Effects of continuous midwifery labour support for women with severe fear of childbirth.

PubMed

Sydsjö, Gunilla; Blomberg, Marie; Palmquist, Sofie; Angerbjörn, Louise; Bladh, Marie; Josefsson, Ann

2015-05-15

Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth. The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95% CI: 3.036-131.731). Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC.

Effects of Targeted Professional Development on Teachers' Specific Praise Rates

ERIC Educational Resources Information Center

Simonsen, Brandi; Freeman, Jennifer; Dooley, Kathryn; Maddock, Eleanor; Kern, Laura; Myers, Diane

2017-01-01

Classroom management continues to be a concern for educators, administrators, and policymakers. Although evidence-based classroom management practices exist, teachers often receive insufficient training and support to implement these practices successfully. Schools need reliable and efficient ways to support teachers' classroom management. This…

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

Faith-Based Institutions, Institutional Mission, and the Public Good

ERIC Educational Resources Information Center

Daniels, Jessica Rose; Gustafson, Jacqueline N.

2016-01-01

Rooted in historical foundations and demonstrated by continued government financial support, one purpose of higher education is to contribute to the "public good," or support and further social causes and human flourishing. This notion has received renewed attention in both the literature as well as in professional practice. Given the…

Beyond ROC Curvature: Strength Effects and Response Time Data Support Continuous-Evidence Models of Recognition Memory

ERIC Educational Resources Information Center

Dube, Chad; Starns, Jeffrey J.; Rotello, Caren M.; Ratcliff, Roger

2012-01-01

A classic question in the recognition memory literature is whether retrieval is best described as a continuous-evidence process consistent with signal detection theory (SDT), or a threshold process consistent with many multinomial processing tree (MPT) models. Because receiver operating characteristics (ROCs) based on confidence ratings are…

Latching device

NASA Technical Reports Server (NTRS)

Ulrich, G. W. (Inventor)

1975-01-01

A latching device is suited for use in establishing a substantially motionless connection between a stationary receiver and a movable latching mechanism. The latching mechanism includes a pivotally supported restraining hook continuously urged into a capturing relationship with the receiver, characterized by a spring-biased pawl having a plurality of aligned teeth. The teeth are seated in the surface of the throat of the hook and positionable into restraining engagement with a rigid restraining shoulder projected from the receiver.

The Ethics of Continued Life-Sustaining Treatment for those Diagnosed as Brain-dead.

PubMed

du Toit, Jessica; Miller, Franklin

2016-03-01

Given the long-standing controversy about whether the brain-dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain-dead loved one continues to receive supportive care. We argue that while it would be ethically inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings. Thus, if a family insists on continuing to care for their brain-dead loved at their home, we should not, from a policy perspective, interfere with the family's wishes. We also argue that healthcare professionals should make some effort to facilitate the transfer of brain-dead patients to these other settings when families insist on continued treatment despite being informed about the lack of any potential for recovery of consciousness. Our arguments are strengthened by the fact that patients in a persistent vegetative state, who, when correctly diagnosed, also have no potential for recovery of consciousness, are routinely transferred from hospitals to nursing homes or long-term care facilities where they continue to be ventilated, tube fed and to receive other supportive care. We also briefly explore the question of who should be responsible for the costs of such treatment at the long-term care facility. © 2015 John Wiley & Sons Ltd.

Systematic review building a preceptor support system.

PubMed

Goss, Carol R

2015-01-01

This systematic review identifies the significance of the preceptor role in affecting new graduate nurse retention. Findings from 20 research studies provide support that nurse preceptors receiving continuing education and perceiving reward and recognition from the preceptor position positively affect new graduate nurse retention. Hospital administration, nurse managers, nurse educators, preceptors, and new graduate nurses each play a role in the successful implementation of a preceptor support system.

Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs

PubMed Central

Finch, Andrew J.; Moberg, D. Paul; Krupp, Amanda Lawton

2014-01-01

Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance abuse, recovery schools appear to successfully function as continuing care providers reinforcing and sustaining therapeutic benefits gained from treatment. Small size and therapeutic programming allow for a potentially broader continuum of services than currently exists in most of the schools. Recovery schools thus provide a useful design for continuing care warranting further study and policy support. PMID:24591808

High-flow nasal prong oxygen therapy or nasopharyngeal continuous positive airway pressure for children with moderate-to-severe respiratory distress?*.

PubMed

ten Brink, Fia; Duke, Trevor; Evans, Janine

2013-09-01

The aim of this study was to compare the use of high-flow nasal prong oxygen therapy to nasopharyngeal continuous positive airway pressure in a PICU at a tertiary hospital; to understand the safety and effectiveness of high-flow nasal prong therapy; in particular, what proportion of children require escalation of therapy, whether any bedside monitoring data predict stability or need for escalation, and complications of the therapies. This was a prospective observational study of the first 6 months after the introduction of high-flow nasal prong oxygen therapy at the Royal Children's Hospital in Melbourne. Data were collected on all children who were managed with either high-flow nasal prong oxygen therapy or nasopharyngeal continuous positive airway pressure. The mode of respiratory support was determined by the treating medical staff. Data were collected on each patient before the use of high-flow nasal prong or nasopharyngeal continuous positive airway pressure, at 2 hours after starting the therapy, and the children were monitored and data collected until discharge from the ICU. Therapy was considered to be escalated if children on high-flow nasal prong required a more invasive form or higher level of respiratory support, including nasopharyngeal continuous positive airway pressure or mask bilevel positive airway pressure or endotracheal intubation and mechanical ventilation. Therapy was considered to be escalated if children on nasopharyngeal continuous positive airway pressure required bilevel positive airway pressure or intubation and mechanical ventilation. As the first mode of respiratory support, 72 children received high-flow nasal prong therapy and 37 received nasopharyngeal continuous positive airway pressure. Forty-four patients (61%) who received high-flow nasal prong first were weaned to low-flow oxygen or to room air and 21 (29%) required escalation of respiratory support, compared with children on nasopharyngeal continuous positive airway pressure: 21 (57%) weaned successfully and 9 (24%) required escalation. Repeated treatment and crossover were common in this cohort. Throughout the study duration, escalation to a higher level of respiratory support was needed in 26 of 100 high-flow nasal prong treatment episodes (26%) and in 10 of 55 continuous positive airway pressure episodes (18%; p = 0.27). The need for escalation could be predicted by two of failure of normalization of heart rate and respiratory rate, and if the FIO2 did not fall to lower than 0.5, 2 hours after starting high-flow nasal prong therapy. Nasopharyngeal continuous positive airway pressure was required for significantly longer periods than high-flow nasal prong (median 48 and 18 hours, respectively; p ≤ 0.001). High-flow nasal prong therapy is a safe form of respiratory support for children with moderate-to-severe respiratory distress, across a large range of diagnoses, whose increased work of breathing or hypoxemia is not relieved by standard oxygen therapy. About one quarter of all children will require escalation to another form of respiratory support. This can be predicted by simple bedside observations.

Child support and alimony: 1983 (supplemental report).

PubMed

Sanders, R A

1986-10-01

The concern has continued over the financial situation of US women and their children after divorce and separation and over the situation of never-married mothers, in part due to the low average incomes and accompanying high incidence of poverty among families with family householders and no husband present. This report presents information on both the award and actual receipt of child support to women on behalf of their children and on alimony for their own support. Additional data concerning receipt and type of property settlement following divorce is provided for ever-divorced women. As of spring 1984, 8.7 million mothers were living with children under 21 years of age whose fathers were not living in the household; 58% or about 5 million of these women were awarded or had an agreement to receive child support payments for their children as of the survey date. Of the 5 million women awarded child support, 4 million were supposed to receive child support for their children in 1983. Of those due payment, about half received the full amount they were due. The child support award rate reported in 1984 (58%) was not significantly different from that of 1982; however, the proportion of women receiving payments in 1983 (76%) increased slightly over that of the previous survey (72%). The average (mean) amount of child support received in 1983 was $2340. About 43% of the 2.9 million women below the poverty level were awarded child support. Whites and college-educated women were more likely to be awarded child support. Only about 14% of the 17.4 million ever-divorced or currently separated women as of spring 1984 were awarded or had an agreement to receive alimony or maintenance payments In spring 1984, about 37% of the 14.8 million women who had ever been divorced reported receiving some form of property settlement.

Changing Beliefs about Corporal Punishment: Increasing Knowledge about Ineffectiveness to Build More Consistent Moral and Informational Beliefs

ERIC Educational Resources Information Center

Robinson, Daniel H.; Funk, Daniel C.; Beth, Alicia; Bush, Angela M.

2005-01-01

Although the effectiveness of corporal punishment (CP) has received little empirical support, public support for this disciplinary method continues despite calls for its abandonment by researchers. Even among educators, favorable attitudes toward the use of CP are prevalent. We measured education majors' beliefs about CP before and after they read…

Access Patterns of ADHD Students Utilizing Campus Disability Services Supports

ERIC Educational Resources Information Center

Jackson, Meribeth L.

2013-01-01

Source of initial access to disability services, accommodations received as supports on campus, and the rate of continuous enrollment data was measured and compared for students diagnosed with ADHD prior to age eighteen and those diagnosed with ADHD after age eighteen. These two groups were compared to analyze the assumption that students who were…

Validity of police contacts as a performance indicator for the public mental health care system in Amsterdam: an open cohort study.

PubMed

Lauriks, S; Buster, M C A; de Wit, M A S; Arah, O A; Hoogendoorn, A W; Peen, J; Klazinga, N S

2018-06-01

The Public Mental Health Care (PMHC) system is a network of public services and care- and support institutions financed from public funds. Performance indicators based on the registration of police contacts could be a reliable and useful source of information for the stakeholders of the PMHC system to monitor performance. This study aimed to provide evidence on the validity of using police contacts as a performance indicator to assess the continuity of care in the PMHC system. Data on services received, police contacts and detention periods of 1928 people that entered the PMHC system in the city of Amsterdam were collected over a period of 51 months. Continuity of care was defined as receiving more than 90 days of uninterrupted service. The associations between police contacts and continuity were analyzed with multilevel Poisson and multivariate linear regression modeling. Clients had on average 2.12 police contacts per person-year. Clients with police contacts were younger, more often single, male, and more often diagnosed with psychiatric or substance abuse disorders than clients without police contacts. Incidence rates of police contacts were significantly lower for clients receiving continuous care than for clients receiving discontinuous care. The number of police contacts of clients receiving PMHC coordination per month was found to be a significant predictor of the percentage of clients in continuous care. The number of police contacts of clients can be used as a performance indicator for an urban PMHC system to evaluate the continuity of care in the PMHC system.

Impact of Postoperative Antibiotic Prophylaxis Duration on Surgical Site Infections in Autologous Breast Reconstruction.

PubMed

Drury, Kerry E; Lanier, Steven T; Khavanin, Nima; Hume, Keith M; Gutowski, Karol A; Thornton, Brian P; Hansen, Nora M; Murphy, Robert X; Fine, Neil A; Kim, John Y S

2016-02-01

Although some surgeons prescribe prolonged postoperative antibiotics after autologous breast reconstruction, evidence is lacking to support this practice. We used the Tracking Operations and Outcomes for Plastic Surgeons database to evaluate the association between postoperative antibiotic duration and the rate of surgical site infection (SSI) in autologous breast reconstruction. The intervention of interest for this study was postoperative duration of antibiotic prophylaxis: either discontinued 24 hours after surgery or continued beyond 24 hours. The primary outcome variable of interest for this study was the presence of SSI within 30 days of autologous breast reconstruction. Cohort characteristics and 30-day outcomes were compared using χ² and Fischer exact tests for categorical variables and Student t tests for continuous variables. Multivariate logistic regression was used to control for confounders. A total of 1036 patients met inclusion criteria for our study. Six hundred fifty-nine patients (63.6%) received antibiotics for 24 hours postoperatively, and 377 patients (36.4%) received antibiotics for greater than 24 hours. The rate of SSI did not differ significantly between patients given antibiotics for only 24 hours and those continued on antibiotics beyond the 24-hour postoperative time period (5.01% vs 2.92%, P = 0.109). Furthermore, antibiotic duration was not predictive of SSI in multivariate regression modeling. We did not find a statistically significant difference in the rate of SSI in patients who received 24 hours of postoperative antibiotics compared to those that received antibiotics for greater than 24 hours. These findings held for both purely autologous reconstruction as well as latissimus dorsi reconstruction in conjunction with an implant. Thus, our study does not support continuation of postoperative antibiotics beyond 24 hours after autologous breast reconstruction.

Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?

PubMed

Paul, Christine L; Boyes, Allison W; O'Brien, Lorna; Baker, Amanda L; Henskens, Frans A; Roos, Ian; Clinton-McHarg, Tara; Bellamy, Douglas; Colburn, Glenda; Rose, Shiho; Cox, Martine E; Fradgley, Elizabeth A; Baird, Hannah; Barker, Daniel

2016-10-26

Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support. A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed. It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support. If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.

UK Breastfeeding Helpline support: An investigation of influences upon satisfaction

PubMed Central

2012-01-01

Background Helpline services have become an increasingly popular mode of providing community access to information and expert information and advice in the health and welfare sector. This paper reports on data collected from 908 callers to UK-based breastfeeding helplines. Methods A mixed methods design was adopted utilising a structured interview schedule to elicit callers experiences of the help and support received. In this paper we report on a series of multiple regression models undertaken to elicit the variables associated with callers’ ‘overall satisfaction’ with the helpline service. Three models were constructed; 1) caller demographic/call characteristics; 2) attitudes and effectiveness of service characteristics and 3) impact of support on caller wellbeing. Results Overall, 74.6% of callers were very satisfied, and 19.8% were satisfied with the help and support received by the helpline service. The caller demographic/call characteristics found to have a significant relationship with overall satisfaction related to the ease of getting through to the helpline and whether the woman had previously breastfed. Service characteristics associated with overall satisfaction related to whether the information received was helpful and whether the support helped to resolve their issues. The extent to which the volunteer was perceived to have enough time, whether the support had encouraged them to continue breastfeeding, met the caller’s expectations and/or provided the support the caller needed were also significantly associated. Caller outcomes contributing significantly to overall satisfaction concerned callers feeling less stressed, more confident, reassured and determined to continue breastfeeding following the call. Consideration of the effect sizes indicated that key factors associated with overall satisfaction related to: volunteers having sufficient time to deal with the callers’ issues; the information being perceived as helpful; the volunteers providing the support the callers needed; and for callers to feel reassured following the call. Conclusion Overall, these results highlight the value of the breastfeeding helpline(s) in terms of providing rapid, targeted, realistic, practical, and responsive support that provides affirmation and encouragement. The benefits include confidence building and callers feeling reassured and motivated to continue breastfeeding. Care needs to be taken to ensure that helpline support is easily accessible to ensure that callers and their families can access support when needed. This may require consideration of extension to a 24 hour service. PMID:23234293

Continuing Care and Trauma in Women Offenders’ Substance Use, Psychiatric Status, and Self-Efficacy Outcomes

PubMed Central

Saxena, Preeta; Grella, Christine E.; Messina, Nena P.

2015-01-01

Using secondary data analysis of 3 separate trauma-informed treatment programs for women offenders, we examine outcomes between those who received both prison and community-based substance abuse treatment (i.e., continuing care; n = 85) and those who received either prison or community aftercare treatment (n = 108). We further account for differences in trauma exposure to examine whether continuing care moderates this effect on substance use, psychiatric severity, and self-efficacy outcomes at follow-up. The main effect models of continuing care showed a significant association with high psychiatric status and did not yield significant associations with substance use or self-efficacy. However, the interaction between trauma history and continuing care showed significant effects on all 3 outcomes. Findings support the importance of a continuing care treatment model for women offenders exposed to multiple forms of traumatic events, and provide evidence of the effectiveness of integrating trauma-informed treatment into women’s substance abuse treatment. PMID:26924891

77 FR 60107 - Marine Mammals; File No. 17298

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... a permit to collect, import, export, and receive marine mammal parts for scientific research. DATES... objective of this application is to support multiple ongoing research programs at the Mystic Aquarium... continued research on these species. [[Page 60108

The Cascade Model of Teachers' Continuing Professional Development in Kenya: A Time for Change?

ERIC Educational Resources Information Center

Bett, Harry Kipkemoi

2016-01-01

Kenya is one of the countries whose teachers the UNESCO (2015) report cited as lacking curriculum support in the classroom. As is the case in many African countries, a large portion of teachers in Kenya enter the teaching profession when inadequately prepared, while those already in the field receive insufficient support in their professional…

Coaching: The Key to Translating Research into Practice Lies in Continuous, Job-Embedded Learning with Ongoing Support

ERIC Educational Resources Information Center

Knight, Jim

2009-01-01

In the past decade, interest in the form of professional learning loosely described as coaching has exploded. This growing interest in coaching is likely fueled by educators' recognition that traditional one-shot approaches to professional development--where teachers hear about practices but do not receive follow-up support--are ineffective at…

The Tenth Step of the BFHI: What midwives need to know about optimal support for mothers, post-discharge.

PubMed

Thorley, Virginia

2015-09-01

This commentary discusses the 10th Step of the Baby-Friendly Hospital Initiative (BFHI), the only step that goes beyond the hospital to provide for the mother to receive breast-feeding support after she returns to the community. The reasons why such support is needed, and how this support has been provided in different settings, will be discussed. Post-discharge support for breast-feeding mothers takes many forms and is optimised when mothers can access both professional and peer support. The mother-baby dyad is best served by the right advice from the right person at the right time. Midwives who assist the new mother with information about easily accessible support in the community enable the care she has received during her short hospital stay and during any midwifery home visiting to continue when she is in an environment that may not be supportive of breast feeding. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of the effects of enteral feeding with continuous and intermittent parenteral nutrition on hepatic triglyceride secretion in human beings

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

Isabel-Martinez, L.; Skinner, C.; Parkin, A.

Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained bymore » deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion.« less

Title 1 Schools Parent Liaisons' Reports Regarding Their Roles and Associated Responsibilities to Facilitate Parent Engagement to Support Children's Academic Achievement

ERIC Educational Resources Information Center

Tacchi, Barbara M.

2013-01-01

Parent Liaisons can play an integral role in working to realize a vision for a strategic, comprehensive, and continuous system of family, school, and community partnerships that demonstrably contribute to children's development and school success. Parent involvement continues to receive an increasing amount of attention in federal and state…

How do Durkheimian variables impact variation in national suicide rates when proxies for depression and alcoholism are controlled?

PubMed

Fernquist, Robert M

2007-01-01

Sociological research on Durkheim's theories of egoistic and anomic suicide has given Durkheim continued support more than a century after Durkheim published his work. Recent criticism by Breault (1994), though, argues that Durkheim's theories of suicide actually have not been empirically supported given the lack of psychological variables included in sociological research on suicide rates. Using proxy measures of depression and alcoholism, two known psychological variables to impact suicide, as well as classic Durkheimian variables, suicide rates in eight European countries from 1973-1997 were examined. Results indicate that Durkheim's theories of egoism and anomie, while not completely supported in statistical analysis of suicide rates, received moderate support. Results suggest the continued usefulness of Durkheim's work in aggregate analyses of suicide.

Judgement of discrete and continuous quantity in adults: number counts!

PubMed

Nys, Julie; Content, Alain

2012-01-01

Three experiments involving a Stroop-like paradigm were conducted. In Experiment 1, adults received a number comparison task in which large sets of dots, orthogonally varying along a discrete dimension (number of dots) and a continuous dimension (cumulative area), were presented. Incongruent trials were processed more slowly and with less accuracy than congruent trials, suggesting that continuous dimensions such as cumulative area are automatically processed and integrated during a discrete quantity judgement task. Experiment 2, in which adults were asked to perform area comparison on the same stimuli, revealed the reciprocal interference from number on the continuous quantity judgements. Experiment 3, in which participants received both the number and area comparison tasks, confirmed the results of Experiments 1 and 2. Contrasting with earlier statements, the results support the view that number acts as a more salient cue than continuous dimensions in adults. Furthermore, the individual predisposition to automatically access approximate number representations was found to correlate significantly with adults' exact arithmetical skills.

Training Teachers to Use Computers: A Case Study of the Summer Training Component of the IBM/ETS Secondary School Computer Education Program. Research Report.

ERIC Educational Resources Information Center

Stecher, Brian

A training program in computer educationtTested in 89 secondary schools focused on the use of computers as tools in all subject areas. Each school received enough computers and software from IBM to equip a full computer laboratory. The schools were organized into local networks in eight regions and received training and continuing support in these…

The role of industry in Internet education.

PubMed

Wieting, Mark W; Mevis, Howard; Zuckerman, Joseph D

2003-07-01

Each year hundreds of accredited continuing medical education conferences and meetings receive industry support through unrestricted educational grants. Many of these programs might not occur without this funding support. With the explosive growth of continuing medical education on the Internet, industry again is being asked to provide assistance through unrestricted educational grants and in some instances educational content. At the same time, industry is using the Internet to provide orthopaedic surgeons with education and information about their products and services. Education and information do not require continuing medical education accreditation to be valuable. Although some people in continuing medical education voice ethical concerns regarding the nature of industry's involvement in education, meeting the needs of orthopaedic surgeons remains the top priority. As demands on the orthopaedic surgeons' time continue to impact participation in educational meetings, industry will continue to play a critical role in helping educational organizations such as medical specialty societies develop new, innovative educational programs for presentation via the Internet.

Predictors of psychological well-being in a diverse sample of HIV-positive patients receiving highly active antiretroviral therapy.

PubMed

Safren, Steven A; Radomsky, Adam S; Otto, Michael W; Salomon, Elizabeth

2002-01-01

The purpose of the present study was to identify variables relevant to psychological well-being in HIV patients receiving highly active antiretroviral therapy (HAART). Multiple stressors accompany living with HIV while managing a HAART regimen. However, a variety of cognitive and behavioral variables can protect against or augment the deleterious effects of stress in this population. The authors hypothesized that satisfaction with social support, coping styles, and maladaptive attributions about HIV would explain more variance in psychological well-being than stressful life events per se. Participants were individuals with HIV receiving antiretroviral therapy-either starting a new HAART regimen or having difficulties adhering to their current regimen. Satisfaction with social support, coping styles, and punishment beliefs about HIV were uniquely associated with depression, quality of life, and self-esteem over and above the effects of stressful life events. These results provide support for continued psychosocial interventions that target these variables among patients with HIV.

ACHP | News

Science.gov Websites

competitive grant projects to support heritage tourism through research and documentation, planning, education funded grant projects remain active, and the National Park Service continues to consult with grantees and receive progress reports as well as specific products produced with the grant funds. First Lady Michelle

Comparison between two forms of vaginally administered progesterone for luteal phase support in assisted reproduction cycles.

PubMed

Geber, Selmo; Moreira, Ana Carolina Ferreira; de Paula, Sálua Oliveira Calil; Sampaio, Marcos

2007-02-01

The use of progesterone for luteal phase support has been demonstrated to be beneficial in assisted reproduction cycles using gonadotrophin-releasing hormone analogues (GnRHa). Two micronized progesterone preparations are available for vaginal administration: capsules and gel. The objective of this study was to compare the efficacy of these two forms for luteal phase support in assisted reproduction cycles. A total of 244 couples undergoing IVF/intracytoplasmic sperm injection cycles were included in the study and were randomly allocated (sealed envelopes) into two groups: group 1 (122) received vaginal capsules of 200 mg of micronized progesterone (Utrogestan), 3 times daily, and group 2 (122) received micronized progesterone in gel (Crinone 8%), once daily. Both groups received progesterone for 13 days beginning day 1 after oocyte retrieval, continuing until the pregnancy test was performed and until 12 weeks of pregnancy. Groups were compared by clinical data and assisted reproduction results and had similar ages and causes of infertility. Although the pregnancy rate was higher for those receiving progesterone gel than capsules (44.26 and 36.06% respectively), this difference was not statistically significant. The study showed that vaginal progesterone gel and capsules used for luteal phase support in assisted reproduction cycles with long protocol GnRHa result in similar pregnancy rates.

Follow-up client satisfaction in a supported education program.

PubMed

Mowbray, C T; Bybee, D; Collins, M E

2001-01-01

Satisfaction data have recently returned to popularity, as an outcome measure in managed behavioral healthcare systems. However, there are few examples of management uses of such data. We collected data 12 months after participants had completed a supported education program, concerning their retrospective satisfaction and the barriers, needs, and personal difficulties currently experienced in their attempts to pursue post-secondary education or training. Data on follow-up supportive contacts were also obtained. Results supported participants' continuing satisfaction, and identified particular information items which were endorsed as most helpful. However, the data indicated that personal difficulties presented obstacles to many and that a majority of participants had current needs for financial aid, tutoring, job placements, support groups, and transportation. Following completion of the supported education program, many participants had continuing contacts in support of their educational plans. The amount of contact was generally low, however. In the future, supported education programs need to build in mechanisms to ensure students receive ongoing support for education, since this support was found to positively and significantly affect individuals' enrolling in college or training.

Cognitive Behavioral Analysis System of Psychotherapy and Brief Supportive Psychotherapy for Augmentation of Antidepressant Nonresponse in Chronic Depression

PubMed Central

Kocsis, James H.; Gelenberg, Alan J.; Rothbaum, Barbara O.; Klein, Daniel N.; Trivedi, Madhukar H.; Manber, Rachel; Keller, Martin B.; Leon, Andrew C.; Wisniewski, Steven R.; Arnow, Bruce A.; Markowitz, John C.; Thase, Michael E.

2012-01-01

Context Previous studies have found that few chronically depressed patients remit with antidepressant medications alone. Objective To determine the role of adjunctive psychotherapy in the treatment of chronically depressed patients with less than complete response to an initial medication trial. Design This trial compared 12 weeks of (1) continued pharmacotherapy and augmentation with cognitive behavioral analysis system of psychotherapy (CBASP), (2) continued pharmacotherapy and augmentation with brief supportive psychotherapy (BSP), and (3) continued optimized pharmacotherapy (MEDS) alone. We hypothesized that adding CBASP would produce higher rates of response and remission than adding BSP or continuing MEDS alone. Setting Eight academic sites. Participants Chronically depressed patients with a current DSM-IV–defined major depressive episode and persistent depressive symptoms for more than 2 years. Interventions Phase 1 consisted of open-label, algorithm-guided treatment for 12 weeks based on a history of antidepressant response. Patients not achieving remission received next-step pharmacotherapy options with or without adjunctive psychotherapy (phase 2). Individuals undergoing psychotherapy were randomized to receive either CBASP or BSP stratified by phase 1 response, ie, as nonresponders (NRs) or partial responders (PRs). Main Outcome Measures Proportions of remitters, PRs, and NRs and change on Hamilton Scale for Depression (HAM-D) scores. Results In all, 808 participants entered phase 1, of which 491 were classified as NRs or PRs and entered phase 2 (200 received CBASP and MEDS, 195 received BSP and MEDS, and 96 received MEDS only). Mean HAM-D scores dropped from 25.9 to 17.7 in NRs and from 15.2 to 9.9 in PRs. No statistically significant differences emerged among the 3 treatment groups in the proportions of phase 2 remission (15.0%), partial response (22.5%), and non-response (62.5%) or in changes on HAM-D scores. Conclusions Although 37.5% of the participants experienced partial response or remitted in phase 2, neither form of adjunctive psychotherapy significantly improved outcomes over that of a flexible, individualized pharmacotherapy regimen alone. A longitudinal assessment of later-emerging benefits is ongoing. Trial Registration clinicaltrials.gov Identifier: NCT00057551 PMID:19884606

Impact of education and training on type of care provided by community-based breastfeeding counselors: a cross-sectional study

PubMed Central

2011-01-01

Background Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. Methods This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ2 test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills. Results The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites. Conclusions Our results show that different programs use different training curricula to train their CBBCs varying in duration and content. Counselor education is not a significant predictor of the type of training they receive. Continuing breastfeeding education is a significant determinant of type of counseling techniques used with clients. Further research is therefore needed to critically examine the content of the various training curricula of CBBC programs. This may show a need for a standardized training curriculum for all CBBC programs worldwide to make CBBCs more proficient and efficient, ensuring successful and optimum breastfeeding experiences for mothers and their newborns. PMID:21871062

The obstetrical and postpartum benefits of continuous support during childbirth.

PubMed

Scott, K D; Klaus, P H; Klaus, M H

1999-12-01

The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.

Teacher Evaluation. Policy Brief.

ERIC Educational Resources Information Center

Glass, Gene V.

2004-01-01

Traditional forms of evaluating teachers (e.g., inspection of credentials, supervisor and peer observation and rating) for purposes of hiring, promotion, and salary increases have served the profession of teaching well for decades and should receive continued support in policy and practice. Newer forms of evaluation--primarily paper-and-pencil…

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes

NASA Technical Reports Server (NTRS)

1997-01-01

This issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes NASA SP-7O11 lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Aerospace Medicine and Biology: A Continuing Bibliography. Supplement 475

NASA Technical Reports Server (NTRS)

1998-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Using Videoconferencing Technology to Provide Breastfeeding Support to Low-Income Women: Connecting Hospital-Based Lactation Consultants with Clients Receiving Care at a Community Health Center.

PubMed

Friesen, Carol A; Hormuth, Laura J; Petersen, Devan; Babbitt, Tina

2015-11-01

The Tele-Lactation Pilot Project (TLPP), 1 of 13 community-based breastfeeding projects implemented in Indiana in 2013 using Centers for Disease Control and Prevention grant funds, explored the feasibility of using videoconferencing technology to provide breastfeeding education and support to low-income women by a centrally located International Board Certified Lactation Consultant (IBCLC). The IBCLC was housed at the Breastfeeding Center at the hospital where the women would deliver; the women receiving the education and support were located at an inner-city community health center (CHC) where they received their primary care. The videoconferencing sessions were juxtaposed with the women's regularly scheduled prenatal and postnatal visits at the CHC. After delivery, the lactation consultant visited the mother and infant in person at the hospital to offer additional support. Overall, 35 mothers were served by the TLPP during the 9-month project period. A total of 134 visits (30-45 minutes each) were conducted (3.8 sessions per woman). At the conclusion of the project, interviews with key participants indicated that the tele-lactation videoconferencing sessions were easy to implement, allowed the IBCLC to reach a wider client base, and allowed the women to receive expert support that they might not have otherwise received. Comments indicated that, in addition to providing education and increasing the women's confidence, the tele-lactation sessions appeared to have decreased the mothers' anxiety about the birthing process and the hospital experience. The TLPP demonstrated that incorporating videoconferencing technology into routine care can help foster collaboration among health care providers and provide mothers with continuous, easily accessible breastfeeding education and support. © The Author(s) 2015.

Associations between perceived institutional support, job enjoyment, and intentions to work in the United Kingdom: national questionnaire survey of first year doctors.

PubMed

Lachish, Shelly; Goldacre, Michael J; Lambert, Trevor

2016-05-23

Identifying factors that improve job satisfaction of new doctors and ease the difficult transition from student to doctor is of great interest to public health agencies. Studies to date have focused primarily on the value of changes to medical school curricula and induction processes in this regard, but have overlooked the extent to which institutional support can influence new doctors' enjoyment of and attitude to work. Here, we examine variation in the perceived level of support received by new medical graduates in the United Kingdom (UK) from their employer and whether this influences enjoyment of and attitudes to the first postgraduate year, and whether doctors who perceived a lower level of support were less inclined to intend a long term career in medicine in the UK. All UK medical graduates of 2012 were surveyed in 2013 in a cross-sectional study, towards the end of their first post-graduate year (the 'F1' year of the 2-year Foundation Training Programme for new UK doctors). We used linear regression to assess whether the level of support doctors reported receiving from their employing Trust (Very Good, Good, Adequate, Poor, or Very Poor) was associated with the extent to which they enjoyed their F1 year. Similarly, we assessed the strength of associations between self-reported level of Trust support and doctors' responses to 12 statements about fundamental aspects of their working lives, each assessed on a 5-point scale of agreement. Using χ (2) tests we examined whether doctors' intentions to practise medicine in the UK varied with the level of support they reported receiving from their Trust. The response rate was 45 % (2324/5171). Of 2324 responding junior doctors, 63.8 % reported receiving 'Very Good' (23.6 %) or 'Good' (40.2 %) initial support from their Trust, while a further 27.4 % stated they received 'Adequate' support. 'Poor' support was reported by 5.8 % and 'Very Poor' support by 2.2 %. We found very strong positive associations between the institutional support doctors reported receiving and their enjoyment of the F1 year and their self-expressed attitudes to aspects of their first year of work. Crucially, doctors who reported receiving lower levels of support ('Poor' or 'Very Poor') were significantly less likely to express intentions to continue practising medicine in the UK. The provision of effective institutional support for graduate doctors may promote workplace satisfaction and could help safeguard the long-term retention of junior doctors.

The Effect of Bilingualism on Self-Perceived Multicultural Counseling Competence

ERIC Educational Resources Information Center

Ivers, Nathaniel N.; Villalba, José A.

2015-01-01

Ethnic and linguistic minorities continue to underutilize and prematurely terminate counseling services at higher rates than their ethnic majority counterparts. To improve the provision of counseling services to culturally diverse clients, new avenues supported by theory and research need to be uncovered. One factor that has received little…

Reading Instruction in Science for Students with Learning Disabilities

ERIC Educational Resources Information Center

Kaldenberg, Erica R.; Watt, Sarah J.; Therrien, William J.

2015-01-01

As a growing number of students with learning disabilities (LD) receive science instruction in general education settings, students with LD continue to perform significantly lower than their non-disabled peers. The shift from textbook-driven instruction to inquiry-based approaches to science learning supports students who struggle with reading.…

ArtBreak Group Counseling for Children: Framework, Practice Points, and Results

ERIC Educational Resources Information Center

Ziff, Katherine; Ivers, Nathaniel N.; Shaw, Edward G.

2016-01-01

Child social/emotional development and mitigation of child stress are receiving continued emphasis in the literature. While choice-based group art studios have a long association with mental health, documentation on their potential for supporting children is limited. This article describes an elementary school counseling intervention designed to…

Receiving Gifts from Commercial Companies. Part 1: The Need for General Institutional Guidelines. Part 2: Example of General Institutional Guidelines.

ERIC Educational Resources Information Center

Harrison, R. Van

1994-01-01

General institutional guidelines for gifts from commercial companies are needed, in light of national trends. Commercially supported continuing medical education, those concerning personal gifts to physicians, and conflict of interest and research are areas to be considered. (SK)

The 1981-82 Student Services Fee Survey.

ERIC Educational Resources Information Center

Matross, Ron; And Others

1981-01-01

Student perceptions and usage of selected services and organizations that receive student services fee support at the University of Minnesota Twin Cities campus were surveyed. Respondents were 417 continuing, fee-paying, nonforeign, day students. Key findings include: 60 percent said the fee should be increased enough to keep pace with inflation;…

Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs

ERIC Educational Resources Information Center

Finch, Andrew J.; Moberg, D. Paul; Krupp, Amanda Lawton

2014-01-01

Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance…

Supporting Quality Teachers with Recognition

ERIC Educational Resources Information Center

Andrews, Hans A.

2011-01-01

Value has been found in providing recognition and awards programs for excellent teachers. Research has also found a major lack of these programs in both the USA and in Australia. Teachers receiving recognition and awards for their teaching have praised recognition programs as providing motivation for them to continue high-level instruction.…

Callers’ attitudes and experiences of UK breastfeeding helpline support

PubMed Central

2013-01-01

Background Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers’ experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). Methods A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers’ experiences of the help and support received via the breastfeeding helpline(s). Results Overall satisfaction with the helpline was high, with the vast majority of callers’ recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of ‘contact with the helplines’; ‘experiences of the helpline service’, ‘perceived effectiveness of support provision’ and ‘impact on caller wellbeing’. Conclusion Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women’s breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted. PMID:23628104

DART Support for Hurricane Matthew

NASA Image and Video Library

2016-10-26

Following Hurricane Matthew, repairs have been made to the roof of the Operations Support Building (OSB) II in the Launch Complex 39 area at NASA's Kennedy Space Center in Florida. Assessments and repairs continue on various structures and facilities across the spaceport, part of the ongoing recovery from the storm, which passed to the east of Kennedy on Oct. 6 and 7, 2016. The center received some isolated roof damage, damaged support buildings, a few downed power lines, and limited water intrusion. Beach erosion also occurred, although the storm surge was less than expected.

Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis.

PubMed

Rodríguez-Álvarez, María Xosé; Roca-Pardiñas, Javier; Cadarso-Suárez, Carmen; Tahoces, Pablo G

2018-03-01

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

Department of the Navy Supporting Data for Fiscal Year 1983 Budget Estimates Descriptive Summaries Submitted to Congress February 1982. Research, Development, Test and Evaluation, Navy. Book 2 of 3. Tactical Programs.

DTIC Science & Technology

1982-02-01

control unit will detect and classify submerged submarins transiting within PJ The EnCAPsulated pedo augments air, surface and submarine anti...vidicon (date link video enhancement). Conduct Operational Test and Evaluation. Complete Large Scale Integration Receiver-Decoder improvement. Continue...analysis, and data link video enhancement focusing on application of a new silicon vidicon was continued; data link improvements such as adaptive null

How is agitation and restlessness managed in the last 24 h of life in patients whose care is supported by the Liverpool care pathway for the dying patient?

PubMed

Gambles, M; McGlinchey, T; Latten, R; Dickman, A; Lowe, D; Ellershaw, J E

2011-12-01

Guidance regarding the patient centred management of agitation and restlessness reinforces the importance of considering underlying causes, non-pharmacological approaches to treatment and judicious use of medications titrated to patient need. In contrast, recent reports in the literature suggest that the practice of continuous deep sedation until death is prevalent in the UK. To use data from the National Care of the Dying Audit-Hospitals (NCDAH) to explore the administration of medication for management of agitation and restlessness in the last 24 h of life. Hospitals submitted data from up to 30 consecutive adult patients whose care in the final hours/days of life was supported by the Liverpool Care Pathway for the Dying Patient (LCP). Data on the total dose received in the last 24 h of life PRN and the last dose prescribed for administration via continuous subcutaneous infusion (CSCI) for agitation and restlessness were submitted. 155 hospitals provided data from 3893 patients. Median total doses in the last 24 h for midazolam, haloperidol and levomepromazine, respectively, were: PRN only, 2.5, 1.5 and 6.25 mg; CSCI only, 10, 3 and 6.25 mg; PRN+CSCI, 15, 3 and 12.5 mg. Only 51% of patients received medication to alleviate agitation and restlessness in the last 24 h of life. Median doses were low in comparison to doses recommended for continuous deep sedation, suggesting that there is no 'blanket' policy for continuous deep sedation at the end of life for patients whose care is supported by the LCP.

Korean Elderly in America: Acculturation and Changes in Life Style.

ERIC Educational Resources Information Center

Koh, Yang K.; Bell, William G.

As the numbers of Korean immigrants, particularly Korean elders continues to increase, their adjustment problems and service needs are beginning to receive attention in communities with a large influx of Asian immigrants. To examine Korean elders' use of filial and formal support systems in dealing with their problems, 151 older Koreans living in…

The Manager's Role in Enhancing the Transfer of Training: A Turkish Case Study.

ERIC Educational Resources Information Center

Gumuseli, Ali Ilker; Ergin, Banu

2002-01-01

Of 20 Turkish sales representatives, 8 received support and guidance for transfer of training. Compared with 12 controls, these 8 showed continuous work behavior change; the control group's changes slowed over time. Experimentals had greater but not significantly increased efficiency, effectiveness, and job satisfaction. Other factors, such as an…

Supporting University Learning through Mobile Technologies: A Global Perspective

ERIC Educational Resources Information Center

Mugo, David Gitumu; Njagi, Kageni; Chemwei, Bernard; Gakuru, Paul Maina

2015-01-01

The workplace in the modern world continues to demand higher qualifications and refined competencies. In the recent past, workers would respond to such demands through learning by correspondence. When the Internet and e-Learning emerged, it received widespread accolade as a solution to the challenges experienced by distant learners. The technology…

The Need of Safety-Net Programme for a Mass Education System

ERIC Educational Resources Information Center

Wong, Edwin K. P.; Ngai, Sze Wan Emily; Lo, King Shuen

2006-01-01

Background: The Project Yi Jin (PYJ), an alternative pathway for secondary school leavers and adults to further their education, has been receiving full support from the government, the Federation for Continuing Education in Tertiary Institutions (FCE) in Hong Kong and the public. Graduates of PYJ have the equivalent academic status of their…

Refining the Use of Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants.

PubMed

Manley, Brett J; Roberts, Calum T; Frøisland, Dag H; Doyle, Lex W; Davis, Peter G; Owen, Louise S

2018-05-01

To identify clinical and demographic variables that predict nasal high-flow (nHF) treatment failure when used as a primary respiratory support for preterm infants. This secondary analysis used data from a multicenter, randomized, controlled trial comparing nHF with continuous positive airway pressure as primary respiratory support in preterm infants 28-36 completed weeks of gestation. Treatment success or failure with nHF was determined using treatment failure criteria within the first 72 hours after randomization. Infants in whom nHF treatment failed received continuous positive airway pressure, and were then intubated if failure criteria were again met. There were 278 preterm infants included, with a mean gestational age (GA) of 32.0 ± 2.1 weeks and a birth weight of 1737 ± 580 g; of these, nHF treatment failed in 71 infants (25.5%). Treatment failure was moderately predicted by a lower GA and higher prerandomization fraction of inspired oxygen (FiO 2 ): area under a receiver operating characteristic curve of 0.76 (95% CI, 0.70-0.83). Nasal HF treatment success was more likely in infants born at ≥30 weeks GA and with prerandomization FiO 2 <0.30. In preterm infants ≥28 weeks' GA enrolled in a randomized, controlled trial, lower GA and higher FiO 2 before randomization predicted early nHF treatment failure. Infants were more likely to be successfully treated with nHF from soon after birth if they were born at ≥30 weeks GA and had a prerandomization FiO 2 <0.30. However, even in this select population, continuous positive airway pressure remains superior to nHF as early respiratory support in preventing treatment failure. Australian New Zealand Clinical Trials Registry: ACTRN12613000303741. Copyright © 2018 Elsevier Inc. All rights reserved.

The effects of new media for emergency tornado notification on the digital divide

NASA Astrophysics Data System (ADS)

Meyers, Stephanie

This study explored the possible continued existence of a digital divide as it related to how residents in two disperse communities received notification of late season tornado events in 2013. The theoretical perspective of the Diffusion of Innovations, Knowledge Gap and Structuration theories were used to examine how notifications were received based on socioeconomic indicators of total household income and education affected the ability for respondents to be notified of the impending danger. Results varied for the communities surveyed, both supporting and negating how specific socioeconomic factors influence how respondents received notifications and the behavior they took after the message was received. Findings of the study indicate that higher total household income and higher education are often times associated with how respondents receive warnings of tornadoes in their area, but associations are not always consistent. Findings of this study show differences in how each community receives and reacts to tornado warnings.

Young men's perspectives on family support and disclosure of same-sex attraction

PubMed Central

Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

2011-01-01

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM’s (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support. PMID:21423842

Young men's perspectives on family support and disclosure of same-sex attraction.

PubMed

Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

2008-06-01

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM's (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support.

Ground test program for a full-size solar dynamic heat receiver

NASA Technical Reports Server (NTRS)

Sedgwick, L. M.; Kaufmann, K. J.; Mclallin, K. L.; Kerslake, T. W.

1991-01-01

Test hardware, facilities, and procedures were developed to conduct ground testing of a full-size, solar dynamic heat receiver in a partially simulated, low earth orbit environment. The heat receiver was designed to supply 102 kW of thermal energy to a helium and xenon gas mixture continuously over a 94 minute orbit, including up to 36 minutes of eclipse. The purpose of the test program was to quantify the receiver thermodynamic performance, its operating temperatures, and thermal response to changes in environmental and power module interface boundary conditions. The heat receiver was tested in a vacuum chamber using liquid nitrogen cold shrouds and an aperture cold plate. Special test equipment was designed to provide the required ranges in interface boundary conditions that typify those expected or required for operation as part of the solar dynamic power module on the Space Station Freedom. The support hardware includes an infrared quartz lamp heater with 30 independently controllable zones and a closed-Brayton cycle engine simulator to circulate and condition the helium-xenon gas mixture. The test article, test support hardware, facilities, and instrumentation developed to conduct the ground test program are all described.

Ground test program for a full-size solar dynamic heat receiver

NASA Technical Reports Server (NTRS)

Sedgwick, L. M.; Kaufmann, K. J.; Mclallin, K. L.; Kerslake, T. W.

1991-01-01

Test hardware, facilities, and procedures were developed to conduct ground testing of a full size, solar dynamic heat receiver in a partially simulated, low Earth orbit environment. The heat receiver was designed to supply 102 kW of thermal energy to a helium and xenon gas mixture continuously over a 94 minute orbit, including up to 36 minutes of eclipse. The purpose of the test program was to quantify the receiver thermodynamic performance, its operating temperatures, and thermal response to changes in environmental and power module interface boundary conditions. The heat receiver was tested in a vacuum chamber using liquid nitrogen cold shrouds and an aperture cold plate. Special test equipment were designed to provide the required ranges in interface boundary conditions that typify those expected or required for operation as part of the solar dynamic power module on the Space Station Freedom. The support hardware includes an infrared quartz lamp heater with 30 independently controllable zones and a closed Brayton cycle engine simulator to circulate and condition the helium xenon gas mixture. The test article, test support hardware, facilities, and instrumentation developed to conduct the ground test program are all described.

Ground test program for a full-size solar dynamic heat receiver

NASA Astrophysics Data System (ADS)

Sedgwick, L. M.; Kaufmann, K. J.; McLallin, K. L.; Kerslake, T. W.

Test hardware, facilities, and procedures were developed to conduct ground testing of a full-size, solar dynamic heat receiver in a partially simulated, low earth orbit environment. The heat receiver was designed to supply 102 kW of thermal energy to a helium and xenon gas mixture continuously over a 94 minute orbit, including up to 36 minutes of eclipse. The purpose of the test program was to quantify the receiver thermodynamic performance, its operating temperatures, and thermal response to changes in environmental and power module interface boundary conditions. The heat receiver was tested in a vacuum chamber using liquid nitrogen cold shrouds and an aperture cold plate. Special test equipment was designed to provide the required ranges in interface boundary conditions that typify those expected or required for operation as part of the solar dynamic power module on the Space Station Freedom. The support hardware includes an infrared quartz lamp heater with 30 independently controllable zones and a closed-Brayton cycle engine simulator to circulate and condition the helium-xenon gas mixture. The test article, test support hardware, facilities, and instrumentation developed to conduct the ground test program are all described.

Aerospace Medicine and Biology: A Continuing Bibliography. Supplement 483

NASA Technical Reports Server (NTRS)

1999-01-01

Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Improved survival of newborns receiving leukocyte transfusions for sepsis

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

Cairo, M.S.; Rucker, R.; Bennetts, G.A.

To determine the role of polymorphonuclear (PMN) leukocyte transfusions in neonates with sepsis, 23 consecutive newborns were prospectively randomly selected during an 18-month period in a treatment plan to receive polymorphonuclear leukocyte transfusions with supportive care or supportive care alone. Thirteen neonates received transfusions every 12 hours for a total of five transfusions. Each transfusion consisting of 15 mL/kg of polymorphonuclear leukocytes was subjected to 1,500 rads of radiation. The polymorphonuclear leukocytes were obtained by continuous-flow centrifugation leukapheresis and contained 0.5 to 1.0 X 10(9) granulocytes per 15 mL with less than 10% lymphocytes. Positive findings on blood cultures weremore » obtained in 14/23 patients and seven were randomly selected for each treatment group. Absolute granulocyte counts were less than 1,500/microL in 13 patients but tibial bone marrow examinations revealed that the neutrophil supply pool was depleted in only three patients. The survival was significantly greater in the treatment group compared with the group that did not receive transfusions.« less

Where are they now? - A case study of the impact of international travel support for early career Arctic researchers

NASA Astrophysics Data System (ADS)

Majaneva, Sanna; Hamon, Gwénaëlle; Fugmann, Gerlis; Lisowska, Maja; Baeseman, Jenny

2016-09-01

Supporting and training the next generation of researchers is crucial to continuous knowledge and leadership in Arctic research. An increasing number of Arctic organizations have developed initiatives to provide travel support for Early Career Researchers (ECRs) to participate in workshops, conferences and meetings and to network with internationally renowned scientific leaders. However, there has been little evaluation of the effectiveness of these initiatives. As a contribution to the 3rd International Conference on Arctic Research Planning, a study was conducted to analyze the career paths of ECRs who received travel funding from the International Arctic Science Committee between the start of the International Polar Year (2007-2008) and 2013. Two surveys were used: one sent to ECRs who received IASC travel support and one as a specific event study to those unsuccessfully applied for IASC travel support to the IPY 2010 Conference. The results of the surveys indicate that travel support was beneficial to both the research and careers of the respondents, especially if the ECR was engaged with a task or responsibility at the event. Survey responses also included suggestions on how funds could be better used to support the next generation of Arctic researchers.

Australian midwifery students and the continuity of care experience--getting it right.

PubMed

Sidebotham, Mary

2014-09-01

The evidence base supporting the value to be gained by women and babies from receiving continuity of care from a known midwife is growing; it is essential, therefore, that we nurture the future workforce to work within this model of care. The Australian National Midwifery Education Standards mandate that midwifery students provide continuity of care to 20 women as part of their practice requirements. The educational value to students and the degree of preparation this provides for future work patterns is well acknowledged. There is also growing evidence that women, too, benefit from having a student follow them through the pregnancy journey. This paper examines the experience of some students working within this model and comments on the importance of providing a flexible programme delivery model and supportive midwifery educators in order to sustain and develop this innovative approach to completing clinical practice requirements within a midwifery education programme.

Developing leadership talent: a statewide nurse leader mentorship program.

PubMed

Rich, Mary; Kempin, Bettyann; Loughlin, Mary Jo; Vitale, Tracy R; Wurmser, Theresa; Thrall, Terese Hudson

2015-02-01

Nurse leaders continue to seek support programs essential for advancement to senior roles. Providing such support presents a challenge for the future of nursing in the state of New Jersey and on a national level. This article discusses the creation of a mentorship program by the Organization of Nurse Executives of New Jersey (ONE NJ). In recognition of the program, which has contributed to the advancement of New Jersey nursing leadership, the ONE NJ received the 2014 American Organization of Nurse Executives Chapter Achievement Award.

Robust and Cost-Efficient Communication Based on SNMP in Mobile Networks

NASA Astrophysics Data System (ADS)

Ryu, Sang-Hoon; Baik, Doo-Kwon

A main challenge in the design of this mobile network is the development of dynamic routing protocols that can efficiently find routes between two communicating nodes. Multimedia streaming services are receiving considerable interest in the mobile network business. An entire mobile network may change its point of attachment to the Internet. The mobile network is operated by a basic specification to support network mobility called Network Mobility (NEMO) Basic Support. However, NEMO basic Support mechanism has some problem in continuous communication. In this paper, we propose robust and cost-efficient algorithm. And we simulate proposed method and conclude some remarks.

Power line detection system

DOEpatents

Latorre, Victor R.; Watwood, Donald B.

1994-01-01

A short-range, radio frequency (RF) transmitting-receiving system that provides both visual and audio warnings to the pilot of a helicopter or light aircraft of an up-coming power transmission line complex. Small, milliwatt-level narrowband transmitters, powered by the transmission line itself, are installed on top of selected transmission line support towers or within existing warning balls, and provide a continuous RF signal to approaching aircraft. The on-board receiver can be either a separate unit or a portion of the existing avionics, and can also share an existing antenna with another airborne system. Upon receipt of a warning signal, the receiver will trigger a visual and an audio alarm to alert the pilot to the potential power line hazard.

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

PubMed

Lycett, Deborah; Hajek, Peter; Aveyard, Paul

2010-10-07

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

Using smartphones to decrease substance use via self-monitoring and recovery support: study protocol for a randomized control trial.

PubMed

Scott, Christy K; Dennis, Michael L; Gustafson, David H

2017-08-10

Alcohol abuse, other substance use disorders, and risk behaviors associated with the human immunodeficiency virus (HIV) represent three of the top 10 modifiable causes of mortality in the US. Despite evidence that continuing care is effective in sustaining recovery from substance use disorders and associated behaviors, patients rarely receive it. Smartphone applications (apps) have been effective in delivering continuing care to patients almost anywhere and anytime. This study tests the effectiveness of two components of such apps: ongoing self-monitoring through Ecological Momentary Assessments (EMAs) and immediate recovery support through Ecological Momentary Interventions (EMIs). The target population, adults enrolled in substance use disorder treatment (n = 400), are being recruited from treatment centers in Chicago and randomly assigned to one of four conditions upon discharge in a 2 × 2 factorial design. Participants receive (1) EMAs only, (2) EMIs only, (3) combined EMAs + EMIs, or (4) a control condition without EMA or EMI for 6 months. People in the experimental conditions receive smartphones with the apps (EMA and/or EMI) specific to their condition. Phones alert participants in the EMA and EMA + EMI conditions at five random times per day and present participants with questions about people, places, activities, and feelings that they experienced in the past 30 min and whether these factors make them want to use substances, support their recovery, or have no impact. Those in the EMI and EMA + EMI conditions have continual access to a suite of support services. In the EMA + EMI condition, participants are prompted to use the EMI(s) when responses to the EMA(s) indicate risk. All groups have access to recovery support as usual. The primary outcome is days of abstinence from alcohol and other drugs. Secondary outcomes are number of HIV risk behaviors and whether abstinence mediates the effects of EMA, EMI, or EMA + EMI on HIV risk behaviors. This project will enable the field to learn more about the effects of EMAs and EMIs on substance use disorders and HIV risk behaviors, an understanding that could potentially make treatment and recovery more effective and more widely accessible. ClinicalTrials.gov, ID: NCT02132481 . Registered on 5 May 2014.

The Behavior Education Support and Treatment (BEST) school intervention program: pilot project data examining schoolwide, targeted-school, and targeted-home approaches.

PubMed

Waschbusch, Daniel A; Pelham, William E; Massetti, Greta

2005-08-01

As part of a pilot project, four elementary schools were randomly assigned to receive one of four interventions: (a) a schoolwide intervention that incorporated universal and targeted treatment, (b) a targeted-school intervention delivered to individual students in regular and special education classrooms, (c) a targeted-home intervention delivered in home and regular classroom settings, and (d) a control condition that did not receive a designated intervention. Results showed that the behavior of disruptive children in all schools improved during the course of the year, with some evidence that interventions provided complementary effects. These findings support the continued use of behavioral interventions in elementary schools and argue for interventions that combine different methods of delivering interventions.

Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

PubMed Central

2008-01-01

BACKGROUND The optimal intensity of renal-replacement therapy in critically ill patients with acute kidney injury is controversial. METHODS We randomly assigned critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis to receive intensive or less intensive renal-replacement therapy. The primary end point was death from any cause by day 60. In both study groups, hemodynamically stable patients underwent intermittent hemodialysis, and hemodynamically unstable patients underwent continuous venovenous hemodiafiltration or sustained low-efficiency dialysis. Patients receiving the intensive treatment strategy underwent intermittent hemodialysis and sustained low-efficiency dialysis six times per week and continuous venovenous hemodiafiltration at 35 ml per kilogram of body weight per hour; for patients receiving the less-intensive treatment strategy, the corresponding treatments were provided thrice weekly and at 20 ml per kilogram per hour. RESULTS Baseline characteristics of the 1124 patients in the two groups were similar. The rate of death from any cause by day 60 was 53.6% with intensive therapy and 51.5% with less-intensive therapy (odds ratio, 1.09; 95% confidence interval, 0.86 to 1.40; P = 0.47). There was no significant difference between the two groups in the duration of renalreplacement therapy or the rate of recovery of kidney function or nonrenal organ failure. Hypotension during intermittent dialysis occurred in more patients randomly assigned to receive intensive therapy, although the frequency of hemodialysis sessions complicated by hypotension was similar in the two groups. CONCLUSIONS Intensive renal support in critically ill patients with acute kidney injury did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with less-intensive therapy involving a defined dose of intermittent hemodialysis three times per week and continuous renal-replacement therapy at 20 ml per kilogram per hour. (ClinicalTrials.gov number, NCT00076219.) PMID:18492867

A surprising discovery of American pika sites in the northwest Great Basin

Treesearch

Mackenzie R. Jeffress; K. Jane Van Gunst; Constance I. Millar

2017-01-01

Although the American pika (Ochotona princeps) continues to receive attention due to documented declines and range retractions, particularly in the Great Basin, thorough range inventories have yet to be completed in many parts of the region. Here we report on recently discovered populations in northwestern Nevada in areas not suspected to support...

Parent Educators in Early Intervention: Insights from Evaluations

ERIC Educational Resources Information Center

Edwards, Nicole Megan; Gallagher, Peggy A.

2014-01-01

In 1 state's Part C early intervention (EI) program, families are afforded a unique opportunity to connect with parent educators (PEs), parents of children who have received EI services, and who are trained to support EI families and staff with a range of tailored duties. In an effort to continually reflect and improve upon the role of PEs, the…

A Systemic Approach to Implementing Response to Intervention in Three Colorado High Schools

ERIC Educational Resources Information Center

Duffy, Helen; Scala, Jenny

2012-01-01

The National High School Center continues to receive inquiries about how to support high school implementation of response to intervention (RTI). Given the National High School Center's previous work on the topic, the authors wanted to better understand the conditions that contribute to or inhibit implementation of tiered frameworks in high…

76 FR 68505 - Solicitation for a Cooperative Agreement-Production of Five Live Satellite/Internet Broadcasts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

... one location as participants/students receive instruction at other locations via technology. NIC uses... learning, continually seeks to use and integrate various forms of visual technology to support and enhance... used by NIC to enhance other training projects; up to 20 short 10- to 15-second video bumps designed...

Is anti-platelet therapy needed in continuous flow left ventricular assist device patients? A single-centre experience.

PubMed

Litzler, Pierre-Yves; Smail, Hassiba; Barbay, Virginie; Nafeh-Bizet, Catherine; Bouchart, François; Baste, Jean-Marc; Abriou, Caroline; Bessou, Jean-Paul

2014-01-01

We report our 5-year experience of continuous flow left ventricular assist device (LVAD) implantation without the use of anti-platelet therapy. Between February 2006 and September 2011, 27 patients (26 men; 1 woman) were implanted with a continuous flow LVAD (HeartMate II, Thoratec Corporation, Pleasanton, CA, USA). The mean age was 55.7 ± 9.9 years. The mean duration of support was 479 ± 436 (1-1555) days with 35.4 patient-years on support. Twenty-one patients were implanted as a bridge to transplantation and 6 for destination therapy. The anticoagulation regimen was fluindione for all patients, with aspirin for only 4 patients. At the beginning of our experience, aspirin was administered to 4 patients for 6, 15, 60 and 460 days. Due to gastrointestinal (GI) bleeding and epistaxis, aspirin was discontinued, and since August 2006, no patients have received anti-platelet therapy. At 3 years, the survival rate during support was 76%. The most common postoperative adverse event was GI bleeding (19%) and epistaxis (30%) (median time: 26 days) for patients receiving fluindione and aspirin. The mean International Normalized Ratio (INR) was 2.58 ± 0.74 during support. Fifteen patients have been tested for acquired Von Willebrand disease. A diminished ratio of collagen-binding capacity and ristocetin cofactor activity to Von Willebrand factor antigen was observed in 7 patients. In the postoperative period, 2 patients presented with ischaemic stroke at 1 and 8 months. One of these 2 patients had a previous history of carotid stenosis with ischaemic stroke. There were no patients with haemorrhagic stroke, transient ischaemic attack or pump thrombosis. The event rate of stroke (ischaemic and haemorrhagic) per patient-year was 0.059 among the patients without aspirin with fluindione regimen only. A fluindione regimen without aspirin in long-duration LVAD support appears to not increase thromboembolic events and could lead to a diminished risk of haemorrhagic stroke.

Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS

PubMed Central

Mehl-Madrona, Lewis; Renfrew, Nita M; Mainguy, Barbara

2011-01-01

Introduction: Reiki is a Japanese form of energy healing that has become popular in the US. Reiki training involves three stages—levels I, II, and III—to a master practitioner level and requires both giving and receiving Reiki. We set out to implement a program to train clients of a supported residence in Brooklyn, NY. They were all older than age 50 years and had HIV/AIDS and substance-abuse and/or mental-health disorders. Methods: A qualitative, narrative-inquiry study was conducted. The Reiki master kept a journal of her 3 years of providing 90 minutes of Reiki treatment and/or training once weekly at the residence. Forty-five of 50 potential participants attended these sessions with various frequencies. Stories were collected from 35 participants regarding their experience of Reiki training. We posited success as continued involvement in the program. Results: All 35 participants reported receiving benefit from participation in Reiki. Participants first took part in training because of the offered subway tokens; however, 40 continued their involvement despite a lack of compensation. When asked why they continued, participants reported life-changing experiences, including a greater ability to cope with addictions, a greater ability to manage counseling, healing of wounds, improvement of T-cell counts, and improved skills of daily living. Conclusion: Reiki training can be successfully implemented in a supported housing facility with people with HIV/AIDS and comorbid disorders. Some people in our study population reported areas of improvement and life-changing experiences. Our study did not establish the efficacy of Reiki, but our findings support the effect of the entire gestalt of implementing a program related to spirituality and healing and supports the goal of implementing a larger randomized, controlled trial in this setting to establish the efficacy of Reiki. PMID:22058669

Programmable rate modem utilizing digital signal processing techniques

NASA Technical Reports Server (NTRS)

Bunya, George K.; Wallace, Robert L.

1989-01-01

The engineering development study to follow was written to address the need for a Programmable Rate Digital Satellite Modem capable of supporting both burst and continuous transmission modes with either binary phase shift keying (BPSK) or quadrature phase shift keying (QPSK) modulation. The preferred implementation technique is an all digital one which utilizes as much digital signal processing (DSP) as possible. Here design tradeoffs in each portion of the modulator and demodulator subsystem are outlined, and viable circuit approaches which are easily repeatable, have low implementation losses and have low production costs are identified. The research involved for this study was divided into nine technical papers, each addressing a significant region of concern in a variable rate modem design. Trivial portions and basic support logic designs surrounding the nine major modem blocks were omitted. In brief, the nine topic areas were: (1) Transmit Data Filtering; (2) Transmit Clock Generation; (3) Carrier Synthesizer; (4) Receive AGC; (5) Receive Data Filtering; (6) RF Oscillator Phase Noise; (7) Receive Carrier Selectivity; (8) Carrier Recovery; and (9) Timing Recovery.

“Staying for the children”: The role of natal relatives in supporting women experiencing intimate partner violence during pregnancy in northern Tanzania – A qualitative study

PubMed Central

Mushi, Declare; Gammeltoft, Tine

2018-01-01

Introduction Intimate partner violence (IPV) is a global health and human rights problem. In Tanzania, national studies have shown that half of all women experience partner violence in their lifetime, 38% reported being abused during a period of 12 months and 30% during pregnancy. Despite the benefits of social support to women victims of violence during pregnancy, a majority of women hesitate to seek help and, if they do, they mainly turn to their natal relatives for support. However, this process of help-seeking and the type of support received is not well documented and needs to be explored with a view to future interventions. This article investigates women’s own perspectives on the support they receive from natal relatives when experiencing IPV during pregnancy. Materials and methods Eighteen participants who experienced physical IPV during pregnancy were purposively selected from a cohort of 1,116 pregnant women enrolled in a project that aimed at assessing the impact of intimate partner violence on reproductive health. In-depth interviews were used to explore the social support received from the natal family among women who experienced partner violence during pregnancy. All interviews were audio recorded, transcribed, coded and analyzed. Results Women who experienced severe IPV during pregnancy were more likely to seek help from natal relatives. Severe violence was defined by the women as acts that occurred frequently and/or resulted in injury. The women’s natal relatives were willing to provide the support; however, they strongly encouraged women to maintain their marriage so that they could continue caring for their children jointly with their partners. Emotional support was the commonest form of support and included showing love and empathy and praying. Information provided to victims aimed mainly at advising them to maintain their marriage. Practical support included direct financial support and building their economic base to reduce dependency on their partners. When the couple was on the verge of separation, mediation was provided to save the marriage. Conclusion Women who experienced partner violence preferred to seek help from their natal relatives. The support provided by natal relatives was beneficial; however, maintaining the marriage for the care of children and family was given the highest priority, over separation. As a consequence, many women continued to live with violence. Stakeholders supporting victims of violence need to understand the priorities of victims of violence and structure intervention to address their needs. PMID:29856784

Aerospace Medicine and Biology: A Continuing Bibliography. Supplement 476

NASA Technical Reports Server (NTRS)

1998-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1998-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

"It Was the Only Thing I Could Hold Onto, But…": Receiving a Letter of Condolence After Loss of a Loved One in the ICU: A Qualitative Study of Bereaved Relatives' Experience.

PubMed

Kentish-Barnes, Nancy; Cohen-Solal, Zoé; Souppart, Virginie; Galon, Marion; Champigneulle, Benoît; Thirion, Marina; Gilbert, Marion; Lesieur, Olivier; Renault, Anne; Garrouste-Orgeas, Maïté; Argaud, Laurent; Venot, Marion; Demoule, Alexandre; Guisset, Olivier; Vinatier, Isabelle; Troché, Gilles; Massot, Julien; Jaber, Samir; Bornstain, Caroline; Gaday, Véronique; Robert, René; Rigaud, Jean-Philippe; Cinotti, Raphaël; Adda, Mélanie; Thomas, François; Azoulay, Elie

2017-12-01

Family members of patients who die in the ICU often remain with unanswered questions and suffer from lack of closure. A letter of condolence may help bereaved relatives, but little is known about their experience of receiving such a letter. The objective of the study was to understand bereaved family members' experience of receiving a letter of condolence. Qualitative study using interviews with bereaved family members who received a letter of condolence and letters written by these family members to the ICU team. This study was designed to provide insight into the results of a larger randomized, controlled, multicenter study. Twenty-two ICUs in France. Family members who lost a loved one in the ICU and who received a letter of condolence. Thematic analysis was used and was based on 52 interviews and 26 letters. Six themes emerged: 1) a feeling of support, 2) humanization of the medical system, 3) an opportunity for reflection, 4) an opportunity to describe their loved one, 5) continuity and closure, and 6) doubts and ambivalence. Possible difficulties emerged, notably the re-experience of the trauma, highlighting the absence of further support. This study describes the benefits of receiving a letter of condolence; mainly, it humanizes the medical institution (feeling of support, confirmation of the role played by the relative, supplemental information). However, this study also shows a common ambivalence about the letter of condolence's benefit. Healthcare workers must strive to adapt bereavement follow-up to each individual situation.

Evaluating nurse prescribers' education and continuing professional development for independent prescribing practice: findings from a national survey in England.

PubMed

Latter, Sue; Maben, Jill; Myall, Michelle; Young, Amanda

2007-10-01

The number of nurses able to independently prescribe medicines in England has risen steadily in recent years. To evaluate the adequacy of nurses' educational preparation for independent prescribing and to describe nurses' experiences of their continuing professional development as prescribers in practice. Postal questionnaire survey. Random sample of 246 nurses registered as nurse independent prescribers with the Nursing and Midwifery Council. The majority of nurses considered that the initial taught course element of their education programme met their needs, either to some extent (61% 151/246), or completely (22% 54/246). Most nurses (77% 190/246) received the specified 12 days support from their supervising medical practitioner and most were satisfied and positive about this experience. Nearly all of the nurses (>95%) reported that they were able to maintain a range of specified prescribing competencies in practice. Two thirds (62% 152/246) of the sample reported that they were receiving support/supervision for prescribing. Ninety five per cent (233/246) of the sample also reported that they engaged in self-directed informal continuing professional development, but only half of the sample had experience of formally provided professional development opportunities. Approximately half (52% 127/246) of the sample identified needs for continuing professional development. This first national survey of the education and professional development experiences of nurse independent prescribers in England provides evidence which highlights areas in which national policy is working well, and also points up issues which may need addressing as the roll out of nurse prescribing continues. The study also highlights characteristics and issues that health care policy makers and nurse educationalists internationally may wish to consider in developing and refining their own nurse prescriber education programmes.

Academic Continuity and School Reentry Support as a Standard of Care in Pediatric Oncology.

PubMed

Thompson, Amanda L; Christiansen, Heather L; Elam, Megan; Hoag, Jennifer; Irwin, Mary Kay; Pao, Maryland; Voll, Megan; Noll, Robert B; Kelly, Katherine Patterson

2015-12-01

Clinicians agree that return to school after diagnosis promotes the positive adjustment of children and adolescents with cancer; however, the school reentry process can present challenges. The aim of this review was to critically evaluate the literature on school reentry support for youth with cancer. Seventeen publications were identified. School reentry services were well-received by families and educators; increased teacher and peer knowledge about childhood cancer; influenced peer and educator attitudes toward the patient; and improved communication and collaboration between patients/families, school, and the healthcare team. Evidence supports a strong recommendation for school reentry support for youth with cancer. © 2015 Wiley Periodicals, Inc.

Prescription for Learning? Meeting the Development Needs of the Pharmacy Profession.

ERIC Educational Resources Information Center

Wilson, Valerie; Schlapp, Ursula; Davidson, Julia

2003-01-01

A survey (n=947) of pharmacists and instructors was compared with 1999 results. Over 90% of both high and low users of formal continuing education also engaged in informal learning. Low users received the most employer support for training. Differences among high, medium, and low users and nonuers suggest a need for diverse formats and services,…

Targeted Radiation Therapy for Cancer Initiative

DTIC Science & Technology

2012-09-01

pelvic floor . Problem Areas: As previously reported, it was unanimously decided to discontinue efforts at VAPSHCS based on several factors...Calypso system, 3) whether Beacon® Transponder is of benefit in pelvic radiation therapy following prostatectomy, 4) whether hypofractionated treatment...Localization System occurred at MAMC. The radiation team continues to receive training and technical support of the system from Calypso as needed

20 CFR 10.417 - What reports are needed when compensation payments continue for children over age 18?

Code of Federal Regulations, 2010 CFR

2010-04-01

... either a student as defined in 5 U.S.C. 8101(17), or physically or mentally incapable of self-support. (b) At least twice each year, OWCP will ask a beneficiary receiving compensation based on the student... herself to submit a medical report verifying that the dependent's medical condition persists and that it...

Big Data in the Campus Landscape: Basic Infrastructure Support. ECAR Working Group Paper

ERIC Educational Resources Information Center

Almes, Guy T.; Zottola, Ralph J.

2014-01-01

This paper is part of series of the EDUCAUSE Center for Analysis and Research Campus Cyberinfrastructure (ECAR-CCI) Working Group. The topic of big data continues to receive a great deal of publicity because of its promise for opening new avenues of scholarly discovery and commercial opportunity. The ability to sift rapidly through massive amounts…

Habitat associations of saproxylic beetles in the southeastern United States: A comparison of forest types, tree species and wood postures.

Treesearch

Michael Ulyshen; James Hanula

2009-01-01

Saproxylic beetles are highly sensitive to forest management practices that reduce the abundance and variety of dead wood. However, this diverse fauna continues to receive little attention in the southeastern United States even though this region supports some of the most diverse, productive and intensively managed forests in North America.

Habitat associations of saproxylic beetles in the southeastern United States: A comparison of forest types, tree species and wood postures.

Treesearch

M.D. Ulyshen; J. L. Hanula

2009-01-01

Saproxylic beetles are highly sensitive to forest management practices that reduce the abundance and variety of dead wood. However, this diverse fauna continues to receive little attention in the southeastern United States even though this region supports some of the most diverse, productive and intensively managed forests in North...

Opioid substitution treatment with sublingual buprenorphine in Manipur and Nagaland in Northeast India: what has been established needs to be continued and expanded

PubMed Central

Kumar, M Suresh; Natale, Richard D; Langkham, B; Sharma, Charan; Kabi, Rachel; Mortimore, Gordon

2009-01-01

Manipur and Nagaland in northeast India report an antenatal HIV prevalence of > 1% and the current HIV prevalence among injecting drug users is 24% and 4.5% respectively. Through support from DFID's Challenge Fund, Emmanuel Hospital Association (EHA) established thirteen drop-in-centres across the two states to deliver opioid substitution treatment with sublingual buprenorphine for 1200 injecting drug users. Within a short span of time the treatment has been found to be attractive to the clients and currently 1248 injecting opioid users are receiving opioid substitution treatment. The project is acceptable to the drug users, the families, the communities, religious as well as the militant groups. The treatment centres operate all days of the week, have trained staff members, utilize standardized protocols and ensure a strict supervised delivery system to prevent illicit diversion of buprenorphine. The drug users receiving the substitution treatment are referred to HIV voluntary counselling and testing. As this treatment has the potential to change HIV related risk behaviours, what has been established in the two states needs to be continued and expanded with the support from the Government of India. PMID:19243636

Power line detection system

DOEpatents

Latorre, V.R.; Watwood, D.B.

1994-09-27

A short-range, radio frequency (RF) transmitting-receiving system that provides both visual and audio warnings to the pilot of a helicopter or light aircraft of an up-coming power transmission line complex. Small, milliwatt-level narrowband transmitters, powered by the transmission line itself, are installed on top of selected transmission line support towers or within existing warning balls, and provide a continuous RF signal to approaching aircraft. The on-board receiver can be either a separate unit or a portion of the existing avionics, and can also share an existing antenna with another airborne system. Upon receipt of a warning signal, the receiver will trigger a visual and an audio alarm to alert the pilot to the potential power line hazard. 4 figs.

High speed semiconductor lasers and integrated receivers for microwave and millimeter wave signal transmission

NASA Technical Reports Server (NTRS)

Eastman, L. F.; Wicks, G. W.

1987-01-01

This project was proposed to be a three-year contract, but was cut off after one year (1987) of support. Sufficient progress was made to allow continuation for a year on minimal internal funds before proper support levels were received from a combination of ONR, RADC, and IBM contracts at about the start of 1989. A major DARPA grant, expected to start August 1, 1990, will sharply expand this effort to include several faculty members. During the course of this project, two students did thesis research, one Ph.D. on lasers and one M.S. on high speed photodetectors. These theses were finished in September 1988, nine months after the contract was cut off. This report covers excerpts from those theses as well as information obtained on other programs since that time.

Transfer from long to short photoperiods affects production efficiency of day-neutral rice

NASA Technical Reports Server (NTRS)

Goldman, K. R.; Mitchell, C. A.

1999-01-01

The day-neutral, semidwarf rice (Oryza sativa L.) cultivar Ai-Nan-Tsao was grown in a greenhouse under summer conditions using high-pressure sodium lamps to extend the natural photoperiod. After allowing 2 weeks for germination, stand establishment, and thinning to a consistent planting density of 212 plants/m2, stands were maintained under continuous lighting for 35 or 49 days before shifting to 8- or 12-h photoperiods until harvest 76 days after planting. Non-shifted control treatments consisting of 8-, 12-, or 24-h photoperiods also were maintained throughout production. Tiller number increased as duration of exposure to continuous light increased before shifting to shorter photoperiods. However, shoot harvest index and yield efficiency rate were lower for all plants receiving continuous light than for those under the 8- or 12-h photoperiods. Stands receiving 12-h photoperiods throughout production had the highest grain yield per plant and equaled the 8-h-photoperiod control plants for the lowest tiller number per plant. As long as stands were exposed to continuous light, tiller formation continued. Shifting to shorter photoperiods late in the cropping cycle resulted in newly formed tillers that were either sterile or unable to mature grain before harvest. Late-forming tillers also suppressed yield of grain in early-forming tillers, presumably by competing for photosynthate or for remobilized assimilate during senescence. Stands receiving 12-h photoperiods throughout production not only produced the highest grain yield at harvest but had the highest shoot harvest index, which is important for resource-recovery strategies in advanced life-support systems proposed for space.

A clinical ladder for occupational health nurses.

PubMed

Lang, Yolanda C

2010-06-01

Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The American Board for Occupational Health Nurses, Inc. encourages advancement with the availability of certification examinations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps necessary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author. Copyright 2010, SLACK Incorporated.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 490

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. Two indexes-subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 498

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 487

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. Two indexes-subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 482

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes. Supplement 502

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-2000-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. Two indexes-subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 489

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 477

NASA Technical Reports Server (NTRS)

1998-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1998-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 478

NASA Technical Reports Server (NTRS)

1998-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1998-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 504

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-2000-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. Two indexes- subject and author are included after the abstract section.

Effect of Neurohormonal Blockade Drug Therapy on Outcomes and Left Ventricular Function and Structure After Left Ventricular Assist Device Implantation.

PubMed

Grupper, Avishay; Zhao, Yanjun M; Sajgalik, Pavol; Joyce, Lyle D; Park, Soon J; Pereira, Naveen L; Stulak, John M; Burnett, John C; Edwards, Brooks S; Daly, Richard C; Kushwaha, Sudhir S; Schirger, John A

2016-06-01

Neurohormonal blockade drug therapy (NHBDT) is the cornerstone therapy in heart failure (HF) management for promoting reverse cardiac remodeling and improving outcomes. It's utility in left ventricular assist device (LVAD) supported patients remains undefined. Sixty-four patients who received continuous flow LVAD at our institution were retrospectively reviewed and divided into 2 groups: no-NHBDT group (n = 33) received LVAD support only and NHBDT group (n = 31) received concurrent NHBDT based on the clinical judgment of the attending physicians. Cardiac remodeling (echocardiographic parameters and biomarkers) and clinical outcome (functional status, HF-related hospital readmissions, and mortality) data were collected. A statistically significant increase in ejection fraction, decrease in LV end-diastolic diameter index and LV mass index, and a sustained reduction in N-terminal pro B-type natriuretic peptide (NTproBNP) were observed in the NHBDT group at 6 months after LVAD implant (p <0.05). NHBDT-treated patients experienced significantly greater improvement in New York Heart Association functional classification and 6-minute-walk distance throughout the study. The combined end point of cardiovascular death or HF hospitalization was significantly reduced in patients receiving NHBDT (p = 0.013) associated primarily with a 12.1% absolute reduction in HF-related hospitalizations (p = 0.046). In conclusion, NHBDT in LVAD-supported patients is associated with a significant reversal in adverse cardiac remodeling and a reduction in morbidity and mortality compared with LVAD support alone. Copyright © 2016 Elsevier Inc. All rights reserved.

Online Continuing Education for Expanding Clinicians' Roles in Breastfeeding Support.

PubMed

Edwards, Roger A; Colchamiro, Rachel; Tolan, Ellen; Browne, Susan; Foley, Mary; Jenkins, Lucia; Mainello, Kristen; Vallu, Rohith; Hanley, Lauren E; Boisvert, Mary Ellen; Forgit, Julie; Ghiringhelli, Kara; Nordstrom, Christina

2015-11-01

Lack of health professional support is an important variable affecting mothers' achievement of breastfeeding goals. Online continuing education is a recognized pathway for disseminating content for improving clinicians' knowledge and supporting efforts to change practices. At the time we developed our project, free, accredited continuing education for physicians related to breastfeeding management that could be easily accessed using portable devices (via tablets/smartphones) was not available. Such resources were in demand, especially for facilities pursuing designation through the Baby-Friendly Hospital Initiative. We assembled a government, academic, health care provider, and professional society partnership to create such a tutorial that would address the diverse content needed for supporting breastfeeding mothers postdischarge in the United States. Our 1.5-hour-long continuing medical and nursing education was completed by 1606 clinicians (1172 nurses [73%] and 434 physicians [27%]) within 1 year. More than 90% of nurses and over 98% of physicians said the tutorial achieved its 7 learning objectives related to breastfeeding physiology, broader factors in infant feeding decisions and practices, the American Academy of Pediatrics' policy statement, and breastfeeding management/troubleshooting. Feedback received from the tutorial led to the creation of a second tutorial consisting of another 1.5 hours of continuing medical and nursing education related to breast examination and assessment prior to delivery, provision of anticipatory guidance to pregnant women interested in breastfeeding, maternity care practices that influence breastfeeding outcomes, breastfeeding preterm infants, breastfeeding's role in helping address disparities, and dispelling common myths. The tutorials contribute to achievement of 8 Healthy People 2020 Maternal, Infant and Child Health objectives. © The Author(s) 2015.

Is Continuous Glucose Monitoring Underappreciated in the UK?

PubMed

Parkin, Christopher G; Holloway, Melissa; Truesdell, Jeffrey; C Walker, Tomas

2017-08-01

Information about continuous glucose monitoring (CGM) use in the UK is limited. We conducted an online survey of a representative sample of current CGM users in England, Scotland and Wales to address this deficit. The 29-item online survey was conducted between 29 December 2016 and 25 January 2017. Persons with type 1 diabetes (T1D) and caregivers of T1D children/adolescents were recruited from mailing lists, using Nielsen and Harris Polling databases. 315 patients and caregivers responded to the survey - 170 adult patients and 145 caregivers. Among respondents, 144 received full funding for CGM use, 72 received partial funding and 83 received no funding. Most reported improvements in glycated haemoglobin (HbA1c) (67.0%), fewer hypoglycaemia episodes (70.2%), improved hypoglycaemia awareness (77.5%) and better diabetes management (92.4%). Self-funders reported significantly higher CGM use (76.1%) than those who were fully funded (58.9%) and/or partially funded (65.9%), p=0.0008. Fewer than 50% of all respondents reported receiving guidance in interpreting CGM data from their diabetes care team; 30.1% of self-funders reported receiving no CGM support from their diabetes team compared with fully funded (2.8%) and partially funded (1.4%) respondents, p<0.0001. Patients with T1D and their caregivers are realising benefits from CGM use but are largely unsupported by the UK healthcare system.

Pneumonitis: a serious adverse effect of PD-L1 inhibitors including pembrolizumab.

PubMed

Rickard, Frances; Hyams, Catherine; Low, Andrew T

2018-05-07

A 70-year-old man presented with breathlessness, cough and fever while receiving pembrolizumab for melanoma. A CT pulmonary angiogram demonstrated small bilateral upper lobe segmental pulmonary emboli with patchy ground-glass opacities and basal perilobular consolidation, in keeping with organising pneumonia. He was treated for community-acquired pneumonia and pulmonary emboli but rapidly deteriorated, with increasing hypoxia and dyspnoea. He was admitted to the intensive care unit for support with continuous positive airway pressure and high flow nasal oxygen. His clinical condition improved once he received high-dose intravenous methylprednisolone to treat pneumonitis. His treatment was continued with a weaning course of high-dose oral steroids, and he was discharged with a persistent oxygen requirement. The patient maintained a requirement for high doses of oral steroids and continued to deteriorate. He was referred to palliative care for symptom management and died a month following hospital discharge, as a result of pneumonitis due to pembrolizumab. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The efficacy of varenicline in achieving abstinence among waterpipe tobacco smokers - study protocol for a randomized controlled trial.

PubMed

Zahid, Raana; Dogar, Omara; Mansoor, Sonia; Khan, Amina; Kanaan, Mona; Jawad, Mohammed; Ahluwalia, Jasjit S; Siddiqi, Kamran

2017-01-11

Waterpipe tobacco smoking has increased among youth across the globe including in the US, and it continues as a common and traditional form of smoking tobacco in Pakistan. A range of behavioral and pharmacological therapies are available to support people in quitting cigarette smoking; however, little evidence exists for the efficacy of these therapies in achieving abstinence among waterpipe tobacco smokers. The objective of this study is to assess the efficacy of varenicline when added to behavioral support for waterpipe tobacco smoking cessation, by measuring biochemically validated continuous abstinence in waterpipe tobacco smokers. This is a two-arm, double-blind, placebo-controlled randomized trial conducted in four districts in Punjab, Pakistan. Study participants include adults using a waterpipe (with or without concomitant cigarette, bidi or other forms of tobacco smoking) on a daily basis for at least 6 months and who are willing to quit. We will individually randomize 510 participants to one of the two arms of the trial. Participants in the intervention arm will receive varenicline and behavioral support and those in the control arm will receive placebo and behavioral support. The primary outcome will be continuous abstinence for at least 6 months (week 25) which is biochemically verified by a carbon monoxide level of <10 ppm. Secondary outcomes will include biochemically verified 7-day point abstinence at 5, 12 and 25 weeks and any lapses and relapses between the different assessment points. Tertiary outcomes will include assessment of withdrawal symptoms using the Mood and Physical Symptoms Scale (MPSS), smoking dependency using the Lebanon Waterpipe Dependency Scale (LWDS-11) and monitoring adverse outcomes. This is an efficacy trial and would require a subsequent effectiveness trial for a definitive evaluation of the intervention. ISRCTN, ISRCTN94103375 . Registered on 1 December 2015.

Reviewing information support during the Great East Japan Earthquake disaster : From the perspective of a hospital library that received support

NASA Astrophysics Data System (ADS)

Terasawa, Motoko

The Great East Japan Earthquake of March 11, 2011 caused extensive damage over a widespread area. Our hospital library, which is located in the affected area, was no exception. A large collection of books was lost, and some web content was inaccessible due to damage to the network environment. This greatly hindered our efforts to continue providing post-disaster medical information services. Information support, such as free access to databases, journals, and other online content related to the disaster areas, helped us immensely during this time. We were fortunate to have the cooperation of various medical employees and library members via social networks, such as twitter, during the process of attaining this information support.

Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation.

PubMed

Buller, David B; Borland, Ron; Bettinghaus, Erwin P; Shane, James H; Zimmerman, Donald E

2014-03-01

Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Young adult smokers 18-30 years old (n = 102) participated in a randomized pretest-posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Self-reported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (p<0.05) than REQ-Mobile. Use of both services predicted increased 30-day abstinence at 12 weeks (used, 47%; not used, 20%; p = 0.03). REQ-Mobile was feasible for delivering cessation support but appeared to not move smokers to quit as quickly as text messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging.

Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

PubMed

Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

2016-01-01

Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

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

PubMed Central

2010-01-01

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

20 CFR 411.210 - What happens if I do not make timely progress toward self-supporting employment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... may continue participating in the Ticket to Work program. Your EN (including a State VR agency which... under § 411.500 et seq. If you are working with a State VR agency which elected payment under the cost reimbursement payment system, your State VR agency may receive payment for which it is eligible under the cost...

Production and Distribution Research Center

DTIC Science & Technology

1986-05-01

Steel, Coca Cola , Standard Oil of Ohio, and Martin Marietta have been involved in joint research with members of the Center. The number of Faculty...permitted the establishment of the Center and supports its continuing development. The Center has also received research sponsorship from the Joint...published relating to results developed within the PDRC under Offce of Naval Research sponsorship . These reports are listed in Appendix A. Many of these

20 CFR 411.210 - What happens if I do not make timely progress toward self-supporting employment?

Code of Federal Regulations, 2014 CFR

2014-04-01

... may continue participating in the Ticket to Work program. Your EN (including a State VR agency which... under § 411.500 et seq. If you are working with a State VR agency which elected payment under the cost reimbursement payment system, your State VR agency may receive payment for which it is eligible under the cost...

20 CFR 411.210 - What happens if I do not make timely progress toward self-supporting employment?

Code of Federal Regulations, 2013 CFR

2013-04-01

... may continue participating in the Ticket to Work program. Your EN (including a State VR agency which... under § 411.500 et seq. If you are working with a State VR agency which elected payment under the cost reimbursement payment system, your State VR agency may receive payment for which it is eligible under the cost...

20 CFR 411.210 - What happens if I do not make timely progress toward self-supporting employment?

Code of Federal Regulations, 2012 CFR

2012-04-01

... may continue participating in the Ticket to Work program. Your EN (including a State VR agency which... under § 411.500 et seq. If you are working with a State VR agency which elected payment under the cost reimbursement payment system, your State VR agency may receive payment for which it is eligible under the cost...

20 CFR 411.210 - What happens if I do not make timely progress toward self-supporting employment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... may continue participating in the Ticket to Work program. Your EN (including a State VR agency which... under § 411.500 et seq. If you are working with a State VR agency which elected payment under the cost reimbursement payment system, your State VR agency may receive payment for which it is eligible under the cost...

Perceptions of continuing medical education, professional development, and organizational support in the United Arab Emirates.

PubMed

Younies, Hassan; Berham, Belal; Smith, Pamela C

2010-01-01

This paper investigates the views of health care providers on continuous medical education (CME). To our knowledge, this is one of the first surveys to examine perspectives of CME in the United Arab Emirates (UAE). A 6-part questionnaire focused on the following areas of CME: the workshop leaders/trainers, the training experience, the relevance of CME information provided in the training session, the training approach, the convenience of CME sessions, and organizational support. Results from 147 respondents indicated moderate satisfaction with these 6 CME areas. Respondents did not indicate satisfaction with organizational support received. Furthermore, participants agreed with the importance of CME to professional development. In our sample of UAE health care workers, they agree on the importance and relevance of CME to the development of their profession, even though the majority of health care workers are expatriates. However, several issues must be addressed, such as organizational, logistical, and financial support to attend CME programs. These issues must be addressed in order to sustain the viability of healthcare workers attending CME.

The experiences of new graduate midwives working in midwifery continuity of care models in Australia.

PubMed

Cummins, Allison M; Denney-Wilson, E; Homer, C S E

2015-04-01

midwifery continuity of care has been shown to be beneficial to women through reducing interventions and other maternal and neonatal morbidity. In Australia, numerous government reports recognise the importance of midwifery models of care that provide continuity. Given the benefits, midwives, including new graduate midwives, should have the opportunity to work in these models of care. Historically, new graduates have been required to have a number of years׳ experience before they are able to work in these models of care although a small number have been able to move into these models as new graduates. to explore the experiences of the new graduate midwives who have worked in midwifery continuity of care, in particular, the support they received; and, to establish the facilitators and barriers to the expansion of new graduate positions in midwifery continuity of care models. a qualitative descriptive study was undertaken framed by the concept of continuity of care. the new graduate midwives valued the relationship with the women and with the group of midwives they worked alongside. The ability to develop trusting relationships, consolidate skills and knowledge, be supported by the group and finally feeling prepared to work in midwifery continuity of care from their degree were all sub-themes. All of these factors led to the participants feeling as though they were 'becoming a real midwife'. this is the first study to demonstrate that new graduate midwives value working in midwifery continuity of care - they felt well prepared to work in this way from their degree and were supported by midwives they worked alongside. The participants reported having more confidence to practice when they have a relationship with the woman, as occurs in these models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Detection of correct and incorrect measurements in real-time continuous glucose monitoring systems by applying a postprocessing support vector machine.

PubMed

Leal, Yenny; Gonzalez-Abril, Luis; Lorencio, Carol; Bondia, Jorge; Vehi, Josep

2013-07-01

Support vector machines (SVMs) are an attractive option for detecting correct and incorrect measurements in real-time continuous glucose monitoring systems (RTCGMSs), because their learning mechanism can introduce a postprocessing strategy for imbalanced datasets. The proposed SVM considers the geometric mean to obtain a more balanced performance between sensitivity and specificity. To test this approach, 23 critically ill patients receiving insulin therapy were monitored over 72 h using an RTCGMS, and a dataset of 537 samples, classified according to International Standards Organization (ISO) criteria (372 correct and 165 incorrect measurements), was obtained. The results obtained were promising for patients with septic shock or with sepsis, for which the proposed system can be considered as reliable. However, this approach cannot be considered suitable for patients without sepsis.

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention

PubMed Central

Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-01-01

Abstract Introduction: SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Methods: Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Results: Three main themes were identified: “impact”, “approach,” and “optimization.” Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Conclusion: Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. Implications: This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants’ desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. PMID:28403457

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention.

PubMed

Sloan, Melanie; Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-05-01

SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Three main themes were identified: "impact", "approach," and "optimization." Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants' desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Women's views and experiences of a mobile phone-based intervention to support post-abortion contraception in Cambodia.

PubMed

Smith, Chris; Ly, Sokhey; Uk, Vannak; Warnock, Ruby; Free, Caroline

2017-06-12

The MObile Technology for Improved Family Planning (MOTIF) trial assessed a mobile phone-based intervention comprising voice messages and counsellor support to increase post-abortion contraception at four Marie Stopes International clinics in Cambodia. The aim of this process evaluation was to assess women's views and experiences of receiving the MOTIF intervention, gain insights into the mechanism of action of the intervention and seek recommendations for improvements. We conducted a qualitative study comprising15 semi-structured interviews with women who had received the intervention and undertook a simple thematic analysis. We identified themes relating to communication via mobile phone, supporting contraception use, broader post-abortion care, interaction with family and friends and suggestions for improvement. The majority of women were positive about the mobile phone-based intervention to support contraception use and reported it to be a convenient way to ask questions or get advice without going to a health centre, although a few women found the voice messages intrusive. The intervention supported contraception use by provision of information, encouragement, reminders to return to clinic, reassurance and advice for problems and had a positive effect on contraceptive uptake and continuation. Women reported a sense of being cared for and received support for additional physical and emotional issues. Most women thought that the duration of the intervention and frequency of messages were acceptable. The majority of women were positive about the mobile phone-based intervention which provided support for contraception use as well as additional physical and emotional issues. The study provides some insights into how the intervention might have worked and considers how the intervention could be improved.

Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

PubMed Central

Umpierrez, Guillermo E.

2013-01-01

Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 366)

NASA Technical Reports Server (NTRS)

1992-01-01

This bibliography lists 248 reports, articles, and other documents introduced into the NASA Scientific and Technical Information System during Aug. 1992. Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 492

NASA Technical Reports Server (NTRS)

1999-01-01

This report lists reports, articles and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Philanthropic Donor Perspectives on Supporting Nursing Excellence in a Community Hospital.

PubMed

Fickley, Sharon K; Mishler, Ray R; Black, Amelia S; DeGuzman, Pam B

2016-11-01

The purpose of this research is to explore donors' perspectives on support of nursing excellence in a community hospital. Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals. Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis. Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received. This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.

The psychosocial experience of parents receiving care closer to home for their ill child.

PubMed

Spiers, Gemma; Parker, Gillian; Gridley, Kate; Atkin, Karl

2011-11-01

Current health policy in England regarding the management of childhood illness advocates for care to be delivered as close to home as possible. The aim of this article is to report findings from a qualitative component of a larger study evaluating models of care closer to home (CCTH) for children and young people who are ill. The focus is on parents' psychosocial experience of receiving CCTH for their ill child. A qualitative case study design was used, with four Primary Care Trusts in England as the case study sites. In-depth, semi-structured interviews were conducted with 27 parents and one extended family caregiver of children using CCTH services within the case study sites. Interviews were conducted face-to-face and audio-recorded with permission. Data were collected in 2009. There was an overall preference for CCTH over hospital-based care where possible. The parents in this study experienced differing levels of responsibility as part of this care, and responded to this in different ways. Being supported emotionally and socially by practitioners was an important part of receiving CCTH for parents, especially when they had increased responsibility as part of this care. Developing relationships with practitioners appeared to be a medium through which parents received support. If the provision of CCTH continues to expand in line with current policy, provision of support for parents should be considered a fundamental aspect of service development. © 2011 Blackwell Publishing Ltd.

Mobilizing women for minority health and social justice in california.

PubMed

Littlefield, Diane; Robison, Connie Chan; Engelbrecht, Luz; González, Belma; Hutcheson, Heather

2002-04-01

Women's Health Leadership is building the leadership capacity of diverse community leaders in California committed to promoting health and social justice in their communities. This program provides opportunities for cross-cultural exchanges of ideas, resources, and expertise. Graduates continue to receive technical support and to engage in peer learning via an alumnae network. The network is dedicated to advancing social justice issues and to addressing health disparities. It is also a way to mobilize trained grassroots leaders to provide expertise to influence policy decisions, to provide technical support and resources to local communities, and to foster new partnerships across the state.

Afghanistan: Post-Taliban Governance, Security, and U.S. Policy

DTIC Science & Technology

2013-10-23

for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 23 OCT 2013 2...York closed, although Taliban representative Abdul Hakim Mujahid continued to operate informally .9 In March 2001, Administration officials received a ...Resolution 2096. Resolution 2096 reiterates the expanded UNAMA mandate, while noting that UNAMA and the international community are moving to a supporting

Lohman Receives 2013 Geodesy Section Award: Response

NASA Astrophysics Data System (ADS)

Lohman, Rowena B.

2014-09-01

I am very honored to be this year's recipient of the AGU Geodesy Section Award. I was fortunate to begin my academic career at a time when there was an explosion of new data types and computational resources. I have been very pleased to watch this trend continue, with the ongoing support of new InSAR missions worldwide and renewed interest in the democratization of access to this data.

U.S. Marine Corps Operations in Nicaragua from 1927 to 1933

DTIC Science & Technology

2011-05-04

true Nicaraguan autonomy . Sandino continued to receive some Conservative support because ofhis popular anti-American sentiment and his denouncement... Nicaraguan society and the multiple missions assigned to this small Brigade of Marines. I was fascinated to read reports from majors and captains...corresponding directly with General Lejeune about their operations covering all aspects ofNicaraguan culture . During this reading, I begm1 to question why

Six-year follow-up on work force and finances of the United States anesthesiology training programs: 2000 to 2006.

PubMed

Kheterpal, Sachin; Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2009-01-01

In the mid 1990s, interest in the field of anesthesiology decreased significantly among medical students, resulting in a decreasing resident class size and, subsequently, fewer anesthesiologists entering the United States workforce. This apparent practitioner shortage was associated with increased salary demands, which placed anesthesiology training departments in financial jeopardy. Starting in 1999, a survey was sent to the department chairs of the United States anesthesiology training programs to assess the status of faculty and finances of their departments. Follow-up surveys have been conducted each year thereafter. We present the results of the 2006 survey and 7 yr trend data. Surveys were distributed by e-mail in September 2006 to anesthesiology department chairs of the United States training programs. The responses were received by e-mail. Descriptive statistics were performed on responder data. In addition, a linear regression model to predict institutional support was developed. One-hundred-eighteen departments were surveyed with a response rate of 61%. There were an average of 4 open faculty positions in the 71% of the departments reporting open faculty positions. This would imply an overall 5% open position rate, down from 10% in 2000. Of the 96% of departments who employ certified registered nurse anesthetists, 70% had an average of 4 open positions, or approximately 11% shortage. The average department received $5,500,000 in total institutional support annually ($120,000/faculty). When the portion of this support provided for certified registered nurse anesthetists was removed, the average amount received was $4,600,000 or $100,000/faculty. This is a 10% increase over the previous year and an approximate 300% increase over the year 2000. Faculty academic time averaged 18% (where 20% is 1 day per week). The departments billed an average of 12,200 U/faculty/year. The average anesthesia unit value collected was $31/unit, while departments would require $46/unit to meet expenses. In a linear regression model, clinical revenue per unit billed minus expenses per unit billed predicted faculty support per full-time equivalent. This current survey reveals a continuing need for institutional support to keep anesthesiology training departments financially solvent. The amount of support is associated with the reimbursement for anesthesia work. There is also a continuing, but decreasing, number of open faculty anesthesiologist positions nationwide.

Effects of Percutaneous LVAD Support on Right Ventricular Load and Adaptation.

PubMed

Yourshaw, Jeffrey P; Mishra, Prabodh; Armstrong, M Christopher; Ramu, Bhavadharini; Craig, Michael L; Van Bakel, Adrian B; Steinberg, Daniel H; DiSalvo, Thomas G; Tedford, Ryan J; Houston, Brian A

2018-04-30

Both operative and hemodynamic mechanisms have been implicated in right heart failure (RHF) following surgical left ventricular assist device (LVAD) implantation. We investigated the effects of percutaneous LVAD (pLVAD; Impella®, Abiomed) support on right ventricular (RV) load and adaptation. We reviewed all patients receiving a pLVAD for cardiogenic shock at our institution between July 2014 and April 2017, including only those with pre- and post-pLVAD invasive hemodynamic measurements. Hemodynamic data was recorded immediately prior to pLVAD implantation and up to 96 h post-implantation. Twenty-five patients were included. Cardiac output increased progressively during pLVAD support. PAWP improved early post-pLVAD but did not further improve during continued support. Markers of RV adaptation (right ventricular stroke work index, right atrial pressure (RAP), and RAP to pulmonary artery wedge pressure ratio (RAP:PAWP)) were unchanged acutely implant but progressively improved during continued pLVAD support. Total RV load (pulmonary effective arterial elastance; E A ) and resistive RV load (pulmonary vascular resistance; PVR) both declined progressively. The relationship between RV load and RV adaptation (E A /RAP and E A /RAP:PAWP) was constant throughout. Median vasoactive-inotrope score declined after pLVAD placement and continued to decline throughout support. Percutaneous LVAD support in patients with cardiogenic shock did not acutely worsen RV adaptation, in contrast to previously described hemodynamic effects of surgically implanted durable LVADs. Further, RV load progressively declined during support, and the noted RV adaptation improvement was load-dependent as depicted by constant E A /RA and E A /RAP:PAWP relationships. These findings further implicate the operative changes associated with surgical LVAD implantation in early RHF following durable LVAD.

Continuing evidence for poorer treatment outcomes for single male patients: retreatment data from RTOG 97-14.

PubMed

Konski, Andre; Desilvio, Michelle; Hartsell, William; Watkins-Bruner, Deborah; Coyne, James; Scarantino, Charles; Janjan, Nora

2006-09-01

The specific aim of this study was to evaluate outcome differences by gender and partner status for patients treated on Radiation Therapy Oncology Group (RTOG) protocol 97-14. RTOG 97-14 randomized patients with metastatic breast or prostate cancer to bone to receive 8 Gy in 1 fraction or 30 Gy in 10 fractions. Retreatment rates and overall survival were made based upon gender, marital status, and Karnofsky Performance Status (KPS). The cumulative incidence method was used to estimate retreatment time at 36 months from enrollment, and Gray's test was used to test for treatment differences within the same groupings. Marital status, gender, KPS, and treatment were variables tested in a univariate Cox model evaluating the time to retreatment. Married men and women and single women receiving 30 Gy had significantly longer time to retreatment, p = 0.0067, p = 0.0052, and p = 0.0009 respectively. We failed to show a difference in retreatment rates over time in single men receiving either 30 Gy or 8 Gy. Univariate analysis of the entire group determined patients receiving 30 Gy in 10 fractions significantly less likely to receive retreatment, p < 0.0001, with a trend toward single patients less likely to be re-treated, p = 0.07. Non-disease-related variables, such as social support, might influence the results of clinical trials with subjective endpoints such as retreatment rates. The statistically nonsignificant difference in the 36-month retreatment rates observed in single male patients receiving 8 Gy may be a result of inadequate social support systems in place to facilitate additional care. Patients receiving 8 Gy in a single fraction had significantly higher retreatment rates compared with patients receiving 30 Gy in 10 fractions.

Poliomyelitis: long-time consequences for social life.

PubMed

Farbu, E; Gilhus, N E

1997-12-01

In a study of 102 consecutive patients hospitalized for previous poliomyelitis, we found that 70 patients had continued education after elementary school and 18 were academics. This is a higher proportion than in the general Norwegian population. All 14 patients with paraparesis had continued education after elementary school, while as many as 12 of 18 patients with a university degree had widespread pareses in the acute phase. Of the patients 46 worked or had worked full-time up to 60 years of age. Only 29 patients were receiving a disabled pension. Another 9 patients had neither been employed nor received any pension, all housewives. Nine of 14 patients with paraparesis were working full-time, only 2 received disabled pension. Among the 35 patients with persisting widespread pareses, 11 were still in full-time work and 7 were working part-time. The employment rate among the patients in this study was nearly identical to the age-correlated general employment rate in Norway. Our conclusion is that polio patients are doing well in society; they have taken education, are working, and are generally self-supported. The degree of pareses does not seem to have been the most determining factor for their educational and professional activity.

Radiation Exposure to Relatives of Patients Treated with Iodine-131 for Thyroid Cancer at Siriraj Hospital.

PubMed

Tonnonchiang, Siriporn; Sritongkul, Nopamon; Chaudakshetrin, Pachee; Tuntawiroon, Malulee

2016-02-01

Thyroid cancer patients treated with 1-131 are potential source of radiation exposure to relatives who are knowingly and willingly exposed to ionizing radiation as a result of providing comfort to patients undergoing I-131 therapy. This study aims to determine radiation dose received by relatives who care for non self-supporting 1-131 patients at Siriraj Hospital. Twenty caregivers of 20 patients underwent I-131 therapy for thyroid cancer with a standard protocol were given specific instructions with regard to radiation safety and provided with electronic digital dosimeter to continuously measure radiation dose received on daily basis, three days in the hospital. On the day patient is released, thyroid uptake estimates were performed to assess internal radiation dose received by caregivers. The 3-day accumulative doses to caregivers to patients receiving 150 mCi (n = 11) and 200 mCi (n = 9) of I-131 ranged from 37 to 333 uSv and 176 to 1,920 pSv respectively depending on the level of supports required. Thyroid uptake estimates in all caregivers were undetectable. Dosimeter indicated a maximum whole-body dose of1.92 mSv was more than the public dose limit of] mSv but within the dose constraint of 5 mSv for caregivers. Radiation dose to caregivers of a non self-supporting hospitalized patient undergoing 1-131 therapy were well below the limits recommended by the ICRP. The patients can be comforted with confidence that dose to caregivers will be less than the limit. This study provides guidance for medical practitioners to obtain practical radiation safety concerns associated with hospitalized patients receiving I-131 therapy especially when patient needs assistance.

Preparing patients with cancer who work and treatment responsiveness.

PubMed

Kamau, Caroline

2017-03-01

Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. A cross-sectional study. An analysis of survey data from 3457 patients with cancer in employment. Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65-1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Physical activity promotion in general practice--patient attitudes.

PubMed

Elley, Carolyn Raina; Dean, Sarah; Kerse, Ngaire

2007-12-01

Long term adherence to primary care physical activity intervention is poor. This study explored attitudes and subjective experiences of those who received such an intervention. Nested qualitative study within mixed methods approach, involving 15 sedentary adults from urban and rural general practices in New Zealand. Semistructured telephone interviews were conducted, transcribed, and analysed using an inductive approach to identify themes. Four themes emerged including: tailoring of advice given; barriers to physical activity such as weather, physical environment, time, health and psychological limitations; internal motivators such as immediate or long term psychological, health or spiritual benefits, commitment, and guilt; and the role of significant others such as health and exercise professionals in initiating advice and continuing support, social interaction and commitment or contracts made to others. This study highlights the need for a personalised approach, continued structured external support and the need to focus on barriers and facilitators.

Final analysis of survival outcomes in the phase 3 FIRST trial of up-front treatment for multiple myeloma.

PubMed

Facon, Thierry; Dimopoulos, Meletios A; Dispenzieri, Angela; Catalano, John V; Belch, Andrew; Cavo, Michele; Pinto, Antonello; Weisel, Katja; Ludwig, Heinz; Bahlis, Nizar J; Banos, Anne; Tiab, Mourad; Delforge, Michel; Cavenagh, Jamie D; Geraldes, Catarina; Lee, Je-Jung; Chen, Christine; Oriol, Albert; De La Rubia, Javier; White, Darrell; Binder, Daniel; Lu, Jin; Anderson, Kenneth C; Moreau, Philippe; Attal, Michel; Perrot, Aurore; Arnulf, Bertrand; Qiu, Lugui; Roussel, Murielle; Boyle, Eileen; Manier, Salomon; Mohty, Mohamad; Avet-Loiseau, Herve; Leleu, Xavier; Ervin-Haynes, Annette; Chen, Guang; Houck, Vanessa; Benboubker, Lotfi; Hulin, Cyrille

2018-01-18

This FIRST trial final analysis examined survival outcomes in patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM) treated with lenalidomide and low-dose dexamethasone until disease progression (Rd continuous), Rd for 72 weeks (18 cycles; Rd18), or melphalan, prednisone, and thalidomide (MPT; 72 weeks). The primary endpoint was progression-free survival (PFS; primary comparison: Rd continuous vs MPT). Overall survival (OS) was a key secondary endpoint (final analysis prespecified ≥60 months' follow-up). Patients were randomized to Rd continuous (n = 535), Rd18 (n = 541), or MPT (n = 547). At a median follow-up of 67 months, PFS was significantly longer with Rd continuous vs MPT (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.59-0.79; P < .00001) and was similarly extended vs Rd18. Median OS was 10 months longer with Rd continuous vs MPT (59.1 vs 49.1 months; HR, 0.78; 95% CI, 0.67-0.92; P = .0023), and similar with Rd18 (62.3 months). In patients achieving complete or very good partial responses, Rd continuous had an ≈30-month longer median time to next treatment vs Rd18 (69.5 vs 39.9 months). Over half of all patients who received second-line treatment were given a bortezomib-based therapy. Second-line outcomes were improved in patients receiving bortezomib after Rd continuous and Rd18 vs after MPT. No new safety concerns, including risk for secondary malignancies, were observed. Treatment with Rd continuous significantly improved survival outcomes vs MPT, supporting Rd continuous as a standard of care for patients with transplant-ineligible NDMM. This trial was registered at www.clinicaltrials.gov as #NCT00689936 and EudraCT as 2007-004823-39. © 2018 by The American Society of Hematology.

Final analysis of survival outcomes in the phase 3 FIRST trial of up-front treatment for multiple myeloma

PubMed Central

Dimopoulos, Meletios A.; Dispenzieri, Angela; Catalano, John V.; Belch, Andrew; Cavo, Michele; Pinto, Antonello; Weisel, Katja; Ludwig, Heinz; Bahlis, Nizar J.; Banos, Anne; Tiab, Mourad; Delforge, Michel; Cavenagh, Jamie D.; Geraldes, Catarina; Lee, Je-Jung; Chen, Christine; Oriol, Albert; De La Rubia, Javier; White, Darrell; Binder, Daniel; Lu, Jin; Anderson, Kenneth C.; Moreau, Philippe; Attal, Michel; Perrot, Aurore; Arnulf, Bertrand; Qiu, Lugui; Roussel, Murielle; Boyle, Eileen; Manier, Salomon; Mohty, Mohamad; Avet-Loiseau, Herve; Leleu, Xavier; Ervin-Haynes, Annette; Chen, Guang; Houck, Vanessa; Benboubker, Lotfi; Hulin, Cyrille

2018-01-01

This FIRST trial final analysis examined survival outcomes in patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM) treated with lenalidomide and low-dose dexamethasone until disease progression (Rd continuous), Rd for 72 weeks (18 cycles; Rd18), or melphalan, prednisone, and thalidomide (MPT; 72 weeks). The primary endpoint was progression-free survival (PFS; primary comparison: Rd continuous vs MPT). Overall survival (OS) was a key secondary endpoint (final analysis prespecified ≥60 months’ follow-up). Patients were randomized to Rd continuous (n = 535), Rd18 (n = 541), or MPT (n = 547). At a median follow-up of 67 months, PFS was significantly longer with Rd continuous vs MPT (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.59-0.79; P < .00001) and was similarly extended vs Rd18. Median OS was 10 months longer with Rd continuous vs MPT (59.1 vs 49.1 months; HR, 0.78; 95% CI, 0.67-0.92; P = .0023), and similar with Rd18 (62.3 months). In patients achieving complete or very good partial responses, Rd continuous had an ≈30-month longer median time to next treatment vs Rd18 (69.5 vs 39.9 months). Over half of all patients who received second-line treatment were given a bortezomib-based therapy. Second-line outcomes were improved in patients receiving bortezomib after Rd continuous and Rd18 vs after MPT. No new safety concerns, including risk for secondary malignancies, were observed. Treatment with Rd continuous significantly improved survival outcomes vs MPT, supporting Rd continuous as a standard of care for patients with transplant-ineligible NDMM. This trial was registered at www.clinicaltrials.gov as #NCT00689936 and EudraCT as 2007-004823-39. PMID:29150421

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

Tagestad, Jerry D.; Bolte, John; Guzy, Michael

During this final year of the Pacific Northwest Regional Collaboratory we focused significantly on continuing the relationship between technical teams and government end-users. The main theme of the year was integration. This took the form of data integration via our web portal and integration of our technologies with the end users. The PNWRC's technical portfolio is based on EOS strategies, and focuses on 'applications of national priority: water management, invasive species, coastal management and ecological forecasting.' The products of our technical approaches have been well received by the community of focused end-users. The objective this year was to broaden thatmore » community and develop external support to continue and operationalize product development.« less

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes. Supplement 497

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP#2000-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention.

Randomized Trial of a Smartphone Mobile Application Compared to Text Messaging to Support Smoking Cessation

PubMed Central

Borland, Ron; Bettinghaus, Erwin P.; Shane, James H.; Zimmerman, Donald E.

2014-01-01

Abstract Background: Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Materials and Methods: Young adult smokers 18–30 years old (n=102) participated in a randomized pretest–posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Self-reported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Results: Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (p<0.05) than REQ-Mobile. Use of both services predicted increased 30-day abstinence at 12 weeks (used, 47%; not used, 20%; p=0.03). Conclusions: REQ-Mobile was feasible for delivering cessation support but appeared to not move smokers to quit as quickly as text messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging. PMID:24350804

Effectiveness of the Size Matters Handwriting Program.

PubMed

Pfeiffer, Beth; Rai, Gillian; Murray, Tammy; Brusilovskiy, Eugene

2015-04-01

The purpose of the research was to study changes in handwriting legibility among kindergarten, first- and second-grade students in response to the Size Matters curricular-based handwriting program. A two-group pre-post-test design was implemented at two public schools with half of the classrooms assigned to receive the Size Matters program and the other continuing to receive standard instruction. All participants completed two standardized handwriting measures at pre-test and after 40 instructional sessions were completed with the classes receiving the handwriting program. Results identified significant changes in legibility in the handwriting intervention group for all three grades when compared with the standard instruction group. The results of this study support the use of a curricular-embedded handwriting program and provide the foundation for future research examining the impact of handwriting legibility on learning outcomes.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 485

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP-1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. The NASA CASI price code table, addresses of organizations, and document availability information are included before the abstract section. Two indexes-subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes. Supplement 506

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP#2000-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. The NASA CASI price code table, addresses of organizations, and document availability information are included before the abstract section. Two indexes- subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 494

NASA Technical Reports Server (NTRS)

1999-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. The NASA CASI price code table, addresses of organizations, and document availability information are included before the abstract section. Two indexes--subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 496

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP#2000-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth#s atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. The NASA CASI price code table, addresses of organizations, and document availability information are included before the abstract section. Two indexes#subject and author are included after the abstract section.

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes. Supplement 499

NASA Technical Reports Server (NTRS)

2000-01-01

This supplemental issue of Aerospace Medicine and Biology, A Continuing Bibliography with Indexes (NASA/SP#1999-7011) lists reports, articles, and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth#s atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract. The NASA CASI price code table, addresses of organizations, and document availability information are included before the abstract section. Two indexes-subject and author are included after the abstract section.

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 368)

NASA Technical Reports Server (NTRS)

1992-01-01

This bibliography lists 305 reports, articles, and other documents introduced into the NASA Scientific and Technical Information System during Sep. 1992. The subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Aerospace Medicine and Biology: A Continuing Bibliography With Indexes. Supplement 486

NASA Technical Reports Server (NTRS)

1999-01-01

In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

'I'm a sick person, not a bad person': patient experiences of treatments for alcohol use disorders.

PubMed

McCallum, Stacey L; Mikocka-Walus, Antonina A; Gaughwin, Matthew D; Andrews, Jane M; Turnbull, Deborah A

2016-08-01

Emerging research indicates that standard treatments for alcohol use disorders may not fully meet the needs of patients with co-occurring severe mental health symptoms. Investigating health quality indicators may provide insight into how current treatment might be improved. To better understand the experiences of patients receiving treatment for alcohol use disorders and compare the experiences of patients with and without co-occurring severe mental health symptoms. Cross-sectional qualitative research design using semi-structured interviews methods and framework analysis approach. Inpatient hospital, outpatient service, inpatient detoxification clinic and a residential/ therapeutic community. Thirty-four patients receiving treatment for an alcohol use disorder. Themes relating to patients' experiences of continuity of care, treatment need and satisfaction with treatment were studied. The qualitative data were divided into two groups: patients with (n = 15) and without (n = 19) severe mental health symptoms. Five themes relating to patient satisfaction with treatment were identified, including: perceived effectiveness of treatment, supportive relationships, specialized but holistic care, patient autonomy and continuity of care. A diverse range of patient treatment needs, staff and service continuity and stigma were also identified as major themes. Five basic themes were identified as more critical to the experiences of patients with severe mental health symptoms. Findings suggest that patients look for supportive relationships with others, to be involved in treatment decisions, effective specialized and holistic approaches to care and a non-judgemental treatment environment. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Telling Stories and Making Books: Evidence for an Intervention to Help Parents in Migrant Head Start Families Support Their Children's Language and Literacy

ERIC Educational Resources Information Center

Boyce, Lisa K.; Innocenti, Mark S.; Roggman, Lori A.; Norman, Vonda K. Jump; Ortiz, Eduardo

2010-01-01

Research Findings: In this study, 75 Spanish-speaking preschoolers (M age = 41.43 months, SD = 10.78 months; 30 girls) attending a Migrant Head Start program were randomly assigned to receive the Storytelling for the Home Enrichment of Language and Literacy Skills (SHELLS) in addition to their Head Start services (n = 32) or to continue to receive…

A Descriptive Study of Military Nurse Practitioners’ Practice Settings and Clinical Practice Activities

DTIC Science & Technology

1996-05-01

experience and/or education, patient appreciation, administrative support and trained co-workers. Prescott (1994) states that there is "substantial evidence...role changing by stating that roles involve more than training a person to follow expectations, that the person takes on an active mode of...he sample had 110 respondents. A significant limitation to the study however, is that the responding NPs received training through continuing

Girls in the UK Have Similar Reasons to Boys for Intending to Study Mathematics Post-16 Thanks to the Support and Encouragement They Receive

ERIC Educational Resources Information Center

Mujtaba, Tamjid; Reiss, Michael

2016-01-01

This paper focuses on the aspirations of 13- and 15-year-olds to continue with mathematics after the age of 16 and the association with perceptions of their mathematics education during the academic year 2008/9. A quantitative analysis was undertaken on the views of 12,176 UK students, obtained through surveys, with qualitative case studies on two…

Social Support and Employee Well-Being: The Conditioning Effect of Perceived Patterns of Supportive Exchange

PubMed Central

Nahum-Shani, Inbal; Bamberger, Peter A.; Bacharach, Samuel B.

2014-01-01

Seeking to explain divergent empirical findings regarding the direct effect of social support on well-being, the authors posit that the pattern of supportive exchange (i.e., reciprocal, under-, or over-reciprocating) determines the impact of receiving support on well-being. Findings generated on the basis of longitudinal data collected from a sample of older blue-collar workers support the authors’ predictions, indicating that receiving emotional support is associated with enhanced well-being when the pattern of supportive exchange is perceived by an individual as being reciprocal (support received equals support given), with this association being weaker when the exchange of support is perceived as being under-reciprocating (support given exceeds support received). Moreover, receiving support was found to adversely affect well-being when the pattern of exchange was perceived as being over-reciprocating (support received exceeds support given). Theoretical and practical implications of these findings are discussed. PMID:21362616

Social support and employee well-being: the conditioning effect of perceived patterns of supportive exchange.

PubMed

Nahum-Shani, Inbal; Bamberger, Peter A; Bacharach, Samuel B

2011-03-01

Seeking to explain divergent empirical findings regarding the direct effect of social support on well-being, the authors posit that the pattern of supportive exchange (i.e., reciprocal, under-, or over-reciprocating) determines the impact of receiving support on well-being. Findings generated on the basis of longitudinal data collected from a sample of older blue-collar workers support the authors' predictions, indicating that receiving emotional support is associated with enhanced well-being when the pattern of supportive exchange is perceived by an individual as being reciprocal (support received equals support given), with this association being weaker when the exchange of support is perceived as being under-reciprocating (support given exceeds support received). Moreover, receiving support was found to adversely affect well-being when the pattern of exchange was perceived as being over-reciprocating (support received exceeds support given). Theoretical and practical implications of these findings are discussed.

The Treatment of cardiovascular Risk in Primary care using Electronic Decision supOrt (TORPEDO) study-intervention development and protocol for a cluster randomised, controlled trial of an electronic decision support and quality improvement intervention in Australian primary healthcare.

PubMed

Peiris, David; Usherwood, Tim; Panaretto, Katie; Harris, Mark; Hunt, Jenny; Patel, Bindu; Zwar, Nicholas; Redfern, Julie; Macmahon, Stephen; Colagiuri, Stephen; Hayman, Noel; Patel, Anushka

2012-01-01

Large gaps exist in the implementation of guideline recommendations for cardiovascular disease (CVD) risk management. Electronic decision support (EDS) systems are promising interventions to close these gaps but few have undergone clinical trial evaluation in Australia. We have developed HealthTracker, a multifaceted EDS and quality improvement intervention to improve the management of CVD risk. It is hypothesised that the use of HealthTracker over a 12-month period will result in: (1) an increased proportion of patients receiving guideline-indicated measurements of CVD risk factors and (2) an increased proportion of patients at high risk will receive guideline-indicated prescriptions for lowering their CVD risk. Sixty health services (40 general practices and 20 Aboriginal Community Controlled Health Services (ACCHSs) will be randomised in a 1:1 allocation to receive either the intervention package or continue with usual care, stratified by service type, size and participation in existing quality improvement initiatives. The intervention consists of point-of-care decision support; a risk communication interface; a clinical audit tool to assess performance on CVD-related indicators; a quality improvement component comprising peer-ranked data feedback and support to develop strategies to improve performance. The control arm will continue with usual care without access to these intervention components. Quantitative data will be derived from cross-sectional samples at baseline and end of study via automated data extraction. Detailed process and economic evaluations will also be conducted. The general practice component of the study is approved by the University of Sydney Human Research Ethics Committee (HREC) and the ACCHS component is approved by the Aboriginal Health and Medical Research Council HREC. Formal agreements with each of the participating sites have been signed. In addition to the usual scientific forums, results will be disseminated via newsletters, study websites, face-to-face feedback forums and workshops. The trial is registered with the Australian Clinical Trials Registry ACTRN 12611000478910.

Quasi-bipolar battery construction and method of fabricating

NASA Technical Reports Server (NTRS)

Rippel, Wally E. (Inventor); Edwards, Dean B. (Inventor)

1982-01-01

A lightweight, battery construction for lead acid batteries in which biplates are formed from a continuous strip of thermoplastic material, one face of the strip being provided with a plurality of electrically isolated lead strip arrays, each having a transverse axis about which the strip is folded or pleated to provide pleated biplate walls. The pleated continuous strip is sealed along edge longitudinal portions to provide chambers for receiving a plurality of non-conductive thermoplastic separator-plates and to contain electrolyte liquid. Separator-plates support resilient yieldable porous glass mats and scrim fabric in which active material is carried. The assembly of pleated biplates and separator-plates is maintained in pressure relation by exterior resilient means. A method of making such a continuous pleated biplate construction and of assembling one or more battery modules which may be connected in series or in parallel. A biplate construction having continuously wound lead stripes attached to a substrate.

Mental Health Support Service for University Students.

PubMed

Gale, Jill; Thalitaya, Madhusudan Deepak

2015-09-01

The Mental Health Support Service provides substantial one to one practical support for students to enable them to manage their mental health and study to provide coordinated support and ensure compliance with the Equality Act 2010. The service consists of a full time Mental Health Advisor and a part time Support Worker and is available all year round. Supervision is received from a Consultant Psychiatrist. To liaise with students and professionals when a student is admitted to hospital/Crisis Teams. Close communication with other services such as Student Engagement, the International Office, the Chaplain and academics. Data from the Office of National Statistics between 2007 and 2011 have shown an increase in the number of student suicides since the start of the recession. Feedback highlights that students benefit from the support and value the professional and welcoming attitude of the team. The service continues to provide good quality support to those who access it. Student feedback shows that they believe the support has helped them to stay at university and complete their degree.

Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans.

PubMed

Sripada, Rebecca K; Bohnert, Amy S B; Teo, Alan R; Levine, Debra S; Pfeiffer, Paul N; Bowersox, Nicholas W; Mizruchi, Mark S; Chermack, Stephen T; Ganoczy, Dara; Walters, Heather; Valenstein, Marcia

2015-09-01

Low social support and small social network size have been associated with a variety of negative mental health outcomes, while their impact on mental health services use is less clear. To date, few studies have examined these associations in National Guard service members, where frequency of mental health problems is high, social support may come from military as well as other sources, and services use may be suboptimal. Surveys were administered to 1448 recently returned National Guard members. Multivariable regression models assessed the associations between social support characteristics, probable mental health conditions, and service utilization. In bivariate analyses, large social network size, high social network diversity, high perceived social support, and high military unit support were each associated with lower likelihood of having a probable mental health condition (p < .001). In adjusted analyses, high perceived social support (OR .90, CI .88-.92) and high unit support (OR .96, CI .94-.97) continued to be significantly associated with lower likelihood of mental health conditions. Two social support measures were associated with lower likelihood of receiving mental health services in bivariate analyses, but were not significant in adjusted models. General social support and military-specific support were robustly associated with reduced mental health symptoms in National Guard members. Policy makers, military leaders, and clinicians should attend to service members' level of support from both the community and their units and continue efforts to bolster these supports. Other strategies, such as focused outreach, may be needed to bring National Guard members with need into mental health care.

Alzheimer's Caregiver Support Online: lessons learned, initial findings and future directions.

PubMed

Glueckauf, Robert L; Loomis, Jeffrey S

2003-01-01

Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are faced with a variety of emotional and behavioral difficulties, such as dealing with persistent, repetitive questions, managing agitation and depression, and monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, most dementia caregivers continue to receive little or no formal instruction in responding effectively to these challenges. The current paper describes the development and implementation of Alzheimer's Caregiver Support Online, a Web- and telephone-based education and support network for caregivers of individuals with progressive dementia. Lessons learned from the first two years of this state-supported initiative are discussed, followed by the findings of a Robert Wood Johnson Foundation-funded strategic marketing initiative and an initial program evaluation of AlzOnline's Positive Caregiving classes. Finally, clinical implications and future directions for program development and evaluation research are proposed.

Text Messaging (SMS) Helping Cancer Care in Patients Undergoing Chemotherapy Treatment: a Pilot Study.

PubMed

Rico, Timóteo Matthies; Dos Santos Machado, Karina; Fernandes, Vanessa Pellegrini; Madruga, Samanta Winck; Noguez, Patrícia Tuerlinckx; Barcelos, Camila Rose Guadalupe; Santin, Mateus Madail; Petrarca, Cristiane Rios; Dumith, Samuel Carvalho

2017-10-09

Cancer treatment is an extremely stressful life experience that is accompanied by a range of psychological, social, physical, and practical difficulties. Cancer patients need to receive information that helps them to better understand the disease, assists them in decision-making, and helps them deal with treatment. Patients are interested in receiving such information. The degree of satisfaction with the information received has been associated with positive health outcomes, specifically regarding quality of life, severity of side effects, and psychological well-being. This study investigates a method of guiding cancer patients, in relation to outpatient chemotherapy treatment, using SMS (short message service) text messaging. A smartphone application called cHEmotHErApp was developed, and its primary function is to send out SMS text messages with guidance for self-care and emotional support for oncology patients undergoing chemotherapy. Thus, the main objective of this study is to evaluate the acceptance and perception of patients of the receipt of these SMS messages, as well as to evaluate the possible benefits reported by the participants. Adult patients diagnosed with cancer, who started the first outpatient chemotherapy treatment scheme between August and November 2016 at the School Hospital (HE) of the Federal University of Pelotas (UFPel), were invited to participate in this pilot study. In total, 14 cancer patients were adherent to this study. Each of these patients received a daily text message on their cell phone with some guidance on encouraging self-care and emotional support. Patients reported that, because of the SMS text messages they received, they felt more confident in their treatment, felt more supported and encouraged, and that the text messages facilitated self-care. In addition, patients reported that the SMS text messages they received helped them to take better care of themselves and to continue further treatment.

Breastfeeding Problems Following Anesthetic Administration

PubMed Central

Howie, William O.; McMullen, Patricia C.

2006-01-01

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to “pump and dump” breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding. PMID:17541461

Breastfeeding problems following anesthetic administration.

PubMed

Howie, William O; McMullen, Patricia C

2006-01-01

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to "pump and dump" breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding.

Once-weekly exenatide as adjunct treatment of type 1 diabetes mellitus in patients receiving continuous subcutaneous insulin infusion therapy.

PubMed

Traina, Andrea N; Lull, Melinda E; Hui, Adrian C; Zahorian, Toni M; Lyons-Patterson, Jane

2014-08-01

The use of once-weekly exenatide in type 2 diabetes mellitus is well supported, but little is known about its effectiveness in type 1 diabetes. The objective of this study was to determine the clinical efficacy of once-weekly exenatide on glycemic control in patients with type 1 diabetes when added to basal-bolus insulin therapy. For this retrospective study, patients with type 1 diabetes, aged 18 years and older, receiving continuous subcutaneous insulin infusion, using a continuous glucose monitoring device or regularly measuring blood glucose levels and receiving 2 mg of exenatide once weekly for at least 3 months were included. Demographic information, glycated hemoglobin (A1C), body weight, body mass index, systolic and diastolic blood pressures, total daily insulin dose, basal and bolus insulin doses, 28-day continuous subcutaneous insulin infusion glucose average and incidence of hypoglycemia were collected at baseline and 3 months after beginning therapy with once-weekly exenatide. An electronic medical record search identified 11 patients with type 1 diabetes who met the inclusion criteria. Comparing baseline and 3 months after initiation of once-weekly exenatide revealed reductions of 0.6% in A1C (p=0.013), 3.7% in body weight (p=0.008), 1.7 kg/m(2) in body mass index (p=0.003), 13% in total daily insulin dose (p=0.011) and 9.3 units in bolus insulin dose (p=0.015). This study revealed that the addition of once-weekly exenatide to insulin therapy for type 1 diabetes patients leads to significant improvements in A1C, body weight, body mass index and insulin doses. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Associations Between Peer Counseling and Breastfeeding Initiation and Duration: An Analysis of Minnesota Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

PubMed

McCoy, Marcia Burton; Geppert, Joni; Dech, Linda; Richardson, Michaela

2018-01-01

Background Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation. Methods Retrospective analysis of observational data from the Minnesota WIC program's administrative database of women who gave birth in 2012 and accepted a PC program referral prenatally (n = 2219). Multivariate logistic regression and Cox regression models examined associations between peer services and breastfeeding initiation and continuation of any breastfeeding. Results Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19-2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33-0.61; months two through twelve: 0.33; 95% CI 0.18-0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother's country of origin. Conclusion for practice Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace.

PubMed

Weber, Danielle; Janson, Anneka; Nolan, Michelle; Wen, Li Ming; Rissel, Chris

2011-11-30

Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively), with little perceived support from the organisation (13%) and human resources (6%). Most women (92%) had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%). Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Enabling women to continue breastfeeding at work has benefits for the infant, employee and organisation. However, this baseline study of health employees revealed that women felt largely unsupported by managers and their organisation to continue breastfeeding at work.

Students' experiences with a longitudinal skills training program on breaking bad news: A follow-up study.

PubMed

Brouwers, M H; Bor, H; Laan, R; van Weel, C; van Weel-Baumgarten, E

2018-05-07

Breaking bad news (BBN) should be trained, preferably early and following a helical model with multiple sessions over time, including feedback on performance. It's unclear how medical students evaluate such an approach. We gathered student opinions regarding a helical BBN training programme, the feedback and emotional support they received, and the applicability of the skills training immediately after BBN skills training (Q1) and after finishing their clinical clerkships (Q2). Students find a helical curriculum useful, but this declines on follow-up. At Q2 students report less satisfaction with the amount of feedback and emotional support they received and report that the skills training was less applicable in clinical practice compared to what they reported at Q1. A helical BBN training programme with early exposure seems to lead to a shift from students being unconsciously incompetent to consciously incompetent. Students would have appreciated more emotional support and feedback. We recommend more feedback and emotional support after BBN during clerkships. The gap between classroom and practice can be diminished by emphasizing real life role play and clinical role models should demonstrate continuity and agreement between the skills that are taught and those that are used in clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

Utilising feedback from patients and their families as a learning strategy in a Foundation Degree in palliative and supportive care: a qualitative study.

PubMed

Pal, Laura M; Dixon, Rachael E; Faull, Christina M

2014-03-01

In the UK, support workers provide much of the care that palliative care patients receive, and a novel Foundation Degree was developed to enhance their skills. Feedback on performance is a recognised educational tool that reinforces good practice, and gives insight into areas of weakness, but its use with this workforce has not been described. The aim of this qualitative study is to explore tutor and support workers' experiences of seeking and receiving feedback from patients and their families; focusing on its values and challenges. Support workers enrolled onto the Foundation Degree in Palliative and Supportive Care, were asked to seek feedback from patients and/or their families about the care that they provided using a 'My Experience' questionnaire. Forms were returned anonymously to the course tutor who discussed results with the student as a formative education strategy. The students' experience of this was explored in focus group interviews at three time points. Two tutors' experiences were similarly explored. Results were analysed thematically. Students enjoyed receiving feedback. Positive feedback helped to increase confidence, and negative feedback allowed students to look critically at their practice and identify areas of weakness. Some experienced challenges in approaching patients/families due to having a small number of suitable patients/families; a reluctance to burden patients; high patient turnover and brevity of care relationships. The tutors enjoyed delivering feedback, recognising its benefits as an educational strategy. Some concern was expressed about how to balance delivering negative feedback while continuing to provide tutorial support throughout the Foundation Degree. User feedback is considered a key formative educational strategy. Its use in health and social support workers is not established. The experiences of students and tutors in this Foundation Degree demonstrate some of the benefits and challenges of this as an educational strategy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supportive care needs and psychological distress and/or quality of life in ambulatory advanced colorectal cancer patients receiving chemotherapy: a cross-sectional study.

PubMed

Sakamoto, Nobuhiro; Takiguchi, Shuji; Komatsu, Hirokazu; Okuyama, Toru; Nakaguchi, Tomohiro; Kubota, Yosuke; Ito, Yoshinori; Sugano, Koji; Wada, Makoto; Akechi, Tatsuo

2017-12-01

Although currently many advanced colorectal cancer patients continuously receive chemotherapy, there are very few findings with regard to the supportive care needs of such patients. The purposes of this study were to investigate the patients' perceived needs and the association with psychological distress and/or quality of life, and to clarify the characteristics of patients with a high degree of unmet needs. Ambulatory colorectal cancer patients who were receiving chemotherapy were asked to complete the Short-Form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support, and sexuality needs), the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Complete data were available for 100 patients. Almost all of the top 10 most common unmet needs belonged to the psychological domain. The patients' total needs were significantly associated with both psychological distress (r = 0.65, P < 0.001) and quality of life (r = -0.38, P < 0.001). A multiple regression analysis revealed that the female gender was significantly associated with higher total needs. The moderate to strong associations that exist between patients' needs and psychological distress and/or quality of life suggest that interventions that respond to patients' needs may be one possible strategy for ameliorating psychological distress and enhancing quality of life. Female patients' needs should be evaluated more carefully. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 97

NASA Technical Reports Server (NTRS)

1972-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 94)

NASA Technical Reports Server (NTRS)

1971-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 96

NASA Technical Reports Server (NTRS)

1971-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Aerospace medicine and biology: A continuing bibliography with indexes, supplement

NASA Technical Reports Server (NTRS)

1972-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 100)

NASA Technical Reports Server (NTRS)

1972-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. Reference describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Understanding resilience in armed conflict: Social resources and mental health of children in Burundi

PubMed Central

Hall, Brian J.; Tol, Wietse A.; Jordans, Mark J.D.; Bass, Judith; de Jong, Joop T.V.M.

2014-01-01

Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa, Johnson, & Feeny, 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B=−0.22, p<.001) and T2 and T3 (β=−0.25, p<.001), and with functional impairment between T1 and T2 (β=−0.15, p=.005) and T2 and T3 (β=−0.14, p=.005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β=0.16, p=.002) and T2 and T3 (β=0.16, p=.002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children’s mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children. PMID:24922609

The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial.

PubMed

van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P

2016-10-06

Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.

Sodium Nitroprusside Enhanced Cardiopulmonary Resuscitation Improves Short Term Survival in a Porcine Model of Ischemic Refractory Ventricular Fibrillation

PubMed Central

Yannopoulos, Demetris; Bartos, Jason A.; George, Stephen A.; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P.

2017-01-01

Introduction Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. Hypothesis SNPeCPR will increase short term (4-hour) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Methods Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5 minutes. Basic life support was performed for 10 minutes. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3 minutes. CPR continued for a total of 45 minutes, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60 minutes, if unsuccessful. SNPeCPR animals received 2 mg of SNP at minute 10 followed by 1 mg every 5 minutes until ROSC. Standard ACLS animals received 0.5 mg epinephrine every 5 minutes until ROSC. Primary endpoints were ROSC and 4-hour survival. Results All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-hour survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. Conclusion SNPeCPR significantly improved ROSC and 4-hour survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. PMID:27771299

Sodium nitroprusside enhanced cardiopulmonary resuscitation improves short term survival in a porcine model of ischemic refractory ventricular fibrillation.

PubMed

Yannopoulos, Demetris; Bartos, Jason A; George, Stephen A; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P

2017-01-01

Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. SNPeCPR will increase short term (4-h) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5min. Basic life support was performed for 10min. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3min. CPR continued for a total of 45min, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60min, if unsuccessful. SNPeCPR animals received 2mg of SNP at minute 10 followed by 1mg every 5min until ROSC. Standard ACLS animals received 0.5mg epinephrine every 5min until ROSC. Primary endpoints were ROSC and 4-h survival. All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-h survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. SNPeCPR significantly improved ROSC and 4-h survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Disorders of sex development: Mothers' experiences of support.

PubMed

Chivers, Clare; Burns, Jan; Deiros Collado, Martha

2017-10-01

An increasing body of research has sought to determine the impact of Disorders of Sex Development (DSD) on the family of the affected child. Little is currently understood about the support needs of the family and how well these needs are met. Interpretive Phenomenological Analysis was used to analyse semi-structured interviews with eight mothers of children with DSD about their experiences of support. Four master themes emerged which encapsulated (a) the stages in their child's development when mothers most needed support, (b) the importance of developing an understanding of the child's condition, (c) the lack of acknowledgement of the emotional needs of the parent and (d) the importance of having close and trusted networks for support. Continuity and availability of support were considered important and while all participants prioritised maintaining privacy about the condition, a minority felt that this impacted the level of support they received. Key time points for support were identified and while some felt that they were well supported others felt that the support available did not meet their emotional needs. Clinical implications and directions for future research were considered.

Continued family smoking after lung cancer diagnosis: the patient's perspective.

PubMed

Bottorff, Joan L; Robinson, Carole A; Sullivan, Kelli M; Smith, Michelle L

2009-05-01

To explore the influence of lung cancer diagnosis on interpersonal dynamics in families in which one or more members continue to smoke following diagnosis. Descriptive, qualitative. Three cancer care sites in western Canada. 16 participants from 8 family dyads. Patients with lung cancer receiving treatment and immediate family members were recruited to participate in individual or conjoint semistructured interviews. Thematic analysis was conducted on transcribed interviews. Intrafamily interaction patterns, smoking and smoking cessation, lung cancer diagnosis. Following diagnosis, patients with lung cancer experienced considerable distress as they struggled to understand family members' continued smoking. Patient orientations to family members who smoked included preserving relationships (maintaining harmony and connection with family members took priority over directly intervening with smokers) and risking relationships (patients repeatedly confronted family members about continued smoking to influence their cessation despite the impact on relationships). Neither pattern was successful in engaging relatives in smoking reduction or cessation, and the risking relationships approach resulted in conflict and strained family relationships. The findings provide additional support for examining family dynamics related to tobacco reduction and cessation as well as directions for future research. Nurses should encourage tobacco reduction as a supportive intervention for patients with lung cancer and their families to eliminate smoking-related distress.

The researchers have left the building: what contributes to sustaining school-based interventions following the conclusion of formal research support?

PubMed

Friend, Sarah; Flattum, Colleen F; Simpson, Danielle; Nederhoff, Dawn M; Neumark-Sztainer, Dianne

2014-05-01

This study examined the sustainability of New Moves, a school-based program aimed at decreasing weight-related problems in adolescent girls. The National Cancer Institute recognizes New Moves as a research-tested intervention program that produced positive behavioral and psychosocial outcomes. Ten schools participated in the sustainability study. Teachers completed a survey and interview, and research staff observed 1 physical education (PE) class within 2 years of the study's completion. Qualitative data were grouped by themes. Frequencies were calculated using quantitative data. All schools continued all-girls PE classes using New Moves components following the study period. Fewer schools continued the nutrition and social support classroom modules and individual coaching sessions while no schools continued lunch get-togethers. Program components were sustained in both New Moves intervention schools and control schools. Programs are most likely to be sustained if they (1) fit into the current school structure, (2) receive buy-in by teachers, and (3) require minimal additional funds or staff time. Providing control schools with minimal training and intervention resources was sufficient to continue program components if staff perceived the program was important for students' health and compatible within the school's existing infrastructure. © 2014, American School Health Association.

Quantum hacking of two-way continuous-variable quantum key distribution using Trojan-horse attack

NASA Astrophysics Data System (ADS)

Ma, Hong-Xin; Bao, Wan-Su; Li, Hong-Wei; Chou, Chun

2016-08-01

We present a Trojan-horse attack on the practical two-way continuous-variable quantum key distribution system. Our attack mainly focuses on the imperfection of the practical system that the modulator has a redundancy of modulation pulse-width, which leaves a loophole for the eavesdropper inserting a Trojan-horse pulse. Utilizing the unique characteristics of two-way continuous-variable quantum key distribution that Alice only takes modulation operation on the received mode without any measurement, this attack allows the eavesdropper to render all of the final keys shared between the legitimate parties insecure without being detected. After analyzing the feasibility of the attack, the corresponding countermeasures are put forward. Project supported by the National Basic Research Program of China (Grant No. 2013CB338002) and the National Natural Science Foundation of China (Grant Nos. 11304397 and 61505261).

Real-world treatment patterns and costs in a US Medicare population with metastatic squamous non-small cell lung cancer.

PubMed

Davis, Keith L; Goyal, Ravi K; Able, Stephen L; Brown, Jacqueline; Li, Li; Kaye, James A

2015-02-01

Despite advances in the treatment of nonsquamous non-small cell lung cancer (NSCLC), therapeutic choices and overall disease course for squamous NSCLC have remained relatively unchanged over the past several years. We provide a detailed account of current treatment patterns, healthcare use, and survival in real-world clinical settings for metastatic squamous NSCLC. Patients aged ≥65 years with metastatic squamous NSCLC diagnosed 2001-2009 were identified and followed through 2010 using the Surveillance, Epidemiology and End Results-Medicare database. Treatment patterns were descriptively analyzed. Multivariate logistic regressions were estimated to identify predictors of treatment pattern events; generalized linear models were estimated for total all-cause and NSCLC-related costs to assess cost drivers. Of 17,133 patients, 72% received cancer-directed therapy (surgery, radiation, chemotherapy, or biologic therapy), whereas 28% received only supportive care. Median survival was significantly longer in patients receiving cancer-directed therapy (8 months) than in patients receiving supportive care only (2 months) (P<0.0001). An agent-specific first-line chemotherapy regimen was identified for 91% of the 7700 patients who received chemotherapy. Among these, the most common first-line regimen was carboplatin-paclitaxel combination therapy (46%). Common second-line regimens were gemcitabine monotherapy (16%) and pemetrexed monotherapy (11%). Factors associated with decreased odds of receiving cancer-directed treatment were black versus white race (OR, 0.72; 95% CI, 0.64-0.82), residence in the West versus South (OR, 0.73; 95% CI, 0.66-0.81), and metastatic disease at initial diagnosis versus progression to metastatic disease (OR, 0.77; 95% CI, 0.70-0.84). Our study shows that prognosis remains poor for patients with metastatic squamous NSCLC, even among those receiving treatment, but particularly for patients limited to supportive care only, highlighting the continuing unmet medical need in this population. Additionally, our analysis indicates that selections for second-line and third-line chemotherapies are not necessarily consistent with National Comprehensive Cancer Network guidelines. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A Holistic Model of Care to Support Those Living with and beyond Cancer.

PubMed

Cadet, Tamara; Davis, Cindy; Elks, Jacinta; Wilson, Patricia

2016-11-18

Globally, the burden of cancer continues to increase and it is well-documented that while not a homogeneous population, cancer patients and cancer survivors face many physical, psychological, social, spiritual, and financial issues. Cancer care is shifting from a disease-focused to a patient-centered approach resulting in an increased need to address these concerns. Utilizing a quality improvement approach, this paper describes an integrated cancer care model at Bloomhill Cancer Center (BCC) in Queensland, Australia that demonstrates the ability to meet the holistic needs of patients living with and beyond cancer and to identify opportunities for better practice and service provision. Survey results indicate that 67% and 77% of respondents were very satisfied and 27% and 17% were satisfied with their first contact and very satisfied with their first meeting with a nurse at BCC. Clients also reported being very satisfied (46%) or satisfied (30%) with the emotional support they received at BCC and over 90% were very satisfied or satisfied with the touch therapies that the received. Due to the early success of the interventions provided by BCC, the model potentially offers other states and countries a framework for supportive cancer care provision for people living with and beyond cancer.

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

Usefulness and Validity of Continuous Performance Tests in the Diagnosis of Attention-Deficit Hyperactivity Disorder Children.

PubMed

Berger, Itai; Slobodin, Ortal; Cassuto, Hanoch

2017-02-01

Despite the popularity of continuous performance tests (CPT) in supporting the diagnostic procedure of attention-deficit hyperactivity disorder (ADHD), these measures are still controversial mainly due to limited sensitivity, specificity, and ecological validity. Thus, there continues to be a need for further validation of these objective attention measures. The purpose of this study was to evaluate the usefulness of a CPT that includes environmental distracting stimuli, in supporting the diagnosis of ADHD in children. Participants were 798 children aged 7-12 years (493 boys and 305 girls). The ADHD group included 339 children, whereas the control group included 459 children without ADHD. The study employed the MOXO-CPT, which incorporates visual and auditory stimuli serving as environmental distractors. Compared to their unaffected peers, children with ADHD received significantly lower scores in all 4 CPT indices: attention, timing, hyperactivity, and impulsivity. Specifically, ADHD children were less attended to the stimuli and performed fewer reactions on accurate timing. Furthermore, children with ADHD performed significantly more impulsive and hyperactive responses than controls. Receiver operating characteristic analysis revealed fair to excellent diagnostic ability of all CPT indices except impulsivity, which showed poor ability to distinguish ADHD children from controls. The test's total score yielded excellent diagnostic performance. MOXO-CPT consistently distinguished between children with ADHD and their unaffected peers, so that children with ADHD performed worse than controls in all study indices. Integration of CPT indices improves the diagnostic capacity of ADHD and may better reflect the complexity and heterogeneity of ADHD. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethical validity of palliative sedation therapy: a multicenter, prospective, observational study conducted on specialized palliative care units in Japan.

PubMed

Morita, Tatsuya; Chinone, Yoshikazu; Ikenaga, Masayuki; Miyoshi, Makoto; Nakaho, Toshimichi; Nishitateno, Kenji; Sakonji, Mitsuaki; Shima, Yasuo; Suenaga, Kazuyuki; Takigawa, Chizuko; Kohara, Hiroyuki; Tani, Kazuhiko; Kawamura, Yasuo; Matsubara, Tatsuhiro; Watanabe, Akihiko; Yagi, Yasuo; Sasaki, Toru; Higuchi, Akiko; Kimura, Hideyuki; Abo, Hirofumi; Ozawa, Taketoshi; Kizawa, Yoshiyuki; Uchitomi, Yosuke

2005-10-01

Although palliative sedation therapy is often required in terminally ill cancer patients to achieve acceptable symptom relief, empirical data supporting the ethical validity of this approach are lacking. The primary aim of this study was to systematically investigate whether empirical evidence supports the ethical validity of sedation. This was a multicenter, prospective, observational study, which was conducted by 21 specialized palliative care units in Japan. One-hundred two consecutive adult cancer patients who received continuous deep sedation were enrolled. Continuous deep sedation was defined as the continuous use of sedative medications to relieve intolerable and refractory distress by achieving almost or complete unconsciousness until death. Prior to the study, we conceptualized the ethical validity of sedation from the viewpoints of physicians' intent, proportionality, and autonomy. Sedation was performed mainly with midazolam and phenobarbital. The initial doses of midazolam and phenobarbital were 1.5 mg/hour and 20 mg/hour, respectively. Main administration routes were continuous subcutaneous infusion and continuous intravenous infusion, and no rapid intravenous injection was reported. Of 59 patients who received artificial hydration or could intake adequate fluids/foods orally before sedation, 63% received artificial hydration therapy after sedation, and in the remaining patients, artificial hydration was withheld or withdrawn due to fluid retention symptoms and/or patient wishes. Of 66 patients who were able to verbally express themselves, 95% explicitly stated that symptoms were intolerable. The etiologies of the symptoms requiring sedation were primarily related to the progression of the underlying malignancy, such as cancer cachexia and organ failure, and standard palliative treatments had failed: steroids in 68% of patients with fatigue, opioids in 95% of patients with dyspnea, antisecretion medications in 75% of patients with bronchial secretion, antipsychotic medications in 74% of patients with delirium, and opioids in all patients with pain. On the basis of the Palliative Prognostic Index, 94% of the patients were predicted to die within 3 weeks. Before sedation, 67% of the patients expressed explicit wishes for sedation. In the remaining 34 patients, previous wishes for sedation were noted in 4 patients, and in the other 30 patients, the families were involved in the decision-making process. The chief reason for patient non-involvement in the decision making was cognitive impairment. These data indicate that palliative sedation therapy performed in specialized palliative care units in Japan generally followed the principles of double effect, proportionality, and autonomy.

Decline of Supportive Attitudes among Husbands toward Female Genital Mutilation and Its Association to Those Practices in Yemen

PubMed Central

Al-Khulaidi, Ghadah Abdulmajid; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi

2013-01-01

Objectives To elucidate the attitudes of women and their husband’s towards female genital mutilation (FGM) and their associations with the continuation of FGM upon their daughters. Methods Subjects were 10,345 (in 1997) and 11,252 (in 2003) ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women. Findings The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001). The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001). When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively) and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively). Conclusion Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters. PMID:24367582

Decline of supportive attitudes among husbands toward female genital mutilation and its association to those practices in Yemen.

PubMed

Al-Khulaidi, Ghadah Abdulmajid; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi

2013-01-01

To elucidate the attitudes of women and their husband's towards female genital mutilation (FGM) and their associations with the continuation of FGM upon their daughters. Subjects were 10,345 (in 1997) and 11,252 (in 2003) ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women. The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001). The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001). When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively) and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively). Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters.

Waste Management Improvement Initiatives at Atomic Energy of Canada Limited - 13091

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

Chan, Nicholas; Adams, Lynne; Wong, Pierre

2013-07-01

Atomic Energy of Canada Limited's (AECL) Chalk River Laboratories (CRL) has been in operation for over 60 years. Radioactive, mixed, hazardous and non-hazardous wastes have been and continue to be generated at CRL as a result of research and development, radioisotope production, reactor operation and facility decommissioning activities. AECL has implemented several improvement initiatives at CRL to simplify the interface between waste generators and waste receivers: - Introduction of trained Waste Officers representing their facilities or activities at CRL; - Establishment of a Waste Management Customer Support Service as a Single-Point of Contact to provide guidance to waste generators formore » all waste management processes; and - Implementation of a streamlined approach for waste identification with emphasis on early identification of waste types and potential disposition paths. As a result of implementing these improvement initiatives, improvements in waste management and waste transfer efficiencies have been realized at CRL. These included: 1) waste generators contacting the Customer Support Service for information or guidance instead of various waste receivers; 2) more clear and consistent guidance provided to waste generators for waste management through the Customer Support Service; 3) more consistent and correct waste information provided to waste receivers through Waste Officers, resulting in reduced time and resources required for waste management (i.e., overall cost); 4) improved waste minimization and segregation approaches, as identified by in-house Waste Officers; and 5) enhanced communication between waste generators and waste management groups. (authors)« less

The Trust: The Classic Example of Soviet Manipulation.

DTIC Science & Technology

1985-09-01

Poland , returned to Paris. Visited Prague for awhile; received no help. Late summer, 1921 (T) Yavk’hev stops in Reval, Estonia and explains the...Paris since he was asked to leave Poland at the end of the Russo-Polish War in 1921. He was still trying to drum up support from Western ’The New York...Liod orge-and bav~ inov at Lloyd George s private home. When Savinkov entered Lloyd George aqd his family were singing. They continued to sing and

TARGET Publication Guidelines | Office of Cancer Genomics

Cancer.gov

Like other NCI large-scale genomics initiatives, TARGET is a community resource project and data are made available rapidly after validation for use by other researchers. To act in accord with the Fort Lauderdale principles and support the continued prompt public release of large-scale genomic data prior to publication, researchers who plan to prepare manuscripts containing descriptions of TARGET pediatric cancer data that would be of comparable scope to an initial TARGET disease-specific comprehensive, global analysis publication, and journal editors who receive such manuscripts, are

A cumulative index to a continuing bibliography on aerospace medicine and biology, January 1972

NASA Technical Reports Server (NTRS)

1972-01-01

Subject coverage concentrates on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Each entry consists of a standard citation accompanied by its abstract.

Defense Infrastructure: Guam Needs Timely Information from DOD to Meet Challenges in Planning and Financing Off-Base Projects and Programs to Support a Larger Military Presence

DTIC Science & Technology

2009-11-13

plan to guide the civilian community as a result of rapid military growth • Designing, testing, and implementation of an econometric model to...continue. 17 48 U.S.C. § 1423a. Most U.S. states and local municipalities have similar...additional revenue. For instance, Guam receives federal income taxes paid by military and civilian employees of the U.S. government stationed in Guam.22

Multidimensional Conservation Laws and Low Regularity Solutions

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

Barbara Lee Keyfitz

This is the concluding report for the project, a continuation of research by Keyfitz and co-workers on multidimensional conservation laws, and applications of nonhyperbolic conservation laws in the two-fluid model for multiphase flow. The multidimensional research project was started with Suncica Canic, at the University of Houston and with Eun Heui Kim, now at California State University Long Beach. Two postdoctoral researchers, Katarina Jegdic and Allen Tesdall, also worked on this research. Jegdic's research was supported (for a total of one year) by this grant. Work on nonhyperbolic models for two-phase flows is being pursued jointly with Michael Sever, Hebrewmore » University. Background for the project is contained in earlier reports. Note that in 2006, the project received a one-year no-cost extension that will end in September, 2007. A new proposal, for continuation of the research and for new projects, will be submitted in the Fall of 2007, with funding requested to begin in the summer of 2008. The reason for the 'funding gap' is Keyfitz's four-year stint as Director of the Fields Institute in Toronto, Canada. The research has continued, but has been supported by Canadian grant funds, as seems appropriate during this period.« less

Medical communication companies and industry grants.

PubMed

Rothman, Sheila M; Brudney, Karen F; Adair, Whitney; Rothman, David J

2013-12-18

Medical communication companies (MCCs) are among the most significant health care stakeholders, supported mainly by drug and device companies. How MCCs share or protect physicians' personal data requires greater transparency. To explore the financial relationships between MCCs and drug and device companies, to describe the characteristics of the large MCCs, and to explore whether they accurately represent themselves to physicians. We combined data from the 2010 grant registries of 14 pharmaceutical and device companies; grouped recipients into categories such as MCCs, academic medical centers, disease-targeted advocacy organizations, and professional associations; and created a master list of 19,272 grants. Determine the distribution of funds from drug and device companies to various entities and assess the characteristics of large MCCs. Of the 6493 recipients of more than $657 million grant awards from drug and device companies, 18 of 363 MCCs received 26%, academic medical centers received 21%, and disease-targeted organizations received 15%. For-profit MCCs received 77% of funds (208 of 363). Among the top 5% of MCCs, 14 of 18 were for-profit. All 18 offered continuing medical education: 14 offered live and 17 offered online CME courses. All required physicians to provide personal data. Ten stated that they shared information with unnamed third parties. Eight stated they did not share information, but almost all added exceptions. None required explicit physician consent to their sharing policies. Medical communication companies receive substantial support from drug and device companies. Physicians who interact with MCCs should be aware that all require personal data from the physician and some share these data with unnamed third parties.

Type D Personality, Social Support, and Depression Among Ethnic Chinese Coronary Artery Disease Patients Undergoing a Percutaneous Coronary Intervention: An Exploratory Study.

PubMed

Su, Shu-Fen; He, Chung-Ping

2018-01-01

This study investigated the relationships between Type D personality, depression, and social support among ethnic Chinese coronary artery disease (CAD) patients undergoing percutaneous coronary interventions. Type D personality is associated with CAD, and may increase patients' depression and mortality rate. However, very few studies have explored the relationships between depression and social support among ethnic Chinese Type D CAD patients. A longitudinal, repeated-measures design was used; 105 Taiwanese CAD patients undergoing a percutaneous coronary intervention were recruited between January and December 2015. A demographic questionnaire, Type D Scale, ENRICHD Social Support Inventory, and Patient Health Questionnaire-9 were completed by 102 participants (mean age = 64.42, SD = 13.67 years) at hospitalization, and at the second week and third month after discharge. Data were analyzed using t tests and a generalized estimating equation. Results indicated that 46.7% of participants who had Type D personality had lower social support and higher depression than did the remaining (non-Type D) participants. At two weeks after discharge, the improvement in social support was higher among Type D patients than non-Type D participants; the same was true for depression at two weeks and three months after discharge each. Type D Taiwanese CAD patients showed lower perceived social support and higher depression during hospitalization than did non-Type D participants. Furthermore, the more social support patients received at home, the lower was their depression. Health-care providers should provide continuous mental health care, conduct early screening of mental health issues, and ensure that patients receive sufficient social support to reduce depression.

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

Memory Support Strategies and Bundles: A Pathway to Improving Cognitive Therapy for Depression?

PubMed Central

Dong, Lu; Lee, Jason Y.; Harvey, Allison G.

2017-01-01

Objective Therapist use of memory support (MS) alongside treatment-as-usual, with the goal of enhancing patient recall of treatment contents, has been of recent interest as a novel pathway to improve treatment outcome. The Memory Support Intervention involves treatment providers’ using eight specific MS strategies to promote patient memory for treatment. The present study examines to what extent therapist use of MS strategies and bundles improves patient recall of treatment contents and treatment outcome. Methods The data were drawn from a pilot randomized controlled trial reported elsewhere. Participants were 48 adults (mean age = 44.27 years, 29 females) with major depressive disorder (MDD), randomized to receive 14 sessions of either CT+Memory Support (n = 25) or CT-as-usual (n = 23). Therapist use of MS was coded using the Memory Support Rating Scale. Patient memory and treatment outcomes were assessed at baseline, mid-treatment (patient recall only), post-treatment, and 6-month follow-up. Results Participants in CT+Memory Support received significantly higher amount of MS relative to CT-as-usual. Though not reaching statistical significance, small-to-medium effects were observed between MS strategies and patient recall in the expected direction. Although MS variables were not significantly associated with changes in continuous depressive symptoms, MS was associated with better global functioning. MS also exhibited small to medium effects on treatment response and recurrence in the expected direction but not on remission, though these effects did not reach statistical significance. Conclusions These results provide initial empirical evidence supporting an active method for therapists to implement MS strategies. PMID:28221056

Memory support strategies and bundles: A pathway to improving cognitive therapy for depression?

PubMed

Dong, Lu; Lee, Jason Y; Harvey, Allison G

2017-03-01

Therapist use of memory support (MS) alongside treatment-as-usual, with the goal of enhancing patient recall of treatment contents, has been of recent interest as a novel pathway to improve treatment outcome. The memory support intervention (MSI) involves treatment providers' using 8 specific MS strategies to promote patient memory for treatment. The present study examines to what extent therapist use of MS strategies and bundles improves patient recall of treatment contents and treatment outcome. The data were drawn from a pilot RCT reported elsewhere. Participants were 48 adults (mean age = 44.27 years, 29 females) with major depressive disorder (MDD), randomized to receive 14 sessions of either CT + Memory Support (n = 25) or CT-as-usual (n = 23). Therapist use of MS was coded using the Memory Support Rating Scale. Patient memory and treatment outcomes were assessed at baseline, midtreatment (patient recall only), posttreatment, and 6-month follow-up. Participants in CT + Memory Support received significantly higher amount of MS relative to CT-as-usual. Although not reaching statistical significance, small-to-medium effects were observed between MS strategies and patient recall in the expected direction. Although MS variables were not significantly associated with changes in continuous depressive symptoms, MS was associated with better global functioning. MS also exhibited small to medium effects on treatment response and recurrence in the expected direction but not on remission, though these effects did not reach statistical significance. These results provide initial empirical evidence supporting an active method for therapists to implement MS strategies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A framework for a context-aware elderly entertainment support system.

PubMed

Hossain, M Anwar; Alamri, Atif; Almogren, Ahmad S; Hossain, S K Alamgir; Parra, Jorge

2014-06-16

Elderly people constitute a major portion of world's population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL) with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers) to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living.

A Framework for a Context-Aware Elderly Entertainment Support System

PubMed Central

Hossain, M. Anwar; Alamri, Atif; Almogren, Ahmad S.; Hossain, SK Alamgir; Parra, Jorge

2014-01-01

Elderly people constitute a major portion of world's population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL) with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers) to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living. PMID:24936946

Long-Term Survival in Patients Receiving a Continuous-Flow Left Ventricular Assist Device.

PubMed

Gosev, Igor; Kiernan, Michael S; Eckman, Peter; Soleimani, Behzad; Kilic, Ahmet; Uriel, Nir; Rich, Jonathan D; Katz, Jason N; Cowger, Jennifer; Lima, Brian; McGurk, Siobhan; Brisco-Bacik, Meredith A; Lee, Sanjin; Joseph, Susan M; Patel, Chetan B

2018-03-01

Long-term survivors after implantation of left ventricular assist devices (LVADs) are increasing in prevalence. We describe the characteristics and outcomes in patients surviving longer than 4 years on LVAD support. We performed a multicenter, retrospective analysis of patients surviving at least 4 years on continuous-flow LVAD (CF-LVAD) support with a HeartMate II at centers participating in the Evolving Mechanical support Research Group. Between 2005 and 2010, 156 long-term survivors were identified with a mean survival of 7.1 years (95% confidence interval: 6.7 to 7.5 years). The mean age was 58.2 ± 15.2 years and 30.1% were women. Readmission rate was low at 1.1 events per patient per year with the most common reasons leading to readmission being infection (0.10 readmissions per patient per year) and gastrointestinal bleeding (0.07 readmissions per patient per year). Two years after implantation, 97% of patients were either New York Heart Association functional class I or II, with 92% at 4 years. Patients surviving 4 years on CF-LVAD support can anticipate ongoing long-term survival with sustained improvements in functionality and low rates of rehospitalization. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Effect on lung function of continuous positive airway pressure administered either by infant flow driver or a single nasal prong.

PubMed

Kavvadia, V; Greenough, A; Dimitriou, G

2000-04-01

The aim of this study was to assess if continuous positive airways pressure (CPAP) delivered by an infant flow driver (IFD) was a more effective method of improving lung function than delivering CPAP by a single nasal prong. A total of 36 infants (median gestational age 29 weeks, range 25-35 weeks) were studied, 12 who received CPAP via an IFD, 12 who received CPAP via a single nasal prong and 12 without CPAP. CPAP was administered post extubation if apnoeas and bradycardias or a respiratory acidosis developed or electively if the infant was of birth weight <1.0 kg. Lung function was assessed by the supplementary oxygen requirement and measurement of compliance of the respiratory system using an occlusion technique. Assessments were made immediately prior to and after 24 h of CPAP administration and at similar postnatal ages in the non-CPAP group. The infants who did not require CPAP had better lung function (non significant) than the other two groups before they received CPAP. After 24 h, lung function had improved in both CPAP groups to the level of the non CPAP infants. The supplementary oxygen requirements of all three groups decreased over the 24 h period, but this only reached significance in the single nasal prong group (P<0.05). Four infants supported by the IFD, but none with a single nasal prong, became hyperoxic. Continuous positive airways pressure administration via the infant flow driver appears to offer no short-term advantage over a single nasal prong system when used after extubation in preterm infants.

Selecting services for a service robot: evaluating the problematic activities threatening the independence of elderly persons.

PubMed

Bedaf, Sandra; Gelderblom, Gert Jan; de Witte, Luc; Syrdal, Dag; Lehmann, Hagen; Amirabdollahian, Farshid; Dautenhahn, Kerstin; Hewson, David

2013-06-01

Sustaining independent living for the elderly is desirable both for the individual as well as for societies as a whole. Substantial care interventions are provided to citizens supporting their independent living. Currently, such interventions are primarily based on human care provision, but due to demographic changes the demand for such support is continuously increasing. Assistive Robotics has the potential to answer this growing demand. The notions research towards service robots that support the independence of elderly people has been given increased attention. The challenge is to develop robots that are able to adequately support with those activities that pose the greatest problems for elderly people seeking to remain independent. In order to develop the capabilities of the Care-O-bot 3 in the ACCOMPANY project, problematic activities that may threaten continued independent living of elderly people were studied. Focus groups were conducted in the Netherlands, UK, and France and included three separate user groups: (1) elderly (N=41), (2) formal caregivers (N=40), and (3) informal caregivers (N=32). This resulted in a top 3 of problematic activity domains that received the highest priority: (1) Mobility, (2) Self-care, and (3) Social isolation. The findings inform the further development of the Care-O-bot. In the ACCOMPANY project the Care-O-bot 3 will be developed further to enable it to support independently living older persons in one of these domains.

Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support: results from the Diabetes Attitudes, Wishes and Needs (DAWN2) study.

PubMed

Byrne, J L; Davies, M J; Willaing, I; Holt, R I G; Carey, M E; Daly, H; Skovlund, S; Peyrot, M

2017-08-01

To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17 countries to assess diabetes healthcare provision, self-management support and training. Of the healthcare professionals surveyed, 33.5% received formal postgraduate training in self-management (19.3-51.4% across countries) and 62.9% received training for medical management of diabetes (47.6-70.6% variation). Training in psychological management was low (19.1%), ranging from 3.6 to 36.5%, while 20.4% (a range of 3.6-36.4% across countries) had received no postgraduate training. Overall, the greatest training need was in the management of psychological aspects of diabetes (59.5%). For some, training in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31-60% of healthcare professionals across the different countries reported that this only occurred if initiated by patients. Approximately two-thirds of participants reported a need for major improvements in emotional/psychological support, but few had received training in this area, with consistent findings across professional affiliations. The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management of diabetes. It is paramount that those responsible for the continuing professional development of healthcare professionals address this skills gap. © 2017 Diabetes UK.

[Effects of social support on the adjustment to extracurricular sports activities among junior high school students].

PubMed

Koshi, Ryoko; Sekizawa, Keiko

2009-10-01

This study examined the hypothesis that when students received and/or provided either support for skill improvement or support for interpersonal relations, their overall adjustment level in extracurricular activities would be higher than for students who received and/or provided neither support. Data were analyzed from 475 junior high school students (female 175, male 300) who were taking extracurricular sports activities, out of 743 research participants. The results were as follows. Students who received support mainly for skill improvement showed a statistically equivalent adjustment level as students who received support mainly for interpersonal relations. Students who received either support showed higher adjustment levels than students who received neither. Additionally, providing support showed the same results. The exchange of different types of social support showed equivalent effects on the adjustment level as the exchange of the same type of social support. These results suggest that even though the types of social support are different for skill improvement or interpersonal relations, the exchange of support positively contributes to junior high school students' adjustment level in extracurricular activities.

Structuring Community Care using Multi-Agent Systems

NASA Astrophysics Data System (ADS)

Beer, Martin D.

Community care is a complex operation that requires the interaction of large numbers of dedicated individuals, managed by an equally wide range of organisations. They are also by their nature highly mobile and flexible, moving between clients in whatever order person receiving care is that they receive what they expect regularly, reliably and when they expect to receive it. Current systems are heavily provider focused on providing the scheduled care with as high apparent cost effectiveness as possible. Unfortunately, the lack of focus on the client often leads to inflexibility with expensive services being provided when they are not needed, large scale duplication of effort or inadequate flexibility to change the care regime to meet changing circumstances. Add to this the problems associated with the lack of integration of emergency and routing care and the extensive support given by friends and family and many opportunities exist to improve both the levels of support and the efficiency of care. The move towards Individual Care Plans requires much closer monitoring to ensure that the care specified for each individual is actually delivered and when linked with smart home technology in conjunction with appropriate sensors allows a much richer range of services to be offered which can be customised to meet the needs of each individual, giving them the assurance to continue to live independently.

Ultrasonics and space instrumentation

NASA Technical Reports Server (NTRS)

1987-01-01

The design topic selected was an outgrowth of the experimental design work done in the Fluid Behavior in Space experiment, which relies on the measurement of minute changes of the pressure and temperature to obtain reasonably accurate volume determinations. An alternative method of volume determination is the use of ultrasonic imaging. An ultrasonic wave system is generated by wall mounted transducer arrays. The interior liquid configuration causes reflection and refraction of the pattern so that analysis of the received wave system provides a description of the configuration and hence volume. Both continuous and chirp probe beams were used in a laboratory experiment simulating a surface wetting propellant. The hardware included a simulated tank with gaseous voids, transmitting and receiving transducers, transmitters, receivers, computer interface, and computer. Analysis software was developed for image generation and interpretation of results. Space instrumentation was pursued in support of a number of experiments under development for GAS flights. The program included thirty undergraduate students pursuing major qualifying project work under the guidance of eight faculty supported by a teaching assistant. Both mechanical and electrical engineering students designed and built several microprocessor systems to measure parameters such as temperature, acceleration, pressure, velocity, and circulation in order to determine combustion products, vortex formation, gas entrainment, EMR emissions from thunderstorms, and milli-g-accelerations due to crew motions.

Solar central receiver heliostat reflector assembly

DOEpatents

Horton, Richard H.; Zdeb, John J.

1980-01-01

A heliostat reflector assembly for a solar central receiver system comprises a light-weight, readily assemblable frame which supports a sheet of stretchable reflective material and includes mechanism for selectively applying tension to and positioning the sheet to stretch it to optical flatness. The frame is mounted on and supported by a pipe pedestal assembly that, in turn, is installed in the ground. The frame is controllably driven in a predetermined way by a light-weight drive system so as to be angularly adjustable in both elevation and azimuth to track the sun and efficiently continuously reflect the sun's rays to a focal zone, i.e. central receiver, which forms part of a solar energy utilization system, such as a solar energy fueled electrical power generation system. The frame may include a built-in system for testing for optical flatness of the reflector. The preferable geometric configuration of the reflector is octagonal; however, it may be other shapes, such as hexagonal, pentagonal or square. Several different embodiments of means for tensioning and positioning the reflector to achieve optical flatness are disclosed. The reflector assembly is based on the stretch frame concept which provides an extremely light-weight, simple, low-cost reflector assembly that may be driven for positioning and tracking by a light-weight, inexpensive drive system.

Patients' perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity.

PubMed

McCann, L; Maguire, R; Miller, M; Kearney, N

2009-03-01

Chemotherapy forms a core component of treatment for the majority patients with cancer. Recent changes in cancer services mean patients frequently receive such treatment as outpatients and are often required to manage side effects at home without direct support from oncology health professionals. Information technology continues to develop to support patients in the community; this study evaluated the impact of a mobile phone-based advanced symptom management system (ASyMS) on chemotherapy related toxicity in patients with lung, breast or colorectal cancer. One hundred and twelve patients were randomized from seven clinical sites across the UK; 56 patients used the mobile phone to record their symptoms, sending their reports directly to the nurses at their clinical site; 56 control group patients received standard care. Health professionals were alerted about any severe or life-threatening symptoms through the development of a chemotherapy symptom risk model. Patients' perceptions of ASyMS were evaluated pre and post participation. Patients reported many benefits of using ASyMS including improved communication with health professionals, improvements in the management of their symptoms, and feeling reassured their symptoms were being monitored while at home. ASyMS has the potential to positively impact on the management of symptoms in patients receiving chemotherapy treatment.

Optimal Timing of Heart Transplant After HeartMate II Left Ventricular Assist Device Implantation.

PubMed

Steffen, Robert J; Blackstone, Eugene H; Smedira, Nicholas G; Soltesz, Edward G; Hoercher, Katherine J; Thuita, Lucy; Starling, Randall C; Mountis, Maria; Moazami, Nader

2017-11-01

Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up. Optimal transplantation timing was the product of surviving on LVAD support and surviving transplant. Three-year survival after both HeartMate II implantation and heart transplantation was unchanged when transplantation occurred within 9 months of implantation. Survival decreased as the duration of support exceeded this. Preoperative risk factors for death on HeartMate II support were prior valve operation, prior coronary artery bypass grafting, low albumin, low glomerular filtration rate, higher mean arterial pressure, hypertension, and earlier date of implant. Survival for patients without these risk factors was lowest when transplant was performed within 3 months but was relatively constant with increased duration of support. Longer duration of support was associated with poorer survival for patients with many of these risk factors. Device reimplantation, intracranial hemorrhage, and postimplant dialysis during HeartMate II support were associated with decreased survival. Survival of patients supported by the HeartMate II is affected by preoperative comorbidities and postoperative complications. Transplantation before complications is imperative in optimizing survival. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Management of Pediatric Perforated Appendicitis: Comparing Outcomes Using Early Appendectomy Versus Solely Medical Management.

PubMed

Bonadio, William; Rebillot, Katie; Ukwuoma, Onyinyechi; Saracino, Christine; Iskhakov, Arthur

2017-10-01

There is controversy regarding whether children with perforated appendicitis should receive early appendectomy (EA) versus medical management (MM) with antibiotics and delayed interval appendectomy. The objective of this study was to compare outcomes of children with perforated appendicitis who receive EA versus MM. Case review of consecutive children <18 years of age with perforated appendicitis who received either EA or MM during an 8-year period. Criteria for hospital discharge included patient being afebrile for at least 24 hours, pain-free and able to tolerate oral intake. Of 203 patients diagnosed with perforated appendicitis, 122 received EA and 81 received MM. All received parenteral antibiotic therapy initiated in the emergency department and continued during hospitalization. There were no significant differences between groups in mean patient age, mean complete blood count total white blood cells count, gender distribution, rates of emergency department fever or rates of intra-abdominal infection (abscess or phlegmon) identified on admission. Compared with patients receiving MM, those receiving EA experienced significantly fewer (1) days of hospitalization, parenteral antibiotic therapy and in-hospital fever; (2) radiographic studies, percutaneous drainage procedures and placement of central venous catheters performed; (3) post admission intra-abdominal complications and (4) unscheduled repeat hospitalizations after hospital discharge. Only 1 EA-managed patient developed a postoperative wound infection. Children with perforated appendicitis who receive EA experience significantly less morbidity and complications versus those receiving MM. The theoretical concern for enhanced morbidity associated with EA management of perforated appendicitis is not supported by our analysis.

Financing graduate medical education in family medicine.

PubMed

Colwill, J M

1989-03-01

Family practice residency programs differ fiscally from residency programs in most other specialties because they have limited income-generating potential. The present review demonstrates that the typical family practice residency program has been fiscally solvent as a result of receiving approximately one-third of its income from state and federal appropriations. The level of such support plateaued in the 1980s and programs have not continued to expand despite an ongoing shortage of family physicians. Today, declining Medicare payments to hospitals threaten hospitals' contributions to family practice residency programs. The ability of family practice residency programs to meet the continuing need for family physicians will depend upon the development of specific state and federal policies that provide fiscal incentives to maintain and expand family practice residencies.

Perspectives on the state-of-the-science in rehabilitation medicine and its implications for Medicare postacute care policies.

PubMed

Gage, Barbara; Stineman, Margaret; Deutsch, Anne; Mallinson, Trudy; Heinemann, Allen; Bernard, Shulamit; Constantine, Roberta

2007-12-01

Better measurement of the case-mix complexity of patients receiving rehabilitation services is critical to understanding variations in the outcomes achieved by patients treated in different postacute care (PAC) settings. The Medicare program recognized this issue and is undertaking a major initiative to develop a new patient-assessment instrument that would standardize case-mix measurement in inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities, and home health agencies. The new instrument, called the Continuity Assessment Record and Evaluation Tool, builds on the scientific advances in measurement to develop standard measures of medical acuity, functional status, cognitive impairment, and social support related to resource need, outcomes, and continuity of care for use in all PAC settings.

Design requirements, challenges, and solutions for high-temperature falling particle receivers

NASA Astrophysics Data System (ADS)

Christian, Joshua; Ho, Clifford

2016-05-01

Falling particle receivers (FPR) utilize small particles as a heat collecting medium within a cavity receiver structure. Previous analysis for FPR systems include computational fluid dynamics (CFD), analytical evaluations, and experiments to determine the feasibility and achievability of this CSP technology. Sandia National Laboratories has fabricated and tested a 1 MWth FPR that consists of a cavity receiver, top hopper, bottom hopper, support structure, particle elevator, flux target, and instrumentation. Design requirements and inherent challenges were addressed to enable continuous operation of flowing particles under high-flux conditions and particle temperatures over 700 °C. Challenges include being able to withstand extremely high temperatures (up to 1200°C on the walls of the cavity), maintaining particle flow and conveyance, measuring temperatures and mass flow rates, filtering out debris, protecting components from direct flux spillage, and measuring irradiance in the cavity. Each of the major components of the system is separated into design requirements, associated challenges and corresponding solutions. The intent is to provide industry and researchers with lessons learned to avoid pitfalls and technical problems encountered during the development of Sandia's prototype particle receiver system at the National Solar Thermal Test Facility (NSTTF).

Effects of a new sports companion on received social support and physical exercise: an intervention study.

PubMed

Rackow, Pamela; Scholz, Urte; Hornung, Rainer

2014-11-01

The role of social support in physical exercise is well documented. However, the majority of studies that investigate the associations between social support and physical exercise target perceived instead of received social support. Moreover, most studies investigate the effects of received social support using a descriptive correlational design. Thus, our study aimed at investigating the effects of received social support by conducting an intervention study. Participants were randomly assigned to an intervention (n = 118) or control group (n = 102). The intervention comprised regularly exercising with a new sports companion for eight weeks. To investigate the time course of physical exercise and received social support, growth curve modelling was employed. Generally, both groups were able to improve their physical exercise. However, the control group tended to decrease again during the final point of measurement. Received social support, however, decreased slightly in the control group, but remained stable in the intervention group. The intervention was suitable to sustain received social support for physical exercise across a two-month interval. Overall, these findings highlight the importance of further investigating social support for physical exercise applying an experimental approach. © 2014 The International Association of Applied Psychology.

Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure.

PubMed

Hassinger, Amanda B; Breuer, Ryan K; Nutty, Kirsten; Ma, Chang-Xing; Al Ibrahim, Omar S

2017-12-01

The objective of this work was to describe the use of negative-pressure ventilation (NPV) in a heterogeneous critically ill, pediatric population. A retrospective chart review was conducted of all patients admitted to a pediatric ICU with acute respiratory failure supported with NPV from January 1, 2012 to May 15, 2015. Two hundred thirty-three subjects at a median age of 15.5 months were supported with NPV for various etiologies, most commonly bronchiolitis (70%). Median (interquartile range) duration of support was 18.7 (8.7-34.3) h. The majority were NPV responders (70%), defined as not needing escalation to any form of positive-pressure ventilation. In non-responders, escalation occurred at a median (interquartile range) of 6.9 (3.3-16.6) h. More NPV non-responders had upper-airway obstruction ( P = .02), and fewer had bronchiolitis ( P = .008) compared with responders. A bedside scoring system developed on these data was 98% specific in predicting NPV failure by 4 h after NPV start (area under the curve 0.759, 95% CI 0.675-0.843, P < .001). Complications from NPV were rare (3%); however, delayed enteral nutrition (33%) and continuous intravenous sedation use (51%) in children while receiving NPV were more frequent. The annual percentage of pediatric ICU admissions requiring intubation declined by 28% in the 3 y after NPV introduction, compared with the 3 y prior. NPV is a noninvasive respiratory support for pediatric acute respiratory failure from all causes with few complications and a 70% response rate. Children receiving NPV often required intravenous sedation for comfort, and one third received delayed enteral nutrition. Those who required escalation from NPV worsened within 6 h; this may be predictable with a bedside scoring system. Copyright © 2017 by Daedalus Enterprises.

Five-year follow-up on the work force and finances of United States anesthesiology training programs: 2000 to 2005.

PubMed

Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2007-04-01

In the middle 1990s, there was a decrease in anesthesiology residency class sizes, which contributed to a nationwide shortage of anesthesiologists, resulting in a competitive market with increased salary demands. In 1999, a nationwide survey of the financial status of United States anesthesiology training programs was conducted. Follow-up surveys have been conducted each year thereafter. We present the results of the sixth survey in this series. Surveys were distributed by e-mail to the anesthesiology department chairs of the United States Training Programs. Responses were also received by e-mail. One hundred twenty-one departments were surveyed with a response rate of 60%. The 87% of departments seeking at least one additional faculty had an average of 2.8 faculty open positions (5.5% open positions overall which is down from 9.7% in 2000). Of the 96% of departments that employ certified registered nurse anesthetists (CRNAs) 89% were seeking additional CRNAs, averaging 3.6 open positions. The average department received $4.9 million (or $116,000/faculty) in institutional support. When the portion of this support allocated for CRNA salaries was removed, the average department received $4.1 million (or $95,000/faculty) in institutional support. This is a 16% increase over the previous year. Faculty academic time averaged 17% (where 20% is 1 d/wk). Departments billed an average of 11,320 anesthesia units/faculty/yr. Although the average anesthesia unit value collected was $31, departments required approximately $40/U to meet expenses. Medicaid payments averaged $15, ranging from $5 to $30/U. These results demonstrate the continuing need for institutional support to keep anesthesiology training departments financially stable.

The Impact of Financial Disclosure on Attendee Assessment of Objectivity in Continuing Medical Education Programs in Psychiatry: A Randomized, Controlled Trial.

PubMed

Jibson, Michael D; Cobourn, Lisa A; Seibert, Jennifer K

2016-04-01

The purpose of financial conflict of interest disclosures by speakers at continuing medical education (CME) programs is to assist attendees in their assessment of the objectivity of the information presented. This empirical study was undertaken to determine what level of disclosure is optimal to achieve this goal. Attendees at five CME programs were randomly assigned to receive either a standard financial disclosure, an intermediate level that included whether speakers received more or less than 5% of their income from each company they disclosed, or a high level of disclosure that included the percent of their income derived from each company. A total of 169 attendees (85.4% response rate) completed a questionnaire regarding the objectivity of the CME presentation they attended. Attendees receiving the highest level of disclosure came significantly closer to the ratings of speaker bias made by peer reviewers than did attendees receiving medium or low levels of disclosure (p = 0.03; effect size 0.31). Among the minority of attendees who received the highest level of disclosure but whose assessment of bias differed from that of peer reviewers, however, there was a tendency to underestimate bias (5.9 vs 31.4%; p < 0.0001). The major limitation of this study was an overall low level of bias in the presentations, making it difficult to generalize these findings to less objective programs. The study did not address whether the process of disclosure had an impact on speakers' behavior. This study provides mixed support for higher levels of financial disclosure than are currently required for CME programs.

The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden

PubMed Central

Melin-Johansson, Christina; Öhlén, Joakim; Koinberg, Ingalill; Berg, Linda; Nolbris, Margaretha Jenholt

2015-01-01

The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs. PMID:28462312

ACS-Hach Programs: Supporting Excellence in High School Chemistry Teaching

NASA Astrophysics Data System (ADS)

Taylor, Terri

2009-05-01

In January 2009, the ACS received a gift of approximately $33 million from the Hach Scientific Foundation, the largest gift in the society's 133-year history. The foundation's programs will be continued by the ACS and will complement pre-existing ACS resources that support high school chemistry teaching. Three activities serve as the pillars of the ACS-Hach programs—the High School Chemistry Grant Program, the Second Career Teacher Scholarship Program, and the Land Grant University Scholars Program. Collectively, the ACS-Hach programs support high school chemistry teaching and learning by responding to the needs of both in-service and pre-service secondary teachers. The goals of each of the ACS-Hach programs align well with the ACS Mission—to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and its people.

Drug Interactions in Childhood Cancer

PubMed Central

Haidar, Cyrine; Jeha, Sima

2016-01-01

Children with cancer are increasingly benefiting from novel therapeutic strategies and advances in supportive care, as reflected in improvements in both their survival and quality of life. However, the continuous emergence of new oncology drugs and supportive care agents has also increased the possibility of deleterious drug interactions and healthcare providers need to practice extreme caution when combining medications. In this review, we discuss the most common interactions of chemotherapeutic agents with supportive care drugs such as anticonvulsants, antiemetics, uric acid–lowering agents, acid suppressants, antimicrobials, and pain management medications in pediatric oncology patients. As chemotherapy agents interact not only with medications but also with foods and herbal supplements that patients receive during the course of their treatment, we also briefly review such interactions and provide recommendations to avoid unwanted and potentially fatal interactions in children with cancer. PMID:20869315

Effects of music therapy on drug avoidance self-efficacy in patients on a detoxification unit: a three-group randomized effectiveness study.

PubMed

Silverman, Michael J

2014-01-01

Self-efficacy is a component of Bandura's social cognitive theory and can lead to abstinence and a reduction of relapse potential for people who have substance abuse disorders. To date, no music therapy researcher has utilized this theoretical model to address abstinence and reduce the likelihood of relapse in people who have addictions. The purpose of this study was to determine the effects of music therapy on drug avoidance self-efficacy in a randomized three-group wait-list control design with patients on a detoxification unit. Participants (N = 131) were cluster randomized to one of three single-session conditions: music therapy, verbal therapy, or wait-list control. Music therapy participants received a group lyric analysis intervention, verbal therapy participants received a group talk therapy session, and wait-list control participants eventually received a group recreational music therapy intervention. Although there was no significant between-group difference in drug avoidance self-efficacy, participants in the music therapy condition tended to have the highest mean drug avoidance self-efficacy scores. Posttest written comments supported the use of both music therapy and verbal therapy sessions. Two music therapy participants specifically noted that their initial skepticism had dissipated after receiving music therapy. Despite a lack of significant differences, the theoretical support of self-efficacy for substance abuse rehabilitation suggests that this may be an area of continued clinical focus and empirical investigation. Clinical anecdotes, limitations of the study, and suggestions for future research are provided.

Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience.

PubMed

Mazerolle, Stephanie M; Clines, Stephanie; Eason, Christianne M; Pitney, William A

2015-12-01

The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Semistructured phone interviews. Graduate-assistant ATs in various clinical settings. Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years. Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience.

Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience

PubMed Central

Mazerolle, Stephanie M.; Clines, Stephanie; Eason, Christianne M.; Pitney, William A.

2015-01-01

Context  The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. Objective  To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Design  Semistructured phone interviews. Setting  Graduate-assistant ATs in various clinical settings. Patients or Other Participants  Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non–athletic training-based curriculum = 6). Median age was 24 years. Data Collection and Analysis  Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Results  Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Conclusions  Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience. PMID:26565423

Cervical cancer survivorship: Long-term quality of life and social support

PubMed Central

Pfaendler, Krista S.; Wenzel, Lari; Mechanic, Mindy B.; Penner, Kristine R.

2015-01-01

Purpose Surgery, radiotherapy and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5 year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. Methods Pertinent articles were identified through searches of PubMed for literature published from 1993-2014. We summarize quality of life data from long-term follow up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. Findings Data is varied in terms of the long term impact of treatment on quality of life but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. Implications Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment, and evaluating the effects of supportive care, may reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care. PMID:25592090

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes. Supplement 488

NASA Technical Reports Server (NTRS)

1999-01-01

This report lists reports, articles and other documents recently announced in the NASA STI Database. In its subject coverage, Aerospace Medicine and Biology concentrates on the biological, physiological, psychological, and environmental effects to which humans are subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects on biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. Applied research receives the most emphasis, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion. Each entry in the publication consists of a standard bibliographic citation accompanied, in most cases, by an abstract.

Extending the Fermi-LAT data processing pipeline to the grid

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

Zimmer, S.; Arrabito, L.; Glanzman, T.

2015-05-12

The Data Handling Pipeline ("Pipeline") has been developed for the Fermi Gamma-Ray Space Telescope (Fermi) Large Area Telescope (LAT) which launched in June 2008. Since then it has been in use to completely automate the production of data quality monitoring quantities, reconstruction and routine analysis of all data received from the satellite and to deliver science products to the collaboration and the Fermi Science Support Center. Aside from the reconstruction of raw data from the satellite (Level 1), data reprocessing and various event-level analyses are also reasonably heavy loads on the pipeline and computing resources. These other loads, unlike Levelmore » 1, can run continuously for weeks or months at a time. Additionally, it receives heavy use in performing production Monte Carlo tasks.« less

Measuring Communities of Faith: A Preliminary Investigation

PubMed Central

Krause, Neal; Hayward, R. David

2013-01-01

Numerous references are made in the literature to communities of faith, yet there have been relatively few efforts to measure them empirically. The purpose of this study is to address this gap in the literature by estimating a higher-order confirmatory factor model that consists of two tiers. Seven dimensions of church-based social support make up the first tier: emotional support received from rank-and-file church members, emotional support given to fellow church members, tangible support received from rank-and-file church members, tangible support given to fellow congregants, spiritual support received from fellow church members, emotional support received from a pastor, and tangible support received from a pastor. It is hypothesized that these first-order constructs are driven by a higher-order latent variable that denotes a community of faith. Data from a nationwide survey reveal that, for the sample taken as a whole, emotional support represents the way in which a community of faith is most likely to be manifest while tangible support is a less critical component. Moreover, the results indicate that a community of faith is more likely to reside in support exchanged among rank-and-file church members than support received from a pastor. PMID:24039556

Explaining the Variable Effects of Social Support on Work-Based Stressor-Strain Relations: The Role of Perceived Pattern of Support Exchange.

PubMed

Nahum-Shani, Inbal; Bamberger, Peter A

2011-01-01

Seeking to explain mixed empirical findings regarding the buffering effect of social support on work-based stress-strain relations, we posit that whether an increase in the level of support received buffers or exacerbates the harmful effects of workload on employee health and well-being is contingent upon the general pattern characterizing an employee supportive exchanges across his/her close relationships. Specifically, we propose that the buffering effect of receiving social support depends on whether the employee perceives his/her social exchanges as reciprocal (support given equals support received), under-reciprocating (support given exceeds support received), or over-reciprocating (support received exceeds support given). Based on longitudinal data collected from a random sample of blue-collar workers, our findings support our predictions, indicating that the buffering effect of social support on the relationship between work hours (on the one hand) and employee health and well-being (on the other) varies as a function of the pattern of exchange relations between an employee and his/her close support providers.

Explaining the Variable Effects of Social Support on Work-Based Stressor-Strain Relations: The Role of Perceived Pattern of Support Exchange

PubMed Central

Nahum-Shani, Inbal; Bamberger, Peter A.

2010-01-01

Seeking to explain mixed empirical findings regarding the buffering effect of social support on work-based stress-strain relations, we posit that whether an increase in the level of support received buffers or exacerbates the harmful effects of workload on employee health and well-being is contingent upon the general pattern characterizing an employee supportive exchanges across his/her close relationships. Specifically, we propose that the buffering effect of receiving social support depends on whether the employee perceives his/her social exchanges as reciprocal (support given equals support received), under-reciprocating (support given exceeds support received), or over-reciprocating (support received exceeds support given). Based on longitudinal data collected from a random sample of blue-collar workers, our findings support our predictions, indicating that the buffering effect of social support on the relationship between work hours (on the one hand) and employee health and well-being (on the other) varies as a function of the pattern of exchange relations between an employee and his/her close support providers. PMID:21152110

Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction.

PubMed

Floris, Lucia; Irion, Olivier; Bonnet, Jocelyne; Politis Mercier, Maria-Pia; de Labrusse, Claire

2018-04-01

According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period. The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care. This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women's Experiences Maternity Care Scale, two months after giving birth. In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care. Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

AIDS chief says nonoxynol-9 not effective against HIV.

PubMed

According to Dr. Peter Piot, executive director of the Joint UN Programme on HIV/AIDS (UNAIDS), the international multi-site trial of the spermicide nonoxynol-9 in gel form has shown that it is not effective in protecting women from HIV infection. This large-scale Phase III efficacy trial was conducted among female sex workers in Benin, Cote d'Ivoire, South Africa, and Thailand. Apart from receiving the trial microbicide or a placebo, participants also received classical HIV prevention support, such as free condoms, free treatment for sexually transmitted infections, counseling, and peer support. One positive outcome of the trial is that fewer of the sex workers who participated became infected with HIV, compared with the sex workers who did not participate at all in the study. However, Piot states that even if the results of the trials are disappointing, the search for an effective microbicide continues. To this effect, at least 36 compounds are at the preclinical testing stage, while 20 are ready for early safety trials in human volunteers and three additional compounds are being considered for large-scale trials.

Social support and subjective burden in caregivers of adults and older adults: A meta-analysis

PubMed Central

Frías-Osuna, Antonio; Palomino-Moral, Pedro A.; Ruzafa-Martínez, María; Ramos-Morcillo, Antonio J.

2018-01-01

Background Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. Objective The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult. Methods A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies. Results Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001). Conclusions 1) perceived and received support are not redundant constructs, 2) the relationships between social support and subjective burden depend on whether the social support is measured as perceived or received, 3) the relationship of perceived social support with subjective burden has a bigger effect size than that of received social support, the relation between received support and subjective burden being clinically irrelevant, 4) perceived social support may be a good predictor of subjective burden. Implications of key findings Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden. PMID:29293522

Social support and subjective burden in caregivers of adults and older adults: A meta-analysis.

PubMed

Del-Pino-Casado, Rafael; Frías-Osuna, Antonio; Palomino-Moral, Pedro A; Ruzafa-Martínez, María; Ramos-Morcillo, Antonio J

2018-01-01

Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult. A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies. Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001). 1) perceived and received support are not redundant constructs, 2) the relationships between social support and subjective burden depend on whether the social support is measured as perceived or received, 3) the relationship of perceived social support with subjective burden has a bigger effect size than that of received social support, the relation between received support and subjective burden being clinically irrelevant, 4) perceived social support may be a good predictor of subjective burden. Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden.

Self-referenced continuous-variable quantum key distribution

DOEpatents

Soh, Daniel B. S.; Sarovar, Mohan; Camacho, Ryan

2017-01-24

Various technologies for continuous-variable quantum key distribution without transmitting a transmitter's local oscillator are described herein. A receiver on an optical transmission channel uses an oscillator signal generated by a light source at the receiver's location to perform interferometric detection on received signals. An optical reference pulse is sent by the transmitter on the transmission channel and the receiver computes a phase offset of the transmission based on quadrature measurements of the reference pulse. The receiver can then compensate for the phase offset between the transmitter's reference and the receiver's reference when measuring quadratures of received data pulses.

Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace

PubMed Central

2011-01-01

Background Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. Methods A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Results Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively), with little perceived support from the organisation (13%) and human resources (6%). Most women (92%) had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%). Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Conclusions Enabling women to continue breastfeeding at work has benefits for the infant, employee and organisation. However, this baseline study of health employees revealed that women felt largely unsupported by managers and their organisation to continue breastfeeding at work. PMID:22129232

WebPresent: a World Wide Web-based telepresentation tool for physicians

NASA Astrophysics Data System (ADS)

Sampath-Kumar, Srihari; Banerjea, Anindo; Moshfeghi, Mehran

1997-05-01

In this paper, we present the design architecture and the implementation status of WebPresent - a world wide web based tele-presentation tool. This tool allows a physician to use a conference server workstation and make a presentation of patient cases to a geographically distributed audience. The audience consists of other physicians collaborating on patients' health care management and physicians participating in continuing medical education. These physicians are at several locations with networks of different bandwidth and capabilities connecting them. Audiences also receive the patient case information on different computers ranging form high-end display workstations to laptops with low-resolution displays. WebPresent is a scalable networked multimedia tool which supports the presentation of hypertext, images, audio, video, and a white-board to remote physicians with hospital Intranet access. WebPresent allows the audience to receive customized information. The data received can differ in resolution and bandwidth, depending on the availability of resources such as display resolution and network bandwidth.

Differentiation of death-row murderers and life-sentence murderers by antisociality and intelligence measures.

PubMed

Heilbrun, A B

1990-01-01

Prior studies of dangerousness have confirmed that the combination of high antisociality and low IQ is associated with male criminal violence and that the same combination can discriminate within a group of violent male criminals by level of severity. My study continued the validation of this two-component measure by showing that men convicted of murder and given the death sentence for their more heinous crimes were more dangerous than murderers who received life sentences. Men who had been extended the death penalty, who selected female victims, and whose murders were judged to have been especially cruel received extraordinarily high dangerousness scores relative to all other murderers. The assumption that high antisociality and low IQ would lead to serious violence because of the criminal's inability to deal with complications that arise in confronting the victim received some support. The murders of more dangerous men followed stronger victim resistance than the murders committed by less dangerous men.

Analyzing and Predicting User Participations in Online Health Communities: A Social Support Perspective.

PubMed

Wang, Xi; Zhao, Kang; Street, Nick

2017-04-24

Online health communities (OHCs) have become a major source of social support for people with health problems. Members of OHCs interact online with similar peers to seek, receive, and provide different types of social support, such as informational support, emotional support, and companionship. As active participations in an OHC are beneficial to both the OHC and its users, it is important to understand factors related to users' participations and predict user churn for user retention efforts. This study aimed to analyze OHC users' Web-based interactions, reveal which types of social support activities are related to users' participation, and predict whether and when a user will churn from the OHC. We collected a large-scale dataset from a popular OHC for cancer survivors. We used text mining techniques to decide what kinds of social support each post contained. We illustrated how we built text classifiers for 5 different social support categories: seeking informational support (SIS), providing informational support (PIS), seeking emotional support (SES), providing emotional support (PES), and companionship (COM). We conducted survival analysis to identify types of social support related to users' continued participation. Using supervised machine learning methods, we developed a predictive model for user churn. Users' behaviors to PIS, SES, and COM had hazard ratios significantly lower than 1 (0.948, 0.972, and 0.919, respectively) and were indicative of continued participations in the OHC. The churn prediction model based on social support activities offers accurate predictions on whether and when a user will leave the OHC. Detecting different types of social support activities via text mining contributes to better understanding and prediction of users' participations in an OHC. The outcome of this study can help the management and design of a sustainable OHC via more proactive and effective user retention strategies. ©Xi Wang, Kang Zhao, Nick Street. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.04.2017.

Analyzing and Predicting User Participations in Online Health Communities: A Social Support Perspective

PubMed Central

Wang, Xi; Street, Nick

2017-01-01

Background Online health communities (OHCs) have become a major source of social support for people with health problems. Members of OHCs interact online with similar peers to seek, receive, and provide different types of social support, such as informational support, emotional support, and companionship. As active participations in an OHC are beneficial to both the OHC and its users, it is important to understand factors related to users’ participations and predict user churn for user retention efforts. Objective This study aimed to analyze OHC users’ Web-based interactions, reveal which types of social support activities are related to users’ participation, and predict whether and when a user will churn from the OHC. Methods We collected a large-scale dataset from a popular OHC for cancer survivors. We used text mining techniques to decide what kinds of social support each post contained. We illustrated how we built text classifiers for 5 different social support categories: seeking informational support (SIS), providing informational support (PIS), seeking emotional support (SES), providing emotional support (PES), and companionship (COM). We conducted survival analysis to identify types of social support related to users’ continued participation. Using supervised machine learning methods, we developed a predictive model for user churn. Results Users’ behaviors to PIS, SES, and COM had hazard ratios significantly lower than 1 (0.948, 0.972, and 0.919, respectively) and were indicative of continued participations in the OHC. The churn prediction model based on social support activities offers accurate predictions on whether and when a user will leave the OHC. Conclusions Detecting different types of social support activities via text mining contributes to better understanding and prediction of users’ participations in an OHC. The outcome of this study can help the management and design of a sustainable OHC via more proactive and effective user retention strategies. PMID:28438725

Support and maneuvering apparatus for solar energy receivers

DOEpatents

Murphy, L.M.

1988-07-28

A support and maneuvering apparatus is disclosed for a solar energy receiving device adapted for receiving and concentrating solar energy and having a central axis extending through the center thereof. The apparatus includes a frame for mounting the perimeter of said solar energy receiving device. A support member extends along the central axis of the receiving device and has a base end passing through the center of the receiving device and an outer distal end adapted for carrying a solar energy receiving and conversion mechanism. A variable tension mechanism interconnects the support member with the frame to provide stiffening for the support member and the frame and to assist in the alignment of the frame to optimize the optical efficiency of the solar energy receiving device. A rotatable base is provided, and connecting members extend from the base for pivotable attachment to the frame at spaced positions therealong. Finally, an elevation assembly is connected to the receiving device for selectively pivoting the receiving about an axis defined between the attachment positions of the connecting members on the frame. 4 figs.

Support and maneuvering apparatus for solar energy receivers

DOEpatents

Murphy, Lawrence M.

1989-01-01

A support and maneuvering apparatus is disclosed for a solar energy receiving device adpated for receiving and concentrating solar energy and having a central axis extending through the center thereof. The apparatus includes a frame for mounting the perimeter of said solar energy receiving device. A support member extends along the central axis of the receiving device and has a base end passing through the center of the receiving device and an outer distal end adapted for carrying a solar energy receiving and conversion mechanism. A variable tension mechanism interconnects the support member with the frame to provide stiffening for the support member and the frame and to assist in the alignment of the frame to optimize the optical efficiency of the solar energy receiving device. A rotatable base is provided, and connecting members extend from the base for pivotable attachment to the frame at spaced positions therealong. Finally, an elevation assembly is connected to the receiving device for selectively pivoting the receiving device about an axis defined between the attachment positions of the connecting members on the frame.

Supported liquid inorganic membranes for nuclear waste separation

DOEpatents

Bhave, Ramesh R; DeBusk, Melanie M; DelCul, Guillermo D; Delmau, Laetitia H; Narula, Chaitanya K

2015-04-07

A system and method for the extraction of americium from radioactive waste solutions. The method includes the transfer of highly oxidized americium from an acidic aqueous feed solution through an immobilized liquid membrane to an organic receiving solvent, for example tributyl phosphate. The immobilized liquid membrane includes porous support and separating layers loaded with tributyl phosphate. The extracted solution is subsequently stripped of americium and recycled at the immobilized liquid membrane as neat tributyl phosphate for the continuous extraction of americium. The sequestered americium can be used as a nuclear fuel, a nuclear fuel component or a radiation source, and the remaining constituent elements in the aqueous feed solution can be stored in glassified waste forms substantially free of americium.

The long term effect of an iris-supported lens on the endothelium.

PubMed

Galin, M A; Dotson, R S; Obstbaum, S A; Tuberville, A W

1982-01-01

A retrospective study of 104 eyes that had iris-supported Sputnik intraocular lenses implanted and no surgery in the fellow eye and a separate series of 30 implanted eyes whose second eyes underwent surgery but did not receive implants disclosed that endothelial cell densities in the eyes with implants decreased immediately after surgery and then continued to decrease at the same rate as those of the control eyes. There was no sudden decrease in the endothelial cell counts during follow-up periods ranging from three to seven years. The main cause of large cell losses immediately after surgery, and possibly long-term corneal decompensation, was surgical manipulation rather than the presence of this style of intraocular lens.

Social Cognitive Career Theory, the Theory of Work Adjustment, and Work Satisfaction of Retirement-Age Adults

PubMed Central

Foley, Pamela F.; Lytle, Megan C.

2015-01-01

Despite a recent increase in the number of adults who work past traditional retirement age, existing theories of vocational behavior have not yet received adequate empirical support. In a large sample of adults age 60–87, we evaluated the relationship between theorized predictors of work satisfaction proposed by Social Cognitive Career Theory (SCCT), work satisfaction as a predictor of continued work, as proposed by the Theory of Work adjustment (TWA), as well as the influence of reported experiences of discrimination on these relationships. While the results supported most of the predicted relationships, the effects of discrimination were stronger than the variables proposed by either SCCT or TWA for the present sample. PMID:26101456

Are We Appropriately Selecting Therapy For Patients With Cervical Cancer? Longitudinal Patterns-of-Care Analysis for Stage IB-IIB Cervical Cancer

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

Carlson, Julie A., E-mail: Julie.A2.Carlson@ucdenver.edu; Rusthoven, Chad; DeWitt, Peter E.

Purpose: We performed a patterns-of-care analysis evaluating the effects of newer technology and recent research findings on treatment decisions over 26 years to determine whether patients with cervical cancer are being appropriately selected for treatment to optimize the therapeutic ratio. Methods and Materials: A retrospective analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) program from 1983 to 2009. We identified 10,933 women with stage IB-IIB cervical carcinoma. Results: Of the 10,933 subjects identified, 40.1% received surgery, 26.8% received radiation (RT), and 33.1% received surgery plus RT. RT use increased after 2000 compared to prior to 2000, with amore » corresponding decrease in surgery and surgery plus RT. Among patients with risk factors including tumor size >4 cm, positive parametria, and positive lymph nodes, declining use of surgery plus RT was observed. However, 23% of patients with tumors >4 cm, 20% of patients with positive parametria, and 55% of node-positive patients continued to receive surgery plus RT as of 2009. Factors associated with increased use of surgery plus RT included patient age <50 and node-positive status. Conclusions: In this largest patterns-of-care analysis to date for patients with locally advanced cervical cancer, we found a substantial proportion of patients continue to undergo surgery followed by radiation, despite randomized data supporting the use of definitive radiation therapy, with lower morbidity than surgery and radiation.« less

A randomised trial of glucose tablets to aid smoking cessation.

PubMed

West, Robert; May, Sylvia; McEwen, Andy; McRobbie, Hayden; Hajek, Peter; Vangeli, Eleni

2010-01-01

Oral glucose has been found to decrease tobacco craving among abstaining smokers. One study has demonstrated an effect of glucose on short-term abstinence. There is a need to examine any long-term benefit of glucose on abstinence. To assess whether glucose tablets improve 6-month continuous abstinence rates compared with low-calorie placebo tablets. Smokers attempting to stop (n = 928) were randomised to receive glucose or sorbitol (placebo) in a double-blind placebo-controlled trial. All participants received group-based psychological support, and approximately half (n = 474) received nicotine replacement therapy (NRT), buproprion, or both. Smokers were seen weekly for 5 weeks and used tablets ad libitum, with a recommended minimum of 12 per day. Participants were recruited through general practitioner referral, word of mouth, and advertising. The participants were 38% male, smoked an average of 23.5 cigarettes per day, and had a mean age of 44 years. There were no significant pretreatment differences between groups. The primary outcome measure was continuous, CO-verified abstinence from the target quit date for 6 months. No significant effect of glucose tablets on abstinence was found (14.6% vs 13.4% abstinence in the glucose and placebo groups, respectively). However, there was a significant interaction with a glucose effect observed in smokers also receiving other medication (18.2% vs 12.6%, p < 0.05) but not otherwise (10.7% vs 14.3% ; p < 0.05 for the interaction). No significant effect of glucose tablets over and above sweet tasting tablets could be detected overall, but the possibility of an effect as an adjunct to NRT or bupropion merits further investigation.

Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

PubMed

Dixon, Brian E; Colvard, Cyril; Tierney, William M

2014-06-24

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

Experiences of care by Australians with a diagnosis of borderline personality disorder

PubMed Central

McMahon, J.

2015-01-01

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them.This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types.People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD. Abstract There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population. PMID:26122817

Parents of elementary school students weigh in on height, weight, and body mass index screening at school.

PubMed

Kubik, Martha Y; Fulkerson, Jayne A; Story, Mary; Rieland, Gayle

2006-12-01

School-based body mass index (BMI) screening and parent notification programs have been recommended as a childhood overweight prevention strategy. However, there are little empirical data available to guide decision making about the acceptability and safety of programs. A pilot study was conducted using a quasiexperimental research design. In fall 2004, children in 4 suburban elementary schools (kindergarten to sixth grade) in the St Paul/Minneapolis, MN, metropolitan area completed height/weight screening. The following spring, parents in 2 schools received letters containing height/weight and BMI results. A self-administered post-only survey examined parents' opinions and beliefs regarding school-based BMI screening and parent notification programs (response rate: 790/1133 = 70%). The chi2 test of significance was used to examine differences in program support by treatment condition, child's weight status, and sociodemographic characteristics. Among all parents, 78% believed it was important for schools to assess student's height/weight annually and wanted to receive height, weight, and BMI information yearly. Among parents receiving the letter, 95% read most/all of the letter. Most parents (80%) and children (83%) reported comfort with the information in the letter. Parents of overweight children were more likely to report parental discomfort as well as child discomfort with letter content. There was considerable parental support for school-based BMI screening and parent notification programs. Programs may be a useful overweight prevention tool for children. However, continued attention to how best to support parents and children affected by overweight is required.

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2013 CFR

2013-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2012 CFR

2012-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2011 CFR

2011-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2014 CFR

2014-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

Received and perceived social support in times of stress: a test of the social support deterioration deterrence model.

PubMed

Norris, F H; Kaniasty, K

1996-09-01

The authors evaluated the impact of receiving social support on subsequent levels of perceived social support and psychological distress in 2 independent samples of victims of severe natural disasters: Hurricane Hugo (n = 498) and Hurricane Andrew (n = 404). A social support deterioration deterrence model was proposed that stipulated that postdisaster mobilization of received support counteracts the deterioration in expectations of support often experienced by victims of major life events. LISREL analyses of data collected 12 and 24 months after Hugo and 6 and 28 months after Andrew provided strong evidence for the hypothesized model: Perceived support mediated the long-term effects on distress of both scope of disaster exposure and postdisaster received support. Theoretical and application issues of social support are discussed.

Conditioned pharmacotherapeutic effects: a preliminary study.

PubMed

Ader, Robert; Mercurio, Mary Gail; Walton, James; James, Deborra; Davis, Michael; Ojha, Valerie; Kimball, Alexa Boer; Fiorentino, David

2010-02-01

To test the hypothesize that psoriasis patients treated under a partial schedule of pharmacologic (corticosteroid) reinforcement would show less severe symptoms and relapse than those given the same amount of drug under standard conditions. Behavioral conditioning as an inherent component of many pharmacotherapeutic protocols has never been examined. A double-blind, simple randomization intervention was conducted with 46 patients from California and New York. Initially, lesions were treated with 0.1% acetonide triamcinolone under standard treatment conditions. Thereafter, a Standard Therapy group continued on continuous reinforcement (active drug every treatment) with 100% of the initial dose; Partial Reinforcement patients received a full dose 25% to 50% of the time and placebo medication other times; Dose Control patients received continuous reinforcement with 25% to 50% of the initial dose. Severity of disease scores in California neither supported nor refuted the hypothesis. In New York, where there was no difference between Partial Reinforcement and Dose Control groups at baseline, partial reinforcement effected a greater reduction in lesion severity than Dose Control conditions and did not differ from Standard Therapy patients receiving two to four times more drug. For the entire population, the frequency of relapse under partial reinforcement (26.7%) was lower than in Dose Control patients (61.5%) and did not differ from full-dose treatment (22.2%). A partial schedule of pharmacotherapeutic reinforcement could maintain psoriasis patients with a cumulative amount of corticosteroid that was relatively ineffective when administered under standard treatment conditions. Conceivably, corticosteroid administration only one quarter or half as frequently as currently prescribed is sufficient to treat psoriasis. We posit, however, that these preliminary observations implicate conditioning processes in-and for the design of-regimens of pharmacotherapy.

26 CFR 1.243-1 - Deduction for dividends received by corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Deduction for dividends received by corporations... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Special Deductions for Corporations § 1.243-1 Deduction for dividends received by corporations. (a)(1) A corporation is allowed a deduction under section 243 for...

Flat-plate solar array project: Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

NASA Technical Reports Server (NTRS)

1981-01-01

The engineering design, fabrication, assembly, operation, economic analysis, and process support research and development for an Experimental Process System Development Unit for producing semiconductor-grade silicon using the slane-to-silicon process are reported. The design activity was completed. About 95% of purchased equipment was received. The draft of the operations manual was about 50% complete and the design of the free-space system continued. The system using silicon power transfer, melting, and shotting on a psuedocontinuous basis was demonstrated.

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 237

NASA Technical Reports Server (NTRS)

1982-01-01

A bibliography is given on the biological, physiological, psychological, and environmental effects to which man is subjected during and following simulated or actual flight in the Earth's atmosphere or in interplanetary space. References describing similar effects of biological organisms of lower order are also included. Such related topics as sanitary problems, pharmacology, toxicology, safety and survival, life support systems, exobiology, and personnel factors receive appropriate attention. In general, emphasis is placed on applied research, but references to fundamental studies and theoretical principles related to experimental development also qualify for inclusion.

Building a case for using technology: health literacy and patient education.

PubMed

Cassey, Margaret Z

2007-01-01

The interplay of a mobile population can affect the quality of patient outcomes and the economics of health care delivery significantly. Helping patients with limited English proficiency understand the basics of self-care for optimal health will continue to be a challenge in the delivery of the highest quality nursing care. Becoming familiar with high-quality, peer-reviewed, and reliable health education materials and Web sites is the responsibility of every health care provider so that patients receive culturally and linguistically appropriate resources to support healthy lifestyles and choices.

Flat-plate solar-array project. Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

NASA Technical Reports Server (NTRS)

1981-01-01

The engineering design, fabrication, assembly, operation, economic analysis, and process support R and D for an Experimental Process System Development Unit (EPSDU) are reported. About 95% of purchased equipment is received and will be reshipped to the West Coast location. The Data Collection System is completed. In the area of melting/consolidation, to the system using silicon powder transfer, melting and shotting on a pseudocontinuous basis is demonstrated. It is proposed to continue the very promising fluid bed work.

A qualitative study of volunteer doulas working alongside midwives at births in England: Mothers' and doulas' experiences.

PubMed

McLeish, Jenny; Redshaw, Maggie

2018-01-01

to explore trained volunteer doulas' and mothers' experiences of doula support at birth and their perceptions of how this related to the midwife's role. a qualitative descriptive study, informed by phenomenological social psychology. semi-structured interviews were carried out between June 2015 and March 2016. Interview transcripts were analysed using inductive thematic analysis. three community volunteer doula projects run by third sector organisations in England. 19 volunteer doulas and 16 mothers who had received doula support during labour. three overarching themes emerged: (1) 'the doula as complementary to midwives', containing subthemes 'skilled physical and emotional support', 'continuous presence', 'woman-centred support', 'ensuring mothers understand and are understood' and 'creating a team for the mother'; (2)'the doula as a colleague to midwives', containing subthemes 'welcomed as a partner', 'co-opted to help the midwives', and 'doulas identify with the midwives'; and (3) 'the doula as challenge to midwives', containing subthemes 'confusion about the doula's role', 'defending informed choice', and 'counterbalancing disempowering treatment'. KEY CONCLUSIONS&IMPLICATIONS FOR PRACTICE: volunteer doulas can play an important role in improving women's birth experiences by offering continuous, empowering, woman-focused support that complements the role of midwives, particularly where the mothers are disadvantaged. Greater clarity is needed about the scope of legitimate volunteer doula advocacy on behalf of their clients, to maximise effective working relationships between midwives and doulas. Copyright © 2017. Published by Elsevier Ltd.

Giving and Receiving Social Support at Work: The Roles of Personality and Reciprocity

ERIC Educational Resources Information Center

Bowling, Nathan A.; Beehr, Terry A.; Swader, William M.

2005-01-01

Social support is an important variable in occupational stress research and theory, yet little is know about the factors that influence the amount of social support one gives, and receives at work. We examined personality (extraversion, neuroticism, and agreeableness) and reciprocity as potential antecedents to giving and receiving support from…

A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome.

PubMed

Gupta, Samir; Sinha, Sunil K; Tin, Win; Donn, Steven M

2009-05-01

To compare the efficacy and safety of bubble continuous positive airway pressure (CPAP) and Infant Flow Driver (IFD) CPAP for the post-extubation management of preterm infants with respiratory distress syndrome (RDS). A total of 140 preterm infants at 24 to 29 weeks' gestation or with a birth weight of 600 to 1500 g who were ventilated at birth for RDS were randomized to receive either IFD CPAP (a variable-flow device) or bubble CPAP (a continuous-flow device). A standardized protocol was used for extubation and CPAP. No crossover was allowed. The primary outcome was successful extubation maintained for at least 72 hours. Secondary outcomes included successful extubation maintained for 7 days, total duration of CPAP support, chronic lung disease, and complications of prematurity. Seventy-one infants were randomized to bubble CPAP, and 69 were randomized to IFD CPAP. Mean gestational age and birth weight were similar in the 2 groups, as were the proportions of infants who achieved successful extubation for 72 hours and for 7 days. However, the median duration of CPAP support was 50% shorter in the infants on bubble CPAP. Moreover, in the subset of infants who were ventilated for less than 14 days, the infants on bubble CPAP had a significantly lower extubation failure rate. There was no difference in the incidence of chronic lung disease or other complications between the 2 study groups. Bubble CPAP is as effective as IFD CPAP in the post-extubation management of infants with RDS; however, in infants ventilated for < or = 14 days, bubble CPAP is associated with a significantly higher rate of successful extubation. Bubble CPAP also is associated with a significantly reduced duration of CPAP support.

An Investigation of Perspectives of Respite Admission Among People Living With Amyotrophic Lateral Sclerosis and the Hospitals That Support Them.

PubMed

Nakai, Michiko; Narita, Yugo; Tomimoto, Hidekazu

2017-07-01

Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them. We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission. We also interviewed 16 representatives from hospitals about awareness of and preparation for respite admission for patients with this disease, the role of regional networks for intractable diseases, and knowledge about communication support schemes. We found significant differences in the revised Amyotrophic Lateral Sclerosis Functional Rating Scale between patients who had and had not received respite admission. Qualitative analysis of the data indicated that respite admission was a contributory factor in continuing and stabilizing home care. Limited provision of social services and hospital care quality were barriers to respite admission. Respite admission was essential to continued home care for patients with amyotrophic lateral sclerosis. Severe-stage patients were eligible for respite admission. Its accessibility, however, was limited, especially for patients living in rural areas. Supporting hospitals had limited capacity to respond to patients' needs. Individualized care and communication were internal barriers to respite admission.

Sources of social support as predictors of health, psychological well-being and life satisfaction among Dutch male and female dual-earners.

PubMed

Daalen, Geertje van; Sanders, Karin; Willemson, Tineke M

2005-01-01

We examined whether gender differences in health, psychological well-being, and life satisfaction, can be explained by effects of work-related and nonwork-related sources of social support. The sample consisted of 459 men and women from dual earner families. Men report better health and psychological well-being than women, whereas women report higher life satisfaction than men. Contrary to our expectations, women receive more social support from colleagues than men, while men and women equally receive support from their supervisor. As for the nonwork-related sources of social support, men receive more social support from their spouse, while women receive more social support from relatives and friends. No gender differences exist in the effects of social support. Although men and women differ with respect to the social support they receive from different sources, these differences cannot explain gender differences in health, psychological well-being and life satisfaction.

Long-Term Supportive Housing is Associated with Decreased Risk for New HIV Diagnoses Among a Large Cohort of Homeless Persons in New York City.

PubMed

Lee, Christopher T; Winquist, Andrea; Wiewel, Ellen W; Braunstein, Sarah; Jordan, Hannah T; Gould, L Hannah; Gwynn, R Charon; Lim, Sungwoo

2018-05-08

It is unknown whether providing housing to persons experiencing homelessness decreases HIV risk. Housing, including access to preventive services and counseling, might provide a period of transition for persons with HIV risk factors. We assessed whether the new HIV diagnosis rate was associated with duration of supportive housing. We linked data from a cohort of 21,689 persons without a previous HIV diagnosis who applied to a supportive housing program in New York City (NYC) during 2007-2013 to the NYC HIV surveillance registry. We used time-dependent Cox modeling to compare new HIV diagnoses among recipients of supportive housing (defined a priori, for program evaluation purposes, as persons who spent > 7 days in supportive housing; n = 6447) and unplaced applicants (remainder of cohort), after balancing the groups on baseline characteristics with propensity score weights. Compared with unplaced applicants, persons who received ≥ 3 continuous years of supportive housing had decreased risk for new HIV diagnosis (HR 0.10; CI 0.01-0.99). Risk of new HIV diagnosis decreased with longer duration placement in supportive housing. Supportive housing might aid in primary HIV prevention.

Received social support and exercising: An intervention study to test the enabling hypothesis.

PubMed

Rackow, Pamela; Scholz, Urte; Hornung, Rainer

2015-11-01

Received social support is considered important for health-enhancing exercise participation. The enabling hypothesis of social support suggests an indirect association of social support and exercising via constructs of self-regulation, such as self-efficacy. This study aimed at examining an expanded enabling hypothesis by examining effects of different kinds of social support (i.e., emotional and instrumental) on exercising not only via self-efficacy but also via self-monitoring and action planning. An 8-week online study was conducted. Participants were randomly assigned to an intervention or a control group. The intervention comprised finding and then exercising regularly with a new exercise companion. Intervention and control group effects were compared by a manifest multigroup model. Received emotional social support predicted self-efficacy, self-monitoring, and action planning in the intervention group. Moreover, received emotional social support was indirectly connected with exercise via the examined mediators. The indirect effect from received emotional social support via self-efficacy mainly contributed to the total effect. No direct or indirect effect of received instrumental social support on exercise emerged. In the control group, neither emotional nor instrumental social support was associated with any of the self-regulation constructs nor with exercise. Actively looking for a new exercise companion and exercising together seems to be beneficial for the promotion of received emotional and instrumental social support. Emotional support in turn promotes exercise by enabling better self-regulation, in particular self-efficacy. Statement of contribution What is already known on this subject? With the 'enabling hypothesis', Benight and Bandura (2004, Behav. Res. Ther., 42, 1129) claimed that social support indirectly affects behaviour via self-efficacy. Research in the domain of physical exercise has provided evidence for this enabling hypothesis on a correlational basis only preventing causal inferences. What does this study add? We found evidence for the enabling hypothesis of received social support via self-efficacy on physical exercise in an intervention study. Moreover, this study demonstrated the distinct contribution of received emotional and instrumental social support in the context of the enabling hypothesis. © 2015 The British Psychological Society.

Scale-up of HIV treatment through PEPFAR: a historic public health achievement.

PubMed

El-Sadr, Wafaa M; Holmes, Charles B; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

2012-08-15

Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.

Online support and education for dementia caregivers: overview, utilization, and initial program evaluation.

PubMed

Glueckauf, Robert L; Ketterson, Timothy U; Loomis, Jeffrey S; Dages, Pat

2004-01-01

Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are confronted with a variety of challenges in providing assistance to their loved ones, such as dealing with persistent, repetitive questions, managing episodes of agitation and aggressive responding, as well as monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, a significant proportion of dementia caregivers in the United States continue to receive little or no formal instruction in responding effectively to these anxiety-provoking situations. This paper describes the development and implementation of Alzheimer's Caregiver Support Online (also known as AlzOnline), an Internet- and telephone-based education and support network for caregivers of individuals with progressive dementia. An outcome analysis of a Robert Wood Johnson Foundation-funded strategic marketing initiative to promote the use of AlzOnline is reviewed, followed by a presentation of the findings of an initial program evaluation. Finally, future directions for online caregiver evaluation research are proposed.

The First Telephone Line for the Psychological Support to Oncological Patients and Their Family Members in Serbia.

PubMed

Klikovac, Tamara

2015-01-01

In October of 2010, Serbian Association for Psycho-Oncology, in collaboration with the Ministry of Health of Serbia and the National Health Insurance has launched the first national telephone line for free psychological counseling and support for oncology patients and their families. The aim of this study was to present results of the first national telephone helpline for psychological support for oncological patients and their families. METHODS The telephone line for the psychological help and support was available from 10 a.m. to 10 p.m., seven days a week and on holidays. A total of 12 previously educated psychologists were involved, with two on duty in the mornings and two in the afternoons.The basic work principles of the Line were anonymity for users (if they wished), free of charge service available to patients from all of Serbia, careful listening, emphatic reflection on anything communicated by users and adequate counselling. Since the beginning of the project (October 2010 up to April 2011) we received a total of 2,748 calls from across Serbia. Almost half of these calls were repeated calls, as patients asked for continuous psychological counselling. Larger percent (63.9%) of women called, when compared to men (35.4%) who used the Line. Most (52.4%) conversations were categorized as "psychological support and counseling," and as continual psychological counseling work (21.1%). The large number of calls suggests that this kind of public, free service for psychosocial and psychological support to cancer patients is necessary in Serbia.

Advancements in Open Geospatial Standards for Photogrammetry and Remote Sensing from Ogc

NASA Astrophysics Data System (ADS)

Percivall, George; Simonis, Ingo

2016-06-01

The necessity of open standards for effective sharing and use of remote sensing continues to receive increasing emphasis in policies of agencies and projects around the world. Coordination on the development of open standards for geospatial information is a vital step to insure that the technical standards are ready to support the policy objectives. The mission of the Open Geospatial Consortium (OGC) is to advance development and use of international standards and supporting services that promote geospatial interoperability. To accomplish this mission, OGC serves as the global forum for the collaboration of geospatial data / solution providers and users. Photogrammetry and remote sensing are sources of the largest and most complex geospatial information. Some of the most mature OGC standards for remote sensing include the Sensor Web Enablement (SWE) standards, the Web Coverage Service (WCS) suite of standards, encodings such as NetCDF, GMLJP2 and GeoPackage, and the soon to be approved Discrete Global Grid Systems (DGGS) standard. In collaboration with ISPRS, OGC working with government, research and industrial organizations continue to advance the state of geospatial standards for full use of photogrammetry and remote sensing.

Letters From Peplau.

PubMed

Peden, Ann R

2018-03-01

Dr. Hildegard Peplau, considered to be our first modern Nurse theorist and the Mother of Psychiatric Nursing, was a prolific writer, engaging in correspondence with colleagues and students who sought her professional and theoretical expertise. Through these letters, she influenced psychiatric nursing while maintaining a broad international network of professional colleagues. An analysis of letters, written between 1990 and 1998, provides insights into Peplau's last decade of professional life and a model of how to support the next generation of nurse scholars. Using content analysis, 24 letters received between 1990 and 1998 were read, reread, and coded. Recurring themes were identified. Three themes were identified. These include Peplau, the Person: Living a Life of Professional Balance; Lighting a Spark: Investing in the Next Generation; and Work in the Vineyards of Nursing: Maintaining a Life of Scholarship. The letters depict Peplau's keen intellect, her wide professional network, her leisure time spent with family and friends, and her own work to assure that her theoretical legacy continued. Peplau's insights continue to be relevant as psychiatric mental health nursing leaders engage in activities to support the next generation of scholars and leaders.

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

PubMed Central

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

2013-01-01

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

NOAA's Undergraduate Scholarship Program Outcomes and Opportunities

NASA Astrophysics Data System (ADS)

Kaplan, M.; Jabanoski, K.; Christenson, T.

2017-12-01

NOAA supports about 115 - 150 undergraduates per year through the Ernest F. Hollings Scholarship and the Educational Partnership Program Undergraduate Scholarship. These programs provide tuition support and paid summer internships at NOAA to exceptional students majoring in the geosciences. Multiple methods were used to evaluate program outcomes and track the career trajectories, including mining LinkedIn data and conducting evaluation surveys of recipients as well as students who applied but did not receive the award. Results show more than 75% of scholars continued on to graduate school, primarily in a NOAA mission fields. This compared to only 56% of nonrecipients. More than 60% of alumni had at least one professional record, with the most alumni working in private industry, followed by nongovernmental organizations and federal, state and local government. The evaluation identified 77 other scholarship programs applied to by NOAA scholarship recipients. The most commonly reported program was the NSF Research Experiences for Undergraduates (REU) for which 20% of scholars applied and 46% of applications were successful. Other common scholarships included the Goldwater Scholarship (received by 5% of NOAA scholars) and the Udall Scholarship (received by 4% of scholars). In the most recent class of 118 undergraduate scholars, 24% reported having another research experience by the time they arrived for orientation at the end of their sophomore year. These results suggest coordination across scholarship opportunities may be useful to engage and retain students in geoscience fields.

Secondary analysis of the "Love Me...Never Shake Me" SBS education program.

PubMed

Deyo, Grace; Skybo, Theresa; Carroll, Alisa

2008-11-01

Shaken baby syndrome (SBS) is preventable; however, an estimated 21-74 per 100,000 children worldwide are victims annually. This study examined the effectiveness of an SBS prevention program in the US. A descriptive, secondary analysis of the Prevent Child Abuse Ohio (PCAO) "Love Me...Never Shake Me" SBS education program database included 7,051 women who completed a commitment statement, pre and post-test, and follow-up survey. Participants were mostly White (76%), had at least some college education (62%), were privately insured (62%), and lived with the father and infant (63%). Mothers knew of the dangers of shaking (96%) and recommended SBS education for all parents (98%) because they found it helpful (97%). Scores on the pre and post-tests were significantly different, but there was no difference based on education site or demographics. There was a significant increase in a pre/post-test item pertaining to infant crying. At follow-up, participants remembered postpartum SBS education (98%), but post-discharge did not receive SBS education from their primary care provider (62%). Most mothers practiced infant soothing techniques (79%) provided in the education; however, few women practiced self-coping techniques (36%) and accessed community support services (9%). Postpartum SBS prevention education should continue. Development of SBS programs should result from these study findings focusing on education content and program evaluation. Mothers report that shaken baby syndrome education is important for all parents and memorable at follow-up. Postpartum SBS education should continue because the hospital is the primary place they receive education. Mothers' report they less frequently receive education from healthcare sources post-discharge. Diligence of primary care providers to incorporate SBS prevention education in well child visits will increase parental exposure to this information. Education may need to place greater emphasis on infant crying and soothing, as well as parent support and self-coping techniques versus the dangers of shaking.

Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.

PubMed

Kilbourne, Amy M; Almirall, Daniel; Eisenberg, Daniel; Waxmonsky, Jeanette; Goodrich, David E; Fortney, John C; Kirchner, JoAnn E; Solberg, Leif I; Main, Deborah; Bauer, Mark S; Kyle, Julia; Murphy, Susan A; Nord, Kristina M; Thomas, Marshall R

2014-09-30

Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months. This study employs a sequential multiple assignment randomized trial (SMART) design to build an adaptive implementation strategy. The EBP to be implemented is life goals (LG) for patients with mood disorders across 80 community-based outpatient clinics (N = 1,600 patients) from different U.S. regions. Sites not initially responding to REP (defined as < 50% patients receiving ≥ 3 EBP sessions) will be randomized to receive additional support from an EF or both EF/IF. Additionally, sites randomized to EF and still not responsive will be randomized to continue with EF alone or to receive EF/IF. The EF provides technical expertise in adapting LG in routine practice, whereas the on-site IF has direct reporting relationships to site leadership to support LG use in routine practice. The primary outcome is mental health-related quality of life; secondary outcomes include receipt of LG sessions, mood symptoms, implementation costs, and organizational change. This study design will determine whether an off-site EF alone versus the addition of an on-site IF improves EBP uptake and patient outcomes among sites that do not respond initially to REP. It will also examine the value of delaying the provision of EF/IF for sites that continue to not respond despite EF. ClinicalTrials.gov identifier: NCT02151331.

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

PubMed

Naughton, Felix; Cooper, Sue; Foster, Katharine; Emery, Joanne; Leonardi-Bee, Jo; Sutton, Stephen; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

2017-07-01

To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. Sixteen antenatal clinics in England. Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were < 25 weeks gestation, smoked at least one daily cigarette (> 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work.

PubMed

Duijts, Saskia F A; van Egmond, Martine P; Gits, Maxime; van der Beek, Allard J; Bleiker, Eveline M

2017-10-01

Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.

Community-based MDR-TB care project improves treatment initiation in patients diagnosed with MDR-TB in Myanmar.

PubMed

Wai, Pyae Phyo; Shewade, Hemant Deepak; Kyaw, Nang Thu Thu; Thein, Saw; Si Thu, Aung; Kyaw, Khine Wut Yee; Aye, Nyein Nyein; Phyo, Aye Mon; Maung, Htet Myet Win; Soe, Kyaw Thu; Aung, Si Thu

2018-01-01

The Union in collaboration with national TB programme (NTP) started the community-based MDR-TB care (CBMDR-TBC) project in 33 townships of upper Myanmar to improve treatment initiation and treatment adherence. Patients with MDR-TB diagnosed/registered under NTP received support through the project staff, in addition to the routine domiciliary care provided by NTP staff. Each township had a project nurse exclusively for MDR-TB and 30 USD per month (max. for 4 months) were provided to the patient as a pre-treatment support. To assess whether CBMDR-TBC project's support improved treatment initiation. In this cohort study (involving record review) of all diagnosed MDR-TB between January 2015 and June 2016 in project townships, CBMDR-TBC status was categorized as "receiving support" if date of project initiation in patient's township was before the date of diagnosis and "not receiving support", if otherwise. Cox proportional hazards regression (censored on 31 Dec 2016) was done to identify predictors of treatment initiation. Of 456 patients, 57% initiated treatment: 64% and 56% among patients "receiving support (n = 208)" and "not receiving support (n = 228)" respectively (CBMDR-TBC status was not known in 20 (4%) patients due to missing diagnosis dates). Among those initiated on treatment (n = 261), median (IQR) time to initiate treatment was 38 (20, 76) days: 31 (18, 50) among patients "receiving support" and 50 (26,101) among patients "not receiving support". After adjusting other potential confounders (age, sex, region, HIV, past history of TB treatment), patients "receiving support" had 80% higher chance of initiating treatment [aHR (0.95 CI): 1.8 (1.3, 2.3)] when compared to patients "not receiving support". In addition, age 15-54 years, previous history of TB and being HIV negative were independent predictors of treatment initiation. Receiving support under CBMDR-TBC project improved treatment initiation: it not only improved the proportion initiated but also reduced time to treatment initiation. We also recommend improved tracking of all diagnosed patients as early as possible.

A mixed methods evaluation of peer support in Bristol, UK: mothers', midwives' and peer supporters' views and the effects on breastfeeding.

PubMed

Ingram, Jenny

2013-10-20

International studies suggest that breastfeeding interventions in primary care are more effective than usual care in increasing short and long term breastfeeding rates. Interventions that combine pre- and postnatal components have larger effects than either alone, and those that including lay support in a multicomponent intervention may be more beneficial. Despite the mixed reports of the effectiveness of breastfeeding peer support in the UK, targeted peer support services are being established in many areas of the UK. In 2010, NHS Bristol Primary Care Trust commissioned a targeted breastfeeding peer support service for mothers in 12 lower socio-economic areas of the city, with one antenatal visit and postnatal contact for up to 2 weeks. Mothers receiving the peer support service were invited to complete an on-line survey covering infant feeding; breastfeeding support; and confidence in breastfeeding (using the Breastfeeding Self-Efficacy Scale). Semi-structured interviews and a focus group explored perceptions of mothers, midwives and peer supporters. The effects of the service on breastfeeding rates were documented and compared. 163 mothers completed the on-line survey; 25 participants were interviewed (14 mothers, 7 peer supporters and 4 maternity health professionals); exclusive and total breastfeeding rates for initiation and at 8 weeks were compared for 12 months before and after the service started.The targeted peer support service was associated with small non-significant increases in breastfeeding rates, (particularly exclusive breastfeeding), compared to the rest of the city. The service was very positively evaluated by mothers, health professionals and peer supporters. Mothers felt that peer support increased their confidence to breastfeed; peer supporters found the contacts rewarding, enjoyable and important for mothers; midwives and maternity support workers were positive about the continuity of an antenatal visit and postnatal support from the same local supporter. The introduction of a targeted peer support service was associated with psycho-social benefits for mothers, health professionals and peer supporters. Continuity of peer support with an antenatal visit and postnatal support from the same local supporter was also thought to be beneficial.

Autobiographical memory functions in young Japanese men and women.

PubMed

Maki, Yoichi; Kawasaki, Yayoi; Demiray, Burcu; Janssen, Steve M J

2015-01-01

The present study examined whether the three major functions of autobiographical memory observed in Western societies (i.e., directing-behaviour, social-bonding and self-continuity) also exist in an East Asian society. Two self-report measures were used to assess the autobiographical memory functions of Japanese men and women. Japanese young adults (N = 451, ages 17-28 years) first completed the original Thinking About Life Experiences (TALE) Questionnaire. They subsequently received three TALE items that represented memory functions and attempted to recall a specific instance of memory recall for each item. Confirmatory factor analyses on the TALE showed that the three functions were replicated in the current sample. However, Japanese participants reported lower levels of all three functions than American participants in a previous study. We also explored whether there was an effect of gender in this Japanese sample. Women reported higher levels of the self-continuity and social-bonding functions than men. Finally, participants recalled more specific instances of memory recall for the TALE items that had received higher ratings on the TALE, suggesting that the findings on the first measure were supported by the second measure. Results are discussed in relation to the functional approach to autobiographical memory in a cross-cultural context.

The mythology of anticoagulation therapy interruption for dental surgery.

PubMed

Wahl, Michael J

2018-01-01

Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo dental surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal. However, embolic complications (some of which were fatal and others possibly permanently debilitating) sometimes have occurred in patients whose anticoagulation therapy was interrupted for dental procedures. Although there is now virtually universal consensus among national medical and dental groups and other experts that anticoagulation therapy should not be interrupted for most dental surgery, there are still some arguments made supporting anticoagulation therapy interruption. An analysis of these arguments shows them to be based on a collection of myths and half-truths rather than on logical scientific conclusions. The time has come to stop anticoagulation therapy interruption for dental procedures. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

Training Lay Interventionists to Support Tobacco Cessation among Teachers in India.

PubMed

Aghi, Mira; Nagler, Eve; Lando, Harry; Pednekar, Mangesh; Gupta, Prakash; Sorensen, Glorian

2016-01-01

Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives - especially cessation - receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco Free Teachers-Tobacco Free Society program (TFT-TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT-TFS intervention, the abstinence findings in favor of the intervention at follow up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT-TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers.

Preventive intervention in diabetes: a new model for continuing medical education.

PubMed

Beaser, Richard S; Brown, Julie A

2013-04-01

Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME. This new approach does not just teach new information but also provides support for improvements where needed most within practice systems based on targeted data-based on self-assessments for the entire system of care. Joslin data conclude that this new approach will benefit support, clinical, and office teams as well as the specialist. In short, the Performance Improvement CME structure reflects the needed components of the successful practice today, particularly for chronic conditions such as diabetes, including the focus on interdisciplinary team care and on quality improvement, which is becoming more and more aligned with reimbursement schemes, public and private, in the U.S. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Numerical research of dynamic characteristics in tower solar cavity receiver based on step-change radiation flux

NASA Astrophysics Data System (ADS)

Chen, Zhengwei; Wang, Yueshe; Hao, Yun; Wang, Qizhi

2013-07-01

The solar cavity receiver is an important light-energy to thermal-energy convector in the tower solar thermal power plant system. The heat flux in the inner surface of the cavity will show the characteristics of non-continuous step change especially in non-normal and transient weather conditions, which may result in a continuous dynamic variation of the characteristic parameters. Therefore, the research of dynamic characteristics of the receiver plays a very important role in the operation and the control safely in solar cavity receiver system. In this paper, based on the non-continuous step change of radiation flux, a non-linear dynamic model is put forward to obtain the effects of the non-continuous step change radiation flux and step change feed water flow on the receiver performance by sequential modular approach. The subject investigated in our study is a 1MW solar power station constructed in Yanqing County, Beijing. This study has obtained the dynamic responses of the characteristic parameters in the cavity receiver, such as drum pressure, drum water level, main steam flow and main steam enthalpy under step change radiation flux. And the influence law of step-change feed water flow to the dynamic characteristics in the receiver also has been analyzed. The results have a reference value for the safe operation and the control in solar cavity receiver system.

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

PubMed Central

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri

2016-01-01

Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

PubMed

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

2016-01-01

Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

Strategies for successful academic writing - institutional and non-institutional support for students.

PubMed

Gopee, Neil; Deane, Mary

2013-12-01

Students develop better academic writing skills as they progress through their higher education programme, but despite recent continuing monitoring of student satisfaction with their education in UK, there has been relatively little research into students' perceptions of the active support that they need and receive to succeed as academic writers. To examine the strategies that university students on health or social care courses utilise to develop as writers in the face of many pressures and demands from different sources. Qualitative research conducted at a British University into undergraduates' writing practices in the field of healthcare. Ten participants took part in semi-structured interviews, half of whom were international students. The data was analysed by the researchers from the field of writing development using thematic analysis. The main findings are that certain students struggle as academic writers if they do not receive tuition on appropriate and effective academic writing through institutional provisions, or through non-institutional strategies, that can promote success with the writing process. There is also uncertainty over the extent to which nurse educators are expected to teach academic writing skills, alongside their discipline-specific subject areas. Both institutional provisions for academic writing development, such as a dedicated writing support department, and non-institutional factors such as peer-collaboration should be fully recognised, supported and resourced in tertiary education at a time when students' satisfaction and performance are high on the agenda. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Neurobiology of Giving Versus Receiving Support: The Role of Stress-Related and Social Reward-Related Neural Activity.

PubMed

Inagaki, Tristen K; Bryne Haltom, Kate E; Suzuki, Shosuke; Jevtic, Ivana; Hornstein, Erica; Bower, Julienne E; Eisenberger, Naomi I

2016-05-01

There is a strong association between supportive ties and health. However, most research has focused on the health benefits that come from the support one receives while largely ignoring the support giver and how giving may contribute to good health. Moreover, few studies have examined the neural mechanisms associated with support giving or how giving support compares to receiving support. The current study assessed the relationships: a) between self-reported receiving and giving social support and vulnerability for negative psychological outcomes and b) between receiving and giving social support and neural activity to socially rewarding and stressful tasks. Thirty-six participants (mean [standard deviation] age = 22.36 [3.78] years, 44% female) completed three tasks in the functional magnetic resonance imaging scanner: 1) a stress task (mental arithmetic under evaluative threat), b) an affiliative task (viewing images of close others), and c) a prosocial task. Both self-reported receiving and giving social support were associated with reduced vulnerability for negative psychological outcomes. However, across the three neuroimaging tasks, giving but not receiving support was related to reduced stress-related activity (dorsal anterior cingulate cortex [r = -0.27], left [r = -0.28] and right anterior insula [r = -0.33], and left [r = -0.32] and right amygdala [r = -0.32]) to a stress task, greater reward-related activity (left [r = 0.42] and right ventral striatum [VS; r = 0.41]) to an affiliative task, and greater caregiving-related activity (left VS [r = 0.31], right VS [r = 0.31], and septal area [r = 0.39]) to a prosocial task. These results contribute to an emerging literature suggesting that support giving is an overlooked contributor to how social support can benefit health.

Perceived caring needs in patient-partner dyads affected by heart failure: a qualitative study.

PubMed

Liljeroos, Maria; Agren, Susanna; Jaarsma, Tiny; Strömberg, Anna

2014-10-01

To explore the perceived caring needs in patient-partner dyads affected by heart failure to develop an understanding of potential areas of support. Being affected by heart failure has a great impact on both the patient and the partner but until now contemporary care has remained patient focused. A qualitative study design was used. Eight focus group interviews were performed, which included nineteen patients diagnosed with heart failure and their cohabiting partner. Patients were aged between 55-89 years and partners' ages ranged from 48-87 years. Data were analysed using qualitative content analyses. The dyads perceived that caring needs could be summarised in two themes 'Dyads perceive a need for continuous guidance through the different phases of the illness trajectory' and 'Dyads perceive a need to share burden and support with each other and others'. The dyads described a need to learn more about heart failure to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital, and having someone who cared about the well-being of the partners was perceived as comforting. Both the patient and the partner need to be present at the clinic visits. Receiving the same information and being able to ask questions reduce insecurity. Meeting others in the same situation and sharing the burden in group sessions were proposed as an opportunity to support each other and others. There is a need to improve education and support for patient-partner dyads affected by heart failure. The result shows the importance to provide continuous healthcare contacts throughout the illness trajectory. Furthermore, partners should be included at follow-up, and support groups should be organised so that dyads can meet and support each other. © 2014 John Wiley & Sons Ltd.

Experiences of caregivers of infants who have been on bubble continuous positive airway pressure at Queen Elizabeth Central Hospital, Malawi: A descriptive qualitative study.

PubMed

Gondwe, Mtisunge Joshua; Gombachika, Belinda; Majamanda, Maureen D

2017-03-01

An innovative, low-cost bubble continuous positive airway pressure (bCPAP) device has recently been introduced in Malawi for the treatment of respiratory distress in infants. While this novel bCPAP system has been shown to be safe and effective in reducing infant mortality, caregivers' experiences have not been investigated. The purpose of this study was to explore experiences of parents and guardians of infants who had been on bCPAP at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. This was a descriptive phenomenological study that was carried out at the Chatinkha nursery unit and the paediatric nursery ward at QECH, from January to February 2015. Purposive sampling was used to select participants for in-depth interviews. Data saturation was reached with 12 caregivers. Data were analysed using Colaizzi's framework. Caregivers received inadequate, inconsistent, and sporadic information about bCPAP. Student nurses and doctors were best able to answer caregivers' questions and concerns. When their infants were on bCPAP, caregivers felt anxious and fearful. However, upon implementation of bCPAP treatment for their children, the caregivers were satisfied with it. The main sources of psychological stress were limited parent-child interaction and the constraints of prescribed visiting hours. Family, friends, and caregiver involvement in the care of infants provided some psychological comfort. The results show gaps in the information and psychological support that mothers of infants on bCPAP receive in hospital. We recommend that psychological support be given to the mothers of infants on bCPAP at QECH.

Prader-Willi syndrome: clinical picture, psychosocial support and current management.

PubMed

Wigren, M; Hansen, S

2003-11-01

Prader-Willi syndrome (PWS) is a rare, genetically based disorder that occurs in about 1 of 15 000 live-born children. To raise a child with PWS is challenging for parents and requires support from multiprofessional habilitation services. This paper maps the need for psychosocial support and current management of children and adolescents with PWS. Parents to 58 children with PWS (aged 5-18 years) completed questionnaires covering clinical, diagnostic and psychosocial issues. The children received their diagnosis at a mean age of 2.5 year. Growth hormone treatment was given to 72%. Sixty-three per cent of the sample was not overweight. Neuropsychiatric symptoms were common from early age and some were related to obesity. Most parents wanted information as to availability of external resources and future child needs. Few parents needed family-directed support. The overall impression is that the eating disorder is managed relatively well. Even so PWS symptoms typically exacerbate over time and consequently parents need continuous support throughout childhood and adolescence. Greater attention should be paid to idiosyncrasies in cognitive functioning and to clinical markers of neuropsychiatric problems.

A burst-mode photon counting receiver with automatic channel estimation and bit rate detection

NASA Astrophysics Data System (ADS)

Rao, Hemonth G.; DeVoe, Catherine E.; Fletcher, Andrew S.; Gaschits, Igor D.; Hakimi, Farhad; Hamilton, Scott A.; Hardy, Nicholas D.; Ingwersen, John G.; Kaminsky, Richard D.; Moores, John D.; Scheinbart, Marvin S.; Yarnall, Timothy M.

2016-04-01

We demonstrate a multi-rate burst-mode photon-counting receiver for undersea communication at data rates up to 10.416 Mb/s over a 30-foot water channel. To the best of our knowledge, this is the first demonstration of burst-mode photon-counting communication. With added attenuation, the maximum link loss is 97.1 dB at λ=517 nm. In clear ocean water, this equates to link distances up to 148 meters. For λ=470 nm, the achievable link distance in clear ocean water is 450 meters. The receiver incorporates soft-decision forward error correction (FEC) based on a product code of an inner LDPC code and an outer BCH code. The FEC supports multiple code rates to achieve error-free performance. We have selected a burst-mode receiver architecture to provide robust performance with respect to unpredictable channel obstructions. The receiver is capable of on-the-fly data rate detection and adapts to changing levels of signal and background light. The receiver updates its phase alignment and channel estimates every 1.6 ms, allowing for rapid changes in water quality as well as motion between transmitter and receiver. We demonstrate on-the-fly rate detection, channel BER within 0.2 dB of theory across all data rates, and error-free performance within 1.82 dB of soft-decision capacity across all tested code rates. All signal processing is done in FPGAs and runs continuously in real time.

Day-to-day care in palliative sedation: survey of nurses' experiences with decision-making and performance.

PubMed

Arevalo, Jimmy J; Rietjens, Judith A; Swart, Siebe J; Perez, Roberto S G M; van der Heide, Agnes

2013-05-01

Continuous palliative sedation has been the focus of extensive international debates in the field of end-of-life decision making. Although nurses may be important participants in the performance of continuous palliative sedation, research has focused primarily on the role and experience of physicians. Nurses' experiences differ from that of physicians; they more often describe that continuous palliative sedation is used with the intention of hastening death and to have experienced serious emotional burden. Therefore, it is important to understand the experience of nurses in continuous palliative sedation. To describe nurses' experiences with the decision-making and performance of continuous palliative sedation in terminally ill patients. Cross-sectional study. In 2008, a structured questionnaire was sent to 576 nurses in six professional home care organizations, ten units for palliative care in nursing homes and in-patient hospices and seven hospitals in the western region of the Netherlands. Respondents provided information about the last patient receiving continuous palliative sedation whom they had cared for. Two-hundred seventy-seven questionnaires were returned and 199 (71.84%) reported a case of continuous palliative sedation. Nurses felt involved in the decision to use sedation in 84% of cases, albeit to a lesser extent in home care (68.75%, p=0.002). They agreed with the performance of continuous palliative sedation in 95.97% of cases and they proposed the use of continuous palliative sedation in 16.16%. Nurses were present at the start of sedation in 81.40% of cases and reported physicians to be present in 45.22%. In 72.77%, arrangements had been made among caregivers about the coordination of health care regarding the sedation. Nurses seem to play an important role in the use of continuous sedation. This role is mainly supportive toward physicians and patients during the decision-making process, but shifts to an active performance of sedation, particularly in settings where they explicitly participate as members of a team. Nurses could develop the practice of palliative sedation by anticipating procedural obstacles in the performance of continuous palliative sedation. We recommend them to become more active participants in the decision-making to improve the care of patients receiving continuous palliative sedation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mid-way and post-intervention effects on potential determinants of physical activity and sedentary behavior, results of the HEIA study - a multi-component school-based randomized trial.

PubMed

Bergh, Ingunn H; Bjelland, Mona; Grydeland, May; Lien, Nanna; Andersen, Lene F; Klepp, Knut-Inge; Anderssen, Sigmund A; Ommundsen, Yngvar

2012-05-29

There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA) and sedentary behavior (SB). Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. At mid-way enjoyment (p = .03), perceived social support from teachers (p = .003) and self-efficacy (p = .05) were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001), while a negative effect was found for self-efficacy (p = .02). Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several determinants were observed among those receiving a high as opposed to a low intervention dose. The intervention affected both psychological and social-environmental determinants. Results indicate that social support from teachers might be a potential mediator of PA change, and that overweight adolescents might be in need of specially targeted interventions to avoid reducing their enjoyment of PA. Further studies should continue to assess how intervention effectiveness is influenced by the participants' self-reported dose of intervention received.

Received and needed social support at the workplace in Norwegian and Finnish stage 1 breast cancer survivors: a study from the Nordic Study Group of Cancer and Work (NOCWO).

PubMed

Gudbergsson, Saevar B; Fosså, Sophie D; Lindbohm, Marja-Liisa; Dahl, Alv A

2009-01-01

Cross-cultural studies of comparable patients can identify differences of health care services and point to issues of possible improvement. In this cross-sectional study we compared self-reported received and needed social support at the workplace of disease-free breast cancer survivors (BCSs) stage I from Norway and Finland. Age-matched samples of 135 BCSs from Norway and 148 from Finland were examined using a questionnaire including socio-demographic factors, employment data, measurements of social support at work from supervisors, colleagues and the occupational health service (OHS), and several other measurements. Finnish BCSs had significantly higher education and a higher rate of full-time employment than Norwegian ones. With adjustment for education and work time, Finnish compared to Norwegian BCSs reported significantly less received social support from supervisors, while they received significantly more social support from OHS. No differences were observed in received support from colleagues between Finnish and Norwegian BCSs. Somatic health was most strongly associated with received and needed support from supervisors, colleagues and OHS. The differences in received and needed social support at work observed between Norwegian and Finnish BCSs treated for stage I disease challenge strengthening of OHS for Norwegian BCSs and increased attention by supervisors in Finnish BCSs.

Life satisfaction and social support received by women in the perinatal period.

PubMed

Gebuza, Grażyna; Kaźmierczak, Marzena; Mieczkowska, Estera; Gierszewska, Małgorzata; Kotzbach, Roman

2014-01-01

Birth of a baby has a big impact on women's lives. The presence and help of loved ones favours wellbeing, health, coping with difficult situations. The aim of this study was to determine whether women's satisfaction with life changes during pregnancy and after delivery, and to identify correlates of life satisfaction. Life satisfaction was measured using The Satisfaction with Life Scale - SWLS and received social support was assessed using the Berlin Social Support Scales - BSSS. The study was conducted in the third trimester of pregnancy and during the postpartum period, before discharge from the hospital. The research sample included a total of 199 women in the third trimester of pregnancy and 188 of initially participating women, who had physiological births or caesarean sections. The results clearly show a significant increase in life satisfaction in the postpartum period (p < 0.0001). An important correlate of life satisfaction in the third trimester of pregnancy is social support received (p < 0.0001). During pregnancy such a correlate is emotional support received, and in the postnatal period- instrumental support received. An increase in instrumental support received (p = 0.031) and informational (p = 0.013) has been observed in the postpartum period. The assessment of life satisfaction and received social support seem to be needed to gain a full picture of women's situation during birth, which will allow for planning and implementing maternity care appropriate to the needs of women.

A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics

PubMed Central

2012-01-01

Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings. PMID:23276303

Survey of practices around pharmaceutical company funding for continuing professional development among medical oncologists and trainees in Australia.

PubMed

Lee, Yeh Chen; Kroon, René; Koczwara, Bogda; Haines, Ian; Francis, Kay; Millward, Michael; Kefford, Richard; Olver, Ian; Mileshkin, Linda

2017-08-01

The completion of continuing professional development (CPD) is mandatory for medical oncologists and trainees (MO&T). Pharmaceutical companies may fund some CPD activities, but there is increasing debate about the potential for conflicts of interest (COI). To assess current practices around funding to attend CPD activities. An electronic survey was distributed to Australian MO&T. The survey asked questions about current practices, institutional policies and perceptions about attending CPD funded by pharmaceutical companies. The design looked at comparing responses between MO&T as well as their understanding of and training around institutional and ethical process. A total of 157 of 653 (24%) responses was received, the majority from MO (76%). Most CPD activities attended by MO&T were self-funded (53%), followed by funding from institutions (19%), pharmaceutical companies (16%) and salary award (16%). Most institutions allowed MO&T to receive CPD funding from professional organisations (104/157, 66%) or pharmaceutical companies (90/157, 57%). A minority of respondents (13/157, 8%) reported that the process to use pharmaceutical funds had been considered by an ethics committee. Although 103/157 (66%) had received pharmaceutical funding for CPD, most (109/157, 69%) reported never receiving training about potential COI. The lack of education was more noticeable among trainees (odds ratio (OR) 8.61, P = 0.02). MO&T acknowledged the potential bias towards a pharmaceutical product (P = 0.05) but believed there was adequate separation between themselves and pharmaceutical companies (P < 0.01). Majority of CPD attended by MO&T is self-funded. There is lack of clarity in institutional policies regarding external funding support for CPD activities. Formal education about potential COI is lacking. © 2017 Royal Australasian College of Physicians.

Relationship between social support and fatigue in geriatric patients receiving outpatient chemotherapy.

PubMed

Karakoç, Tuğba; Yurtsever, Sabire

2010-02-01

This descriptive study was conducted with the purpose of determining the relationship between fatigue and social support in elderly individuals receiving chemotherapy. It was conducted in the oncology outpatient chemotherapy units of two university hospitals and one research hospital. A total of 71 patients who were 60 years old and older and receiving outpatient chemotherapy were included. Data were collected using a "Personal Information Form," "Social Support Scale in Cancer Patients," and "Visual Analogue Scale for Fatigue." Fatigue was the most common symptom (93%) in elderly patients receiving chemotherapy. The elderly individuals' perceived level of social support was found to be "good", the main form of support they received from those around them was "security" and the area most lacking was felt to be "information." As the individuals' level of social support increased, the severity of the fatigue they experienced decreased. The data demonstrate that social support was imperative in coping with fatigue. Copyright 2009 Elsevier Ltd. All rights reserved.

Middle-Aged Couples' Exchanges of Support with Aging Parents: Patterns and Association with Marital Satisfaction

PubMed Central

Lee, Jeong Eun; Zarit, Steven H.; Rovine, Michael J.; Birditt, Kira S.; Fingerman, Karen L.

2011-01-01

We examined the context of intergenerational support exchanges with aging parents and its association with middle-aged couples' marital satisfaction. A sample of 197 middle-aged couples reported support they gave to and received from their parents (n = 440). Results indicated that couples provided more total support to and received more from their parents as a function of number of living parents, but the amount of support each parent received (‘parent-adjusted support’) was lower when there were more living parents. The amount of support given to and received from parents had no association with the couple's marital satisfaction, but discrepancies in support given to and received from parents did have a significant association with marital satisfaction. Husbands who gave more support to their living parent(s) than their wives reported lower marital satisfaction. A similar effect on marital satisfaction was found for wives who gave more support to their living parents than their husbands. These findings contrast with caregiving studies where amount of support affected marital satisfaction and suggest that inequalities in involvement with parents may be a critical dimension in marriages of midlife adults. PMID:21540558

Evaluation of Altered Drug Pharmacokinetics in Critically Ill Adults Receiving Extracorporeal Membrane Oxygenation.

PubMed

Ha, Michael A; Sieg, Adam C

2017-02-01

Extracorporeal membrane oxygenation (ECMO) is a life-support modality used in patients with refractory cardiac and/or respiratory failure. A significant resurgence in the use ECMO has been seen in recent years as a result of substantial improvements in technology and survival benefit. With expanding ECMO use, a better understanding of how ECMO affects drug pharmacokinetics (PK) is necessary. The vast majority of PK studies in patients receiving ECMO have been conducted within neonatal or pediatric populations or within a controlled environment (e.g., in vitro or ex vivo). Because of significant differences in absorption, distribution, metabolism, and excretion, it may be inappropriate to extrapolate these PK data to adults. Thus, the aims of this review are to evaluate the changes in drug PK during ECMO and to summarize the available PK data for common drugs used in the adult critically ill patients during ECMO support. A search of the PubMed (1965-July 2016), EMBASE (1965-July 2016), and Cochrane Controlled Trial Register databases was performed. All relevant studies describing PK alterations during ECMO in ex vivo experiments and in adults were included. Evaluation of the data indicated that drug PK in adults receiving ECMO support may be significantly altered. Factors influencing these alterations are numerous and have intricate relationships with each other but can generally be classified as ECMO circuit factors, drug factors, and patient factors. Commonly used drugs in these patients include antimicrobials, sedatives, and analgesics. PK data for most of these drugs are generally lacking; however, recent research efforts in this patient population have provided some limited guidance in drug dosing. With an improved understanding of altered drug PK secondary to ECMO therapy, optimization of pharmacotherapy within this critically ill population continues to move forward. © 2016 Pharmacotherapy Publications, Inc.

Vane segment support and alignment device

DOEpatents

McLaurin, L.D.; Sizemore, J.D.

1999-07-13

A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pin is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position. 5 figs.

Vane segment support and alignment device

DOEpatents

McLaurin, Leroy Dixon; Sizemore, John Derek

1999-01-01

A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pin is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position.

Reconstructing meaning through occupation after the death of a family member: accommodation, assimilation, and continuing bonds.

PubMed

Hoppes, Steve; Segal, Ruth

2010-01-01

Reactions to death have been studied extensively from psychological, behavioral, and physiological perspectives. Occupational adaptation to loss has received scant attention. Qualitative research was undertaken to identify and describe occupational responses in bereavement. The constant comparative approach was used to analyze and interpret the occupational responses. Adaptive strategies of occupational accommodation and assimilation were used after the death of a family member. Desire to sustain bonds with the deceased motivated specific occupational engagements. These occupational responses served to reconstruct meaning after the death of a family member. These findings contribute to understanding adaptation after death by adding an occupational perspective to previous theories. Occupational therapists' abilities to support clients after loss can be enhanced through appreciation of occupational accommodation and assimilation and the role of continuing occupational bonds after the death of a loved one.

[Conflict of interest regarding clinical physicians' relationship with pharmaceutical industry and medical education].

PubMed

Miyata, Yasushi

2010-01-01

The relationship between clinical physicians and the pharmaceutical industry is becoming an important social issue. Many lawsuits against drug companies in the area of psychiatric medicine have been heavily covered by the mass media in the U.S., and the injustices of drug companies and clinical physicians have been revealed in court. Although there are few such large social issues in Japan, the relationship between clinical physicians and the pharmaceutical industry in Japan appears inappropriate. A study on the relationship between Japanese clinical physicians and the pharmaceutical industry revealed that many physicians received "gifts" from pharmaceutical companies. This is one form of evidence for the inappropriate relationship between Japanese physicians and pharmaceutical industries. Recently, many recommendations to realize an appropriate relationship between physicians and the pharmaceutical industry have been published in the U.S. However, discussion concerning the relationship between clinical physicians and pharmaceutical companies in Japan is not active. We have received a lot of financial support for continuing medical education from pharmaceutical industries. Without such support, we may not be able to maintain the same level of medical education. Understanding such present conditions, we need to discuss what is an appropriate relationship between clinical physicians and the pharmaceutical industry.

Relationships between received and perceived social support and health-related quality of life among patients receiving methadone maintenance treatment in Mainland China.

PubMed

Zhou, Kaina; Li, Hengxin; Wei, Xiaoli; Yin, Juan; Liang, Peifeng; Zhang, Hongmei; Kou, Lingling; Hao, Mengmeng; You, Lijuan; Li, Xiaomei; Zhuang, Guihua

2017-06-26

Social support has been considered one of the most important factors of health-related quality of life (HRQoL) evaluations among different populations; however, few studies have explored the relationships of both received and perceived social support to HRQoL among patients undergoing methadone maintenance treatment (MMT). Thus, the purpose of this cross-sectional study was to clarify these relationships. Participants were patients admitted at the two largest privately and publicly funded MMT clinics in Xi'an. The main explanatory variable was social support, both received (i.e., social network support and professional support services) and perceived (Multidimensional Scale of Perceived Social Support). The outcome was HRQoL, which was evaluated using the Short-Form 36 Health Survey version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0). We carried out independent samples t-tests and multiple linear regression analysis to examine the relationships between received and perceived social support and HRQoL. The study findings revealed that patients with good social support had significantly higher scores on the SF-36v2 and QOL-DAv2.0 (p < 0.05). After controlling for individual characteristics, the significant factors predicting HRQoL were good family relationships, usually communicating with others, a convenient service time, appropriate treatment charges, and good perceived social support (p < 0.05). Our results suggest that received and perceived social support influences HRQoL among individuals receiving MMT. Thus, these variables should be considered during health management efforts and interventions directed at this patient population.

Attendees' perceptions of commercial influence in noncommercially funded CME programs.

PubMed

Goldfarb, Elizabeth; Baer, Lee; Fromson, John A; Gorrindo, Tristan; Iodice, Kristin E; Birnbaum, Robert J

2012-01-01

The controversy surrounding commercial support for continuing medical education (CME) programs has led to policy changes, but data show no significant difference in perceived bias between commercial and noncommercial CME. Indeed, what attendees perceive as commercial influence is not fully understood. We sought to clarify what sources contribute to attendees' perceptions of commercial influence in non-industry-supported CME programs, and how attendees perceive that this influence manifests itself on both speaker and program levels. Evaluation forms were received from 1 544 attendees at 14 live noncommercially supported CME programs in 2006, 2007, and 2010. Attendees rated perceived commercial influence for each lecture and the entire program. Using open-ended and "check all that apply'' questions, participants specified perceived sources and manifestations of commercial influence. Attendees rating individual lectures but not the entire program as commercially influenced accounted for 59.9% of those who identified bias. The most frequently endorsed source of commercial influence was individual speakers' funding, and the most listed manifestations were speakers' mentions of pharmaceuticals and expressions of personal opinions. Rating the entire program commercially influenced correlated with whether attendees considered the funding of referenced research a source of influence. CME attendees consider a broad spectrum of factors when reporting commercial influence. Evaluation forms should include bias questions per lecture as well as items to clarify perceived sources and manifestations of commercial influence. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

In Cyprus, 'midwifery is dying...'. A qualitative exploration of midwives' perceptions of their role as advocates for normal childbirth.

PubMed

Hadjigeorgiou, Eleni; Coxon, Kirstie

2014-09-01

advocacy has been identified as vital for improving maternal and newborn health. In many countries, midwives struggle to advocate for women; in Cyprus, there has been no research into perceptions of advocacy amongst midwives. this study provides an exploration of the perceptions of midwives as client advocates for normal childbirth in Cyprus. a qualitative approach was adopted, using participant observation and semi-structured interviews with a purposive sample of twenty experienced midwives. A thematic approach was taken for the analysis. five main interconnected themes emerged, two of which, 'Lack of professional recognition' and 'Deficiencies in basic or continuing education' presented barriers to midwives' adoption of an advocacy role. Three themes reflected structural factors that also discouraged midwives from acting as advocates: these were 'physician dominance', 'medicalisation of childbirth' and 'lack of institutional support'. advocacy is a demanding and challenging role and midwives should be empowered to feel confident in undertaking this role through continuing professional education programmes and professional recognition. In order to be effective advocates, midwives needed to be recognised and valued by the public and by other health professionals as equal partners within the multidisciplinary team. However, midwives in Cyprus find themselves in difficult situations when advocating normal childbirth due to medical domination of the health services, medicalisation of childbirth and inadequate institutional support. in this setting, midwives need to gain professional recognition, to have more effective basic and continuing education programmes and receive better support from managers and policy makers in order to become advocates for normal childbirth. © 2013 Elsevier Ltd. All rights reserved.

Frequency of respiratory deterioration after immunisation in preterm infants.

PubMed

Hacking, Douglas F; Davis, Peter G; Wong, Ester; Wheeler, Kevin; McVernon, Jodie

2010-12-01

To determine the relationship between the initiation of respiratory support and the first routine immunisation of neonates at 2 months of age during primary hospitalisation. An historical cohort study design was used to study the neonatal factors associated with the initiation of respiratory support within 7 days of immunisation in a cohort of 7629 preterm and term infants admitted to the Neonatal Unit of the Royal Women's Hospital between 2001 and 2008. The 411 infants who received their first immunisations in hospital were both very preterm and of extremely low birth weight (ELBW, below 1000 g). Twenty-two infants experienced post-immunisation apnoea of sufficient severity to warrant the initiation of either intermittent positive pressure ventilation (two cases) or continuous positive airway pressure (20 cases). Infants exhibiting a respiratory deterioration following immunisation had a higher incidence of previous septicaemia (Odds ratio 2.5, 95% confidence interval 1.0, 6.1; P = 0.04) and received CPAP for a longer period prior to vaccination (P = 0.03). Apnoea following immunisation may be an aetiological factor in the requirement of respiratory support in a small number of preterm, ELBW infants particularly those with significant lung disease and those who have previously experienced septicaemia. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Recent graduate nurse views of nursing, work and leadership.

PubMed

Cleary, Michelle; Horsfall, Jan; Jackson, Debra; Muthulakshmi, Paulpandi; Hunt, Glenn E

2013-10-01

To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention. Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world. Qualitative interviews with recent nursing graduates. Seventeen face-to-face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes. Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention-related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service. Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work. Quality health care is dependent on a well-educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce. © 2013 John Wiley & Sons Ltd.

Midwifery students׳ experiences of an innovative clinical placement model embedded within midwifery continuity of care in Australia.

PubMed

Carter, Amanda G; Wilkes, Elizabeth; Gamble, Jenny; Sidebotham, Mary; Creedy, Debra K

2015-08-01

midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices. a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha. sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 p<.001) and assessment (r=.87 p<.001). Scores on the clinical learning environment scale were significantly correlated with perceptions of the caseload model (rho=.86 p<.001), learning culture (rho=.94 p<.001) and assessment (rho=.65 p<.01) scales. embedding students within midwifery continuity of care models was perceived to be highly beneficial to learning, developed partnerships with women, and provided appropriate clinical skills development required for registration, while promoting students׳ confidence and competence. The flexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

PubMed Central

Nachega, Jean B; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F; Altice, Frederick L; Burke, Jessica G; Lester, Richard T; Uthman, Olalekan A; Knowlton, Amy R; Cotton, Mark F; Anderson, Jean R; Theron, Gerhard B

2016-01-01

Objective To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting A community primary care clinic in Cape Town, South Africa. Participants HIV-infected pregnant women. Main outcomes Acceptability and feasibility of mHealth and cDOT interventions. Results Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. PMID:27175068

Relational Psychotherapy Mothers’ Group: A developmentally informed intervention for at-risk mothers

PubMed Central

Luthar, Suniya S.; Suchman, Nancy E.

2012-01-01

The Relational Psychotherapy Mothers’ Group (RPMG), a developmentally informed, supportive psychotherapy designed to serve heroin-addicted mothers with children up to 16 years of age, aims at addressing psychosocial vulnerabilities, and facilitating optimal parenting, among at-risk mothers. We present preliminary evidence on the efficacy of RPMG as an “add on” treatment in comparison with standard methadone counseling alone. At the end of the 24-week treatment period, mothers receiving RPMG plus standard methadone counseling demonstrated lower levels of risk for child maltreatment, greater involvement with their children, and more positive psychosocial adjustment than women who received methadone counseling alone. Children of RPMG participants also reflected fewer problems in multiple areas. At 6 months posttreatment, RPMG recipients continued to be at a relative advantage, although the magnitude of group differences was often attenuated. Notably, urinalyses indicated that RPMG mothers showed greater improvements in levels of opioid use over time than comparison mothers. PMID:10847626

[Pharmaceutical services for patients receiving AC chemotherapy].

PubMed

Higuchi, Minako; Matsuo, Koichi; Ureshino, Yuko; Ogata, Kentaro; Futagami, Koujiro; Kitamura, Kaoru; Nishino, Hiroaki

2009-02-01

General treatments for breast cancer patients, such as surgery, chemotherapy, radiotherapy and lymphatic edema drainage, are performed at the Department of Breast Surgery in Kyushu Central Hospital. In those treatments, pharmacists provide the pharmaceutical treatment. Combination chemotherapy of doxorubicin and cyclophosphamide (AC therapy) is one of the standard regimens for breast cancer. In breast cancer patients who received AC therapy, we carried out investigations on side effects, and prepared pamphlets to support patients' self-management in their daily lives. In the process of preparing pamphlets, we made check sheets to monitor the severity and incidence of side effects. Based on the results of analysis and patients' opinions as well as staff remarks, we prepared pamphlets. According to the evaluation survey, pamphlets are regarded as useful. To meet the needs of patients, we intend to periodically revise pamphlets by continuing investigations on side effects, and provide up-to-date information.

High-Efficiency Low-Cost Solar Receiver for Use Ina a Supercritical CO 2 Recompression Cycle

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

Sullivan, Shaun D.; Kesseli, James; Nash, James

This project has performed solar receiver designs for two supercritical carbon dioxide (sCO 2) power cycles. The first half of the program focused on a nominally 2 MWe power cycle, with a receiver designed for test at the Sandia Solar Thermal Test Facility. This led to an economical cavity-type receiver. The second half of the program focused on a 10 MWe power cycle, incorporating a surround open receiver. Rigorous component life and performance testing was performed in support of both receiver designs. The receiver performance objectives are set to conform to the US DOE goals of 6¢/kWh by 2020 .more » Key findings for both cavity-type and direct open receiver are highlighted below: A tube-based absorber design is impractical at specified temperatures, pressures and heat fluxes for the application; a plate-fin architecture however has been shown to meet performance and life targets; the $148/kW th cost of the design is significantly less than the SunShot cost target with a margin of 30%; the proposed receiver design is scalable, and may be applied to both modular cavity-type installations as well as large utility-scale open receiver installations; the design may be integrated with thermal storage systems, allowing for continuous high-efficiency electrical production during off-sun hours; costs associated with a direct sCO 2 receiver for a sCO 2 Brayton power cycle are comparable to those of a typical molten salt receiver; lifetimes in excess of the 90,000 hour goal are achievable with an optimal cell geometry; the thermal performance of the Brayton receiver is significantly higher than the industry standard, and enables at least a 30% efficiency improvement over the performance of the baseline steam-Rankine boiler/cycle system; brayton’s patent-pending quartz tube window provides a greater than five-percent efficiency benefit to the receiver by reducing both convection and radiation losses.« less

Alternative nutrition therapies in cancer patients.

PubMed

Maritess, Canlas; Small, Shayne; Waltz-Hill, Megan

2005-08-01

To review diet guidelines on selected alternative nutrition therapies, and the origins, limitations, and implication of these recommendations. Clinical research articles on alternative nutrition therapy. Alternative nutrition therapy will continue to receive increasing scrutiny as research in science and technology develops. Individual needs vary widely; there is not one perfect diet for everyone. However, nutrition/diet plays a major role in cancer care and patients need to be educated about safe alternative nutrition therapy. Whatever decision patients make regarding alternative nutrition therapies, support should be provided so that communication is increased between the patient and the health care team.

Nasal Bubble CPAP: One Year Experience in a Neonatal Unit of a Tertiary Health Facility in Northwestern Nigeria.

PubMed

Abdulkadir, I; Hassan, L; Abdullahi, F; Purdue, S; Ogala, W N

2015-03-01

Nasal bubble continuous positive airway pressure (NBCPAP) respiratory support, though decades old, is beginning to gain popularity in developing countries including Nigeria. We reviewed neonates who benefitted from NBCPAP, to describe the demographics and outcome of NBCPAP respiratory support in newborns admitted to the neonatal unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a one year period. The study is a descriptive observational review of all neonates who required NBCPAP respiratory support in the neonatal unit of ABUTH Zaria. Data was extracted from a specifically designed proforma used to obtain information on each neonate throughout the period of admission. Twenty babies received NBCPAP respiratory support during the period of study. Seventeen (85%) of the neonates were successfully weaned off CPAP while three (15%) failed CPAP. Three neonates developed complications with two having CPAP belly syndrome and the third had facial swelling which resolved spontaneously after 6 hours. Overall, seven (41%) of the neonates who were successfully weaned off CPAP were discharged home. MajorityofnewbornswhorequirerespiratorysupportwillbenefitfromNBCPAP therefore, this method of respiratory support should be popularized and neonatal units in the country should be supported to efficiently offer the service.

A response surface analysis of expected and received support for smoking cessation: Expectancy violations predict greater relapse.

PubMed

Derrick, Jaye L; Britton, Maggie; Baker, Zachary G; Haddad, Sana

2018-08-01

People attempting to stop smoking cigarettes (quitters) hold expectations about the extent to which their partner will provide helpful support during a quit attempt. However, these expectations may not align with their perceptions of the helpfulness of the support they receive. We examine expected and received helpful support during a quit attempt. We hypothesized that receiving less helpful support than expected (i.e., creating an expectancy violation) would be associated with the greatest return to smoking. Sixty-two quitters completed a 21-day ecological momentary assessment (EMA) study. They reported expected support at baseline and support receipt and smoking during the EMA phase. At follow-up, they completed an expelled breath carbon monoxide test. Analyses using polynomial generalized linear models with response surface analysis indicated that smoking outcomes depended on the joint influence of expected and received helpful support. As hypothesized, when quitters expected more helpful support than they received, they were more likely to smoke in the first 24h and the last seven days of the EMA, and they provided higher carbon monoxide readings at follow-up. These results are consistent with an expectancy violation explanation: quitters are more likely to smoke when they perceive their partner has failed to provide support that is as helpful as expected. Given the importance of support for smoking cessation, many researchers have attempted to experimentally increase provision of support. The current findings suggest that partner support interventions might backfire if the quitter is led to expect more helpful support than the partner is able to provide. Copyright © 2018 Elsevier Ltd. All rights reserved.

Benefits of regular walking exercise in advanced pre-dialysis chronic kidney disease.

PubMed

Kosmadakis, George C; John, Stephen G; Clapp, Emma L; Viana, Joao L; Smith, Alice C; Bishop, Nicolette C; Bevington, Alan; Owen, Paul J; McIntyre, Christopher W; Feehally, John

2012-03-01

There is increasing evidence of the benefit of regular physical exercise in a number of long-term conditions including chronic kidney disease (CKD). In CKD, this evidence has mostly come from studies in end stage patients receiving regular dialysis. There is little evidence in pre-dialysis patients with CKD Stages 4 and 5. A prospective study compared the benefits of 6 months regular walking in 40 pre-dialysis patients with CKD Stages 4 and 5. Twenty of them were the exercising group and were compared to 20 patients who were continuing with usual physical activity. In addition, the 40 patients were randomized to receive additional oral sodium bicarbonate (target venous bicarbonate 29 mmol/L) or continue with previous sodium bicarbonate treatment (target 24 mmol/L). Improvements noted after 1 month were sustained to 6 months in the 18 of 20 who completed the exercise study. These included improvements in exercise tolerance (reduced exertion to achieve the same activity), weight loss, improved cardiovascular reactivity, avoiding an increase in blood pressure medication and improvements in quality of health and life and uraemic symptom scores assessed by questionnaire. Sodium bicarbonate supplementation did not produce any significant alterations. This study provides further support for the broad benefits of aerobic physical exercise in CKD. More studies are needed to understand the mechanisms of these benefits, to study whether resistance exercise will add to the benefit and to evaluate strategies to promote sustained lifestyle changes, that could ensure continued increase in habitual daily physical activity levels.

[Experiences and support needs of parents of hospitalized children with multiple disabilities: a qualitative study].

PubMed

Seliner, Brigitte; Latal, Bea; Spirig, Rebecca

2016-01-01

The hospitalisation of a multiple disabled child is stressful for parents because they continue to carry out demanding care procedures in hospital. Yet, systematic knowledge of the parental experience and of their support needs is missing. How do parents experience the hospitalisation, and which support needs do they identify for this period? Methods: Twenty-six parents (24 mothers, 2 fathers) of 24 children with multiple disabilities have participated in this qualitative study. Between 1 January 2011 and 1 September 2013, semi-structured interviews were conducted in a children's university hospital. A qualitative content analysis formed the basis for the analysis. “Concerns for the child's well-being” was central for the parents and focussed on the areas of “Pain”, “Complications” and “Development”. Perception of the child's well-being governs the extent of the “Parents' Work” and defines the parental “Support needs” to “Receive information and training”, “Be known and experience continuity”, “Be taken seriously and experience communion”, “Be accompanied by experienced nurses”, and “Be relieved and get organisational support”. Parents work hard to safeguard the well-being of their hospitalised child with multiple handicaps. Care professionals can ease the parents' burden by promoting parental confidence in their child's welfare in hospital. This will be successful if continuity of care and competence are ensured, for instance if it is provided by nurses with Advanced Practice background.

Topical Polymyxin-Trimethoprim Prophylaxis May Decrease the Incidence of Driveline Infections in Patients With Continuous-Flow Left Ventricular Assist Devices.

PubMed

Durand, Marlene L; Ennis, Stephanie C; Baker, Joshua N; Camuso, Janice M; McEachern, Kathleen M; Kotton, Camille N; Lewis, Gregory D; Garcia, Jose P; MacGillivray, Thomas E

2017-02-01

This retrospective cohort study evaluated the effect of topical polymyxin-trimethoprim (poly) prophylaxis on the incidence of driveline infections (DLIs) in patients with continuous-flow left ventricular assist devices. All 84 cases implanted 2005-2014 with device support ≥30 days were reviewed; support ranged 1 m-5.2 yrs. Beginning 2008, poly was applied to the exit site with dressing changes. Sixty-five patients received poly (poly group) for duration of follow-up, 19 did not (no-poly); group baseline characteristics were similar. No patient developed side effects from poly. Nineteen DLIs (10 in no-poly) occurred; not using poly was a risk factor. 89% of poly group DLIs were superficial, 4 were culture-negative. DLI-related bacteremia occurred in 11% of no-poly group and 0% of poly group. Compared with no-poly, poly group demonstrated improved freedom from DLI by Kaplan-Meier analysis (P < 0.0001) and a 75% lower overall and 95% lower deep DLI incidence (P ≤ 0.001). Deep DLIs occurred in 31.6% of no-poly vs. 1.5% of poly patients (P = 0.0004), although mean support duration (1 yr) and % support >1 yr (38%) were similar. These findings, which should be confirmed with larger comparative studies, suggest that topical polymyxin-trimethoprim prophylaxis may be effective in preventing DLIs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

26 CFR 1.956-3T - Certain trade or service receivables acquired from United States persons (temporary).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Certain trade or service receivables acquired from United States persons (temporary). 1.956-3T Section 1.956-3T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.956-3T Certain...

Academia-industry collaboration in continuing medical education: description of two approaches.

PubMed

Katz, Harvey P; Goldfinger, Stephen E; Fletcher, Suzanne W

2002-01-01

Although concerns have been raised about industry support of continuing medical education (CME), there are few published reports of academia-industry collaboration in the field. We describe and evaluate Pri-Med, a CME experience for primary care clinicians developed jointly by the Harvard Medical School (HMS) and M/C Communications. Since 1995, 19 Pri-Med conferences have been held in four cities, drawing more than 100,000 primary care clinicians. The educational core of each Pri-Med conference is a 3-day Harvard course, "Current Clinical Issues in Primary Care." Course content is determined by a faculty committee independent of any commercial influence. Revenues from multiple industry sources flow through M/C Communications to the medical school as an educational grant to support primary care education. Pri-Med also offers separate pharmaceutical company-funded symposia. Comparing the two educational approaches during four conferences, 221 HMS talks and 103 symposia were presented. The HMS course covered a wide range with 133 topics; the symposia focused on 30 topics, most of which were linked to recently approved new therapeutic products manufactured by the funders. Both the course and the symposia were highly rated by attendees. When CME presentations for primary care physicians receive direct support from industry, the range of offered topics is narrower than when programs are developed independently of such support. There appear to be no differences in the perceived quality of presentations delivered with and without such support. Our experience suggests that a firewall between program planners and providers of financial support will result in a broader array of educational subjects relevant to the field of primary care.

Evaluation of a breastfeeding peer support program for fathers of Hispanic participants in a Texas special supplemental nutrition program for women, infants, and children.

PubMed

Lovera, Dalia; Sanderson, Maureen; Bogle, Margaret L; Vela Acosta, Martha S

2010-11-01

A mother's decision to breastfeed and the duration of breastfeeding depends on different factors; among them are the support of her husband or male partner and other social support. There have been different types of support programs for mothers and few have targeted fathers. In 2002, the Texas Special Supplemental Nutrition Program for Women, Infants, and Children introduced an innovative approach for encouraging breastfeeding among mothers and their spouses. The pilot Peer Dad Program targeted fathers to promote and support their spouse in breastfeeding. This cohort study evaluated duration of breastfeeding among Hispanic couples who enrolled in the pilot Peer Dad Program (n=101) and those who did not enroll (n=99). Structured interviews were conducted with Special Supplemental Nutrition Program for Women, Infants, and Children participants and their male partners. Unconditional logistic regression was used to estimate the likelihood of continuing breastfeeding past 6 months associated with participation in the Peer Dad Program and significant predictors. Mothers whose partner participated in the pilot Peer Dad Program were no more likely to continue breastfeeding past 6 months (odds ratio 1.44, 95% confidence interval 0.82 to 2.54) compared with mothers who received peer counseling only. The percentage of women in the intervention group (63.4%) who breastfed for 6 months or longer compared with women in the control group (54.6%) was not significant (P=0.20). Although other studies suggest that father's support lengthens breastfeeding duration, our study, which targeted Hispanic fathers, found no association due to its small sample size. Further research with larger studies is needed to establish this association. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

How do parents experience support after the death of their child?

PubMed

Gijzen, Sandra; L'Hoir, Monique P; Boere-Boonekamp, Magda M; Need, Ariana

2016-12-07

A child's death is an enormous tragedy for both the parents and other family members. Support for the parents can be important in helping them to cope with the loss of their child. In the Netherlands little is known about parents' experiences of the support they receive after the death of their child. The purpose of this study is to determine what support parents in the Netherlands receive after the death of their child and whether the type of care they receive meets their needs. Parents who lost a child during pregnancy, labour or after birth (up to the age of two) were eligible for participation. They were recruited from three parents' associations. Sixty-four parents participated in four online focus group discussions. Data on background characteristics were gathered through an online questionnaire. SPSS was used to analyse the questionnaires and Atlas ti. was used for the focus group discussions. Of the 64 participating parents, 97% mentioned the emotional support they received after the death of their child. This kind of support was generally provided by family, primary care professionals and their social network. Instrumental and informational support, which respectively 80% and 61% of the parents reported receiving, was mainly provided by secondary care professionals. Fifty-two per cent of the parents in this study reported having received insufficient emotional support. Shortcomings in instrumental and informational support were experienced by 25% and 19% of the parents respectively. Parental recommendations were directed at ongoing support and the provision of more information. To optimise the way Dutch professionals respond to a child's death, support initiated by the professional should be provided repeatedly after the death of a child. Parents appreciated follow-up contacts with professionals at key moments in which they were asked whether they needed support and what kind of support they would like to receive.

Cohort Differences in Received Social Support in Later Life: The Role of Network Type.

PubMed

Suanet, Bianca; Antonucci, Toni C

2017-07-01

The objective is to assess cohort differences in received emotional and instrumental support in relation to network types. The main guiding hypothesis is that due to increased salience of non-kin with recent social change, those in friend-focused and diverse network types receive more support in later birth cohorts than earlier birth cohorts. Data from the Longitudinal Aging Study Amsterdam are employed. We investigate cohort differences in total received emotional and instrumental support in a series of linear regression models comparing birth cohorts aged 55-64, 65-74, 75-84, and 85-94 across three time periods (1992, 2002, and 2012). Four network types (friend, family, restricted, and diverse) are identified. Friend-focused networks are more common in later birth cohorts, restrictive networks less common. Those in friend-focused networks in later cohorts report receiving more emotional and instrumental support. No differences in received support are evident upon diverse networks. The increased salience of non-kin is reflected in an increase in received emotional and instrumental support in friend-focused networks in later birth cohorts. The preponderance of non-kin in networks should not be perceived as a deficit model for social relationships as restrictive networks are declining across birth cohorts. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Clinical Management of Ebola Virus Disease in the United States and Europe.

PubMed

Uyeki, Timothy M; Mehta, Aneesh K; Davey, Richard T; Liddell, Allison M; Wolf, Timo; Vetter, Pauline; Schmiedel, Stefan; Grünewald, Thomas; Jacobs, Michael; Arribas, Jose R; Evans, Laura; Hewlett, Angela L; Brantsaeter, Arne B; Ippolito, Giuseppe; Rapp, Christophe; Hoepelman, Andy I M; Gutman, Julie

2016-02-18

Available data on the characteristics of patients with Ebola virus disease (EVD) and clinical management of EVD in settings outside West Africa, as well as the complications observed in those patients, are limited. We reviewed available clinical, laboratory, and virologic data from all patients with laboratory-confirmed Ebola virus infection who received care in U.S. and European hospitals from August 2014 through December 2015. A total of 27 patients (median age, 36 years [range, 25 to 75]) with EVD received care; 19 patients (70%) were male, 9 of 26 patients (35%) had coexisting conditions, and 22 (81%) were health care personnel. Of the 27 patients, 24 (89%) were medically evacuated from West Africa or were exposed to and infected with Ebola virus in West Africa and had onset of illness and laboratory confirmation of Ebola virus infection in Europe or the United States, and 3 (11%) acquired EVD in the United States or Europe. At the onset of illness, the most common signs and symptoms were fatigue (20 patients [80%]) and fever or feverishness (17 patients [68%]). During the clinical course, the predominant findings included diarrhea, hypoalbuminemia, hyponatremia, hypokalemia, hypocalcemia, and hypomagnesemia; 14 patients (52%) had hypoxemia, and 9 (33%) had oliguria, of whom 5 had anuria. Aminotransferase levels peaked at a median of 9 days after the onset of illness. Nearly all the patients received intravenous fluids and electrolyte supplementation; 9 (33%) received noninvasive or invasive mechanical ventilation; 5 (19%) received continuous renal-replacement therapy; 22 (81%) received empirical antibiotics; and 23 (85%) received investigational therapies (19 [70%] received at least two experimental interventions). Ebola viral RNA levels in blood peaked at a median of 7 days after the onset of illness, and the median time from the onset of symptoms to clearance of viremia was 17.5 days. A total of 5 patients died, including 3 who had respiratory and renal failure, for a mortality of 18.5%. Among the patients with EVD who were cared for in the United States or Europe, close monitoring and aggressive supportive care that included intravenous fluid hydration, correction of electrolyte abnormalities, nutritional support, and critical care management for respiratory and renal failure were needed; 81.5% of these patients who received this care survived.

Vane segment support and alignment device

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

McLaurin, L.D.; Sizemore, J.D.

1999-07-13

A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pinmore » is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position. 5 figs.« less

The Process and Effect of Supportive Message Expression and Reception in Online Breast Cancer Support Groups

PubMed Central

Kim, Eunkyung; Han, Jeong Yeob; Moon, Tae Joon; Shaw, Bret; Shah, Dhavan V.; McTavish, Fiona M.; Gustafson, David H.

2011-01-01

Objective To better understand the process and effect of social support exchanges within computer-mediated social support (CMSS) groups for breast cancer patients, this study examines 1) the dynamic interplay between emotional support giving and receiving and 2) the relative effects of emotional support giving and receiving on patients’ psychosocial health outcomes. Methods Data was collected from 177 patients who participated in online cancer support groups within the Comprehensive Health Enhancement Support System (CHESS) during the 4-month intervention. Data included 1) pretest and/or posttest survey scores of demographic, disease-related, and psychosocial factors, 2) automatically collected CHESS usage data, and 3) computer-aided content analysis of social support messages posts. Results Hierarchical regression analyses revealed that those who receive higher levels of support from others have fewer breast cancer-related concerns (β= −.15, p<.05), while those who give higher levels of support to others reframe their own problems in a positive light and adopt more positive strategies for coping (β= .16, p<.05). In addition to these positive effects, partial correlation analysis indicated that these two supportive behaviors are reciprocal. Conclusions We concluded that supportive exchanges of receiving and giving play positive, but different, roles in predicting psychosocial health outcomes. Moreover, emotional support giving and receiving tend to reinforce each other. Our findings help practitioners, health care providers, and health system designers make sense of diverse social support processes among cancer patients participating within CMSS groups. PMID:21416553

Insurance continuity and receipt of diabetes preventive care in a network of Federally Qualified Health Centers

PubMed Central

Gold, Rachel; DeVoe, Jennifer; Shah, Amit; Chauvie, Susan

2009-01-01

Background and Objectives Having health insurance is usually associated with better access to care and better health outcomes. For patients receiving care at Federally Qualified Health Centers (FQHCs), where care is provided regardless of insurance status, the role health insurance status plays in affecting receipt of services is less well understood. Research Design We used practice management data from a coalition of FQHCs in Oregon, and linked to Oregon’s electronic insurance data, to examine whether receipt of diabetes preventive care services was associated with continuity of insurance coverage among adult FQHC patients receiving diabetes care in 2005. Results About one-third (32%) of patients with diabetes received a flu vaccination in 2005, 36% an LDL screening, 54% at least one HbA1c screening, and 21% a nephropathy screening. Compared to the continuously insured, the continuously uninsured were less likely to receive an LDL screening, a flu vaccination, and/or a nephropathy screening; those with partial coverage were less likely than the continuously insured to receive a flu shot, at least one HbA1c screening, or an LDL screening. Conclusions Our results suggest that FQHCs do an excellent job in delivering most services to their uninsured and partially insured patients, but also underscore that for diabetic patients from underserved communities, having both an FQHC medical home and continuous health insurance plays a critical role in receiving optimal chronic disease management. Our study is one of the first to demonstrate how electronic administrative data from a network of FQHCs can be successfully used to gauge the state of healthcare delivery. PMID:19330890

Discharge prescribing of enteral opioids after initiation as a weaning strategy from continuous opioid infusions in the Intensive Care Unit.

PubMed

Kram, Bridgette; Weigel, Kylie M; Kuhrt, Michelle; Gilstrap, Daniel L

To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). Retrospective, observational study. Five adult ICUs at a large, quaternary care academic medical center. Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated. Exclusion criteria were receipt of fewer than two enteral opioid doses, documentation of a long-acting opioid as a home medication, the indication for the enteral opioid was not a weaning strategy, death during hospital admission or discharge to hospice. None. The proportion of ICU and hospital survivors who received a discharge prescription for a scheduled enteral opioid, total duration of continuous opioid infusion, duration of continuous opioid infusion after initiation of an enteral opioid therapy, total duration of enteral therapy, ICU and hospital length of stay. Of 62 included patients, 19 patients (30.6 percent) received a new prescription for a scheduled enteral opioid at hospital discharge. The median duration of enteral opioid therapy was longer for patients who received a discharge prescription compared to those who did not (20.09 vs 8.89 days, p = 0.02), though the remaining endpoints were not different. Utilizing scheduled enteral opioids as a weaning strategy from continuous opioid infusions may place patients at risk of ICU-acquired physical dependence on opioids.

Recommendations for the use of medications with continuous enteral nutrition.

PubMed

Wohlt, Paul D; Zheng, Lan; Gunderson, Shelly; Balzar, Sarah A; Johnson, Benjamin D; Fish, Jeffrey T

2009-08-15

Recommendations for the use of medications with continuous enteral nutrition are provided. A literature review was conducted to identify primary literature reporting medication interactions with continuous enteral nutrition. For medications without supporting literature, manufacturers were contacted for information. Package inserts for specific medications were also investigated for any information to help guide recommendations. If no specific recommendations were made by the pharmaceutical manufacturer or the package insert concerning administration of products with continuous enteral nutrition, a tertiary database was consulted. Recommendations were generated by a consensus of clinicians for those medications that lacked specific recommendations in the primary literature or from the pharmaceutical manufacturer. Documentation of medication interactions with continuous enteral nutrition and food was then collated along with specific recommendations on how to administer the medication with regard to continuous enteral nutrition. Recommendations were classified as strong (grade 1) or weak (grade 2). The quality of evidence was classified as high (grade A), moderate (grade B), or low (grade C). Forty-six medications commonly given to hospitalized patients were evaluated. Twenty-four medications had recommendations based on available data, and the remaining 22 medications had recommendations based on a consensus of clinicians. There was a lack of published data regarding drug-nutrient interactions for a majority of the drugs commonly administered to patients receiving continuous enteral nutrition. Clinicians should recognize potential drug-nutrient interactions and use available evidence to optimize patients' drug therapy.

Women receiving news of a family BRCA1/2 mutation: messages of fear and empowerment.

PubMed

Crotser, Cheryl B; Dickerson, Suzanne S

2010-12-01

Communication of genetic test results to healthy at-risk family members is complicated considering family dynamics and the complexity of cancer genetics. The purpose of this study was to understand the experience of family communication of BRCA1/2 results from the perspective of young and middle-aged women receiving the news. THEORETICAL RATIONALE: Individuals are self-interpretive beings influenced by family culture, history, and communication patterns. Humans express meaning through language and stories. Heideggerian hermeneutics guided in-depth interviews and team interpretation of data. Using purposive and network sampling, 19 women 18 to 50 years of age who received news of a family BRCA1/2 mutation from a biologic relative were recruited from support groups and two health facilities in upstate New York. Five themes emerged: (a) situating the story, (b) receiving the message from family, (c) responding to receipt of the message, (d) impacting family communication, and (e) advice for communicating risk. Two constitutive patterns were identified: (a) communicating risk as a message of fear and empowerment and (b) integrating the message by taking one step at a time. Healthcare professionals (HCPs) have an important role in provision of anticipatory guidance for communication of genetic test results, including the potential behavioral and emotional responses to family risk communication. Future research is indicated to understand the role of HCPs in family risk communication. Presentation of comprehensive and balanced information and the use of patient-centered communication is essential. HCPs need to view women as whole rather than as a person at risk. Continued support is needed for women who subsequently test positive or negative for the family BRCA1/2 mutation from HCPs and others, often outside the family network. © 2010 Sigma Theta Tau International.

Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy.

PubMed

Peterson, Douglas E; Ohrn, Kerstin; Bowen, Joanne; Fliedner, Monica; Lees, Judith; Loprinzi, Charles; Mori, Takehiko; Osaguona, Anthony; Weikel, Dianna S; Elad, Sharon; Lalla, Rajesh V

2013-01-01

This systematic review analyzed the strength of the literature and defined clinical practice guidelines for the use of oral cryotherapy for the prevention and/or treatment of oral mucositis caused by cancer therapy. A systematic review on relevant oral cryotherapy studies indexed prior to 31 December 2010 was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using OVID/MEDLINE, with publications selected for review based on defined inclusion and exclusion criteria. Findings from the reviewed studies were integrated into guidelines based on the overall level of evidence for each intervention. Guidelines were classified into three types: recommendation, suggestion, or no guideline possible. Twenty-two clinical studies and two meta-analyses were analyzed. Results were compared with the MASCC/ISOO guidelines published in 2007. The recommendation for the use of oral cryotherapy to prevent oral mucositis in patients receiving bolus fluorouracil (5-FU) was maintained, in agreement with the 2007 guidelines. A suggestion for use of oral cryotherapy to prevent oral mucositis in patients receiving high-dose melphalan as conditioning regimen with or without total body irradiation for HCST was revised from the 2007 guidelines. No guideline was possible for any other intervention, due to insufficient evidence. The evidence continues to support the use of oral cryotherapy for prevention of oral mucositis in patients receiving bolus 5-FU chemotherapy or high-dose melphalan. This intervention is consistent with the MASCC/ISOO guidelines published in 2007. The literature is limited by the fact that utilization of a double-blind study design is not feasible. Future studies that compare efficacy of oral cryotherapy with other mucositis agents in patients receiving chemotherapy with relatively short plasma half-lives would be useful.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women.

PubMed

Kang, Nam Mi; Lee, Jung Eun; Bai, Yeon; Van Achterberg, Theo; Hyun, Taisun

2015-04-01

The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Support of EarthScope GPS Campaigns at the UNAVCO Facility

NASA Astrophysics Data System (ADS)

Boyce, E.; Blume, F.; Normandeau, J.

2008-12-01

In order to support portable GPS deployments funded by the NSF's EarthScope Science panel, PBO has purchased 100 campaign GPS systems. Based Topcon GB-1000 equipment, the systems have been designed for stand-alone temporary or semi-permanent deployment that will be used for densifying areas not sufficiently covered by continuous GPS, and responding to volcanic and tectonic crises. UNAVCO provides support for all aspects of these projects, including proposal and budget development, project planning, equipment design, field support, and data archiving. Ten of the 100 systems have been equipped with real-time kinematic (RTK) capability requiring additional radio and data logging equipment. RTK systems can be used to rapidly map fault traces and profile fault escarpments and collect precise position information for GIS based geologic mapping. Each portable self-contained campaign systems include 18 Ah batteries, a regulated 32 watt solar charging system, and a low-power dual frequency GPS receiver and antenna in a waterproof case with security enhancements. The receivers have redundant memory sufficient for storing over a year's worth of data as well as IP and serial communications capabilities for longer-term deployments. Monumentation options are determined on a project-by-project basis, with options including Tech2000 masts, low-profile spike mounts, and traditional tripods and optical tribrachs. Drilled-braced monuments or masts can be installed for "semi- permanent" style occupations. The systems have been used to support several projects to date, including the University of Washington's 30-unit deployment to monitor the Episodic Tremor and Slip event in November, 2005 and the ongoing Rio Grande Rift experiment, run by the Universities of Colorado, Utah State, and New Mexico, which has seen the construction of 25 permanent monuments in 2006 and 2007 and a 26-site campaign reoccupation in 2008.

Support of EarthScope GPS Campaigns at the UNAVCO Facility

NASA Astrophysics Data System (ADS)

Boyce, E.; Blume, F.; Normandeau, J.

2007-12-01

In order to support portable GPS deployments funded by the NSF's EarthScope Science panel, PBO has purchased 100 campaign GPS systems. Based Topcon GB-1000 equipment, the systems have been designed for stand-alone temporary or semi-permanent deployment that will be used for densifying areas not sufficiently covered by continuous GPS, and responding to volcanic and tectonic crises. UNAVCO provides support for all aspects of these projects, including proposal and budget development, project planning, equipment design, field support, and data archiving. Ten of the 100 systems will be purchased with real-time kinematic (RTK) capability requiring additional radio and data logging equipment. RTK systems can be used to rapidly map fault traces and profile fault escarpments and collect precise position information for GIS based geologic mapping. Each portable self-contained campaign systems include 18 Ah batteries, a regulated 32 watt solar charging system, and a low-power dual frequency GPS receiver and antenna in a waterproof case with security enhancements. The receivers have redundant memory sufficient for storing over a year's worth of data as well as IP and serial communications capabilities for longer-term deployments. Monumentation options are determined on a project-by-project basis, with options including Tech2000 masts, low-profile spike mounts, and traditional tripods and optical tribrachs. Drilled-braced monuments or masts can be installed for "semi-permanent" style occupations. The systems have been used to support several projects to date, including the University of Washington's 30- unit deployment to monitor the Episodic Tremor and Slip event in November, 2005 and the ongoing Rio Grande Rift experiment, run by the Universities of Colorado, Utah State, and New Mexico, which has seen the construction of 25 permanent monuments in 2006 and 2007.

Integrating education, group support, and case management for diabetic Hispanics.

PubMed

Brown, Sharon A; García, Alexandra A; Winter, Mary; Silva, Lita; Brown, Adama; Hanis, Craig L

2011-01-01

Culturally tailored diabetes self-management education (DSME) improves glycemic control and other health outcomes in Mexican Americans but sociocultural barriers to health improvements remain. This study explored the feasibility of adding a nurse case manager (NCM) to DSME to foster DSME attendance and increase utilization of other available health care services. The setting was a rural community on the Texas-Mexico border in one of the poorest counties in the United States. Using a repeated measures pretest, post-test control group design, we enrolled 165 Mexican American adults into: 1) an experimental group that received a DSME intervention plus access to a NCM; or 2) a control group that received DSME only. Both experimental and control groups received the DSME intervention, reported positive changes in diet and physical activity, and showed improved clinical outcomes; there were no significant group differences. A statistically significant reduction in body mass index was seen in women compared to men, regardless of group or number of NCM contacts. For individuals having the most NCM contacts, DSME attendance rates were greater. Participants expressed acceptance of the NCM; they preferred face-to-face contact rather than by telephone. Our previously tested, culturally tailored DSME continues to be an effective strategy for improving glycemic control in Mexican Americans. This feasibility study provided partial support for the NCM model for underserved border communities, but additional research is needed on resource utilization and the nature of NCM contacts.

A qualitative study of occupational well-being for people with severe mental illness.

PubMed

Milbourn, Benjamin; McNamara, Beverley; Buchanan, Angus

2017-07-01

People with severe mental illness (SMI) do not receive adequate attention in research or clinical practice. They are considered hard to reach and difficult to engage. Information is needed to help provide support for this vulnerable population. This paper aims to investigate the well-being of adults diagnosed with SMI and receiving Assertive Community Treatment (ACT) by applying the occupational well-being framework to the everyday activities of this vulnerable group of people. Eleven adults diagnosed with an SMI, living in the community, participated in semi-structured interviews over a 12-month period. A longitudinal design was used to collect data through using field notes and audio recordings. For this paper, secondary analysis was conducted by coding the data deductively thereby investigating the participants' experiences in relation to the seven Occupational Well-being framework descriptors (accomplishment, affirmation, agency, coherence, companionship, pleasure and renewal). Participants' everyday activities and occupational well-being appeared severely restricted and largely determined by the type of care they received. There was minimal evidence of the well-being descriptors, though all the participants reported experiencing some form of pleasure, even though some of the pleasurable experiences negatively impacted their health. The episodic nature of SMI means that people living with an SMI require continuity in key relationships and support to achieve Occupational Well-being. Occupational therapists working with mental health consumers need to facilitate the types of activities that foster well-being through accomplishment, affirmation, agency and companionship, and that derive pleasure in healthy and positive ways.

Caregiving and mutuality among long-term colorectal cancer survivors with ostomies: qualitative study.

PubMed

Altschuler, Andrea; Liljestrand, Petra; Grant, Marcia; Hornbrook, Mark C; Krouse, Robert S; McMullen, Carmit K

2018-02-01

The cancer caregiving literature focuses on the early phases of survivorship, but caregiving can continue for decades when cancer creates disability. Survivors with an ostomy following colorectal cancer (CRC) have caregiving needs that may last decades. Mutuality has been identified as a relationship component that can affect caregiving. This paper discusses how mutuality may affect long-term ostomy caregiving. We conducted semi-structured, in-depth interviews with 31 long-term CRC survivors with ostomies and their primary informal caregivers. Interviewees were members of an integrated health care delivery system in the USA. We used inductive theme analysis techniques to analyze the interviews. Most survivors were 71 years of age or older (67%), female (55%), and with some college education (54%). Two thirds lived with and received care from spouses. Caregiving ranged from minimal support to intimate assistance with daily ostomy care. While some survivors received caregiving far beyond what was needed, others did not receive adequate caregiving for their health care needs. Low mutuality created challenges for ostomy caregiving. Mutuality impacts the quality of caregiving, and this quality may change over time, depending on various factors. Emotional feedback and amplification is the proposed mechanism by which mutuality may shift over time. Survivorship care should include assessment and support of mutuality as a resource to enhance health outcomes and quality of life for survivors with long-term caregiving needs and their caregivers. Appropriate questionnaires can be identified or developed to assess mutuality over the survivorship trajectory.

Postincident Support for Healthcare Workers Experiencing Occupational Violence and Aggression.

PubMed

Shea, Tracey; Cooper, Brian; De Cieri, Helen; Sheehan, Cathy; Donohue, Ross; Lindsay, Sarah

2018-05-10

To investigate the relative contributions of workplace type, occupational violence and aggression (OVA) strategies and interventions along with perceptions of the occupational health and safety (OHS) environment on the likelihood of receiving postincident support following the experience of OVA. We used a cross-sectional study design with an online survey to collect data from employees in nursing and midwifery in Victoria, Australia. Survey data collected from 3,072 members of the Australian Nursing and Midwifery Federation (Victorian branch) were analyzed using logistic regression. Of the 3,072 respondents who had experienced OVA in the preceding 12 months, 1,287 (42%) reported that they had received postincident support. Hierarchical logistic regression revealed that the OHS environment was the dominant factor that predicted the likelihood of workers receiving postincident support. Working in a positive OHS environment characterized by higher levels of leading indicators of OHS, prioritization of OHS, supervisor support for safety, and team psychological safety was the stronger predictor of postincident support. Being employed in a workplace that offered training in the management and prevention of OVA also increased the likelihood of receiving postincident support. While training in the management and prevention of OVA contributed to the likelihood of receiving postincident support, a greater emphasis on the OHS environment was more important in predicting the likelihood that workers received support. This study identifies workplace practices that facilitate the provision of postincident support for healthcare workers. Facilitating effective postincident support could improve outcomes for workers, their patients and workplaces, and society in general. © 2018 Sigma Theta Tau International.

Dental treatment and employment outcomes among social assistance recipients in Ontario, Canada.

PubMed

Singhal, Sonica; Mamdani, Muhammad; Mitchell, Andrew; Tenenbaum, Howard; Lebovic, Gerald; Quiñonez, Carlos

2016-10-01

Policy advocates continue to argue for the expansion of dental care services for people on social assistance in order to meet their health needs and to promote the move from welfare-to-work. However, there is little to no evidence to support the idea that receiving dental care ultimately improves employment outcomes. A retrospective cohort study was designed using administrative data from five Ontario regions and from the province's social assistance ministry. Employment outcomes among treatment and no-treatment cohorts were assessed at three, six and 12 months from baseline. Multivariable regression modeling was performed. We received data for 8742 people (2742 treatment, 6000 no-treatment). At one year, employment outcomes were not significantly different between the two groups (adjusted odds ratio=0.93; 95% CI: 0.83-1.03). Post-hoc analysis show that the change in proportion of individuals leaving social assistance for employment over time was significantly higher (p=0.0014) among those receiving treatment (13-29%; 124% increase) than those not receiving treatment (18-33%; 83% increase). At one year, dental treatment alone does not appear to be significantly associated with leaving assistance for employment in this population. However, this study suggests that people who received dental treatment may have been particularly disadvantaged and dental treatment may help to level them up in terms of employment outcomes over time. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Emotions and support needs following a distressing birth: Scoping study with pregnant multigravida women in North-West England.

PubMed

Thomson, Gill; Downe, Soo

2016-09-01

to identify the emotional and support needs of pregnant multigravida women who have experienced adverse responses associated with a previous childbirth experience. four maternity hospitals in North-West England. 100 surveys were distributed at an anomaly scan clinic in each of four maternity hospitals (total n=400). The survey included an adapted version of a Post-Traumatic Stress Disorder Symptom Scale to explore trauma responses at two broad time points: (a) following a previous birth and (b) during the current pregnancy. Participants were also asked about the optimal time to receive support post-birth, and the type and provider of support they had accessed/would have liked to access. Descriptive and inferential statistics were undertaken on the quantitative data. The qualitative data were analysed using a basic thematic approach. multigravida pregnant women aged 18+ years. the overall response rate was 28% (n=112); 43% (n=46) of the women had experienced negative/trauma responses associated with a previous birth, 74% of whom (n=34) continued/re-experienced adverse responses in their current pregnancy. Most commonly reported trauma responses were difficulties in recalling the previous birth(s), avoiding memories associated with it, and the distress associated with these memories when they were recalled. Approximately 54% (n=25) had received some form of support post-birth, and variations in preferred timing of postnatal support provision were reported. Information on available support and opportunities to discuss the birth with a maternity professional were identified most frequently as preferred support options. women's views about what might work should form the basis for effectiveness studies in this area. Among the participants in this study there was evidence of unmet support needs relating to negative or traumatic responses to a previous birth. The range of preferred timing and types of support indicate that flexible needs-based support options should be provided. Further research should assess if these findings are reinforced in a more diverse sample with a higher response rate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Eliciting and Receiving Online Support: Using Computer-Aided Content Analysis to Examine the Dynamics of Online Social Support

PubMed Central

Kraut, Robert E; Levine, John M

2015-01-01

Background Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. Objective The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Methods Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Results Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=–.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=–.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). Conclusions Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities. PMID:25896033

Eliciting and receiving online support: using computer-aided content analysis to examine the dynamics of online social support.

PubMed

Wang, Yi-Chia; Kraut, Robert E; Levine, John M

2015-04-20

Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=-.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=-.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities.

Well-Being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support

PubMed Central

Kroemeke, Aleksandra; Gruszczynska, Ewa

2016-01-01

Background The aim of the study was to examine the cross-sectional and longitudinal effects of provided and received support on older adults’ subjective well-being (positive affect and depression) and to examine whether being a recipient of institutional care moderates these effects. Methods Social support (provided and received), positive affect, and depressive symptoms were assessed twice (at baseline and 1 month later) for 277 older adults (age 77.39 ± 9.20 years, 67.50% women, 65% residents of an institutional care facility). Findings Two structural equation models were analyzed: cross-sectional (at baseline) and longitudinal (after 1 month). The first model revealed a significant positive relationship between providing and receiving support and positive affect, and a negative relationship between receiving support and depression. However, being a recipient of institutional care appeared to be a significant moderator in the longitudinal model. Specifically, the findings indicated effects of both providing and receiving support on positive affect but only for noninstitutionalized older adults. Discussion Although both types of support may be beneficial for older adults, their effects depend on the nature of social exchange and the dimensions of well-being. This suggests that such factors should be systematically investigated in future research. PMID:27548721

Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

PubMed

Haas, Sheila A; Vlasses, Frances; Havey, Julia

2016-01-01

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

Omnidirectional fiber optic tiltmeter

DOEpatents

Benjamin, B.C.; Miller, H.M.

1983-06-30

A tiltmeter is provided which is useful in detecting very small movements such as earth tides. The device comprises a single optical fiber, and an associated weight affixed thereto, suspended from a support to form a pendulum. A light source, e.g., a light emitting diode, mounted on the support transmits light through the optical fiber to a group of further optical fibers located adjacent to but spaced from the free end of the single optical fiber so that displacement of the single optical fiber with respect to the group will result in a change in the amount of light received by the individual optical fibers of the group. Photodetectors individually connectd to the fibers produce corresponding electrical outputs which are differentially compared and processed to produce a resultant continuous analog output representative of the amount and direction of displacement of the single optical fiber.

Child support and alimony: 1981.

PubMed

Sanders, R A

1985-02-01

This report presents information (including 13 tables) as of spring 1982 on payments made to mothers for child support by fathers not living in the same household, and information on support payments and property settlement awards for women involved in marital dissolution. As of spring 1982, 8.4 million mothers were living with a child under 21 years of age whose father was not living with them; 59% of these women were or would be awarded child support payments than black women (34%) or those of Spanish origin (44%). College educated women were more likely to be awarded and to receive child support payments than women with only a high school education. The average amount of child support received in 1981 was $2,110, a decrease of about 16% from the 1978 level of $2,510. Of the 2.6 million women below the poverty level with children present from an absent father, about 40% received child support. Among the poor, 806,000 women were due child support in 1981 but only 61% received some amount of payment. As of spring 1982, only about 15% of the 17 million divorced or separated women received alimony. In 1981 alimony averaged $3,000, a 25% decrease from the 1978 level of $3,980. In spring 1982, about 42% of the 14.2 million divorced women reported receiving some form of property settlement.

Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum: a prospective cohort study

PubMed Central

Forster, Della A; Johns, Helene M; McLachlan, Helen L; Moorhead, Anita M; McEgan, Kerri M; Amir, Lisa H

2015-01-01

Objective To explore whether feeding only directly from the breast in the first 24–48 h of life increases the proportion of infants receiving any breast milk at 6 months. Design A prospective cohort study. Setting Three maternity hospitals in Melbourne, Australia. Participants 1003 postpartum English-speaking women with a healthy singleton term infant, who intended to breast feed, were recruited between 2009 and 2011. Women were excluded if they or their infant were seriously ill. 92% (n=924) were followed up at 6 months postpartum. Primary and secondary outcome measures Main exposure variable —type of infant feeding in hospital up to time of study recruitment (24–48 h postpartum), categorised as ‘fed directly at the breast only’ or ‘received at least some expressed breast milk (EBM) or infant formula’. Primary outcome—proportion of infants receiving any breast milk feeding at 6 months postpartum. Secondary outcomes—proportion of infants receiving only breast milk feeding at 6 months; breast milk feeding duration; and maternal characteristics associated with giving any breast milk at 6 months. Results Infants who had fed only at the breast prior to recruitment were more likely to be continuing to have any breast milk at 6 months than those who had received any EBM and/or infant formula (76% vs 59%; adjusted OR 1.76, 95% CI 1.24 to 2.48 (adjusted for parity, type of birth, breastfeeding intention, breastfeeding problems at recruitment, public/private status, epidural for labour or birth, maternal body mass index and education)). Conclusions Healthy term infants that fed only directly at the breast 24–48 h after birth were more likely to be continuing to breast feed at 6 months than those who received any EBM and/or formula in the early postpartum period. Support and encouragement to initiate breastfeeding directly at the breast is important. PMID:25953728

Interpreting a helping hand: cultural variation in the effectiveness of solicited and unsolicited social support.

PubMed

Mojaverian, Taraneh; Kim, Heejung S

2013-01-01

Research has shown that Asians/Asian Americans are less likely to seek social support to deal with stressful situations than European Americans. Two studies examined the effectiveness of two types of social support: support that is sought directly (solicited support) and support received without prompting from the recipient (unsolicited support). It was theorized that receiving unsolicited support may reinforce social belonging and relational ties, whereas soliciting support may pose relational threats for Asian Americans. In contrast, European Americans may be less affected by type of support received. The first study examined culture (European American vs. Asian American) and type of social support (solicited vs. unsolicited) on stress responses to a task in a lab setting. The second study used vignettes of possible stressors with unsolicited or solicited coping techniques. Results supported our hypothesis, with Asian Americans reporting better outcomes from unsolicited support and European Americans showing little difference between support types.

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature

PubMed Central

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems. PMID:26113945

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature.

PubMed

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.

Ceramic turbine stator vane and shroud support

DOEpatents

Glenn, Robert G.

1981-01-01

A support system for supporting the stationary ceramic vanes and ceramic outer shrouds which define the motive fluid gas path in a gas turbine engine is shown. Each individual segment of the ceramic component whether a vane or shroud segment has an integral radially outwardly projecting stem portion. The stem is enclosed in a split collet member of a high-temperature alloy material having a cavity configured to interlock with the stem portion. The generally cylindrical external surface of the collet engages a mating internal cylindrical surface of an aperture through a supporting arcuate ring segment with mating camming surfaces on the two facing cylindrical surfaces such that radially outward movement of the collet relative to the ring causes the internal cavity of the collet to be reduced in diameter to tightly engage the ceramic stem disposed therein. A portion of the collet extends outwardly through the ring segment opposite the ceramic piece and is threaded for receiving a nut and a compression washer for retaining the collet in the ring segment under a continuous biasing force urging the collet radially outwardly.

The experience of older people living in an elderly residential home (Panti Sosial Tresna Werdha): a phenomenology.

PubMed

Rahayu, Septirina; Catharina Daulima, Novy Helena; Eka Putri, Yossie Susanti

2018-02-01

The aim of this study was to gain an overview of the experiences of older people living in an elderly residential home (Panti Sosial Tresna Werdha [PSTW]). The study used qualitative method with the descriptive phenomenology approach. The participants consisted of six older people who live in institutions. Data were collected through in-depth interviews in accordance with the purpose of the research, and an analysis of the data from the interviews was performed using the analysis stage by Collaizi. Three themes emerged from this study, namely independent living needs and support systems as a reason for staying at PSTW, the adaptive response to life in PSTW, and family support as a contributing factor to remaining at PSTW. Most of the elderly's support came from their children or nephews and nieces. Receiving full emotional support from relatives through family visits was deemed necessary for the elderly, as it made them feel happy to continue the rest of their lives in the elderly care home. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Scale-up of HIV Treatment Through PEPFAR: A Historic Public Health Achievement

PubMed Central

El-Sadr, Wafaa M.; Holmes, Charles B.; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N.; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

2012-01-01

Since its inception in 2003, the US President’s Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems. PMID:22797746

45 CFR 400.104 - Continued coverage of recipients who receive increased earnings from employment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Conditions of Eligibility for Refugee Medical Assistance § 400.104 Continued coverage of recipients who receive increased earnings from...

SFINX-a drug-drug interaction database designed for clinical decision support systems.

PubMed

Böttiger, Ylva; Laine, Kari; Andersson, Marine L; Korhonen, Tuomas; Molin, Björn; Ovesjö, Marie-Louise; Tirkkonen, Tuire; Rane, Anders; Gustafsson, Lars L; Eiermann, Birgit

2009-06-01

The aim was to develop a drug-drug interaction database (SFINX) to be integrated into decision support systems or to be used in website solutions for clinical evaluation of interactions. Key elements such as substance properties and names, drug formulations, text structures and references were defined before development of the database. Standard operating procedures for literature searches, text writing rules and a classification system for clinical relevance and documentation level were determined. ATC codes, CAS numbers and country-specific codes for substances were identified and quality assured to ensure safe integration of SFINX into other data systems. Much effort was put into giving short and practical advice regarding clinically relevant drug-drug interactions. SFINX includes over 8,000 interaction pairs and is integrated into Swedish and Finnish computerised decision support systems. Over 31,000 physicians and pharmacists are receiving interaction alerts through SFINX. User feedback is collected for continuous improvement of the content. SFINX is a potentially valuable tool delivering instant information on drug interactions during prescribing and dispensing.

Perspectives of self-direction: a systematic review of key areas contributing to service users' engagement and choice-making in self-directed disability services and supports.

PubMed

Lakhani, Ali; McDonald, Donna; Zeeman, Heidi

2018-05-01

Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research must continue to investigate the perspectives of service users pertaining to their engagement, as their participation is central to the effectiveness of the approach. © 2016 John Wiley & Sons Ltd.

The role of social support in weight loss maintenance: results from the MedWeight study.

PubMed

Karfopoulou, Eleni; Anastasiou, Costas A; Avgeraki, Evangelia; Kosmidis, Mary H; Yannakoulia, Mary

2016-06-01

The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally lost ≥10 % of their weight and are either maintaining this loss for over a year (maintainers), or have regained weight (regainers). Demographics and lifestyle habits questionnaires are completed online. Dietary assessment is carried out by two telephone 24 h recalls. Perceived social support was assessed by validated scales examining support from family and friends regarding healthy eating and exercise. 289 maintainers and 122 regainers participated. Regainers received more support compared to maintainers. However, maintainers reported receiving compliments and active participation, whereas regainers receiving verbal instructions and encouragements. Maintainers who received diet support displayed improved dietary intakes, such as lower energy intake; regainers' diet was unaffected by support. Positive, rather than instructive, support appears beneficial in weight loss maintenance.

Sustainability of current agriculture practices, community perception, and implications for ecosystem health: an Indian study.

PubMed

Sarkar, Atanu; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary

2011-12-01

In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.

Trends in use of neonatal CPAP: a population-based study

PubMed Central

2011-01-01

Background Continuous positive airway pressure (CPAP) is used widely to provide respiratory support for neonates, and is often the first treatment choice in tertiary centres. Recent trials have demonstrated that CPAP reduces need for intubation and ventilation for infants born at 25-28 weeks gestation, and at > 32weeks, in non-tertiary hospitals, CPAP reduces need for transfer to NICU. The aim of this study was to examine recent population trends in the use of neonatal continuous positive airway pressure. Methods We undertook a population-based cohort study of all 696,816 liveborn neonates ≥24 weeks gestation in New South Wales (NSW) Australia, 2001-2008. Data were obtained from linked birth and hospitalizations records, including neonatal transfers. The primary outcome was CPAP without mechanical ventilation (via endotracheal intubation) between birth and discharge from the hospital system. Analyses were stratified by age ≤32 and > 32 weeks gestation. Results Neonates receiving any ventilatory support increased from 1,480 (17.9/1000) in 2001 to 2,486 (26.9/1000) in 2008, including 461 (5.6/1000) to 1,465 (15.8/1000) neonates who received CPAP alone. There was a concurrent decrease in mechanical ventilation use from 12.3 to 11.0/1000. The increase in CPAP use was greater among neonates > 32 weeks (from 3.2 to 11.8/1000) compared with neonates ≤32 weeks (from 18.1 to 32.7/1000). The proportion of CPAP > 32 weeks initiated in non-tertiary hospitals increased from 6% to 30%. Conclusions The use of neonatal CPAP is increasing, especially > 32 weeks gestation and among non-tertiary hospitals. Recommendations are required regarding which infants should be considered for CPAP, resources necessary for a unit to offer CPAP and monitoring of longer term outcomes. PMID:21999325

Trends in use of neonatal CPAP: a population-based study.

PubMed

Roberts, Christine L; Badgery-Parker, Tim; Algert, Charles S; Bowen, Jennifer R; Nassar, Natasha

2011-10-17

Continuous positive airway pressure (CPAP) is used widely to provide respiratory support for neonates, and is often the first treatment choice in tertiary centres. Recent trials have demonstrated that CPAP reduces need for intubation and ventilation for infants born at 25-28 weeks gestation, and at > 32 weeks, in non-tertiary hospitals, CPAP reduces need for transfer to NICU. The aim of this study was to examine recent population trends in the use of neonatal continuous positive airway pressure. We undertook a population-based cohort study of all 696,816 liveborn neonates ≥24 weeks gestation in New South Wales (NSW) Australia, 2001-2008. Data were obtained from linked birth and hospitalizations records, including neonatal transfers. The primary outcome was CPAP without mechanical ventilation (via endotracheal intubation) between birth and discharge from the hospital system. Analyses were stratified by age ≤32 and > 32 weeks gestation. Neonates receiving any ventilatory support increased from 1,480 (17.9/1000) in 2001 to 2,486 (26.9/1000) in 2008, including 461 (5.6/1000) to 1,465 (15.8/1000) neonates who received CPAP alone. There was a concurrent decrease in mechanical ventilation use from 12.3 to 11.0/1000. The increase in CPAP use was greater among neonates > 32 weeks (from 3.2 to 11.8/1000) compared with neonates ≤32 weeks (from 18.1 to 32.7/1000). The proportion of CPAP > 32 weeks initiated in non-tertiary hospitals increased from 6% to 30%. The use of neonatal CPAP is increasing, especially > 32 weeks gestation and among non-tertiary hospitals. Recommendations are required regarding which infants should be considered for CPAP, resources necessary for a unit to offer CPAP and monitoring of longer term outcomes.

Sources of information used to support quality use of medicines: findings from a national survey of nurse practitioners in Australia.

PubMed

Buckley, Thomas; Stasa, Helen; Cashin, Andrew; Stuart, Meg; Dunn, Sandra V

2015-02-01

The purpose of this study was to investigate the sources, both print and electronic formats, which Australian nurse practitioners (NPs) currently use to obtain information regarding quality use of medicines (QUM). An additional aim was to document NPs' preferences for continuing education in relation to QUM. A national electronic survey of Australian NPs was conducted in 2007 and again in 2010. Eighty percent of respondents accessed information on QUM from professional literature, which may include scholarly journal articles, reports, and independent publications. There was a decrease in the percentage of respondents who obtained information from drug industry representatives. NPs prefer to receive medicines information in an electronic form, rather than a paper-based version, and over the time period more NPs are utilizing electronic sources rather than paper. These findings provide important insights into medical information products for the developers who may be able to use these results to ensure that their products meet the needs of NP clinicians. Additionally, the finding that NPs prefer to receive their continuing information related to medicines in electronic format, but also highly value conference proceedings, may help to inform future planning of NP education needs in relation to QUM. ©2014 American Association of Nurse Practitioners.

The Impact of Support Received and Support Provision on Changes in Perceived Social Support among Older Adults

ERIC Educational Resources Information Center

Tyler, Kimberly A.

2006-01-01

The current study uses longitudinal data from the 1993 U.S. Midwest floods to examine the influence of support received and support provision on changes in perceived social support among older adults exposed to an acute stressor. Results indicated that flood exposure and higher levels of social support at Time 1 were positively associated with…

Outcomes for Patients With Diabetes After Continuous-Flow Left Ventricular Assist Device Implantation.

PubMed

Vest, Amanda R; Mistak, Stanley M; Hachamovitch, Rory; Mountis, Maria M; Moazami, Nader; Young, James B

2016-10-01

Diabetes mellitus (DM) is a risk factor for mortality among patients with heart failure as well as for patients who undergo cardiothoracic surgery. However it is unknown whether DM is associated with increased mortality or major complications during continuous-flow left ventricular assist device (CF-LVAD) support. We retrospectively reviewed 300 consecutive adults who received CF-LVADs at a single center in the years 2006-2013; 129 patients had DM before LVAD, as defined by American Diabetes Association criteria (HbA1c ≥6.5% and/or taking DM medications). Compared with the non-DM group, DM patients were older, with a higher pre-LVAD body mass index, more ischemic heart failure etiology, and higher pre-LVAD creatinine. Ninety-three patients died on LVAD support, 43 with DM and 50 without DM (P = .4526). After control for 9 covariates in a Cox proportional hazards model, DM was unassociated with all-cause mortality (hazard ratio 0.883, 95% confidence interval 0.571-1.366; P = .5768). Diabetes was also unassociated with the adverse event end points of stroke/transient ischemic attack, intracerebral hemorrhage, pump thrombosis, and device-related infections. Diabetes is common in LVAD recipients (43% of the present cohort) but does not increase mortality or rates of major adverse events during CF-LVAD support. Copyright © 2016 Elsevier Inc. All rights reserved.

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

PubMed

Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

2018-04-17

In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

Journey to confidence: women's experiences of pain in labour and relational continuity of care.

PubMed

Leap, Nicky; Sandall, Jane; Buckland, Sara; Huber, Ulli

2010-01-01

An evaluation carried out at King's College Hospital Foundation National Health Service Trust in London identified that women who received continuity of carer from the Albany Midwifery Practice were significantly less likely to use pharmacological pain relief when comparisons were made with eight other midwifery group practices and the local maternity service as a whole. This study was designed to explore women's views of this phenomenon. We conducted a thematic analysis of semistructured, audiotaped, in-depth interviews with 10 women who reflected on their experiences of preparation and support for pain in labour and midwifery continuity of carer with Albany midwives, using a qualitative descriptive methodological approach. Women reflected positively on how, throughout pregnancy and labour, their midwives promoted a sense of their ability to cope with the challenge of labour pain. This building of confidence was enabled through a relationship of trust that developed with their midwives and the value of hearing other women's stories during antenatal groups. These experiences enhanced women's ability to overcome fears and self-doubt about coping with pain and led to feelings of pride, elation, and empowerment after birth. Women valued being encouraged and supported to labour without using pharmacological pain relief by midwives with whom they developed a trusting relationship throughout pregnancy. Features of midwifery approaches to pain in labour and relational continuity of care have important implications for promoting normal birth and a positive experience of pregnancy, labour, and birth for women. Copyright (c) 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.

Child support and alimony: 1985 (supplemental report).

PubMed

Hanlon, R A

1989-03-01

This report on child support and alimony is based on data from the 1987 and 1986 US Current Population Surveys. As of spring 1986, 8.8 million mothers were living with children under 21 years of age whose fathers were not living in the household; 61%, or about 5.4 million, of these women were awarded or had an agreement to receive child support payments for their children as of the survey date. Of the 5.4 million women awarded child support, 4.4 million were supposed to receive child support for their children in 1985. Of those due payment, about half received the full amount they were due. Of the remaining women, there was no evidence of a difference between the proportion receiving partial payment and those receiving no payment at all--about 26% each. Of the 5.4 million women with awards for their children, 45% had health insurance included as part of the award. Of the 3.4 million women without child support awards, about half (48%) wanted but could not obtain awards for their children. The child support award rate reported in 1986 showed a slight increase from that of 1984 (up 2.2% to 58%). The proportion of women awarded child support payments in 1986 was higher for Whites (71%) than for Blacks (36%) or Hispanics (42%). Women with 4 or more years of college were more likely to have been awarded support payments (77%) than women with 4 years of high school (63%). The average (mean) amount of child support received in 1985 was $2200.

Mothers' lived experiences of support when living with young children with congenital heart defects

PubMed Central

Bruce, Elisabeth; Lilja, Catrine; Sundin, Karin

2014-01-01

Purpose The purpose of this study was to illuminate the meanings of support as disclosed by mothers of children with congenital heart defects (CHD). Design and Method Narrative interviews were conducted with 10 mothers of children with CHD. A phenomenological-hermeneutic method was used for interpretation of the transcribed interviews. Results The comprehensive understanding of mothers' lived experiences of support emerged as the experiences of receiving good support, receiving “poor support,” and absence of support. Practice Implications Mothers receiving person-centered and family-centered care feel more supported and are more likely to adapt to the stresses of parenting a child with CHD. PMID:24124764

The effect of luteal-phase support with vaginal progesterone on pregnancy rates in gonadotropin and clomiphene citrate/intra-uterine insemination cycles in unexplained infertility: A prospective randomised study.

PubMed

Karadag, Burak; Dilbaz, Berna; Karcaaltincaba, Deniz; Sahin, Elif Gulsah; Ercan, Fedi; Karasu, Yetkin; Tonyalı, Nazan Vanlı

2016-08-01

The purpose of this study is to analyse the effect of luteal-phase support on pregnancy rates in gonadotropin + intra-uterine insemination (Gn/IUI) and clomiphene citrate (CC) +IUI (CC/IUI) cycles in patients with unexplained infertility. Equal numbers of patients were recruited in two treatment arms (CC/IUI and Gn/IUI) (n = 100, n = 100, respectively). In each group, 50 patients received vaginal progesterone for 14 days (Crinone 8% vaginal gel, 90 mg per day) for luteal-phase support from the day after IUI and continued until menstruation or the 10th week of gestation if pregnant. There were 29 clinical pregnancies among 200 patients. Pregnancy rates were 12% in CC/IUI cycles, 10% in luteal-phase-supported CC/IUI cycles 16% in Gn/IUI cycles and 20% in luteal-phase-supported Gn/IUI cycles. Although pregnancy rates were higher in Gn/IUI cycles compared to CC/IUI cycles, luteal-phase support did not significantly affect the pregnancy rates in both groups. This study implies that luteal-phase support with progesterone has no pronounced beneficial effect on pregnancy rates in either CC/IUI or Gn/IUI cycles in patients with unexplained infertility.

SCaN Network Ground Station Receiver Performance for Future Service Support

NASA Technical Reports Server (NTRS)

Estabrook, Polly; Lee, Dennis; Cheng, Michael; Lau, Chi-Wung

2012-01-01

Objectives: Examine the impact of providing the newly standardized CCSDS Low Density Parity Check (LDPC) codes to the SCaN return data service on the SCaN SN and DSN ground stations receivers: SN Current Receiver: Integrated Receiver (IR). DSN Current Receiver: Downlink Telemetry and Tracking (DTT) Receiver. Early Commercial-Off-The-Shelf (COTS) prototype of the SN User Service Subsystem Component Replacement (USS CR) Narrow Band Receiver. Motivate discussion of general issues of ground station hardware design to enable simple and cheap modifications for support of future services.

The US Network of Pediatric Multiple Sclerosis Centers: Development, Progress, and Next Steps.

PubMed

Casper, T Charles; Rose, John W; Roalstad, Shelly; Waubant, Emmanuelle; Aaen, Gregory; Belman, Anita; Chitnis, Tanuja; Gorman, Mark; Krupp, Lauren; Lotze, Timothy E; Ness, Jayne; Patterson, Marc; Rodriguez, Moses; Weinstock-Guttman, Bianca; Browning, Brittan; Graves, Jennifer; Tillema, Jan-Mendelt; Benson, Leslie; Harris, Yolanda

2015-09-01

Multiple sclerosis and other demyelinating diseases in the pediatric population have received an increasing level of attention by clinicians and researchers. The low incidence of these diseases in children creates a need for the involvement of multiple clinical centers in research efforts. The Network of Pediatric Multiple Sclerosis Centers was created initially in 2006 to improve the diagnosis and care of children with demyelinating diseases. In 2010, the Network shifted its focus to multicenter research while continuing to advance the care of patients. The Network has obtained support from the National Multiple Sclerosis Society, the Guthy-Jackson Charitable Foundation, and the National Institutes of Health. The Network will continue to serve as a platform for conducting impactful research in pediatric demyelinating diseases of the central nervous system. This article provides a description of the history and development, organization, mission, research priorities, current studies, and future plans of the Network. © The Author(s) 2014.

The US Network of Pediatric Multiple Sclerosis Centers: Development, Progress, and Next Steps

PubMed Central

Casper, T. Charles; Rose, John W.; Roalstad, Shelly; Waubant, Emmanuelle; Aaen, Gregory; Belman, Anita; Chitnis, Tanuja; Gorman, Mark; Krupp, Lauren; Lotze, Timothy E.; Ness, Jayne; Patterson, Marc; Rodriguez, Moses; Weinstock-Guttman, Bianca; Browning, Brittan; Graves, Jennifer; Tillema, Jan-Mendelt; Benson, Leslie; Harris, Yolanda

2014-01-01

Multiple sclerosis and other demyelinating diseases in the pediatric population have received an increasing level of attention by clinicians and researchers. The low incidence of these diseases in children creates a need for the involvement of multiple clinical centers in research efforts. The Network of Pediatric Multiple Sclerosis Centers was created initially in 2006 to improve the diagnosis and care of children with demyelinating diseases. In 2010, the Network shifted its focus to multicenter research while continuing to advance the care of patients. The Network has obtained support from the National Multiple Sclerosis Society, the Guthy-Jackson Charitable Foundation, and the National Institutes of Health. The Network will continue to serve as a platform for conducting impactful research in pediatric demyelinating diseases of the central nervous system. This article provides a description of the history and development, organization, mission, research priorities, current studies, and future plans of the Network. PMID:25270659

26 CFR 1.956-3T - Certain trade or service receivables acquired from United States persons (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... investment in United States property by the seller's controlled foreign corporation, unless it can be... SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Controlled Foreign... foreign corporation has acquired a trade or service receivable. (2) Indirect acquisitions—(i) Acquisition...

26 CFR 1.245-1 - Dividends received from certain foreign corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... corporations. 1.245-1 Section 1.245-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Special Deductions for Corporations § 1.245-1 Dividends received from certain foreign corporations. (a) General rule. (1) A corporation is allowed a deduction...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2010 CFR

2010-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from regulated...

34 CFR 691.15 - Eligibility to receive a grant.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 4 2013-07-01 2013-07-01 false Eligibility to receive a grant. 691.15 Section 691.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND...

34 CFR 691.15 - Eligibility to receive a grant.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 4 2014-07-01 2014-07-01 false Eligibility to receive a grant. 691.15 Section 691.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND...

34 CFR 691.15 - Eligibility to receive a grant.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 4 2012-07-01 2012-07-01 false Eligibility to receive a grant. 691.15 Section 691.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND...

34 CFR 691.15 - Eligibility to receive a grant.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Eligibility to receive a grant. 691.15 Section 691.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

34 CFR 379.54 - What are the reporting requirements for the compliance indicators?

Code of Federal Regulations, 2011 CFR

2011-07-01

... indicators? 379.54 Section 379.54 Education Regulations of the Offices of the Department of Education... INDUSTRY What Compliance Indicator Requirements Must a Grantee Meet To Receive Continuation Funding? § 379.54 What are the reporting requirements for the compliance indicators? (a) To receive continuation...

34 CFR 379.54 - What are the reporting requirements for the compliance indicators?

Code of Federal Regulations, 2010 CFR

2010-07-01

... indicators? 379.54 Section 379.54 Education Regulations of the Offices of the Department of Education... INDUSTRY What Compliance Indicator Requirements Must a Grantee Meet To Receive Continuation Funding? § 379.54 What are the reporting requirements for the compliance indicators? (a) To receive continuation...

Front-Loaded Versus Weekly Counseling for Treatment of Tobacco Addiction

PubMed Central

Kalman, David; Hoskinson, Randall A.; Kinnunen, Taru; Wadler, Brianna M.; Thomson, Carey C.; Rosner, Bernard

2012-01-01

Introduction: Approximately 60%–70% of cigarette smokers who try to quit relapse by 2 weeks postcessation. We tested the efficacy of a front-loaded (FL) counseling intervention whose goal was to increase the likelihood of successful early abstinence and subsequent long-term abstinence. Methods: We randomized 278 adult smokers to an FL or weekly behavioral smoking cessation counseling schedule. The total number of sessions across treatment was the same for both groups. However, those assigned to the FL schedule received 6 counseling sessions in the first 2 weeks postcessation, while those in the weekly condition received 2 sessions. Participants in both groups also received standard nicotine patch treatment. Results: At 1 year postcessation, FL participants were significantly less likely to have relapsed when continuous abstinence was used as the definition of abstinence/relapse (11.7% abstinent vs. 6.3%, hazard ratio [HR] = 0.69, p = .007); and there were nonsignificant trends for FL subjects to have better outcomes when abstinence was defined as never smoking for 7 or more consecutive days nor for 7 or more consecutive episodes (18.4% abstinent vs. 14.8%, HR = 0.83, p = .20) and as point prevalence abstinence (15.6% abstinent vs. 12.9%, p = .11). The relationship between FL counseling treatment and continuous abstinence was partially mediated by higher postcessation levels of social support perceived from counseling and greater use of cessation-related coping strategies. Conclusions: We conclude that FL counseling is a promising treatment model that should be evaluated further, perhaps using modifications of the FL schedule used in this study. PMID:22058190

Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial.

PubMed

Hazell, Cassie M; Hayward, Mark; Cavanagh, Kate; Jones, Anna-Marie; Strauss, Clara

2016-07-26

Cognitive behavior therapy for psychosis (CBTp) is an effective intervention for people who hear distressing voices (auditory hallucinations). However, there continues to be a problem of poor access to CBTp. Constraints on health care funding require this problem to be addressed without a substantial increase in funding. One solution is to develop guided self-help forms of CBTp to improve access, and a symptom-specific focus on, for example, distressing voices (auditory verbal hallucinations) has the potential to enhance effectiveness. We term this cognitive behavior therapy for distressing voices (CBTv). This trial is an external pilot randomized controlled trial comparing the effects of 12-week guided self-help CBTv (with eight therapist support sessions) with a wait list control condition. Informed consent will be obtained from each participant. Half of the 30 participants will be randomized to receive guided self-help CBTv immediately; the remaining half will receive the intervention after a 12-week delay. All participants will continue with their usual treatment throughout the study. Outcomes will be assessed using questionnaires completed at baseline and 12 weeks postrandomization. Interviews will be offered to all those who receive therapy immediately to explore their experiences with the intervention. The outcomes of this trial, both quantitative and qualitative, will inform the design of a definitive randomized controlled trial of guided self-help CBTv. If this intervention is effective, it could help to increase access to CBT for those who hear distressing voices. ISRCTN registration number  ISRCTN77762753 . Registered on 23 July 2015.

Church-Based Social Support Among Caribbean Blacks in the United States

PubMed Central

Nguyen, Ann W.; Taylor, Robert Joseph; Chatters, Linda M.

2016-01-01

An emerging body of research notes the importance of church-based social support networks in the daily lives of Americans. However, few studies examine church-based support, and especially among ethnic subgroups within the U.S. Black population, such as Caribbean Blacks. This study uses data from the National Survey of American Life (NSAL) to examine demographic and religious participation (e.g., attendance, interaction) correlates of church-based social support (e.g., receipt of emotional support, receipt of general support, provision of support to others, and negative interaction) among Caribbean Blacks residing in the U.S. Multiple regression analyses indicated that religious participation was associated with all four dependent variables. Church attendance was positively associated with receiving emotional support, general social support, and providing support to others, but was not associated with negative interaction. Frequency of interaction with fellow congregants was positively associated with receiving emotional support, receiving general support, providing support to others and negative interaction. Demographic findings indicated that women provided more support to church members and experienced more negative interactions with members than did men. Education was positively associated with frequency of support; household income was negatively associated with receiving emotional support and providing social support to others. Findings are discussed in relation to the role of church-based support networks in the lives of Caribbean Black immigrants and communities. PMID:27942078

Retooling Institutional Support Infrastructure for Clinical Research

PubMed Central

Snyder, Denise C.; Brouwer, Rebecca N.; Ennis, Cory L.; Spangler, Lindsey L.; Ainsworth, Terry L.; Budinger, Susan; Mullen, Catherine; Hawley, Jeffrey; Uhlenbrauck, Gina; Stacy, Mark

2016-01-01

Clinical research activities at academic medical centers are challenging to oversee. Without effective research administration, a continually evolving set of regulatory and institutional requirements can detract investigator and study team attention away from a focus on scientific gain, study conduct, and patient safety. However, even when the need for research administration is recognized, there can be struggles over what form it should take. Central research administration may be viewed negatively, with individual groups preferring to maintain autonomy over processes. Conversely, a proliferation of individualized approaches across an institution can create inefficiencies or invite risk. This article describes experiences establishing a unified research support office at the Duke University School of Medicine based on a framework of customer support. The Duke Office of Clinical Research was formed in 2012 with a vision that research administration at academic medical centers should help clinical investigators navigate the complex research environment and operationalize research ideas. The office provides an array of services that have received high satisfaction ratings. The authors describe the ongoing culture change necessary for success of the unified research support office. Lessons learned from implementation of the Duke Office of Clinical Research may serve as a model for other institutions undergoing a transition to unified research support. PMID:27125563

Are industry financial ties associated with greater scholarly impact among academic otolaryngologists?

PubMed

Svider, Peter F; Bobian, Michael; Lin, Ho-Sheng; Setzen, Michael; Baredes, Soly; Eloy, Jean Anderson; Folbe, Adam J

2017-01-01

In response to concerns regarding physician-industry relationships, the Physician Sunshine Act of 2010 was passed in an effort to increase transparency and accountability. Our objective was to determine whether there is an association between industry support and scholarly impact among academic otolaryngologists. Faculty listings, academic rank, and fellowship training of academic otolaryngologists were accessed from departmental websites. H-indices, number of publications, and publication range (years) of each individual were calculated using the Scopus database. The Center for Medicare and Medicaid Services Open Payments database was used to determine industry payments during 2014 to each otolaryngologist. Of 1,515 otolaryngologists, 65.4% received industry support and 15.8% received support > $1,000. No difference in impact, as measured by the h-index, was noted upon comparison of those receiving support and those who did not (P > 0.05). Individuals receiving > $1,000 had higher h-indices and total publications than those receiving < $1,000 or receiving no support (H = 17.8 vs. 10.9, P < 0.0001), even upon controlling for academic seniority. Upon organization by subspecialty, individuals receiving > $1,000 had greater scholarly impact among most subspecialties. Industry contributions increased with advancing experience. Receiving industry contributions greater than $1,000 is associated with greater scholarly impact among academic otolaryngologists. In a smaller surgical specialty, such as otolaryngology-head and neck surgery, direct industry research support-as well as indirect contributions through the support of educational programs, consulting, and other expenses-potentially impacts scholarly discourse; these findings do not reflect a causal relationship and may require further characterization. NA Laryngoscope, 127:87-94, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Support and Self-Efficacy among Latino and White Parents of Children with ID

ERIC Educational Resources Information Center

Cohen, Shana R.; Holloway, Susan D.; Dominguez-Pareto, Irenka; Kuppermann, Miriam

2015-01-01

Research indicates that mothers of children with ID who receive familial support experience less stress than those who receive less support. Less is known about the relation of support to mothers' evaluation of parenting self-efficacy, particularly in Latino families. We examined the relationship of different types of family support to life…

Doula support during first-trimester surgical abortion: a randomized controlled trial.

PubMed

Chor, Julie; Hill, Brandon; Martins, Summer; Mistretta, Stephanie; Patel, Ashlesha; Gilliam, Melissa

2015-01-01

The objective of the study was to evaluate the impact of doula support on first-trimester abortion care. Women were randomized to receive doula support or routine care during first-trimester surgical abortion. We examined the effect of doula support on pain during abortion using a 100 mm visual analog scale. The study had the statistical power to detect a 20% difference in mean pain scores. Secondary measures included satisfaction, procedure duration, and patient recommendations regarding doula support. Two hundred fourteen women completed the study: 106 received doula support, and 108 received routine care. The groups did not differ regarding demographics, gestational age, or medical history. Pain scores in the doula and control groups did not differ at speculum insertion (38.6 [±26.3 mm] vs 43.6 mm [±25.9 mm], P = .18) or procedure completion (68.2 [±28.0 mm] vs 70.6 mm [±23.5 mm], P = .52). Procedure duration (3.39 [±2.83 min] vs 3.18 min [±2.36 min], P = .55) and patient satisfaction (75.2 [±28.6 mm] vs 74.6 mm [±27.4 mm], P = .89) did not differ between the doula and control groups. Among women who received doula support, 96.2% recommended routine doula support for abortion and 60.4% indicated interest in training as doulas. Among women who did not receive doula support, 71.6% of women would have wanted it. Additional clinical staff was needed to provide support for 2.9% of women in the doula group and 14.7% of controls (P < .01). Although doula support did not have a measurable effect on pain or satisfaction, women overwhelmingly recommended it for routine care. Women receiving doula support were less likely to require additional clinic support resources. Doula support therefore may address patient psychosocial needs. Copyright © 2015 Elsevier Inc. All rights reserved.

Early Right Ventricular Assist Device Use in Patients Undergoing Continuous-Flow Left Ventricular Assist Device Implantation: Incidence and Risk Factors From the Interagency Registry for Mechanically Assisted Circulatory Support.

PubMed

Kiernan, Michael S; Grandin, E Wilson; Brinkley, Marshall; Kapur, Navin K; Pham, Duc Thinh; Ruthazer, Robin; Rame, J Eduardo; Atluri, Pavan; Birati, Edo Y; Oliveira, Guilherme H; Pagani, Francis D; Kirklin, James K; Naftel, David; Kormos, Robert L; Teuteberg, Jeffrey J; DeNofrio, David

2017-10-01

To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression. We compared survival between patients with and without RVAD using Kaplan-Meier method and Cox proportional hazards modeling. Of 9976 patients undergoing continuous-flow-LVAD implantation, 386 patients (3.9%) required an RVAD within 14 days of LVAD surgery. Preimplant characteristics associated with RVAD use included interagency registry for mechanically assisted circulatory support patient profiles 1 and 2, the need for preoperative extracorporeal membrane oxygenation or renal replacement therapy, severe preimplant tricuspid regurgitation, history of cardiac surgery, and concomitant procedures other than tricuspid valve repair at the time of LVAD. Hemodynamic determinants included elevated right atrial pressure, reduced pulmonary artery pulse pressure, and reduced stroke volume. The final model demonstrated good performance for both RVAD implant (area under the curve, 0.78) and the combined end point of RVAD or death within 14 days (area under the curve, 0.73). Compared with patients receiving an isolated LVAD, patients requiring RVAD had decreased 1- and 6-month survival: 78.1% versus 95.8% and 63.6% versus 87.9%, respectively ( P <0.0001 for both). The need for RVAD implantation after LVAD is associated with indices of global illness severity, markers of end-organ dysfunction, and profiles of hemodynamic instability. © 2017 American Heart Association, Inc.

Development of clinical application for a nutritional prescription support system for total parenteral/enteral nutrition.

PubMed

Masuda, Syuzo; Oka, Ryusho; Uwai, Koji; Matsuda, Yumi; Shiraishi, Tadashi; Nakagawa, Yoshito; Shoji, Tohru; Mihara, Chie; Takeshita, Mitsuhiro; Ozawa, Koichiro

2009-09-01

One of the important roles of pharmacists as members of a nutrition support team is nutritional prescription support. We developed a nutritional prescription support system (NPSS) that facilitates prescription support and analysis and evaluated its usefulness in nutritional therapy. An NPSS for prescription support and the management of patient information was created. With this NPSS, the nutritional status was assessed, and, on the basis of the results, such variables as the total energy expenditure were calculated. This system allows prescription support for parenteral nutrition (PN) therapy, enteral nutrition (EN) therapy, and the transition period between them. This system was used for 2 representative patients and evaluated. In a malnourished patient receiving oral warfarin, EN solutions were compared by means of the NPSS, and an appropriate EN solution was selected. In addition, the prothrombin time-international normalized ratio was monitored, and favorable results were obtained regarding the adjustment of the warfarin dose and nutritional management. In a patient with aspiration pneumonia, continuous nutritional management to EN from PN therapy was straightforwardly performed with the NPSS. This NPSS allows rapid, comprehensive nutritional management during the transition period to EN from PN therapy, despite these therapies being considered separately in conventional nutritional management. The NPSS is useful for simplifying prescription support and facilitating information sharing among members of a nutrition support team.

Predicting re-victimization of battered women 3 years after exiting a shelter program.

PubMed

Bybee, Deborah; Sullivan, Cris M

2005-09-01

This study examined interpersonal and ecological predictors of re-victimization of a sample of women with abusive partners. All women (N = 124) had sought refuge from a battered women's shelter 3 years earlier, and half the sample had been randomly assigned to receive free, short-term advocacy services immediately upon exit from the shelter. Results 2 years post-intervention revealed positive change in the lives of participants (C. M. Sullivan & D. Bybee, 1999), including a decrease in abuse for women who had worked with advocates. The current study examined intervention effects 3 years after the program ended, as well as other predictors of re-abuse. Nineteen percent of the original sample had experienced domestic violence between 2 and 3 years after shelter exit (65% by current partners, 35% by ex-partners). The advocacy program's effect on risk of re-victimization did not continue 3 years post-intervention. However, having worked with an advocate 3 years prior continued to have a positive impact on women's quality of life and level of social support. The risk of being abused 3 years post-shelter stay was exacerbated by a number of factors present 1 year prior, including women's (1) having experienced abuse in the 6 months before that point; (2) having difficulties accessing resources; (3) having problems with the state welfare system; and (4) having people in their social networks who made their lives difficult. Women were at less risk of abuse if, 1 year earlier, they (1) were employed; (2) reported higher quality of life; and (3) had people in their networks who provided practical help and/or were available to talk about personal matters. These findings support the hypothesis that access to resources and social support serve as protective factors against continued abuse.

"Always looking for a new balance": toward an understanding of what it takes to continue working while being diagnosed with relapsing-remitting multiple sclerosis.

PubMed

Meide, Hanneke van der; Gorp, Dennis van; van der Hiele, Karin; Visser, Leo

2017-06-22

The aim of this study was to gain insight into the meaning of work in the everyday lives of people with relapsing-remitting multiple sclerosis, and the barriers and facilitators to staying in work. Nineteen employed adults diagnosed with relapsing-remitting multiple sclerosis participated in narrative interviews. All interviews were transcribed and coded for thematic analysis. For people with relapsing-remitting multiple sclerosis, continuing to work was a precarious balancing act. Five themes influenced this balance: becoming familiar with the disease, adjusting expectations, having an understanding and realistic line manager, seeing work as meaningful life activity and strategic considerations. People receiving a diagnosis of relapsing-remitting multiple sclerosis have to refamiliarize themselves with their own body in a meaningful way to be able to continue their work. Rehabilitation professionals can support them herein by taking into account not merely functional capabilities but also identity aspects of the body. Medication that stabilizes symptoms supports making the necessary adjustments. A trusting relationship with the line manager is vital for this adaptation process. Additionally, a match between being adequately challenged by work, while still having the capacity to meet those work demands, is needed, as is long-term financial stability. Implications for rehabilitation Rehabilitation professionals can support employees with relapsing-remitting multiple sclerosis by taking into account not merely functional capabilities but also identity aspects of the body. A trusting relationship with the line manager, including a timely disclosure of the diagnosis, is vital for people with relapsing-remitting multiple sclerosis to remain at work. For people with relapsing-remitting multiple sclerosis, there is a delicate balance between being adequately challenged by work while still having the capacity to meet work demands.

Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

PubMed Central

Giraldo, Nubia Amparo; Aguilar, Nora Luz; Restrepo, Beatriz Elena; Vanegas, Marcela; Alzate, Sandra; Martínez, Mónica; Gamboa, Sonia Patricia; Castaño, Eliana; Barbosa, Janeth; Román, Juliana; Serna, Ángela María; Hoyos, Gloria Marcela

2012-01-01

Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p= 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest incidence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an association with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits. PMID:24893056

Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms.

PubMed

Safren, Steven A; Otto, Michael W; Sprich, Susan; Winett, Carol L; Wilens, Timothy E; Biederman, Joseph

2005-07-01

The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.

In search of altruistic community: patterns of social support mobilization following Hurricane Hugo.

PubMed

Kaniasty, K; Norris, F H

1995-08-01

Twelve months after Hurricane Hugo, 1,000 disaster victims and nonvictims were asked about social support they exchanged following the hurricane. Victims of disaster received and provided very high levels of tangible, informational, and emotional support. Disaster exposure (loss and harm) was a strong predictor of help received and a modest predictor of help provided. However, postdisaster help was not distributed equally and disaster exposure was more strongly related to social support in some groups than in others. Race, education, and age most consistently moderated the impact of disaster exposure on receipt of postdisaster support. Blacks and less educated victims received less help than similarly affected victims who were white or more educated. Relative disadvantage of being old in receiving support was not the case for those elderly disaster victims who experienced threats to their lives or health. Some subgroups of victims were relied upon disproportionately for providing assistance. Implications for social support research are addressed.

Correlated petrographic, electron microprobe, and ion microprobe studies of selected primitive and processed phase assemblages in meteorites

NASA Technical Reports Server (NTRS)

Albee, Arden L.

1993-01-01

During the past three years we have received support to continue our research in elucidating the formation and alteration histories of selected meteoritic materials by a combination of petrographic, trace element, and isotopic analyses employing optical and scanning electron microscopes and electron and ion microprobes. The awarded research funds enabled the P.I. to attend the annual LPSC, the co-I to devote approximately 15 percent of his time to the research proposed in the grant, and partial support for a visiting summer post-doctoral fellow to conduct electron microprobe analyses of meteoritic samples in our laboratory. The research funds, along with support from the NASA Education Initiative awarded to P.I. G. Wasserburg, enabled the co-I to continue a mentoring program with inner-city minority youth. The support enabled us to achieve significant results in the five projects that we proposed (in addition to the Education Initiative), namely: studies of the accretional and post-accretional alteration and thermal histories in CV meteorites, characterization of periclase-bearing Fremdlinge in CV meteorites, characterization of Ni-Pt-Ge-Te-rich Fremdlinge in CV meteorites in an attempt to determine the constraints they place on the petrogenetic and thermal histories of their host CAI's, correlated electron and ion microprobe studies of silicate and phosphate inclusions in the Colomera meteorite in an attempt to determine the petrogenesis of the IE iron meteorites, and development of improved instrumental and correction procedures for improved accuracy of analysis of meteoritic materials with the electron microprobe. This grant supported, in part or whole, 18 publications so far by our research team, with at least three more papers anticipated. The list of these publications is included. The details of the research results are briefly summarized.

Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm.

PubMed

Huang, Li; Roberts, Calum T; Manley, Brett J; Owen, Louise S; Davis, Peter G; Dalziel, Kim M

2018-05-01

To compare the cost-effectiveness of 2 common "noninvasive" modes of respiratory support for infants born preterm. An economic evaluation was conducted as a component of a multicenter, randomized control trial from 2013 to 2015 enrolling infants born preterm at ≥28 weeks of gestation with respiratory distress, <24 hours old, who had not previously received endotracheal intubation and mechanical ventilation or surfactant. The economic evaluation was conducted from a healthcare sector perspective and the time horizon was from birth until death or first discharge. The cost-effectiveness of continuous positive airway pressure (CPAP) vs high-flow with "rescue" CPAP backup and high-flow without rescue CPAP backup (as sole primary support) were analyzed by using the hospital cost of inpatient stay in a tertiary center and the rates of endotracheal intubation and mechanical ventilation during admission. Hospital inpatient cost records for 435 infants enrolled in all Australian centers were obtained. With "rescue" CPAP backup, an incremental cost-effectiveness ratio was estimated of A$179 000 (US$123 000) per ventilation avoided if CPAP was used compared with high flow. Without rescue CPAP backup, cost per ventilation avoided was A$7000 (US$4800) if CPAP was used compared with high flow. As sole primary support, CPAP is highly likely to be cost-effective compared with high flow. Neonatal units choosing to use only one device should apply CPAP as primary respiratory support. Compared with high-flow with rescue CPAP backup, CPAP is unlikely to be cost-effective if willingness to pay per ventilation avoided is less than A$179 000 (US$123 000). Copyright © 2018 Elsevier Inc. All rights reserved.

Helping Your Partner with Chronic Pain: The Importance of Helping Motivation, Received Social Support, and Its Timeliness.

PubMed

Kindt, Sara; Vansteenkiste, Maarten; Josephy, Haeike; Bernardes, Sonia F; Goubert, Liesbet

2018-02-02

Like all intentional acts, social support provision varies with respect to its underlying motives. Greater autonomous or volitional motives (e.g., enjoyment, full commitment) to help individuals with chronic pain (ICPs) are associated with greater well-being benefits for the latter, as indexed by improved satisfaction of their psychological needs for autonomy, competence, and relatedness. The present study investigates the processes explaining why partners' autonomous or volitional helping motivation yields these benefits. A total of 134 couples, where at least one partner had chronic pain, completed a 14-day diary. Partners reported on their daily helping motives, whereas ICPs reported on their daily received support, timing of help, need-based experiences, and pain. On days when partners provided help for volitional motives, ICPs indicated receiving more help, which partially accounted for the effect of autonomous helping motivation on ICP need-based experiences. Timing of help moderated the effects of daily received support on ICP need-based experiences. Findings highlight the importance of ICPs of receiving support in general and the role of timing in particular, which especially matters when there is little support being received. © 2018 American Academy of Pain Medicine. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Neonatal Lemierre Syndrome: Youngest Reported Case and Literature Review.

PubMed

Raggio, Blake S; Grant, Maria C; Rodriguez, Kimsey; Cripe, Patrick J

2018-03-01

A previously healthy 5-week-old female was admitted for sepsis secondary to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. After several days of hospitalization, she experienced acute decompensation in mental status despite having received targeted antibiotic therapy. Imaging revealed left peritonsillar/parapharyngeal space abscess, left venous thrombophlebitis of the internal jugular vein, and septic emboli of the lungs and brain consistent with Lemierre syndrome. Bedside needle aspiration of the parapharyngeal abscess confirmed MRSA involvement. Unfortunately, the patient continued to deteriorate over the next several days and life support was withdrawn on hospital day 16. We present the youngest reported case of Lemierre syndrome and review the literature.

Lunar Processing Cabinet 2.0: Retrofitting Gloveboxes into the 21st Century

NASA Technical Reports Server (NTRS)

Calaway, M. J.

2015-01-01

In 2014, the Apollo 16 Lunar Processing Glovebox (cabinet 38) in the Lunar Curation Laboratory at NASA JSC received an upgrade including new technology interfaces. A Jacobs - Technology Innovation Project provided the primary resources to retrofit this glovebox into the 21st century. NASA Astromaterials Acquisition & Curation Office continues the over 40 year heritage of preserving lunar materials for future scientific studies in state-of-the-art facilities. This enhancement has not only modernized the contamination controls, but provides new innovative tools for processing and characterizing lunar samples as well as supports real-time exchange of sample images and information with the scientific community throughout the world.

The Experiences of School Nurses Caring for Students Receiving Continuous Subcutaneous Insulin Infusion Therapy

ERIC Educational Resources Information Center

Darby, Wendy

2006-01-01

Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important…

20 CFR 416.990 - When and how often we will conduct a continuing disability review.

Code of Federal Regulations, 2010 CFR

2010-04-01

... continuing disability review. 416.990 Section 416.990 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...(a) of the Social Security Act if you receive benefits based on disability or § 416.986 of this... and have received social security benefits as well as supplemental security income payments. (b) When...

29 CFR 1915.172 - Portable air receivers and other unfired pressure vessels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Portable air receivers and other unfired pressure vessels. 1915.172 Section 1915.172 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Portable, Unfired Pressure...

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

20 CFR 416.990 - When and how often we will conduct a continuing disability review.

Code of Federal Regulations, 2012 CFR

2012-04-01

... continuing disability review. 416.990 Section 416.990 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...(a) of the Social Security Act if you receive benefits based on disability or § 416.986 of this... and have received social security benefits as well as supplemental security income payments. (b) When...

Exploring the views and experiences of callers to the PANDA Post and Antenatal Depression Association Australian National Perinatal Depression Helpline: a cross-sectional survey.

PubMed

Biggs, Laura J; Shafiei, Touran; Forster, Della A; Small, Rhonda; McLachlan, Helen L

2015-09-07

Anxiety and depression are common in the perinatal period. Telephone interventions, including telephone peer support and counselling, have been developed to support those experiencing perinatal mental illness. PANDA Post and Antenatal Depression Association provides support to women and men experiencing perinatal mental illness via the Australian National Perinatal Depression Helpline, encompassing both volunteer peer support and professional counselling. This study aimed to explore the experiences of callers to the Helpline. A cross-sectional survey design was used. All new callers from 1(st) May to 30(th) September 2013 were invited to participate. The survey, adapted from a previous survey of PANDA callers, included 23 questions using Likert-type scales, demographic and open-ended questions. Thematic network analysis was undertaken for responses to open-ended questions. 124 responses were received (124/405; 30% response). The majority of callers had called the Helpline regarding themselves (90%), with over one third (33%) of all callers seeking crisis support and help. Ninety-nine per cent of respondents 'agreed' or 'strongly agreed' that staff and/or volunteers understood their concerns, and 97% 'agreed' or 'strongly agreed' that overall PANDA had helped them. Callers described the PANDA service as uniquely tailored to the perinatal period, providing accessible, non-judgemental understanding and support, with a global theme from open-ended comments describing PANDA as 'a safe space to be heard and receive support without judgement'. Recommendations for service changes included increased hours of availability. Callers reported positive experiences of accessing support from the PANDA National Perinatal Depression Helpline. The Helpline was described as an accessible and acceptable telephone support for individuals experiencing perinatal mental illness. Recommendations for changes to the service included an increase in hours of operation to enable greater responsiveness at times of need, reduced waiting times, and access to continuity with the same volunteer and/or telephone counsellor. The findings of the study will be useful in informing future service provision, review, and implementation.

The provision of and need for social support among adult and pediatric patients with tuberculosis in Lima, Peru: a qualitative study

PubMed Central

2013-01-01

Background Tuberculosis (TB) remains a significant public health problem in Peru, causing an estimated 35,000 new cases each year, 6.7% of whom are co-infected with HIV. Social support mechanisms are key in influencing health-seeking behavior, adherence, and overall patient wellbeing in clinical settings. We examine the types of social support received by TB patients and parents of pediatric patients in peri-urban Lima, Peru, to understand its role in patients’ psychosocial wellbeing during treatment. Methods Semi-structured interviews were conducted between August 2004 and May 2005 among 43 individuals: 19 adults with TB, 8 adults with TB/HIV, 13 parents of pediatric TB patients, and 3 parents of pediatric TB/HIV patients. Results Patients described the need for psychosocial support to mitigate the difficulty of continually going to the clinic to take medications, tending to other family or professional responsibilities while on treatment, and confronting stigma and social isolation within their community. Family members most often contributed to meeting these psychosocial needs, and were also crucial in providing economic support to patients faced with burdensome medical expenses or who were forced to leave their jobs due to being on treatment. Most healthcare personnel were described as key providers of emotional support and encouragement for patients to successfully adhere to treatment, however there were a select few doctors whose “scare tactics” seemingly discouraged patient adherence. During the treatment process, patients described being more socially withdrawn as a result of feeling fatigued from their medications, however most participants also described forming new mutually supportive friendships among their fellow patients. Conclusions Despite the general reluctance of patients to disclose their disease status, patients received a significant amount of psychosocial support from both family members to whom they disclosed, and from positive interactions with healthcare providers. High levels of depression were reported, with many patients voicing need for improved and more frequent psychological interventions. To improve the Peru TB program, participants suggested extending educational opportunities to patients’ families and the wider community, increasing the existing amount of nutritional support, and programmatic provision of vocational activities to increase economic opportunities. PMID:23899353

Interpersonal interactions on online forums addressing eating concerns.

PubMed

Ransom, Danielle C; La Guardia, Jennifer G; Woody, Erik Z; Boyd, Jennifer L

2010-03-01

Although some research suggests that online eating disorder forums promote "pro-eating-disorder" lifestyles and discourage recovery, other research suggests that such forums are an important source of interpersonal support. The current study extends this research by exploring the positive and negative behaviors encouraged on these forums and by comparing forum members' perceptions of support received from online and offline relationships to support received in relationships of age-matched controls. In a survey of 60 forum members, we assessed information exchanged and support provided on eating disorder forums. Further, we assessed perceptions of social support for general and specific life concerns in this group of forum members as well as 64 age-matched university controls. Results show that both adaptive and maladaptive behaviors are encouraged on the forums, and that this encouragement has some influence on forum members trying out these behaviors. Overall, forum members reported receiving less support for their eating concerns as compared to their general life stressors, and they perceived less support for both their general concerns and eating concerns in their offline relationships as compared to their online forum relationships. Moreover, forum members reported receiving less support from their offline relationships as compared to support received in relationships by age-matched controls. Forum members perceive less support in their important relationships than other peers do, and they seek out and participate in forums as a means of attaining greater social support. However, our research suggests that these forums also encourage dysregulated eating behaviors. Implications of online forum support and its impact on recovery are discussed further.

Should ongoing airway education be a mandatory component of continuing professional development for College of Intensive Care Medicine Fellows?

PubMed

Brewster, D J; Nickson, C P; Gatward, J J; Staples, M; Hawker, F

2018-03-01

This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program. All responses were tabled for comparison. Data was analysed to establish any significant effect of another specialty qualification and current co-practice in anaesthesia on volume of practice, confidence with multiple airway procedures, use of airway equipment, and support for airway education. In total, 112 responses (response rate 80%) to the questionnaire were received within four weeks; 107 were completed in full (compliance 96%). All results were tabled. There is currently widespread support amongst CICM Fellows for airway skills education as a CPD requirement for CICM Fellows. Volumes of practice and confidence levels with different airway procedures vary amongst Fellows and further support the need for education.

Frame for a firearm

DOEpatents

Crandall, David L [Idaho Falls, ID; Watson, Richard W [Blackfoot, ID

2008-03-04

A firearm frame which is adapted to be disposed in operative relationship as a component part of a firearm, the firearm having disposed in operative relationships each with one or more of the others, a barrel, a receiver, and at least one firing mechanism; wherein the barrel and receiver form operative parts of a movable assembly and the at least one firing mechanism is disposed in a substantially stationary operative relationship therewith; the firearm frame including at least one elongated support structure discrete from the barrel and receiver, the elongated support structure being adapted to directly support the movable assembly in an operative movable relationship therewith; whereby at least one of the barrel and receiver is in direct contact with and movable on the elongated support structure; and, a firing mechanism support structure connected to the at least one elongated support structure, the firing mechanism support structure being adapted to have the firing mechanism connected thereto; the firearm frame also directly supporting the movable assembly and the firing mechanism in corresponding movable and stationary operative relationships each with the other.

Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients.

PubMed

Zhang, Jun-e; Wong, Frances Kam Yuet; You, Li-ming; Zheng, Mei-chun; Li, Qiong; Zhang, Bing-yan; Huang, Man-rong; Ye, Xin-Mei; Liang, Ming-juan; Liu, Jin-ling

2013-01-01

People with a new colostomy encounter many difficulties as they struggle to adjust to their ostomies. Nurse telephone follow-up is a convenient way to ensure continuity of care. There is a paucity of studies testing if nurse telephone follow-up can enhance adjustment of postdischarged colostomy patients. The purpose of this study was to evaluate the effect of enterostomal nurse telephone follow-up on the adjustment levels of discharged colostomy patients. This was a randomized controlled trial. Participants (n = 103) who had undergone colostomy operations in China were recruited and randomly assigned to the study or control group. Both the study and control groups received routine discharge care, whereas the study group received 2-3 nurse telephone calls in the follow-up period. The outcome measures included Ostomy Adjustment Scale, Stoma Self-efficacy Scale, satisfaction with care, and stoma complications. Results of this study indicated that participants in the study group had significantly better ostomy adjustment, higher stoma self-efficacy, higher satisfaction with care, and less stoma complications compared with those in the control group. This study provided evidence to support that enterostomal nurse telephone follow-up can improve patient ostomy adjustment level and other related outcomes. Nurse telephone follow-up is an effective intervention to support the adjustment of stoma patients after hospital discharge.

Infant feeding intentions among first time pregnant women in urban Melbourne, Australia.

PubMed

York, Elissa; Hoban, Elizabeth

2013-07-01

to identify first time pregnant women's infant feeding intentions for the first 2 years of life. a qualitative phenomenological approach was used, with semi-structured interviews as the primary method of data collection. two of Eastern Health's antenatal clinics in the outer east region of Melbourne, Australia. seven first time pregnant women from an Eastern Health antenatal clinic. women's infant feeding intention for the first 2 years of life. all the participants intend to breast feed their infant for around 6 months. Women rely heavily on information about infant feeding options from friends, books and the internet, as the information provided by health professionals was found to be inadequate, acquired late in the pregnancy and difficult to access. the information women receive from midwives at antenatal appointments and parenting classes about infant feeding options is inadequate, as women are not satisfied with the timing, amount and usefulness of the information they receive. in order to see an increase in the rate of breast feeding it is imperative to create supportive environments for women to breast feed, and for midwives and health professionals to provide information and continued support for women in both the pre- and postnatal period. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

[Outcome of rapidly progressive glomerulonephritis post-streptococcal disease in children].

PubMed

Jellouli, Manel; Maghraoui, Sondos; Abidi, Kamel; Hammi, Yosra; Goucha, Rim; Naija, Ouns; Zarrouk, Chokri; Gargah, Tahar

2015-11-01

Rapidly progressive glomerulonephritis is a rare form of postinfectious glomerulonephritis. The aim of this study was to describe the outcome of our patients with severe post-streptococcal glomerulonephritis. This retrospective study was conducted in the department of pediatrics in Charles-Nicolle Hospital during a period of 13 years (1997-2009). Twenty-seven children were identified. The mean age was 8.7 years. All patients presented renal failure at presentation. The mean serum creatinine at presentation was 376.9 μmol/L. Six patients presented nephrotic syndrome. Twenty-six children had renal biopsies. Renal biopsies showed crescents in 24 cases. Eighteen children received pulse dose of corticosteroids (66.6%) and 6 children (22%) received pulse dose of corticosteroids and cyclophosphamide. Eleven patients required dialysis. At last follow-up, 22 patients (81.5%) had normal kidney function, 2 had renal dysfunction and 3 reached end stage renal disease. The only significant determinant for renal survival was the supportive dialysis (P=0.015). Rapidly progressive glomerulonephritis is uncommon. There have been significant advancements in supportive, as well as specific therapy, but the outcome continues to be poor. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Does lying in the recovery position increase the likelihood of not delivering cardiopulmonary resuscitation?

PubMed

Freire-Tellado, Miguel; Navarro-Patón, Rubén; Pavón-Prieto, Maria Del Pilar; Fernández-López, Marta; Mateos-Lorenzo, Javier; López-Fórneas, Ivan

2017-06-01

Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation. Basic life support-trained university students were randomly divided into two groups: one received a standardized cardiopulmonary resuscitation refresher course including the recovery position and the other received a modified cardiopulmonary resuscitation course using continuous head tilt and chin lift for unconscious and spontaneously breathing patients. A human simulation test to evaluate the victim's breathing assessment was performed a week later. In total, 59 participants with an average age of 21.9 years were included. Only 14 of 27 (51.85%) students in the recovery position group versus 23 of 28 (82.14%) in the head tilt and chin lift group p=0.006 (OR 6.571) detected breathing arrest within 2min. The recovery position hindered breathing assessment, delayed breathing arrest identification and the initiation of cardiac compressions, and significantly increased the likelihood of not starting cardiopulmonary resuscitation when compared to the results shown when the continuous head tilt and chin lift technique was used. Copyright © 2017 Elsevier B.V. All rights reserved.

An Empirical Review of the Neural Underpinnings of Receiving and Giving Social Support: Implications for Health

PubMed Central

Eisenberger, Naomi I.

2013-01-01

Decades of research have demonstrated strong links between social ties and health. Although considerable evidence has shown that social support can attenuate downstream physiological stress responses that are relevant to health, the neurocognitive mechanisms that translate perceptions of social ties into altered physiological responses are still not fully understood. This review integrates research from social and affective neuroscience to illuminate some of the neural mechanisms involved in social support processes, which may further our understanding of the ways in which social support influence health. This review focuses on two types of social support that have been shown to relate to health: receiving and giving social support. As the neural basis of receiving support, this article reviews the hypothesis that receiving support may benefit health through the activation of neural regions that respond to safety and inhibit threat-related neural and physiological responding. This article will then review neuroimaging studies in which subjects were primed with or received support during a negative experience as well as studies in which self-reports of perceived support were correlated with neural responses to a negative experience. As the neural basis of giving support, this article reviews the hypothesis that neural regions involved in maternal caregiving behavior may be critical for the health benefits of support-giving through the inhibition of threat-related neural and physiological responding. Neuroimaging studies in which subjects provided support to others or engaged in other related forms of prosocial behavior will then be reviewed. Implications of these findings for furthering our understanding of the relationships between social support and health are discussed. PMID:23804014

A complex breastfeeding promotion and support intervention in a developing country: study protocol for a randomized clinical trial.

PubMed

Nabulsi, Mona; Hamadeh, Haya; Tamim, Hani; Kabakian, Tamar; Charafeddine, Lama; Yehya, Nadine; Sinno, Durriyah; Sidani, Saadieh

2014-01-15

Breastfeeding has countless benefits to mothers, children and community at large, especially in developing countries. Studies from Lebanon report disappointingly low breastfeeding exclusivity and continuation rates. Evidence reveals that antenatal breastfeeding education, professional lactation support, and peer lay support are individually effective at increasing breastfeeding duration and exclusivity, particularly in low-income settings. Given the complex nature of the breastfeeding ecosystem and its barriers in Lebanon, we hypothesize that a complex breastfeeding support intervention, which is centered on the three components mentioned above, would significantly increase breastfeeding rates. A multi-center randomized controlled trial. 443 healthy pregnant women in their first trimester will be randomized to control or intervention group. A "prenatal/postnatal" professional and peer breastfeeding support package continuing till 6 months postpartum, guided by the Social Network and Social Support Theory. Control group will receive standard prenatal and postnatal care. Mothers will be followed up from early pregnancy till five years after delivery. Total and exclusive breastfeeding rates, quality of life at 1, 3 and 6 months postpartum, maternal breastfeeding knowledge and attitudes at 6 months postpartum, maternal exclusive breastfeeding rates of future infants up to five years from baseline, cost-benefit and cost-effectiveness analyses of the intervention. Descriptive and regression analysis will be conducted under the intention to treat basis using the most recent version of SPSS. Exclusive breastfeeding is a cost-effective public health measure that has a significant impact on infant morbidity and mortality. In a country with limited healthcare resources like Lebanon, developing an effective breastfeeding promotion and support intervention that is easily replicated across various settings becomes a priority. If positive, the results of this study would provide a generalizable model to bolster breastfeeding promotion efforts and contribute to improved child health in Lebanon and the Middle East and North Africa (MENA) region. Current Controlled Trials ISRCTN17875591.

A complex breastfeeding promotion and support intervention in a developing country: study protocol for a randomized clinical trial

PubMed Central

2014-01-01

Background Breastfeeding has countless benefits to mothers, children and community at large, especially in developing countries. Studies from Lebanon report disappointingly low breastfeeding exclusivity and continuation rates. Evidence reveals that antenatal breastfeeding education, professional lactation support, and peer lay support are individually effective at increasing breastfeeding duration and exclusivity, particularly in low-income settings. Given the complex nature of the breastfeeding ecosystem and its barriers in Lebanon, we hypothesize that a complex breastfeeding support intervention, which is centered on the three components mentioned above, would significantly increase breastfeeding rates. Methods/Design A multi-center randomized controlled trial. Study population: 443 healthy pregnant women in their first trimester will be randomized to control or intervention group. Intervention: A “prenatal/postnatal” professional and peer breastfeeding support package continuing till 6 months postpartum, guided by the Social Network and Social Support Theory. Control group will receive standard prenatal and postnatal care. Mothers will be followed up from early pregnancy till five years after delivery. Outcome measures: Total and exclusive breastfeeding rates, quality of life at 1, 3 and 6 months postpartum, maternal breastfeeding knowledge and attitudes at 6 months postpartum, maternal exclusive breastfeeding rates of future infants up to five years from baseline, cost-benefit and cost-effectiveness analyses of the intervention. Statistical analysis: Descriptive and regression analysis will be conducted under the intention to treat basis using the most recent version of SPSS. Discussion Exclusive breastfeeding is a cost-effective public health measure that has a significant impact on infant morbidity and mortality. In a country with limited healthcare resources like Lebanon, developing an effective breastfeeding promotion and support intervention that is easily replicated across various settings becomes a priority. If positive, the results of this study would provide a generalizable model to bolster breastfeeding promotion efforts and contribute to improved child health in Lebanon and the Middle East and North Africa (MENA) region. Trial registration Current Controlled Trials ISRCTN17875591 PMID:24428951

'Feeling someone is there for you' - experiences of women with vulvar neoplasia with care delivered by an Advanced Practice Nurse.

PubMed

Kobleder, Andrea; Mayer, Hanna; Senn, Beate

2017-02-01

To explore the experiences of women with vulvar neoplasia with care delivered by an Advanced Practice Nurse. Women with vulvar neoplasia suffer from a high number of symptoms and report a lack of information and support by health care professionals. Further, talking about their disease, which is still a social taboo, is difficult for them. From approaches for other patients, it can be suggested that support from an Advanced Practice Nurse can be helpful. For Advanced Practice Nurse development, implementation and evaluation, it is important to assess patients' perceptions. But so far, little is known about how patients with vulvar neoplasia experience support of an Advanced Practice Nurse. A qualitative interview study was chosen to gain understanding of the experience of women with vulvar neoplasia who received care delivered by an Advanced Practice Nurse. Narrative interviews were conducted with a purposive sample of 13 women with vulvar neoplasia after they received care from an Advanced Practice Nurse for six months. Thematic analysis was used to analyse the data from the interviews. Four main themes could be identified: a trusting relationship; accessibility; feeling safe and secure; and feeling someone is there for you. Women felt more secure and less alone in the experience of their illness through having the possibility of contacting an Advanced Practice Nurse and getting sufficient information and psychosocial support. Women with vulvar neoplasia experienced care delivered by an Advanced Practice Nurse as 'feeling someone is there for you'. Due to the localisation of the disease and the associated social taboo, psychosocial support from the Advanced Practice Nurse beyond months after surgery was very important for them. Addressing psychosocial needs in caring for women with vulvar neoplasia must be given greater attention in clinical practice. Further, continuous nursing support delivered by an Advanced Practice Nurse beyond the acute treatment phase can be recommended. © 2016 John Wiley & Sons Ltd.

Why are children still having preventable extractions under general anaesthetic? A service evaluation of the views of parents of a high caries risk group of children.

PubMed

Olley, R C; Hosey, M T; Renton, T; Gallagher, J

2011-04-23

Introduction Despite overall improvements in oral health, the number of children admitted to hospital for extraction of teeth due to caries under general anaesthesia (GA) has been reported as increasing dramatically in England. The new UK government plans to transform NHS dentistry by improving oral health.Aim To evaluate the dental care received by children who required caries-related extractions under GA and obtain the views of their parents or guardians on their experiences of oral health services and the support they would like to improve their child's oral health, to inform future planning.Method An interview questionnaire was designed and piloted to collect data from a consecutive sample of 100 parents or guardians during their child's pre-operative assessment appointment. This took place at one London dental hospital between November 2009 and February 2010.Results Most children were either white (43%) or black British (41%); the average age was seven years (range 2-15, SD 3.1, SE 0.31) and the female:male ratio was 6:5. Most (84%) had experienced dental pain and 66% were referred by a general dental practitioner (GDP). A large proportion of parents or guardians (47%) reported previous dental treatment under GA in their children or child's sibling/s. Challenges discussed by parents in supporting their child's oral health included parenting skills, child behaviour, peer pressure, insufficient time, the dental system and no plans for continuing care for their child. Three out of four parents (74%) reported that they would like support for their child's oral health. Sixty percent of all parents supported school/nursery programmes and 55% supported an oral health programme during their pre-assessment clinic.Discussion These findings suggest that the oral health support received by high caries risk children is low. Health promotion programmes tailored to this cohort are necessary and our findings suggest that they would be welcomed by parents.

['NischE - Nicht von schlechten Eltern' - Evaluation of a Multidisciplinary Teamwork Approach to Support Children in Families with Mentally Ill Parents].

PubMed

Nienaber, A; Wieskus-Friedemann, E; Kliem, S; Hoppmann, J; Kemper, U; Löhr, M; Kronmüller, K-T; Wabnitz, P

2017-02-01

Objective: Evaluation of a project offering low-threshold anonymous counseling services jointly by mental health services and child and youth services to support children in families with mentally ill parents Methods: Evaluating performance data and completed questionnaires returned by parents included in the project. Results: Between 2011-2014, 150 families received up to 10 sessions of family-oriented counseling. The survey results indicate a high level of satisfaction with the services of the cooperation project. The vast majority of respondents said that they would recommend this service to others or would themselves take advantage of the services again. Conclusion: A collaboration of service providers from psychiatry and child and youth welfare department resulting in continuous availability of counseling with a common family medical perspective represents a forward-looking model for families with a mentally ill parent. © Georg Thieme Verlag KG Stuttgart · New York.

The psychology of neurofeedback: Clinical intervention even if applied placebo.

PubMed

Thibault, Robert T; Raz, Amir

2017-10-01

Advocates of neurofeedback make bold claims concerning brain regulation, treatment of disorders, and mental health. Decades of research and thousands of peer-reviewed publications support neurofeedback using electroencephalography (EEG-nf); yet, few experiments isolate the act of receiving feedback from a specific brain signal as a necessary precursor to obtain the purported benefits. Moreover, while psychosocial parameters including participant motivation and expectation, rather than neurobiological substrates, seem to fuel clinical improvement across a wide range of disorders, for-profit clinics continue to sprout across North America and Europe. Here, we highlight the tenuous evidence supporting EEG-nf and sketch out the weaknesses of this approach. We challenge classic arguments often articulated by proponents of EEG-nf and underscore how psychologists and mental health professionals stand to benefit from studying the ubiquitous placebo influences that likely drive these treatment outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

From nutrition scientist to nutrition communicator: why you should take the leap.

PubMed

Miller, Gregory D; Cohen, Nancy L; Fulgoni, Victor L; Heymsfield, Steven B; Wellman, Nancy S

2006-06-01

Media reports about new nutrition research are abundant, but they may confuse the public when unqualified sources are quoted, findings are reported out of context, or results appear to contradict previous studies. The nutrition scientist who conducts the research is best qualified to communicate the findings accurately and within context. Yet, some nutrition scientists hesitate to speak out in the media because of barriers such as a lack of time, media skills, and support from administrators or fear that their results will be miscommunicated or sensationalized. Scientists who do grant media interviews enjoy benefits such as positively affecting the public's eating habits, influencing health and nutrition policy, and receiving heightened attention to their work, which can lead to future research funding. Scientists who want to improve their media skills can seek support from their institution's public relations professionals and can learn from continuing education opportunities at conferences and self-study through articles and other resources.

On Dreams and Motivation: Comparison of Freud's and Hobson's Views.

PubMed

Boag, Simon

2016-01-01

The merits of Freudian dream theory continue to be debated and both supporters and critics appeal to empirical evidence to support their respective positions. What receives much less attention is the theoretical coherency of either Freudian dream theory or alternative perspectives. This paper examines Freudian dream theory and J. Allan Hobson's alternative position by addressing the role of motivation in dreams. This paper first discusses motivation in Freudian theory and its relation to dreams and disguise-censorship. The role of motivation in Hobson's theory is then considered. Hobson's claim that dream plot and content selection is random and based on design error and functional imbalance is then discussed in relation to the protoconsciousness theory proposal that dreams serve an adaptive function. While there are apparent inconsistencies in Hobson's position, his appeal to emotions and instincts provides a preliminary platform for understanding the role of motivation in dreams that is consonant with the Freudian position.

Teacher, parent, and child evaluative ratings of a school reintegration intervention for children with newly diagnosed cancer.

PubMed

Katz, E R; Varni, J W; Rubenstein, C L; Blew, A; Hubert, N

1992-01-01

The disruption of school participation and accompanying social experiences because of cancer and its treatment has been related to major problems in adaptation to the disease. For the child with cancer, continuation of his/her social and academic activities provides an important opportunity to normalize as much as possible a very difficult experience. The present study reports on the children's, parents', and teachers' subjective evaluations of the benefits of a comprehensive school reintegration intervention. Forty-nine children, newly diagnosed with cancer, received comprehensive school reintegration consisting of supportive counseling, educational presentations, systematic liaison between the hospital and the school, and periodic follow-ups. Children parents, and teachers were asked to rate their perceptions of the utility and value of the intervention approach. Overall subjective evaluations were very positive, providing support for the social validity of the school reintegration approach for children with newly diagnosed cancer.

2013 Community Earth System Model (CESM) Tutorial-Proposal to DOE

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

Holland, Marika; Bates, Susan

2014-12-04

THE SAME REQUEST WILL BE SENT TO BOTH NSF AND DOE TO EACH SUPPORT $35K. The third annual Community Earth System Model (CESM) tutorial for students and early career scientists was held from 30 July to 3 August, 2012. This event was extremely successful and, as for the tutorials in previous years, there was a greater demand than could be met. This indicates a continuing need for a tutorial of this type and we anticipate that the 2013 tutorial will be well received. The tutorial will include lectures on simulating the climate system and practical sessions on running CESM, modifyingmore » components, and analyzing data. These will be targeted to the graduate student level. Attendance will be limited to a maximum of 80 students with financial support for up to 40 students. Attendees will be balanced across institutions.« less

Unintended consequences of the WIC formula rebate program on infant feeding outcomes: will the new food packages be enough?

PubMed

Jensen, Elizabeth; Labbok, Miriam

2011-06-01

Approximately half of all mothers of infants born in the United States receive services through the Special Supplemental Nutrition Program for Woman, Infants and Children (WIC). Although WIC promotes breastfeeding, data suggest that, despite advances in the last 2 decades, WIC participants are less likely to initiate breastfeeding, and much less likely to continue, than non-WIC participants, including the non-WIC participants who are eligible for WIC. WIC recently revised their food packages and enhanced the monetary value of the breastfeeding packages. While these changes are an important step in supporting WIC's efforts to promote breastfeeding, other major factors, such as participants' perceptions of the value of the packages and WIC's dependency on rebates from formula companies to fund a portion of the program, may dampen WIC's breastfeeding promotion and support efforts. There is great need for additional research on these issues.

Data analysis and archival

NASA Technical Reports Server (NTRS)

Danielsen, Edwin F.; Pfister, Leonhard; Hipskind, R. Stephen; Gaines, Steven E.

1990-01-01

The purpose of this task is the acquisition, distribution, archival, and analysis of data collected during and in support of the Upper Atmospheric Research Program (UARP) field experiments. Meteorological and U2 data from the 1984 Stratosphere-Troposphere Exchange Project (STEP) was analyzed to determine characteristics of internal atmospheric waves. CDROM's containing data from the 1987 STEP, 1987 Airborne Antarctic Ozone Expedition (AAOE), and the 1989 Airborne Arctic Stratospheric Expedition (AASE) were produced for archival and distribution of those data sets. The AASE CDROM contains preliminary data and a final release is planned for February 1990. Comparisons of data from the NASA ER-2 Meteorological Measurement System (MMS) with radar tracking and radiosonde data show good agreement. Planning for a Meteorological Support Facility continues. We are investigating existing and proposed hardware and software to receive, manipulate, and display satellite imagery and standard meteorological analyses, forecasts, and radiosonde data.

NASA's UAS [Unmanned Aircraft Systems] Related Activities

NASA Technical Reports Server (NTRS)

Bauer, Jeffrey

2012-01-01

NASA continues to operate all sizes of UAS in all classes of airspace both domestically and internationally. Missions range from highly complex operations in coordination with piloted aircraft, ground, and space systems in support of science objectives to single aircraft operations in support of aeronautics research. One such example is a scaled commercial transport aircraft being used to study recovery techniques due to large upsets. NASA's efforts to support routine UAS operations continued on several fronts last year. At the national level in the United States (U.S.), NASA continued its support of the UAS Executive Committee (ExCom) comprised of the Federal Aviation Administration (FAA), Department of Defense (DoD), Department of Homeland Security (DHS), and NASA. The committee was formed in recognition of the need of UAS operated by these agencies to access to the National Airspace System (NAS) to support operational, training, development and research requirements. Recommendations were received on how to operate both manned and unmanned aircraft in class D airspace and plans are being developed to validate and implement those recommendations. In addition the UAS ExCom has begun developing recommendations for how to achieve routine operations in remote areas as well as for small UAS operations in class G airspace. As well as supporting the UAS ExCom, NASA is a participant in the recently formed Aviation Rule Making Committee for UAS. This committee, established by the FAA, is intended to propose regulatory guidance which would enable routine civil UAS operations. As that effort matures NASA stands ready to supply the necessary technical expertise to help that committee achieve its objectives. By supporting both the UAS ExCom and UAS ARC, NASA is positioned to provide its technical expertise across the full spectrum of UAS airspace access related topic areas. The UAS NAS Access Project got underway this past year under the leadership of NASA s Aeronautics Research Mission Directorate. This project is focused on advancing the state of the art and providing research and analysis results in the areas of Separation Assurance, Communications (non-governmental spectrum allocation for UAS), Certification, and Human System Integration (ground control station design/pilot interfaces). The project is working in close coordination with the FAA and industry standards organizations (e.g. RTCA SC 203). More details on this project are provided in a separate article in this year's yearbook

Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.

PubMed

Cassin, Stephanie E; Rector, Neil A

2011-01-01

The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

Community-based directly observed treatment for TB patients to improve HIV services: a cross-sectional study in a South African province.

PubMed

Howell, Embry M; Kigozi, N Gladys; Heunis, J Christo

2018-04-07

There is uncertainty about how directly observed treatment (DOT) support for tuberculosis (TB) can be delivered most effectively and how DOT support can simultaneously be used to strengthen human immunodeficiency virus (HIV) prevention and control among TB patients. This study describes how DOT support by community health workers (CHWs) was used in four municipalities in the Free State province - a high TB/HIV burden, poorly-resourced setting - to provide HIV outreach, referrals, and health education for TB patients. The study was part of a larger cross-sectional study of HIV counselling and testing (HCT) among 1101 randomly-selected TB patients registered at 40 primary health care (PHC) facilities (clinics and community health centres) across small town/rural and large town/urban settings. Univariate analysis of percentages, chi-square tests and t-tests for difference in means were used to describe differences between the types of TB treatment support and patient characteristics, as well as the types of - and patient satisfaction with - HIV information and referrals received from various types of treatment supporters including home-based DOT supporters, clinic-based DOT supporters or support from family/friends/employers. Multivariate logistic regression was used to predict the likelihood of not having receiving home-based DOT and of never having received HIV counselling. The independent variables include poverty-related health and socio-economic risk factors for poor outcomes. Statistical significance is shown using a 95% confidence interval and a 0.05 p-value. Despite the fact that DOT support for all TB patients was the goal of South African health policy at the time (2012), most TB patients were not receiving formal DOT support. Only 155 (14.1%) were receiving home-based DOT, while 114 (10.4%) received clinic-based DOT. TB patients receiving home-based DOT reported higher rates of HIV counselling than other patients. Public health providers should train DOT supporters to provide HIV prevention and target DOT to those at greatest risk of HIV, particularly those at greatest socio-economic risk.

Feeding the Larger Low-Birthweight Infant in a Resource-Poor Environment.

PubMed

Kirsten, Gert F

2015-01-01

The high low birthweight prevalence in resource-poor countries (16.5%) places a burden on overstretched resources. Labor ward must have written guidelines to triage these infants for optimal nutritional support to the special care nursery (SCN; 1,500-1,800 g and <34 weeks) and postnatal ward (PW; >1,800 g and ≥ 34 weeks). Separation of mother and infant should be prevented. Initiating breastfeeding and kangaroo mother care (KMC) in labor ward by skilled nurses in the latter group is a priority and continues in the PW. SCN infants receive an intravenous 10% glucose-electrolyte solution and, if stable, commence with expressed colostrum and breast milk (EBM) feeding and intermittent KMC which progresses to continuous KMC and breastfeeding. Enteral feeding is advanced more slowly in unstable infants. Parenteral nutrition is only administered to infants with bowel obstruction or feeding intolerance. EBM of HIV+ mothers in the SCN is pasteurized. The decision to discharge a mother-infant dyad should be individualized. Infants in the SCN are discharged at 34 weeks, a weight of 1,600-1,800 g and are gaining adequate weight. Discharge from the PW usually takes place after 48 h, often before the infant has regained his birthweight but breastfeeding must be established. Multivitamin- and iron-containing syrup is continued for at least 12 months. The clinics in the community must provide postdischarge nutritional support. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

Therapeutic burst-suppression coma in pediatric febrile refractory status epilepticus.

PubMed

Lin, Jainn-Jim; Chou, Cheng-Che; Lan, Shih-Yun; Hsiao, Hsiang-Ju; Wang, Yu; Chan, Oi-Wa; Hsia, Shao-Hsuan; Wang, Huei-Shyong; Lin, Kuang-Lin

2017-09-01

Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013. The clinical characteristics were analyzed. Thirty-five patients (23 boys; age range: 1-18years) were enrolled, of whom 28 (80%) developed super-refractory status epilepticus. All of the patients received the continuous administration of intravenous antiepileptic drugs for febrile refractory status epilepticus, and 26 (74.3%) achieved therapeutic burst-suppression coma. All of the patients received mechanical ventilatory support, and 26 (74.3%) received inotropic agents. Eight (22.9%) patients died within 1month. The neurologically functional outcomes at 6months were good in six (27.3%) of the 22 survivors, of whom two returned to clinical baseline. The patients with therapeutic burst-suppression coma were significantly associated with hemodynamic support than the patients with electrographic seizures control (p=0.03), and had a trend of higher 1-month mortality rate, worse 6months outcomes, and a longer duration of hospitalization. Our results suggest that therapeutic burst-suppression coma to treat febrile refractory status epilepticus may lead to an increased risk of hemodynamic instability and a trend of worse outcomes. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

17 CFR 275.204-1 - Amendments to application for registration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... you have received a continuing hardship exemption under § 275.203-3. (2) If you have received a... (CONTINUED) RULES AND REGULATIONS, INVESTMENT ADVISERS ACT OF 1940 § 275.204-1 Amendments to application for... a complete Part 1A of Form ADV on paper with the SEC by mailing it to FINRA. (c) Special rule for...

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

Social Support for Families of Children with Mental Retardation: Comparison between Korea and the United States.

ERIC Educational Resources Information Center

Shin, Jin Y.

2002-01-01

Thirty-eight American and 40 Korean mothers of children with mental retardation participated in home-visit interviews concerning types of informal and professional social support received. Results showed American mothers received more informal and professional support in almost all domains of social support. Korean mothers experienced more stress.…

Effectiveness of Dysphagia Training for Adult Learning Disabilities Support Workers

ERIC Educational Resources Information Center

Tredinnick, Gerlind; Cocks, Naomi

2014-01-01

This study investigated the effectiveness of a 1-day dysphagia training package delivered to support workers who work with adults with a learning disability. Thirty-eight support staff took part in this study. Twenty-five support staff received training, and 13 did not receive training and therefore acted as a control group. Three questionnaires…

47 CFR 15.519 - Technical requirements for hand held UWB systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information to an associated receiver. The UWB intentional radiator shall cease transmission within 10 seconds... received. An acknowledgment of reception must continue to be received by the UWB intentional radiator at...

Recovery Of Chromium Metal (VI) Using Supported Liquid Membrane (SLM) Method, A study of Influence of NaCl and pH in Receiving Phase on Transport

NASA Astrophysics Data System (ADS)

Cholid Djunaidi, Muhammad; Lusiana, Retno A.; Rahayu, Maya D.

2017-06-01

Chromium metal(VI) is a valuable metal but in contrary has high toxicity, so the separation and recovery from waste are very important. One method that can be used for the separation and recovery of chromium (VI) is a Supported Liquid Membrane (SLM). SLM system contains of three main components: a supporting membrane, organic solvents and carrier compounds. The supported Membrane used in this research is Polytetrafluoroethylene (PTFE), organic solvent is kerosene, and the carrier compound used is aliquat 336. The supported liquid membrane is placed between two phases, namely, feed phase as the source of analyte (Cr(VI)) and the receiving phase as the result of separation. Feed phase is the electroplating waste which contains of chromium metal with pH variation about 4, 6 and 9. Whereas the receiving phase are the solution of HCl, NaOH, HCl-NaCl and NaOH-NaCl with pH variation about 1, 3, 5 and 7. The efficiency separation is determined by measurement of chromium in the feed and the receiving phase using AAS (Atomic Absorption Spectrophotometry). The experiment results show that transport of Chrom (VI) by Supported Liquid membrane (SLM) is influenced by pH solution in feed phase and receiving phase as well as NaCl in receiving phase. The highest chromium metal is transported from feed phase about 97,78%, whereas in receiving phase shows about 58,09%. The highest chromium metal transport happens on pH 6 in feed phase, pH 7 in receiving phase with the mixture of NaOH and NaCl using carrier compound aliquat 336.

Active-passive bistatic surveillance for long range air defense

NASA Astrophysics Data System (ADS)

Wardrop, B.; Molyneux-Berry, M. R. B.

1992-06-01

A hypothetical mobile support receiver capable of working within existing and future air defense networks as a means to maintain essential surveillance functions is considered. It is shown how multibeam receiver architecture supported by digital signal processing can substantially improve surveillance performance against chaff and jamming threats. A dual-mode support receiver concept is proposed which is based on the state-of-the-art phased-array technology, modular processing in industry standard hardware and existing networks.

Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty.

PubMed

Fusco, Pierfrancesco; Cofini, Vincenza; Petrucci, Emiliano; Scimia, Paolo; Fiorenzi, Maurizio; Paladini, Giuseppe; Behr, Astrid U; Borghi, Battista; Flamini, Stefano; Pizzoferrato, Renzo; Colafarina, Olivo; Di Francesco, Alexander; Tabacco, Tito; Necozione, Stefano; Marinangeli, Franco

2018-05-01

Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours after surgery could provide more effective postoperative analgesia with better rehabilitation. A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia and a local infiltration analgesia. A multihole catheter was placed next to the implant and connected to an electronic pump containing a 300-mL solution of 0.2% levobupivacaine (experimental group) or saline (control group). A total of 96 consecutive patients were enrolled and randomized. Of these, 48 patients received local infiltration analgesia and continuous wound infusion of local anesthetics, and the remainder received local infiltration analgesia and continuous wound infusion of saline solution. The analysis showed a significant main effect of treatment on the postoperative incident of pain (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(1,93)=15.62, P=0.0002). The pain scores during the rehabilitation period were significantly less in the experimental group. Analgesic consumption was less in the experimental group. The addition of continuous wound infusion of anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.