago, before viruses were even discovered, from medical case reports of infections associated with cancer remissions. Since then, there has been no shortage of hype, hope, or fear regarding the prospect of oncolytic virotherapy for cancer. Early developments in the field included encouraging antitumor efficacy both in animal studies in the 1920s-1940s and in human clinical trials in the 1950s-1970s. Despite its long-standing history, oncolytic virotherapy was an idea ahead of its time. Without needed advances in molecular biology, virology, immunology, and clinical research ethics, early clinical trials resulted in infectious complications and were fraught with controversial research conduct, so that enthusiasm in the medical community waned. Oncolytic virotherapy is now experiencing a major growth spurt, having sustained numerous laboratory advances and undergone multiple encouraging adult clinical trials, and is now witnessing the emergence of pediatric trials. Here we review the history and salient biology of the field, including preclinical and clinical data, with a special emphasis on those agents now being tested in pediatric cancer patients.

  11. Arctic Landscape Within Reach

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image, one of the first captured by NASA's Phoenix Mars Lander, shows flat ground strewn with tiny pebbles and marked by small-scale polygonal cracking, a pattern seen widely in Martian high latitudes and also observed in permafrost terrains on Earth. The polygonal cracking is believed to have resulted from seasonal contraction and expansion of surface ice.

    Phoenix touched down on the Red Planet at 4:53 p.m. Pacific Time (7:53 p.m. Eastern Time), May 25, 2008, in an arctic region called Vastitas Borealis, at 68 degrees north latitude, 234 degrees east longitude.

    This image was acquired at the Phoenix landing site by the Surface Stereo Imager on day 1 of the mission on the surface of Mars, or Sol 0, after the May 25, 2008, landing.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  12. [Frequency of congenital anomalies in cattle: results from the practice in comparison with literature].

    PubMed

    Bähr, C; Distl, O

    2005-04-01

    The study gives a short survey of the literature of frequently observed congenital anomalies in cattle and refers to data on cases of congenital anomalies registered in a veterinary practice over a period of 8 years and in an AI (artificial insemination) station of the Rinder-Union West (RUW) during 4 years. The frequency of congenital anomalies was estimated at 0.013% in the area of the RUW. In the veterinary practice a frequency of 0.51% was found. The most prevalent anomalies were seen in legs (39% in the veterinary practice and 21% in RUW) followed by congenital anomalies of the spine (9% in the veterinary practice and 17% in RUW). Arthrogryposes were most frequent among the anomalies of the legs with 65% (veterinary practice) and 39% (RUW), respectively, of all cases of registered leg anomalies in the respective area. Umbilical hernia and atresia of segments of the intestinum were seen in 8-30% of all registered cases. The frequency of congenital anomalies differed not significantly among paternal half sib groups. A questionnaire was proposed for the registration of congenital anomalies in progeny tests of AI bulls. A series of photographs showing the most prevalent congenital anomalies is supporting the registration form.

  13. News Outreach: Polish physics club reaches out with practical demonstrations Networking: Online workspace helps teachers to share ideas Mauritius: Telescope inspires science specification Fusion: EFDA sparks resources Olympiad: British team enjoys success at the International Physics Olympiad 2009 Nanoscience: 'Quietest' building in the world opens in Bristol, UK Conference: University of Leicester hosts the GIREP EPEC 2009 international conference

    NASA Astrophysics Data System (ADS)

    2009-11-01

    Outreach: Polish physics club reaches out with practical demonstrations Networking: Online workspace helps teachers to share ideas Mauritius: Telescope inspires science specification Fusion: EFDA sparks resources Olympiad: British team enjoys success at the International Physics Olympiad 2009 Nanoscience: 'Quietest' building in the world opens in Bristol, UK Conference: University of Leicester hosts the GIREP EPEC 2009 international conference

  14. College and University Dining Services Administrators' Intention to Adopt Sustainable Practices: Results from US Institutions

    ERIC Educational Resources Information Center

    Chen, Chao-Jung; Gregoire, Mary B.; Arendt, Susan; Shelley, Mack C.

    2011-01-01

    Purpose: The purpose of this paper is to examine college and university dining services administrators' (CUDSAs) intention to adopt sustainable practices. Design/methodology/approach: The theory of planned behavior (TPB) including constructs of subjective norm (SN), attitude, perceived behavior control, and personal norm (PN), formed the…

  15. FERPA Training Practices: Results of the AACRAO January 2016 60 Second Survey

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2016

    2016-01-01

    The January 2016 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" focused on institutional Family Educational Rights and Privacy Act (FERPA) training practices and measuring the level of interest in an AACRAO-developed online FERPA training module. The survey received 878 usable responses.…

  16. Distance Education Practices: Summary Results of the AACRAO February 2015 60 Second Survey

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2015

    2015-01-01

    The February 2015 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" asked respondents to identify whether or not their institution offers distance education, and if so, to answer additional questions about distance education course practices. The survey received 838 unique institutional…

  17. International Student Recruitment Practices. Summary Results of the AACRAO January 2015 60 Second Survey

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2015

    2015-01-01

    The January 2015 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" asked respondents to indicate their institutions' international student recruiting practices. As with other 60 Second Surveys, the survey was distributed through the FluidSurveys platform to all AACRAO members. After…

  18. Does Professional Development Change Teaching Practice? Results from a Three-Year Study.

    ERIC Educational Resources Information Center

    Porter, Andrew C.; Garet, Michael S.; Desimone, Laura; Yoon, Kwang Suk; Birman, Beatrice F.

    This report, the third in a series of reports from the longitudinal evaluation of the Eisenhower Professional Development Program, examines the effects of professional development on improving classroom teaching practice. The Eisenhower Professional Development Program, Title II of the Elementary and Secondary Education Act, is the federal…

  19. A collaborative accountable care model in three practices showed promising early results on costs and quality of care.

    PubMed

    Salmon, Richard B; Sanderson, Mark I; Walters, Barbara A; Kennedy, Karen; Flores, Robert C; Muney, Alan M

    2012-11-01

    Cigna's Collaborative Accountable Care initiative provides financial incentives to physician groups and integrated delivery systems to improve the quality and efficiency of care for patients in commercial open-access benefit plans. Registered nurses who serve as care coordinators employed by participating practices are a central feature of the initiative. They use patient-specific reports and practice performance reports provided by Cigna to improve care coordination, identify and close care gaps, and address other opportunities for quality improvement. We report interim quality and cost results for three geographically and structurally diverse provider practices in Arizona, New Hampshire, and Texas. Although not statistically significant, these early results revealed favorable trends in total medical costs and quality of care, suggesting that a shared-savings accountable care model and collaborative support from the payer can enable practices to take meaningful steps toward full accountability for care quality and efficiency.

  20. 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…

  1. A primer on selected aspects of evidence-based practice to questions of treatment. Part 2: interpreting results, application to clinical practice, and self-evaluation.

    PubMed

    Noteboom, J Timothy; Allison, Stephen C; Cleland, Joshua A; Whitman, Julie M

    2008-08-01

    The process of evidence-based practice (EBP) guides clinicians in the integration of individual clinical expertise, patient values and expectations, and the best available evidence. Becoming proficient with this process takes time and consistent practice, but should ultimately lead to improved patient outcomes. The EBP process entails 5 steps: (1) formulating an appropriate question, (2) performing an efficient literature search, (3) critically appraising the best available evidence, (4) applying the best evidence to clinical practice, and (5) assessing outcomes of care. This second commentary in a 2-part series will review principles relating to steps 3 through 5 of this 5-step model. The purpose of this commentary is to provide a perspective to assist clinicians in interpreting results, applying the evidence to patient care, and evaluating proficiency with EBP skills in studies of interventions for orthopaedic and sports physical therapy.

  2. New circuit theory of multiconductor transmission lines resulting from a new practice of noise reduction.

    PubMed

    Toki, Hiroshi; Sato, Kenji

    2014-01-01

    In modern life, we are surrounded by and filled with electromagnetic noise caused by the dominant use of energy in the form of electricity. This situation is brought about by the fact that the noise is not understood theoretically. A new practice of noise reduction was introduced for the construction of Heavy Ion Medical Accelerator in Chiba (HIMAC). The key concept is a symmetric three-line circuit that arranges power supplies, noise filters and magnets around a third central ground line. A continuous theoretical effort forced us to find a new circuit theory involving a multiconductor transmission-line system starting from Maxwell's equations without any approximation. We discuss the essence of all of these experimental and theoretical developments with the hope to remove unnecessary electromagnetic noise not only from power supplies, but also from all electric devices. The newly derived circuit theory of multiconductor transmission lines is universal, and establishes the validity of the practice of noise reduction.

  3. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students].

    PubMed

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori

    2016-01-01

    A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, "This health provider is professional", or "What a great person he/she is as a health provider". We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy-American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students).

  4. Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

    PubMed

    Farmer, Jane; Stimpson, Paul; Tucker, Janet

    2003-11-01

    There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

  5. Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

    PubMed Central

    Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

    2011-01-01

    More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

  6. 49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disclosed by the safety audit will result in a notice to a new entrant that its USDOT new entrant... MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.321 What failures of safety management practices disclosed by the safety audit will result in a...

  7. Alitretinoin and acitretin in severe chronic hand eczema; results from a retrospective daily practice study.

    PubMed

    Politiek, Klaziena; Christoffers, Wietske Andrea; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise Anna

    2016-09-01

    Acitretin has been used off-label for years to treat chronic hand eczema, but acitretin is less often prescribed as alitretinoïne was approved. This study evaluates both retinoids in a daily practice cohort of patients with severe chronic hand eczema in terms of drug survival and reasons for discontinuation. Patients using alitretinoin or acitretin between 01-01-1994 and 01-08-2015 were included in this retrospective daily practice study and analyzed by Kaplan-Meier drug survival curves. Potential determinants were analyzed by Cox regression analyses. Ninety-five patients were treated with alitretinoin and 109 patients with acitretin. The main reasons for discontinuation were adverse events and cleared hand eczema, 29.5 and 27.4% in alitretinoin versus 43.1 and 23.9% in acitretin. Patients with hyperkeratotic hand eczema had most often a good effect of treatment: 68.3% in alitretinoin and 50.7% in acitretin treatment. The drug survival rates of alitretinoin and acitretin after 12, 24, 36, and 52 weeks were 69.3, 45.1, 19.6, 7.0% and 74.3, 45.5, 33.8, 23.2%, respectively. Alitretinoin and acitretin are effective treatment options for patients with hand eczema. However, both treatments were more effective in patients with hyperkeratotic hand eczema. Fewer patients discontinued alitretinoin compared with acitretin due to adverse events.

  8. New circuit theory of multiconductor transmission lines resulting from a new practice of noise reduction

    PubMed Central

    TOKI, Hiroshi; SATO, Kenji

    2014-01-01

    In modern life, we are surrounded by and filled with electromagnetic noise caused by the dominant use of energy in the form of electricity. This situation is brought about by the fact that the noise is not understood theoretically. A new practice of noise reduction was introduced for the construction of Heavy Ion Medical Accelerator in Chiba (HIMAC). The key concept is a symmetric three-line circuit that arranges power supplies, noise filters and magnets around a third central ground line. A continuous theoretical effort forced us to find a new circuit theory involving a multiconductor transmission-line system starting from Maxwell’s equations without any approximation. We discuss the essence of all of these experimental and theoretical developments with the hope to remove unnecessary electromagnetic noise not only from power supplies, but also from all electric devices. The newly derived circuit theory of multiconductor transmission lines is universal, and establishes the validity of the practice of noise reduction. PMID:24522153

  9. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    PubMed

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

  10. Is it possible and worth keeping track of deaths within general practice? Results of a 15 year observational study

    PubMed Central

    Beaumont, B; Hurwitz, B

    2003-01-01

    Aim: To assess the value of maintaining a death register in a general practice with particular reference to monitoring quality of care. Design of study: Observational study. Setting: Inner London general practice. Method: The practice maintained a manual death register, retained medical records of all deceased patients, and requested information on cause of death from health authorities and coroners for 15 years. Main outcome measures: Number and causes of deaths; 3 yearly age standardised death rates; proportion of deaths formally notified to the practice; place of death; source of cause of death information. Results: During the study period 578 patients died. Practice age standardised death rates fell significantly from 35.59 to 27.12/1000. 498 (86.2%) deaths were formally notified to the practice, 392 within 7 days of death. Of 143 deaths reported to the coroner, only 45 coroners' reports were received. 360 (64.1%) died in hospital, 139 (24.8%) at home, and 38 (6.8%) in a hospice. Death certificate cause of death information was obtained from patients' records in 33.6% (n=194) of cases and from health authority sources for 50% (n=289). The pattern of ascertained causes of deaths was similar to the national pattern. Conclusion: A death register can examine trends in practice deaths by age and place of death and comparisons undertaken with nationally published mortality data. An accurate picture of cause of death cannot be generated from routine data flows alone. There is delay in informing GPs of patient deaths. Meaningful and timely monitoring of deaths cannot be undertaken by individual practices. National Statistics should provide routine analysis of GP death certificate information. PMID:14532364

  11. The effect of quality management practices on operational and business results in the petroleum industry in Iran

    NASA Astrophysics Data System (ADS)

    Mellat Parast, Mahour

    The trend toward globalization has challenged management thinking, organizational practices, and the ways companies interact with their customers and suppliers as well as with other segments of society. One such practice, Total Quality Management (TQM), has emerged as a management paradigm for enhancing organizational performance and profitability, to the extent that it has been regarded as "the second industrial revolution" (Kanji, 1990). Despite extensive research in quality management, little empirical research has been done on this in an international context, especially in the Middle East. This study attempts to investigate: (1) the relationship among quality management constructs based on the Malcolm Baldrige National Quality Award; and (2) the effect of quality management practices on operational and business results in the petroleum industry. A validated and reliable survey instrument was used for the study to collect data from 31 project managers/consultants in the petroleum industry in Iran. The results of the correlation analysis show that top management support is the major driver of quality management, which significantly correlates with other quality management practices. It was also found that customer orientation is not significantly correlated with external quality results (profitability). A regression analysis indicated top management support, employee training, and employee involvement as the three statistically significant variables in explaining the variability in internal quality results. Furthermore, it was found that internal quality results was statistically significant in explaining the variability of external quality results.

  12. 'Bolam' to 'Montgomery' is result of evolutionary change of medical practice towards 'patient-centred care'.

    PubMed

    Lee, Albert

    2017-01-01

    The Supreme Court judgement in 'Montgomery v Lanarkshire Health Board' has caused a change in the law concerning the duty of doctors on disclosure of information to patients regarding risks. The law now requires a doctor to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. Are doctors totally removed from the protective shield even if the practice is accepted by a reasonable body of medical opinion previously laid down by 'Bolam' with the recent Supreme Court decision in the 'Montgomery' case? This paper questions whether the 'Bolam' principle needs to be discarded or re-interpreted in the modern context of health care. Adopting 'patient-centred' care to unfold the 'significant risks' attached to patients would align with the evolving changes in medical law. It should be the changing context of health care driving the evolving change of law.

  13. Complementary and Alternative Medicine Use among Allergy Practices: Results of a Nationwide Survey of Allergists.

    PubMed

    Land, Michael H; Wang, Julie

    2017-03-25

    The use of complementary and alternative practices in the field of Allergy/Immunology is growing. A recent survey of American Academy of Allergy, Asthma, and Immunology members examining patterns of complementary and alternative medicine (CAM) use and adverse effects from CAM revealed that a majority of practitioners (81% of respondents) had patients who are using CAM therapies over conventional treatments and many practitioners (60% of survey respondents) have encountered patients experiencing adverse reactions. During routine office visits, a majority of practitioners do not ask patients about CAM use, and when they do, most do not have a standard intake form to take a CAM history. There is a strong need to increase knowledge and improve measures to prevent adverse reactions to CAMs.

  14. Estimation of catchment-scale evapotranspiration from baseflow recession data: Numerical model and practical application results

    NASA Astrophysics Data System (ADS)

    Szilagyi, Jozsef; Gribovszki, Zoltan; Kalicz, Peter

    2007-03-01

    SummaryBy applying a nonlinear reservoir approach for groundwater drainage, catchment-scale evapotranspiration (ET) during flow recessions can be expressed with the help of the lumped version of the water balance equation for the catchment. The attractiveness of the approach is that ET, in theory, can be obtained by the sole use of observed flow values for which relatively abundant and long records are available. A 2D finite element numerical model of subsurface flow in the unsaturated and saturated zones, capable of simulating moisture removal by vegetation, was first successfully employed to verify the water balance approach under ideal conditions. Subsequent practical applications over four catchments with widely varying climatic conditions however showed large disparities in comparison with monthly ET estimates of Morton's WREVAP model.

  15. Risk management policies and practices regarding radio frequency electromagnetic fields: results from a WHO survey.

    PubMed

    Dhungel, Amit; Zmirou-Navier, Denis; van Deventer, Emilie

    2015-04-01

    This study aims to describe current risk management practices and policies across the world in relation to personal exposures from devices emitting radiofrequency fields, environmental exposures from fixed installations and exposures in the work environment. Data from 86 countries representing all WHO regions were collected through a survey. The majority of countries (76.8 %) had set exposure limits for mobile devices, almost all (90.7 %) had set public exposure limits for fixed installations and 76.5 % had specified exposure limits for personnel in occupational settings. A number of other policies had been implemented at the national level, ranging from information provisions on how to reduce personal exposures and restrictions of usage for certain populations, such as children or pregnant women to prevention of access around base stations. This study suggests that countries with higher mobile subscriptions tend to have set radiofrequency exposure limits for mobile devices and to have provisions on exposure measurements about fixed installations.

  16. Chronic disease management in general practice: results from a national study.

    PubMed

    Darker, C; Martin, C; O'Dowd, T; O'Kelly, F; O'Shea, B

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380/527).The majority of GPs (240/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267/380; 71%), asthma / COPD (279/380; 74%) and hypertension (297/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379/380; 99%), lack of appropriate funding (286/380; 76%), with GPs interested in targeted payments (244/380; 68%). This study provides baseline data to assess future changes in CDM.

  17. Risk management policies and practices regarding radio frequency electromagnetic fields: results from a WHO survey

    PubMed Central

    Dhungel, Amit; Zmirou-Navier, Denis; van Deventer, Emilie

    2015-01-01

    This study aims to describe current risk management practices and policies across the world in relation to personal exposures from devices emitting radiofrequency fields, environmental exposures from fixed installations and exposures in the work environment. Data from 86 countries representing all WHO regions were collected through a survey. The majority of countries (76.8 %) had set exposure limits for mobile devices, almost all (90.7 %) had set public exposure limits for fixed installations and 76.5 % had specified exposure limits for personnel in occupational settings. A number of other policies had been implemented at the national level, ranging from information provisions on how to reduce personal exposures and restrictions of usage for certain populations, such as children or pregnant women to prevention of access around base stations. This study suggests that countries with higher mobile subscriptions tend to have set radiofrequency exposure limits for mobile devices and to have provisions on exposure measurements about fixed installations. PMID:25394650

  18. The database for reaching experiments and models.

    PubMed

    Walker, Ben; Kording, Konrad

    2013-01-01

    Reaching is one of the central experimental paradigms in the field of motor control, and many computational models of reaching have been published. While most of these models try to explain subject data (such as movement kinematics, reaching performance, forces, etc.) from only a single experiment, distinct experiments often share experimental conditions and record similar kinematics. This suggests that reaching models could be applied to (and falsified by) multiple experiments. However, using multiple datasets is difficult because experimental data formats vary widely. Standardizing data formats promises to enable scientists to test model predictions against many experiments and to compare experimental results across labs. Here we report on the development of a new resource available to scientists: a database of reaching called the Database for Reaching Experiments And Models (DREAM). DREAM collects both experimental datasets and models and facilitates their comparison by standardizing formats. The DREAM project promises to be useful for experimentalists who want to understand how their data relates to models, for modelers who want to test their theories, and for educators who want to help students better understand reaching experiments, models, and data analysis.

  19. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  20. The Sustainability of Change in Teacher Beliefs and Practices as a Result of an Overseas Professional Development Course

    ERIC Educational Resources Information Center

    Wong, Ruth

    2013-01-01

    This article examines whether there are changes in students' teaching practices as a result of their experiencing an overseas professional development course (PDC); the process of any such changes; and whether any changes found are sustainable in the long term. Three forms of data gathering are used, lesson observation, in-depth interviews, and…

  1. School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results. Volume 2

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Terry-McElrath, Yvonne; Colabianchi, Natalie

    2012-01-01

    This report provides updated results from one of the most comprehensive studies of health-related policies and practices in U.S. public middle and high schools to date, which was released in August 2011. The major findings and trends presented in this report describe issues relevant to childhood obesity for four school years, from 2006-07 to…

  2. Practice improvement as a result of an end of life care programme for care homes.

    PubMed

    Springett, Angela

    2017-03-31

    This article explores practice outcomes from a Six Steps+ programme for end of life care (EoLC) delivered in care homes in the south of England. The education programme aims to increase staff's knowledge, skills and confidence to counter-balance their anxiety about EoLC. The Six Steps+ programme promotes a culture of high quality, compassionate, person-centred and dignified holistic care to meet the needs of residents who may have increasing complex requirements throughout their last year or more of life. Through integrated working and a reduction in avoidable hospital admissions, residents are enabled to die in their place of choice where possible. Case studies show that participating in the Six Steps+ programme increases care home staff's knowledge, skills and confidence and enhances the quality of EoLC for residents. With the cost of the education and support required essentially covered by six avoided hospital admissions throughout the one-year course, the Six Steps+ programme is an attractive and cost-effective approach to improving EoLC.

  3. Four Years of Practical Arrangements between IAEA and Moscow SIA 'Radon': Preliminary Results - 13061

    SciTech Connect

    Batyukhnova, O.G.; Karlina, O.K.; Neveikin, P.P.

    2013-07-01

    The International Education Training Centre (IETC) at Moscow State Unitary Enterprise Scientific and Industrial Association 'Radon' (SIA 'Radon'), in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries- IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practical Arrangements) was signed between SIA 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. The paper summarizes the current experience of the SIA 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)

  4. [Ambulatory medical practice in the French-speaking region of Switzerland (1981-1987). Preliminary results].

    PubMed

    Amport, P; Hausser, D; Lehmann, P; Martin, J; Gutzwiller, F

    1989-01-01

    Between 1981 and 1987, population in the two "cantons" of Vaud and Fribourg increased by 4.5 percent (from 709200 to 740700) but private medical practitioners increased by 26.1 percent (from 971 to 1,224). How did the medical profession adjust itself to such a challenge? The average weekly number of visits reduced (e.g. from 118 to 109 in paediatrics, from 96 to 85 in internal medicine...). Nevertheless, the average duration of each visit did not significantly increase. Consequently, the weekly time devoted to contacts with patients in the office decreased in most specialities (e.g. from 33.9 hours to 31.1 hours in general practice). But the most salient feature was the reduction of time spent by private practitioners in institutions, hospitals or other "medical/social" organizations. The reduction was obvious among internists, surgeons, paediatricians... It was probably caused by the increased number of practitioners. However, "cohort effect" might have played a role in the matter: as the physicians aged, they were less attracted by activities outside their private office. It is noteworthy that all the above figures were observed among the same practitioners, in 1981 and 1987. Moreover, the proportion of patients invited to come back to the physician's office did not grow, the behaviour of the practitioners remaining unchanged during the period. The study also displayed data about a new group of physicians, who were surveyed for the first time in 1987.

  5. [A double-blind nomifensine-nortriptyline trial in ambulatory patients conducted by psychiatrists in private practice: results and comments].

    PubMed

    Coudray, J P; Dufour, H; Garello, J L; Mollo, Y; Pascal, F; Poisson, D; Scotto, J C; Simart, G; Sormani, J; Tourame, G

    1978-06-28

    Nomifensine and nortriptyline were compared in a collaborative trial by psychiatrists in private practice. The trial impiled:--selection of ambulatory depressed patients--randomization in parallel groups (respectively 31 and 34 subjects)--administration in double-blind condition of 4 capsuels daily of either compound during 4 weeks--quotation of depressvie syndrom with Hamilton depression scale before treatment after 2 and 4 weeks. The analysis of results shows clear improvment of depression scores, equivalent in both groups (non significant difference and posterior rejection of an alternative hypothesis). Practical problems encountered in controlled trials in psychiatrist's outpatients are discussed.

  6. Use of the NHS Choices website for primary care consultations: results from online and general practice surveys

    PubMed Central

    Murray, Joanna; Majeed, Azeem; Khan, Muhammad Saleem; Lee, John Tayu; Nelson, Paul

    2011-01-01

    Objectives To determine the effect of using the NHS Choices website on primary care consultations in England and Wales. We examined the hypothesis that using NHS Choices may reduce the frequency of primary care consultations among young, healthy users. Design Two cross-sectional surveys of NHS Choices users. Setting Survey of NHS Choices users using an online pop-up questionnaire on the NHS Choices website and a snapshot survey of patients in six general practices in London. Participants NHS Choices website users and general practice patients. Main outcome measures For both surveys, we measured the proportion of people using NHS Choices when considering whether to consult their GP practice and on subsequent frequency of primary care consultations. Results Around 59% (n = 1559) of online and 8% (n = 125) of general practice survey respondents reported using NHS Choices in relation to their use of primary care services. Among these, 33% (n = 515) of online and 18% (n = 23) of general practice respondents reported reduced primary care consultations as a result of using NHS Choices. We estimated the equivalent capacity savings in primary care from reduced consultations as a result of using NHS Choices to be approximately £94 million per year. Conclusions NHS Choices has been shown to alter healthcare-seeking behaviour, attitudes and knowledge among its users. Using NHS Choices results in reduced demand for primary care consultations among young, healthy users for whom reduced health service use is likely to be appropriate. Reducing potentially avoidable consultations can result in considerable capacity savings in UK primary care. PMID:21847438

  7. Prison in-reach mental health nursing.

    PubMed

    Armitage, Claire; Fitzgerald, Carole; Cheong, Paula

    Surveys have shown that over 90 per cent of the prison population have a diagnosable mental illness, substance abuse problem, or both (ONS 1998). There is general agreement that although there are areas where practice is excellent, practice is not consistent across England and Wales, and often does not equate to standards in the NHS. In 2001 the Department of Health and the prison service set out their joint approach to the modernization of mental health services in prisons (DoH 2001), and proposed mental health in-reach as a means of improving services and achieving the objectives of the NHS Plan (DoH 2000). This article looks at the one of the first prison in-reach services that was launched at HMP Leicester early in 2002, and considers the effect these nurses have had on the care of mentally ill adults at the prison. A case study outlining the in-reach team's approach to one of the prison's greatest challenges, self-harm, is also included.

  8. ST-segment Elevation Myocardial Infarction Resulting from Stent Thrombosis in Contemporary Real-World Practice.

    PubMed

    Kanei, Yumiko; Nallu, Kishore; Makker, Parth; Behuria, Supreeti; Fox, John

    2017-03-01

    Stent thrombosis (ST) is a rare but devastating complication after percutaneous coronary intervention. Newer generation drug-eluting stents (DES) and newer antiplatelet therapies have been shown to decrease the incidence of ST, but we continue to observe ST-segment elevation myocardial infarction (STEMI) due to ST in contemporary practice. A retrospective analysis of 527 patients who presented with STEMI was performed; 57 patients (11%) with angiographically confirmed ST were compared with the patients with STEMI due to de novo lesion. The type of previous stent, the timing of ST, and the use of antiplatelet therapy were reviewed in patients with ST. Patients with ST had higher prevalence of comorbid conditions, such as hypertension, diabetes mellitus, and coronary artery disease, and had lower left ventricular ejection fraction (37 ± 5 vs. 44 ± 16%, p = 0.0011). There was no difference in in-hospital mortality (2 vs. 4%, p = 0.7082). ST was seen most commonly as "very late" (56%), and with previous second-generation DES (40%). Eighty-two percent of patients among early ST, compared with 22% of patients with very late ST were on dual antiplatelet therapy (DAPT). In 12% of patients, ST happened after DAPT was stopped by physician for procedures. ST is seen in a variety of clinical settings with the most common presentation being very late ST and in second-generation DES, which most likely represent the growing population with previous second-generation stents.

  9. Practice and Repetition during Exam Preparation in Blended Learning Courses: Correlations with Learning Results

    ERIC Educational Resources Information Center

    Andergassen, Monika; Mödritscher, Felix; Neumann, Gustaf

    2014-01-01

    Learner-centric research on factors influencing learning results has focused, among other things, on student characteristics, demographic data, and usage patterns in learning management systems (LMSs). This paper complements the existing research by investigating potential correlations between learning results and LMS usage during exam…

  10. The use of augmented auditory feedback to improve arm reaching in stroke: a case series

    PubMed Central

    Schlaug, Gottfried

    2016-01-01

    Purpose After practice, augmented feedback is the most important factor that facilitates motor learning. We assess the potential effectiveness of two types of augmented auditory feedback on the re-learning of arm reaching in individuals with stroke: (a) real-time knowledge of performance (KP) feedback and (b) rhythmic cueing in the form of knowledge of results (KR) feedback. Method Five participants with stroke underwent short-term practice, reaching with their affected arm with KP, KR and no feedback, on separate days. We assessed range of motion of the upper extremity (shoulder, elbow) and trunk, mean error and variability of the performed trajectory, and movement time, before and after training. Results All participants benefitted from practice with feedback, though the effects varied across participants and feedback type. In three participants, KP feedback increased elbow extension and reduced compensatory trunk flexion. In four participants, KR feedback reduced movement time taken to perform the reach. Of note, one participant benefitted mostly from KP feedback, which increased shoulder flexion and elbow extension, and decreased compensatory trunk flexion and mean error. Conclusions Within day practice with augmented auditory feedback improves reaching in individuals with stroke. This warrants further investigation with longer practice periods in a larger sample size. PMID:26314746

  11. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    ERIC Educational Resources Information Center

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  12. Practical Model and Protocol for Interpreting MCMI-III Results to Clients.

    ERIC Educational Resources Information Center

    Staley, Joy D.; Brown, Nathan C.

    One ethical dilemma for psychologists is finding methods to share test results with their clients in such a way that the client is not deleteriously labeled, but is encouraged by the knowledge of assessed strength and growth areas. This paper offers one answer by presenting a structured protocol that draws on an iceberg metaphor for categorizing…

  13. Policy Impacts on Pedagogical Practice and ICT Use: An Exploration of the Results from Sites 2006

    ERIC Educational Resources Information Center

    Law, N.; Lee, M. W.; Chan, A.

    2010-01-01

    The Second Information Technology in Education Study (SITES) 2006 results reveal that principals' perceived presence of lifelong learning-related pedagogical activities in their schools had changed markedly since the same data was collected in 1998 in SITES-M1. More intriguing was the fact that the directions of the changes were quite different…

  14. Practical implementation issues and challenges for biobanks in the return of individual research results

    PubMed Central

    Bledsoe, Marianna J.; Grizzle, William E.; Clark, Brian J.; Zeps, Nikolajs

    2012-01-01

    Whether or not to give research results back to individuals whose specimens are used for biomedical research is a subject of considerable controversy. Much of the debate has been focused around the ethical and legal concerns with some consideration of broader social issues such as whether or not people will be affected by such information for employment or health care. Much less attention has been paid to biobanks that collect the specimens used to generate the research findings and the issues and operational requirements for implementing return of individual research results. In this article, we give the biobanks’ perspective and highlight that given the diversity among the types of biobanks, it may be difficult to design and implement a blanket policy in this complex area. We discuss the variability in the types of biobanks and some important issues that should be considered in determining whether or not research results should be provided to individuals whose specimens are used in biomedical research. We also discuss challenges that should be considered in implementing any approaches to the return of research results. PMID:22323073

  15. Challenging Segregational Practices in a Spanish Secondary School: Results from an Ethnographic Research

    ERIC Educational Resources Information Center

    Sanchez-Valero, Joan-Anton; Padilla-Petry, Paulo

    2016-01-01

    This article presents partial results of a multi-sited ethnographic study about the role of multiple literacies in young people's learning in and outside school. In one of the five participant secondary schools, fourth grade students were segregated in groups according to their special needs. We start with a critical review on segregated and…

  16. Analyzing data in aquaculture: practical significance, a new paradigm for determining the importance of results

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Analyzing data and interpreting results is often the most difficult and yet important part of the scientific research process. Currently, aquaculture researchers almost exclusively employ null hypothesis significance testing (NHST), a synthesis of the Fisher test of significance and the Neyman-Pears...

  17. Pilot phase evaluation of the elective general practice class: results of student surveys of the first two years

    PubMed Central

    Samos, Franziska-Antonia; Heise, Marcus; Fuchs, Stephan; Mittmann, Susanne; Bauer, Alexander; Klement, Andreas

    2017-01-01

    Background: Primary health care in rural regions is currently undergoing a global crisis in respect of the next generation of practitioners. National and international recommendations advise placing greater emphasis upon practical skills and competences in medical studies. It is also in the interest of training the next generation to include mentoring and longitudinal integration of contact to teaching practices for general medicine in an early stage. Consequently, the General Practice Class (KAM) was introduced in Halle in 2011 as an elective with 20 individually mentored students per year, beginning with the first subject-related semester. We are now reporting on the results of the evaluation for the first two years. Method: A standardised online survey was carried out with all students who took part in the KAM in the two years 2011 and 2012 (N=38). For both years the survey was made at the end of the first summer semester on the basis of an adapted version of the Heidelberger Inventar zur Lehrevaluation (Heidelberg Inventory for the Evaluation of Teaching, HILVE-II) and the Berliner Evaluationsinstrument für selbsteingeschätzte, studentische Kompetenzen (Berlin Evaluation Instrument for the self-assessment of student competences, BEvaKomp). Furthermore, each year the preference for the choice of specialty and location of a medical practice was queried. Predictors for the preference of the chosen specialty and the location of a medical practice were estimated by binary logistic regression analysis. Via univariate evaluations the number of students who reported an increase in knowledge in different areas of competence as a result of the KAM was counted. Correlations between the intention to remain in the KAM and the quality of teaching were evaluated on the basis of bivariate correlations. Results: 48% of the students agreed partly or fully that the KAM seminars enhanced their specialist competence. This individual acquiring of competence in the model project

  18. 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…

  19. Schools Reaching Out: An Introduction.

    ERIC Educational Resources Information Center

    Heleen, Owen

    1990-01-01

    Introduces an issue devoted to the Schools Reaching Out projects at David A. Ellis School in Roxbury (MA) and Adolph S. Ochs School in New York City. Projects attempt to link the schools with parents and their communities to promote the students' academic and social success. (DM)

  20. Reaching the "iBored"

    ERIC Educational Resources Information Center

    Bauleke, Debra S.; Herrmann, Kathleen E.

    2010-01-01

    As teachers, they are always looking for creative ways to engage their students. They start the school year determined to bring to the classroom creative projects that generate student interest and foster critical thinking skills. Reaching today's Gen M student is challenging and changing the way they teach. The idea of using music to teach…

  1. Cardiological biopharmaceuticals in the conception of drug targeting delivery: practical results and research perspectives.

    PubMed

    Maksimenko, A V

    2012-07-01

    The results of the clinical use of thrombolytic and antithrombotic preparations developed on the basis of protein conjugates obtained within the framework of the conception of drug targeting delivery in the organism are considered. A decrease has been noted in the number of biomedical projects focused on these derivatives as a result of various factors: the significant depletion of financial and organizational funds, the saturation of the pharmaceutical market with preparations of this kind, and the appearance of original means for interventional procedures. Factors that actively facilitate the conspicuous potentiation of the efficacy of bioconjugates were revealed: the biomedical testing of protein domains and their selected combinations, the optimization of molecular sizes for the bioconjugates obtained, the density of target localization, the application of cell adhesion molecules as targets, and the application of connected enzyme activities. Enzyme antioxidants and the opportunity for further elaboration of the drug delivery conception via the elucidation and formation of therapeutic targets for effective drug reactions by means of pharmacological pre- and postconditioning of myocardium arouse significant interest.

  2. [Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

    PubMed

    Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

    2014-01-01

    Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements.

  3. [Biofeedback for urinary bladder dysfunctions in childhood. Indications, practice and the results of therapy].

    PubMed

    Hoang-Böhm, J; Lusch, A; Sha, W; Alken, P

    2004-07-01

    In children, abnormal behavior during micturition, i.e. detrusor/sphincter dyscoordination, causes persistent voiding problems, urinary incontinence and/or recurrent urinary tract infections in up to 15% of cases. Contractions of the external urethral sphincter during micturition lead to functional subvesical obstruction. Nowadays, biofeedback training is the most suitable therapy. Biofeedback training for children is based on the assumption that relaxation and contraction of the urinary external sphincter is a habitual phenomenon and can be restored. With specially developed, computer-assisted biofeedback programs, sphincter contraction and relaxation can be transformed into acoustic or visual signals. Acoustic or optical feedback indicates relaxation and contraction control to the patient. The residual urine volume should subsequently be assessed. The results should be reviewed after each micturition. Poor compliance sometimes makes biofeedback training impossible. Further biofeedback training at home is a reasonable suggestion. Good results-a response rate of up to 90%-demonstrates that biofeedback training is successful in the treatment of detrusor-sphincter dyscoordination. After effective therapy, associated urinary tract infections and vesicoureterorenal reflux may disappear.

  4. Automated antibody structure prediction using Accelrys tools: results and best practices.

    PubMed

    Fasnacht, Marc; Butenhof, Ken; Goupil-Lamy, Anne; Hernandez-Guzman, Francisco; Huang, Hongwei; Yan, Lisa

    2014-08-01

    We describe the methodology and results from our participation in the second Antibody Modeling Assessment experiment. During the experiment we predicted the structure of eleven unpublished antibody Fv fragments. Our prediction methods centered on template-based modeling; potential templates were selected from an antibody database based on their sequence similarity to the target in the framework regions. Depending on the quality of the templates, we constructed models of the antibody framework regions either using a single, chimeric or multiple template approach. The hypervariable loop regions in the initial models were rebuilt by grafting the corresponding regions from suitable templates onto the model. For the H3 loop region, we further refined models using ab initio methods. The final models were subjected to constrained energy minimization to resolve severe local structural problems. The analysis of the models submitted show that Accelrys tools allow for the construction of quite accurate models for the framework and the canonical CDR regions, with RMSDs to the X-ray structure on average below 1 Å for most of these regions. The results show that accurate prediction of the H3 hypervariable loops remains a challenge. Furthermore, model quality assessment of the submitted models show that the models are of quite high quality, with local geometry assessment scores similar to that of the target X-ray structures.

  5. Temporal-spatial reach parameters derived from inertial sensors: Comparison to 3D marker-based motion capture.

    PubMed

    Cahill-Rowley, Katelyn; Rose, Jessica

    2017-02-08

    Reaching is a well-practiced functional task crucial to daily living activities, and temporal-spatial measures of reaching reflect function for both adult and pediatric populations with upper-extremity motor impairments. Inertial sensors offer a mobile and inexpensive tool for clinical assessment of movement. This research outlines a method for measuring temporal-spatial reach parameters using inertial sensors, and validates these measures with traditional marker-based motion capture. 140 reaches from 10 adults, and 30 reaches from nine children aged 18-20 months, were recorded and analyzed using both inertial-sensor and motion-capture methods. Inertial sensors contained three-axis accelerometers, gyroscopes, and magnetometers. Gravitational offset of accelerometer data was measured when the sensor was at rest, and removed using sensor orientation measured at rest and throughout the reach. Velocity was calculated by numeric integration of acceleration, using a null-velocity assumption at reach start. Sensor drift was neglected given the 1-2s required for a reach. Temporal-spatial reach parameters were calculated independently for each data acquisition method. Reach path length and distance, peak velocity magnitude and timing, and acceleration at contact demonstrated consistent agreement between sensor- and motion-capture-based methods, for both adult and toddler reaches, as evaluated by intraclass correlation coefficients from 0.61 to 1.00. Taken together with actual difference between method measures, results indicate that these functional reach parameters may be reliably measured with inertial sensors.

  6. [The results of the practical use of the destructive peritonitis' standartized treatment].

    PubMed

    Miller, S V; Vinnik, Iu S; Tepliakova, O V

    2012-01-01

    The results of inspection and treatment 117 patients with an acute destructive pancreatitis from 1998 to 2010 are presented. Distinguishing features of management approach of the patients, which was hospitalized in clinic from 2005 to 2010, were high frequency of octreotide use, de-escalated orientation of antibacterial therapy, without early laparotomy interventions and expansion of indications to program sanitation by development of widespread forms of infected pancreatic necrosis. Achievements of intensive therapy of last years and change of surgical tactics have allowed to reduce postoperative mortality by sterile necrosis from 21.1 to 11.8%, to reduce frequency of infected pancreatic necrosis from 68.3 to 40.4%. Development of the infected pancreatic necrosis accompanied by statistically significant growth of frequency of local purulent complications and the tendency to increase--extended.

  7. Adoption potential of conservation agriculture practices in sub-Saharan Africa: results from five case studies.

    PubMed

    Ndah, Hycenth Tim; Schuler, Johannes; Uthes, Sandra; Zander, Peter; Traore, Karim; Gama, Mphatso-S; Nyagumbo, Isaiah; Triomphe, Bernard; Sieber, Stefan; Corbeels, Marc

    2014-03-01

    Despite the reported benefits of conservation agriculture (CA), its wider up-scaling in Sub-Saharan Africa (SSA) has remained fairly limited. This paper shows how a newly developed qualitative expert assessment approach for CA adoption (QAToCA) was applied to determine its adoption potential in SSA. CA adoption potential is not a predictor of observed adoption rates. Instead, our aim was to systematically check relevant factors that may be influencing its adoption. QAToCA delivers an assessment of how suitable conditions "and thus the likelihood for CA adoption" are. Results show that the high CA adoption potentials exhibited by the Malawi and Zambia case relate mostly to positive institutional factors. On the other hand, the low adoption potential of the Zimbabwe case, in spite of observed higher estimates, is attributed mainly to unstable and less secured market conditions for CA. In the case of Southern Burkina Faso, the potential for CA adoption is determined to be high, and this assessment deviates from lower observed figures. This is attributed mainly to strong competition of CA and livestock for residues in this region. Lastly, the high adoption potential found in Northern Burkina Faso is explained mainly by the fact that farmers here have no alternative other than to adopt the locally adapted CA system-Zaï farming. Results of this assessment should help promoters of CA in the given regions to reflect on their activities and to eventually adjust or redesign them based on a more explicit understanding of where problems and opportunities are found.

  8. Consumer home refrigeration practices: results of a web-based survey.

    PubMed

    Kosa, Katherine M; Cates, Sheryl C; Karns, Shawn; Godwin, Sandria L; Chambers, Delores

    2007-07-01

    To reduce bacterial growth and to ensure the quality and safety of food products, the U.S. Department of Agriculture and the U.S. Food and Drug Administration advise consumers to clean their refrigerators regularly, use a refrigerator thermometer, and keep refrigerator temperatures at 40 degrees F (4.4 degrees C) or below. We conducted a nationally representative Web-enabled survey (n = 2,060) to collect data on refrigerator thermometer ownership, home refrigerator temperatures, and the frequency of home refrigerator cleaning. We stratified the sample to provide results for pregnant women, older adults (60 years or older), and the remaining population. About half of all respondents had cleaned their refrigerators at least 1 month before the survey. Only 11% of all respondents had a thermometer in their refrigerator before the survey. Older adults (77.5%) were more likely than the remaining population (70.4%) to have their refrigerators at the recommended temperature (P < 0.01). Older adults who were not married and who lived alone were less likely to have refrigerator thermometers and to have their refrigerators at a recommended temperature (P < 0.05). For all respondents, those who had previously owned a refrigerator thermometer were more likely to have their refrigerators at the recommended temperature than were respondents who did not previously own a thermometer (P < 0.01). Food safety educators can use the survey findings and results of previous research to target educational materials and help consumers, especially those at risk for listeriosis, to safely store refrigerated foods at home.

  9. Adoption Potential of Conservation Agriculture Practices in Sub-Saharan Africa: Results from Five Case Studies

    NASA Astrophysics Data System (ADS)

    Ndah, Hycenth Tim; Schuler, Johannes; Uthes, Sandra; Zander, Peter; Traore, Karim; Gama, Mphatso-S.; Nyagumbo, Isaiah; Triomphe, Bernard; Sieber, Stefan; Corbeels, Marc

    2014-03-01

    Despite the reported benefits of conservation agriculture (CA), its wider up-scaling in Sub-Saharan Africa (SSA) has remained fairly limited. This paper shows how a newly developed qualitative expert assessment approach for CA adoption (QAToCA) was applied to determine its adoption potential in SSA. CA adoption potential is not a predictor of observed adoption rates. Instead, our aim was to systematically check relevant factors that may be influencing its adoption. QAToCA delivers an assessment of how suitable conditions "and thus the likelihood for CA adoption" are. Results show that the high CA adoption potentials exhibited by the Malawi and Zambia case relate mostly to positive institutional factors. On the other hand, the low adoption potential of the Zimbabwe case, in spite of observed higher estimates, is attributed mainly to unstable and less secured market conditions for CA. In the case of Southern Burkina Faso, the potential for CA adoption is determined to be high, and this assessment deviates from lower observed figures. This is attributed mainly to strong competition of CA and livestock for residues in this region. Lastly, the high adoption potential found in Northern Burkina Faso is explained mainly by the fact that farmers here have no alternative other than to adopt the locally adapted CA system—Zaï farming. Results of this assessment should help promoters of CA in the given regions to reflect on their activities and to eventually adjust or redesign them based on a more explicit understanding of where problems and opportunities are found.

  10. Survey results of the training, nutrition, and mental preparation of triathletes: practical implications of findings.

    PubMed

    Dolan, Shawn H; Houston, Melinda; Martin, Scott B

    2011-07-01

    Although triathlon is growing in popularity at a remarkable rate, it has not been extensively studied. The aims of this research were to identify preparation strategies used by triathletes and to categorize these strategies according to gender and consultation with triathlon coaches. Survey data collected from 401 triathletes (207 males, 194 females) revealed training, nutritional, and mental preparation habits. Most participants engaged in strength training, consumed food and/or fluids during and after training, set training and competition goals, and applied mental preparation strategies during training and the hour before racing. Water was the most commonly consumed fluid; positive self-talk was the most used mental strategy. Participants were more likely to consult with a triathlon coach than a nutrition or sport psychology professional. Athletes with more years of experience in triathlon and those competing in longer distances were more likely to consult a triathlon coach. Female triathletes were more likely than male triathletes to train with others, use mental preparation strategies, and report feeling anxious before competitions. More male triathletes reported using nutritional supplements during training than their female counterparts. These findings add to the limited research base on triathletes' training habits, and hopefully will help guide practitioners who work with this group. The results provide guidance for collaborative efforts among training, nutrition, and mental health professionals to best support triathletes.

  11. Decadal changes in aerosol absorption across Brazil resulting from changes in biomass burning practices

    NASA Astrophysics Data System (ADS)

    Coe, H.; Morgan, W.; Darbyshire, E.; Allan, J. D.; Flynn, M.; Liu, D.; Langridge, J.; Johnson, B. T.; Haywood, J. M.; Longo, K.; Artaxo, P.; Highwood, E.; Mollard, J.

    2015-12-01

    Open biomass burning makes a substantial contribution to the global budget of black carbon, yet models significantly underestimate absorption aerosol optical depth compared to observations by approximately a factor of two over South America. These large differences need to be addressed. Recent work has shown that the number of deforestation fires has decreased across Amazonia over the last decade, giving rise to a decrease in the abundance of biomass burning aerosol across the region. At the same time there has been an increase in the frequency of agricultural burning across regions that have previously been deforested, as well as increased burning in the east of Brazil in the Cerrado regions. We sampled both of these types of open burning extensively during a recent aircraft experiment. Significant concentrations of organic carbon as well as black carbon were observed, with this ratio providing the main control on the single scattering albedo (SSA).Deforestation fires and wild forest fires are prevalent across the south west of the Amazon Basin, where smouldering burning dominates. In the east of Brazil, agricultural burning proceeds via a much more efficient form of combustion and as a result, black carbon is a much larger fraction of the aerosol mass and SSAs are much lower than in the west. We have analysed MISR data across the region to show that whilst aerosol optical depths have decreased during the dry season over the last decade, with greater rates of reduction occurring over the south western margins of Amazonia, absorption aerosol optical depths have significantly increased over the Cerrado and remained constant over south western Amazonia. This has led to a decline in SSA across the whole of the region with greater reductions occurring over the eastern states. This finding is consistent with our aircraft measurements. We will discuss the implications of these changes for air quality and climate across the region.

  12. Chemotherapy drug handling in first opinion small animal veterinary practices in the United Kingdom: results of a questionnaire survey.

    PubMed

    Edery, E G

    2017-03-07

    To investigate how first opinion small animal veterinary surgeons in the UK handled chemotherapeutic agents, a questionnaire was distributed at the 2014 British Small Animal Veterinary Association congress and by internet. Chemotherapy was regularly offered by 70.4 per cent of the respondents. Gold standards defined according to available guidelines for safe handling of antineoplastic drugs were poorly followed by general practitioners with only 2 per cent of respondents complying with all of them. Dedicated facilities for preparation and administration of cytotoxic drugs were variably available among participants. The level of training of staff indirectly involved in handling chemotherapy was appropriate in less than 50 per cent of practices. No association was found between demographic characteristics of the sampled population and the decision to perform chemotherapy. The results of this study raise concerns about the safety of the veterinary staff in first opinion practices involved in handling chemotherapy.

  13. Modelling Study at Kutlular Copper FIELD with Spat This Study, Evaluation Steps of Copper Mine Field SP Data Are Shown How to Reach More Accurate Results for SP Inversion Method.

    NASA Astrophysics Data System (ADS)

    Sahin, O. K.; Asci, M.

    2014-12-01

    At this study, determination of theoretical parameters for inversion process of Trabzon-Sürmene-Kutlular ore bed anomalies was examined. Making a decision of which model equation can be used for inversion is the most important step for the beginning. It is thought that will give a chance to get more accurate results. So, sections were evaluated with sphere-cylinder nomogram. After that, same sections were analyzed with cylinder-dike nomogram to determine the theoretical parameters for inversion process for every single model equations. After comparison of results, we saw that only one of them was more close to parameters of nomogram evaluations. But, other inversion result parameters were different from their nomogram parameters.

  14. Motion Plan Changes Predictably in Dyadic Reaching

    PubMed Central

    Burdet, Etienne

    2016-01-01

    Parents can effortlessly assist their child to walk, but the mechanism behind such physical coordination is still unknown. Studies have suggested that physical coordination is achieved by interacting humans who update their movement or motion plan in response to the partner’s behaviour. Here, we tested rigidly coupled pairs in a joint reaching task to observe such changes in the partners’ motion plans. However, the joint reaching movements were surprisingly consistent across different trials. A computational model that we developed demonstrated that the two partners had a distinct motion plan, which did not change with time. These results suggest that rigidly coupled pairs accomplish joint reaching movements by relying on a pre-programmed motion plan that is independent of the partner’s behaviour. PMID:27911938

  15. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa.

    PubMed

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  16. Measuring the economic value of alternative clam fishing management practices in the Venice Lagoon: results from a conjoint valuation application

    NASA Astrophysics Data System (ADS)

    Nunes, Paulo A. L. D.; Rossetto, Luca; de Blaeij, Arianne

    2004-11-01

    This article focuses on the economic valuation of alternative clam management practices in the Venice Lagoon. The proposed valuation method is characterized by the design of a survey questionnaire applied to the fishermen population. In each questionnaire, two fishing alternatives are described. The respondent is asked to choose one of them. This valuation method, referred in the article as conjoint valuation, gives sufficient flexibility to set, alter, and combine the valuation of different clam management practices. Furthermore, this approach presents an important advantage to the well-known contingent valuation method since it makes the monetary valuation of each management attribute possible. Estimation results show that all three attributes used in the questionnaire to describe and value different clam management practices—price of the annual permit and fishing technological system—are statistically robust, indicating that fishermen bear a utility change whenever these attributes change. In particular, fishermen's willingness to pay for a larger clam fishing area ranges between 568 and 811 € per year. In addition, an individual's willingness to pay for a fishing practice exclusively based on the vibrant rake system ranges between 1005 and 2456 €. Finally, the adoption of a clam fish management practice in the Venice Lagoon that is exclusively based on the use of manual rakes, which is associated with the lowest damage to the lagoon ecosystem, will represent a welfare loss of 5904 € per fisherman per year. Combining such a value estimate with the total number of fishermen currently operating in the Lagoon of Venice, the welfare loss associated with the adoption of this type of clam management policy amounts to 11.8 € million per year. This figure can be regarded as an upper bound to the cost of implementation of a clam fishing system anchored in the use of manual, ecosystem friendly rakes.

  17. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa

    NASA Astrophysics Data System (ADS)

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  18. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    NASA Technical Reports Server (NTRS)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  19. A qualitative analysis of Emergency Department physicians' practices and perceptions in relation to test result follow-up.

    PubMed

    Callen, Joanne; Georgiou, Andrew; Prgomet, Mirela; Paoloni, Richard; Westbrook, Johanna

    2010-01-01

    Follow-up of abnormal test results for discharged Emergency Department (ED) patients is a critical safety issue. This study aimed to explore ED physicians' perceptions, practices, and suggestions for improvements of test result follow-up when using an electronic provider order entry system to order all laboratory and radiology tests and view results. Interviews were conducted with seven ED physicians and one clinical information system support person. Interviews were analyzed to elicit key concepts relating to physicians' perceptions of test result follow-up and how the process could be improved. Results described the current electronic test result follow-up system with two paper-based manual back-up systems for microbiology and radiology results. The key issues for physicians were: responsibility for test follow-up; the unique ED environment and time pressures, and the role of the family physician in test result follow-up. The key suggestion for improvement was a complete integrated electronic information system with on-line result endorsement. The study highlighted the complexity of the test result follow-up process and the importance of engaging clinicians in devising solutions for improvements.

  20. The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

    PubMed Central

    Abe, Tomonobu; Ito, Hideki; Mutsuga, Masato; Fujimoto, Kazuro; Terazawa, Sachie; Narita, Yuji; Oshima, Hideki; Usui, Akihiko

    2016-01-01

    ABSTRACT Mitral valve surgery has changed with the wide acceptance of mitral valve repair. The aim of this study is to obtain the long-term results of patients who underwent mitral valve replacement (MVR) using a biological prosthesis in contemporary practice in Japan. From January 1990 to December 2013, 76 patients underwent MVR using a biological prosthesis with or without concomitant surgery. Data were obtained by means of a questionnaire and a telephone interview. The mean follow-up period was 4.26 years. The etiologies of the patients included dilated cardiomyopathy (DCM) (n=20 [26.3%]), ischemic mitral regurgitation (n=7 [9.2%]). There is a trend towards decreasing number of rheumatic and degenerative disease and increasing number of DCM and ischemic mitral regurgitation. Three patients (3.9%) died in the perioperative period. The 5- and 10-year overall survival rates were 69.6% and 31.7%, respectively. The 5- and 10-year freedom from valve related death were 95.6% and 80.6 %, respectively. The linearized rates of valve-related complications were as follows: thromboembolism (0.63%/patient/year), bleeding (1.25%/patient/year). One patient underwent reoperation for structural degeneration 13 years after the first operation. The present study shows the long-term results of mitral valve replacement with bioproshtesis in a contemporary case series. The practice pattern is changing. The low rate of valve-related complication justify the current patient selection. PMID:28008192

  1. Results from three years of the world's largest interlaboratory comparison for total mercury and methylmercury: Method performance and best practices

    NASA Astrophysics Data System (ADS)

    Creswell, J. E.; Engel, V.; Carter, A.; Davies, C.

    2013-12-01

    Brooks Rand Instruments has conducted the world's largest interlaboratory comparison study for total mercury and methylmercury in natural waters annually for three years. Each year, roughly 50 laboratories registered to participate and the majority of participants submitted results. Each laboratory was assigned a performance score based on the distance between its results and the consensus mean, as well as the precision of its replicate analyses. Participants were also asked to provide detailed data on their analytical methodology and equipment. We used the methodology data and performance scores to assess the performance of the various methods reported and equipment used. Although the majority of methods in use show no systematic trend toward poor analytical performance, there are noteworthy exceptions. We present results from each of the three years of the interlaboratory comparison exercise, as well as aggregated method performance data. We compare the methods used in this study to methods from other published interlaboratory comparison studies and present a list of recommended best practices. Our goals in creating a list of best practices are to maximize participation, ensure inclusiveness, minimize non-response bias, guarantee high data quality, and promote transparency of analysis. We seek to create a standardized methodology for interlaboratory comparison exercises for total mercury and methylmercury analysis in water, which will lead to more directly comparable results between studies. We show that in most cases, the coefficient of variation between labs measuring replicates of the same sample is greater than 20% after the removal of outlying data points (e.g. Figure 1). It is difficult to make comparisons between studies and ecosystems with such a high variability between labs. We highlight the need for regular participation in interlaboratory comparison studies and continuous analytical method improvement in order to ensure accurate data. Figure 1

  2. Practices to "Avoid" in Out-of-School Time Programs. Research-to-Results Brief. Publication #2010-03

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Collins, Ashleigh; Bronte-Tinkew, Jacinta

    2010-01-01

    Perhaps one of the fastest ways to improve the quality of out-of-school time programs would be to replace practices that individuals know do not work with practices that appear to be more effective. In this brief, the authors highlight lessons from an expanding body of knowledge about specific program practices that should be avoided or minimized…

  3. Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013–2014) of a nationwide continuing surveillance study

    PubMed Central

    Boffin, N; Moreels, S; Deblonde, J; Van Casteren, V

    2017-01-01

    Objectives To describe and explore data from the surveillance of chlamydia, syphilis, gonorrhoea and genital warts by the Belgian Network of Sentinel General Practices (SGP) over the first 2 years (2013 and 2014) and to estimate the incidence of these 4 sexually transmitted infections (STIs). A special focus is put on data quality. Design Retrospective observational study. Setting General practices from the nationwide representative SGP network. Outcome measures Agreement between data distributions by year, agreement between SGP-based incidence and incidence based on mandatory notification, missingness of patient age or gender and incompleteness of sexual risk history of patients. Results 306 new STI episodes were reported from 298 patients, corresponding with an episode-based incidence of 91.9/100 000 (95% CI 81.9 to 102.8) general practice patients, with almost half of it due to chlamydia. The incidence of chlamydia in men was significantly higher in 2014 than in 2013. Population characteristics were similarly distributed in 2013 and 2014. The SGP-based incidence of gonorrhoea and syphilis in Flanders were in agreement with the incidence based on mandatory notification of cases. Patient age or gender was missing from 35 episodes (11.4%). Independent determinants of missingness of patient age or gender were the Flemish region (OR 3.46; 95% CI 1.02 to 11.73) and genital warts infection (OR 2.23; 95% CI 1.07 to 4.63). An incomplete sexual risk history was reported for 54.6% STI episodes. The odds for an incomplete sexual history were higher for older patients (OR 1.72; 95% CI 1.06 to 2.76) and for patients infected with syphilis, gonorrhoea or co-infection(s) (OR 1.71; 95% CI 1.03 to 2.83). Conclusions Incompleteness of reports about patients with STI sexual risk histories is important from the perspective of quality of data and of quality of care. Together with the low rates of both HIV testing and discussion of partner notification, this suggests that a

  4. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England

    PubMed Central

    Krakower, Douglas S.; Oldenburg, Catherine E.; Mitty, Jennifer A.; Wilson, Ira B.; Kurth, Ann E.; Maloney, Kevin M.; Gallagher, Donna; Mayer, Kenneth H.

    2015-01-01

    Background Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and pre-exposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01–1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98–11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06–1.34), whereas female gender (aOR 0.26, 95% CI 0.10–0.71) was associated

  5. Comprehensive Coach Education and Practice Contact Restriction Guidelines Result in Lower Injury Rates in Youth American Football

    PubMed Central

    Kerr, Zachary Y.; Yeargin, Susan; Valovich McLeod, Tamara C.; Nittoli, Vincent C.; Mensch, James; Dodge, Thomas; Hayden, Ross; Dompier, Thomas P.

    2015-01-01

    Background: Research evaluating the effect of comprehensive coach education and practice contact restriction in youth football injury rates is sparse. In 2012, USA Football released their Heads Up Football coaching education program (HUF), and Pop Warner Football (PW) instituted guidelines to restrict contact during practice. Purpose: To compare injury rates among youth football players aged 5 to 15 years by whether their leagues implemented HUF and/or were PW-affiliated. Study Design: Cohort study; Level of evidence, 2. Methods: Athletic trainers (ATs) evaluated and tracked injuries at each practice and game during the 2014 youth football season. Players were drawn from 10 leagues across 4 states. The non–Heads Up Football (NHUF) group consisted of 704 players (none of whom were PW-affiliated) from 29 teams within 4 leagues. The HUF+PW group consisted of 741 players from 27 teams within 2 leagues. The HUF-only group consisted of 663 players from 44 teams within 4 leagues. Injury rates and injury rate ratios (IRRs) were reported with 95% CIs. Results: A total of 370 injuries were reported during 71,262 athlete-exposures (AEs) (rate, 5.19/1000 AEs). Compared with the NHUF group (7.32/1000 AEs), the practice injury rates were lower for the HUF+PW group (0.97/1000 AEs; IRR, 0.13; 95% CI, 0.08-0.21) and the HUF-only group (2.73/1000 AEs; IRR, 0.37; 95% CI, 0.26-0.53). Compared with the NHUF group (13.42/1000 AEs), the game injury rate was lower for the HUF+PW group (3.42/1000 AEs; IRR, 0.25; 95% CI, 0.15-0.44) but not for the HUF-only group (13.76/1000 AEs; IRR, 1.02; 95% CI, 0.73-1.43). Also, the HUF+PW game injury rate was lower than that of HUF-only (IRR, 0.20; 95% CI, 0.12-0.36). Higher injury rates were typically found in those aged 11 to 15 years compared with those aged 5 to 10 years. However, stronger effects related to HUF implementation and PW affiliation were seen among 11- to 15-year-olds. When restricted to concussions only, the sole difference was found

  6. [Improvement of quality of practices for the preparation of cytotoxic drugs: results of a "before-after" study].

    PubMed

    Gilles, L; Favier, B; Catillon, F; Dussart, C; Peyron, F; Simoens, X; Latour, J-F; Farsi, F; Biron, P

    2009-09-01

    Despite the publication of guidelines for handling antineoplastic agents, measurable amounts of these drugs are still found at various hospital sites. In this context, the French cancer network ONCORA supported the present study to assess the impact of environmental contamination controls on the quality of practices during the preparation of cytotoxic drugs. The first part of the study was conducted at five voluntary hospitals. A total of 65 wipe samples of objects and surfaces were taken in the drug preparation rooms and analyzed for the presence of 5-fluorouracil (5-FU). Measurable amounts of 5-FU were detected in 21 samples (32%). Many surfaces within Biological Safety Cabinets and isolators were found contaminated (36%). The worse results were obtained on gloves and on the outside of infusion bags. The same method was applied during the second part of the study, conducted six months after the end of the first audit. Global contamination was reduced to 17%. This study shows that appropriate handling helps decrease the number of samples contaminated, making it possible to recommend these controls for evaluating and improving the quality of practices. Since 2007, the network's laboratory has extended its activities to all French hospitals interested in this quality assurance programme.

  7. Rapid plasticity of motor corticospinal system with robotic reach training.

    PubMed

    Kantak, S S; Jones-Lush, L M; Narayanan, P; Judkins, T N; Wittenberg, G F

    2013-09-05

    Goal-directed reaching is important for the activities of daily living. Populations of neurons in the primary motor cortex that project to spinal motor circuits are known to represent the kinematics of reaching movements. We investigated whether repetitive practice of goal-directed reaching movements induces use-dependent plasticity of those kinematic characteristics, in a manner similar to finger movements, as had been shown previously. Transcranial magnetic stimulation (TMS) was used to evoke upper extremity movements while the forearm was resting in a robotic cradle. Plasticity was measured by the change in kinematics of these evoked movements following goal-directed reaching practice. Baseline direction of TMS-evoked arm movements was determined for each subject. Subjects then practiced three blocks of 160 goal-directed reaching movements in a direction opposite to the baseline direction (14 cm reach 180° from baseline direction) against a 75-Nm spring field. Changes in TMS-evoked whole arm movements were assessed after each practice block and after 5 min following the end of practice. Direction and the position of the point of peak velocity of TMS-evoked movements were significantly altered following training and at a 5-min interval following training, while amplitude did not show significant changes. This was accompanied by changes in the motor-evoked potentials (MEPs) of the shoulder and elbow agonist muscles that partly explained the change in direction, mainly by increase in agonist MEP, without significant changes in antagonists. These findings demonstrate that the arm representation accessible by motor cortical stimulation under goes rapid plasticity induced by goal-directed robotic reach training in healthy subjects.

  8. Reaching for the red planet

    PubMed

    David, L

    1996-05-01

    The distant shores of Mars were reached by numerous U.S. and Russian spacecraft throughout the 1960s to mid 1970s. Nearly 20 years have passed since those successful missions which orbited and landed on the Martian surface. Two Soviet probes headed for the planet in July, 1988, but later failed. In August 1993, the U.S. Mars Observer suddenly went silent just three days before it was to enter orbit around the planet and was never heard from again. In late 1996, there will be renewed activity on the launch pads with three probes departing for the red planet: 1) The U.S. Mars Global Surveyor will be launched in November on a Delta II rocket and will orbit the planet for global mapping purposes; 2) Russia's Mars '96 mission, scheduled to fly in November on a Proton launcher, consists of an orbiter, two small stations which will land on the Martian surface, and two penetrators that will plow into the terrain; and finally, 3) a U.S. Discovery-class spacecraft, the Mars Pathfinder, has a December launch date atop a Delta II booster. The mission features a lander and a microrover that will travel short distances over Martian territory. These missions usher in a new phase of Mars exploration, setting the stage for an unprecedented volley of spacecraft that will orbit around, land on, drive across, and perhaps fly at low altitudes over the planet.

  9. [Treatment of depressive patients in private practice--empirical results, health political and social conditions and recommendations].

    PubMed

    Goesmann, Cornelia; Bühren, Astrid; Neuy-Bartmann, Astrid

    2007-09-01

    Although depression and symptoms of depression belong to the most common disorders in private practice, affected patients are not always diagnosed as early as possible in Germany and often not sufficiently treated. In order to improve the care for persons with depression it is necessary that family doctors are prepared to guide these patients with empathy, treat them adequately pharmacologically both in respect to the depression and to all other somatic aspects and to refer them in time to specialists for psychiatry, psychosomatic medicine or psychotherapy. Political and social conditions that have pathogenic effects should be changed and the shortage of psychotherapy needs to be overcome. In future, the integrated care in ambulant and clinical settings will probably be successful, first trials and test setups have shown good results.

  10. Knowledge, Attitudes, and Practices Concerning Malaria in Pregnancy: Results from a Qualitative Study in Madang, Papua New Guinea

    PubMed Central

    Andrew, Erin V. W.; Pell, Christopher; Angwin, Angeline; Auwun, Alma; Daniels, Job; Mueller, Ivo; Phuanukoonnon, Suparat; Pool, Robert

    2015-01-01

    Background Malaria is the leading cause of illness and death in Papua New Guinea (PNG). Infection during pregnancy with falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria during pregnancy and it’s prevention in Madang, PNG, a high prevalence area. Methods As part of a qualitative study in Madang, exploring MiP, participatory techniques (free-listing and sorting) were conducted along with focus group discussions, in-depth interviews (with pregnant women, health staff and other community members) and observations in the local community and health facilities. Results The main themes explored were attitudes towards and knowledge of MiP, its risks, and prevention. Although there was a general awareness of the term “malaria”, it was often conflated with general sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women’s heavy workload influenced Chloroquine adherence. Conclusion The non-specific symptoms of MiP and its resultant conflation with symptoms of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this was compounded by the inadequacy of health staff’s message about MiP. PMID:25893405

  11. Ophthalmologists' practice patterns and challenges in achieving optimal management for glaucoma in Nigeria: results from a nationwide survey

    PubMed Central

    Kyari, Fatima; Nolan, Winifred; Gilbert, Clare

    2016-01-01

    Purpose of the study Glaucoma, a chronic non-communicable disease, and leading cause of irreversible blindness worldwide is a public health problem in Nigeria, with a prevalence of 5.02% in people aged ≥40 years. The purpose of this nationwide survey was to assess Nigerian ophthalmologists’ practice patterns and their constraints in managing glaucoma. Study design Ophthalmologists were sent a semistructured questionnaire on how they manage glaucoma, their training in glaucoma care, where they practice, their access to equipment for diagnosis and treatment, whether they use protocols and the challenges they face in managing patients with glaucoma. Results 153/250 ophthalmologists in 80 centres completed questionnaires. Although 79% felt their training was excellent or good, 46% needed more training in glaucoma diagnosis and surgery. All had ophthalmoscopes, 93% had access to applanation tonometers, 81% to visual field analysers and 29% to laser machines (in 19 centres). 3 ophthalmologists had only ophthalmoscopes and schiøtz tonometers. For 85%, a glaucomatous optic disc was the most important feature that would prompt glaucoma work-up. Only 56% routinely performed gonioscopy and 61% used slit-lamp stereoscopic biomicroscopy for disc assessment. Trabeculectomy (with/without antimetabolites) was the only glaucoma surgery performed with one mention of canaloplasty. Poor compliance with medical treatment (78%) and low acceptance of surgery (71%) were their greatest challenges. Conclusions This study indicates that a systems-oriented approach is required to enhance ophthalmologist's capability for glaucoma care. Strategies to improve glaucoma management include strengthening poorly equipped centres including provision of lasers and training, and improving patients’ awareness and education on glaucoma. PMID:27729348

  12. Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results

    PubMed Central

    2013-01-01

    Background Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. Methods GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Discussion Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems

  13. Patterns of Radiotherapy Practice for Pancreatic Cancer in Japan: Results of the Japanese Radiation Oncology Study Group (JROSG) Survey

    SciTech Connect

    Ogawa, Kazuhiko; Ito, Yoshinori; Karasawa, Katsuyuki; Ogawa, Yoshihiro; Onishi, Hiroshi; Kazumoto, Tomoko; Shibuya, Keiko; Shibuya, Hitoshi; Okuno, Yoshishige; Nishino, Shigeo; Ogo, Etsuyo; Uchida, Nobue; Karasawa, Kumiko; Nemoto, Kenji; Nishimura, Yasumasa

    2010-07-01

    Purpose: To determine the patterns of radiotherapy practice for pancreatic cancer in Japan. Methods and Materials: A questionnaire-based national survey of radiotherapy for pancreatic cancer treated between 2000 and 2006 was conducted by the Japanese Radiation Oncology Study Group (JROSG). Detailed information on 870 patients from 34 radiation oncology institutions was accumulated. Results: The median age of all patients was 64 years (range, 36-88), and 80.2% of the patients had good performance status. More than 85% of patients had clinical Stage T3-T4 disease, and 68.9% of patients had unresectable disease at diagnosis. Concerning radiotherapy (RT), 49.8% of patients were treated with radical external beam RT (EBRT) (median dose, 50.4 Gy), 44.4% of patients were treated with intraoperative RT (median dose, 25 Gy) with or without EBRT (median dose, 45 Gy), and 5.9% of patients were treated with postoperative radiotherapy (median dose, 50 Gy). The treatment field consisted of the primary tumor (bed) only in 55.6% of the patients. Computed tomography-based treatment planning and conformal RT was used in 93.1% and 83.1% of the patients treated with EBRT, respectively. Chemotherapy was used for 691 patients (79.4%; before RT for 66 patients; during RT for 531; and after RT for 364). Gemcitabine was the most frequently used drug, followed by 5-fluorouracil. Conclusion: This study describes the general patterns of RT practice for pancreatic cancer in Japan. Most patients had advanced unresectable disease, and radical EBRT, as well as intraoperative RT with or without EBRT, was frequently used. Chemotherapy with gemcitabine was commonly used in conjunction with RT during the survey period.

  14. Prevention of episodic migraines with topiramate: results from a non-interventional study in a general practice setting.

    PubMed

    Nelles, Gereon; Schmitt, Lukas; Humbert, Thomas; Becker, Veit; Sandow, Petra; Bornhoevd, Karin; Fritzsche, Dirk; Schäuble, Barbara

    2010-02-01

    The majority of patients with migraine headaches are treated in non-specialized institutions though data on treatment outcomes are largely derived from tertiary care centers. The current non-interventional study explores efficacy and tolerability outcomes of patients with episodic migraines receiving topiramate as preventive agent in a general practice setting. A total of 366 patients (87% female, mean age 41.8 +/- 11.6 years) were eligible for migraine prevention and treated with flexible dose topiramate for 6 months (core phase), and optionally for a total of 12 months (follow-up phase). Overall, 261 patients (77.7% of safety analysis set, SAF) completed the core phase. Reasons for discontinuation included adverse events (2.1%), lost to follow-up (1.8%), other reasons (1.5%), and end of therapy (0.3%) though in the majority of patients who discontinued no reasons were listed. The median daily dose at endpoint was 50 mg/day (range, 25-187.5 mg/day). The median days with migraine headaches decreased from 6.0 to 1.2 days (p < 0.001), median pain intensity score decreased from 17.0 to 3.2 points (p < 0.001). In women with reported menstruation-associated migraine, the median number of migraine attacks decreased from 4.0 to 0.9 (p < 0.001). Absenteeism as well as triptan use decreased significantly, and significant improvements in activities of daily living and quality of life were reported. The most frequently reported AEs were paraesthesia (4.2%) and nausea (3%). Results suggest that migraine prevention with topiramate in a general practice is generally well tolerated and associated with a significant improvement in migraine headaches and related functional impairment.

  15. Maximal lateral reaching distance on the affected side using the multi-directional reach test in persons with stroke

    PubMed Central

    Hwang, Won-Jeong; Kim, Jung-Hyun; Jeon, Seo-Hyun; Chung, Yijung

    2015-01-01

    [Purpose] This study aimed to examine the relationship between maximal lateral reaching distance on the affected side and weight shifting using the Multi-directional Reach Test in persons with stoke. [Subjects] Fifty-one chronic stroke participants were recruited from two rehabilitation hospitals. This study administered the Berg Balance Scale, Timed Up-and-Go, Trunk Impairment Scale, Modified Barthel Index and measured different maximal reaching distances. [Results] The maximal lateral reaching distance on the affected side was correlated with the BBS (r=0.571), TUG (r=−0.478), TIS (r=0.561), and MBI scores (r=0.499), the lateral reaching distance in all directions on the non-affected side (r=0.785), the maximal backward reaching distance (r=0.723), and the maximal forward reaching distance (r=0.673). The maximal reaching distance on the affected side was also affected by that on the non-affected side, in addition to the maximal backward reaching distance and MBI score. The final step model of stepwise multiple regression was explained 69.5%. [Conclusion] Maximal lateral reaching distance on the affected side as determined by the Multi-directional Reach Test is a good method of assessing functional performance in stroke patients. Data regarding maximal reaching distance on the non-affected side can be used to measure functional impairment on the affected side in clinical settings. PMID:26504275

  16. Intelligence Reach for Expertise (IREx)

    NASA Astrophysics Data System (ADS)

    Hadley, Christina; Schoening, James R.; Schreiber, Yonatan

    2015-05-01

    IREx is a search engine for next-generation analysts to find collaborators. U.S. Army Field Manual 2.0 (Intelligence) calls for collaboration within and outside the area of operations, but finding the best collaborator for a given task can be challenging. IREx will be demonstrated as part of Actionable Intelligence Technology Enabled Capability Demonstration (AI-TECD) at the E15 field exercises at Ft. Dix in July 2015. It includes a Task Model for describing a task and its prerequisite competencies, plus a User Model (i.e., a user profile) for individuals to assert their capabilities and other relevant data. These models use a canonical suite of ontologies as a foundation for these models, which enables robust queries and also keeps the models logically consistent. IREx also supports learning validation, where a learner who has completed a course module can search and find a suitable task to practice and demonstrate that their new knowledge can be used in the real world for its intended purpose. The IREx models are in the initial phase of a process to develop them as an IEEE standard. This initiative is currently an approved IEEE Study Group, after which follows a standards working group, then a balloting group, and if all goes well, an IEEE standard.

  17. Spiking and LFP activity in PRR during symbolically instructed reaches.

    PubMed

    Hwang, Eun Jung; Andersen, Richard A

    2012-02-01

    The spiking activity in the parietal reach region (PRR) represents the spatial goal of an impending reach when the reach is directed toward or away from a visual object. The local field potentials (LFPs) in this region also represent the reach goal when the reach is directed to a visual object. Thus PRR is a candidate area for reading out a patient's intended reach goals for neural prosthetic applications. For natural behaviors, reach goals are not always based on the location of a visual object, e.g., playing the piano following sheet music or moving following verbal directions. So far it has not been directly tested whether and how PRR represents reach goals in such cognitive, nonlocational conditions, and knowing the encoding properties in various task conditions would help in designing a reach goal decoder for prosthetic applications. To address this issue, we examined the macaque PRR under two reach conditions: reach goal determined by the stimulus location (direct) or shape (symbolic). For the same goal, the spiking activity near reach onset was indistinguishable between the two tasks, and thus a reach goal decoder trained with spiking activity in one task performed perfectly in the other. In contrast, the LFP activity at 20-40 Hz showed small but significantly enhanced reach goal tuning in the symbolic task, but its spatial preference remained the same. Consequently, a decoder trained with LFP activity performed worse in the other task than in the same task. These results suggest that LFP decoders in PRR should take into account the task context (e.g., locational vs. nonlocational) to be accurate, while spike decoders can robustly provide reach goal information regardless of the task context in various prosthetic applications.

  18. Crossing New Uncharted Territory: Shifts in Academic Identity as a Result of Modifying Teaching Practice in Undergraduate Mathematics

    ERIC Educational Resources Information Center

    Kensington-Miller, Barbara; Sneddon, Jamie; Stewart, Sepideh

    2014-01-01

    The changes in academic identity a teacher may undergo, as they modify their teaching practice, will vary depending on their experiences and the support they receive. In this paper, we describe the shifts in academic identity of two lecturers, a mathematician and a mathematics educator, as they both made changes to their teaching practice by…

  19. A Study of the Results of the Implementation of a Non-Punitive Grading Practice at Mattatuck Community College.

    ERIC Educational Resources Information Center

    Maxwell, James

    Mattatuck Community College implemented non-punitive grading practices into its grading system in the Fall 1973 semester. These practices centered about the elimination of plus and minus grades, elimination of the grade of F, and liberalizing the course withdrawal policy to allow for withdrawal without penalty throughout the semester. A comparison…

  20. Using a Class to Conduct a Carbon Inventory: A Case Study with Practical Results at Macalester College

    ERIC Educational Resources Information Center

    Wells, Christopher W.; Savanick, Suzanne; Manning, Christie

    2009-01-01

    Purpose: The purpose of this paper is to discuss the practical realities of using a college seminar to fulfill the carbon audit requirement for signatories to the American College and University Presidents Climate Commitment (ACUPCC) and presents evidence of this approach's advantages as an educational and practical tool.…

  1. [Practical experience on improving activities of daily living competence in Parkinson's patients treated with ropinirole. Results of a applied study].

    PubMed

    Reichmann, H; Angersbach, D; Buchwald, B

    2005-10-01

    Ropinirole is a non-ergot-selective D2 dopamine agonist. Its efficacy, tolerability, and safety have been extensively proven in controlled, double-blind trials. The present prospective, multicentre, postmarketing surveillance study tested whether the results of controlled clinical trials are also valid in routine clinical practice. For evaluation, international rating scales for tremor and activities of daily living were applied in a slightly modified manner. In 172 German centres, 453 parkinsonian patients (272 men, 174 women, average age 67 years) in advanced stages of the disease were treated with ropinirole alone or in combination with L-dopa. Activities of daily living and tremor significantly improved. This is the first prospective study which demonstrates beneficial effects of ropinirole on PD tremor. The dosage of L-dopa could be reduced in 31% of the patients. Side effects were reported in only 7.6%. The results of this postmarketing study corroborate the good clinical efficacy of ropinirole together with high safety under routine clinical conditions.

  2. 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

  3. Understanding Dutch practice nurses' adherence to evidence-based smoking cessation guidelines and their needs for web-based adherence support: results from semistructured interviews

    PubMed Central

    de Ruijter, D; Smit, E S; de Vries, H; Goossens, L; Hoving, C

    2017-01-01

    Objectives Practice nurses in general practices suboptimally adhere to smoking cessation guidelines. Since the effectiveness of their smoking cessation support is greatest when full adherence to these guidelines is achieved, interventions need to be developed to improve practice nurses' guideline adherence, for example, by tailoring their content to adherence determinants. However, the sociocognitive determinants explaining adherence have not yet been investigated. Therefore, this qualitative needs assessment aimed to explore practice nurses' current counselling practices, as well as their sociocognitive beliefs related to their smoking cessation guideline adherence and their needs regarding web-based adherence support. Setting Primary care; general practices in the Netherlands. Participants 19 practice nurses, actively involved in smoking cessation counselling. Methods Semistructured individual interviews, based on the I-Change Model and the Diffusion of Innovations Theory, were conducted from May to September 2014. Data were systematically analysed using the Framework Method and considered reliable (κ 0.77; % agreement 99%). Results Respondents felt able to be empathic and collaborative during smoking cessation consultations. They also reported psychological (eg, low self-efficacy to increase patient motivation and arranging adequate follow-up consultations) and practical barriers (eg, outdated information on quit support compensation and a perceived lack of high-quality trainings for practice nurses) to smoking cessation guideline adherence. Most respondents were interested in web-based adherence support to overcome these barriers. Conclusions Sociocognitive determinants influence practice nurses' smoking cessation guideline adherence. To improve their adherence, web-based tailored adherence support can provide practice nurses with personally relevant feedback tailored to individually perceived barriers to smoking cessation guideline adherence. More

  4. Reaching the community in Guatemala.

    PubMed

    1996-08-01

    A knowledge, attitude, and practices (KAP) survey in the area near San Lucas Toliman, Solola State, where JOICFP is implementing its integrated project (IP) in Guatemala, will target the ethnic Mayan people living in the area. The IP is promoted by the Family Planning Association of Guatemala (APROFAM) and uses community participation with the support of women's clubs and traditional birth attendants (TBAs). The survey of about 1000 women of reproductive age will gauge progress in family planning, maternal and child health, reproductive health, and environmental sanitation using a method sensitive to the Mayan culture. A JOICFP mission to Guatemala, which included Saeko Ichikawa (Global Link Management) and Ayumi Shingo (a public health nurse serving with the Japan Overseas Cooperation Volunteers in Guatemala) pretested the survey. The team also discussed the work plan for the approved JOICFP/UNFPA Latin American regional project RLA/96//P02 and the country-level Integrated Reproductive Health/Family Planning with IEC for Adolescents Project. The mission met three volunteers at the IP laboratory, which provides basic examinations for a fee and uses volunteers who learn skills for future employment. The team discussed the laboratory as a model for the 13 new laboratories planned by APROFAM throughout the country. Another IP activity is the Chilam Balam education center in Aldea Panimatzalam, San Andres Semetabaj. Covering a population of 4616 in 8 communities, the center provides literacy education, vocational training, and education on adolescent health and environmental protection. The team discussed plans to start a revolving fund and received a request for typewriters for skills training. The team donated 8 typewriters to the women's club.

  5. US Urban Elementary Teachers' Knowledge and Practices in Teaching Science to English Language Learners: Results from the first year of a professional development intervention

    NASA Astrophysics Data System (ADS)

    Santau, Alexandra O.; Secada, Walter; Maerten-Rivera, Jaime; Cone, Neporcha; Lee, Okhee

    2010-10-01

    The study examined US elementary teachers' knowledge and practices in four key domains of science instruction with English language learning (ELL) students. The four domains included: (1) teachers' knowledge of science content, (2) teaching practices to promote scientific understanding, (3) teaching practices to promote scientific inquiry, and (4) teaching practices to support English language development during science instruction. The study was part of a larger five-year research and development intervention aimed at promoting science and literacy achievement of ELL students in urban elementary schools. It involved 32 third grade, 21 fourth grade, and 17 fifth grade teachers participating in the first-year implementation of the intervention. Based on teachers' questionnaire responses and classroom observation ratings, results indicated that (1) teachers' knowledge and practices were within the bounds of acceptability but short of reform-oriented practices and (2) grade-level differences existed, especially between Grades 3 and 5.

  6. [A case of long thoracic nerve palsy, with winged scapula, as a result of prolonged exertion on practicing archery].

    PubMed

    Shimizu, J; Nishiyama, K; Takeda, K; Ichiba, T; Sakuta, M

    1990-08-01

    Reports of isolated long thoracic nerve palsy are rare in Japan. We reported a case of isolated long thoracic nerve palsy, resulted from recurrent injury to the nerve. Muscle CT and electrodiagnostic study were useful for confirming diagnosis of this cases. This patient was a student aged 20 years, with nothing of importance in his family or past history. After he started practicing archery, winging of left scapula was gradually developed. Physical examination revealed weakness and atrophy of left serratus anterior muscle. There was no wasting and weakness of other should girdle muscles. Hematochemical tests were normal, except slight hyperthyroidism. Radiography and myelography of the cervical spine were normal. Muscle CT of upper thoracic level demonstrated atrophy of left serratus anterior muscle, and no abnormality were found in other muscles. Electromyogram of the left serratus anterior revealed discrete activity of reduced amplitude, and fibrillation potentials and positive sharp waves. Conduction time for left long thoracic nerve was prolonged, and amplitude of the evoked response was small and there were temporal dispersion. Muscle CT and electrodiagnostic studies were suggestive of neuroapraxia of left long thoracic nerve. Over stretching or compression during exercises may be responsible for the damage to the long thoracic nerve.

  7. ALMA telescope reaches new heights

    NASA Astrophysics Data System (ADS)

    2009-09-01

    of the Array Operations Site. This means surviving strong winds and temperatures between +20 and -20 Celsius whilst being able to point precisely enough that they could pick out a golf ball at a distance of 15 km, and to keep their smooth reflecting surfaces accurate to better than 25 micrometres (less than the typical thickness of a human hair). Once the transporter reached the high plateau it carried the antenna to a concrete pad - a docking station with connections for power and fibre optics - and positioned it with an accuracy of a few millimetres. The transporter is guided by a laser steering system and, just like some cars today, also has ultrasonic collision detectors. These sensors ensure the safety of the state-of-the-art antennas as the transporter drives them across what will soon be a rather crowded plateau. Ultimately, ALMA will have at least 66 antennas distributed over about 200 pads, spread over distances of up to 18.5 km and operating as a single, giant telescope. Even when ALMA is fully operational, the transporters will be used to move the antennas between pads to reconfigure the telescope for different kinds of observations. "Transporting our first antenna to the Chajnantor plateau is a epic feat which exemplifies the exciting times in which ALMA is living. Day after day, our global collaboration brings us closer to the birth of the most ambitious ground-based astronomical observatory in the world", said Thijs de Graauw, ALMA Director. This first ALMA antenna at the high site will soon be joined by others and the ALMA team looks forward to making their first observations from the Chajnantor plateau. They plan to link three antennas by early 2010, and to make the first scientific observations with ALMA in the second half of 2011. ALMA will help astronomers answer important questions about our cosmic origins. The telescope will observe the Universe using light with millimetre and submillimetre wavelengths, between infrared light and radio waves in

  8. ALMA Telescope Reaches New Heights

    NASA Astrophysics Data System (ADS)

    2009-09-01

    ball at a distance of nine miles, and to keep their smooth reflecting surfaces accurate to less than the thickness of a human hair. Once the transporter reached the high plateau it carried the antenna to a concrete pad -- a docking station with connections for power and fiber optics -- and positioned it with an accuracy of a small fraction of an inch. The transporter is guided by a laser steering system and, just like some cars, also has ultrasonic collision detectors. These sensors ensure the safety of the state-of-the-art antennas as the transporter drives them across what will soon be a rather crowded plateau. Ultimately, ALMA will have at least 66 antennas distributed over about 200 pads, spread over distances of up to 11.5 miles and operating as a single, giant telescope. Even when ALMA is fully operational, the transporters will be used to move the antennas between pads to reconfigure the telescope for different kinds of observations. This first ALMA antenna at the high site will soon be joined by others, and the ALMA team looks forward to making their first observations from the Chajnantor plateau. They plan to link three antennas by early 2010, and to make the first scientific observations with ALMA in the second half of 2011. ALMA will help astronomers answer important questions about our cosmic origins. The telescope will observe the Universe using light with millimeter and submillimeter wavelengths, between infrared light and radio waves in the electromagnetic spectrum. Light at these wavelengths comes from some of the coldest, and from some of the most distant objects in the cosmos. These include cold clouds of gas and dust where new stars are being born, or remote galaxies towards the edge of the observable universe. The Universe is relatively unexplored at submillimeter wavelengths, as the telescopes need extremely dry atmospheric conditions, such as those at Chajnantor, and advanced detector technology. The Atacama Large Millimeter/submillimeter Array

  9. 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…

  10. 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…

  11. REVERSE AUCTION RESULTS FOR IMPLEMENTATION OF DECENTRALIZED RETROFIT BEST MANAGEMENT PRACTICES IN A SMALL URBAN WATERSHED (CINCINNATI OH)

    EPA Science Inventory

    Although urban stormwater is typically conveyed to centralized infrastructure, there is great potential for reducing stormwater runoff quantity through decentralization. In this case we hypothesize that smaller-scale retrofit best management practices (BMPs) such as rain gardens ...

  12. Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

    PubMed Central

    Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.

    2015-01-01

    Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. Results A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was results provide a basis for national immunization programmes to develop, implement and monitor corrective activities to improve the availability and utilization of HBRs. Much work remains to improve forecasting where appropriate, to prevent HBR stock-outs, to identify and improve sustainable financing options and to explore viable market shaping opportunities. PMID:25733540

  13. Reaching Teenagers with Sex Information.

    ERIC Educational Resources Information Center

    Feldman, Margaret

    The problem of teenage pregnancy can be viewed as endemic, a part of American culture not easy to change. Although the number of girls under 15 who are becoming pregnant is not very large (13,000 in 1978), the cost of pregnancy to the girls themselves, their families, and society is very great. Results of data analyses from action research,…

  14. Action plans can interact to hinder or facilitate reach performance.

    PubMed

    Fournier, Lisa R; Wiediger, Matthew D; Taddese, Ezana F

    2015-11-01

    Executing a reach action can be delayed while retaining another action in working memory (WM) if the two action plans partly overlap rather than do not overlap. This delay (partial repetition cost) occurs when reach responses are under cognitive control. In this study, we investigated whether facilitation (a partial repetition benefit) occurs when reach responses are automatic. We also examined whether the hemisphere controlling the limb or selection of the preferred limb (based on a free-reach task) influences reach performance when the actions partly overlap. Left- and right-handers reached to different stimulus locations to the left and right of body midline with their ipsilateral hand while maintaining an action plan in WM that required the same or the different hand. The results showed a partial repetition benefit for spatially compatible reaches to left and right stimulus locations far from the body midline, but not for those near the body midline. Also, no partial repetition cost was found at any of the stimulus-reach locations. This indicates that automatic reach responses that partly overlap with an action plan maintained in WM are not delayed, but instead can be facilitated (partial repetition benefit). The roles of hemisphere and reach-hand preference in action control and the importance of the degree of feature overlap in obtaining a partial repetition benefit (and cost) are discussed.

  15. 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.

  16. Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

    PubMed

    Bluth, Edward I; Muroff, Lawrence R; Cernigliaro, Joseph G; Moore, Arl V; Smith, Geoffrey G; Flug, Jonathan; DeStigter, Kristen K; Allen, Bibb; Thorwarth, William T; Roberts, Anne C

    2015-05-01

    The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future.

  17. 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.

  18. Relationships between Electronic Information Media and Records Management Practices: Results of a Survey of United Nations Organizations. A Rand Note.

    ERIC Educational Resources Information Center

    Bikson, T. K.; Schieber, L.

    A Technical Panel on Electronic Records Management (TP/REM), which was established by the Advisory Committee for the Co-ordination of Information Systems (ACCIS), conducted a survey of existing electronic records management practices and standards related to new information and communication technologies and their interrelationships within the…

  19. The Development of Inclusive Practices as a Result of the Process of Integrating Deaf/Hard of Hearing Students

    ERIC Educational Resources Information Center

    Angelides, Panayiotis; Aravi, Christiana

    2007-01-01

    In recent years there has been a significant debate regarding the ways in which different educational systems throughout the world could develop more inclusive practices in their schools. Based on the notion that the education of children considered as having special needs should be considered as part of a wider process of school development, in…

  20. Federal-State partnership yields success in remote sensing evaluation of conservation practice effectiveness: Results from the Choptank river CEAP

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The use of winter cover crops to sequester residual soil nitrogen (N) following the summer row-crop growing season has been identified as an important and successful conservation practice in the Chesapeake Bay watershed. Nitrogen losses to groundwater are reduced during the winter season, provided ...

  1. Results from an Exploratory Study of Sun Protection Practice: Implications for the Design of Health Promotion Messages

    ERIC Educational Resources Information Center

    Eadie, Douglas; MacAskill, Susan

    2007-01-01

    Purpose: The primary aim of the research reported here is to provide strategic guidance for the development of a national communication strategy to improve sun protection practice amongst young people. Design/methodology/approach: The research adopted an exploratory approach, employing qualitative focus groups to represent three population groups,…

  2. Teaching Practice of Life Study Lesson of Classroom Teacher Candidates Analysis of the Results of Peer Assessment

    ERIC Educational Resources Information Center

    Bektas, Mustafa

    2013-01-01

    The purpose of this study is to examine peer assessments that the classroom candidates applied at teaching practice on life study lesson. The cross sectional survey method which is one of the survey methods has been used in the research. In this study the sampling criteria, one of the purposive sampling methods, is used. Thus, in the fall semester…

  3. Practices to "Foster" in Out-of-School Time Programs. Research-to-Results Brief. Publication #2010-02

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Bronte-Tinkew, Jacinta; Collins, Ashleigh

    2010-01-01

    A lot has been learned about effective approaches to realizing intended out-of-school time program outcomes. As program practitioners consider fostering evidence-based practices, program administrators, staff, and stakeholders must keep in mind that it is difficult to change behavior overnight, even among children. Efforts to improve outcomes for…

  4. Validating CAR - A comparison study of experimentally-derived and computer-generated reach envelopes. [Crewstation Assessment of Reach

    NASA Technical Reports Server (NTRS)

    Harris, R.; Bennett, J.; Stokes, J.

    1982-01-01

    In the present investigation, Crewstation Assessment of Reach (CAR) results in the form of male hand reach envelopes were generated and compared with an anthropometric survey performed by Kennedy (1978) to determine the extent of the validity of the CAR model with respect to experimentally-derived anthropometric data. The CAR-generated reach envelopes extensively matched the Kennedy envelopes. The match was particularly good in the areas to the front and side from which the reach originated. Attention is given to the crewstation model, the operator sample population, the CAR analysis, aspects of validation methodology, and the modeling of experimental parameters.

  5. Mass reach scaling for future hadron colliders

    NASA Astrophysics Data System (ADS)

    Rizzo, Thomas G.

    2015-04-01

    The primary goal of any future hadron collider is to discover new physics (NP) associated with a high mass scale, , beyond the range of the LHC. In order to maintain the same relative mass reach for rate-limited NP, , as increases, Richter recently reminded us that the required integrated luminosity obtainable at future hadron colliders (FHC) must grow rapidly, , in the limit of naive scaling. This would imply, e.g., a 50-fold increase in the required integrated luminosity when going from the 14 TeV LHC to a FHC with TeV, an increase that would prove quite challenging on many different fronts. In this paper we point out, due to the scaling violations associated with the evolution of the parton density functions (PDFs) and the running of the strong coupling, , that the actual luminosity necessary in order to maintain any fixed value of the relative mass reach is somewhat greater than this scaling result indicates. However, the actual values of the required luminosity scaling are found to be dependent upon the detailed nature of the NP being considered. Here we elucidate this point explicitly by employing several specific benchmark examples of possible NP scenarios and briefly discuss the (relatively weak) search impact in each case if these luminosity goals are not met.

  6. A model for learning human reaching movements.

    PubMed

    Karniel, A; Inbar, G F

    1997-09-01

    Reaching movement is a fast movement towards a given target. The main characteristics of such a movement are straight path and a bell-shaped speed profile. In this work a mathematical model for the control of the human arm during ballistic reaching movements is presented. The model of the arm contains a 2 degrees of freedom planar manipulator, and a Hill-type, non-linear mechanical model of six muscles. The arm model is taken from the literature with minor changes. The nervous system is modeled as an adjustable pattern generator that creates the control signals to the muscles. The control signals in this model are rectangular pulses activated at various amplitudes and timings, that are determined according to the given target. These amplitudes and timings are the parameters that should be related to each target and initial conditions in the work-space. The model of the nervous system consists of an artificial neural net that maps any given target to the parameter space of the pattern generator. In order to train this net, the nervous system model includes a sensitivity model that transforms the error from the arm end-point coordinates to the parameter coordinates. The error is assessed only at the termination of the movement from knowledge of the results. The role of the non-linearity in the muscle model and the performance of the learning scheme are analysed, illustrated in simulations and discussed. The results of the present study demonstrate the central nervous system's (CNS) ability to generate typical reaching movements with a simple feedforward controller that controls only the timing and amplitude of rectangular excitation pulses to the muscles and adjusts these parameters based on knowledge of the results. In this scheme, which is based on the adjustment of only a few parameters instead of the whole trajectory, the dimension of the control problem is reduced significantly. It is shown that the non-linear properties of the muscles are essential to achieve

  7. Education, Out-reach and In-reach Infrastructure Support for the Hydrologic Sciences

    NASA Astrophysics Data System (ADS)

    Hannigan, R.; McCaffrey, M.

    2002-05-01

    The Consortium of Universities for the Advancement of Hydrologic Science, incorporated (CUAHSI) is designed as an infrastructure support mechanism for research in the hydrologic sciences. Education, Out-reach and In-reach (EOI) is one of the five support thrusts of CUAHSI. EOI interfaces intimately with the other four thrusts (Hydrologic Science, Hydrologic Observatories, Hydrologic Information Systems, Hydrologic Measurement Technology). In addition, the EOI infrastructure will provide additional support to the scientific and educational communities as well as the general public. The EOI infrastructure aims to support scientists, educators, students and other interested parties through a variety of mechanisms including summer institutes, instrumentation training, student fellowships and institutional linkages. EOI's overall goal is to develop strategies, which have a broad impact and national significance. All EOI programs will link to CUAHSI science driven initiatives and will be evaluated in the basis of the impact of the program to the intended audience(s) and attainment of measurable outcomes. EOI, in addition to providing opportunities to the hydrologic science community, the broader scientific and education communities and the general public, will consistently interact with key members of pertinent communities to make them aware of available programs and to insure their participation by the interactive development of programs and opportunities. Potential activities include summer institutes at CUAHSI member universities for scientists, educators and students to exchange new ideas and learn new techniques. Potential exists for graduate student fellowships in support of research activities linked to CUAHSI science plans. Outreach to the general public and policy-makers may include distinguished speakers presenting general hydrologic science information and highlighting CUAHSI related research initiatives. In-reach is also a priority for EOI, and opportunities

  8. The Reach Ratio—A New Indicator for Comparing Quitline Reach Into Smoking Subgroups

    PubMed Central

    2014-01-01

    Introduction: There is growing concern about population disparities in tobacco-related morbidity and mortality. This paper introduces the reach ratio as a complementary measure to reach for monitoring whether quitline interventions are reaching high risk groups of smokers proportionate to their prevalence in the population. Methods: Data on smokers were collected at intake by 7 Canadian provincial quitlines from 2007 to 2009 and grouped to identify 4 high risk subgroups: males, young adults, heavy smokers, and those with low education. Provincial data are from the Canadian Tobacco Use Monitoring Survey. Reach ratios (ReRas), defined as the proportion of quitline callers from a subgroup divided by the proportion of the smoking population in the subgroup, and 95% confidence intervals were calculated for the subgroups. A ReRa of 1.0 indicates proportionate representation. Results: ReRas for male smokers and young adults are consistently less than 1.0 across all provinces, indicating that a lower proportion of these high-risk smokers were receiving evidence-based smoking cessation treatment from quitlines. Those with high levels of tobacco addiction and less than high school education have ReRas greater than 1.0, indicating that a greater proportion of these smokers were receiving cessation treatments. Conclusion: ReRas complement other measures of reach and provide a standardized estimate of the extent to which subgroups of interest are benefiting from available cessation interventions. This information can help quitline operators, funders, and policymakers determine the need for promotional strategies targeted to high risk subgroups, and allocate resources to meet program and policy objectives. PMID:24311698

  9. Perspectives of women with disabilities on reaching those who are hard to reach.

    PubMed

    Smeltzer, Suzanne C; Sharts-Hopko, Nancy C; Ott, Barbara B; Zimmerman, Vanessa; Duffin, Janice

    2007-06-01

    Healthcare needs of women with disabilities are often neglected, even for women who are well connected to the community and to the healthcare system. So-called "hard-to-reach" women, whose degree of disability impedes use of community resources, have even greater difficulty obtaining health care. The purpose of this study was to gain insight into the perceptions of women with mobility and sensory limitations about several healthcare issues that may affect them: barriers to obtaining care, sources of information about health issues, ways to improve access to care, and ways to help hard-to-reach women overcome barriers to health care and health information. Researchers conducted six focus groups, comprising 43 women with limitations of mobility, hearing, or vision. To validate the women's input, researchers conducted two additional focus groups: the first comprised female physicians with special interest in the health care of women with disabilities, and the second included professional administrative staff of agencies that provide services for people with disabilities. In several cases, members of the physician and agency focus groups were themselves women with disabilities. In addition, 16 women with disabilities participated in an online survey; their responses were used to validate the findings of the face-to-face focus groups. Transcribed data were content analyzed and 10 themes identified. Seven of those themes are discussed in this article: communication barriers; lack of knowledge and awareness among healthcare providers; access issues; working the system; system issues; outreach to healthcare providers; and reaching hard-to-reach women. The findings of this study can provide direction to development of more effective outreach to hard-to-reach women with disabilities, resulting in better integration of healthcare services for this population.

  10. Epidemiology of alcohol dependence in UK primary care: Results from a large observational study using the Clinical Practice Research Datalink

    PubMed Central

    Wright, Alison K.; Ashcroft, Darren M.; van Staa, Tjeerd P.; Pirmohamed, Munir

    2017-01-01

    This study aims to investigate the incidence and annual presentation rates of alcohol dependence in general practice in the UK, and examine age-, gender-, socioeconomic-, and region-specific variation. We conducted a retrospective 'open' cohort study using the Clinical Practice Research Datalink (CPRD), an anonymised primary care database. Prior to data extraction, a case definition for alcohol dependence in CPRD was established using 47 Read codes, which included primary alcohol dependence and consequences of alcohol dependence. Directly standardised rates for incidence and annual presentation were calculated for each year between 1990 and 2013. Rates were compared by gender, age, UK home nation, and practice-level Index of Multiple Deprivation. The directly standardised annual incidence rates were 8.3 and 3.7 per 10,000 male and female patients, respectively. The estimated annual rates of presentation per 10,000 were 17.1 for males and 7.6 for females. Female to male rate ratios were: 0.40 (95% CI: 0.39–0.41) for incident cases; and 0.37 (95% CI: 0.36–0.39) for annual presentation. Rates were highest in those aged 35–54 for both measures and across genders, and lowest in those aged over 75 years. With England as the reference nation, Northern Ireland and Scotland had significantly higher rates for both measures. Patients from the most deprived areas had the highest incidence and annual presentation rates. There is unequal distribution of patients with severe alcohol dependence across population subgroups in general practice. Given the health and economic burden associated with dependent drinking, these data will be useful in informing future public health initiatives. PMID:28362848

  11. [New oral anticoagulants for prophylaxis of stroke. Results of an expert conference on practical use in geriatric patients].

    PubMed

    Bahrmann, Philipp; Harms, Fred; Schambeck, Christian Martin; Wehling, Martin; Flohr, Jürgen

    2016-04-01

    Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with novel oral anticoagulants (NOAC) to prevent ischemic stroke. This article highlights the outcome of an expert meeting on the practical use of NOAC in elderly patients. An interdisciplinary group of experts discussed the current situation of stroke prevention in geriatric patients and its practical management in daily clinical practice. The topic was examined through focused impulse presentations and critical analyses as the basis for the expert consensus. The key issues are summarized in this paper. The European Society of Cardiology (ESC) guidelines from 2012 for the management of patients with non-valvular AF recommend NOAC as the preferred treatment and vitamin K antagonists (VKA) only as an alternative option. Currently, the NOAC factor Xa inhibitors apixaban and rivaroxaban and the thrombin inhibitor dabigatran are more commonly used in clinical practice for patients with AF. Although these drugs have many similarities and are often grouped together it is important to recognize that the pharmacology and dose regimes differ between compounds. Especially n elderly patients NOAC drugs have some advantages compared to VKA, e.g. less drug-drug interactions with concomitant medication and a more favorable risk-benefit ratio mostly driven by the reduction of bleeding. Treatment of anticoagulation in geriatric patients requires weighing the serious risk of stroke against an equally high risk of major bleeding and pharmacoeconomic considerations. Geriatric patients in particular have the greatest benefit from NOAC, which can also be administered in cases of reduced renal function. Regular control of the indications is indispensable, as also for all other medications of the patient. The use of NOAC should certainly not be withheld from geriatric patients who have a clear need for oral anticoagulation.

  12. 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

  13. Legal Rights of Asbestos Exposure Victims. A Practical Legal Guide for People With Breathing and Other Medical Problems, Possibly Resulting from Exposure to Asbestos.

    ERIC Educational Resources Information Center

    Silberfeld, Roman M.; Hecht, Richard L.

    This practical legal guide for people with breathing and other medical problems, possibly resulting from exposure to asbestos, provides 19 questions and detailed answers about Asbestosis and other diseases resulting from asbestos exposure. Included is information concerning symptoms, difficulty of diagnosis, necessity of a detailed…

  14. HIV medical care provider practices for reducing high-risk sexual behavior: results of a qualitative study.

    PubMed

    Drainoni, Mari-Lynn; Dekker, Debra; Lee-Hood, Elizabeth; Boehmer, Ulrike; Relf, Michael

    2009-05-01

    A first step in ensuring that HIV-infected persons practice the safer sexual behaviors that reduce disease transmission is to make certain that they receive accurate information about the relationship between sexual risk behaviors and HIV transmission. Health care providers can play a pivotal role in preventing secondary transmission of HIV; federal agencies and professional guidelines encourage providers to counsel HIV-infected patients about safer sex practices and transmission risks, particularly since the health care encounter may be the only time that HIV-infected persons receive information about prevention and risk reduction interventions. Yet research indicates that these opportunities are often missed. Prior to implementing a prevention demonstration project in an urban HIV and STD clinic, we conducted a qualitative investigation with providers, including physicians, nurse practitioners, physician assistants, and nurses. The purpose of this investigation was to examine the current status of prevention education and counseling efforts at the clinic, examine the barriers and facilitators to providing prevention counseling, and identify key areas where providers believed that they needed additional training.

  15. Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey.

    PubMed

    Trautmann, Jennifer; Epstein, Elizabeth; Rovnyak, Virginia; Snyder, Audrey

    2015-01-01

    The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale-Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting.

  16. Reach preparation enhances visual performance and appearance.

    PubMed

    Rolfs, Martin; Lawrence, Bonnie M; Carrasco, Marisa

    2013-10-19

    We investigated the impact of the preparation of reach movements on visual perception by simultaneously quantifying both an objective measure of visual sensitivity and the subjective experience of apparent contrast. Using a two-by-two alternative forced choice task, observers compared the orientation (clockwise or counterclockwise) and the contrast (higher or lower) of a Standard Gabor and a Test Gabor, the latter of which was presented during reach preparation, at the reach target location or the opposite location. Discrimination performance was better overall at the reach target than at the opposite location. Perceived contrast increased continuously at the target relative to the opposite location during reach preparation, that is, after the onset of the cue indicating the reach target. The finding that performance and appearance do not evolve in parallel during reach preparation points to a distinction with saccade preparation, for which we have shown previously there is a parallel temporal evolution of performance and appearance. Yet akin to saccade preparation, this study reveals that overall reach preparation enhances both visual performance and appearance.

  17. Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.

    PubMed

    Chenoweth, Carol E; Hines, Stephen C; Hall, Kendall K; Saran, Rajiv; Kalbfleisch, John D; Spencer, Teri; Frank, Kelly M; Carlson, Diane; Deane, Jan; Roys, Erik; Scholz, Natalie; Parrotte, Casey; Messana, Joseph M

    2015-07-01

    OBJECTIVE To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. SETTING AND PARTICIPANTS Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status. MEASUREMENTS Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012. RESULTS There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%-92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%-100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation. CONCLUSIONS Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.

  18. Simulated crop yield in response to changes in climate and agricultural practices: results from a simple process based model

    NASA Astrophysics Data System (ADS)

    Caldararu, S.; Smith, M. J.; Purves, D.; Emmott, S.

    2013-12-01

    Global agriculture will, in the future, be faced with two main challenges: climate change and an increase in global food demand driven by an increase in population and changes in consumption habits. To be able to predict both the impacts of changes in climate on crop yields and the changes in agricultural practices necessary to respond to such impacts we currently need to improve our understanding of crop responses to climate and the predictive capability of our models. Ideally, what we would have at our disposal is a modelling tool which, given certain climatic conditions and agricultural practices, can predict the growth pattern and final yield of any of the major crops across the globe. We present a simple, process-based crop growth model based on the assumption that plants allocate above- and below-ground biomass to maintain overall carbon optimality and that, to maintain this optimality, the reproductive stage begins at peak nitrogen uptake. The model includes responses to available light, water, temperature and carbon dioxide concentration as well as nitrogen fertilisation and irrigation. The model is data constrained at two sites, the Yaqui Valley, Mexico for wheat and the Southern Great Plains flux site for maize and soybean, using a robust combination of space-based vegetation data (including data from the MODIS and Landsat TM and ETM+ instruments), as well as ground-based biomass and yield measurements. We show a number of climate response scenarios, including increases in temperature and carbon dioxide concentrations as well as responses to irrigation and fertiliser application.

  19. Treatment trends for haemophilia A and haemophilia B in the United States: results from the 2010 practice patterns survey.

    PubMed

    Zappa, S; McDaniel, M; Marandola, J; Allen, G

    2012-05-01

    Frequent evaluation of haemophilia treatment is necessary to improve patient care. The 2010 Practice Patterns Survey (PPS) investigated current trends in haemophilia treatment in the United States, as reported by nurses. The aim was to document practice patterns for haemophilia A and haemophilia B Survey questionnaires were sent to nurses at haemophilia treatment centres (HTCs) across the United States. Seventy-one of 126 HTCs (56%) responded to the survey. Factor dosage across treatment modalities ranged from 20 to 50 IU kg(-1) for severe haemophilia A. Dosage for severe haemophilia B was more variable (<40 to >100 IU kg(-1)). On-demand dosing regimens were inconsistent for haemophilia A and more so for haemophilia B. Rates of adherence to prescribed treatment were similar for both haemophilia types (∼80%). The main barrier to adherence was identified as inconvenience. More bleeding episodes occurred in adults (16.6 bleeding episodes per year) with severe haemophilia A than in younger patients (11.3 bleeding episodes per year) before switching patients to prophylaxis. For both haemophilia types, most patients who switched from prophylaxis to on-demand treatment were aged 13-24 years; these patients also had the lowest adherence (60-71%). More paediatric patients with severe haemophilia A and inhibitors (53%) received prophylactic bypassing therapy than their haemophilia B counterparts (38%). Adults with severe haemophilia A faced challenges in relation to co-morbidities and long-term care. This PPS provides insights into previously unexplored aspects of haemophilia care that will serve to increase awareness and promote discussion of current issues affecting haemophilia patient care.

  20. Variation in reach-scale bankfull discharge of the Jingjiang Reach undergoing upstream and downstream boundary controls

    NASA Astrophysics Data System (ADS)

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

    2017-04-01

    Remarkable channel degradation has occurred in the Jingjiang Reach of the Middle Yangtze River, since the operation of the Three Gorges Project, which has caused significant geomorphic adjustments, including the variation in bankfull discharge. Bankfull discharge is a key indicator of flood-discharge capacity in the Jingjiang Reach, which can adjust in response to the altered water and sediment conditions and local base-level changes. Therefore, it is important to investigate the variation in reach-scale bankfull discharge, because of longitudinal variability in channel geometry and bankfull discharge in the study reach. In this study, a general method to calculate the section-scale bankfull discharge using the simulated stage-discharge relation is outlined briefly, and an integrated method is then presented for estimating the reach-scale bankfull discharge. The post-flood reach-scale bankfull discharges in the study reach from 2002 to 2015 were calculated, using the proposed method, based on surveyed post-flood profiles at 171 sections and measured hydrological data at three hydrometric sections and eight water gauge sections. The calculated results indicate that: (i) the reach-scale bankfull discharge in the Jingjiang Reach ranged between 32,731 and 38,949 m3/s over this period, with the average bankfull discharge in the Upper Jingjiang Reach being generally greater than the value in the Lower Jingjiang Reach; (ii) the magnitude of the reach-scale bankfull discharge responded well to the cumulative effect of incoming flow and sediment conditions at the inlet boundary, as well as the change of local base level at the outlet boundary; and (iii) the flood-discharge capacity of the reach was controlled by both the upstream and downstream boundary conditions, and the reach-scale bankfull discharge was expressed by an empirical function of the previous five-year average fluvial erosion intensity during flood seasons at Zhicheng, and the difference between the flood

  1. Health campaign channels: tradeoffs among reach, specificity, and impact.

    PubMed

    Schooler, C; Chaffee, S H; Flora, J A; Roser, C

    1998-03-01

    Stanford University's Five-City Multifactor Risk Reduction Project (FCP) was a 14-year trial of community-wide cardiovascular disease (CVD) risk reduction through integrated programs of community organization and mass media health promotion. The project was launched in 1978 in 5 central California cities, including Monterey, Salinas, Modesto, and San Luis Obispo. TV public service announcements (PSAs), TV shows, booklets, printed tip sheets with brief health suggestions on 7 topics, and newspaper coverage were the types of mass media approaches used in the FCP. These strategies are compared with regard to reach, specificity, and impact for a 5-year study period from 1979/80. Reach is measured as the number of messages intervention community residents remembered, specificity was assessed by examining whether the campaign differentially reached people who were already knowledgeable and practicing cardiovascular disease risk reduction, and impact is defined as the amount of knowledge gained during the course of the campaign. Reach was highest for tip sheets, while specificity was highest for booklets followed by TV programs. Newspaper messages had the most impact, followed by booklets and TV PSAs, tip sheets, and TV programs. Communication channels varied according to reach, specificity, and impact, with each criterion being distinct. No channel was optimal for all 3 of the outcome measures.

  2. Decoding Movement Goals from the Fronto-Parietal Reach Network

    PubMed Central

    Gertz, Hanna; Lingnau, Angelika; Fiehler, Katja

    2017-01-01

    During reach planning, fronto-parietal brain areas need to transform sensory information into a motor code. It is debated whether these areas maintain a sensory representation of the visual cue or a motor representation of the upcoming movement goal. Here, we present results from a delayed pro-/anti-reach task which allowed for dissociating the position of the visual cue from the reach goal. In this task, the visual cue was combined with a context rule (pro vs. anti) to infer the movement goal. Different levels of movement goal specification during the delay were obtained by presenting the context rule either before the delay together with the visual cue (specified movement goal) or after the delay (underspecified movement goal). By applying functional magnetic resonance imaging (fMRI) multivoxel pattern analysis (MVPA), we demonstrate movement goal encoding in the left dorsal premotor cortex (PMd) and bilateral superior parietal lobule (SPL) when the reach goal is specified. This suggests that fronto-parietal reach regions (PRRs) maintain a prospective motor code during reach planning. When the reach goal is underspecified, only area PMd but not SPL represents the visual cue position indicating an incomplete state of sensorimotor integration. Moreover, this result suggests a potential role of PMd in movement goal selection. PMID:28286476

  3. 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.

  4. Television Project to Reach the Handicapped Deaf.

    ERIC Educational Resources Information Center

    Hertzler, Ann A.; And Others

    1981-01-01

    Describes a project designed to use television public service announcements to present basic nutrition concepts and the nutritional choices in the marketplace in a format that would reach the handicapped deaf and the nonhandicapped as well. (CT)

  5. 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.

  6. The impact of REACH on classification for human health hazards.

    PubMed

    Oltmanns, J; Bunke, D; Jenseit, W; Heidorn, C

    2014-11-01

    The REACH Regulation represents a major piece of chemical legislation in the EU and requires manufacturers and importers of chemicals to assess the safety of their substances. The classification of substances for their hazards is one of the crucial elements in this process. We analysed the effect of REACH on classification for human health endpoints by comparing information from REACH registration dossiers with legally binding, harmonised classifications. The analysis included 142 chemicals produced at very high tonnages in the EU, the majority of which have already been assessed in the past. Of 20 substances lacking a harmonised classification, 12 chemicals were classified in REACH registration dossiers. More importantly, 37 substances with harmonised classifications for human health endpoints had stricter classifications in registration dossiers and 29 of these were classified for at least one additional endpoint not covered by the harmonised classification. Substance-specific analyses suggest that one third of these additional endpoints emerged from experimental studies performed to fulfil information requirements under REACH, while two thirds resulted from a new assessment of pre-REACH studies. We conclude that REACH leads to an improved hazard characterisation even for substances with a potentially good data basis.

  7. How is post-mortem microbiology appraised by pathologists? Results from a practice survey conducted by ESGFOR.

    PubMed

    Saegeman, V; Cohen, M C; Alberola, J; Ziyade, N; Farina, C; Cornaglia, G; Fernández-Rodríguez, A

    2017-02-24

    Post-mortem microbiology (PMM) is an important tool in forensic pathology, assisting to determine the cause and manner of death. However, there is a lack of standardisation of PMM sampling. In order to get a better insight into the methods used, the available technical options and developmental needs, ESCMID Study Group for Forensic and Postmortem Microbiology (ESGFOR) members designed a survey aimed at pathologists regarding common practices of PMM in clinical and forensic autopsies. Multiple choice questions were developed based on Cumulative Techniques and Procedures in Clinical Microbiology (Cumitech). The questionnaire was sent to pathologists mainly across Europe and Turkey using SurveyMonkey. The survey had 147 respondents. Although all pathologists were aware of the existence of PMM, 39% (19/49) of the participants were not using it. The three main indications for PMM were: (i) clinical suspicion of an infection not confirmed antemortem (83%), (ii) infectious signs at autopsy (83%) and (iii) as part of a standard protocol for foetal/perinatal or paediatric death (67%). Almost 80% of the participants using PMM stated taking 1-10 samples per case. Of the requested examinations, a general bacteriological culture (96%) and a specific polymerase chain reaction (PCR) assay for a particular infectious agent (34%) were most popular. The most frequent samples were: heart blood (66%), peripheral femoral blood (49%), spleen (64%) and lung (56%). Eighty-nine percent of the participants considered PMM a useful resource when investigating the cause of death. Although there are some common uses, this survey indicates that there is a need for improvement towards standardising sampling procedures in PMM.

  8. Factor VIII prophylaxis for adult patients with severe haemophilia A: results of a US survey of attitudes and practices.

    PubMed

    Walsh, C E; Valentino, L A

    2009-09-01

    The emergence of a population of relatively healthy adults with severe haemophilia A presents a unique challenge for haemophilia care in the 21st century. Understanding how best to continue, restart, initiate or modify prophylaxis in younger and older adult patients is essential to optimizing their care. To elucidate practice and outcome data, a survey was sent to 23 US hemophilia treatment centers (HTCs); 10 centers responded, providing data concerning up to 145 adults (mean age of 34 years). Forty-eight patients (33%) were on regular prophylaxis when first seen at the HTC; the prophylactic regimen was modified for 22/48 (46%), often because of breakthrough bleeding. Five of 21 patients (24%) for whom data were available discontinued prophylaxis. Three of those five patients (60%) experienced increased bleeding episodes and the other two (40%) subsequently resumed regular prophylactic infusions because of the increased bleeding. Of the 77 patients not initially receiving prophylaxis for whom data were available, prophylaxis was started or resumed in all. The prophylactic regimen was modified in 57/77 patients (74%) at some point during treatment, often because of breakthrough bleeding. Of the 55 patients whose prophylactic regimens were modified for whom data were available, 22 (40%) discontinued prophylaxis. Thirteen of 20 patients (65%) for whom data were available experienced an increase in bleeding episodes and 7/18 patients (39%) who had discontinued prophylaxis and for whom data were available subsequently resumed regular prophylactic infusions because of bleeding. These findings suggest that prophylaxis prevents bleeding in adults with severe haemophilia A and that discontinuation of the prophylactic regimen is associated with increased bleeding events.

  9. [Which recent results in Oncology and Hematology will have an impact on our practices? The point of vue of Bulletin du Cancer editorial board].

    PubMed

    Vignot, Stéphane; André, Thierry; Gonçalves, Anthony; Guièze, Romain; Magné, Nicolas; Orbach, Daniel; Penel, Nicolas; Thariat, Juliette; Wislez, Marie; Bay, Jacques-Olivier

    2017-01-01

    Among the results presented at international congresses or published in scientific journals, which are those that have a real impact on daily practice? Every year, the editorial board of the Bulletin du Cancer proposes a selection of key data in oncology and hematology. The objective is to discuss results that change or reinforce the strategies in 2016 but also identify key information for our reflections in 2017.

  10. 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.

  11. Best Practices in Grid Integration of Variable Wind Power: Summary of Recent US Case Study Results and Mitigation Measures

    SciTech Connect

    Smith, J. Charles; Parsons, Brian; Acker, Thomas; Milligan, Michael; Zavidil, Robert; Schuerger, Matthew; DeMeo, Edgar

    2010-01-22

    This paper will summarize results from a number of utility wind integration case studies conducted recently in the US, and outline a number of mitigation measures based on insights from those studies.

  12. Inhibitory control of reaching movements in humans.

    PubMed

    Mirabella, Giovanni; Pani, Pierpaolo; Paré, Martin; Ferraina, Stefano

    2006-09-01

    Behavioral flexibility provides a very large repertoire of actions and strategies, however, it carries a cost: a potential interference between different options. The voluntary control of behavior starts exactly with the ability of deciding between alternatives. Certainly inhibition plays a key role in this process. Here we examined the inhibitory control of reaching arm movements with the countermanding paradigm. Right-handed human subjects were asked to perform speeded reaching movements toward a visual target appearing either on the same or opposite side of the reaching arm (no-stop trials), but to withhold the commanded movement whenever an infrequent stop signal was presented (stop trials). As the delay between go and stop signals increased, subjects increasingly failed to inhibit the movement. From this inhibitory function and the reaction times of movements in no-stop trials, we estimated the otherwise unobservable duration of the stopping process, the stop signal reaction time (SSRT). We found that the SSRT for reaching movements was, on average, 206 ms and that it varied with the reaching arm and the target position even though the stop signal was a central stimulus. In fact, subjects were always faster to withhold reaching movements toward visual targets appearing on the same side of the reaching arm. This behavior strictly parallels the course of the reaction times of no-stop trials. These data show that the stop and go processes interacting in this countermanding task are independent, but most likely influenced by a common factor when under the control of the same hemisphere. In addition, we show that the point beyond which the response cannot be inhibited, the so-called point-of-no-return that divides controlled and ballistic phases of movement processing, lies after the inter-hemispheric transfer.

  13. Optic ataxia: from Balint's syndrome to the parietal reach region.

    PubMed

    Andersen, Richard A; Andersen, Kristen N; Hwang, Eun Jung; Hauschild, Markus

    2014-03-05

    Optic ataxia is a high-order deficit in reaching to visual goals that occurs with posterior parietal cortex (PPC) lesions. It is a component of Balint's syndrome that also includes attentional and gaze disorders. Aspects of optic ataxia are misreaching in the contralesional visual field, difficulty preshaping the hand for grasping, and an inability to correct reaches online. Recent research in nonhuman primates (NHPs) suggests that many aspects of Balint's syndrome and optic ataxia are a result of damage to specific functional modules for reaching, saccades, grasp, attention, and state estimation. The deficits from large lesions in humans are probably composite effects from damage to combinations of these functional modules. Interactions between these modules, either within posterior parietal cortex or downstream within frontal cortex, may account for more complex behaviors such as hand-eye coordination and reach-to-grasp.

  14. Effects of check dams on runoff characteristics along gully reaches, the case of Northern Ethiopia

    NASA Astrophysics Data System (ADS)

    Guyassa, Etefa; Frankl, Amaury; Zenebe, Amanuel; Poesen, Jean; Nyssen, Jan

    2017-02-01

    In the Highlands of Northern Ethiopia soil and water conservation (SWC) practices, including construction of check dams in gullies, have been widely implemented for the last three decades. Despite this extensive installation of check dams, their effects on runoff response are not well understood as compared to those of other SWC practices. Hence, this study examines the effects of check dams on runoff response in gully channels. 90 degree V-notch weirs were installed to measure a wide range of runoff discharges at the upper and lower sections of five gully reaches: two channel cut in sandstone (a gully with check dams and vegetation (SCV) and an untreated gully (S)) and three cut in limestone (an untreated gully (L), a gully with check dams but no vegetation (LC) and a gully with check dams and vegetation (LCV)). Automatic sensors were installed to monitor runoff depth during two rainy seasons (29/08/14 - 17/09/14 and 24/7/15 - 14/09/15). All runoff characteristics at the lower section of each gully reaches were calculated for a gully reaches length of 50 m. In the sandstone area, the results show longer lag times of runoff to reach the lower section of the channel reach in the treated gully (SCV) compared to the untreated gully: difference in time lag equal lag to production of runoff equals 51% for runoff initiation, 61% for peak runoff and 44% for runoff end. An increase of hydraulic roughness by check dams and water transmission losses in deposited sediments are responsible for the delay of runoff to reach the lower part of the gully channels. In the limestone area, different time lags were recorded in different gully reaches regardless of the treatment effects (lag to runoff initiation, lag to peak flow and lag to runoff end were larger at LC, L and LCV, respectively). The reduction of peak runoff discharge between the upper and lower gully sections was larger in the gullies with check dam and vegetation (8-17%) than in gullies without treatment (5

  15. Dissociable effects of the implicit and explicit memory systems on learning control of reaching.

    PubMed

    Hwang, Eun Jung; Smith, Maurice A; Shadmehr, Reza

    2006-08-01

    Adaptive control of reaching depends on internal models that associate states in which the limb experienced a force perturbation with motor commands that can compensate for it. Limb state can be sensed via both vision and proprioception. However, adaptation of reaching in novel dynamics results in generalization in the intrinsic coordinates of the limb, suggesting that the proprioceptive states in which the limb was perturbed dominate representation of limb state. To test this hypothesis, we considered a task where position of the hand during a reach was correlated with patterns of force perturbation. This correlation could be sensed via vision, proprioception, or both. As predicted, when the correlations could be sensed only via proprioception, learning was significantly better as compared to when the correlations could only be sensed through vision. We found that learning with visual correlations resulted in subjects who could verbally describe the patterns of perturbations but this awareness was never observed in subjects who learned the task with only proprioceptive correlations. We manipulated the relative values of the visual and proprioceptive parameters and found that the probability of becoming aware strongly depended on the correlations that subjects could visually observe. In all conditions, aware subjects demonstrated a small but significant advantage in their ability to adapt their motor commands. Proprioceptive correlations produced an internal model that strongly influenced reaching performance yet did not lead to awareness. Visual correlations strongly increased the probability of becoming aware, yet had a much smaller but still significant effect on reaching performance. Therefore, practice resulted in acquisition of both implicit and explicit internal models.

  16. Rethinking the Basic Ideas and Assumptions about the Nature, Function and Results of Child-Rearing Practices.

    ERIC Educational Resources Information Center

    Vaughan, Jerry L.

    This discussion argues that two approaches are helpful in reconciling the dissonance and conflict between attitudes and behavior in families, that results from faulty expectations in childrearing processes. One such approach is to change attitudes so they conform to actual behavior. An alternative approach is to change behavioral patterns to make…

  17. Improving Library Service Quality to Graduate Students: LibQual+[TM] Survey Results in a Practical Setting

    ERIC Educational Resources Information Center

    Jankowska, Maria Anna; Hertel, Karen; Young, Nancy J.

    2006-01-01

    The LibQUAL+[TM] survey was conducted to determine user satisfaction and expectations concerning library service quality. The results of the "22 items and a box" constituted a rich source of information for the University of Idaho (UI) Library's strategic planning process. Focusing on graduate students, this study used three…

  18. Sustainable Permaculture systems demonstration in the high mountain desert region of New Mexico -- results of five years practice

    SciTech Connect

    Lawrence, V.

    1997-12-31

    This paper reports on five years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Recently completed work includes a grant-financed (US Fish and Wildlife Service Partners for Wildlife Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. The paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  19. Sustainable permaculture systems demonstration in the high mountain desert region of New Mexico -- results of three years practice

    SciTech Connect

    Lawrence, V.

    1995-11-01

    This paper reports on three years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico which receives less than 11 inches rainfall/year. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Additionally, significant work has been performed in the area of youth education and community development. Current work includes a grant-financed (US Fish and Wildlife Service ``Partners for Wildlife`` Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. This paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  20. Assessment of Environmental Qualification Practices and Condition Monitoring Techniques for Low-Voltage Electric Cables: LOCA Test Results

    SciTech Connect

    Lofaro, R.; Grove, E.; Villaran, M.; Soo, P.; Hsu, F.

    2001-02-01

    This report documents the results of a research program addressing issues related to the qualification process for low-voltage instrumentation and control (I&C) electric cables used in commercial nuclear power plants. Three commonly used types of I&C cable were tested: Cross-Linked Polyethylene (XLPE) insulation with a Neoprene® jacket, Ethylene Propylene Rubber (EPR) insulation with an unbonded Hypalon® jacket, and EPR with a bonded Hypalon® jacket. Each cable type received accelerated aging to simulate 20, 40, and 60 years of qualified life. In addition, naturally aged cables of the same types were obtained from decommissioned nuclear power plants and tested. The cables were subjected to simulated loss-of-coolant-accident (LOCA) conditions, which included the sequential application of LOCA radiation followed by exposure to steam at high temperature and pressure, as well as to chemical spray. Periodic condition monitoring (CM) was performed using nine different techniques to obtain data on the condition of the cable, as well as to evaluate the effectiveness of those CM techniques for in situ monitoring of cables. Volume 1 of this report presents the results of the LOCA tests, and Volume 2 discusses the results of the condition monitoring tests.

  1. Understanding CMMI Measurement Capabilities & Impact on Performance: Results from the 2007 SEI State of the Measurement Practice Survey

    DTIC Science & Technology

    2007-11-14

    Measurement in the Organization ML1&DK ML2 ML3 ML4&5 N = 151 N = 84 N = 59 N = 71 Gamma = .73 p < .0001 30% 28% 34% 8% 8% 2% 70% 22% 75% 3% 1...2007 © 2007 Carnegie Mellon University Interpreting the results: The Respondents’ Measurement Roles ML1&DK ML2 ML3 ML4&5 N = 151 N = 84 N = 59 N = 70...Goldenson, 14 November 2007 © 2007 Carnegie Mellon University How Measurement Work is Staffed ML1&DK ML2 ML3 ML4&5 N = 78 N = 60 N = 58 N = 60 p < .006

  2. Reaching hard-to-reach individuals: Nonselective versus targeted outbreak response vaccination for measles.

    PubMed

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

    2014-01-15

    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.

  3. A new method to decide the practical feature of Fresnel lens from the result of ultra-high refractive index method (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Shibuya, Masato; Hiramatsu, Takashi; Araki, Keisuke; Nakadate, Suezou; Fujii, Junki

    2016-10-01

    We propose a new method to decide the brazed feature of Fresnel lens from the result of high refractive index method. Traditionally the feature has been designed to satisfy the phase-difference function for a point object by having brazed surface relieves only on one side of the lens. Therefore the exit ray of the practical feature is different from that of high-index method even for this point object. Thus the aberration is changed. To solve this problem, we propose Fresnel lens having brazed feature on both sides. Studying the spherical Fresnel lens which collects sun light, we theoretically show how to decide the shape. Also by practical lens designing, we demonstrate the validity of our theory. The proposed method is useful to decide the brazed feature of Fresnel lens from the result of high refractive index method, especially for small view angle lenses.

  4. Role of epidural anesthesia in a fast track liver resection protocol for cirrhotic patients - results after three years of practice

    PubMed Central

    Siniscalchi, Antonio; Gamberini, Lorenzo; Bardi, Tommaso; Laici, Cristiana; Gamberini, Elisa; Francorsi, Letizia; Faenza, Stefano

    2016-01-01

    AIM To evaluate the potential benefits and risks of the use of epidural anaesthesia within an enhanced recovery protocol in this specific subpopulation. METHODS A retrospective review was conducted, including all cirrhotic patients who underwent open liver resection between January 2013 and December 2015 at Bologna University Hospital. Patients with an abnormal coagulation profile contraindicating the placement of an epidural catheter were excluded from the analysis. The control group was composed by patients refusing epidural anaesthesia. RESULTS Of the 183 cirrhotic patients undergoing open liver resections, 57 had contraindications to the placement of an epidural catheter; of the remaining 126, 86 patients received general anaesthesia and 40 combined anaesthesia. The two groups presented homogeneous characteristics. Intraoperatively the metabolic data did not differ between the two groups, whilst the epidural group had a lower mean arterial pressure (P = 0.041) and received more colloid infusions (P = 0.007). Postoperative liver and kidney function did not differ significantly. Length of mechanical ventilation (P = 0.003) and hospital stay (P = 0.032) were significantly lower in the epidural group. No complications related to the epidural catheter placement or removal was recorded. CONCLUSION The use of Epidural Anaesthesia within a fast track protocol for cirrhotic patients undergoing liver resections had a positive impact on the patient’s outcomes and comfort as demonstrated by a significantly lower length of mechanical ventilation and hospital stay in the epidural group. The technique appears to be safely manageable in this fragile population even though these results need confirmation in larger studies. PMID:27660677

  5. 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.

  6. Integrated Georeferencing of Stereo Image Sequences Captured with a Stereovision Mobile Mapping System - Approaches and Practical Results

    NASA Astrophysics Data System (ADS)

    Eugster, H.; Huber, F.; Nebiker, S.; Gisi, A.

    2012-07-01

    Stereovision based mobile mapping systems enable the efficient capturing of directly georeferenced stereo pairs. With today's camera and onboard storage technologies imagery can be captured at high data rates resulting in dense stereo sequences. These georeferenced stereo sequences provide a highly detailed and accurate digital representation of the roadside environment which builds the foundation for a wide range of 3d mapping applications and image-based geo web-services. Georeferenced stereo images are ideally suited for the 3d mapping of street furniture and visible infrastructure objects, pavement inspection, asset management tasks or image based change detection. As in most mobile mapping systems, the georeferencing of the mapping sensors and observations - in our case of the imaging sensors - normally relies on direct georeferencing based on INS/GNSS navigation sensors. However, in urban canyons the achievable direct georeferencing accuracy of the dynamically captured stereo image sequences is often insufficient or at least degraded. Furthermore, many of the mentioned application scenarios require homogeneous georeferencing accuracy within a local reference frame over the entire mapping perimeter. To achieve these demands georeferencing approaches are presented and cost efficient workflows are discussed which allows validating and updating the INS/GNSS based trajectory with independently estimated positions in cases of prolonged GNSS signal outages in order to increase the georeferencing accuracy up to the project requirements.

  7. Morbidity by tuberculosis in the Jiu Valley: relation with diagnostic practice and the impact on therapeutic results

    PubMed Central

    PETRE, NICOLAE; HOMORODEAN, DANIELA; POP, CARMEN MONICA

    2017-01-01

    Background and aim In the last two and a half decades the dynamics of tuberculosis has been modelled by social and economic conditions, with consequences on the life style, and effects on the onset and evolution of the disease. The Jiu Valley is an area with social problems: mining, mines closing down and ceasing activity, poverty. We looked for a relationship between changes of life style in the Jiu Valley and the dynamics of tuberculosis. Methods We studied 528 patients who asked for medical services in different hospitals in the Jiu Valley between 2010–2013. We structurally characterized this group, we identified the characteristics of life style, and we assessed the health state, in particular the relation with tuberculosis. Results We found out that the quality of life was influenced by the health state, especially by tuberculous disease. Quality of life was influenced by the life style, professional factors and their long term consequences. The study evidenced a strong relationship between apparently very different factors such as life style, professional factors on one side and those characterizing tuberculosis. Conclusions We report the first detailed epidemiological data on tuberculosis in an economically poor area, the Jiu Valley. PMID:28246497

  8. Techniques, tools and best practices for ligand electron-density analysis and results from their application to deposited crystal structures.

    PubMed

    Pozharski, Edwin; Weichenberger, Christian X; Rupp, Bernhard

    2013-02-01

    As a result of substantial instrumental automation and the continuing improvement of software, crystallographic studies of biomolecules are conducted by non-experts in increasing numbers. While improved validation almost ensures that major mistakes in the protein part of structure models are exceedingly rare, in ligand-protein complex structures, which in general are most interesting to the scientist, ambiguous ligand electron density is often difficult to interpret and the modelled ligands are generally more difficult to properly validate. Here, (i) the primary technical reasons and potential human factors leading to problems in ligand structure models are presented; (ii) the most common categories of building errors or overinterpretation are classified; (iii) a few instructive and specific examples are discussed in detail, including an electron-density-based analysis of ligand structures that do not contain any ligands; (iv) means of avoiding such mistakes are suggested and the implications for database validity are discussed and (v) a user-friendly software tool that allows non-expert users to conveniently inspect ligand density is provided.

  9. Can ESD Reach the Year 2020?

    ERIC Educational Resources Information Center

    Lenglet, Frans

    2014-01-01

    In order to have long-term impact ESD concepts, practices and policies should move into societal, policy and research arenas with high visibility and traction. In the process of going "transboundary", the ESD label may fade but the practice and organization of social and collaborative learning may gain.

  10. Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

    PubMed Central

    Einstein, Andrew J.; Pascual, Thomas N. B.; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V.; Mahmarian, John J.; Better, Nathan; Bouyoucef, Salah E.; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V. Peter C.; Alexánderson, Erick; Allam, Adel H.; Al-Mallah, Mouaz H.; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A.; Luxenburg, Osnat; Shaw, Leslee J.; Underwood, S. Richard; Rehani, Madan M.; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

    2015-01-01

    Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. PMID:25898845

  11. Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries

    PubMed Central

    2015-01-01

    Background Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Design Multicenter, multilevel cross-sectional study. Setting and Participants Seventy-three acute care hospitals with 276 departments managing acute myocardial infarction, deliveries, hip fracture, and stroke in seven countries. Intervention None. Measures Predictor variables included 3 hospital- and 4 department-level quality measures. Six measures were collected through direct observation by an external surveyor and one was assessed through a questionnaire completed by hospital quality managers. Dependent variables included 24 clinical practice indicators based on case note reviews covering the 4 conditions (acute myocardial infarction, deliveries, hip fracture and stroke). A directed acyclic graph was used to encode relationships between predictors, outcomes, and covariates and to guide the choice of covariates to control for confounding. Results and Limitations Data were provided on 9021 clinical records by 276 departments in 73 hospitals. There were substantial variations in compliance with the 24 clinical practice indicators. Weak associations were observed between hospital quality systems and 4 of the 24 indicators, but on analyzing department-level quality systems, strong associations were observed for 8 of the 11 indicators for acute myocardial infarction and stroke. Clinical indicators supported by higher levels of evidence were more frequently associated with quality systems and activities. Conclusions There are significant gaps between recommended standards of care and clinical practice in a large sample of hospitals. Implementation of department-level quality strategies was significantly

  12. Evidence supporting primary prevention of cardiovascular diseases with statins: Gaps between updated clinical results and actual practice.

    PubMed

    Bruckert, Eric; Ferrières, Jean

    2014-03-01

    The use of pharmacological lipid-lowering intervention in individuals with hypercholesterolaemia and known cardiovascular disease or diabetes/chronic kidney disease is well established. Current European Society of Cardiology guidelines recommend immediate initiation of drugs in adjunct to lifestyle intervention in these patients at high or very high cardiovascular risk. In these clinical settings, statins are generally chosen as the first-choice drug intervention, in consideration of the robust evidence showing a reduction in all-cause mortality and major adverse cardiac events (MACE). In contrast, primary prevention with statins, even in the subset of patients at high-risk of cardiovascular events, is not well implemented. This might be related to a lack of public awareness regarding the actual risk associated with prolonged exposure to high concentrations of low-density lipoprotein cholesterol (LDL-C) and uncertainties in the clinical evidence coming from the earliest trials in this patient subset. However, recent observational studies suggest that lowering LDL-C earlier in life and for a longer duration can substantially decrease the burden of cardiovascular disease and mortality. Moreover, results from recent well-conducted large meta-analyses of randomized clinical trials showed that primary prevention with statins reduced all-cause mortality by 14% and MACE by > 20% - findings similar to those observed for the use of statins in secondary prevention. Recently published American Heart Association/American College of Cardiology guidelines on the treatment of blood cholesterol emphasize that primary prevention using high-dose statins in individuals with LDL-C ≥ 190 mg/dL induces a benefit in atherosclerotic cardiovascular risk reduction that clearly exceeds the potential for adverse effects. We aim in this review to discuss the new data that advocate the use of statins in primary prevention earlier and more frequently, putting the efficacy evidence into

  13. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer

    PubMed Central

    Davidson, Susan E; Gillespie, Catherine; Allum, William H; Swarbrick, Edwin

    2011-01-01

    Backgound The number of patients with chronic gastrointestinal (GI) symptoms after cancer therapies which have a moderate or severe impact on quality of life is similar to the number diagnosed with inflammatory bowel disease annually. However, in contrast to patients with inflammatory bowel disease, most of these patients are not referred for gastroenterological assessment. Clinicians who do see these patients are often unaware of the benefits of targeted investigation (which differ from those required to exclude recurrent cancer), the range of available treatments and how the pathological processes underlying side effects of cancer treatment differ from those in benign GI disorders. This paper aims to help clinicians become aware of the problem and suggests ways in which the panoply of syndromes can be managed. Methods A multidisciplinary literature review was performed to develop guidance to facilitate clinical management of GI side effects of cancer treatments. Results Different pathological processes within the GI tract may produce identical symptoms. Optimal management requires appropriate investigations and coordinated multidisciplinary working. Lactose intolerance, small bowel bacterial overgrowth and bile acid malabsorption frequently develop during or after chemotherapy. Toxin-negative Clostridium difficile and cytomegalovirus infection may be fulminant in immunosuppressed patients and require rapid diagnosis and treatment. Hepatic side effects include reactivation of viral hepatitis, sinusoidal obstruction syndrome, steatosis and steatohepatitis. Anticancer biological agents have multiple interactions with conventional drugs. Colonoscopy is contraindicated in neutropenic enterocolitis but endoscopy may be life-saving in other patients with GI bleeding. After cancer treatment, simple questions can identify patients who need referral for specialist management of GI symptoms. Other troublesome pelvic problems (eg, urinary, sexual, nutritional) are frequent

  14. Reaching out: Beyond School Walls. Spotlight Feature

    ERIC Educational Resources Information Center

    Dopke-Wilson, MariRae

    2008-01-01

    In this article, the author features ideas and strategies for outreach that librarians can do to promote one's library media program and the good work it does. She stresses that by working together and reaching out, librarians can help foster visibility and support for school library media programs and professionals alike nationwide. Here, she…

  15. Reaching Rural Women: Case Studies and Strategies.

    ERIC Educational Resources Information Center

    Colle, Royal D.; Fernandez de Colle, Susana

    Although not often considered in the past by planners because their economic contributions are not performed for money, rural women are contributors to the development of their countries. The urgency of reaching women with important information to break the cycle of poverty is now being recognized by the major development agencies. While there are…

  16. Science Experiments: Reaching Out to Our Users

    ERIC Educational Resources Information Center

    Nolan, Maureen; Tschirhart, Lori; Wright, Stephanie; Barrett, Laura; Parsons, Matthew; Whang, Linda

    2008-01-01

    As more users access library services remotely, it has become increasingly important for librarians to reach out to their user communities and promote the value of libraries. Convincing the faculty and students in the sciences of the value of libraries and librarians can be a particularly "hard sell" as more and more of their primary…

  17. The REACH Youth Program Learning Toolkit

    ERIC Educational Resources Information Center

    Sierra Health Foundation, 2011

    2011-01-01

    Believing in the value of using video documentaries and data as learning tools, members of the REACH technical assistance team collaborated to develop this toolkit. The learning toolkit was designed using and/or incorporating components of the "Engaging Youth in Community Change: Outcomes and Lessons Learned from Sierra Health Foundation's…

  18. Pumpdown assistance extends coiled tubing reach

    SciTech Connect

    Tailby, R.J. )

    1992-07-01

    One of the most challenging coiled tubing applications to emerge in the last few years is horizontal well maintenance. When wireline cannot be used, techniques that offer some of the same flexibility, availability and relatively low cost must be used. During this same period, however, drilling technology has also made huge strides in horizontal and extended-reach areas. Wells are now being drilled with horizontal lengths in excess of 6,000 ft and measured depths of more than 22,000 ft. This paper reports that although horizontal wells are definitely here to stay, many operators have had to reevaluate their positions after being confronted with the problem of recompleting these wells to eliminate excessive water or gas production. A full workover with workstring using either a drilling rig or snubbing unit can be expensive and may lead to lost production because of limited rig availability. Coiled tubing has successfully been used in most cases thus far, but it has length and horizontal reach limitations that drilling technology will soon overtake. Within the constraints of current technology and tube capabilities, coiled tubing does not have the buckling resistance or reel capacity to service today's longest horizontal and extended reach wells or those planned and foreseen in the future. Even if coiled tubing can reach TD, operations requiring downward force are severely restricted.

  19. 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…

  20. REACH. Teacher's Guide, Volume III. Task Analysis.

    ERIC Educational Resources Information Center

    Morris, James Lee; And Others

    Designed for use with individualized instructional units (CE 026 345-347, CE 026 349-351) in the electromechanical cluster, this third volume of the postsecondary teacher's guide presents the task analysis which was used in the development of the REACH (Refrigeration, Electro-Mechanical, Air Conditioning, Heating) curriculum. The major blocks of…

  1. A Rotation Invariant in 3-D Reaching

    ERIC Educational Resources Information Center

    Mitra, Suvobrata; Turvey, M. T.

    2004-01-01

    In 3 experiments, the authors investigated changes in hand orientation during a 3-D reaching task that imposed specific position and orientation requirements on the hand's initial and final postures. Instantaneous hand orientation was described using 3-element rotation vectors representing current orientation as a rotation from a fixed reference…

  2. 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.…

  3. Saturated muscle activation contributes to compensatory reaching strategies following stroke

    PubMed Central

    McCrea, Patrick H; Eng, Janice J; Hodgson, Antony J

    2012-01-01

    The control and execution of movement could potentially be altered by the presence of stroke-induced weakness if muscles are incapable of generating sufficient power. The purpose of this study was to identify compensatory strategies during a forward (sagittal) reaching task for twenty persons with chronic stroke and ten healthy age-matched controls. We hypothesized that the paretic anterior deltoid would be maximally activated (i.e., saturated) during a reaching task and that task completion would require activation of additional muscles, resulting in compensatory movements out of the sagittal plane. For reaching movements by control subjects, joint motion remained largely in the sagittal plane and hand trajectories were smooth and direct. Movement characteristics of the non-paretic arm of stroke subjects were similar to control subjects except for small increases in the abduction angle and the percentage that anterior deltoid was activated. In contrast, reaching movements of the paretic arm of stroke subjects were characterized by increased activation of all muscles, especially the lateral deltoid, in addition to the anterior deltoid, with resulting shoulder abduction power and segmented and indirect hand motion. For the paretic arm of stroke subjects, muscle and kinetic compensations increased with impairment severity and weaker muscles were used at a higher percentage of their available muscle activity. These results suggest that the inability to generate sufficient force with the typical agonists involved during a forward reaching task may necessitate compensatory muscle recruitment strategies to complete the task. PMID:16014786

  4. Saturated muscle activation contributes to compensatory reaching strategies after stroke.

    PubMed

    McCrea, Patrick H; Eng, Janice J; Hodgson, Antony J

    2005-11-01

    The control and execution of movement could potentially be altered by the presence of stroke-induced weakness if muscles are incapable of generating sufficient power. The purpose of this study was to identify compensatory strategies during a forward (sagittal) reaching task for 20 persons with chronic stroke and 10 healthy age-matched controls. We hypothesized that the paretic anterior deltoid would be maximally activated (i.e., saturated) during a reaching task and that task completion would require activation of additional muscles, resulting in compensatory movements out of the sagittal plane. For reaching movements by control subjects, joint motion remained largely in the sagittal plane and hand trajectories were smooth and direct. Movement characteristics of the nonparetic arm of stroke subjects were similar to control subjects except for small increases in the abduction angle and the percentage that anterior deltoid was activated. In contrast, reaching movements of the paretic arm of stroke subjects were characterized by increased activation of all muscles, especially the lateral deltoid, in addition to the anterior deltoid, with resulting shoulder abduction power and segmented and indirect hand motion. For the paretic arm of stroke subjects, muscle and kinetic compensations increased with impairment severity and weaker muscles were used at a higher percentage of their available muscle activity. These results suggest that the inability to generate sufficient force with the typical agonists involved during a forward reaching task may necessitate compensatory muscle recruitment strategies to complete the task.

  5. Engagement of patients in religious and spiritual practices: Confirmatory results with the SpREUK-P 1.1 questionnaire as a tool of quality of life research

    PubMed Central

    Büssing, Arndt; Matthiessen, Peter F; Ostermann, Thomas

    2005-01-01

    Background Quality of life is a multidimensional construct composed of functional, physical, emotional, social and spiritual well-being. In order to examine how patients with severe diseases view the impact of spirituality and religiosity on their health and how they cope with illness, we have developed the SpREUK questionnaire. We deliberately avoided the intermingling of attitudes, convictions and practices, and thus addressed the distinct forms and frequencies of spiritual/religious practices in an additional manual, the SpREUK-P questionnaire. Methods The SpREUK-P was designed to differentiate spiritual, religious, existentialistic and philosophical practices. It was tested in a sample of 354 German subjects (71% women; 49.0 ± 12.5 years). Half of them were healthy controls, while among the patients cancer was diagnosed in 54%, multiple sclerosis in 22%, and other chronic diseases in 23%. Reliability and factor analysis of the inventory were performed according to the standard procedures. Results We confirmed the structure and consistency of the previously described 18-item SpREUK-P manual and improved the quality of the current construct by adding several new items. The new 25-item SpREUK-P 1.1 (Cronbach's alpha = 0.8517) has the following scales: (1) conventional religious practice (CRP), (2) existentialistic practice (ExP), (3) unconventional spiritual practice (USP), (4) nature/environment-oriented practice (NoP), and (5) humanistic practice (HuP). Among the tested individuals, the highest engagement scores were found for HuP and NoP, while the lowest were found for the USP. Women had significantly higher scores for ExP than male patients. With respect to age, the engagement in CRP increases with increasing age, while the engagement in a HuP decreased. Individuals with a Christian orientation and with a religious and spiritual attitude had the highest engagement scores for CRP, while the engagement in an USP was high with respect to a spiritual attitude

  6. Factors influencing breastfeeding practices and postponement of solid food to prevent allergic disease in high-risk children: results from an explorative study.

    PubMed

    Gijsbers, Barbara; Mesters, Ilse; André Knottnerus, J; Legtenberg, Anita H G; van Schayck, Constant P

    2005-04-01

    This paper presents results of seven focus group interviews conducted to gain insight into the feelings, opinions and perceived barriers of parents with a history of asthma who have recently delivered a child. The parents participated in an educational program regarding breastfeeding and postponement of solid food to prevent their child from developing allergic symptoms. Breastfeeding exclusively for 6 months seemed an advice difficult to follow. The most important influencing factors regarding initiation and continuation of breastfeeding were health advantages for the baby, bonding, social support, modelling, knowledge about all the aspects of breastfeeding and breastfeeding confidence. In general, parents adhered to the advice to postpone solid food until the child had reached the age of 6 years. The few obstacles revealed were social pressure, hungry babies and eagerness of parents to give solid food.

  7. Unconstrained three-dimensional reaching in rhesus monkeys.

    PubMed

    Jindrich, Devin L; Courtine, Gregoire; Liu, James J; McKay, Heather L; Moseanko, Rod; Bernot, Timothy J; Roy, Roland R; Zhong, Hui; Tuszynski, Mark H; Reggie Edgerton, V

    2011-03-01

    To better understand normative behavior for quantitative evaluation of motor recovery after injury, we studied arm movements by non-injured rhesus monkeys during a food-retrieval task. While seated, monkeys reached, grasped, and retrieved food items. We recorded three-dimensional kinematics and muscle activity, and used inverse dynamics to calculate joint moments due to gravity, segmental interactions, and to the muscles and tissues of the arm. Endpoint paths showed curvature in three dimensions, suggesting that maintaining straight paths was not an important constraint. Joint moments were dominated by gravity. Generalized muscle and interaction moments were less than half of the gravitational moments. The relationships between shoulder and elbow resultant moments were linear during both reach and retrieval. Although both reach and retrieval required elbow flexor moments, an elbow extensor (triceps brachii) was active during both phases. Antagonistic muscles of both the elbow and hand were co-activated during reach and retrieval. Joint behavior could be described by lumped-parameter models analogous to torsional springs at the joints. Minor alterations to joint quasi-stiffness properties, aided by interaction moments, result in reciprocal movements that evolve under the influence of gravity. The strategies identified in monkeys to reach, grasp, and retrieve items will allow the quantification of prehension during recovery after a spinal cord injury and the effectiveness of therapeutic interventions.

  8. Cerebellar contributions to reach adaptation and learning sensory consequences of action.

    PubMed

    Izawa, Jun; Criscimagna-Hemminger, Sarah E; Shadmehr, Reza

    2012-03-21

    When we use a novel tool, the motor commands may not produce the expected outcome. In healthy individuals, with practice the brain learns to alter the motor commands. This change depends critically on the cerebellum as damage to this structure impairs adaptation. However, it is unclear precisely what the cerebellum contributes to the process of adaptation in human motor learning. Is the cerebellum crucial for learning to associate motor commands with novel sensory consequences, called forward model, or is the cerebellum important for learning to associate sensory goals with novel motor commands, called inverse model? Here, we compared performance of cerebellar patients and healthy controls in a reaching task with a gradual perturbation schedule. This schedule allowed both groups to adapt their motor commands. Following training, we measured two kinds of behavior: in one case, people were presented with reach targets near the direction in which they had trained. The resulting generalization patterns of patients and controls were similar, suggesting comparable inverse models. In the second case, participants reached without a target and reported the location of their hand. In controls, the pattern of change in reported hand location was consistent with simulation results of a forward model that had learned to associate motor commands with new sensory consequences. In patients, this change was significantly smaller. Therefore, in our sample of patients, we observed that while adaptation of motor commands can take place despite cerebellar damage, cerebellar integrity appears critical for learning to predict visual sensory consequences of motor commands.

  9. Reach-Scale Channel Geometry of a Mountain River

    NASA Astrophysics Data System (ADS)

    Wohl, E.; Kuzma, J.; Brown, N.

    2002-12-01

    N. St. Vrain Creek drains 250 km2 of the Colorado Front Range. The basin is underlain by granitic rocks, and the upper half was glaciated. We used 25 study reaches to examine controls on reach-scale channel geometry. Variables measured included channel geometry (width, depth, gradient, bedforms), grain size, and mean velocity. Drainage area at each study reach ranged from 2.2-245 km2, and gradient from 0.013-0.147 m/m. The increase in discharge with drainage area is strongly linear. Channel types included cascade, step-pool, plane-bed and pool-riffle. We examined correlations among (1) the reach-scale response variables bankfull width (w), hydraulic radius (R), mean velocity (v), Darcy-Weisbach ff, bedform wavelength (bw) and amplitude (a), grain size, relative roughness (R/D84) and shear stress (ss), and (2) potential control variables that change progressively downstream (drainage area, discharge) or that are reach-specific (bed gradient). Specifically, we tested the hypothesis that response variables correlate most strongly with local gradient because of the segmented nature of mountain channels. Results from linear regression analyses indicate that most response variables(R/D84, D50, D84, ff, ss) correlate best with gradient, although w, w/d ratio, and bw correlate best with discharge. Multiple regression analyses using Mallow's Cp selection criterion produced similar results in that most response variables correlate strongly with gradient, although the specific variables differ from those selected with linear regressions: w, a, v, ff and ss correlate with gradient, whereas R, bw and v correlate with discharge. These results suggest that the hypothesis is partially supported: channel bed gradient is likely to be a good predictor for many reach-scale response variables along mountain rivers, but discharge is also a good predictor for some response variables. Thus, although subject to strong constraints imposed by changes in gradient and grain size supplied by

  10. 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.

  11. An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

    PubMed Central

    2014-01-01

    Background There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. Results A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. Conclusions The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups. PMID:24667040

  12. 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

  13. Effectiveness of an educational intervention to improve child feeding practices and growth in rural China: updated results at 18 months of age.

    PubMed

    Zhang, Jingxu; Shi, Ling; Chen, Da-Fang; Wang, Jing; Wang, Yan

    2013-01-01

    Inappropriate complementary feeding practices have led to, in part, significant disparities in growth and nutritional status between rural and urban children in China. A cluster-randomised, controlled trial was implemented in Laishui, China to assess the effectiveness of an educational intervention on caregivers' feeding practices and children's growth. Eight townships were randomly assigned to the intervention or control. Five hundred ninety-nine healthy infants were enrolled at 2-4 months old, and were followed up at ages 6, 9, 12, 15 and 18 months. The intervention group received information on enhanced home-prepared recipes and food preparation and hygiene through group training, counselling and home visit. Key outcomes were children's physical growth, caregivers' knowledge and behaviours on complementary feeding, and the infant and child feeding index (ICFI). Analysis was by intention to treat. The intervention group achieved better knowledge and practices related to complementary feeding, and significantly higher ICFI scores at each follow-up point. Children in the intervention group achieved higher z-scores for weight-for-age (WAZ) and weight-for-height (WHZ) than the control (0.18 vs. 0.01 and 0.49 vs. 0.19, respectively) at 18 months old, and were less likely to have stunted growth (odds ratio = 0.71, 95% confidence interval: 0.53-0.94). Mixed model showed that the intervention group achieved significantly better linear growth over time, including WAZ (P = 0.016), WHZ (P = 0.030) and HAZ (P = 0.078). These results indicated that an educational intervention delivered through local health services can enhance caregivers' knowledge and practices of complementary feeding and ultimately improve children's growth.

  14. Which patient and treatment factors are related to successful cardiovascular risk score reduction in general practice? Results from a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Cardiovascular disease is a leading cause of death. It is important to identify patient and treatment factors that are related to successful cardiovascular risk reduction in general practice. This study investigates which patient and treatment factors are related to changes in cardiovascular risk estimation, expressed as the Systematic Coronary Risk Evaluation (SCORE) 10 year risk of cardiovascular mortality. Methods 179 general practice patients with mild-moderately elevated cardiovascular risk followed a one-year programme which included structured lifestyle and medication treatment by practice nurses, with or without additional self-monitoring. From the patient and treatment data collected as part of the “Self-monitoring and Prevention of RIsk factors by Nurse practitioners in the region of Groningen” randomized controlled trial (SPRING-RCT), the contribution of patient and treatment factors to the change in SCORE was analysed with univariate and multivariate analyses. Results In multivariate analyses with multiple patient and treatment factors, only SCORE at baseline, and addition of or dose change in lipid lowering or antihypertensive medications over the course of the study were significantly related to change in SCORE. Conclusions Our analyses support the targeting of treatment at individuals with a high SCORE at presentation. Lipid lowering medication was added or changed in only 12% of participants, but nevertheless was significantly related to ΔSCORE in this study population. Due to the effect of medication in this practice-based project, the possible additional effect of the home monitoring devices, especially for individuals with no indication for medication, may have been overshadowed. Trial registration trialregister.nl NTR2188 PMID:23968366

  15. The gap between practice and guidelines in the choice of first-line disease modifying antirheumatic drug in early rheumatoid arthritis: results from the ESPOIR cohort

    PubMed Central

    Benhamou, Mathilde; Rincheval, Nathalie; Roy, Carine; Foltz, Violaine; Rozenberg, Sylvie; Sibilia, Jean; Schaeverbeke, Thierry; Bourgeois, Pierre; Ravaud, Philippe; Fautrel, Bruno

    2009-01-01

    Introduction To compare rheumatologists’ prescription for first disease-modifying anti-rheumatic drug (DMARD) in early rheumatoid arthritis (RA) in real-life settings with two clinical practice guidelines (CPG), STPR [1] and EULAR [2] and thus assess the gap between practices and guidelines. Methods ESPOIR is a French multicentre cohort study that included 813 early arthritis patients between 2002 and 2005. ‘Definite’ and ‘probable’ RA were defined according to ACR criteria and the level of diagnostic certainty. The objectives were to: 1/assess conformity between the observed first-line DMARD prescribed for those patients and the guidelines’ recommended DMARD; and 2/conduct a mail survey of patients’ usual rheumatologists to explore the reasons for their non-conformity with guidelines. Results 627 patients with definite or probable RA were identified. Conformity rates were 58% for STPR guidelines and 54% for EULAR guidelines. At 6 months, 83 (34%) patients with early RA did not receive any DMARD. Main determinants associated with conformity to guidelines were: disease activity and presence of severity predictive factors. The main reason leading to a discrepancy between guidelines and daily practice appeared to be diagnostic uncertainty, i.e., the difficulty to reliably assess RA diagnosis as soon as the first visits to the rheumatologist. Conclusion There is a substantial gap between CPG and rheumatologists’ daily practice concerning the first DMARD to prescribe in early RA. It is explained mainly by diagnostic uncertainty. More attention should be paid in future guidelines to the diagnostic difficulties of early RA. PMID:19286850

  16. Is rural radiation oncology practice quality as good as the big smoke? Results of the Australian radiotherapy single machine unit trial.

    PubMed

    Shakespeare, T P; Turner, M; Chapman, A

    2007-08-01

    Radiotherapy utilization rates in rural Australia are suboptimal, with one solution being the building of single machine units (SMUs). One concern raised with such an approach is the quality of care delivered in SMUs. The Australian and Victorian governments have established two SMUs in the state of Victoria, with each SMU operated as a satellite service of a major 'hub' site. We report on the planned evaluation of practice quality. Radiation oncologist (RO) clinical practice was externally audited using the Royal Australian and New Zealand College of Radiologists Peer Review Audit instrument. This tool splits RO clinical practice into documentation/quality assurance (QA) criteria and decision-making criteria. Over the four sites, 130 patients were randomly selected for audit. At hub sites, 79.6% of all criteria audited were adequate, compared with 84.4% of criteria audited at SMUs (P = 0.0002). This difference was largely because of better adherence to documentation/QA criteria at the SMU sites. RO decision-making and protocol adherence were routinely very high and consistent with other clinical practice audits. There were no significant differences between hubs and SMUs for adherence to decision-making criteria; however, the few potential deficiencies in patient care identified occurred only at the hub sites. In at least one of these cases, potential suboptimal management was as a direct result of inadequate documentation. This audit found that SMUs provide as high a standard of radiotherapeutic care as larger hub departments. The findings also emphasize the need for all departments to target clinical documentation.

  17. 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)…

  18. Use of evidence based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population based cohort

    PubMed Central

    Manktelow, Bradley N; Piedvache, Aurelie; Cuttini, Marina; Boyle, Elaine; van Heijst, Arno; Gadzinowski, Janusz; Van Reempts, Patrick; Huusom, Lene; Weber, Tom; Schmidt, Stephan; Barros, Henrique; Dillalo, Dominico; Toome, Liis; Norman, Mikael; Blondel, Beatrice; Bonet, Mercedes; Draper, Elisabeth S; Maier, Rolf F

    2016-01-01

    Objectives To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. Design Prospective multinational population based observational study. Setting 19 regions from 11 European countries covering 850 000 annual births participating in the EPICE (Effective Perinatal Intensive Care in Europe for very preterm births) project. Participants 7336 infants born between 24+0 and 31+6 weeks’ gestation in 2011/12 without serious congenital anomalies and surviving to neonatal admission. Main outcome measures Combined use of four evidence based practices for infants born before 28 weeks’ gestation using an “all or none” approach: delivery in a maternity unit with appropriate level of neonatal care; administration of antenatal corticosteroids; prevention of hypothermia (temperature on admission to neonatal unit ≥36°C); surfactant used within two hours of birth or early nasal continuous positive airway pressure. Infant outcomes were in-hospital mortality, severe neonatal morbidity at discharge, and a composite measure of death or severe morbidity, or both. We modelled associations using risk ratios, with propensity score weighting to account for potential confounding bias. Analyses were adjusted for clustering within delivery hospital. Results Only 58.3% (n=4275) of infants received all evidence based practices for which they were eligible. Infants with low gestational age, growth restriction, low Apgar scores, and who were born on the day of maternal admission to hospital were less likely to receive evidence based care. After adjustment, evidence based care was associated with lower in-hospital mortality (risk ratio 0.72, 95% confidence interval 0.60 to 0.87) and in-hospital mortality or severe morbidity, or both (0.82, 0.73 to 0.92), corresponding to an estimated 18% decrease

  19. 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.

  20. The Cognition of Maximal Reach Distance in Parkinson's Disease.

    PubMed

    Otsuki, Satoru; Nagaoka, Masanori

    2016-01-01

    This study aimed to investigate whether the cognition of spatial distance in reaching movements was decreased in patients with Parkinson's disease (PD) and whether this cognition was associated with various symptoms of PD. Estimated and actual maximal reaching distances were measured in three directions in PD patients and healthy elderly volunteers. Differences between estimated and actual measurements were compared within each group. In the PD patients, the associations between "error in cognition" of reaching distance and "clinical findings" were also examined. The results showed that no differences were observed in any values regardless of dominance of hand and severity of symptoms. The differences between the estimated and actual measurements were negatively deviated in the PD patients, indicating that they tended to underestimate reaching distance. "Error in cognition" of reaching distance correlated with the items of posture in the motor section of the Unified Parkinson's Disease Rating Scale. This suggests that, in PD patients, postural deviation and postural instability might affect the cognition of the distance from a target object.

  1. Review of the mechanism of cell death resulting from streptozotocin challenge in experimental animals, its practical use and potential risk to humans

    PubMed Central

    2013-01-01

    Streptozotocin (STZ) (2-deoxy-2-({[methyl(nitroso)amino]carbonyl}amino)-β-D-glucopyranose) is a naturally occurring diabetogenic compound, produced by the soil bacterium streptomyces achromogenes, that exhibits broad spectrum of antibacterial properties. Streptozotocin functions as a DNA synthesis inhibitor in both bacterial and mammalian cells. In mammalian cells, the actual mechanism and metabolic targets of STZ toxicity that results in cell death is not known. This review identifies four key areas that explain the mechanism of the cytotoxicity of STZ in mammalian cell lines, investigates the practical aspects of using STZ in experimental animals and the potential risks of its exposure to human health. PMID:24364898

  2. 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,…

  3. An investigation of the neural circuits underlying reaching and reach-to-grasp movements: from planning to execution

    PubMed Central

    Begliomini, Chiara; De Sanctis, Teresa; Marangon, Mattia; Tarantino, Vincenza; Sartori, Luisa; Miotto, Diego; Motta, Raffaella; Stramare, Roberto; Castiello, Umberto

    2014-01-01

    Experimental evidence suggests the existence of a sophisticated brain circuit specifically dedicated to reach-to-grasp planning and execution, both in human and non-human primates (Castiello, 2005). Studies accomplished by means of neuroimaging techniques suggest the hypothesis of a dichotomy between a “reach-to-grasp” circuit, involving the anterior intraparietal area, the dorsal and ventral premotor cortices (PMd and PMv – Castiello and Begliomini, 2008; Filimon, 2010) and a “reaching” circuit involving the medial intraparietal area and the superior parieto-occipital cortex (Culham et al., 2006). However, the time course characterizing the involvement of these regions during the planning and execution of these two types of movements has yet to be delineated. A functional magnetic resonance imaging study has been conducted, including reach-to-grasp and reaching only movements, performed toward either a small or a large stimulus, and Finite Impulse Response model (Henson, 2003) was adopted to monitor activation patterns from stimulus onset for a time window of 10 s duration. Data analysis focused on brain regions belonging either to the reaching or to the grasping network, as suggested by Castiello and Begliomini (2008). Results suggest that reaching and grasping movements planning and execution might share a common brain network, providing further confirmation to the idea that the neural underpinnings of reaching and grasping may overlap in both spatial and temporal terms (Verhagen et al., 2013). But, although responsive for both actions, they show a significant predominance for either one of the two actions and such a preference is evident on a temporal scale. PMID:25228872

  4. Building a pyramid to practice success.

    PubMed

    Levin, Roger P

    2003-01-01

    Although decisions about the goals of the practice originate with the dentist and drive every other system, a successful dental practice looks like a pyramid. The bottom level includes the effective management of time and resources through efficient scheduling and patient communication. The second level ensures the ability of the practice to reach its goals through results-oriented case acceptance scripting, patient finance options and advanced customer service. The third level focuses on creating long-term relationships with patients and turning the hygiene department into a "WOW" experience profit-center. Dentists must set practice management and production/profitability goals before all others.

  5. Separate adaptive mechanisms for controlling trajectory and final position in reaching.

    PubMed

    Scheidt, Robert A; Ghez, Claude

    2007-12-01

    We examined control of the hand's trajectory (direction and shape) and final equilibrium position in horizontal planar arm movements by quantifying transfer of learned visuomotor rotations between two tasks that required aiming the hand to the same spatial targets. In a trajectory-reversal task ("slicing"), the hand reversed direction within the target and returned to the origin. In a positioning task ("reaching"), subjects moved the hand to the target and held it there; cursor feedback was provided only after movement ended to isolate learning of final position from trajectory direction. We asked whether learning acquired in one task would transfer to the other. Transfer would suggest that the hand's entire trajectory, including its endpoint, was controlled using a common spatial plan. Instead we found minimal transfer, suggesting that the brain used different representations of target position to specify the hand's initial trajectory and its final stabilized position. We also observed asymmetrical practice effects on hand trajectory, including systematic curvature of reaches made after rotation training and hypermetria of untrained slice reversals after reach training. These are difficult to explain with a unified control model, but were replicated in computer simulations that specified the hand's initial trajectory and its final equilibrium position. Our results suggest that the brain uses different mechanisms to plan the hand's initial trajectory and final position in point-to-point movements, that it implements these control actions sequentially, and that trajectory planning does not account for specific impedance values to be implemented about the final stabilized posture.

  6. Riparian Vegetation Mapping Along the Hanford Reach

    SciTech Connect

    FOGWELL, T.W.

    2003-07-11

    During the biological survey and inventory of the Hanford Site conducted in the mid-1990s (1995 and 1996), preliminary surveys of the riparian vegetation were conducted along the Hanford Reach. These preliminary data were reported to The Nature Conservancy (TNC), but were not included in any TNC reports to DOE or stakeholders. During the latter part of FY2001, PNNL contracted with SEE Botanical, the parties that performed the original surveys in the mid 1990s, to complete the data summaries and mapping associated with the earlier survey data. Those data sets were delivered to PNNL and the riparian mapping by vegetation type for the Hanford Reach is being digitized during the first quarter of FY2002. These mapping efforts provide the information necessary to create subsequent spatial data layers to describe the riparian zone according to plant functional types (trees, shrubs, grasses, sedges, forbs). Quantification of the riparian zone by vegetation types is important to a number of DOE'S priority issues including modeling contaminant transport and uptake in the near-riverine environment and the determination of ecological risk. This work included the identification of vegetative zones along the Reach by changes in dominant plant species covering the shoreline from just to the north of the 300 Area to China Bar near Vernita. Dominant and indicator species included Agropyron dasytachyudA. smithii, Apocynum cannabinum, Aristida longiseta, Artemisia campestris ssp. borealis var scouleriana, Artemisa dracunculus, Artemisia lindleyana, Artemisia tridentata, Bromus tectorum, Chrysothamnus nauseosus, Coreopsis atkinsoniana. Eleocharis palustris, Elymus cinereus, Equisetum hyemale, Eriogonum compositum, Juniperus trichocarpa, Phalaris arundinacea, Poa compressa. Salk exigua, Scirpus acutus, Solidago occidentalis, Sporobolus asper,and Sporobolus cryptandrus. This letter report documents the data received, the processing by PNNL staff, and additional data gathered in FY2002

  7. Spallation Neutron Source reaches megawatt power

    SciTech Connect

    Dr. William F. Brinkman

    2009-09-30

    The Department of Energy's Spallation Neutron Source (SNS), already the world's most powerful facility for pulsed neutron scattering science, is now the first pulsed spallation neutron source to break the one-megawatt barrier. "Advances in the materials sciences are fundamental to the development of clean and sustainable energy technologies. In reaching this milestone of operating power, the Spallation Neutron Source is providing scientists with an unmatched resource for unlocking the secrets of materials at the molecular level," said Dr. William F. Brinkman, Director of DOE's Office of Science.

  8. AGU Scholarship Fund Reaches Its Goal

    NASA Astrophysics Data System (ADS)

    Howard, Claire

    2014-11-01

    The Edmond M. Dewan Young Scientist Scholarship fund has reached its goal of $25,000. Those who donated to the fund share AGU's mission in taking an active role in educating and nurturing the next generation of scientists and ensuring a sustainable future for society. Thanks to the generosity of more than 100 members of the AGU and science community, a deserving graduate student of atmospheric or space physics will receive financial assistance to further his or her research and advance his or her research and future career.

  9. Spallation Neutron Source reaches megawatt power

    ScienceCinema

    Dr. William F. Brinkman

    2016-07-12

    The Department of Energy's Spallation Neutron Source (SNS), already the world's most powerful facility for pulsed neutron scattering science, is now the first pulsed spallation neutron source to break the one-megawatt barrier. "Advances in the materials sciences are fundamental to the development of clean and sustainable energy technologies. In reaching this milestone of operating power, the Spallation Neutron Source is providing scientists with an unmatched resource for unlocking the secrets of materials at the molecular level," said Dr. William F. Brinkman, Director of DOE's Office of Science.

  10. Ethical and practical guidelines for reporting genetic research results to study participants: updated guidelines from a National Heart, Lung, and Blood Institute working group.

    PubMed

    Fabsitz, Richard R; McGuire, Amy; Sharp, Richard R; Puggal, Mona; Beskow, Laura M; Biesecker, Leslie G; Bookman, Ebony; Burke, Wylie; Burchard, Esteban Gonzalez; Church, George; Clayton, Ellen Wright; Eckfeldt, John H; Fernandez, Conrad V; Fisher, Rebecca; Fullerton, Stephanie M; Gabriel, Stacey; Gachupin, Francine; James, Cynthia; Jarvik, Gail P; Kittles, Rick; Leib, Jennifer R; O'Donnell, Christopher; O'Rourke, P Pearl; Rodriguez, Laura Lyman; Schully, Sheri D; Shuldiner, Alan R; Sze, Rebecca K F; Thakuria, Joseph V; Wolf, Susan M; Burke, Gregory L

    2010-12-01

    In January 2009, the National Heart, Lung, and Blood Institute convened a 28-member multidisciplinary Working Group to update the recommendations of a 2004 National Heart, Lung, and Blood Institute Working Group focused on Guidelines to the Return of Genetic Research Results. Changes in the genetic and societal landscape over the intervening 5 years raise multiple questions and challenges. The group noted the complex issues arising from the fact that technological and bioinformatic progress has made it possible to obtain considerable information on individuals that would not have been possible a decade ago. Although unable to reach consensus on a number of issues, the working group produced 5 recommendations. The working group offers 2 recommendations addressing the criteria necessary to determine when genetic results should and may be returned to study participants, respectively. In addition, it suggests that a time limit be established to limit the duration of obligation of investigators to return genetic research results. The group recommends the creation of a central body, or bodies, to provide guidance on when genetic research results are associated with sufficient risk and have established clinical utility to justify their return to study participants. The final recommendation urges investigators to engage the broader community when dealing with identifiable communities to advise them on the return of aggregate and individual research results. Creation of an entity charged to provide guidance to institutional review boards, investigators, research institutions, and research sponsors would provide rigorous review of available data, promote standardization of study policies regarding return of genetic research results, and enable investigators and study participants to clarify and share expectations for the handling of this increasingly valuable information with appropriate respect for the rights and needs of participants.

  11. The Two Places Every School Reaches Quality.

    ERIC Educational Resources Information Center

    McCarthy, Kevin J.

    This paper indicates that there are two school locations where the principles of quality are at work: on the team practice field and in the band rehearsal hall. Participants in instrumental music and athletics have shown significantly higher scores on achievement tests, higher grade point averages, and lower absenteeism than the rest of the school…

  12. Integrated Curricular Approaches in Reaching Adult Students

    ERIC Educational Resources Information Center

    Emerick-Brown, Dylan

    2013-01-01

    In the field of adult basic education, there are two strategies that have been found to be of particular value to student learning: multiple intelligences and purpose-based learning. However, putting these learning theories into practice is not always as easy as an educator might at first believe. Adult basic education teacher Dylan Emerick-Brown…

  13. Instructor Manuals That Reach beyond the Basics

    ERIC Educational Resources Information Center

    Eney, Patricia; Davidson, Evelyn; Lau, Pam

    2008-01-01

    Providing instructor manuals for part-time faculty is not a new practice. Post-secondary institutions often produce manuals filled with everything from the college calendar to the procedure for obtaining a parking pass. However, in the age of stretched budgets and waning support from their institutions, developmental education programs are looking…

  14. The effect of fluid flow on coiled tubing reach

    SciTech Connect

    Bhalla, K.; Walton, I.C.

    1996-12-31

    A critical parameter to the success of many coiled tubing (CT) operations in highly deviated or horizontal wells is the depth penetration that can be attained before the CT buckles and locks up. Achieving a desired depth is always critical in CT operations and attaining an additional reach of a few hundred feet can be crucial. This paper addresses the effect of fluid flow in the CT and in the CT/wellbore annulus on the state of force and stress in the CT, and thereby predicts its effect on the reach attainable by the CT. The flow of fluid through the CT and annulus between the CT and borehole modifies the pressures and the effective force which governs the mechanical stability of the CT. The net force per unit length due to fluid flow in the coiled tubing and annulus between the coiled tubing casing/well is calculated in terms of the shear stress and its effect on the onset of buckling and lockup is determined. The model is then implemented in a full tubing forces calculation and the effect of flowing fluids and producing fluids on reach is analyzed. The new model is utilized in the design of commercial jobs. The exact analytic model shows that fluid flow inside the CT has zero impact on reach, that downward flow in the annulus has a favourable impact, and upward flow in the annulus reduces the maximum attainable reach. Using the full tubing forces model, a coiled tubing job can be designed taking into account the flow of a fluid with a specified rheology, density and flow rate. Thus the feasibility of attaining a given reach can be more accurately determined. Results are presented in the form of the surface weight for commercial wells and compared to field jobs.

  15. NASA's Astronomy Education Program: Reaching Diverse Audiences

    NASA Astrophysics Data System (ADS)

    Hasan, Hashima; Smith, Denise Anne; Hertz, Paul; Meinke, Bonnie

    2015-08-01

    An overview will be given of the rich programs developed by NASA to inject the science from it's Astrophysics missions into STEM activities targeted to diverse audiences. For example, Astro4Girls was started as a pilot program during IYA2009. This program partners NASA astrophysics education programs with public libraries to provide NASA-themed hands-on education activities for girls and their families, and has been executed across the country. School curricula and NASA websites have been translated in Spanish; Braille books have been developed for the visually impaired; programs have been developed for the hearing impaired. Special effort has been made to reach underrepresented minorities. Audiences include students, teachers, and the general public through formal and informal education settings, social media and other outlets. NASA Astrophysics education providers include teams embedded in its space flight missions; professionals selected though peer reviewed programs; as well as the Science Mission Directorate Astrophysics Education forum. Representative examples will be presented to demonstrate the reach of NASA education programs, as well as an evaluation of the effectiveness of these programs.

  16. Can donated media placements reach intended audiences?

    PubMed

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer; Polonec, Lindsey

    2013-09-01

    Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.

  17. [Risk assessment and chemical safety under REACH].

    PubMed

    Foth, Heidi

    2008-12-01

    Under the new European chemical legislation REACH (EG 1907/2006), dangerous properties of chemical substances will be evaluated and data gaps will be closed. This information is needed for other regulations, such as safety at the working place or for the safe handling of products. Existing knowledge on chemical compounds must be broadened because previous regulations have focused on high production volume compounds. The evaluation procedures needed too much time, and for the majority of non-evaluated substances a new strategy is needed. REACH places the duty for registration of substances with the producers and importers. Data gaps for risk evaluation will be closed. Competent authorities will be relieved from the primary risk evaluation of most substances. Alternative strategies of evaluation using previous information and non-animal testing approaches will be supported to avoid animal testing where appropriate. The new European chemical agency ECHA will use the provided information in order to identify very dangerous chemical substances which should be controlled by authorization of its use and the circumstances thereof.

  18. Risk-based immunization policies and tuberculosis screening practices for animal care and research workers in the United States: survey results and recommendations.

    PubMed

    Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

    2012-01-01

    A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health assessments and risk communication for vaccine-preventable diseases. Most (72.7%) institutions did not store serum samples from animal research personnel. More than half of the institutions housed nonhuman primates and maintained tuberculosis screening programs, although screening methods varied. Immunization protocols included various recommended or required vaccines that differed depending on job duties, type of institution, and nature of scientific programs. A single case of an identified vaccine-preventable illness in a laboratory worker was noted. Tetanus toxoid was the predominant vaccine administered (91.7%) to animal care and research workers, followed by hepatitis B (54.8%), influenza (39.9%), and rabies (38.3%). For some immunization protocols, an inconsistent rationale for administration was evident. Indications that animal care and research workers are unprotected from work-related etiologic agents did not emerge from this survey; rather, existing guidelines from the Advisory Committee on Immunization Practices and available biologics seem sufficient to address most needs of the laboratory animal research community. Institutions should commit to performance-based standards in parallel with context-specific risk assessment methods to maintain occupational health and safety programs and practices appropriate to their needs.

  19. Risk-Based Immunization Policies and Tuberculosis Screening Practices for Animal Care and Research Workers in the United States: Survey Results and Recommendations

    PubMed Central

    Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

    2012-01-01

    A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health assessments and risk communication for vaccine-preventable diseases. Most (72.7%) institutions did not store serum samples from animal research personnel. More than half of the institutions housed nonhuman primates and maintained tuberculosis screening programs, although screening methods varied. Immunization protocols included various recommended or required vaccines that differed depending on job duties, type of institution, and nature of scientific programs. A single case of an identified vaccine–preventable illness in a laboratory worker was noted. Tetanus toxoid was the predominant vaccine administered (91.7%) to animal care and research workers, followed by hepatitis B (54.8%), influenza (39.9%), and rabies (38.3%). For some immunization protocols, an inconsistent rationale for administration was evident. Indications that animal care and research workers are unprotected from work-related etiologic agents did not emerge from this survey; rather, existing guidelines from the Advisory Committee on Immunization Practices and available biologics seem sufficient to address most needs of the laboratory animal research community. Institutions should commit to performance-based standards in parallel with context-specific risk assessment methods to maintain occupational health and safety programs and practices appropriate to their needs. PMID:23312084

  20. 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.

  1. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 31: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SME mail survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical communications practices of U.S. aerospace engineers and scientists affiliated with, not necessarily belonging to, the Society of Manufacturing Engineers (SME).

  2. The use of risk sharing tools for post adoption surveillance of a non pharmacological technology in routine practice: results after one year

    PubMed Central

    2013-01-01

    Background To report results obtained by combining risk sharing tools with post-adoption surveillance mechanisms in order to control quality of care and implement a value-based reimbursement scheme for Neuro-reflexotherapy (NRT), a non-pharmacological treatment proven effective for neck pain (NP), thoracic pain (TP) and low back pain (LBP). Methods Pre-post prospective cohort study in routine clinical practice, carried out in primary care centers in the Spanish National Health Service in the Balearic Islands (Ib-Salut). Eight-hundred and seventy-one subacute and chronic NP, TP and LBP patients treated in Ib-Salut, who underwent NRT during 2011. A shared risk contract (SRC) was developed, where payments for NRT were linked to results on patients’ clinical evolution, reduction in medication and proportion of patients undergoing spinal surgery. Main outcome measures were local pain (NP, TP or LBP), referred pain, LBP-related disability and NP-related disability, measured using previously validated instruments at referral and 3 months later, use of medication assessed at referral and discharge, and rates of spinal surgery prescription after undergoing NRT. Results Median improvements at discharge corresponded to 57.1% of baseline value for local pain, 75.0% for referred pain, 53.8% for LBP-related disability and 45.0% for NP-related disability. Patients taking medication at discharge represented 29.0% of those taking it at referral. The proportion of patients in whom spinal surgery was prescribed after undergoing NRT was 0%. These results were consistent with those from previous randomised controlled trials (RCTs) and studies in routine practice, and complied with the standards set in the SRC. Conclusions It is feasible and effective to enhance post adoption surveillance methods with risk sharing tools to improve quality control and support value-based reimbursement decisions for NRT. The feasibility of generalising this approach to other settings and to other non

  3. Combining Intensive Counseling by Frontline Workers with a Nationwide Mass Media Campaign Has Large Differential Impacts on Complementary Feeding Practices but Not on Child Growth: Results of a Cluster-Randomized Program Evaluation in Bangladesh123

    PubMed Central

    Nguyen, Phuong Hong; Saha, Kuntal Kumar; Khaled, Adiba; Sanghvi, Tina; Baker, Jean; Afsana, Kaosar; Haque, Raisul; Frongillo, Edward A; Ruel, Marie T; Rawat, Rahul

    2016-01-01

    Background: Complementary feeding (CF) contributes to child growth and development, but few CF programs are delivered at scale. Alive & Thrive addressed this in Bangladesh through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM). Objective: The objective was to evaluate the impact of providing IPC + MM + CM (intensive) compared with standard nutrition counseling + less intensive MM + CM (nonintensive) on CF practices and anthropometric measurements. Methods: We used a cluster-randomized, nonblinded evaluation with cross-sectional surveys [n = ∼600 and 1090 children 6–23.9 mo and 24–47.9 mo/group, respectively, at baseline (2010) and n = ∼500 and 1100 children of the same age, respectively, at endline (2014)]. We derived difference-in-difference impact estimates (DDEs), adjusting for geographic clustering, infant age, sex, differences in baseline characteristics, and differential change in characteristics over time. Results: Groups were similar at baseline. CF improvements were significantly greater in the intensive than in the nonintensive group [DDEs: 16.3, 14.7, 22.0, and 24.6 percentage points (pp) for minimum dietary diversity, minimum meal frequency, minimum acceptable diet, and consumption of iron-rich foods, respectively]. In the intensive group, CF practices were high: 50.4% for minimum acceptable diet, 63.8% for minimum diet diversity, 75.1% for minimum meal frequency, and 78.5% for consumption of iron-rich foods. Timely introduction of foods improved. Significant, nondifferential stunting declines occurred in intensive (6.2 pp) and nonintensive (5.2 pp) groups in children 24–47.9 mo. Conclusions: The intensive program substantially improved CF practices compared with the nonintensive program. Large-scale program delivery was feasible and, with the use of multiple platforms, reached 1.7 million households. Nondifferential impacts on stunting were likely due to rapid positive secular trends in Bangladesh

  4. Specificity of human cortical areas for reaches and saccades

    PubMed Central

    Levy, Ifat; Schluppeck, Denis; Heeger, David J.; Glimcher, Paul W.

    2007-01-01

    Electrophysiological studies in monkeys have identified effector-related regions in the posterior parietal cortex (PPC). The lateral intraparietal area (LIP), for example, responds preferentially for saccades whereas the parietal reach region (PRR) responds preferentially for arm movements. However, the degree of effector selectivity actually observed is limited; each area contains neurons selective for the non-preferred effector, and many neurons in both areas respond for both effectors. We used fMRI to assess the degree of effector preference at the population level, focusing on topographically organized regions in the human PPC (V7, IPS1 and IPS2). An event-related design adapted from monkey experiments was employed. In each trial, an effector cue preceded the appearance of a spatial target, after which a go-signal instructed subjects to produce the specified movement with the specified effector. Our results show that the degree of effector specificity is limited in many cortical areas, and transitions gradually from saccade to reach preference as one moves through the hierarchy of areas in the occipital, parietal, and frontal cortices. Saccade preference was observed in visual cortex, including early areas and V7. IPS1 exhibited balanced activation to saccades and reaches, whereas IPS2 showed a weak but significant preference for reaches. In frontal cortex, areas near the central sulcus showed a clear and absolute preference for reaches while the Frontal Eye Field (FEF) showed little or no effector selectivity. Although these results contradict many theoretical conclusions about effector specificity, they are compatible with the complex picture arising from electrophysiological studies and also with previous imaging studies that reported largely overlapping saccade and arm related activation. The results are also compatible with theories of efficient coding in cortex. PMID:17460081

  5. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico

    PubMed Central

    Fritz, Jimena; Walker, Dilys M.; Cohen, Susanna; Angeles, Gustavo; Lamadrid-Figueroa, Hector

    2017-01-01

    Background In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness. Objective To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births. Methods A pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention) on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls) in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training). Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554. Results Significant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p.) for complete Active Management of Third Stage of Labor (AMTSL) (p = 0.044), and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067); at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026) and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004); at 4 months a 30 (p = 0.001) and at 8 months a 22 (p = 0.010) p.p. decrease for Uterine Sweeping. Conclusions The intervention has an

  6. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    PubMed

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-06-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  7. [Nurses in geriatrics and Alzheimer's disease: knowledge, image, and common practice-results from a survey in a French area (Alsace)].

    PubMed

    Grosclaude, Michèle

    2007-06-01

    From the data of a multicentric investigation, performed in a French area (Alsace) using questionnaires filled by 800 geriatrics nurses, the author analyses their current knowledge and representations of Alzheimer's disease, their attitudes and practice concerning the disclosure of the diagnosis to the patients, and the influence of these data for the patients care. The results show three principal common aspects: first very important gaps, difficulties and contradictions concerning Alzheimer's disease knowledge; then heavy feelings of incompetence, loneliness, and therapeutic inanity with regard to the problems of their practice; last of all, their requests insisting on their need of information, formation, and aid, all missing for them. The nurses' language was devoid of specific and professional contents. It was similar to the general public, mediatic, and societal speeches, loaded with aprioristic assertions, reducing Alzheimer's disease to an organic process of humanity decline. This alarming picture calls to question its ground, mechanisms and solutions concerning the needs conveyed by the nurses, and the pertinency of the common concept of Alzheimer's disease. It enjoins to reconsider the nurses formation and a transdisciplinar further reflection about the notion of Alzheimer's disease and the messages which are transmitted by it.

  8. 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.

  9. Reaching Consensus by Allowing Moments of Indecision

    NASA Astrophysics Data System (ADS)

    Svenkeson, A.; Swami, A.

    2015-10-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form.

  10. Reaching Consensus by Allowing Moments of Indecision

    PubMed Central

    Svenkeson, A.; Swami, A.

    2015-01-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form. PMID:26439503

  11. 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

  12. Overlapping representations for grip type and reach direction.

    PubMed

    Fabbri, Sara; Strnad, Lukas; Caramazza, Alfonso; Lingnau, Angelika

    2014-07-01

    To grasp an object, we need to move the arm toward it and assume the appropriate hand configuration. While previous studies suggested dorsomedial and dorsolateral pathways in the brain specialized respectively for the transport and grip components, more recent studies cast doubt on such a clear-cut distinction. It is unclear, however, to which degree neuronal populations selective for the two components overlap, and if so, to which degree they interact. Here, we used multivoxel pattern analysis (MVPA) of functional magnetic resonance imaging (fMRI) data to investigate the representation of three center-out movements (touch, pincer grip, whole-hand grip) performed in five reach directions. We found selectivity exclusively for reach direction in posterior and rostral superior parietal lobes (SPLp, SPLr), supplementary motor area (SMA), and the superior portion of dorsal premotor cortex (PMDs). Instead, we found selectivity for both grip type and reach direction in the inferior portion of dorsal premotor cortex (PMDi), ventral premotor cortex (PMv), anterior intraparietal sulcus (aIPS), primary motor (M1), somatosensory (S1) cortices and the anterior superior parietal lobe (SPLa). Within these regions, PMv, M1, aIPS and SPLa showed weak interactions between the transport and grip components. Our results suggest that human PMDi and S1 contain both grip- and reach-direction selective neuronal populations that retain their functional independence, whereas this information might be combined at the level of PMv, M1, aIPS, and SPLa.

  13. Posterior cortical atrophy: visuomotor deficits in reaching and grasping

    PubMed Central

    Meek, Benjamin P.; Shelton, Paul; Marotta, Jonathan J.

    2013-01-01

    Posterior Cortical Atrophy (PCA) is a rare clinical syndrome characterized by the predominance of higher-order visual disturbances such as optic ataxia, a characteristic of Balint's syndrome. Deficits result from progressive neurodegeneration of occipito-temporal and occipito-parietal cortices. The current study sought to explore the visuomotor functioning of four individuals with PCA by testing their ability to reach out and grasp real objects under various viewing conditions. Experiment 1 had participants reach out and grasp simple, rectangular blocks under visually- and memory-guided conditions. Experiment 2 explored participants' abilities to accurately reach for objects located in their visual periphery. This investigation revealed that PCA patients demonstrate many of the same deficits that have been previously reported in other individuals with optic ataxia, such as “magnetic misreaching”—a pathological reaching bias toward the point of visual fixation when grasping peripheral targets. Unlike many other individuals with optic ataxia, however, the patients in the current study also show symptoms indicative of damage to the more perceptual stream of visual processing, including abolished grip scaling during memory-guided grasping and deficits in face and object identification. These investigations are the first to perform a quantitative analysis of the visuomotor deficits exhibited by patients with PCA. Critically, this study helps characterize common symptoms of PCA, a vital first step for generating effective diagnostic criteria and therapeutic strategies for this understudied neurodegenerative disorder. PMID:23801956

  14. Macroscopic Neural Oscillation during Skilled Reaching Movements in Humans

    PubMed Central

    Chung, Chun Kee

    2016-01-01

    The neural mechanism of skilled movements, such as reaching, has been considered to differ from that of rhythmic movement such as locomotion. It is generally thought that skilled movements are consciously controlled by the brain, while rhythmic movements are usually controlled autonomously by the spinal cord and brain stem. However, several studies in recent decades have suggested that neural networks in the spinal cord may also be involved in the generation of skilled movements. Moreover, a recent study revealed that neural activities in the motor cortex exhibit rhythmic oscillations corresponding to movement frequency during reaching movements as rhythmic movements. However, whether the oscillations are generated in the spinal cord or the cortical circuit in the motor cortex causes the oscillations is unclear. If the spinal cord is involved in the skilled movements, then similar rhythmic oscillations with time delays should be found in macroscopic neural activity. We measured whole-brain MEG signals during reaching. The MEG signals were analyzed using a dynamical analysis method. We found that rhythmic oscillations with time delays occur in all subjects during reaching movements. The results suggest that the corticospinal system is involved in the generation and control of the skilled movements as rhythmic movements. PMID:27524996

  15. Head, arm and trunk coordination during reaching in children.

    PubMed

    Sveistrup, H; Schneiberg, S; McKinley, P A; McFadyen, B J; Levin, M F

    2008-06-01

    head-stabilized-on-trunk (HST) or "en bloc" pattern was observed with approximately the same frequency as a head-stabilized-in-space (HSS) pattern in the youngest children in the yaw plane for reaches within arm's length. In all other planes and for reaches of all distances, a HSS pattern was evident in the youngest children and remained consistent across the groups of children. Compared to the children, adult reaching was characterised by fixed head-trunk coordination (HST) in the roll plane at all reach distances, and greater decoupling in yaw plane motion for the two closest distances. There were no age-related differences in the pitch plane strategy which was mainly HSS. The DI patterns matured by 2-3 or 4-5 years of age, except for reaches to T1 in the pitch plane. In addition, in the roll plane, there was evidence of a two-step maturation that was not complete until adulthood. Maturation of strategies used to stabilize the head and trunk relative to each other and to the reaching arm differ across movement planes for a seated reaching task. Our data suggest that different aspects of head and trunk coordination during reaching movement mature at different rates, like for locomotor tasks previously described, and that the maturation follows a non-chronological and protracted course. These results can serve as a comparative database with which to contrast head and trunk coordination in children with movement disorders. However, in terms of typical development, these data should be considered specific for the task studied and may not reflect general principles of motor development.

  16. External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

    SciTech Connect

    Shakespeare, Thomas P. . E-mail: ThomasShakespeare@gmail.com; Back, Michael F.; Lu, Jiade J.; Lee, Khai Mun; Mukherjee, Rahul K.

    2006-03-01

    Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/quality assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs.

  17. Combining Real-Time fMRI Neurofeedback Training of the DLPFC with N-Back Practice Results in Neuroplastic Effects Confined to the Neurofeedback Target Region

    PubMed Central

    Sherwood, Matthew S.; Weisend, Michael P.; Kane, Jessica H.; Parker, Jason G.

    2016-01-01

    In traditional fMRI, individuals respond to exogenous stimuli and are naïve to the effects of the stimuli on their neural activity patterns. Changes arising in the fMRI signal are analyzed post-hoc to elucidate the spatial and temporal activation of brain regions associated with the tasks performed. The advent of real-time fMRI has enabled a new method to systematically alter brain activity across space and time using neurofeedback training (NFT), providing a new tool to study internally-driven processes such as neuroplasticity. In this work, we combined n-back practice with fMRI-NFT of the left dorsolateral prefrontal cortex (DLPFC) to better understand the relationship between open- and closed-loop neuromodulation. FMRI data were acquired during both traditional n-back and NFT across five imaging sessions. Region-of-interest (ROI) and voxel-wise 2 × 2 within subjects ANOVAs were carried out to determine the effects of, and interaction between, training session and neuromodulation type. A main effect of training session was identified for only a single, highly focused cluster that shared spatial properties with the fMRI-NFT target region (left DLPFC). This finding indicates that combined open- and closed-loop neuroplastic enhancement techniques result in focal changes that are confined to the target area of NFT, and do not affect up- or down-stream network components that are normally engaged during working memory. Additionally, we identified a main effect of neuromodulation type for 15 clusters with significantly different activation between open- and closed-loop neuromodulation during training, 12 of which demonstrated higher activity during the open-loop neuromodulation. Our results, taken together with previous reports, indicate that fMRI-NFT combined with n-back practice leads to a highly focal volume exhibiting neuroplasticity without additional network effects. PMID:27445733

  18. The multiple process model of goal-directed reaching revisited.

    PubMed

    Elliott, Digby; Lyons, James; Hayes, Spencer J; Burkitt, James J; Roberts, James W; Grierson, Lawrence E M; Hansen, Steve; Bennett, Simon J

    2017-01-01

    Recently our group forwarded a model of speed-accuracy relations in goal-directed reaching. A fundamental feature of our multiple process model was the distinction between two types of online regulation: impulse control and limb-target control. Impulse control begins during the initial stages of the movement trajectory and involves a comparison of actual limb velocity and direction to an internal representation of expectations about the limb trajectory. Limb-target control involves discrete error-reduction based on the relative positions of the limb and the target late in the movement. Our model also considers the role of eye movements, practice, energy optimization and strategic behavior in limb control. Here, we review recent work conducted to test specific aspects of our model. As well, we consider research not fully incorporated into our earlier contribution. We conclude that a slightly modified and expanded version of our model, that includes crosstalk between the two forms of online regulation, does an excellent job of explaining speed, accuracy, and energy optimization in goal-directed reaching.

  19. Age-dependent parathormone levels and different CKD-MBD treatment practices of dialysis patients in Hungary - results from a nationwide clinical audit

    PubMed Central

    2013-01-01

    Background Achieving target levels of laboratory parameters of bone and mineral metabolism in chronic kidney disease (CKD) patients is important but also difficult in those living with end-stage kidney disease. This study aimed to determine if there are age-related differences in chronic kidney disease-mineral and bone disorder (CKD-MBD) characteristics, including treatment practice in Hungarian dialysis patients. Methods Data were collected retrospectively from a large cohort of dialysis patients in Hungary. Patients on hemodialysis and peritoneal dialysis were also included. The enrolled patients were allocated into two groups based on their age (<65 years and ≥65 years). Characteristics of the age groups and differences in disease-related (epidemiology, laboratory, and treatment practice) parameters between the groups were analyzed. Results A total of 5008 patients were included in the analysis and the mean age was 63.4±14.2 years. A total of 47.2% of patients were women, 32.8% had diabetes, and 11.4% were on peritoneal dialysis. Diabetes (37.9% vs 27.3%), bone disease (42.9% vs 34.1%), and soft tissue calcification (56.3% vs 44.7%) were more prevalent in the older group than the younger group (p<0.001 for all). We found an inverse relationship between age and parathyroid hormone (PTH) levels (p<0.001). Serum PTH levels were lower in patients with diabetes compared with those without diabetes below 80 years (p<0.001). Diabetes and age were independently associated with serum PTH levels (interaction: diabetes × age groups, p=0.138). Older patients were more likely than younger patients to achieve laboratory target ranges for each parameter (Ca: 66.9% vs 62.1%, p<0.001; PO4: 52.6% vs 49.2%, p<0.05; and PTH: 50.6% vs 46.6%, p<0.01), and for combined parameters (19.8% vs 15.8%, p<0.001). Older patients were less likely to receive related medication than younger patients (66.9% vs 79.7%, p<0.001). Conclusions The achievement of laboratory target ranges for bone

  20. When rheumatologists report that they agree with a guideline, does this mean that they practise the guideline in clinical practice? Results of the International Recommendation Implementation Study (IRIS)

    PubMed Central

    Gvozdenović, Emilia; Allaart, Cornelia F; van der Heijde, Désirée; Ferraccioli, Gianfranco; Smolen, Josef S; Huizinga, Tom W J; Landewé, Robert

    2016-01-01

    Introduction The European League Against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) and the treat-to-target (T2T) principles have been developed in order to improve the treatment outcome of patients with RA, and have received broad attention. It is not clear, though, whether these recommendations are indeed followed up in clinical practice. Objective To investigate if rheumatologists that report to agree with existing guidelines indeed follow them up in clinical practice. Methods The International Recommendation Implementation Study (IRIS) included 132 participating rheumatologists from 14 countries. Participating rheumatologists received a questionnaire measuring their awareness/commitment with the EULAR/T2T recommendations and followed a dedicated educational programme. Subsequently, they were asked to enrol 5–10 patients with new-onset RA in the online IRIS database and monitor disease activity and treatment for a period of 1–2 years. Four recommendations (3 from the EULAR recommendations and one from the T2T recommendations) were selected on the basis of testability, and analysed with regard to compliance by participating rheumatologists. Results In total, 72 of the 132 participating rheumatologists contributed 378 patients to the database. Of these participants, 70 (98%) agreed upfront with the recommendation that disease-modifying antirheumatic drug (DMARD) therapy should be started as soon as possible after diagnosis in every patient; 69 (96%) of the rheumatologists agreed with the recommendation that methotrexate (MTX) should be part of the first treatment strategy. When measuring the actual performance, it was found that the recommendation on early DMARD start was met in 253 (67%) of the recorded patients, and the recommendation on MTX in 225 (60%) of the recorded patients. Of the participants, 60 (83%) agreed that composite measures should be recorded regularly, but only in 134(54%) of the patients were

  1. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 24: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SAE mail survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists affiliated with the Society of Automotive Engineers (SAE).

  2. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 33: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 AIAA mail survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists who are members of the American Institute of Aeronautics and Astronautics (AIAA).

  3. Poleward reach of the California Undercurrent extension

    NASA Astrophysics Data System (ADS)

    Thomson, Richard E.; Krassovski, Maxim V.

    2010-09-01

    The California Undercurrent is known to transport relatively warm, high-salinity, nutrient-rich water from the equatorial Pacific to Vancouver Island along the western continental slope of North America. This transport helps maintain the high productivity of the eastern boundary California Current system. In this study, we use several decades of water property survey data for the coasts of Oregon, Washington, British Columbia, and Alaska to show that equatorial Pacific water carried poleward by the undercurrent can eventually reach the Aleutian Islands, roughly 11,000 km from the source region. Long-term current meter records confirm the undercurrent as far north as Vancouver Island, where the current is found to be weakest in spring but then to strengthen through the summer and fall before merging with the wind-forced, poleward flowing Davidson Current in winter. The core depth of the equatorial water increases from 150 m ± 25 m off northwest Washington (near the northern end of the western North America coastal upwelling domain) to 225 m ± 25 m off southeast Alaska (near the southern end of the Gulf of Alaska coastal downwelling domain).

  4. Media perspective - new opportunities for reaching audiences

    NASA Astrophysics Data System (ADS)

    Haswell, Katy

    2007-08-01

    The world of media is experiencing a period of extreme and rapid change with the rise of internet television and the download generation. Many young people no longer watch standard TV. Instead, they go on-line, talking to friends and downloading pictures, videos, music clips to put on their own websites and watch/ listen to on their laptops and mobile phones. Gone are the days when TV controllers determined what you watched and when you watched it. Now the buzzword is IPTV, Internet Protocol Television, with companies such as JOOST offering hundreds of channels on a wide range of subjects, all of which you can choose to watch when and where you wish, on your high-def widescreen with stereo surround sound at home or on your mobile phone on the train. This media revolution is changing the way organisations get their message out. And it is encouraging companies such as advertising agencies to be creative about new ways of accessing audiences. The good news is that we have fresh opportunities to reach young people through internet-based media and material downloaded through tools such as games machines, as well as through the traditional media. And it is important for Europlanet to make the most of these new and exciting developments.

  5. ESO telbib: Linking In and Reaching Out

    NASA Astrophysics Data System (ADS)

    Grothkopf, U.; Meakins, S.

    2015-04-01

    Measuring an observatory's research output is an integral part of its science operations. Like many other observatories, ESO tracks scholarly papers that use observational data from ESO facilities and uses state-of-the-art tools to create, maintain, and further develop the Telescope Bibliography database (telbib). While telbib started out as a stand-alone tool mostly used to compile lists of papers, it has by now developed into a multi-faceted, interlinked system. The core of the telbib database is links between scientific papers and observational data generated by the La Silla Paranal Observatory residing in the ESO archive. This functionality has also been deployed for ALMA data. In addition, telbib reaches out to several other systems, including ESO press releases, the NASA ADS Abstract Service, databases at the CDS Strasbourg, and impact scores at Altmetric.com. We illustrate these features to show how the interconnected telbib system enhances the content of the database as well as the user experience.

  6. Reaching lost-to-care populations.

    PubMed

    Jordan, Wilbert C

    2007-12-15

    Identification of patients who are at high risk for human immunodeficiency virus (HIV) infection can lead to reduced frequencies of high-risk behaviors, provision of timely care for infected individuals, and decreased transmission of HIV. The HIV-associated outreach programs at the OASIS Clinic of the King-Harbor/Drew University complex (Los Angeles, CA) has 3 components: a traditional partner-notification (i.e., contact-tracing) component, a focused-intervention component through which clients are given incentives to bring in persons they feel are at high risk for HIV infection, and an outreach component targeting hard-to-reach populations. These interventions are highly effective in identifying individuals early during the course of their disease, when initiation of antiretroviral therapy is most effective. The partner-services program at the OASIS Clinic has been particularly useful in identifying partners of HIV-positive women, whereas the focused-intervention program is most useful for identifying gay men who are unaware of their positive HIV serostatus. Successful targeted outreach programs can identify many individuals who would not otherwise be aware of their HIV infection, but the programs also require more clinicians to manage these patients.

  7. Using New Media to Reach Broad Audiences

    NASA Astrophysics Data System (ADS)

    Gay, P. L.

    2008-06-01

    The International Year of Astronomy New Media Working Group (IYA NMWG) has a singular mission: To flood the Internet with ways to learn about astronomy, interact with astronomers and astronomy content, and socially network with astronomy. Within each of these areas, we seek to build lasting programs and partnerships that will continue beyond 2009. Our weapon of choice is New Media. It is often easiest to define New Media by what it is not. Television, radio, print and their online redistribution of content are not New Media. Many forms of New Media start as user provided content and content infrastructures that answer that individual's creative whim in a way that is adopted by a broader audience. Classic examples include Blogs and Podcasts. This media is typically distributed through content specific websites and RSS feeds, which allow syndication. RSS aggregators (iTunes has audio and video aggregation abilities) allow subscribers to have content delivered to their computers automatically when they connect to the Internet. RSS technology is also being used in such creative ways as allowing automatically updating Google-maps that show the location of someone with an intelligent GPS system, and in sharing 100 word microblogs from anyone (Twitters) through a single feed. In this poster, we outline how the IYA NMWG plans to use New Media to reach target primary audiences of astronomy enthusiasts, image lovers, and amateur astronomers, as well as secondary audiences, including: science fiction fans, online gamers, and skeptics.

  8. Are medical educators in general practice untapped potential to increase training capacity in sexual and reproductive healthcare? Results of a survey in London, UK

    PubMed Central

    Ma, Richard; Shah, Radhika

    2016-01-01

    Abstract Background Long waiting times for training in sexual and reproductive healthcare (SRH) including long acting reversible contraception (LARC) might lead to attrition from training programmes, leading to reduced capacity for sexual health services, and reduced access to such contraception for women. Setting General practice in London, UK. Question Can medical educators in general practice be used as untapped potential to train other health care professionals in sexual and reproductive healthcare? Method We conducted an online survey to find out the qualifications, skills and willingness of established educators in primary care in London to train other clinicians in sexual and reproductive healthcare, including LARC. Results We received 124 responses from medical educators (10.1% response rate from general practitioner (GP) trainers and 59.0% of clinical supervisors for Foundation Year doctors). 86 (69.9%) had diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH) qualification and further 18 (14.6%) were interested in obtaining this qualification. Eleven respondents were trained to fit intrauterine contraception only, three for contraceptive implants only and 37 were trained to fit both. 50 (40.3%) of 124 respondents were willing get involved in DFSRH training; 74% of these were willing to teach on any component of DFSRH including LARC. Discussion There is a shortage of training places and long waiting list for clinicians who wish to train in SRH. This survey suggests there is a pool of GP educators with skills and experience in SRH and are willing to train others. This can potentially increase the training capacity and improve overall access to good contraception and LARC for women. PMID:28250840

  9. Mobile Technology and Social Media in the Clinical Practice of Young Radiation Oncologists: Results of a Comprehensive Nationwide Cross-sectional Study

    SciTech Connect

    Bibault, Jean-Emmanuel; Leroy, Thomas; Blanchard, Pierre; Biau, Julian; Cervellera, Mathilde; Diaz, Olivia; Faivre, Jean Christophe; and others

    2014-09-01

    Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital.

  10. [Physician Counseling about Physical and Sports Activity in Neurological Practices in Germany: Results of a Survey Among Members of the German Neurological Society].

    PubMed

    Reimers, C D; Reuter, I; Straube, A; Tettenborn, B; Braumann, K M; Reimers, A K

    2016-01-01

    Physical inactivity is a major but modifiable risk factor for morbidity and mortality. Regular physical activity has preventive and therapeutic effects on numerous diseases including neurological disorders. Therefore, it is desirable that physicians motivate their patients to increase their physical and sports activities and that they help them to overcome barriers to exercising. The present study is a survey of neurologists who are members of the German Neurological Society with their own practices; they were asked whether they advised their patients on the benefits of physical activity. Details on physician counseling on physical activity were obtained, such as the frequency of counseling, the neurological disorders considered by the practitioners to be worth the effort of counseling, and the barriers to exercise on the part of patients. More than 80 % of the participants who responded to the survey stated that they frequently provide their patients with advice on the preventive and therapeutic aspects of physical activity. Almost all of them recommended endurance sports; this was followed by Far Eastern types of sport such as tai chi or yoga (70 % of all physicians who advice sports activities). The frequency of counseling about physical activity significantly correlated to the physician's own sports activity. Frequency of counseling was reduced if the physician assessed the patients to be incapable of adopting and maintaining a lifestyle of habitual physical activity. Lack of time as well as an insufficient reimbursement of the counseling, however, did not significantly influence the frequency of counseling. The physician's own sports activity matched that of individuals with similar social status. Thus, a selection bias does not seem to be of importance regarding the results of the survey. However, since only 169 of the 784 invited neurologists (21.6 %) responded to the questionnaire, the representativeness of the survey may be limited. Counseling about

  11. Lactate dehydrogenase is a prognostic indicator in patients with hepatocellular carcinoma treated by sorafenib: results from the real life practice in HBV endemic area

    PubMed Central

    Li, Mu-xing; Zhao, Hong; Bi, Xin-yu; Li, Zhi-yu; Yao, Xue-song; Li, Huai; Huang, Zhen; Han, Yue; Zhou, Jian-guo; Zhao, Jian-jun; Zhang, Ye-fan; Zhao, Dong-bin; Cai, Jian-qiang

    2016-01-01

    Purpose Lactate dehydrogenase (LDH), which was an indirect marker of hypoxia, was a potentially prognostic factor in several malignancies. There is a lack of evidence about the prognostic value of serum LDH level in patients with hepatocellular carcinoma (HCC) receiving sorafenib treatment from hepatitis B virus endemic areas. Materials and Methods A total of 119 HBV-related HCC patients treated by sorafenib from a Chinese center were included into the study. They were categorized into 2 groups according to the cut-off value of pre-treatment LDH, which was determined by the time dependent receiver operating characteristics (ROC) curve for the overall survival. The prognostic value of LDH was evaluated. The relationships between LDH and other clinicopathological factors were also assessed. Results The cut-off value was 221 U/L. With a median follow up of 15 (range, 3-73) months, 91 patients reached the endpoint. Multivariate analysis proved that pre-treatment serum LDH level was an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). For patients whose pre-treatment LDH ≥ 221 U/L, increased LDH value after 3 months of sorafenib treatment predicted inferior OS and PFS. And patients with elevated pre-treatment LDH level predisposed to be featured with lower serum albumin, presence of macroscopic vascular invasion, advanced Child-Pugh class, advanced T category, higher AFP, and higher serum total bilirubin. Conclusions Serum LDH level was a potentially prognostic factor in HCC patients treated by sorafenib in HBV endemic area. More relevant studies with reasonable study design are needed to further strengthen its prognostic value. PMID:27880930

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

    PubMed Central

    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. PMID:23055968

  13. Columbia River Estuary Ecosystem Classification Hydrogeomorphic Reach

    USGS Publications Warehouse

    Cannon, Charles M.; Ramirez, Mary F.; Heatwole, Danelle W.; Burke, Jennifer L.; Simenstad, Charles A.; O'Connor, Jim E.; Marcoe, Keith

    2012-01-01

    Estuarine ecosystems are controlled by a variety of processes that operate at multiple spatial and temporal scales. Understanding the hierarchical nature of these processes will aid in prioritization of restoration efforts. This hierarchical Columbia River Estuary Ecosystem Classification (henceforth "Classification") of the Columbia River estuary is a spatial database of the tidally-influenced reaches of the lower Columbia River, the tidally affected parts of its tributaries, and the landforms that make up their floodplains for the 230 kilometers between the Pacific Ocean and Bonneville Dam. This work is a collaborative effort between University of Washington School of Aquatic and Fishery Sciences (henceforth "UW"), U.S. Geological Survey (henceforth "USGS"), and the Lower Columbia Estuary Partnership (henceforth "EP"). Consideration of geomorphologic processes will improve the understanding of controlling physical factors that drive ecosystem evolution along the tidal Columbia River. The Classification is organized around six hierarchical levels, progressing from the coarsest, regional scale to the finest, localized scale: (1) Ecosystem Province; (2) Ecoregion; (3) Hydrogeomorphic Reach; (4) Ecosystem Complex; (5) Geomorphic Catena; and (6) Primary Cover Class. For Levels 4 and 5, we mapped landforms within the Holocene floodplain primarily by visual interpretation of Light Detection and Ranging (LiDAR) topography supplemented with aerial photographs, Natural Resources Conservation Service (NRCS) soils data, and historical maps. Mapped landforms are classified as to their current geomorphic function, the inferred process regime that formed them, and anthropogenic modification. Channels were classified primarily by a set of depth-based rules and geometric relationships. Classification Level 5 floodplain landforms ("geomorphic catenae") were further classified based on multivariate analysis of land-cover within the mapped landform area and attributed as "sub

  14. Does the Responsive Classroom Approach Affect the Use of Standards-Based Mathematics Teaching Practices?: Results from a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Ottmar, Erin R.; Rimm-Kaufman, Sara E.; Berry, Robert Q.; Larsen, Ross A.

    2013-01-01

    This study highlights the connections between two facets of teachers' skills--those supporting teachers' mathematical instructional interactions and those underlying social interactions within the classroom. The impact of the Responsive Classroom (RC) approach and use of RC practices on the use of standards-based mathematics teaching practices was…

  15. From Research to Practice: The Application of Research Results to Program Improvement across After-School, Camp, and Community Recreation Programs

    ERIC Educational Resources Information Center

    Bennett, Troy

    2016-01-01

    Academic researchers dedicated to contributing to quality improvement in professional practice need to find more effective ways to bridge the gap between research and practice. Bridging the gap requires understanding what encourages the use of research findings by practitioners and what discourages it, as well as understanding how practitioners…

  16. Identification of consistency in rating curve data: Bidirectional Reach (BReach)

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

    Before calculating rating curve discharges, it is crucial to identify possible interruptions in data consistency. In this research, a methodology to perform this preliminary analysis is developed and validated. This methodology, called Bidirectional Reach (BReach), evaluates in each data point results of a rating curve model with randomly sampled parameter sets. The combination of a parameter set and a data point is classified as non-acceptable if the deviation between the accompanying model result and the measurement exceeds observational uncertainty. Moreover, a tolerance degree that defines satisfactory behavior of a sequence of model results is chosen. This tolerance degree equals the percentage of observations that are allowed to have non-acceptable model results. Subsequently, the results of the classification is used to assess the maximum left and right reach for each data point of a chronologically sorted time series. This maximum left and right reach in a gauging point 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. This analysis is repeated for a variety of tolerance degrees. Plotting results of this analysis for all data points and all tolerance degrees in a combined BReach plot enables the detection of changes in data consistency. Moreover, if consistent periods are detected, limits of these periods can be derived. The methodology is validated with various synthetic stage-discharge data sets and proves to be a robust technique to investigate temporal consistency of rating curve data. It provides satisfying results despite of low data availability, large errors in the estimated observational uncertainty, and a rating curve model that is known to cover only a limited part of the observations.

  17. 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

  18. Safety and effectiveness of controlled-release paroxetine in routine clinical practice: results of a postmarketing surveillance study of patients with depression

    PubMed Central

    Kato, Masaki; Kimura, Toshifumi; Kimura, Takeshi; Hara, Terufumi

    2015-01-01

    Objective Selective serotonin reuptake inhibitors are commonly used in the pharmacotherapy of depression. However, adverse events can lead to their early discontinuation. This study evaluated the safety and effectiveness of paroxetine controlled-release (CR) tablets in Japanese patients with depression/depressive state (hereafter referred to as depression) in routine clinical practice in Japan. Patients and methods This was an open-label, noninterventional, prospective, postmarketing surveillance study. A total of 3,213 patients aged 12–92 years with depression were prescribed paroxetine CR for 8 weeks at the physician’s discretion. Safety was evaluated on the basis of the reporting of adverse drug reactions. Effectiveness was evaluated on the basis of the physician’s assessment using the Clinical Global Impression-Global Improvement (CGI-GI) and the Clinical Global Impression-Severity of Illness (CGI-SI) scales, as well as on the basis of the patients’ self-reported satisfaction. The primary effectiveness outcome was the improvement rate based on the physician’s assessment using the CGI-GI. Results The incidence of adverse drug reactions was 11.2% (359/3,213; 95% confidence interval [CI]: 10.1%–12.3%). The common adverse drug reactions that accounted for 1.0% or more of the incidence were nausea (3.5%) and somnolence (2.7%). The proportion of patients who continued paroxetine CR at week 8 was 80.2% (2,577/3,213; 95% CI: 78.8%–81.6%). The improvement rate at week 8 (last observation carried forward) was 72.8% (2,132/2,927; 95% CI: 71.2%–74.4%). The proportion of patients with CGI-SI scores of moderately or severely ill decreased from 63.6% at baseline to 17.9% at week 8. The proportion of patients who were satisfied with paroxetine CR treatment was 69.8% (2,040/2,921; 95% CI: 68.1%–71.5%). Conclusion The results of this study suggest that paroxetine CR is a well-tolerated and efficacious treatment for depression in routine clinical practice. PMID

  19. Implementation of Tobacco Cessation Quitline Practices in the United States and Canada

    PubMed Central

    Bonito, Joseph A.; Provan, Keith; Ruppel, Erin; Leischow, Scott J.

    2014-01-01

    Objectives. We examined relationships between implementation of tobacco quitline practices, levels of evidence of practices, and quitline reach and spending. Methods. In June and July 2009, a total of 176 quitline funders and providers in the United States and Canada completed a survey on quitline practices, in particular quitline-level implementation for the reported practices. From these data, we selected and categorized evidence-based and emerging quitline practices by the strength of the evidence for each practice to increase quitline efficacy and reach. Results. The proportion of quitlines implementing each practice ranged from 3% (text messaging) to 92% (providing a multiple-call protocol). Implementation of practices showing higher levels of evidence for increasing either reach or efficacy showed moderate but significant positive correlations with both reach outcomes and spending levels. The strongest correlation was between reach outcomes and spending levels (r = 0.80; P < .01). Conclusions. The strong relationship between quitline spending and reach reinforces the need to increase quitline funding to levels commensurate with national cessation goals. PMID:25122024

  20. Reaching remote areas in Latin America.

    PubMed

    Jaimes, R

    1994-01-01

    Poor communities in remote and inaccessible areas tend to not only be cut off from family planning education and services, but they are also deprived of basic primary health care services. Efforts to bring family planning to such communities and populations should therefore be linked with other services. The author presents three examples of programs to bring effective family planning services to remote communities in Central and South America. Outside of the municipal center in the Tuxtlas region of Mexico, education and health levels are low and people live according to ancient customs. Ten years ago with the help of MEXFAM, the IPPF affiliate in Mexico, two social promoters established themselves in the town of Catemaco to develop a community program of family planning and health care offering education and prevention to improve the quality of people's lives. Through their health brigades taking health services to towns without an established health center, the program has influenced an estimated 100,000 people in 50 villages and towns. The program also has a clinic. In Guatemala, the Family Welfare Association (APROFAM) gave bicycles to 240 volunteer health care workers to facilitate their outreach work in rural areas. APROFAM since 1988 has operated an integrated program to treat intestinal parasites and promote family planning in San Lucas de Toliman, an Indian town close to Lake Atitlan. Providing health care to more than 10,000 people, the volunteer staff has covered the entire department of Solola, reaching each family in the area. Field educators travel on motorcycles through the rural areas of Guatemala coordinating with the health volunteers the distribution of contraceptives at the community level. The Integrated Project's Clinic was founded in 1992 and currently carries out pregnancy and Pap tests, as well as general lab tests. Finally, Puna is an island in the middle of the Gulf of Guayaquil, Ecuador. Women on the island typically have 10

  1. Solomon Islands: reaching street children in Honiara.

    PubMed

    Gatu, R

    2000-01-01

    The situation of homeless children in Honiara, Solomon Islands had attracted the attention of Sister Doreen of the Angelican Sisters of the Church. One discovery was that these young people had little knowledge of sexuality but were often sexually active. This article discusses the workshop developed by the Angelican Sisters of the Church that addresses the needs of the youth, particularly on the topics of adolescent sexual and reproductive health and HIV/AIDS and sexually transmitted diseases (STDs). About 34 young people attended the 4-day seminar, which aimed to empower the kids into making the right decision and changing their behavior. Among the activities during the program were the use of games, information and practical sessions, which included a condom demonstration in the form of a bingo game. The workshop was a success, with kids started teaching their peers and parents and more requests for such workshops indicated that young people in Honoria are hungry for information on sex, sexuality, HIV/AIDS and STDs.

  2. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    PubMed

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs.

  3. Personal breathing zone exposures among hot-mix asphalt paving workers; preliminary analysis for trends and analysis of work practices that resulted in the highest exposure concentrations.

    PubMed

    Osborn, Linda V; Snawder, John E; Kriech, Anthony J; Cavallari, Jennifer M; McClean, Michael D; Herrick, Robert F; Blackburn, Gary R; Olsen, Larry D

    2013-01-01

    An exposure assessment of hot-mix asphalt (HMA) paving workers was conducted to determine which of four exposure scenarios impacted worker exposure and dose. Goals of this report are to present the personal-breathing zone (PBZ) data, discuss the impact of substituting the releasing/cleaning agent, and discuss work practices that resulted in the highest exposure concentration for each analyte. One-hundred-seven PBZ samples were collected from HMA paving workers on days when diesel oil was used as a releasing/cleaning agent. An additional 36 PBZ samples were collected on days when B-100 (100% biodiesel, containing no petroleum-derived products) was used as a substitute releasing/cleaning agent. Twenty-four PBZ samples were collected from a reference group of concrete workers, who also worked in outdoor construction but had no exposure to asphalt emissions. Background and field blank samples were also collected daily. Total particulates and the benzene soluble fraction were determined gravimetrically. Total organic matter was determined using gas chromatography (GC) with flame ionization detection and provided qualitative information about other exposure sources contributing to worker exposure besides asphalt emissions. Thirty-three individual polycyclic aromatic compounds (PACs) were determined using GC with time-of-flight mass spectrometry; results were presented as either the concentration of an individual PAC or a summation of the individual PACs containing either 2- to 3-rings or 4- to 6-rings. Samples were also screened for PACs containing 4- to 6-rings using fluorescence spectroscopy. Arithmetic means, medians, and box plots of the PBZ data were used to evaluate trends in the data. Box plots illustrating the diesel oil results were more variable than the B-100. Also, the highest diesel oil results were much higher in concentration than the highest B-100 results. An analysis of the highest exposure results and field notes revealed a probable association between

  4. Personal Breathing Zone Exposures among Hot-Mix Asphalt Paving Workers; Preliminary Analysis for Trends and Analysis of Work Practices That Resulted in the Highest Exposure Concentrations

    PubMed Central

    Osborn, Linda V.; Snawder, John E.; Kriech, Anthony J.; Cavallari, Jennifer M.; McClean, Michael D.; Herrick, Robert F.; Blackburn, Gary R.; Olsen, Larry D.

    2015-01-01

    An exposure assessment of hot-mix asphalt (HMA) paving workers was conducted to determine which of four exposure scenarios impacted worker exposure and dose. Goals of this report are to present the personal-breathing zone (PBZ) data, discuss the impact of substituting the releasing/cleaning agent, and discuss work practices that resulted in the highest exposure concentration for each analyte. One-hundred-seven PBZ samples were collected from HMA paving workers on days when diesel oil was used as a releasing/cleaning agent. An additional 36 PBZ samples were collected on days when B-100 (100% biodiesel, containing no petroleum-derived products) was used as a substitute releasing/cleaning agent. Twenty-four PBZ samples were collected from a reference group of concrete workers, who also worked in outdoor construction but had no exposure to asphalt emissions. Background and field blank samples were also collected daily. Total particulates and the benzene soluble fraction were determined gravimetrically. Total organic matter was determined using gas chromatography (GC) with flame ionization detection and provided qualitative information about other exposure sources contributing to worker exposure besides asphalt emissions. Thirty-three individual polycyclic aromatic compounds (PACs) were determined using GC with time-offlight mass spectrometry; results were presented as either the concentration of an individual PAC or a summation of the individual PACs containing either 2- to 3-rings or 4- to 6-rings. Samples were also screened for PACs containing 4- to 6-rings using fluorescence spectroscopy. Arithmetic means, medians, and box plots of the PBZ data were used to evaluate trends in the data. Box plots illustrating the diesel oil results were more variable than the B-100. Also, the highest diesel oil results were much higher in concentration than the highest B-100 results. An analysis of the highest exposure results and field notes revealed a probable association between

  5. 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.

  6. Control of reaching finger movement accompanied with inhibitory intention.

    PubMed

    Fukuda, Hiroshi; Hiwaki, Osamu

    2011-01-01

    In the present study, we investigated the motor control of reaching finger movement interfered by the inhibitory intention triggered by the stop-signal. In the experiment, the subject started the reaching movement of the index finger with the go-signal of a green LED and stopped the ongoing movement with the stop-signal of a red LED. The stop-signal delay (SSD) was set at 0, 100, 200, 300 and 400 ms. The movement trajectory was measured during the task. The index finger was able to stop prior to the target point when SSD was less than 400 ms, whereas not when SSD was 400 ms. We also measured electroencephalogram (EEG) during the task. A negative peak around the stop-signal response time (SSRT) and a positive peak around 400-600 ms of the event-related potentials (ERPs) were observed at Fz and Cz. These results indicate that these components of the ERPs were associated with the stop-signal task in the human reaching movement.

  7. Monkey see, Monkey reach: Action selection of reaching movements in the macaque monkey

    PubMed Central

    Sartori, Luisa; Camperio-Ciani, Andrea; Bulgheroni, Maria; Castiello, Umberto

    2014-01-01

    Highly efficient systems are needed to link perception with action in the context of the highly complex environments in which primates move and interact. Another important component is, nonetheless, needed for action: selection. When one piece of fruit from a branch is being chosen by a monkey, many other pieces are within reach and visible: do the perceptual features of the objects surrounding a target determine interference effects? In humans, reaching to grasp a desired object appears to integrate the motor features of the objects which might become potential targets - a process which seems to be driven by inhibitory attention mechanisms. Here we show that non-human primates use similar mechanisms when carrying out goal-directed actions. The data indicate that the volumetric features of distractors are internally represented, implying that the basic cognitive operations allowing for action selection have deep evolutionary roots. PMID:24503774

  8. The leading joint hypothesis for spatial reaching arm motions.

    PubMed

    Ambike, Satyajit; Schmiedeler, James P

    2013-02-01

    The leading joint hypothesis (LJH), developed for planar arm reaching, proposes that the interaction torques experienced by the proximal joint are low compared to the corresponding muscle torques. The human central nervous system could potentially ignore these interaction torques at the proximal (leading) joint with little effect on the wrist trajectory, simplifying joint-level control. This paper investigates the extension of the LJH to spatial reaching. In spatial motion, a number of terms in the governing equation (Euler's angular momentum balance) that vanish for planar movements are non-trivial, so their contributions to the joint torque must be classified as net, interaction or muscle torque. This paper applies definitions from the literature to these torque components to establish a general classification for all terms in Euler's equation. This classification is equally applicable to planar and spatial motion. Additionally, a rationale for excluding gravity torques from the torque analysis is provided. Subjects performed point-to-point reaching movements between targets whose locations ensured that the wrist paths lay in various portions of the arm's spatial workspace. Movement kinematics were recorded using electromagnetic sensors located on the subject's arm segments and thorax. The arm was modeled as a three-link kinematic chain with idealized spherical and revolute joints at the shoulder and elbow. Joint torque components were computed using inverse dynamics. Most movements were 'shoulder-led' in that the interaction torque impulse was significantly lower than the muscle torque impulse for the shoulder, but not the elbow. For the few elbow-led movements, the interaction impulse at the elbow was low, while that at the shoulder was high, and these typically involved large elbow and small shoulder displacements. These results support the LJH and extend it to spatial reaching motion.

  9. Food use in middle and high school fundraising: does policy support healthful practice? Results from a survey of Minnesota school principals.

    PubMed

    Kubik, Martha Y; Lytle, Leslie A; Farbakhsh, Kian; Moe, Stacey; Samuelson, Anne

    2009-07-01

    This descriptive, cross-sectional study aimed to examine classroom, school-wide, and club/sports teams fundraising policies and practices of middle and high schools; concordance between policy and practice; and associations between healthful policy/practice scores and selected school characteristics. In 2006, principals/designees of middle (n=45) and high (n=71) schools in the St Paul/Minneapolis, MN, metropolitan area completed a self-administered mailed survey. Schools were attended by a convenience sample of students (n=349) participating in a longitudinal measurement study of children and their environments to assess obesity-related factors. Descriptive statistics, chi(2) tests, and multivariate linear regression were used to examine variables and associations of interest. Across schools, 50% had policies addressing the nutrient quality of food and drink items used in fundraising or disallowed food use for fundraising. About one third used chocolate, candy, and high-fat baked goods for classroom and school-wide fundraising; 60% sold these items for club/sports teams fundraising. More middle than high schools reported healthful fundraising policies or practices, as well as greater concordance between policies and practices. For all fundraising activities, high schools had significantly lower healthful policy/practice scores than middle schools (P<0.01). For school-wide fundraising, scores were significantly lower for public than private schools (P=0.02). Policies to regulate food used for fundraising were common and most supported healthful practice, particularly in middle schools. However, use of foods high in fat and added sugars remains a prevalent fundraising practice, especially in high schools and for club/sports teams, and requires additional attention.

  10. Investigating Linkages Between Watershed Scale Erosion and Reach Scale Channel Response

    NASA Astrophysics Data System (ADS)

    Sullivan, K.; McDavitt, B.; O'Connor, M.

    2003-12-01

    The Pacific Lumber Company Habitat Conservation Plan generates both watershed-specific and generally applicable management practices (prescriptions) to reduce erosion and sedimentation rates. Watershed analyses produced under terms of the HCP include sediment budgets with detailed field measurements of in-stream sediment storage and a reach-scale sediment routing model. Monitoring of erosion, and stream channel conditions is being conducted to test the effectiveness of the erosion control prescriptions. As part of the monitoring process, a hypothesis was developed predicting changes in stored sediment in monitoring reaches resulting from predicted decreases in sediment inputs caused by management. Predicted changes in stored sediment were calculated based a range of assumptions regarding effectiveness of erosion control prescriptions over ten years. Long term monitoring of stored sediment in channels is being conducted to determine whether predicted changes in sediment inputs can be detected. Existing theory supports the hypotheses linking erosion processes with sediment routing and storage predictions. Potential limitations regarding measurement precision and statistical power are considered.

  11. Characteristics of interventional cardiologists and their work practices for the study on radiation-induced lens opacities based on the methodology developed by ELDO—preliminary results

    PubMed Central

    Domienik, Joanna; Gryglak, Szymon; Jurewicz, Joanna

    2016-01-01

    Preliminary results of the Polish epidemiology study on eye lens opacities among interventional cardiologists (ICs), based on the methodology proposed by ELDO (epidemiological studies of radio-induced cataracts in interventional cardiologists and radiologists: methodology implementation), are presented. The aim of the study is to test the hypothesis concerning the excess risk of cataract in the group of ICs. The first results concern the study population characteristics, including the most important confounding factors for cataract, as well as a detailed description of the work practices in interventional cardiology needed in order to reconstruct the cumulative eye lens dose. The data from 69 ICs and 23 controls collected based on the general medical questionnaire and the occupational questionnaire (for ICs only) were analyzed. The mean age of ICs and of the control group was 41 and 44, respectively, while the mean duration of work for exposed physicians was 9 years. The analysis of the data from the occupational questionnaire concerning the procedures performed, the use of various access routes, as well as radiation protection tools (eye lens glasses, ceiling suspended transparent shield, etc.) are also presented. On the basis of this information and additional assumptions about the doses per procedure (as well as reduction factors for various types of radiation measures), the cumulative doses to the eye lens of ICs were evaluated. They ranged up to 1.55 Sv and 0.4 Sv for left and right eye, respectively; however, the dose to only 3% of ICs exceeded the new threshold for development of eye lens opacities (0.5 Gy) proposed by the ICRP. PMID:26983990

  12. 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.

  13. 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…

  14. School Leadership Teams: Extending the Reach of School Based Literacy Coaches

    ERIC Educational Resources Information Center

    Morgan, Denise N.; Clonts, Christy M.

    2008-01-01

    This article describes how establishing a literacy-focused school leadership team can strengthen and expand the reach of the literacy coach. This team helps bring faculty into dialogue to critique and transform their current literacy practices and works towards developing a common vision, beliefs, and a shared language within the school. This…

  15. "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…

  16. 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,…

  17. Red meat and poultry, cooking practices, genetic susceptibility and risk of prostate cancer: results from a multiethnic case–control study

    PubMed Central

    Stern, Mariana C.

    2012-01-01

    Red meat, processed and unprocessed, has been considered a potential prostate cancer (PCA) risk factor; epidemiological evidence, however, is inconclusive. An association between meat intake and PCA may be due to potent chemical carcinogens that are generated when meats are cooked at high temperatures. We investigated the association between red meat and poultry intake and localized and advanced PCA taking into account cooking practices and polymorphisms in enzymes that metabolize carcinogens that accumulate in cooked meats. We analyzed data for 1096 controls, 717 localized and 1140 advanced cases from the California Collaborative Prostate Cancer Study, a multiethnic, population-based case–control study. We examined nutrient density-adjusted intake of red meat and poultry and tested for effect modification by 12 SNPs and 2 copy number variants in 10 carcinogen metabolism genes: GSTP1, PTGS2, CYP1A2, CYP2E1, EPHX1, CYP1B1, UGT1A6, NAT2, GSTM1 and GSTT1. We observed a positive association between risk of advanced PCA and high intake of red meat cooked at high temperatures (trend P = 0.026), cooked by pan-frying (trend P = 0.035), and cooked until well-done (trend P = 0.013). An inverse association was observed for baked poultry and advanced PCA risk (trend P = 0.023). A gene-by-diet interaction was observed between an SNP in the PTGS2 gene and the estimated levels of meat mutagens (interaction P = 0.008). Our results support a role for carcinogens that accumulate in meats cooked at high temperatures as potential PCA risk factors, and may support a role for heterocyclic amines (HCAs) in PCA etiology. PMID:22822096

  18. Impact of a peer-counseling intervention on breastfeeding practices in different socioeconomic strata: results from the equity analysis of the PROMISE-EBF trial in Uganda

    PubMed Central

    Eide, Kristiane Tislevoll; Fadnes, Lars Thore; Engebretsen, Ingunn Marie Stadskleiv; Onarheim, Kristine Husøy; Wamani, Henry; Tumwine, James K.; Norheim, Ole Frithjof

    2016-01-01

    Background Undernutrition is highly prevalent among infants in Uganda. Optimal infant feeding practices may improve nutritional status, health, and survival among children. Objective Our study evaluates the socioeconomic distribution of exclusive breastfeeding (EBF) and growth outcomes among infants included in a trial, which promoted EBF by peer counselors in Uganda. Design Twenty-four clusters comprising one to two communities in Uganda were randomized into intervention and control arms, including 765 mother-infant pairs (PROMISE-EBF trial, 200608, ClinicalTrials.gov no. NCT00397150). Intervention clusters received the promotion of EBF by peer counselors in addition to standard care. Breastfeeding and growth outcomes were compared according to wealth quintiles and intervention/control arms. Socioeconomic inequality in breastfeeding and growth outcomes were measured using the concentration index 12 and 24 weeks postpartum. We used the decomposition of the concentration index to identify factors contributing to growth inequality at 24 weeks. Results EBF was significantly concentrated among the poorest in the intervention group at 24 weeks postpartum, concentration index −0.060. The control group showed a concentration of breastfeeding among the richest part of the population, although not statistically significant. Stunting, wasting, and underweight were similarly significantly concentrated among the poorest in the intervention group and the total population at 24 weeks, but showing non-significant concentrations for the control group. Conclusion This study shows that EBF can be successfully promoted among the poor. In addition, socioeconomic inequality in growth outcomes starts early in infancy, but the breastfeeding intervention was not strong enough to counteract this influence. PMID:27473676

  19. Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS)

    PubMed Central

    Gagliardino, Juan J; Atanasov, Petar K; Chan, Juliana C N; Mbanya, Jean C; Shestakova, Marina V; Leguet-Dinville, Prisca; Annemans, Lieven

    2017-01-01

    Objective Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. Research design and methods In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011–2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3–6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations. Results Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions. Conclusions In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU. PMID:28123754

  20. Impact of a peer-counseling intervention on breastfeeding practices in different socioeconomic strata: results from the equity analysis of the PROMISE-EBF trial in Uganda.

    PubMed

    Eide, Kristiane Tislevoll; Fadnes, Lars Thore; Engebretsen, Ingunn Marie Stadskleiv; Onarheim, Kristine Husøy; Wamani, Henry; Tumwine, James K; Norheim, Ole Frithjof

    2016-01-01

    Background Undernutrition is highly prevalent among infants in Uganda. Optimal infant feeding practices may improve nutritional status, health, and survival among children. Objective Our study evaluates the socioeconomic distribution of exclusive breastfeeding (EBF) and growth outcomes among infants included in a trial, which promoted EBF by peer counselors in Uganda. Design Twenty-four clusters comprising one to two communities in Uganda were randomized into intervention and control arms, including 765 mother-infant pairs (PROMISE-EBF trial, 200608, ClinicalTrials.gov no. NCT00397150). Intervention clusters received the promotion of EBF by peer counselors in addition to standard care. Breastfeeding and growth outcomes were compared according to wealth quintiles and intervention/control arms. Socioeconomic inequality in breastfeeding and growth outcomes were measured using the concentration index 12 and 24 weeks postpartum. We used the decomposition of the concentration index to identify factors contributing to growth inequality at 24 weeks. Results EBF was significantly concentrated among the poorest in the intervention group at 24 weeks postpartum, concentration index -0.060. The control group showed a concentration of breastfeeding among the richest part of the population, although not statistically significant. Stunting, wasting, and underweight were similarly significantly concentrated among the poorest in the intervention group and the total population at 24 weeks, but showing non-significant concentrations for the control group. Conclusion This study shows that EBF can be successfully promoted among the poor. In addition, socioeconomic inequality in growth outcomes starts early in infancy, but the breastfeeding intervention was not strong enough to counteract this influence.

  1. Factors that Determine Academic Versus Private Practice Career Interest in Radiation Oncology Residents in the United States: Results of a Nationwide Survey

    SciTech Connect

    Chang, Daniel T.; Shaffer, Jenny L.; Haffty, Bruce G.; Wilson, Lynn D.

    2013-11-01

    Purpose: To determine what factors US radiation oncology residents consider when choosing academic or nonacademic careers. Methods and Materials: A 20-question online survey was developed and sent to all US radiation oncology residents to assess factors that influence their career interest. Residents were asked to rate their interest in academics (A) versus private practice (PP) on a 0 (strong interest in A) to 100 (strong interest in PP) scale. Responses were classified as A (0-30), undecided (40-60), and PP (70-100). Residents were also asked to rank 10 factors that most strongly influenced their career interest. Results: Three hundred thirty-one responses were collected, of which 264 were complete and form the basis for this analysis. Factors that correlated with interest in A included having a PhD (P=.018), postgraduate year level (P=.0006), research elective time (P=.0003), obtaining grant funding during residency (P=.012), and number of publications before residency (P=.0001), but not number of abstracts accepted in the past year (P=.65) or publications during residency (P=.67). The 3 most influential factors for residents interested in A were: (1) baseline interest before residency; (2) academic role models; and (3) research opportunities during residency. The 3 most influential factors for residents interested in PP were: (1) baseline interest before residency; (2) academic role models; and (3) academic pressure and obligations. Conclusions: Interest in A correlated with postgraduate year level, degree, and research time during residency. Publications before but not during residency correlated with academic interest, and baseline interest was the most influential factor. These data can be used by residency program directors to better understand what influences residents' career interest.

  2. Red meat and poultry, cooking practices, genetic susceptibility and risk of prostate cancer: results from a multiethnic case-control study.

    PubMed

    Joshi, Amit D; Corral, Román; Catsburg, Chelsea; Lewinger, Juan Pablo; Koo, Jocelyn; John, Esther M; Ingles, Sue A; Stern, Mariana C

    2012-11-01

    Red meat, processed and unprocessed, has been considered a potential prostate cancer (PCA) risk factor; epidemiological evidence, however, is inconclusive. An association between meat intake and PCA may be due to potent chemical carcinogens that are generated when meats are cooked at high temperatures. We investigated the association between red meat and poultry intake and localized and advanced PCA taking into account cooking practices and polymorphisms in enzymes that metabolize carcinogens that accumulate in cooked meats. We analyzed data for 1096 controls, 717 localized and 1140 advanced cases from the California Collaborative Prostate Cancer Study, a multiethnic, population-based case-control study. We examined nutrient density-adjusted intake of red meat and poultry and tested for effect modification by 12 SNPs and 2 copy number variants in 10 carcinogen metabolism genes: GSTP1, PTGS2, CYP1A2, CYP2E1, EPHX1, CYP1B1, UGT1A6, NAT2, GSTM1 and GSTT1. We observed a positive association between risk of advanced PCA and high intake of red meat cooked at high temperatures (trend P = 0.026), cooked by pan-frying (trend P = 0.035), and cooked until well-done (trend P = 0.013). An inverse association was observed for baked poultry and advanced PCA risk (trend P = 0.023). A gene-by-diet interaction was observed between an SNP in the PTGS2 gene and the estimated levels of meat mutagens (interaction P = 0.008). Our results support a role for carcinogens that accumulate in meats cooked at high temperatures as potential PCA risk factors, and may support a role for heterocyclic amines (HCAs) in PCA etiology.

  3. ESA's Venus Express to reach final destination

    NASA Astrophysics Data System (ADS)

    2006-04-01

    burn, at 09:45 (CEST), Venus Express will disappear behind the planet and will not be visible from Earth. This is known as its ‘occultation’ period. The spacecraft will re-emerge from behind Venus’s disc some ten minutes later. So, even with the low gain antenna’s signal, it will only be visible during the first half of the burn and the last six minutes. Receiving the spacecraft signal after the occultation period will be the first positive sign of successful orbit insertion. 11 April, h 11:13 (CEST), re-establish communication with Earth. At the end of the burn, Venus Express still has to perform a few automatic operations. These re-orient the solar panels towards the sun and one of the high gain antennas (the smaller High Gain Antenna 2) towards Earth. If everything goes as expected, at 11:13 the spacecraft should be able to establish its first communication link with ESA’s Cebreros ground station near Madrid. Over the next few hours, it will send much-awaited information about its state of health. Information about its actual trajectory will be available from ESOC’s flight dynamics team around 12:30 (CEST). 12 to 13 April 2006, full reactivation starts. During the 24 hours following orbital capture, time will be devoted to reactivating all spacecraft functions, including all internal monitoring capacity. By the morning of the 13th, the larger ‘High Gain Antenna 1, hitherto unused, will be oriented and fed by the transmitter to communicate with Earth. The two high gain antennas, located on different sides of the spacecraft, will be used alternately during the mission, to avoid exposure to the sun of critical equipment on the outside. Reaching final orbit A series of further manoeuvres and many more days will be required to settle Venus Express into its final orbit. The preliminary nine-day orbit is elliptical, ranging from 350 000 kilometres at its furthest point from the planet (apocentre) to less than 400 kilometres at its closest (pericentre). During

  4. Can We Reach the Urban Disadvantaged Adult?

    ERIC Educational Resources Information Center

    Hampton, Leonard A.; Ashton, Dub

    1979-01-01

    Reports results from a survey--conducted under the auspices of the Neighborhood Continuing Education Program of Savannah, Georgia--of residents of a former model cities area to find out what education and retraining they might want and need, with implications for extension programing. (MF)

  5. Policies and Practices in the Delivery of HIV Services in Correctional Agencies and Facilities: Results from a Multi-Site Survey

    PubMed Central

    Belenko, Steven; Hiller, Matthew; Visher, Christy; Copenhaver, Michael; O’Connell, Daniel; Burdon, William; Pankow, Jennifer; Clarke, Jennifer; Oser, Carrie

    2013-01-01

    HIV risk is disproportionately high among incarcerated individuals. Corrections agencies have been slow to implement evidence-based guidelines and interventions for HIV prevention, testing, and treatment. The emerging field of implementation science focuses on organizational interventions to facilitate adoption and implementation of evidence-based practices. A survey of among CJ-DATS correctional agency partners revealed that HIV policies and practices in prevention, detection and medical care varied widely, with some corrections agencies and facilities closely matching national guidelines and/or implementing evidence-based interventions. Others, principally attributed to limited resources, had numerous gaps in delivery of best HIV service practices. A brief overview is provided of a new CJ-DATS cooperative research protocol, informed by the survey findings, to test an organization-level intervention to reduce HIV service delivery gaps in corrections. PMID:24078624

  6. Generalization patterns for reach adaptation and proprioceptive recalibration differ after visuomotor learning.

    PubMed

    Cressman, Erin K; Henriques, Denise Y P

    2015-07-01

    Visuomotor learning results in changes in both motor and sensory systems (Cressman EK, Henriques DY. J Neurophysiol 102: 3505-3518, 2009), such that reaches are adapted and sense of felt hand position recalibrated after reaching with altered visual feedback of the hand. Moreover, visuomotor learning has been shown to generalize such that reach adaptation achieved at a trained target location can influence reaches to novel target directions (Krakauer JW, Pine ZM, Ghilardi MF, Ghez C. J Neurosci 20: 8916-8924, 2000). We looked to determine whether proprioceptive recalibration also generalizes to novel locations. Moreover, we looked to establish the relationship between reach adaptation and changes in sense of felt hand position by determining whether proprioceptive recalibration generalizes to novel targets in a similar manner as reach adaptation. On training trials, subjects reached to a single target with aligned or misaligned cursor-hand feedback, in which the cursor was either rotated or scaled in extent relative to hand movement. After reach training, subjects reached to the training target and novel targets (including targets from a second start position) without visual feedback to assess generalization of reach adaptation. Subjects then performed a proprioceptive estimation task, in which they indicated the position of their hand relative to visual reference markers placed at similar locations as the trained and novel reach targets. Results indicated that shifts in hand position generalized across novel locations, independent of reach adaptation. Thus these distinct sensory and motor generalization patterns suggest that reach adaptation and proprioceptive recalibration arise from independent error signals and that changes in one system cannot guide adjustments in the other.

  7. Imaging Guidance Improves the Results of Viscosupplementation with HANOX-M-XL in Patients with Ankle Osteoarthritis: Results of a Clinical Survey in 50 Patients Treated in Daily Practice

    PubMed Central

    Bossert, Marie; Boublil, Daniel; Parisaux, Jean-Marc; Bozgan, Ana-Maria; Richelme, Emmanuel; Conrozier, Thierry

    2016-01-01

    BACKGROUND The objective of this survey was to assess retrospectively the interest of performing viscosupplementation using imaging guidance in patients suffering from ankle osteoarthritis (OA). PATIENTS AND METHODS This is a multicenter retrospective survey using a standardized questionnaire. Fifty patients suffering from ankle OA and treated, in daily clinical practice, with a single intra-articular injection of a novel viscosupplement made of a combination of a non-animal cross-linked hyaluronan and mannitol, HANOX M-XL, were included in the survey. The injection procedure (imaging or landmark guidance), demographic data, patient’s self-evaluation of pain, satisfaction, treatment efficacy, and tolerability were collected. Predictive factors of both efficacy and patient’s satisfaction were investigated. RESULTS The percentages of patients very satisfied/satisfied and not really satisfied/dissatisfied with the treatment were 68% and 32%, respectively. Efficacy was rated as very good, good, moderate, and poor by 38%, 30%, 12%, and 20% of the cases, respectively. Efficacy was unrelated to gender and age and was highly correlated with pain score (P < 0.0001). In satisfied patients, the decrease in consumption of analgesics/non-steroidal anti-inflammatory drugs was >75% in 64% of the cases. Efficacy was significantly different with regard to imaging guidance. There was a statistically significant difference in efficacy and satisfaction between landmark-guided and imaging-guided injections (P = 0.02). The success rate was 2.3 times higher in the imaging-guided group than in the landmark-guided group. No significant difference was found between patients injected under fluoroscopy or ultrasound guidance, despite a trend favoring ultrasound (P = 0.09). Tolerability was rated as very good/good in 47 patients, moderate in two, and poor in one and was unrelated to the type of guidance. CONCLUSION This preliminary study suggests that the use of imaging guidance

  8. 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

  9. Flexibility, Reach, and the Vietnam Fire Base

    DTIC Science & Technology

    2014-05-22

    generators Water supply Piped water distribution Point supply with limited distribution Point supply Sewage Waterborne Consolidated treatment...could be decimated simply from the results of poor hygiene. “Military planning had to consider provisions for fresh water , and countering the problems of...York: Harper Collins Publishers, 1993. Doughty, Robert, Ira Gruber, Roy Flint , Mark Grimsley, and George Herring. Warfare in the Western World

  10. Clinical benefits, referral practice and cost implications of an in-hospital pain service: results of a service evaluation in a London teaching hospital

    PubMed Central

    Sussman, Maya; Goodier, Elizabeth; Fabri, Izabella; Borrowman, Jessica; Thomas, Sarah; Guest, Charlotte; Bantel, Carsten

    2016-01-01

    Background: In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients’ pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy. Methods: Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS). Non-parametric tests were used to evaluate differences between initial and final NRS. Spearman’s rank correlation analysis was used to create a correlation matrix to evaluate associations between all identified independent variables with the change in NRS. All strongly correlated variables (ρ > 0.5) were subsequently included in a binary logistic regression analysis to identify predictors of pain resolution greater than 50% NRS and improvement rather than deterioration or no change in NRS. Finally, referral practice and cost of inappropriate referrals were estimated. Referrals were thought to be inappropriate when pain was not optimised by the referring team; they were identified using a set algorithm. Results: Initial median NRS and final median NRS were significantly different when a Wilcoxon signed-rank test was applied to the whole cohort; Z = –5.5 (p = 0.000). Subgroup analysis demonstrated no significant difference in the ‘mild’ pain group; z = –1.1 (p = 0.253). Regression analysis showed that for every unit increase in initial NRS, there was a 62% chance of general and a 33% chance of >50% improvement in final NRS. An estimated annual cost-saving potential of £1546 to £4558 was found in inappropriate referrals and patients experiencing no benefit from the service. Discussion: Results suggest that patients with moderate to severe pain benefit most from IPS input. Also pain management resources are often

  11. The challenge of reproductive and developmental toxicology under REACH.

    PubMed

    Scialli, Anthony R

    2008-07-01

    The European Union's REACH regulation has explicit requirements for reproductive and developmental toxicity data on all substances manufactured in or imported into the European Union at > or = 10 metric tons/year. Meeting the data requirements with whole-animal testing could result in the use of almost 22 million vertebrate animals for the registration of existing chemicals and cost up to several hundred thousand dollars per registered substance. The requirement for financial and animal resources can be reduced by the use of in vitro testing, quantitative structure-activity relationship models, and grouping of related substances. Although REACH strongly encourages these methods of avoiding vertebrate animal testing, it does not appear that in vitro testing or quantitative structure-activity relationship analysis will be able to replace whole-animal reproductive and developmental toxicity testing. Grouping of related compounds offers the possibility, perhaps in conjunction with in vitro testing and structure-activity analysis, of reducing vertebrate animal testing provided there is sufficient information on the related compounds and sufficient reason to believe that the related compounds will have similar toxicological properties. The designation of a substance as a reproductive or developmental toxicant follows criteria that do not consider the dose level of the substance at which reproductive or developmental effects occur, as long as excessive generalized toxicity does not occur. This method of labeling substances without consideration of effective dose level does not provide information on the actual risk of the chemical. Designation of a substance as a reproductive or developmental toxicant may have important implications under REACH and can be expected to result in the need to obtain authorization for marketing of the substance in the European Union.

  12. 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.

  13. 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.

  14. Ethnic Variation in the Association between Family Structures and Practices on Child Outcomes at 36 Months: Results from Early Head Start

    ERIC Educational Resources Information Center

    Iruka, Iheoma U.

    2009-01-01

    Research Findings: This study analyzed data from the Early Head Start Research and Evaluation Study (EHSRES) to examine whether the association between family structural characteristics (maternal education, number of parents, employment status, and number of children), parenting practices (sensitive and negative parenting, cognitively stimulating…

  15. Funding and Distribution of Institutional Grants in 1999-2000: Results from the 2001 Survey of Undergraduate Financial Aid Policies, Practices, and Procedures.

    ERIC Educational Resources Information Center

    Redd, Kenneth E.

    2002-01-01

    Examined data from the 2001 Survey of Undergraduate Financial Aid Policies, Practices, and Procedures. Findings included that all institutional types, even low-cost community colleges, have awarded a large share of their institutional grants based on students' academic merit or other criteria besides their demonstrated financial need, but that…

  16. Results from a Survey of Current Practices for Sampling of Nervous System in Rodents and Non-rodents in General Toxicity Studies

    EPA Science Inventory

    A survey of current practices for sampling and examination of the nervous system in rodents and non-rodents for general and neurotoxicity (NT) studies was conducted by the Nervous System Sampling Subcommittee of the STP. For general toxicity studies most of those surveyed (>63%) ...

  17. 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].

  18. Practical results of heat conservation in a housing estate scale-actions implemented by the Pradnik-Bialy-Zachod housing cooperative in Cracow

    SciTech Connect

    Piotrowski, L.

    1995-12-31

    There are 11,600,000 apartments occupied in Poland. More than 7,700,000 of these apartments are located in towns. Energy consumption for heating, ventilation and district hot water in residential housing reaches 40% of the national power balance. A portion of district heat distribution and relatively low energy efficiency is characteristic for Polish residential housing. Seventy five percent of apartments in towns are provided with central heating installations and 55% of the entire heat demand in Polish buildings is covered by district heating systems. The total installed heat power of these systems reaches 46,000 MW. The situation with regard to conservation in Polish residential housing is directly related to the legacy of central planning of the national economy and to the current phase of its re-organization to the market-oriented system. The standard value of the overall heat-transfer coefficient for external walls in Poland until 1980 was 1.16 W/m{sup 2}K; at present it is reduced to 0.55 W/m{sup 2}K. There are numerous reasons for the low energy efficiency in residential housing. These reasons are discussed.

  19. 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.

  20. DOTS expansion: will we reach the 2005 targets?

    PubMed

    Véron, L J; Blanc, L J; Suchi, M; Raviglione, M C

    2004-01-01

    The global targets for tuberculosis control consist of detecting 70% of estimated infectious cases and curing 85% of these by 2005. Since the introduction of the DOTS strategy, DOTS geographical coverage has increased substantially and treatment success rates under DOTS are approaching the targets, standing at 82% in 2000. However, DOTS case detection, albeit increasing, is still relatively low, at 32% in 2001. This target may not be reached by 2005. The low case detection is unlikely to stem from overestimating the global number of TB cases which has been estimated on several occasions, but from TB cases not being detected or notified for various reasons. The population may have poor access to TB services, cases may not be suspected or correctly diagnosed, cases may not be notified, and/or public health programmes or the private sector may not be adequately linked to the National Tuberculosis Programmes. Since the global TB targets were set, progress has been made. Political commitment has increased, additional financial resources mobilised, access to anti-tuberculosis drugs augmented and planning and coordination improved. Constraints still remain, the most important related to human resource capacity. Although the issue is being tackled, many countries still suffer from a lack of trained health care professionals. Finally, new strategies have been developed to face the current challenges such as public-private mix, community TB care, social mobilisation, TB/HIV collaborative interventions and Practical Approach to Lung Health. The current efforts should be maintained and strengthened in order to approach these targets.

  1. Advanced REACH Tool: A Bayesian Model for Occupational Exposure Assessment

    PubMed Central

    McNally, Kevin; Warren, Nicholas; Fransman, Wouter; Entink, Rinke Klein; Schinkel, Jody; van Tongeren, Martie; Cherrie, John W.; Kromhout, Hans; Schneider, Thomas; Tielemans, Erik

    2014-01-01

    This paper describes a Bayesian model for the assessment of inhalation exposures in an occupational setting; the methodology underpins a freely available web-based application for exposure assessment, the Advanced REACH Tool (ART). The ART is a higher tier exposure tool that combines disparate sources of information within a Bayesian statistical framework. The information is obtained from expert knowledge expressed in a calibrated mechanistic model of exposure assessment, data on inter- and intra-individual variability in exposures from the literature, and context-specific exposure measurements. The ART provides central estimates and credible intervals for different percentiles of the exposure distribution, for full-shift and long-term average exposures. The ART can produce exposure estimates in the absence of measurements, but the precision of the estimates improves as more data become available. The methodology presented in this paper is able to utilize partially analogous data, a novel approach designed to make efficient use of a sparsely populated measurement database although some additional research is still required before practical implementation. The methodology is demonstrated using two worked examples: an exposure to copper pyrithione in the spraying of antifouling paints and an exposure to ethyl acetate in shoe repair. PMID:24665110

  2. Effect of savings-led economic empowerment on HIV preventive practices among orphaned adolescents in rural Uganda: results from the Suubi-Maka randomized experiment.

    PubMed

    Jennings, Larissa; Ssewamala, Fred M; Nabunya, Proscovia

    2016-01-01

    Improving economic resources of impoverished youth may alter intentions to engage in sexual risk behaviors by motivating positive future planning to avoid HIV risk and by altering economic contexts contributing to HIV risk. Yet, few studies have examined the effect of economic-strengthening on economic and sexual behaviors of orphaned youth, despite high poverty and high HIV infection in this population. Hierarchal longitudinal regressions were used to examine the effect of a savings-led economic empowerment intervention, the Suubi-Maka Project, on changes in orphaned adolescents' cash savings and attitudes toward savings and HIV-preventive practices over time. We randomized 346 Ugandan adolescents, aged 10-17 years, to either the control group receiving usual orphan care plus mentoring (n = 167) or the intervention group receiving usual orphan care plus mentoring, financial education, and matched savings accounts (n = 179). Assessments were conducted at baseline, 12, and 24 months. Results indicated that intervention adolescents significantly increased their cash savings over time (b = $US12.32, ±1.12, p < .001) compared to adolescents in the control group. At 24 months post-baseline, 92% of intervention adolescents had accumulated savings compared to 43% in the control group (p < .001). The largest changes in savings goals were the proportion of intervention adolescents valuing saving for money to buy a home (ΔT1-T0 = +14.9, p < .001), pursue vocational training (ΔT1-T0 = +8.8, p < .01), and start a business (T1-T0 = +6.7, p < .01). Intervention adolescents also had a significant relative increase over time in HIV-preventive attitudinal scores (b = +0.19, ±0.09, p < .05), most commonly toward perceived risk of HIV (95.8%, n = 159), sexual abstinence or postponement (91.6%, n = 152), and consistent condom use (93.4%, n = 144). In addition, intervention adolescents had 2.017 significantly greater

  3. Vestibular feedback maintains reaching accuracy during body movement

    PubMed Central

    Reynolds, Raymond F.

    2016-01-01

    Key points Reaching movements can be perturbed by vestibular input, but the function of this response is unclear.Here, we applied galvanic vestibular stimulation concurrently with real body movement while subjects maintained arm position either fixed in space or fixed with respect to their body.During the fixed‐in‐space conditions, galvanic vestibular stimulation caused large changes in arm trajectory consistent with a compensatory response to maintain upper‐limb accuracy in the face of body movement.Galvanic vestibular stimulation responses were absent during the body‐fixed task, demonstrating task dependency in vestibular control of the upper limb.The results suggest that the function of vestibular‐evoked arm movements is to maintain the accuracy of the upper limb during unpredictable body movement, but only when reaching in an earth‐fixed reference frame. Abstract When using our arms to interact with the world, unintended body motion can introduce movement error. A mechanism that could detect and compensate for such motion would be beneficial. Observations of arm movements evoked by vestibular stimulation provide some support for this mechanism. However, the physiological function underlying these artificially evoked movements is unclear from previous research. For such a mechanism to be functional, it should operate only when the arm is being controlled in an earth‐fixed rather than a body‐fixed reference frame. In the latter case, compensation would be unnecessary and even deleterious. To test this hypothesis, subjects were gently rotated in a chair while being asked to maintain their outstretched arm pointing towards either earth‐fixed or body‐fixed memorized targets. Galvanic vestibular stimulation was applied concurrently during rotation to isolate the influence of vestibular input, uncontaminated by inertial factors. During the earth‐fixed task, galvanic vestibular stimulation produced large polarity‐dependent corrections in arm

  4. Spatial location and pathway memory compared in the reaching vs. walking domains.

    PubMed

    Piccardi, L; Bianchini, F; Nori, R; Marano, A; Iachini, F; Lasala, L; Guariglia, C

    2014-04-30

    Spatial information processing is influenced by the space in which an individual acts and the nature of the stimulus. This distinction is also present in spatial memory, where stimuli are processed differently because of their nature and the space in which they are released. The aim of the present study was to compare college students' performance on spatial location and pathway memory tasks in two different domains (reaching and walking). Reaching space refers to the portion of space within "grasping distance" and walking space to that beyond arm's reach. Research results indicate that it is easier to remember a pathway in the walking than the reaching domain and to remember single spatial locations in the reaching domain. Women are more able to perform the task in the walking domain than the reaching domain and men perform equally well in both domains.

  5. [Nursing observation chart: between the objectives targeted by this model and actual practice, where should we place the reflective process of the nurse? Results of the study. Future prospects of teaching tools].

    PubMed

    Ripoche, Sébastien

    2012-09-01

    The research presented below examines the focus charting model in French nursing practice. Between the objectives targeted by this model and actual practice, where to place the reflective process of the nurse? To answer this question, the methodology used is the comprehensive approach. It is characterized by the production of semi-structured interviews of nurses using the model studied, but also by the in situ observation of practices. The results show that nurses engaged a reflexive process in the use of the focus charting model. This reflexive process is "in" the action rather than "on" or "for" the action. Nurse's position vis a vis at their disposal is investigated.

  6. Development of the southern reaches of Laurentia

    SciTech Connect

    Reed, J.C. Jr. . Federal Center)

    1993-02-01

    Laurentia, the Late Proterozoic continental fragment that now forms the core of North America, has a long and complex history, much of which involves development along its southern margin. The southernmost parts of the Archean continental core are the Wyoming and Superior cratons, both of which contain gneisses that record crust-forming events in the interval 3.8--3.1 Ga as well as greenstone belts that reflect continental growth in the interval 2.8--2.6 Ga. Each of these cratonic elements was assembled and stabilized prior to deposition of passive margin sequences along their southern flanks during the interval [approximately]2.5--1.9 Ga. Between [approximately]1.8 Ga and 1.6 Ga arc-related sedimentary and volcanic rocks were accreted to the southern margin of the Laurentian core during a complex series of tectonic episodes that included events locally referred to as the Penokean, Ivanpah, Yavapai, and Mazatzal orogenies, resulting in the addition of a belt of continental crust at least 1,000 km wide. Voluminous highly evolved granite and rhyolite were emplaced along this southern marginal belt between [approximately] 1.45 and 1.35 Ga under conditions of general tectonic stability, or perhaps dispersed regional extension. This same interval was also marked by onset of deposition of thick Middle Proterozoic sedimentary sequences along the western and southern margins of Laurentia. The eastern margin of Laurentia contains the complexly deformed and metamorphosed rocks of the 1.25 to 1.1 Ga Grenville orogen which, according to recent reconstructions, may record a collision with cratonic elements in western South America. The 2,000 km-long Midcontinent rift system in central Laurentia opened and filled with basalt and sediments at about the same time as the end of Grenville activity.

  7. Dynamic channel adjustments in the Jingjiang Reach of the Middle Yangtze River

    PubMed Central

    Xia, Junqiang; Deng, Shanshan; Lu, Jinyou; Xu, Quanxi; Zong, Quanli; Tan, Guangming

    2016-01-01

    Significant channel adjustments have occurred in the Jingjiang Reach of the Middle Yangtze River, because of the operation of the Three Gorges Project (TGP). The Jingjiang Reach is selected as the study area, covering the Upper Jingjiang Reach (UJR) and Lower Jingjiang Reach (LJR). The reach-scale bankfull channel dimensions in the study reach were calculated annually from 2002 to 2013 by means of a reach-averaged approach and surveyed post-flood profiles at 171 sections. We find from the calculated results that: the reach-scale bankfull widths changed slightly in the UJR and LJR, with the corresponding depths increasing by 1.6 m and 1.0 m; the channel adjustments occurred mainly with respect to bankfull depth because of the construction of large-scale bank revetment works, although there were significant bank erosion processes in local regions without the bank protection engineering. The reach-scale bankfull dimensions in the UJR and LJR generally responded to the previous five-year average fluvial erosion intensity during flood seasons, with higher correlations being obtained for the depth and cross-sectional area. It is concluded that these dynamic adjustments of the channel geometry are a direct result of recent human activities such as the TGP operation. PMID:26965069

  8. Ethnic differences in infant feeding practices and their relationship with BMI at 3 years of age - results from the Born in Bradford birth cohort study.

    PubMed

    Santorelli, Gillian; Fairley, Lesley; Petherick, Emily S; Cabieses, Baltica; Sahota, Pinki

    2014-05-28

    The present study aimed to explore previously unreported ethnic differences in infant feeding practices during the introduction of solid foods, accounting for maternal and birth factors, and to determine whether these feeding patterns are associated with BMI at 3 years of age. An observational study using Poisson regression was carried out to investigate the relationship between ethnicity and infant feeding practices and linear regression was used to investigate the relationship between feeding practices and BMI at 3 years of age in a subsample of 1327 infants in Bradford. It was found that compared with White British mothers, mothers of Other ethnicities were less likely to replace breast milk with formula milk before introducing solid foods (adjusted relative risk (RR) - Pakistani: 0·76 (95 % CI 0·64, 0·91), Other South Asian: 0·58 (95 % CI 0·39, 0·86), and Other ethnicities: 0·50 (95 % CI 0·34, 0·73)). Pakistani and Other South Asian mothers were less likely to introduce solid foods early ( < 17 weeks) (adjusted RR - Pakistani: 0·92 (95 % CI 0·87, 0·96) and Other South Asian: 0·87 (95 % CI 0·81, 0·93)). Other South Asian mothers and mothers of Other ethnicities were more likely to continue breast-feeding after introducing solid foods (adjusted RR - 1·72 (95 % CI 1·29, 2·29) and 2·12 (95 % CI 1·60, 2·81), respectively). Pakistani and Other South Asian infants were more likely to be fed sweetened foods (adjusted RR - 1·18 (95 % CI 1·13, 1·23) and 1·19 (95 % CI 1·10, 1·28), respectively) and Pakistani infants were more likely to consume sweetened drinks (adjusted RR 1·72 (95 % CI 1·15, 2·57)). No association between infant feeding practices and BMI at 3 years was observed. Although ethnic differences in infant feeding practices were found, there was no association with BMI at 3 years of age. Interventions targeting infant feeding practices need to consider ethnicity to identify which populations are failing to follow

  9. Reaching for the APEX at Ames

    NASA Technical Reports Server (NTRS)

    Kohut, Matthew

    2008-01-01

    The multidimensional design of the APEX program is the result of an extensive research and development effort dating back nearly a decade. "In the late 1990s and early 2000, we were pretty successful at getting new research and technology projects here at the center," Johnson says, "and we had a lack of critical mass of project managers. We were taking people who were primarily researchers and putting them in the position of managing projects." Smith and Johnson held a series of workshops across the center during 2000 and 2001 to gather feedback about how to address this issue. When they briefed the center's senior management on their findings, one of the top recommendations was to establish a project manager development program at Ames. At that point, they cast a wide net for ideas and information. "We did centerwide needs assessment, we did focus groups, we did surveys," Smith says. "We came up with a proposal for what a program would look like, tying in what we knew about the Academy of Program1 Project Leadership (now the Academy for Program/Project and Engineering Leadership, or APPEL), what we've seen at other centers, what other centers have tried. We were always checking to make sure our program mapped to APPEL. We also looked at the PMI [Project Management Institute] model, INCOSE [International Council on Systems Engineering], CMMI [Capability Maturity Model Integration], you name it." "We had a lot of conversations with the Jet Propulsion Lab and Goddard," Johnson adds. "We saw those centers as models for what Ames was aspiring to be in terms of a center for managing space flight missions." Their research confirmed what they already knew-that strong practitioner involvement would be critical to their program design process. 'XPEX is for the practitioner by the practitioner," Smith says. "They have to be a part of designing it. Otherwise there's no way we could design a program that meets their needs." At the same time that they worked at the grassroots

  10. [Family practice diagnosis of patients with venous diseases in relation to severity, diagnosis and practice facilities. Results of the ASAM study "Physician status and factor evaluation study of ambulatory patient management"].

    PubMed

    Hoopmann, M; Klein-Lange, M; Busse, R; Schwartz, F W; Weber, J

    1996-01-01

    Although venous diseases are very common and represent frequent reasons for consultations in general practices, little is known about the actual ambulatory care for these patients. In a sentinel network consisting of general practitioners, 385 contacts with patients suffering from venous diseases (64% with varicose veins, 24% with phlebitis and 11% with ulcers) were documented. In 9% of the cases, the functional disability was "severe". The diagnostic procedures included laboratory tests in 23%, ECG in 11%, Doppler sonography in 8% and X-ray or angiography in 5%. The frequency of these diagnostic procedures correlated significantly with the degree of severity. The probability of a Doppler sonography in practices with ultrasound equipment compared to practices without it, was-stratified for the degree of severity, the unequal distribution of diseases and the level of acquaintance with the patient-between 2.2 and 2.6 (p always < 0.05), the probability of laboratory tests between 2.4 and 2.6 (p always < 0.001). This significant dependence of diagnostic procedures from the available equipment calls for the introduction of diagnostic standards as measures of quality assurance even for so-called trivial diseases.

  11. Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results.

    PubMed

    Link, Jenny; Ramanujam, Ryan; Auer, Michael; Ryner, Malin; Hässler, Signe; Bachelet, Delphine; Mbogning, Cyprien; Warnke, Clemens; Buck, Dorothea; Hyldgaard Jensen, Poul Erik; Sievers, Claudia; Ingenhoven, Kathleen; Fissolo, Nicolas; Lindberg, Raija; Grummel, Verena; Donnellan, Naoimh; Comabella, Manuel; Montalban, Xavier; Kieseier, Bernd; Soelberg Sørensen, Per; Hartung, Hans-Peter; Derfuss, Tobias; Lawton, Andy; Sikkema, Dan; Pallardy, Marc; Hemmer, Bernhard; Deisenhammer, Florian; Broët, Philippe; Dönnes, Pierre; Davidson, Julie; Fogdell-Hahn, Anna

    2017-01-01

    Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFNβ-1a subcutaneous (s.c.) and IFNβ-1b s.c. in favor of the least immunogenic preparation IFNβ-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years) and IFNβ-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFNβ ADA was observed in test samples taken from older

  12. Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results

    PubMed Central

    Auer, Michael; Ryner, Malin; Hässler, Signe; Bachelet, Delphine; Mbogning, Cyprien; Warnke, Clemens; Buck, Dorothea; Hyldgaard Jensen, Poul Erik; Sievers, Claudia; Ingenhoven, Kathleen; Fissolo, Nicolas; Lindberg, Raija; Grummel, Verena; Donnellan, Naoimh; Comabella, Manuel; Montalban, Xavier; Kieseier, Bernd; Soelberg Sørensen, Per; Hartung, Hans-Peter; Derfuss, Tobias; Lawton, Andy; Sikkema, Dan; Pallardy, Marc; Hemmer, Bernhard; Deisenhammer, Florian; Broët, Philippe; Dönnes, Pierre; Davidson, Julie; Fogdell-Hahn, Anna

    2017-01-01

    Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFNβ-1a subcutaneous (s.c.) and IFNβ-1b s.c. in favor of the least immunogenic preparation IFNβ-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years) and IFNβ-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFNβ ADA was observed in test samples taken from older

  13. Reaching site closure for groundwater under multiple regulatory agencies

    SciTech Connect

    Glucksberg, N.; Couture, B.

    2007-07-01

    , however CTDEP has approved the United States Environmental Protection Agency's (USEPA's) Maximum Contaminant Levels (MCLs) as the clean up standards for individual constituents. After remediation of an identified contamination source, the RSRs require that at least one groundwater monitoring well, hydraulically down-gradient of the remediation area, be sampled to confirm that the remediation has not impacted groundwater quality. After four quarters of groundwater monitoring with results below the MCLs, additional groundwater sampling must continue for up to three years to reach site closure in accordance with the RSRs. The cleanup criteria for chemical constituents, including boron, are regulated by the USEPA under the Resource Conservation and Recovery Act (RCRA) and the CTDEP Bureau of Water Protection and Land Reuse. The USEPA, however, has accepted the CTDEP RSRs as the cleanup criteria for RCRA. Therefore attainment of the CTDEP RSRs is the only set of criteria needed to reach closure, but both agencies retain oversight, interpretation, and closure authority. As stated above, under the RSRs, groundwater must be monitored following a source remediation for a minimum of four quarters. After demonstrating that the remediation was successful, then additional groundwater sampling is required for up to three additional years. However, the number of monitoring wells and frequency of sampling are not defined in the RSRs and must be negotiated with CTDEP. To successfully reach closure, the conceptual site model, groundwater transport mechanisms, and potential receptors must be defined. Once the hydrogeology is understood, a long term groundwater monitoring program can then be coordinated to meet each agencies requirement to both terminate the NRC license and reach site closure under RCRA. (authors)

  14. 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.

  15. Livestock First Reached Southern Africa in Two Separate Events

    PubMed Central

    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. PMID:26295347

  16. Transient Storage Parameterization of Wetland-dominated Stream Reaches

    NASA Astrophysics Data System (ADS)

    Wilderotter, S. M.; Lightbody, A.; Kalnejais, L. H.; Wollheim, W. M.

    2014-12-01

    Current understanding of the importance of transient storage in fluvial wetlands is limited. Wetlands that have higher connectivity to the main stream channel are important because they have the potential to retain more nitrogen within the river system than wetlands that receive little direct stream discharge. In this study, we investigated how stream water accesses adjacent fluvial wetlands in New England coastal watersheds to improve parameterization in network-scale models. Break through curves of Rhodamine WT were collected for eight wetlands in the Ipswich and Parker (MA) and Lamprey River (NH) watersheds, USA. The curves were inverse modeled using STAMMT-L to optimize the connectivity and size parameters for each reach. Two approaches were tested, a single dominant storage zone and a range of storage zones represented using a power-law distribution of storage zone connectivity. Multiple linear regression analyses were conducted to relate transient storage parameters to stream discharge, area, length-to-width ratio, and reach slope. Resulting regressions will enable more accurate parameterization of surface water transient storage in network-scale models.

  17. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    PubMed

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.

  18. A Bayesian approach of high impaired river reaches identification and total nitrogen load estimation in a sparsely monitored basin.

    PubMed

    Li, Xue; Feng, Jianfeng; Wellen, Christopher; Wang, Yuqiu

    2017-01-01

    In this study, a modeling framework based on the theory of SPAtially Referenced Regression On Watershed attributes (SPARROW) model was developed to identify impaired river reaches with respect to total nitrogen (TN) and estimate the TN sources in the Xin'anjiang River basin, which had limited monitoring sites. A Bayesian approach was applied to estimate the mean values and uncertainties of parameters, including land use export coefficients and in-stream attention rates. Based on the parameters, the midranges (25-75 %) of annual TN concentrations were assessed by the model and 4.5 % of river reaches in the basin were found to be with higher impaired probabilities (namely [TN] > 1.5 mg/l) than other reaches. The amount and yields of TN discharged from diffuse sources were estimated for each county in the basin. The results suggested that Tunxi City had the highest TN yields from farm land and population, while the highest TN yields in Huangshan City were from tea plantations. The outcomes of this study will guide the implementation of practical management measures to reduce TN loads.

  19. 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

  20. Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? Results of the START (Self-Titration With Apidra to Reach Target) Study: a randomized noninferiority trial.

    PubMed

    Harris, Stewart B; Yale, Jean-François; Berard, Lori; Stewart, John; Abbaszadeh, Babak; Webster-Bogaert, Susan; Gerstein, Hertzel C

    2014-01-01

    OBJECTIVE Diabetes self-management is universally regarded as a foundation of diabetes care. We determined whether comparable glycemic control could be achieved by self-titration versus physician titration of a once-daily bolus insulin dose in patients with type 2 diabetes who are unable to achieve optimal glycemia control with a basal insulin. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes, an HbA1c level >7% (53 mmol/mol), and either nocturnal hypoglycemia episodes or an insufficient basal insulin glargine level (with or without oral agents) to achieve a fasting plasma glucose level ≤6 mmol/L (108 mg/dL) were studied. Participants all had bolus insulin glulisine added at breakfast and were allocated to either algorithm-guided patient self-titration or physician titration. The primary outcome was an HbA1c level ≤7% (53 mmol/mol) without severe hypoglycemia. RESULTS After a mean (SD) follow-up of 159.4 days (36.2 days), 28.4% of participants in the self-titration arm vs. 21.2% in the physician titration arm achieved an HbA1c level of ≤7% (53 mmol/mol) without severe hypoglycemia (between-group absolute difference 7.2%; 95% CI -3.2 to 17.7). The lower end of this 95% confidence interval was within the predetermined noninferiority boundary of -5% (P noninferiority = 0.011). CONCLUSIONS In stable patients with type 2 diabetes who are receiving doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-managed titration algorithm is as effective as a physician-managed algorithm.

  1. Contextualized theory-based predictors of intention to practice monogamy among adolescents in Botswana junior secondary schools: Results of focus group sessions and a cross-sectional study.

    PubMed

    Chilisa, Bagele; Mohiemang, Irene; Mpeta, Kolentino Nyamadzapasi; Malinga, Tumane; Ntshwarang, Poloko; Koyabe, Bramwell Walela; Heeren, G Anita

    2016-01-01

    Culture and tradition influences behaviour. Multiple partner and concurrent relationships are made responsible for the increase of HIV infection in Sub-Saharan Africa. A contextualized "Theory of Planned Behaviour" was used to identify predictors of intention to practice monogamy. A mixed method design using qualitative data from focus groups, stories and a survey were analyzed for quantitative data. The qualitative data added to the behavioural beliefs a socio-cultural belief domain as well as attitudes, subjective norms, and perceived behavioural control predicted the intention to practice monogamy. The adolescents showed a tendency towards having more than one sexual partner. The normative beliefs and the socio cultural beliefs also predicted intentions while hedonistic belief and partner reaction did not. In contextualizing theory-based interventions, it is important to draw from stories and the langauage that circulate in a community about a given behaviour. More studies are needed on ways to combine qualitative approaches with quantitative approaches to inform the development of theory based culturally appropriate and context specific intervention strategies to reduce the risk of HIV.

  2. 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.

  3. Reach Scale Sediment Balance of Goodwin Creek Watershed, Mississippi

    NASA Astrophysics Data System (ADS)

    Ran, L.; Garcia, T.; Ye, S.; Harman, C. J.; Hassan, M. A.; Simon, A.

    2010-12-01

    Several reaches of Goodwin Creek, an experimental watershed within the Mississippi river basin, were analyzed for the period 1977-2007 in terms of long-term trends in sediment gain and loss in each reach, the relation of input and output to within-reach sediment fluxes, and the impacts of land use and bank erosion on reach sediment dynamics. Over the period 1977-2007, degradational and aggradational reaches were identified indicating slight vertical adjustment along the mainstream. Lateral adjustment was the main response of the channel to changes in flow and sediment regimes. Event-based sediment load was estimated using suspended concentration data, bedload transport rate, and changes in cross-sectional data. Bank erosion was estimated using cross-sectional data and models. The spatial and temporal patterns of within-reach sediment dynamics correspond closely with river morphology and also reflect basin conditions over the last three decades; thus they are conditioned by coeval trends in climate, hydrology, and land use. The sediment exchange within the mainstream was calculated by the development of reach sediment balances that reveal complex spatial and temporal patterns of sediment dynamics. Sediment load during the rising limb of the hydrograph was slightly higher than those estimated for the falling limb indicating the relative importance of sediment supply on reach sediment dynamic in the basin. Cumulative plots of sediment exchange reveal that major changes in within reach sediment storage are associated with large floods or major inputs from bank erosion.

  4. 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

  5. Evidence for a reference frame transformation of vestibular signal contributions to voluntary reaching.

    PubMed

    Moreau-Debord, Ian; Martin, Christophe Z; Landry, Marianne; Green, Andrea M

    2014-05-01

    To contribute appropriately to voluntary reaching during body motion, vestibular signals must be transformed from a head-centered to a body-centered reference frame. We quantitatively investigated the evidence for this transformation during online reach execution by using galvanic vestibular stimulation (GVS) to simulate rotation about a head-fixed, roughly naso-occipital axis as human subjects made planar reaching movements to a remembered location with their head in different orientations. If vestibular signals that contribute to reach execution have been transformed from a head-centered to a body-centered reference frame, the same stimulation should be interpreted as body tilt with the head upright but as vertical-axis rotation with the head inclined forward. Consequently, GVS should perturb reach trajectories in a head-orientation-dependent way. Consistent with this prediction, GVS applied during reach execution induced trajectory deviations that were significantly larger with the head forward compared with upright. Only with the head forward were trajectories consistently deviated in opposite directions for rightward versus leftward simulated rotation, as appropriate to compensate for body vertical-axis rotation. These results demonstrate that vestibular signals contributing to online reach execution have indeed been transformed from a head-centered to a body-centered reference frame. Reach deviation amplitudes were comparable to those predicted for ideal compensation for body rotation using a biomechanical limb model. Finally, by comparing the effects of application of GVS during reach execution versus prior to reach onset we also provide evidence that spatially transformed vestibular signals contribute to at least partially distinct compensation mechanisms for body motion during reach planning versus execution.

  6. Can A Complex Online Intervention Improve Cancer Nurses' Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study.

    PubMed

    Phillips, Jane L; Heneka, Nicole; Hickman, Louise; Lam, Lawrence; Shaw, Tim

    2017-04-01

    Unrelieved cancer pain has an adverse impact on quality of life. While routine screening and assessment forms the basis of effective cancer pain management, it is often poorly done, thus contributing to the burden of unrelieved cancer pain. The aim of this study was to test the impact of an online, complex, evidence-based educational intervention on cancer nurses' pain assessment capabilities and adherence to cancer pain screening and assessment guidelines. Specialist inpatient cancer nurses in five Australian acute care settings participated in an intervention combining an online spaced learning cancer pain assessment module with audit and feedback of pain assessment practices. Participants' self-perceived pain assessment competencies were measured at three time points. Prospective, consecutive chart audits were undertaken to appraise nurses' adherence with pain screening and assessment guidelines. The differences in documented pre-post pain assessment practices were benchmarked and fed back to all sites post intervention. Data were analyzed using inferential statistics. Participants who completed the intervention (n = 44) increased their pain assessment knowledge, assessment tool knowledge, and confidence undertaking a pain assessment (p < .001). The positive changes in nurses' pain assessment capabilities translated into a significant increasing linear trend in the proportion of documented pain assessments in patients' charts at the three time points (χ(2) trend = 18.28, df = 1, p < .001). There is evidence that learning content delivered using a spaced learning format, augmented with pain assessment audit and feedback data, improves inpatient cancer nurses' self-perceived pain screening and assessment capabilities and strengthens cancer pain guideline adherence.

  7. Evaluation of Intervention Reach on a Citywide Health Behavior Change Campaign: Cross-Sectional Study Results.

    PubMed

    Shimazaki, Takashi; Takenaka, Koji

    2015-12-01

    Little is known about dissemination strategies that contribute to health information recognition. This study examined (a) health campaign exposure and awareness (slogan and logo recognition); (b) perceived communication channels; (c) differences between perceptions of researcher-developed and enhancement community health information materials; and (d) differences in campaign awareness and communication channels, according to Japanese community demographic characteristics. A cross-sectional survey (N = 508) was conducted in Tokigawa, Japan, in 2013. The Small Change Campaign focused on increasing physical activity and improving dietary habits. Information dissemination was carried out using leaflets, newsletters, posters, website, local public relations magazines, health classes, events, and online newsletters. The participants completed a survey assessing their campaign awareness (i.e., slogan and logo) and exposure to the informational materials presented during the campaign. Fewer than half (45.4%) knew the slogan, and only 24.4% were aware of the logo. Public relations magazines, leaflets, and newsletters were significantly better-perceived health communication channels. Researcher-developed and enhancement community health information materials were equally recognized (p = .34, w = .08). Furthermore, women and those who were employed were significantly more aware of the slogan, logo, and communication materials. Further research should explore effective communication strategies for community-based health promotion intervention via randomized control trials.

  8. Evaluation of Intervention Reach on a Citywide Health Behavior Change Campaign: Cross-Sectional Study Results

    ERIC Educational Resources Information Center

    Shimazaki, Takashi; Takenaka, Koji

    2015-01-01

    Little is known about dissemination strategies that contribute to health information recognition. This study examined (a) health campaign exposure and awareness (slogan and logo recognition); (b) perceived communication channels; (c) differences between perceptions of researcher-developed and enhancement community health information materials; and…

  9. 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.

  10. Reaching and grasping behavior in Macaca fascicularis: a kinematic study.

    PubMed

    Sartori, Luisa; Camperio Ciani, Andrea; Bulgheroni, Maria; Castiello, Umberto

    2013-01-01

    The prehensile hand is one of the major traits distinguishing primates from other mammal species. All primates, in fact, are able to grasp an object and hold it in part or entirely using a single hand. Although there is a wealth of behavioral data regarding grasping movements in humans and apes, there is relatively little material on macaques, the animal model often used to investigate neuronal mechanisms responsible for grip control in humans. To date, evidence regarding free-ranging macaques is confined to observational data, while quantitative reports describe studies carried out in laboratory settings or in captivity. The purpose of the present study was to provide the first kinematic descriptions of basic grip behavior with regard to precision and power grips in free-ranging macaque monkeys. Video footage of those animals grasping objects was analyzed frame-by-frame using digitalization techniques. The results revealed that the two types of grips considered are each characterized by specific kinematic signatures. It was also found that hand kinematics was scaled depending on the type of grasp needing to be adopted and the intrinsic properties of the object to be grasped. In accordance with data concerning humans, these findings indicate that the intrinsic features of an object affect the planning and control of reach-to-grasp movements even in free-ranging macaques. The data presented here take research in the field of comparative reach-to-grasp kinematics in human and non-human primates another step forward as they are based on precise measurements of spontaneous grasping movements by animals living/acting in their natural environment.

  11. The cortical timeline for deciding on reach motor goals.

    PubMed

    Westendorff, Stephanie; Klaes, Christian; Gail, Alexander

    2010-04-14

    Flexible sensorimotor planning is the basis for goal-directed behavior. We investigated the integration of visuospatial information with context-specific transformation rules during reach planning. We were especially interested in the relative timing of motor-goal decisions in monkey dorsal premotor cortex (PMd) and parietal reach region (PRR). We used a rule-based mapping task with different cueing conditions to compare task-dependent motor-goal latencies. The task allowed us a separation of cue-related from motor-related activity, and a separation of activity related to motor planning from activity related to motor initiation or execution. The results show that selectivity for the visuospatial goal of a pending movement occurred earlier in PMd than PRR whenever the task required spatial remapping. Such remapping was needed if the spatial representation of a cue or of a default motor plan had to be transformed into a spatially incongruent representation of the motor goal. In contrast, we did not find frontoparietal latency differences if the spatial representation of the cue or the default plan was spatially congruent with the motor goal. The fact that frontoparietal latency differences occurred only in conditions with spatial remapping was independent of the subjects' partial a priori knowledge about the pending goal. Importantly, frontoparietal latency differences existed for motor-goal representations during movement planning, without immediate motor execution. We interpret our findings as being in support of the hypothesis that latency differences reflect a dynamic reorganization of network activity in PRR, and suggest that the reorganization is contingent on frontoparietal projections from PMd.

  12. Modifications to the Standard Sit-and-Reach Flexibility Protocol.

    ERIC Educational Resources Information Center

    Holt, Laurence E.; Burke, Darren G.; Pelham, Thomas W.

    1999-01-01

    Describes several modifications of the standard sit-and-reach flexibility protocol using a new device called the multitest flexometer (MTF). Using the MTF, researchers could take six flexibility measures beyond the stand-and-reach test. The modified protocol allowed the indirect assessment of the influence of the four major muscle groups that…

  13. 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.…

  14. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 26: The technical communication practices of aerospace engineering students: Results of the phase 3 AIAA National Student Survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Hecht, Laura M.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of aerospace engineering students. The reported data were obtained from a survey of student members of the American Institute of Aeronautics and Astronautics (AIAA). The survey was undertaken as a phase 3 activity of the NASA/DoD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance; use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign language technical reports; and foreign language (reading and speaking) skills.

  15. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 27: The technical communication practices of engineering and science students: Results of the phase 3 academic surveys

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Hecht, Laura M.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering science students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer or a scientist, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of engineers and science (Physics) students. The reported data were obtained from a survey of students enrolled in the College of Engineering at the University of Illinois at Urbana-Champaign, Bowling Green State University, and Texas A&M University. The survey was undertaken as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance, use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign technical reports; and foreign language (reading and speaking) skills.

  16. Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544).

    PubMed

    Kontio, R; Hätönen, H; Joffe, G; Pitkänen, A; Lahti, M; Välimäki, M

    2013-04-01

    eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures.

  17. 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.

  18. Toward minimum effort reaching trajectories formation in robot-based rehabilitation after stroke: an innovative guidance scheme proposition.

    PubMed

    Zadravec, Matjaž; Matjačić, Zlatko

    2014-09-01

    In therapy after stroke, intensive and repetitive training is crucial for relearning of motor abilities and functionalities. Besides conventional therapy, rehabilitation robotic systems are used in the treatment, where a minimum jerk model is used widely in the formation of the point-to-point movement trajectory, which is not necessarily the appropriate choice for hemiparetic upper extremity training. This paper examines and analyzes the influence of a selected form of a flexor muscle tightness on trajectory formation and proposes a guidance scheme that yields minimum effort in robot-assisted arm reaching movement. A dynamic upper extremity model with the three clinically most relevant muscles that develop tightness because of spasticity after stroke was used in the optimization study that examined key features of trajectory formation. The results showed that the trajectories and their velocity profiles become significantly different in the presence of muscle tightness. On the basis of dynamic optimization results, we experimentally examined selected trajectories in a selected individual with chronic hemiparesis. The experimental results confirmed the importance of appropriate selection of reaching trajectories' velocity profiles. The results of optimization and experimentation showed the importance of the velocity profile of the robot-based guidance scheme, which has an influence on the necessary invested 'effort' between starting/ending points to overcome muscle tightness. This study showed that muscle tightness exerts a significant influence on trajectory formation as well as on its velocity profile. The proposed innovative guidance scheme might be useful for practical arm reaching robot-supported movement training in the clinical environment. We suggested that for each hemiparetic patient, the initial identification session before training should experimentally determine the 'optimal' parameters for the rehabilitation guidance scheme that would optimally match

  19. The Continued Development and Practice of School Psychology in Singapore: Using REACH as an Illustration

    ERIC Educational Resources Information Center

    Ooi, Yoon Phaik; Ang, Rebecca P.; Ibrahim, Noor Haslinda; Koh, Delphine; Lee, Poh Yin; Ong, Lue Ping; Wong, Geraldine; Fung, Daniel S. S.

    2014-01-01

    School psychology in Singapore gained greater prominence with the development of the National Mental Health Blueprint in 2007 that included a focus on children and adolescents. A partnership between the Ministry of Health and the Ministry of Education was formed to develop a community mental health pilot program called 'Response, Early…

  20. Reaching Underserved Populations with Basic Education in Deprived Areas of Ghana: Emerging Good Practices. Final Report.

    ERIC Educational Resources Information Center

    2003

    Achieving Education for All (EFA) in Ghana and many parts of sub-Saharan Africa remains an elusive goal. Extensive research in diverse countries has revealed that formalized systems that work on fixed timetables, a loaded curriculum, and trained teachers, are often not performing as well in rural environments in providing basic literacy, numeracy,…

  1. Can I Reach That Sticker? Preschoolers' Practical Judgments about Their Own and Others' Body Size

    ERIC Educational Resources Information Center

    Dunphy-Lelii, Sarah; Hooley, Merrilyn; McGivern, Lisa; Skouteris, Helen; Cox, Rachael

    2014-01-01

    Research to date has focused mostly on children's representation of their physical self as a prelude to the development of a theory of mind (ToM) and on their understanding of the self as distinct from others over time. Whether children approaching the well-known age of ToM mastery are also accurately appraising their own "body's"…

  2. Reaching Out: Best Practices for Educating Mexican-Origin Children and Youth.

    ERIC Educational Resources Information Center

    Romo, Harriett D.

    School systems in the United States are not serving Latino students well, especially those from low-income families. This book examines difficulties encountered by Mexican-origin students--one of the fastest growing minority groups--and describes why some schools fall short and how others have improved student outcomes. The focus throughout the…

  3. The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.

    PubMed

    Lackner, Nina; Unterrainer, Human F; Skliris, Dimitris; Wood, Guilherme; Wallner-Liebmann, Sandra J; Neuper, Christa; Gruzelier, John H

    2016-07-01

    The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community.

  4. The effects of telmisartan alone or with hydrochlorothiazide on morning and 24-h ambulatory BP control: results from a practice-based study (SURGE 2).

    PubMed

    Parati, Gianfranco; Bilo, Grzegorz; Redon, Josep

    2013-04-01

    Observational studies have shown that 24-h and morning ambulatory blood pressure (BP) control is low. This large-scale, practice-based study evaluated the effects of telmisartan 40 or 80 mg alone or in combination with hydrochlorothiazide (HCTZ) 12.5 mg on these BP parameters over 8 weeks; treatment was adjusted if clinic BP remained ≥140/90 mm Hg. A total of 863 patients were evaluated (baseline mean clinic BP, morning and 24-h ambulatory BP: 155±15/93±10 mm Hg, 137±15/83±11 mm Hg, 133±14/79±10 mm Hg, respectively; 68% were previously treated at baseline). Telmisartan with/without HCTZ significantly reduced the mean morning ambulatory BP (-8.2/-4.9 mm Hg), daytime ambulatory BP (-8.0/-4.7 mm Hg), 24-h ambulatory BP (-7.9/-4.7 mm Hg) and clinic BP (-22.3/-13.2 mm Hg) (all P<0.001) in previously untreated and in treated patients who switched to telmisartan and telmisartan/HCTZ. After treatment with telmisartan with/without HCTZ, the morning ambulatory BP control increased from 36.5 to 64.4%; daytime ambulatory BP control increased from 40.8 to 67.6%; 53.0% of patients achieved 24-h ambulatory BP <125/80 mm Hg and 62% achieved <130/80 mm Hg targets. Only 0.8% (7/863) reported an adverse event. In summary, telmisartan and telmisartan/HCTZ increased smooth 24-h BP control in daily management of hypertension.

  5. A practice-based clinical evaluation of the survival and success of metal-ceramic and zirconia molar crowns: 5-year results.

    PubMed

    Rinke, S; Kramer, K; Bürgers, R; Roediger, M

    2016-02-01

    This practice-based study evaluates the survival and success of conventionally luted metal-ceramic and zirconia molar crowns fabricated by using a prolonged cooling period for the veneering porcelain. Fifty-three patients were treated from 07/2008 to 07/2009 with either metal-ceramic crowns (MCC) or zirconia crowns (ZC). Forty-five patients (26 female) with 91 restorations (obser-vational period: 64.0 ± 4.8 months) participated in a clinical follow-up examination and were included in the study. Estimated cumulative survival (ECSv), success (ECSc) and veneering ceramic success (ECVCSc) were calculated (Kaplan-Meier) and analysed by the crown fabrication technique and the position of the restoration (Cox regression model) (P < 0.05). Five complete failures (MCC: 2, ZC: 3) were recorded (5-year ECSv: MCC: 97.6%, (95% confidence interval (95%-CI): [93%; 100%]/ZC: 94.0%, (95%-CI): [87%; 100%]). Of the MCCs (n = 41), 85.0%, [95%-CI: (77%; 96%)] remained event-free, whereas the ECSc for the ZCs (n = 50) was 74.3% (95%-CI): [61%; 87%]. No significant differences in ECSv (P = 0.51), ECSc (P = 0.43) and ECVCSc (P = 0.36) were detected between the two fabrication techniques. Restorations placed on terminal abutments (n = 44) demonstrated a significantly lower ECVCSc (P = 0.035), (5-year VCF-rate: 14.8%) than crowns placed on tooth-neighboured abutments (n = 47), (5-year VCF-rate: 4.3%). In the present study, zirconia molar crowns demonstrated a 5-year ECSv, ECSc and ECVCSc comparable to MCCs. Irrespective of the fabrication technique, crowns on terminal abutments bear a significantly increased risk for VCFs. Clinical investigations with an increased number of restorations are needed.

  6. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice-based cohort study.

    PubMed

    Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna

    2016-12-05

    Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia.

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

    PubMed Central

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

    2016-01-01

    [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. PMID:27942129

  8. Runoff and soil loss under different land management practices in vineyards: grass cover treatments and traditional tillage. Results from simulated rainfall.

    NASA Astrophysics Data System (ADS)

    Ruiz-Colmenero, Marta; Bienes, Ramon; Marques, Maria-Jose

    2010-05-01

    second simulation). Before tillage the average runoff coefficient in "till" was 19% (six times higher than in plant cover treatments) probably because of its sealing and compaction due to the lack of plants. After tillage, in spite of the increase of roughness, and on the contrary to obtained in summer, the runoff increases. It is explained by the soil moisture: In the first simulated rainfall, the soil was 72% of its water holding capacity at 10 cm, and 44% at 35 cm soil depth. However, in the second simulated rainfall the surface was completely wet, and at 35 cm it reached the 85% of water holding capacity. Comparing the runoff and erosion behavior in each treatment for both seasons, it is shown that in summer a shallow tillage increases the infiltration significantly. However in autumn, when the soil is wetter, the tillage increases runoff and erosion significantly. This has to be taken into account in order to change traditional uses in steep crops. Keywords: erosion, runoff, simulated rainfall, vineyard, tillage, vegetable cover Aknowledgements: Projects FP06-DR3 IMIDRA and RTA2007-0086 INIA. Predoctoral grant from INIA. Bodegas and Viñedos Gosálbez-Ortí.

  9. Subsurface Paleo-Stream Reach Reconstruction and Classification Using Seismic Data Interpretation

    NASA Astrophysics Data System (ADS)

    Dotson, Benjamin Ward

    Incorporating the techniques and applications used in the 3D seismic geophysical interpretations with the Rosgen (1996) stream classification, this study was able to identify paleo-stream reaches in the Frio Formation within the Stratton 3D seismic data set. Hydraulic geometry variables from Rosgen's classification scheme were used to classify paleo-stream reaches shown in the seismic data. Estimated paleo-discharges were reconstructed to compare the potential magnitude of flow in the paleo-stream reaches to that in modern rivers in Texas and Mississippi. However, classification and discharge results were accompanied with a high margin of error and many uncertainties regarding the stream channel's geometry and features.

  10. Uniformly cationized protein efficiently reaches the cytosol of mammalian cells.

    PubMed

    Futami, Midori; Watanabe, Yasuyoshi; Asama, Takashi; Murata, Hitoshi; Tada, Hiroko; Kosaka, Megumi; Yamada, Hidenori; Futami, Junichiro

    2012-10-17

    Protein cationization techniques are powerful protein transduction methods for mammalian cells. As we demonstrated previously, cationized proteins with limited conjugation to polyethylenimine have excellent ability to enter into cells by adsorption-mediated endocytosis [Futami, J., et al. (2005) J. Biosci. Bioeng. 99, 95-103]. In this study, we show that proteins with extensive and uniform cationization covering the protein surface reach the cytoplasm and nucleus more effectively than proteins with limited cationic polymers or proteins that are fused to cationic peptides. Although extensive modification of carboxylates results in loss of protein function, chicken avidin retains biotin-binding ability even after extensive amidation of carboxylates. Using this cationized avidin carrier system, the protein transduction ability of variously cationized avidins was investigated using biotinylated protein as a probe. The results revealed that cationized avidins bind rapidly to the cell surface followed by endocytotic uptake. Small amounts of uniformly cationized avidin showed direct penetration into the cytoplasm within a 15 min incubation. This penetration route seemed to be energy dependent and functioned under cellular physiological conditions. A biotinylated exogenous transcription factor protein that penetrated cells was demonstrated to induce target gene expression in living cells.

  11. Recovery of three arctic stream reaches from experimental nutrient enrichment

    USGS Publications Warehouse

    Benstead, J.P.; Green, A.C.; Deegan, Linda A.; Peterson, B.J.; Slavik, K.; Bowden, W.B.; Hershey, A.E.

    2007-01-01

    1. Nutrient enrichment and resulting eutrophication is a widespread anthropogenic influence on freshwater ecosystems, but recovery from nutrient enrichment is poorly understood, especially in stream environments. We examined multi-year patterns in community recovery from experimental low-concentration nutrient enrichment (N + P or P only) in three reaches of two Arctic tundra streams (Kuparuk River and Oksrukuyik Creek) on the North Slope of Alaska (U.S.A.). 2. Rates of recovery varied among community components and depended on duration of enrichment (2-13 consecutive growing seasons). Biomass of epilithic algae returned to reference levels rapidly (within 2 years), regardless of nutrients added or enrichment duration. Aquatic bryophyte cover, which increased greatly in the Kuparuk River only after long-term enrichment (8 years), took 8 years of recovery to approach reference levels, after storms had scoured most remnant moss in the recovering reach. 3. Multi-year persistence of bryophytes in the Kuparuk River appeared to prevent recovery of insect populations that had either been positively (e.g. the mayfly Ephemerella, most chironomid midge taxa) or negatively (e.g. the tube-building chironomid Orthocladius rivulorum) affected by this shift in dominant primary producer. These lags in recovery (of >3 years) were probably driven by the persistent effect of bryophytes on physical benthic habitat. 4. Summer growth rates of Arctic grayling (both adults and young-of-year) in Oksrukuyik Creek (fertilised for 6 years with no bryophyte colonisation), which were consistently increased by nutrient addition, returned to reference rates within 1-2 years. 5. Rates of recovery of these virtually pristine Arctic stream ecosystems from low-level nutrient enrichment appeared to be controlled largely by duration of enrichment, mediated through physical habitat shifts caused by eventual bryophyte colonisation, and subsequent physical disturbance that removed bryophytes. Nutrient

  12. New Stream-Reach Hydropower Development (NSD) Fact Sheet

    SciTech Connect

    2014-04-25

    This fact sheet explores the more than 65 gigawatts (GW) of sustainable hydropower potential in U.S. stream-reaches, according to the hydropower resource assessment funded by DOE and executed by Oak Ridge National Laboratory.

  13. Birth Defects from Zika More Far-Reaching Than Thought

    MedlinePlus

    ... gov/news/fullstory_162538.html Birth Defects From Zika More Far-Reaching Than Thought Studies found greater ... 14, 2016 WEDNESDAY, Dec. 14, 2016 (HealthDay News) -- Zika's ability to damage the infant brain may be ...

  14. Reaching and Teaching: A Study in Audience Targeting.

    ERIC Educational Resources Information Center

    Ritter, Ellen M.; Welch, Diane T.

    1988-01-01

    Describes a project conducted by the Texas Agricultural Extension Service to market the Family Day Home Care Providers Program to an unknown clientele. Discusses the problems involved in identifying and reaching the target audience. (JOW)

  15. Helping the Library Reach Out to the Future

    MedlinePlus

    ... Bar Home Current Issue Past Issues Helping the Library Reach Out to the Future Past Issues / Fall ... On behalf of the Friends of the National Library of Medicine (FNLM), welcome to the Fall 2007 ...

  16. 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.

  17. DAMCAL; Damage Reach Stage-Damage Calculation: Users Manual

    DTIC Science & Technology

    1979-02-01

    M AD-A273 611 US Army Corps of Engineers Hydrologic Engineering Center GENERALIZED COMPUTER PROGRAM DTIC "k ELECTE DEC 13 1993 DAMCAL A Damage Reach...Stage- Damage Calculation User’s Manual February 1979 93-30134 ApprOved for Public Release. Distribution Unlimited. CPD-35 93 12 100 3 8 DAMCAL Damage ...Reach Stage- Damage Calculation Accesion For User’s Manual TIS ’C&I DTIC TA.3 Juhfificatoc.n By ............. .......................... February 1979

  18. Evaluating Curricular Influence on Preparation for Practice, Career Outcomes, and Job Satisfaction: Results from an Alumni Survey of a 40-Year Rehabilitation and Mental Health Counseling Program

    ERIC Educational Resources Information Center

    Smith, Tammy Jorgensen; Reid, Joan A.; Henry, Ryan G.; Dixon, Charlotte G.; Wright, Tennyson J.

    2013-01-01

    Alumni of a Council on Rehabilitation Education (CORE)-accredited graduate rehabilitation counselor education (RCE) program were surveyed to evaluate career outcomes, job satisfaction, licensure and certification rates, client populations served, and RCE program satisfaction and effectiveness. Results indicate a high level of satisfaction with the…

  19. Legislation and Litigation Resulting from the Canadian Commission of Inquiry into the Use of Drugs and Banned Practices Intended To Increase Athletic Performance.

    ERIC Educational Resources Information Center

    Moriarty, Dick; And Others

    This paper presents the results from the Dubin Inquiry Report (1990) into drug abuse for athletic purposes. The inquiry involved testimonies from 48 steroid users, and from coaches, sport administrators, medical doctors, sport scientists, and International Olympic Committee representatives. Recommendations from the Dubin Report include: (1)…

  20. REACH: next step to a sound chemicals management.

    PubMed

    Van der Wielen, Arnold

    2007-12-01

    REACH is the new European Regulation for Registration, Evaluation, Authorisation and Restriction of Chemicals. It entered into force on 1st June 2007 to streamline and improve the former legislative framework on new and on existing chemical substances of the European Union. Companies which manufacture or import more than 1 tonne of a substance per year will be required to register the substance at the new EU Chemicals Agency located in Helsinki. REACH places greater responsibility on industry to manage the risks that chemicals may pose to the health and the environment and to provide safety information that will be passed down the supply chain. In principle, REACH applies to all chemicals as such, as components in preparations and as used in articles. REACH is a radical step forward in the EU chemicals management. The onus will move from the authorities to industry. In addition, REACH will allow the further evaluation of substances where there are grounds for concern, foresees an authorisation system for the use of substances of very high concern and a system of restrictions, where applicable, for substances of concern. The Authorisation system will require companies to switch progressively to safer alternatives where a suitable alternative exists. Current use restrictions will remain under REACH system.

  1. Action, perception and postural planning when reaching for tools.

    PubMed

    Sunderland, Alan

    2013-06-01

    The dorsal and ventral streams model of action and perception suggests that reaching to grasp a tool for use involves integrated operation of the two streams. Few attempts have been made to test the limits of this integration in normal subjects. Twenty normal subjects reached for tools or geometric objects which were rotated rapidly during reaching or immediately beforehand. In a first experiment it was shown that reaching for an inverted tool was slower than reaching for objects which required hand inversion due to proximity to a physical barrier. Also, for the right hand, tool rotation during reaching provoked a higher incidence of hand rotation in the wrong direction than did rotation of objects. In a second similar experiment, hand inversion when grasping objects was induced by the need to plan a future action rather than by proximity of a physical barrier. Despite this balancing of complexity of postural planning for tools and objects, hand rotation errors for both hands were more common for tools than objects. This was consistent with the two-stream model in suggesting that there was a process which produced rapid online tracking of stimulus rotation and this had to be overcome by a slower process which dictated grasping in accordance with knowledge of tool use.

  2. Teaching thinking and reaching the limits of memorization: enacting new pedagogies.

    PubMed

    Ironside, Pamela M

    2005-10-01

    Contemporary practice environments are complex and require students and new graduates to possess high-level thinking capabilities to ensure patient safety and quality of care. To achieve this goal, many nurse educators are exploring new pedagogies (critical, feminist, phenomenological, and postmodern) to teach students the practices of thinking that contemporary clinical situations demand. These new pedagogies offer alternatives to the predominant use of conventional pedagogies, which emphasize students' memorization of content and its subsequent application in practice situations. This study, using Heideggerian hermeneutics, documents how teachers are using new pedagogies in ways that shift their attention to teaching thinking and away from devising strategies to help students memorize and apply more content. One of the themes that emerged from this study, Teaching Thinking and Reaching the Limits of Memorization, and two subthemes, Thinking AS Memorization and Recall, and Beyond Memorization: Thinking in Context are presented.

  3. Lotic community responses in the Lees Ferry reach

    NASA Astrophysics Data System (ADS)

    McKinney, T.; Rogers, R. S.; Ayers, A. D.; Persons, W. R.

    Responses of periphyton, aquatic macrophytes, benthic macroinvertebrates, and rainbow trout to the 1996 controlled flood were investigated in the Lees Ferry tailwater reach below Glen Canyon Dam on the Colorado River. Lotic biota differed spatially and temporally in abundance and distribution following recession of flood waters, and there was no evidence that the flood benefitted trout or lower trophic levels. The flood was associated with short-term changes in lower trophic levels, but benthic vegetation and macrofauna with low resistance were resilient. Adverse impacts of the flood on lower trophic levels were greater and more prolonged in depositional areas than on cobble bar habitat, but recovery occurred in both habitat types 4-8 months after the flood. The flood likely resulted in some downstream displacement of smaller fish but had no effects on catch rate or condition indices of trout. Percentage of young-of-the-year trout 8 months after the event indicates that the flood did not prevent successful spawning. The flood had little direct influence on diets of trout, but relative gut volume increased in the week after the event, remained high in summer, and composition changed seasonally. Amphipods (Gammarus lacustris), chironomids, and snails were predominant food items, and Gammarus generally were eaten more often and comprised greater relative volume in the diet than other macroinvertebrate taxa.

  4. Breakthrough Capability for UVOIR Space Astronomy: Reaching the Darkest Sky

    NASA Technical Reports Server (NTRS)

    Greenhouse, Matthew A.; Benson, Scott W.; Englander, Jacob; Falck, Robert D.; Fixsen, Dale J.; Gardner, Jonathan P.; Kruk, Jeffrey W.; Oleson, Steven R.; Thronson, Harley A.

    2014-01-01

    We describe how availability of new solar electric propulsion (SEP) technology can substantially increase the science capability of space astronomy missions working within the near-UV to far-infrared (UVOIR) spectrum by making dark sky orbits accessible for the first time. We present a proof of concept case study in which SEP is used to enable a 700 kg Explorer-class observatory payload to reach an orbit beyond where the zodiacal dust limits observatory sensitivity. The resulting scientific performance advantage relative to a Sun-Earth L2 point orbit is presented and discussed. We find that making SEP available to astrophysics Explorers can enable this small payload program to rival the science performance of much larger long development-time systems. We also present flight dynamics analysis which illustrates that this concept can be extended beyond Explorers to substantially improve the sensitivity performance of heavier (7000 kg) flagship-class astrophysics payloads such as the UVOIR successor to the James Webb Space Telescope by using high power SEP that is being developed for the Asteroid Redirect Robotics Mission.

  5. Breakthrough Capability for UVOIR Space Astronomy: Reaching the Darkest Sky

    NASA Technical Reports Server (NTRS)

    Greenhouse, Matthew A.; Benson, Scott W.; Englander, Jacob; Falck, Robert D.; Fixsen, Dale J.; Gardner, Jonathan P.; Kruk, Jeffery W.; Oleson, Steven R.; Thronson, Harley A.

    2015-01-01

    We describe how availability of new solar electric propulsion (SEP) technology can substantially increase the science capability of space astronomy missions working within the near-UV to far-infrared (UVOIR) spectrum by making dark sky orbits accessible for the first time. We present two case studies in which SEP is used to enable a 700 kg Explorer-class and 7000 kg flagship-class observatory payload to reach an orbit beyond where the zodiacal dust limits observatory sensitivity. The resulting scientific performance advantage relative to a Sun-Earth L2 point (SEL2) orbit is presented and discussed. We find that making SEP available to astrophysics Explorers can enable this small payload program to rival the science performance of much larger long development-time systems. Similarly, we find that astrophysics utilization of high power SEP being developed for the Asteroid Redirect Robotics Mission (ARRM) can have a substantial impact on the sensitivity performance of heavier flagship-class astrophysics payloads such as the UVOIR successor to the James Webb Space Telescope.

  6. On reaching the adiabatic limit in multi-field inflation

    SciTech Connect

    Renaux-Petel, Sébastien; Turzyński, Krzysztof E-mail: krzysztof-jan.turzynski@fuw.edu.pl

    2015-06-01

    We calculate the scalar spectral index n{sub s} and the tensor-to-scalar ratio r in a class of recently proposed two-field no-scale inflationary models in supergravity. We show that, in order to obtain correct predictions, it is crucial to take into account the coupling between the curvature and the isocurvature perturbations induced by the noncanonical form of the kinetic terms. This coupling enhances the curvature perturbation and suppresses the resulting tensor-to-scalar ratio to the per mille level even for values of the slow-roll parameter ε ∼ 0.01. Beyond these particular models, we emphasise that multifield models of inflation are a priori not predictive, unless one supplies a prescription for the post-inflationary era, or an adiabatic limit is reached before the end of inflation. We examine the conditions that enabled us to actually derive predictions in the models under study, by analysing the various contributions to the effective isocurvature mass in general two-field inflationary models. In particular, we point out a universal geometrical contribution that is important at the end of inflation, and which can be directly extracted from the inflationary Lagrangian, independently of a specific trajectory. Eventually, we point out that spectator fields can lead to oscillatory features in the time-dependent power spectra at the end of inflation. We demonstrate how these features can be model semi-analytically as well as the theoretical uncertainties they can entail.

  7. Automatic movement error detection and correction processes in reaching movements.

    PubMed

    Brière, Julien; Proteau, Luc

    2011-01-01

    Manual aiming movements can be amended during their execution. Recent evidence suggests that error detection and correction are based on automatic and even reflexive processing of afferent information. In this study, we wanted to determine whether these processes are affected by the occurrence of successive events requiring adjustments of the originally planned movement. To reach our goal, we used a video-aiming task. For a small proportion of the trials, the cursor moved by the participant was translated laterally by 15 mm (cursor jump) soon after movement initiation. For some of the cursor-jump trials, a second cursor jump occurred 100 ms after the first one and canceled or doubled the initial cursor translation. Results showed that participants were able to cancel or double the size of the correction in response to the second cursor jump. More importantly, in double-jump trials, the correction latency for the first and second cursor jumps did not differ from that of single-jump trials. Moreover, the correction for the second cursor jump blended seamlessly with the correction for the first cursor jump. These observations suggest that the processes leading of a correction for a cursor jump do not interfere with incoming visual information.

  8. A serological survey for bovine immunodeficiency-like virus in Ontario dairy cattle and associations between test results, production records and management practices.

    PubMed Central

    McNab, W B; Jacobs, R M; Smith, H E

    1994-01-01

    A chemiluminescence Western blot analysis (WBA) for detecting antibovine immunodeficiency-like virus (BIV) antibodies, had good repeatability. The test was subsequently applied to a bank of serum samples from 928 adult cows from 265 herds in Ontario; the number of cows sampled within each herd ranged from 1 to 13. The overall prevalence of anti-BIV antibodies among cows was 5.5% with a 95% confidence interval of 4.2% to 7.2%. In contrast, 18.1% of herds had at least one reactor among cows tested, resulting in a herd-prevalence confidence interval of 13.8% to 23.4%. These estimates of prevalence were in the same range as previous reports from the US and Europe. Bovine immunodeficiency-like virus may have a worldwide distribution. Unfortunately, BIV test sensitivity and specificity are difficult to estimate because virus isolation is inefficient. Therefore, the apparent prevalences could not be adjusted for test sensitivity and specificity, to estimate the true prevalence of infection. The serum samples had previously been tested for antibodies to bovine leukemia virus (BLV). There were no significant associations between BIV and BLV test results. Least squares regression was used to investigate potential associations between BIV test results and selected production indices.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8143251

  9. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 23: The communications practices of US aerospace engineering faculty and students: Results of the phase 3 survey

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis U.S. aerospace engineering faculty and students.

  10. Correction of patient results for Beckman Coulter LX-20 assays affected by interference due to hemoglobin, bilirubin or lipids: a practical approach.

    PubMed

    Vermeer, Henricus J; Steen, Gerard; Naus, André J M; Goevaerts, Berrie; Agricola, Pauline T; Schoenmakers, Christian H H

    2007-01-01

    The influence of interference by hemolysis, icterus and lipemia on the results of routine chemistries may lead to wrong interpretations. On Synchron LX-20 instruments (Beckman Coulter) serum or plasma indices can be used as reliable semi-quantitative measures of the magnitude of such interference. In an article recently published in this journal, we presented the results of a multicenter study carried out in Dutch hospitals in which we determined cutoff indices for analytes above which analytically significant interference exists. Clinically significant interference cutoff indices were also derived for these analytes. In this article, we describe the handling of patient samples with clinically significant interference by hemolysis, icterus or lipemia. We investigated several possible approaches for correction of the result: dilution of the interference; mathematical correction in the case of hemolysis; treatment with ferrocyanide to destroy bilirubin; and removal of lipids in lipemic patient samples. We concluded, that mathematical correction of potassium or lactate dehydrogenase results in hemolytic samples can only be carried out if intravascular hemolysis is ruled out. Hemoglobin quantification in serial patient samples, combined with measurement of haptoglobin, represents a useful tool to rule out in vivo hemolysis. We derived an algorithm for this situation. We do not simply recommend mathematical correction, unless it is clinically acceptable. We present formulas for potassium and lactate dehydrogenase: corrected potassium=measured potassium-(hemolytic index increment x 0.14); corrected lactate dehydrogenase=measured lactate dehydrogenase-(hemolytic index increment x 75). The dilution studies indicated that dilution is only applicable for bilirubin, C-reactive protein and iron. The results of treatment with ferrocyanide were poor, and we do not recommend this method. Removal of lipids using high-speed centrifugation or LipoClear (StatSpin Inc.), a non

  11. 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, 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.)

  12. 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

  13. Healthcare Costs Reduced After Incorporating the Results of the American College of Surgeons Oncology Group Z0011 Trial into Clinical Practice.

    PubMed

    Fillion, Michelle M; Glass, Katherine E; Hayek, Joe; Wehr, Allison; Phillips, Gary; Terando, Alicia; Agnese, Doreen M

    2016-11-30

    The purpose of our study was to quantitate the changes in axillary lymph node dissection (ALND), frozen section (FS), and the impact on costs after the publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial. We compared axillary nodal management and cost data in breast cancer patients who met Z0011 criteria and were treated with lumpectomy and sentinel lymph nodes (SLN) biopsy from 2007 to July 2013. Of 800 patients, 67 (13.5%) and 34 (12.5%) patients in the pre- and post-Z0011 era had 1-2 positive SLN. ALND decreased from 78% to 21% (p < 0.001) after publication of Z0011. The mean overall cost of SLN biopsy was $41,059 per patient, while SLN biopsy with completion ALND was $50,999 (p < 0.001). Intraoperative FS use decreased from 95% to 66% (p = 0.015). Omitting the FS decreased mean costs from $4,319 to $2,036. The application of Z0011 resulted in an overall mean cost savings of $571,653 from 2011 to July 2013. ACOSOG Z0011 significantly impacted axillary management resulting in a 20% reduction in the mean overall cost per patient by omitting ALND. In these patients, intraoperative FS analysis had poor sensitivity (56%) and doubled the cost of pathologic examination. Fewer ALND and intraoperative FS were performed after the publication of ACOSOG Z0011. Eliminating FS and ALND in patients who met Z0011 criteria, results in significant cost savings.

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

    PubMed

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

    2017-04-07

    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.

  15. Optic ataxia: from Balint’s syndrome to the parietal reach region

    PubMed Central

    Andersen, Richard A.; Andersen, Kristen N.; Hwang, EunJung; Hauschild, Markus

    2014-01-01

    Optic ataxia is a high order deficit in reaching to visual goals that occurs with posterior parietal cortex (PPC) lesions. It is a component of Balint’s syndrome that also includes attentional and gaze disorders. Aspects of optic ataxia are misreaching in the contralesional visual field, difficulty preshaping the hand for grasping, and an inability to correct reaches online. Recent research in non-human primates (NHPs) suggests that many aspects of Balint’s syndrome and optic ataxia are a result of damage to specific functional modules for reaching, saccades, grasp, attention, and state estimation. The deficits from large lesions in humans are likely composite effects from damage to combinations of these functional modules. Interactions between these modules, either within posterior parietal cortex or downstream within frontal cortex, may account for more complex behaviors such as hand-eye coordination and reach-to-grasp. PMID:24607223

  16. A memory-based model for planning target reach postures in the presence of obstructions.

    PubMed

    Park, W; Singh, D; Martin, B J

    2006-12-15

    Existing posture prediction and motion simulation models generally lack the capability of simulating human obstruction avoidance during target reach. This compromises the utility of digital human models for ergonomics, as many design problems involve interactions between humans and obstructions. To address this problem, this paper presents a novel memory-based posture planning (MBPP) model, which plans reach postures that avoid obstructions. In this model, the task space is partitioned into small regions called cells. For a given human figure, each cell is linked to a memory that stores various alternative postures for reaching the cell. When a posture planning problem is given in terms of a target and an obstruction configuration, the model examines postures belonging to the relevant cell, selects collision-free ones and modifies them to exactly meet the hand target acquisition constraint. Simulation results showed that the MBPP model is capable of rapidly and robustly planning reach postures for various scenarios.

  17. Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey

    PubMed Central

    Guichard, Anne; Guignard, Romain; Lert, France; Roy, Elise

    2015-01-01

    Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter) sharing. Results. Among the 262 respondents (mean age 25 years), 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0) and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1). Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8). Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important. PMID:26504609

  18. Stream solute tracer timescales changing with discharge and reach length confound process interpretation

    NASA Astrophysics Data System (ADS)

    Schmadel, Noah M.; Ward, Adam S.; Kurz, Marie J.; Fleckenstein, Jan H.; Zarnetske, Jay P.; Hannah, David M.; Blume, Theresa; Vieweg, Michael; Blaen, Phillip J.; Schmidt, Christian; Knapp, Julia L. A.; Klaar, Megan J.; Romeijn, Paul; Datry, Thibault; Keller, Toralf; Folegot, Silvia; Arricibita, Amaia I. Marruedo; Krause, Stefan

    2016-04-01

    Improved understanding of stream solute transport requires meaningful comparison of processes across a wide range of discharge conditions and spatial scales. At reach scales where solute tracer tests are commonly used to assess transport behavior, such comparison is still confounded due to the challenge of separating dispersive and transient storage processes from the influence of the advective timescale that varies with discharge and reach length. To better resolve interpretation of these processes from field-based tracer observations, we conducted recurrent conservative solute tracer tests along a 1 km study reach during a storm discharge period and further discretized the study reach into six segments of similar length but different channel morphologies. The resulting suite of data, spanning an order of magnitude in advective timescales, enabled us to (1) characterize relationships between tracer response and discharge in individual segments and (2) determine how combining the segments into longer reaches influences interpretation of dispersion and transient storage from tracer tests. We found that the advective timescale was the primary control on the shape of the observed tracer response. Most segments responded similarly to discharge, implying that the influence of morphologic heterogeneity was muted relative to advection. Comparison of tracer data across combined segments demonstrated that increased advective timescales could be misinterpreted as a change in dispersion or transient storage. Taken together, our results stress the importance of characterizing the influence of changing advective timescales on solute tracer responses before such reach-scale observations can be used to infer solute transport at larger network scales.

  19. Clades reach highest morphological disparity early in their evolution

    PubMed Central

    Hughes, Martin; Gerber, Sylvain; Wills, Matthew Albion

    2013-01-01

    There are few putative macroevolutionary trends or rules that withstand scrutiny. Here, we test and verify the purported tendency for animal clades to reach their maximum morphological variety relatively early in their evolutionary histories (early high disparity). We present a meta-analysis of 98 metazoan clades radiating throughout the Phanerozoic. The disparity profiles of groups through time are summarized in terms of their center of gravity (CG), with values above and below 0.50 indicating top- and bottom-heaviness, respectively. Clades that terminate at one of the “big five” mass extinction events tend to have truncated trajectories, with a significantly top-heavy CG distribution overall. The remaining 63 clades show the opposite tendency, with a significantly bottom-heavy mean CG (relatively early high disparity). Resampling tests are used to identify groups with a CG significantly above or below 0.50; clades not terminating at a mass extinction are three times more likely to be significantly bottom-heavy than top-heavy. Overall, there is no clear temporal trend in disparity profile shapes from the Cambrian to the Recent, and early high disparity is the predominant pattern throughout the Phanerozoic. Our results do not allow us to distinguish between ecological and developmental explanations for this phenomenon. To the extent that ecology has a role, however, the paucity of bottom-heavy clades radiating in the immediate wake of mass extinctions suggests that early high disparity more probably results from the evolution of key apomorphies at the base of clades rather than from physical drivers or catastrophic ecospace clearing. PMID:23884651

  20. Clades reach highest morphological disparity early in their evolution

    NASA Astrophysics Data System (ADS)

    Hughes, Martin; Gerber, Sylvain; Albion Wills, Matthew

    2013-08-01

    There are few putative macroevolutionary trends or rules that withstand scrutiny. Here, we test and verify the purported tendency for animal clades to reach their maximum morphological variety relatively early in their evolutionary histories (early high disparity). We present a meta-analysis of 98 metazoan clades radiating throughout the Phanerozoic. The disparity profiles of groups through time are summarized in terms of their center of gravity (CG), with values above and below 0.50 indicating top- and bottom-heaviness, respectively. Clades that terminate at one of the "big five" mass extinction events tend to have truncated trajectories, with a significantly top-heavy CG distribution overall. The remaining 63 clades show the opposite tendency, with a significantly bottom-heavy mean CG (relatively early high disparity). Resampling tests are used to identify groups with a CG significantly above or below 0.50; clades not terminating at a mass extinction are three times more likely to be significantly bottom-heavy than top-heavy. Overall, there is no clear temporal trend in disparity profile shapes from the Cambrian to the Recent, and early high disparity is the predominant pattern throughout the Phanerozoic. Our results do not allow us to distinguish between ecological and developmental explanations for this phenomenon. To the extent that ecology has a role, however, the paucity of bottom-heavy clades radiating in the immediate wake of mass extinctions suggests that early high disparity more probably results from the evolution of key apomorphies at the base of clades rather than from physical drivers or catastrophic ecospace clearing.

  1. Similar Motor Cortical Control Mechanisms for Precise Limb Control during Reaching and Locomotion

    PubMed Central

    Yakovenko, Sergiy

    2015-01-01

    Throughout the course of evolution there has been a parallel development of the complexity and flexibility of the nervous system and the skeletomuscular system that it controls. This development is particularly evident for the cerebral cortical areas and the transformation of the use of the upper limbs from a purely locomotor function to one including, or restricted to, reaching and grasping. This study addresses the issue of whether the control of reaching has involved the development of new cortical circuits or whether the same neurons are used to control both locomotion and reaching. We recorded the activity of pyramidal tract neurons in the motor cortex of the cat both during voluntary gait modifications and during reaching. All cells showed generally similar patterns of activity in both tasks. More specifically, we showed that, in many cases, cells maintained a constant temporal relationship to the activity of synergistic muscle groups in each task. In addition, in some cells the relationship between the intensity of the cell discharge activity and the magnitude of the EMG activity was equally constant during gait modifications and reaching. As such, the results are compatible with the hypothesis that the corticospinal circuits used to control reaching evolved from those used to precisely modify gait. SIGNIFICANCE STATEMENT In an article in 1989, Georgopoulos and Grillner (1989) proposed that the corticospinal control mechanisms used for reaching movements in primates may have evolved from those used to control precise modifications of gait during quadrupedal locomotion. In this article, we provide a test of this hypothesis by recording the activity of individual motor cortical cells during both behaviors. Our results are compatible with the hypothesis in that they demonstrate that individual cortical neurons exhibit similar qualitative and quantitative patterns during each behavior. Beyond a general similarity of activity patterns, we show that some cortical

  2. Specificity of human parietal saccade and reach regions during transcranial magnetic stimulation.

    PubMed

    Vesia, Michael; Prime, Steven L; Yan, Xiaogang; Sergio, Lauren E; Crawford, J Douglas

    2010-09-29

    Single-unit recordings in macaque monkeys have identified effector-specific regions in posterior parietal cortex (PPC), but functional neuroimaging in the human has yielded controversial results. Here we used on-line repetitive transcranial magnetic stimulation (rTMS) to determine saccade and reach specificity in human PPC. A short train of three TMS pulses (separated by an interval of 100 ms) was delivered to superior parieto-occipital cortex (SPOC), a region over the midposterior intraparietal sulcus (mIPS), and a site close to caudal IPS situated over the angular gyrus (AG) during a brief memory interval while subjects planned either a saccade or reach with the left or right hand. Behavioral measures then were compared to controls without rTMS. Stimulation of mIPS and AG produced similar patterns: increased end-point variability for reaches and decreased saccade accuracy for contralateral targets. In contrast, stimulation of SPOC deviated reach end points toward visual fixation and had no effect on saccades. Contralateral-limb specificity was highest for AG and lowest for SPOC. Visual feedback of the hand negated rTMS-induced disruptions of the reach plan for mIPS and AG, but not SPOC. These results suggest that human SPOC is specialized for encoding retinally peripheral reach goals, whereas more anterior-lateral regions (mIPS and AG) along the IPS possess overlapping maps for saccade and reach planning and are more closely involved in motor details (i.e., planning the reach vector for a specific hand). This work provides the first causal evidence for functional specificity of these parietal regions in healthy humans.

  3. Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

    PubMed Central

    Echeverría, Patricia; Domingo, Pere; Llibre, Josep-María; Gutierrez, Mar; Mateo, Gracia; Puig, Jordi; Bonjoch, Anna; Pérez-Alvarez, Nuria; Sirera, Guillem; Clotet, Bonaventura; Negredo, Eugenia

    2014-01-01

    Background. There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) in HIV-infected patients. Methods. We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results. We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus). Other CVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol (P = 0.025) and LDL-cholesterol (P = 0.004) was observed. However, the percentage of patients who maintained LDL-cholesterol > 100 mg/dL remained stable (from 46% to 41%, P = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time (P = 0.028). Conclusions. The prevalence of coronary events in our cohort is low. CVRF prevalence is high and their management is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients. PMID:25170515

  4. Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder

    PubMed Central

    Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

    2015-01-01

    This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

  5. Influence of the inter-reach-interval on motor learning.

    PubMed

    Francis, Joseph T

    2005-11-01

    Previous studies have demonstrated changes in motor memories with the passage of time on the order of hours. We sought to further this work by determining the influence that time on the order of seconds has on motor learning by changing the duration between successive reaches (inter-reach-interval (IRI)). Human subjects made reaching movements to visual targets while holding onto a robotic manipulandum that presented a viscous curl field. We tested four experimental groups that differed with respect to the IRI (0.5, 5, 10 or 20 s). The 0.5 s IRI group performed significantly worse with respect to a learning index than the other groups over the first set of 192 reaches. Each group demonstrated significant learning during the first set. There was no significant difference with respect to the learning index between the 5, 10 and 20 s IRI groups. During the second and third set of 192 reaches the 0.5 s IRI group's performance became indistinguishable from the other groups indicating that with continued training the initial deficit in performance could be overcome.

  6. Visually targeted reaching in horse-head grasshoppers.

    PubMed

    Niven, Jeremy E; Ott, Swidbert R; Rogers, Stephen M

    2012-09-22

    Visually targeted reaching to a specific object is a demanding neuronal task requiring the translation of the location of the object from a two-dimensionsal set of retinotopic coordinates to a motor pattern that guides a limb to that point in three-dimensional space. This sensorimotor transformation has been intensively studied in mammals, but was not previously thought to occur in animals with smaller nervous systems such as insects. We studied horse-head grasshoppers (Orthoptera: Proscopididae) crossing gaps and found that visual inputs are sufficient for them to target their forelimbs to a foothold on the opposite side of the gap. High-speed video analysis showed that these reaches were targeted accurately and directly to footholds at different locations within the visual field through changes in forelimb trajectory and body position, and did not involve stereotyped searching movements. The proscopids estimated distant locations using peering to generate motion parallax, a monocular distance cue, but appeared to use binocular visual cues to estimate the distance of nearby footholds. Following occlusion of regions of binocular overlap, the proscopids resorted to peering to target reaches even to nearby locations. Monocular cues were sufficient for accurate targeting of the ipsilateral but not the contralateral forelimb. Thus, proscopids are capable not only of the sensorimotor transformations necessary for visually targeted reaching with their forelimbs but also of flexibly using different visual cues to target reaches.

  7. The Protective Effect of Low-Dose Aspirin against Colorectal Cancer Is Unlikely Explained by Selection Bias: Results from Three Different Study Designs in Clinical Practice

    PubMed Central

    Cea Soriano, Lucía; Soriano-Gabarró, Montse; García Rodríguez, Luis A.

    2016-01-01

    Background We conducted three differently designed nested case–control studies to evaluate whether the protective effect of low-dose aspirin against colorectal cancer (CRC) is explained by selection bias. Methods Using a large validated UK primary care database, we followed different cohorts of patients, who varied in their demographic and clinical characteristics, to identify first ever cases of CRC. In Studies 1 and 2, two cohorts were followed, i) new users of low-dose aspirin at start of follow-up (N = 170,336 in Study 1, N = 171,527 in Study 2) and either ii) non-users of low-dose aspirin (Study 1, N = 170,336) or new users of paracetamol (Study 2, N = 149,597) at start of follow-up. In Study 3 a single cohort of individuals näive to low-dose aspirin at the start of observation was followed. Controls were selected using incidence sampling and logistic regression used to obtain an unbiased estimate of the incidence rate ratio (RR) with 95% confidence intervals (CIs). Low-dose aspirin exposure was analyzed ‘as-treated’ before the index date (CRC date for cases, random date for controls). Results In the three studies, median (maximum) follow-up was 5.1 (12), 5.8 (12) and 7.5 (13) years, respectively. 3033 incident CRC cases were identified in Study 1, 3174 in Study 2, and 12,333 in Study 3. Current use of low-dose aspirin was associated with a significantly reduced risk of 34%, 29% and 31% in the three studies, respectively; corresponding RRs (95% CIs) were 0.66 (0.60–0.73), 0.71 (0.63–0.80) and 0.69 (0.64–0.74). In each study, significantly reduced risks of CRC were seen when low-dose aspirin was used for primary or secondary cardiovascular disease prevention, in both sexes, and across all age groups evaluated. Conclusion Low-dose aspirin is associated with a significantly reduced risk of CRC. The consistency of our findings across different studies makes selection bias an unlikely explanation. PMID:27428004

  8. 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

    2016-10-06

    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.

  9. Shining new light on braided rivers: capturing grain-to-reach scale morphodynamics with terrestrial laser scanning

    NASA Astrophysics Data System (ADS)

    Brasington, J.; Williams, R. D.; Vericat, D.; Hicks, M.; Goodsell, B.

    2011-12-01

    The last decade has witnessed a technological revolution in the acquisition of geospatial data. These developments have profound implications for the practice of river science, creating a step-change in the dimensionality, resolution and precision of measurement of fluvial forms and processes. The pace of change has been remarkable; typical datasets of channel geometry have grown from cross-sections containing a few hundred survey observations, to airborne lidar surveys incorporating millions of points. With wide-area terrestrial laser scans comprising tens of billions observations now set to emerge, our data perspectives have been expanded by seven orders of magnitude. Such rapid modernization brings with it new challenges and necessitates the development of novel data management strategies, original algorithms to process dense 3d data, higher dimensional spatial metrics and innovative simulation methods to make optimal use of this rich vein of information. In this paper we describe a field-to-product methodology which aims to address these challenges and has been used to generate an unparalleled dataset capturing the morphological evolution of a labile gravel-bed braided river through a continuous sequence of floods between Oct 2009 and May 2010. These data were generated using a data-fusion approach that combines close-range terrestrial laser scanning with bathymetric data derived from non-metric aerial photography. Surveys were acquired over a 2.5 x 0.7 km reach of the Rees River; a piedmont braided system draining a highland catchment of Southern Alps of NZ. During a 10 month field campaign through the summer flood season, this study reach was resurveyed systematically after each competent flood event. Multi-scale DEMs were derived that capture the spatial distribution of facies and morphological changes at high precision. Results indicate that over 80% of the reach was subject to significant erosion or deposition, with a complex pattern of response to the

  10. Telerobotic operation of structurally flexible, long-reach manipulators

    SciTech Connect

    Kwon, D.S.; Hwang, D.H.; Babcock, S.M.

    1994-09-01

    As a part of the Department of Energy`s Environmental Restoration and Waste Management Program, long-reach manipulators are being considered for the retrieval of waste from large storage tanks. Long-reach manipulators may have characteristics significantly different from those of typical industrial robots because of the flexibility of long links needed to cover the large workspace. To avoid structural vibrations during operation, control algorithms employing various types of shaping filters were investigated. A new approach that uses embedded simulation was developed and compared with others. In the new approach, generation of joint trajectories considering link flexibility was also investigated.

  11. What causes cooling water temperature gradients in forested stream reaches?

    NASA Astrophysics Data System (ADS)

    Garner, G.; Malcolm, I. A.; Sadler, J. P.; Hannah, D. M.

    2014-06-01

    Previous studies have suggested that shading by riparian vegetation may reduce maximum water temperature and provide refugia for temperature sensitive aquatic organisms. Longitudinal cooling gradients have been observed during the daytime for stream reaches shaded by coniferous trees downstream of clear cuts, or deciduous woodland downstream of open moorland. However, little is known about the energy exchange processes that drive such gradients, especially in semi-natural woodland contexts, and in the absence of potentially confounding cool groundwater inflows. To address this gap, this study quantified and modelled variability in stream temperature and heat fluxes along an upland reach of the Girnock Burn (a tributary of the Aberdeenshire Dee, Scotland) where riparian landuse transitions from open moorland to semi-natural forest. Observations were made along a 1050 m reach using a spatially-distributed network of ten water temperature micro-loggers, three automatic weather stations and >200 hemispherical photographs, which were used to estimate incoming solar radiation. These data parameterised a high-resolution energy flux model, incorporating flow-routing, which predicted spatio-temporal variability in stream temperature. Variability in stream temperature was controlled largely by energy fluxes at the water column-atmosphere interface. Predominantly net energy gains occurred along the reach during daylight hours, and heat exchange across the bed-water column interface accounted for <1% of the net energy budget. For periods when daytime net radiation gains were high (under clear skies), differences between water temperature observations decreased in the streamwise direction; a maximum difference of 2.5 °C was observed between the upstream reach boundary and 1050 m downstream. Furthermore, daily maximum water temperature at 1050 m downstream was ≤1°C cooler than at the upstream reach boundary and lagged the occurrence of daily maximum water temperature

  12. NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 54: The technical communications practices of engineering technology students: Results of the NASA/DOD Aerospace Knowledge Diffusion Research Project phase 3 student surveys

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; England, Mark; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    Engineering technology programs are characterized by their focus on application and practice, and by their approximately 50/50 mix of theory and laboratory experience. Engineering technology graduates are employed across the technological spectrum and are often found in areas that deal with application, implementation, and production. Yet we know very little about the communications practices and information-use skills of engineering technology students. In this paper, we report selected results of an exploratory study of engineering technology students enrolled in three U.S. institutions of higher education. Data are presented for the following topics: career goals and aspirations; the importance of, receipt of, and helpfulness of communications and information-use skills instruction; collaborative writing; use of libraries; and the use of electronic (computer) networks.

  13. Taking OSCE examiner training on the road: reaching the masses

    PubMed Central

    Reid, Katharine; Smallwood, David; Collins, Margo; Sutherland, Ruth; Dodds, Agnes

    2016-01-01

    Background To ensure the rigour of objective structured clinical examinations (OSCEs) in assessing medical students, medical school educators must educate examiners with a view to standardising examiner assessment behaviour. Delivering OSCE examiner training is a necessary yet challenging part of the OSCE process. A novel approach to implementing training for current and potential OSCE examiners was trialled by delivering large-group education sessions at major teaching hospitals. Methods The ‘OSCE Roadshow’ comprised a short training session delivered in the context of teaching hospital ‘Grand Rounds’ to current and potential OSCE examiners. The training was developed to educate clinicians about OSCE processes, clarify the examiners’ role and required behaviours, and to review marking guides and mark allocation in an effort to standardise OSCE processes and encourage consistency in examiner marking behaviour. A short exercise allowed participants to practise marking a mock OSCE to investigate examiner marking behaviour after the training. Results OSCE Roadshows at four metropolitan and one rural teaching hospital were well received and well attended by 171 clinicians across six sessions. Unexpectedly, medical students also attended in large numbers (n=220). After training, participants’ average scores for the mock OSCE clustered closely around the ideal score of 28 (out of 40), and the average scores did not differ according to the levels of clinical experience. Conclusion The OSCE Roadshow demonstrated the potential of brief familiarisation training in reaching large numbers of current and potential OSCE examiners in a time and cost-effective manner to promote standardisation of OSCE processes. PMID:27687287

  14. The parietal reach region is limb specific and not involved in eye-hand coordination.

    PubMed

    Yttri, Eric A; Wang, Cunguo; Liu, Yuqing; Snyder, Lawrence H

    2014-02-01

    Primates frequently reach toward visual targets. Neurons in early visual areas respond to stimuli in the contralateral visual hemifield and without regard to which limb will be used to reach toward that target. In contrast, neurons in motor areas typically respond when reaches are performed using the contralateral limb and with minimal regard to the visuospatial location of the target. The parietal reach region (PRR) is located early in the visuomotor processing hierarchy. PRR neurons are significantly modulated when targets for either limb or eye movement appear, similar to early sensory areas; however, they respond to targets in either visual field, similar to motor areas. The activity could reflect the subject's attentional locus, movement of a specific effector, or a related function, such as coordinating eye-arm movements. To examine the role of PRR in the visuomotor pathway, we reversibly inactivated PRR. Inactivation effects were specific to contralateral limb movements, leaving ipsilateral limb and saccadic movements intact. Neither visual hemifield bias nor visual attention deficits were observed. Thus our results are consistent with a motoric rather than visual organization in PRR, despite its early location in the visuomotor pathway. We found no effects on the temporal coupling of coordinated saccades and reaches, suggesting that this mechanism lies downstream of PRR. In sum, this study clarifies the role of PRR in the visuomotor hierarchy: despite its early position, it is a limb-specific area influencing reach planning and is positioned upstream from an active eye-hand coordination-coupling mechanism.

  15. [Effect of translating water on vegetation at the lower reaches of Tarim river].

    PubMed

    Xu, Hailiang; Chen, Yaning; Yang, Ge

    2003-07-01

    Due to human irrational resource exploit in recent 50 years, many environment problems have appeared at the lower reaches of Tarim River, the environment degradation of this region became seriously. In order to restore green corridor and improve the environment at the lower reaches of Tarim River, the project of transporting water to the lower reaches of Tarim River was carried out from June 14, 2000 and the water reached Taitema lake finally. After two years' monitoring and analyzing in this region, it was found that the ground-water level went up and much extremely degraded vegetation was restored. Some xerophytic arbor and bush restored obviously with the change of habitat. Correspondingly, the groundwater level, vegetation coverage, diversity of biology, the species richness and crown of Populus euphratica all changed. By the end of September 2002, the result showed that the respond range of the ground-water level was 800 m from the river, and the respond range of vegetation was not beyond 700 m at the middle part of lower reaches of Tarim River. Due to the different environmental factors in different parts at the lower reaches of Tarim River, the response range changed accordingly. In general, the respond range became smaller and smaller from the upriver part to downstream part.

  16. A key region in the human parietal cortex for processing proprioceptive hand feedback during reaching movements.

    PubMed

    Reichenbach, Alexandra; Thielscher, Axel; Peer, Angelika; Bülthoff, Heinrich H; Bresciani, Jean-Pierre

    2014-01-01

    Seemingly effortless, we adjust our movements to continuously changing environments. After initiation of a goal-directed movement, the motor command is under constant control of sensory feedback loops. The main sensory signals contributing to movement control are vision and proprioception. Recent neuroimaging studies have focused mainly on identifying the parts of the posterior parietal cortex (PPC) that contribute to visually guided movements. We used event-related TMS and force perturbations of the reaching hand to test whether the same sub-regions of the left PPC contribute to the processing of proprioceptive-only and of multi-sensory information about hand position when reaching for a visual target. TMS over two distinct stimulation sites elicited differential effects: TMS applied over the posterior part of the medial intraparietal sulcus (mIPS) compromised reaching accuracy when proprioception was the only sensory information available for correcting the reaching error. When visual feedback of the hand was available, TMS over the anterior intraparietal sulcus (aIPS) prolonged reaching time. Our results show for the first time the causal involvement of the posterior mIPS in processing proprioceptive feedback for online reaching control, and demonstrate that distinct cortical areas process proprioceptive-only and multi-sensory information for fast feedback corrections.

  17. A novel technology for investigating the dynamics of infant perseverative reaching.

    PubMed

    Feng, Jing; Spencer, John; Schöner, Gregor; Clearfield, Melissa W; Thelen, Esther

    2007-11-01

    We designed and tested a novel technology that enables us to capture the entire stream of behavior in perseverative reaching tasks. Beyond fitting the criteria of the conventional A-not-B task, the novel technology gives us better access to the core features of perseverative reaching, such as timing, behavior history, and reinforcement. The technology allows us to quantitatively manipulate reinforcement characteristics, to accurately program onsets, delays, and stimulus durations as well as locations and salience of the targets, and to automatically record the number of reaches to each target and compute timing. We did a validation study on this new technology, investigating the influence of a number of novel factors on perseverative reaching. We replicated the A-not-B phenomenon and associated developmental changes. In addition, results demonstrated that the new technology offers insights into infants' behavior beyond the first reaching action. Moreover, data collection is fully automated, yielding precise, quantitative data. Future studies using this technology will capitalize on the salient advantages of this technology to more precisely measure goal-directed actions and understand the development of reaching skill.

  18. Multimodal decoding and congruent sensory information enhance reaching performance in subjects with cervical spinal cord injury

    PubMed Central

    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

  19. Contribution of return flows to streamflow in selected stream reaches in Illinois, 1988-89

    USGS Publications Warehouse

    LaTour, J.K.

    1993-01-01

    Water returns by sewage-treatment plants and various water users can be a significant part of streamflow. Knowledge of the effect of return flows on stream- flow is needed for purposes of assessing streamwater quality and water supply. The results of a study by the U.S. Geological Survey, in cooperation with the Illinois Environmental Protection Agency, are presented to describe the contribution of return flows to streamflow for five stream reaches in Illinois during 1988-89. The reaches studied were South Branch Kishwaukee River upstream from De Kaib, Mackinaw River upstream from Congerville, Addison Creek upstream from Bellwood, Flag Creek upstream from Willow Springs, and Thorn Creek upstream from Glenwood. The annual average contributions of return flows to streamflow in each reach ranged from 1 to 99 percent of the annual average streamflow. Return flows significantly affected streamflows in the Flag Creek and Thorn Creek reaches. Significant return flows probably sustained streamflows in the Addison Creek, Flag Creek, and Thorn Creek reaches. Return flows exceeded streamflow during at least 1 month during the 1988 drought at all of the study reaches, except the Thorn Creek reach. Of the amount of return flows that exceeded streamflow, all reaches lost an estimated 0.01 to 0.34 Mgal/d (million gallons per day) to evaporation and 0.36 to 1.33 Mgal/d to infiltration. An analysis-of-variance test indicated that return flows did not differ among seasons. A second analysis indicated that the proportion of return flows to streamflow did differ seasonally. Return flows during July through September 1988-89 constituted a large proportion (67 percent) of the annual streamflows.

  20. 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.

  1. Predictive validity of the UPDRS postural stability score and the Functional Reach Test, when compared with ecologically valid reaching tasks.

    PubMed

    Jenkins, M E; Johnson, A M; Holmes, J D; Stephenson, F F; Spaulding, S J

    2010-07-01

    Balance problems and falls are a common concern among individuals with Parkinson's disease (PD). Falls frequently occur during daily activities such as reaching into cupboards in the kitchen or bathroom. This study compared the correlation among two standard postural stability tests - the postural stability score on the Unified Parkinson's Disease Rating Scale (UPDRS) and the Functional Reach Test (FRT) - and ecologically valid reaching tasks that correspond to reaching at different cupboard heights among 20 individuals with PD and 20 age-matched controls. Both the FRT and the UPDRS postural stability tests are quick measures that can be performed during the clinical examination. The FRT, but not the postural stability score, demonstrated a significant correlation with the ecologically valid reaching tasks, among individuals with PD. Furthermore the FRT scores did not correlate with the UPDRS postural stability scores, indicating that these are measuring different aspects of balance. This study suggests that the FRT score may better predict the risk of postural instability encountered during daily activities among individuals with PD.

  2. The Educational Results in Practice Teaching

    ERIC Educational Resources Information Center

    Kurenkova, Iu. V.

    2013-01-01

    Education reforms in Russia are aimed at increasing goal-based instruction and at expanding the range of desired outcomes, but survey research data show that teachers are not well-prepared to implement these changes. (Contains 2 tables and 4 notes.)

  3. Reaching the Underserved: Complementary Models of Effective Schooling

    ERIC Educational Resources Information Center

    DeStefano, Joseph; Moore, Audrey-Marie Schuh; Balwanz, David; Hartwell, Ash

    2007-01-01

    Many countries that have undergone expansion of access to public education still face significant disparities in school enrollment and attendance rates at sub-national levels, and fail to reach a high proportion of children who are outside of the government system. Completion and student learning have also continued to be system-wide challenges…

  4. Reaching Rural Communities: Increasing Access to Disability Research Information.

    ERIC Educational Resources Information Center

    Research Exchange, 2002

    2002-01-01

    Nonmetropolitan areas have the highest percentage of people with disabilities, including severe disabilities. However, rural people with disabilities may represent a population that is underserved or difficult to reach. Barriers to information dissemination in rural areas include limited transportation and communications infrastructures, greater…

  5. Settlement Reached at Callahan Mine Superfund Site in Brooksville, Maine

    EPA Pesticide Factsheets

    A settlement has been reached that will facilitate the cleanup of the Callahan Mine Superfund Site in Brooksville, ME. The agreement is between the USEPA, US DOJ, the State of Maine, and site property owner Smith Cove Preservation Trust (Smith Cove).

  6. Science Behind Bars: Reaching Inmates from Rikers Island

    NASA Astrophysics Data System (ADS)

    Mocsy, Agnes

    2017-01-01

    I report on the project ``Science Behind Bars: Reaching Inmates on Rikers Island'' partially funded through an APS Public Outreach and Informing the Public grant. This project involves developing leave-behind materials and setting up meetings to speak with Rikers Island inmates about science, evidence-based reasoning, and the dangers of stereotype threat. APS Mini Grant.

  7. Science Behind Bars: Reaching Inmates on Rikers Island

    NASA Astrophysics Data System (ADS)

    Mócsy, Ágnes

    2016-03-01

    I report on the project ``Science Behind Bars: Reaching Inmates on Rikers Island'' partially funded through an APS Public Outreach and Informing the Public Grant. This project involves setting up meetings to speak with female prisoners on Rikers Island about science, evidence based reasoning and the dangers of stereo-type threat.

  8. Reach for the Stars: Visions for Literacy Coaching Programs

    ERIC Educational Resources Information Center

    DeFord, Diane

    2012-01-01

    This brief by the Literacy Coaching Clearinghouse is about reaching for the stars--stories of vision and commitment from educators in small and large schools. Everyone knows of people who are held up as "visionaries" throughout history: Leonardo Da Vinci, Mahatma Gandhi, Jules Verne, Thomas Edison, Susan Anthony, or John Dewey, to name a few. The…

  9. Research Within Reach: Resources for School Improvement. Final Report.

    ERIC Educational Resources Information Center

    Meehan, Merrill L.

    A detailed report is given on the mechanics involved in conducting a successful bi-regional workshop for educators. The theme of the workshop was designed around two Research Within Reach (RWR) documents dealing with oral/written communications and secondary mathematics; however, papers and discussion generated by the workshop are not included in…

  10. Accessible Buildings for People with Walking and Reaching Limitations.

    ERIC Educational Resources Information Center

    Steinfeld, Edward; And Others

    Research was reviewed and conducted regarding the accessibility of buildings for physically disabled persons. Data was produced regarding anthropometrics (eye level and reach limits for ambulant, semiambulant, and wheelchair bound persons); wheelchair maneuvers; speed and distance (maximum travel distances for people with limitations of stamina);…

  11. 14. RAILROAD BRIDGE MISSISSIPPI, MONROE CO., ABERDEEN Reach by foot ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. RAILROAD BRIDGE MISSISSIPPI, MONROE CO., ABERDEEN Reach by foot from E end of Vine St. St. Louis and San Francisco RR bridge. Bridge built 1887, replaced, 1969. Credit: Evans Memorial Library, Aberdeen, Ms. No date. Sarcone Photography, Columbus, Ms. Sep 1978. - Bridges of the Upper Tombigbee River Valley, Columbus, Lowndes County, MS

  12. 12. INTERIOR VIEW WITH JAMES WILLIAMS REACHING FOR THE SAND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. INTERIOR VIEW WITH JAMES WILLIAMS REACHING FOR THE SAND RELEASE LEVER WHICH WILL OPEN THE OVERHEAD STORAGE BIN AND PERMIT A SET AMOUNT OF SAND TO BE DEPOSITED INTO THE FLASK PRIOR TO COMPRESSION BY THE MOLDING MACHINE INSIDE GREY IRON UNIT NO. 1. - Stockham Pipe & Fittings Company, Grey Iron Foundry, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

  13. Perceiving Children's Behavior and Reaching Limits in a Risk Environment

    ERIC Educational Resources Information Center

    Cordovil, Rita; Santos, Carlos; Barreiros, Joao

    2012-01-01

    The purpose of this study was to investigate the accuracy of parents' perception of children's reaching limits in a risk scenario. A sample of 68 parents of 1- to 4-year-olds were asked to make a prior estimate of their children's behavior and action limits in a task that involved retrieving a toy out of the water. The action modes used for…

  14. Within Our Reach: How America Can Educate Every Child

    ERIC Educational Resources Information Center

    Chubb, John E.

    2005-01-01

    The No Child Left Behind Act (NCLB) is bolder than all previous federal education laws, setting ambitious goals for universal student achievement and authorizing severe remedies for schools not reaching them. In a nation where most youngsters are far from proficient in reading and mathematics and where innumerable efforts to boost learning levels…

  15. Reaching a Representative Sample of College Students: A Comparative Analysis

    ERIC Educational Resources Information Center

    Giovenco, Daniel P.; Gundersen, Daniel A.; Delnevo, Cristine D.

    2016-01-01

    Objective: To explore the feasibility of a random-digit dial (RDD) cellular phone survey in order to reach a national and representative sample of college students. Methods: Demographic distributions from the 2011 National Young Adult Health Survey (NYAHS) were benchmarked against enrollment numbers from the Integrated Postsecondary Education…

  16. The Child Care Connection: Reaching Children in Day Care.

    ERIC Educational Resources Information Center

    Dworkin, Judith Daniels

    1993-01-01

    Describes the Child Care Connection, a public library project serving preschool children by providing hard-to-reach home day-care providers with bags of children's materials. Details of planning, funding, delivery of materials, and evaluation are provided. A sample of the thematic book list for Child Care Connection Kits is appended. (KRN)

  17. Third Thursday Thing: A Success Story for Reaching Underserved Clients

    ERIC Educational Resources Information Center

    Andries, Kenneth M.; Simon, Marion; Rivers, Louie

    2016-01-01

    Kentucky State University has been conducting a monthly field day known as the Third Thursday Thing for many years. This program has been successful in reaching limited-resource, minority, and underserved clients. The success of the program has indicated that a nontraditional approach can be successful when working with nontraditional clients. The…

  18. 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

  19. Reaching All Students with Excellent STEM Teachers. Education Leaders' Brief

    ERIC Educational Resources Information Center

    Public Impact, 2014

    2014-01-01

    In the U.S., STEM subjects--science, technology, engineering, and math--face urgent needs for great STEM teachers and well-educated students. An Opportunity Culture can help by extending the reach of excellent STEM teachers already in our schools and creating a teaching profession that attracts and retains these teachers through higher pay, within…

  20. Reaching Part-Time Distance Students in Diverse Environments

    ERIC Educational Resources Information Center

    Whitehair, Kristin J.

    2010-01-01

    This article focuses on the model used at the University of Kansas Medical Center to reach graduate students in the School of Nursing. Like many students returning for graduate degrees, distance students are balancing the demands of professional positions, graduate studies, and family life. Topics addressed include: point-of-need assistance,…