Approval Motivation, Group Cohesiveness, and Leadership as Mediators of Perceived Stress.

ERIC Educational Resources Information Center

Kovacs, Karl V.; Martin, Harry J.

Although stress related to work has received increased attention in recent years, the role of personality characteristics in mediating job stress has not been systematically investigated. Nonetheless, the perception of work stress and the significance of various sources of support may vary considerably based on individual characteristics.…

Charter Schools: Taking a Closer Look

ERIC Educational Resources Information Center

Bulkley, Katrina E.

2011-01-01

Since the adoption of the first charter school law in Minnesota in 1991, charter schools have received considerable attention from policy makers, parents, educators, and the media. In the United States, at the national level, three consecutive presidents--Bill Clinton, George W. Bush, and Barack Obama--have actively supported charters. Given the…

Mentoring Urban Black Middle School Male Students: Implications for Academic Achievement

ERIC Educational Resources Information Center

Gordon, Derrick M.; Iwamoto, Derek K.; Ward, Nadia; Potts, Randolph; Boyd, Elizabeth

2009-01-01

Researchers have called for innovative and culturally responsive intervention programs to enhance male, Black middle school students' academic achievement. Mentoring has received considerable attention as a novel remedy. Although anecdotal evidence supports the positive role of mentoring on academic achievement, these results are not consistent.…

University Academics' Experiences of Learning through Mentoring

ERIC Educational Resources Information Center

Ambler, Trudy; Harvey, Marina; Cahir, Jayde

2016-01-01

The use of mentoring for staff development is well established within schools and the business sector, yet it has received limited consideration in the higher education literature as an approach to supporting learning for academics. In this study located at one metropolitan university in Australia, an online questionnaire and one-on-one…

Hydrology, geomorphology, and vegetation of Coastal Plain rivers in the southeastern United States

Treesearch

Cliff R. Hupp

2000-01-01

Rivers of the Coastal Plain of the southeastern United States are characteristically low-gradient meandering systems that develop broad floodplains subjected to frequent and prolonged flooding. These floodplains support a relatively unique forested wetland (Bottomland Hardwoods), which have received considerable ecological study, but distinctly less hydrogeomorphic...

[Psychological containment at home].

PubMed

Garcia, Marilyne; Velay, Anne-Sophie

2014-01-01

The mobile care and rehabilitation team offers patients who have been receiving long-term, in-patient care, when they are stabilised, a discharge programme underpinned by considerable support from a nursing team. Through apartments owned by associations and the CATTP (part-time therapy centre), the team will guide the patient along their sometimes precarious pathway. This well thought-out and shared support, takes on the function of psychological containment for the patient, helping to ensure a successful reintegration.

An Examination of the Mechanisms of Action in Cognitive Behavioral Therapy for Bulimia Nervosa

ERIC Educational Resources Information Center

Spangler, Diane L.; Baldwin, Scott A.; Agras, W. Stewart

2004-01-01

Cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) has received considerable empirical support for its efficacy. However, few investigators have examined the mechanisms proposed to account for the reduction of BN symptoms during CBT. The current study examined the associations between therapist interventions, client mechanisms, and…

Estimating Apprentice and Trainee Completion and Attrition Rates Using a "Life Tables" Approach. Technical Paper

ERIC Educational Resources Information Center

Karmel, Tom; Mlotkowski, Peter

2010-01-01

The proportion of apprentices and trainees completing their contract of training has received considerable attention in recent years. To support public discussion, the National Centre for Vocational Education Research (NCVER) has been publishing tabulations of both completion and attrition rates. Up until recently, the approach taken was to…

Application of the Environmental Sensation Learning Vehicle Simulation Platform in Virtual Reality

ERIC Educational Resources Information Center

Hsu, Kuei-Shu; Jiang, Jinn-Feng; Wei, Hung-Yuan; Lee, Tsung-Han

2016-01-01

The use of simulation technologies in learning has received considerable attention in recent years, but few studies to date have focused on vehicle driving simulation systems. In this study, a vehicle driving simulation system was developed to support novice drivers in practicing their skills. Specifically, the vehicle driving simulation system…

The Experiences of Early Career Teachers: New Initiatives and Old Problems

ERIC Educational Resources Information Center

Schuck, Sandy; Aubusson, Peter; Buchanan, John; Varadharajan, Meera; Burke, Paul F.

2018-01-01

The task of supporting beginning teachers has received considerable attention in recent years, and numerous initiatives have been implemented. In this article we investigate the experiences of early career teachers (ECTs) in New South Wales, Australia, at a time when their employing authority mandated the provision of mentors and a reduction in…

Issues of Cause and Control in Patient Accounts of Type 2 Diabetes

ERIC Educational Resources Information Center

Parry, O.; Peel, E.; Douglas, M.; Lawton, J.

2006-01-01

Patients experience considerable difficulties in making and sustaining health-related lifestyle changes. Many Type 2 diabetes patients struggle to follow disease risk-management advice even when they receive extensive information and support. Drawing on a qualitative study of patients with Type 2 diabetes, the paper uses discourse analysis to…

Early Fatherhood: A Mapping of the Evidence Base Relating to Pregnancy Prevention and Parenting Support

ERIC Educational Resources Information Center

Trivedi, D.; Brooks, F.; Bunn, F.; Graham, M.

2009-01-01

Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual…

Computer Based Intelligence Support: An Integrated Expert System and Decision Support Systems Approach

DTIC Science & Technology

1988-06-01

and for that reason has received considerable attention recently. Of particular interest in this research Is the work of Toulmin et. al. [19793 In...whenever we make a claim there must be some grounds in which to base our conclusion, Toulmin states that our thoughts are generally directed from the...WARRANT will be the absolute reason to believe the CLAIM on the basis of the GROUNDS. For that, Toulmin allows for further BACKING which, in his

Using the UTAUT Model to Examine the Acceptance Behavior of Synchronous Collaboration to Support Peer Translation

ERIC Educational Resources Information Center

Liu, Yi Chun; Huang, Yong-Ming

2015-01-01

The teaching of translation has received considerable attention in recent years. Research on translation in collaborative learning contexts, however, has been less studied. In this study, we use a tool of synchronous collaboration to assist students in experiencing a peer translation process. Afterward, the unified theory of acceptance and use of…

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.

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.

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

Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care.

PubMed

Cronfalk, Berit Seiger; Strang, Peter; Ternestedt, Britt-Marie

2009-08-01

This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. Qualitative design Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.

Mental Well-being Considerations in Preparation for Disaster Health Care: Learning From Deployment.

PubMed

Mäkinen, Tytti H; Miettinen, Sari M; Kernohan, W George

2015-08-01

The mental well-being of internationally deployed disaster-relief workers has become an issue of concern. The psychological consequences for the relief worker being exposed to trauma and threats have been well documented; however, the role of pre-deployment preparation in supporting mental well-being has not received due attention, despite research indicating the need for it. This case series examines the experiences of deployed volunteers of one emergency-relief organization. The aim of this research was to identify the participants' interpretations of the appropriateness of the pre-deployment preparation they had received in light of supporting their mental well-being during and after deployment. The main research questions were: How appropriate was pre-deployment preparation in supporting mental well-being? What elements were lacking, and what else would be useful? Using a hermeneutic phenomenological approach, thematic, semi-structured interviews were conducted with six deployed volunteers of an international emergency-relief organization. Data were analyzed using content analysis. The participants in this study regarded the pre-deployment preparation they had received, on the whole, as appropriate in supporting their mental well-being. The seven main themes identified as important and supportive of mental well-being were: (1) realistic expectations, (2) team building and support, (3) self-awareness and self-care, (4) post-deployment support, (5) practical skills and creative solutions, (6) shared values and beliefs, and (7) safety and security. Specific areas identified as lacking within these themes included communication, self-care, post-deployment support, and safety and security. Themes identified as important for supporting mental well-being in this research largely were consistent with those in previous research. The generally positive experiences of the support received do not reflect results from existing research, where significant shortcomings in worker support have been expressed. However, important elements were also identified as lacking in this specific pre-deployment preparation.

Deep learning aided decision support for pulmonary nodules diagnosing: a review.

PubMed

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

2018-04-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

Financial Aid and Minority Participation in Graduate Education: A Research Agenda for Today. A Research Report of the Minority Graduate Education (MGE) Project.

ERIC Educational Resources Information Center

Nettles, Michael

A proposed agenda to study why minority participation in graduate education is so limited and so often unsuccessful is presented. Considerations to bear in mind include: what kind of financial returns minority students receive as a result of completing graduate school; the limited financial support available for graduate education; the lack of…

Referrals. Electric avenue.

PubMed

Solly, J

2001-11-22

A pilot electronic booking project for outpatient appointments at King's College Hospital, London, has been well received by consultants. But only a minority of practices are taking part--only 24 of the 160 local practices are participating. A considerable culture change is needed to persuade practices to become involved. GPs accustomed to traditional referral letters find electronic referrals a big step. More day-to-day support might encourage GP involvement.

Implementing Dynamic Assessment of Vocabulary Development as a Trialogical Learning Process: A Practice of Teacher Support in Primary Education Schools

ERIC Educational Resources Information Center

van der Veen, Chiel; Dobber, Marjolein; van Oers, Bert

2016-01-01

Dynamic Assessment (DA) has received a considerable amount of attention in the educational sciences and beyond. DA combines instruction or feedback with assessment or testing within a single activity. DA has great potential for classroom practices, but has not been implemented in many classrooms yet. In this article, we argue that teacher…

Family functioning, health and social support assessed by aged home care clients and their family members.

PubMed

Hautsalo, Katja; Rantanen, Anja; Astedt-Kurki, Päivi

2013-10-01

The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. A survey design with convenience sampling. The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family. © 2012 Blackwell Publishing Ltd.

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists.

PubMed

Rosenkrantz, Andrew B; Hirsch, Joshua A; Allen, Bibb; Wang, Wenyi; Hughes, Danny R; Nicola, Gregory N

2017-03-01

In implementing the Merit-Based Incentive Payment System (MIPS), CMS will provide special considerations to physicians with infrequent face-to-face patient encounters by reweighting MIPS performance categories to account for the unique circumstances facing these providers. The aim of this study was to determine the impact of varying criteria on the fraction of radiologists who are likely to receive special considerations for performance assessment under MIPS. Data from the 2014 Medicare Physician and Other Supplier file for 28,710 diagnostic radiologists were used to determine the fraction of radiologists meeting various proposed criteria for receiving special considerations. For each definition, the fraction of patient-facing encounters among all billed codes was determined for those radiologists not receiving special considerations. When using the criterion proposed by CMS that physicians will receive special considerations if billing ≤25 evaluation and management services or surgical codes, 72.0% of diagnostic radiologists would receive special considerations, though such encounters would represent only 2.1% of billed codes among remaining diagnostic radiologists without special considerations. If CMS were to apply an alternative criterion of billing ≤100 evaluation and management codes exclusively, 98.8% of diagnostic radiologists would receive special considerations. At this threshold, patient-facing encounters would represent approximately 10% of billed codes among remaining radiologists without special considerations. The current CMS proposed criterion for special considerations would result in a considerable fraction of radiologists being evaluated on the basis of measures that are not reflective of their practice and beyond their direct control. Alternative criteria could help ensure that radiologists are provided a fair opportunity for success in performance review under the MIPS. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

New approaches to hyperkalemia in patients with indications for renin angiotensin aldosterone inhibitors: Considerations for trial design and regulatory approval.

PubMed

Zannad, Faiez; Rossignol, Patrick; Stough, Wendy Gattis; Epstein, Murray; Alonso Garcia, Maria de Los Angeles; Bakris, George L; Butler, Javed; Kosiborod, Mikhail; Berman, Lance; Mebazaa, Alexandre; Rasmussen, Henrik S; Ruilope, Luis M; Stockbridge, Norman; Thompson, Aliza; Wittes, Janet; Pitt, Bertram

2016-08-01

Hyperkalemia is a common clinical problem, especially in patients with chronic kidney disease, diabetes mellitus, or heart failure. Treatment with renin angiotensin aldosterone system inhibitors exacerbates the risk of hyperkalemia in these patients. Concern about hyperkalemia can result in the failure to initiate, suboptimal dosing, or discontinuation of renin angiotensin aldosterone system inhibitor therapy in patients; effective treatments for hyperkalemia might mitigate such undertreatment. New treatments for hyperkalemia in development may offer better efficacy, tolerability and safety profiles than do existing approved treatments. These compounds might enable more eligible patients to receive renin angiotensin aldosterone system inhibitor therapy or to receive renin angiotensin aldosterone system inhibitors at target doses. The evidence needed to support a treatment claim (reduction in serum potassium) differs from that needed to support a prevention claim (preventing hyperkalemia to allow renin angiotensin aldosterone system inhibitor treatment). Thus, several issues related to clinical trial design and drug development need to be considered. This paper summarizes and expands upon a discussion at the Global Cardiovascular Clinical Trialists 2014 Forum and examines methodologic considerations for trials of new potassium binders for the prevention and management of hyperkalemia in patients with renin angiotensin aldosterone system inhibitor indications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Advances in the research of application of hydrogels in three-dimensional bioprinting].

PubMed

Yang, J; Zhao, Y; Li, H H; Zhu, S H

2016-08-20

Hydrogels are three-dimensional networks made of hydrophilic polymer crosslinked through covalent bonds or physical intermolecular attractions, which can contain growth media and growth factors to support cell growth. In bioprinting, hydrogels are used to provide accurate control over cellular microenvironment and to dramatically reduce experimental repetition times, meanwhile we can obtain three-dimensional cell images of high quality. Hydrogels in three-dimensional bioprinting have received a considerable interest due to their structural similarities to the natural extracellular matrix and polyporous frameworks which can support the cellular proliferation and survival. Meanwhile, they are accompanied by many challenges.

41 CFR 102-37.525 - What should a holding agency do if it wants a public airport to receive priority consideration...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What should a holding agency do if it wants a public airport to receive priority consideration for excess personal property it... agency do if it wants a public airport to receive priority consideration for excess personal property it...

Some business and tax aspects of clinical practice plans.

PubMed

Mancino, D

1978-10-01

Medical schools throughout the country have developed diverse organizational forms through which their faculty members provide clinical services. In this article the author reviews several of the reasons frequently offered to support involvement of a medical school in a faculty practice plan and suggests many business and tax considerations which should be taken into account by a medical school in developing a plan to meet its objectives. He also reviews many of the considerations involved in establishing and operating specific types of group practice plans. The author concludes that, with conscientious planning and implementation, faculty members can receive professional satisfaction, medical schools can obtain many benefits, and the public will benefit from improved health care.

Deep learning aided decision support for pulmonary nodules diagnosing: a review

PubMed Central

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping

2018-01-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing. PMID:29780633

49 CFR 389.23 - Consideration of comments received.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Consideration of comments received. 389.23 Section 389.23 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER... PROCEDURES-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.23 Consideration...

49 CFR 389.23 - Consideration of comments received.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Consideration of comments received. 389.23 Section 389.23 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER... PROCEDURES-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.23 Consideration...

Shuttle remote manipulator system mission preparation and operations

NASA Technical Reports Server (NTRS)

Smith, Ernest E., Jr.

1989-01-01

The preflight planning, analysis, procedures development, and operations support for the Space Transportation System payload deployment and retrieval missions utilizing the Shuttle Remote Manipulator System are summarized. Analysis of the normal operational loads and failure induced loads and motion are factored into all procedures. Both the astronaut flight crews and the Mission Control Center flight control teams receive considerable training for standard and mission specific operations. The real time flight control team activities are described.

Interventions in exclusive breastfeeding: a systematic review.

PubMed

Bevan, Gillian; Brown, Michelle

Now recognised as a worldwide public health issue, the significance of promoting and encouraging exclusive breastfeeding (EBF) has been acknowledged by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Documented policies about the importance of facilitating the support of breastfeeding women is currently receiving worldwide recognition (WHO, 2011; WHO and UNICEF, 2003). This literature review will examine provision of support mechanisms for breastfeeding mothers, focusing on peer support in encouraging the starting and maintaining of EBF. Consideration will also be given to any barriers that may prevent higher success rates, as cultural and educational factors may have a significant impact on the starting and maintaining of EBF. These factors must be considered when starting support groups, networks or activities that aim to address this significant public health issue.

Size, composition, and strength of ties of personal social support networks among adult people living with HIV/AIDS in Henan and Beijing, China.

PubMed

Zhang, Ting; Cao, Weihua; Lv, Jun; Wang, Ning; Reilly, Kathleen Heather; Zhu, Qian; Li, Liming

2012-05-01

To characterize the level of personal support available to people living with HIV/AIDS (PLWHA) in Henan and Beijing, China, face-to-face interviews were conducted to collect information on network size, composition, and strength of ties. The number of people as sources of support for participants in Henan varied from 1 to 13 and 1 to 16 in Beijing. In Henan, family members were more likely to provide support than non-relatives and they provided support more frequently; in Beijing non-relatives were more likely to provide support than family members. Family members were closer to PLWHA than non-relatives in both sites, but the closest type of relative and non-relative supporters were different between Henan and Beijing. PLWHA in Henan and Beijing receive considerable social support, but there is still opportunity for additional social support. Efforts should be made to mobilize civil society to provide support for PLWHA in China.

A new approach in psychotherapy: ACT (acceptance and commitment therapy).

PubMed

McHugh, Louise

2011-09-01

Acceptance and commitment therapy (ACT) focuses on enhancing psychological flexibility in the service of achieving core life values. One thing that distinguishes ACT from other psychotherapies is its grounding in empirical behavioural science. The results of the latter suggest that the capacity for human language can produce seriously negative psychological effects under certain circumstances. ACT is a therapeutic approach in which the negative effects of human language are undermined so as to support flexible values based living. ACT therapeutic work involves six key processes proposed under the "hexaflex" model. ACT has received considerable empirical support at a number of different levels of analysis.

Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs.

PubMed

Glassman, Paul; Caputo, Anthony; Dougherty, Nancy; Lyons, Ray; Messieha, Zakaria; Miller, Christine; Peltier, Bruce; Romer, Maureen

2009-01-01

Many people with special needs (PSN) have difficulty having good oral health or accessing oral health services because of a disability or medical condition. The number of people with these conditions living in community settings and needing oral health services is increasing dramatically due to advances in medical care, deinstitutionalization, and changing societal values. Many of these individuals require additional supports beyond local anesthesia in order to receive dental treatment services. The purpose of this consensus statement is to focus on the decision-making process for choosing a method of treatment or a combination of methods for facilitating dental treatment for these individuals. These guidelines are intended to assist oral health professionals and other interested parties in planning and carrying out oral health treatment for PSN. Considerations for planning treatment and considerations for each of several alternative modalities are listed. Also discussed are considerations for the use of combinations of modalities and considerations for the repeated or frequent use of these modalities. Finally, the need to advocate for adequate education and reimbursement for the full range of support alternatives is addressed. The Special Care Dentistry Association (SCDA) is dedicated to improving oral health and well being of PSN. The SCDA hopes that these guidelines can help oral health professionals and other interested individuals and groups to work together to ensure that PSN can achieve a "lifetime of oral health."

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.

Multicenter study of crystalloid boluses and transfusion in pediatric trauma-When to go to blood?

PubMed

Polites, Stephanie F; Nygaard, Rachel M; Reddy, Pooja N; Zielinski, Martin D; Richardson, Chad J; Elsbernd, Terri A; Petrun, Branden M; Weinberg, Sean L; Murphy, Sherrie; Potter, Donald D; Klinkner, Denise B; Moir, Christopher R

2018-07-01

The 9th edition of Advanced Trauma Life Support recommends up to three crystalloid boluses in pediatric trauma patients with consideration of transfusion after the second bolus; however, this approach is debated. We aimed to determine if requirement of more than one fluid bolus predicts the need for transfusion. The 2010 to 2016 highest tier activation patients younger than 15 years from two ACS Level I pediatric trauma centers were identified from prospectively maintained trauma databases. Those with a shock index (heart rate/systolic blood pressure) greater than 0.9 were included. Crystalloid boluses (20 ± 10 mL/kg) and transfusions administered prehospital and within 12 hours of hospital arrival were determined. Univariate and multivariable analyses were conducted to determine association between crystalloid volume and transfusion. Among 208 patients, the mean age was 5 ± 4 years (60% male), 91% sustained blunt injuries, and median (interquartile range) Injury Severity Score was 11 (6,25). Twenty-nine percent received one bolus, 17% received two, and 10% received at least three. Transfusion of any blood product occurred in 50 (24%) patients; mean (range) red blood cells was 23 (0-89) mL/kg, plasma 8 (0-69), and platelets 1 (0-18). The likelihood of transfusion increased logarithmically from 11% to 43% for those requiring 2 or more boluses (Fig. 1). This relationship persisted on multivariable analysis that adjusted for institution, age, and shock index with good discrimination (Area under the Receiver Operating Characteristic, 0.84). Shock index was also strongly associated with transfusion. Almost half of pediatric trauma patients with elevated shock index require transfusion following two crystalloid boluses and the odds of requiring a transfusion plateau at this point in resuscitation. This supports consideration of blood with the second bolus in conjunction with shock index though prospective studies are needed to confirm this and its impact on outcomes. Therapeutic study, level IV.

The inter-relationship between formal and informal care: a study in France and Israel

PubMed Central

LITWIN, HOWARD; ATTIAS-DONFUT, CLAUDINE

2012-01-01

This study examined whether formal care services delivered to frail older people’s homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care. PMID:23316096

Improving the effectiveness of sickness benefit case management through a public-private partnership? A difference-in-difference analysis in eighteen Danish municipalities.

PubMed

Larsen, Malene Rode; Aust, Birgit; Høgelund, Jan

2017-04-18

The aim of this study was to investigate whether a multidimensional public-private partnership intervention, focussing on improving the quality and efficiency of sickness benefit case management, reduced the sickness benefit duration and the duration until self-support. We used a difference-in-difference (DID) design with six intervention municipalities and 12 matched control municipalities in Denmark. The study sample comprised 282,103 sickness benefit spells exceeding four weeks. The intervention group with 110,291 spells received the intervention, and the control group with 171,812 spells received ordinary sickness benefit case management. Using register data, we fitted Cox proportional hazard ratio models, estimating hazard ratios (HR) and confidence intervals (CI). We found no joint effect of the intervention on the sickness benefit duration (HR 1.02, CI 0.97-1.07) or the duration until self-support (HR 0.99, CI 0.96-1.02). The effect varied among the six municipalities, with sickness benefit HRs ranging from 0.96 (CI 0.93-1.00) to 1.13 (CI 1.08-1.18) and self-support HRs ranging from 0.91 (CI 0.82-1.00) to 1.11 (CI 1.06-1.17). Compared to receiving ordinary sickness benefit management the intervention had on average no effect on the sickness benefit duration or duration until self-support. However, the effect varied considerably among the six municipalities possibly due to differences in the implementation or the complexity of the intervention.

Radio Astronomy Software Defined Receiver Project

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

Vacaliuc, Bogdan; Leech, Marcus; Oxley, Paul

The paper describes a Radio Astronomy Software Defined Receiver (RASDR) that is currently under development. RASDR is targeted for use by amateurs and small institutions where cost is a primary consideration. The receiver will operate from HF thru 2.8 GHz. Front-end components such as preamps, block down-converters and pre-select bandpass filters are outside the scope of this development and will be provided by the user. The receiver includes RF amplifiers and attenuators, synthesized LOs, quadrature down converters, dual 8 bit ADCs and a Signal Processor that provides firmware processing of the digital bit stream. RASDR will interface to a usermore » s PC via a USB or higher speed Ethernet LAN connection. The PC will run software that provides processing of the bit stream, a graphical user interface, as well as data analysis and storage. Software should support MAC OS, Windows and Linux platforms and will focus on such radio astronomy applications as total power measurements, pulsar detection, and spectral line studies.« less

Many-Agent Controlled Teleportation of Multi-qubit Quantum Information via Quantum Entanglement Swapping

NASA Astrophysics Data System (ADS)

Zhang, Zhan-Jun; Liu, Yi-Min; Man, Zhong-Xiao

2005-11-01

We present a method to teleport multi-qubit quantum information in an easy way from a sender to a receiver via the control of many agents in a network. Only when all the agents collaborate with the quantum information receiver can the unknown states in the sender's qubits be fully reconstructed in the receiver's qubits. In our method, agents's control parameters are obtained via quantum entanglement swapping. As the realization of the many-agent controlled teleportation is concerned, compared to the recent method [C.P. Yang, et al., Phys. Rev. A 70 (2004) 022329], our present method considerably reduces the preparation difficulty of initial states and the identification difficulty of entangled states, moreover, it does not need local Hadamard operations and it is more feasible in technology. The project supported by National Natural Science Foundation of China under Grant No. 10304022

Workaholism and relationship quality: a spillover-crossover perspective.

PubMed

Bakker, Arnold B; Demerouti, Evangelia; Burke, Ronald

2009-01-01

This study of 168 dual-earner couples examined the relationship between workaholism and relationship satisfaction. More specifically, on the basis of the literature, it was hypothesized that workaholism is positively related to work-family conflict. In addition, the authors predicted that workaholism is related to reduced support provided to the partner, through work-family conflict, and that individuals who receive considerable support from their partners are more satisfied with their relationship. Finally, the authors hypothesized direct crossover of relationship satisfaction between partners. The results of structural equation modeling analyses using the matched responses of both partners supported these hypotheses. Moreover, in line with predictions, the authors found that gender did not affect the strength of the relationships in the proposed model. The authors discuss workplace interventions as possible ways to help workaholics and their partners.

Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

PubMed

Yoon, Hyung-In

2016-10-01

This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

A single-centre comparison of the clinical outcomes at 6 months of renal transplant recipients administered Adoport® or Prograf® preparations of tacrolimus

PubMed Central

Connor, Andrew; Prowse, Andrew; Newell, Paul; Rowe, Peter A.

2013-01-01

Background The use of generic formulations of immunosuppressive drugs in place of brand name drugs offers considerable cost savings. Brand name tacrolimus (Prograf®) came off patent in April 2008. However, published evidence supporting therapeutic equivalence of generic formulations of tacrolimus in solid organ transplantation is lacking. The South West Transplant Centre switched from administering Prograf® to a generic formulation (Adoport®) for de novo transplant recipients in November 2010. This study sought to compare the clinical outcomes of renal transplant recipients administered Prograf® with those receiving Adoport®. Methods Data regarding patient characteristics and clinical outcomes were collected retrospectively for all patients undergoing renal transplantation at the South West Transplant Centre between 8 November 2009 and 8 November 2011 to whom tacrolimus was prescribed. Results A total of 48 patients received Prograf® and 51 received Adoport®. At 6 months, no statistically significant differences were identified in the rates of patient survival, graft survival, acute allograft rejection, delayed graft function, calcineurin inhibitor toxicity or cytomegalovirus infection occurring within the two groups. Conclusions This is the first study to compare the clinical outcomes of patients receiving Adoport® with those receiving brand name tacrolimus. We report comparable clinical outcomes at 6 months in patients receiving either Prograf® or Adoport® from the time of renal transplantation. These early outcome data therefore support the use of Adoport® in place of Prograf® as a potential cost-saving measure. PMID:27818747

A constant radius of curvature model for the organization of DNA in toroidal condensates.

PubMed Central

Hud, N V; Downing, K H; Balhorn, R

1995-01-01

Toroidal DNA condensates have received considerable attention for their possible relationship to the packaging of DNA in viruses and in general as a model of ordered DNA condensation. A spool-like model has primarily been supported for DNA organization within toroids. However, our observations suggest that the actual organization may be considerably different. We present an alternate model in which DNA for a given toroid is organized within a series of equally sized contiguous loops that precess about the toroid axis. A related model for the toroid formation process is also presented. This kinetic model predicts a distribution of toroid sizes for DNA condensed from solution that is in good agreement with experimental data. Images Fig. 1 Fig. 2 Fig. 3 Fig. 5 PMID:7724602

National aerospace meeting of the Institute of Navigation

NASA Astrophysics Data System (ADS)

Fell, Patrick

The program for this year's aerospace meeting of The Institute of Navigation addressed developments in the evolving Global Positioning System (GPS) of navigation satellites, inertial navigation systems, and other electronic navigation systems and their applications. Also included in the program were a limited number of papers addressing the geodetic use of the GPS system.The Global Positioning System is a constellation of 18 navigation satellites being developed by the Department of Defense to provide instantaneous worldwide navigation. The system will support a multitude of military applications. The first paper by Jacobson reviewed the engineering development of GPS navigation receivers stressing the use of common hardware and software modules. A later paper by Ould described the mechanization of a digital receiver for GPS applications designed for faster acquisition of the spread spectrum satellite transmissions than analog receivers. The paper by Brady discussed the worldwide coverage that is provided by the limited number of satellites that will constitute the GPS constellation through 1983. The capability provided by the satellites presently on orbit would support a variety of experiments at almost any location. Tables of multiple satellite availability are provided for numerous worldwide locations. For civil aviation applications, Vogel addressed the satellite geometry considerations for low cost GPS user equipment, Esposito described the Federal Aviation Administration acceptance tests of a GPS navigation receiver, and Hopkins discussed the design and capability of an integrated GPS strapdown attitude and heading reference system for avionics.

Development of Structural Health Management Technology for Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Prosser, W. H.

2003-01-01

As part of the overall goal of developing Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, NASA has focused considerable resources on the development of technologies for Structural Health Management (SHM). The motivations for these efforts are to increase the safety and reliability of aerospace structural systems, while at the same time decreasing operating and maintenance costs. Research and development of SHM technologies has been supported under a variety of programs for both aircraft and spacecraft including the Space Launch Initiative, X-33, Next Generation Launch Technology, and Aviation Safety Program. The major focus of much of the research to date has been on the development and testing of sensor technologies. A wide range of sensor technologies are under consideration including fiber-optic sensors, active and passive acoustic sensors, electromagnetic sensors, wireless sensing systems, MEMS, and nanosensors. Because of their numerous advantages for aerospace applications, most notably being extremely light weight, fiber-optic sensors are one of the leading candidates and have received considerable attention.

Support for User Interfaces for Distributed Systems

NASA Technical Reports Server (NTRS)

Eychaner, Glenn; Niessner, Albert

2005-01-01

An extensible Java(TradeMark) software framework supports the construction and operation of graphical user interfaces (GUIs) for distributed computing systems typified by ground control systems that send commands to, and receive telemetric data from, spacecraft. Heretofore, such GUIs have been custom built for each new system at considerable expense. In contrast, the present framework affords generic capabilities that can be shared by different distributed systems. Dynamic class loading, reflection, and other run-time capabilities of the Java language and JavaBeans component architecture enable the creation of a GUI for each new distributed computing system with a minimum of custom effort. By use of this framework, GUI components in control panels and menus can send commands to a particular distributed system with a minimum of system-specific code. The framework receives, decodes, processes, and displays telemetry data; custom telemetry data handling can be added for a particular system. The framework supports saving and later restoration of users configurations of control panels and telemetry displays with a minimum of effort in writing system-specific code. GUIs constructed within this framework can be deployed in any operating system with a Java run-time environment, without recompilation or code changes.

Are Key Principles for improved health technology assessment supported and used by health technology assessment organizations?

PubMed

Neumann, Peter J; Drummond, Michael F; Jönsson, Bengt; Luce, Bryan R; Schwartz, J Sanford; Siebert, Uwe; Sullivan, Sean D

2010-01-01

Previously, our group-the International Working Group for HTA Advancement-proposed a set of fifteen Key Principles that could be applied to health technology assessment (HTA) programs in different jurisdictions and across a range of organizations and perspectives. In this commentary, we investigate the extent to which these principles are supported and used by fourteen selected HTA organizations worldwide. We find that some principles are broadly supported: examples include being explicit about HTA goals and scope; considering a wide range of evidence and outcomes; and being unbiased and transparent. Other principles receive less widespread support: examples are addressing issues of generalizability and transferability; being transparent on the link between HTA findings and decision-making processes; considering a full societal perspective; and monitoring the implementation of HTA findings. The analysis also suggests a lack of consensus in the field about some principles--for example, considering a societal perspective. Our study highlights differences in the uptake of key principles for HTA and indicates considerable room for improvement for HTA organizations to adopt principles identified to reflect good HTA practices. Most HTA organizations espouse certain general concepts of good practice--for example, assessments should be unbiased and transparent. However, principles that require more intensive follow-up--for example, monitoring the implementation of HTA findings--have received little support and execution.

Premarital relationships and livelihoods in Ghana.

PubMed

Ankomah, A

1996-10-01

This study is based on interviews with a sample of 400 single women aged 18-25 years from the Fante ethnic group in Cape Coast, Ghana, in 1991, and on focus groups. This case study illustrates the importance of economic and living arrangement support expected from partners in premarital relationships. Support may be for living and maintenance ('chopmoney', provisions, household items, and rent); for financial security (provision of capital); and for clothing and hairdressing. Women did not always require economic support in premarital relationships. Women expect boyfriends to provide 'chopmoney' (money for food and general upkeep) and contribute some money for the rent. Only 36% of sexually active women expected their boyfriends to supply food provisions. Premarital sexual relationships are used to obtain start-up capital. The author refers to evidence that senior government officials engaged in sexual transactions with clients before loans and credit facilities were offered. 87% of sexually experienced women expected their partners to pay for at least part of clothing expenses. The study revealed that there was considerable disparity between women's expectations and actual receipt of economic support. 56% desired, but only 36% received, 'chopmoney' in full. 40% expected their partners to pay for household furnishings in full, while only 10% did so. 55% expected capital, but only 15% received it. The three most frequently received benefits in full were hair dressing, shoes, and dresses. Men provided most non-negotiable items as a means of "boosting their egos." Many young women rely on the support of men in order to improve their status. Ghanaian men control financial resources and economic power. Mothers of adolescent daughters encourage premarital sexual behavior. Prostitution is considered different from sexual exchange relationships. It is argued that gender inequalities and domestic abuse are perpetuated through sexual exchange relationships.

Scholarly investigation into otitis media: who is receiving funding support from the National Institutes of Health?

PubMed

Hojjat, Houmehr; Johnson, Andrew P; Svider, Peter F; Hong, Robert S; Zuliani, Giancarlo; Folbe, Adam J; Shkoukani, Mahdi A

2015-07-01

Otitis media (OM) is highly prevalent and represents a major public health concern. We evaluate National Institutes of Health (NIH) funding support for OM research and examine the role of otolaryngology primary investigators (PIs). Examination of bibliometrics and funding history of NIH grant recipients. The NIH RePORTER database was examined for PIs funded for otitis media-related projects. The specialty, education level, academic department, scholarly impact (as measured by the h-index), and funding levels of PIs were obtained. There were 320 projects funded for 1,102 fiscal years supporting OM research. Since 2000, there has been >$280 million in support. PhDs received 47.5% of awards, more than any single medical specialty. Pediatricians received 54.8% of grants awarded to physicians followed by otolaryngologists (29.9%). Pediatric infectious disease specialists and pediatric otolaryngologists had the greatest funding per PI upon considering subspecialties, whereas non-fellowship-trained otolaryngologists had the lowest funding levels. Funded otolaryngologists had lower scholarly impact than several specialties. Aggregate funding levels to otolaryngologists decreased between 2000 and 2013. The NIH provided considerable grant support for researchers studying OM as awards to practitioners in numerous specialties exceeded a quarter of a billion dollars since 2000. Although awards to otolaryngologists were significant, the share of grants awarded to otolaryngologists has declined, suggesting that increased recruitment of basic scientists and enhanced cooperation with other specialists may facilitate further scholarship. These findings suggest a need for improving initiatives that prepare otolaryngology trainees interested in translational OM research for the rigorous NIH peer-review grant process. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Risk Factors for Anticipatory Grief in Family Members of Terminally Ill Veterans Receiving Palliative Care Services.

PubMed

Burke, Laurie A; Clark, Karen A; Ali, Khatidja S; Gibson, Benjamin W; Smigelsky, Melissa A; Neimeyer, Robert A

2015-01-01

Anticipatory grief is the process associated with grieving the loss of loved ones in advance of their inevitable death. Because anticipatory grief has been associated with a variety of outcomes, risk factors for this condition deserve closer consideration. Fifty-seven family members of terminally ill, hospice-eligible veterans receiving palliative care services completed measures assessing psychosocial factors and conditions. Elevated anticipatory grief was found in families characterized by relational dependency, lower education, and poor grief-specific support, who also experienced discomfort with closeness and intimacy, neuroticism, spiritual crisis, and an inability to make sense of the loss. Thus, in this sample, anticipatory grief appears to be part of a cluster of factors and associated distress that call for early monitoring and possible intervention.

Cultural values and secondary prevention of breast cancer in african american women.

PubMed

Beckjord, Ellen Burke; Klassen, Ann C

2008-01-01

Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.

Teaching the science of learning.

PubMed

Weinstein, Yana; Madan, Christopher R; Sumeracki, Megan A

2018-01-01

The science of learning has made a considerable contribution to our understanding of effective teaching and learning strategies. However, few instructors outside of the field are privy to this research. In this tutorial review, we focus on six specific cognitive strategies that have received robust support from decades of research: spaced practice, interleaving, retrieval practice, elaboration, concrete examples, and dual coding. We describe the basic research behind each strategy and relevant applied research, present examples of existing and suggested implementation, and make recommendations for further research that would broaden the reach of these strategies.

Participation of Academic Scientists in Relationships with Industry

PubMed Central

Zinner, Darren E.; Bolcic-Jankovic, Dragana; Clarridge, Brian; Blumenthal, David; Campbell, Eric G.

2013-01-01

Relationships between academic researchers and industry have received considerable attention in the last 20 years, but current data on the prevalence, magnitude, and trends in such relationships are rare. In a mailed survey of 3080 academic life science researchers conducted in 2007, we found the majority (52.8%) of academic life scientists have some form of relationship with industry. Compared to our previous studies in 1995 and 1985, we found a significant decrease in industry support of university research, which could have major consequences for the academic life science research sector. PMID:19887423

Forgotten but not gone: an examination of fit between leader consideration and initiating structure needed and received.

PubMed

Lambert, Lisa Schurer; Tepper, Bennett J; Carr, Jon C; Holt, Daniel T; Barelka, Alex J

2012-09-01

We examined the effects of fit between leader consideration and initiating structure needed and received on employees' work-related attitudes (i.e., trust in the supervisor, job satisfaction, and affective commitment to the organization). Consistent with predictions that derive from the person-environment fit research tradition, results from Study 1 suggested that deficient amounts of both leadership behaviors were associated with unfavorable attitudinal outcomes. However, while excess levels of consideration were associated with favorable attitudinal outcomes, excess levels of initiating structure were associated with unfavorable attitudes, and for both forms of leadership, higher levels of absolute fit were associated with more favorable outcomes. Results from Study 2 suggested that attitudes generated by the fit between leadership needed and received influence employees' organizational citizenship behavior as reported by their supervisors. The relationship between consideration needed and received and subordinates' organizational citizenship behavior relating to individuals (OCBI) and organizational citizenship behavior relating to the organization itself (OCBO) was partially mediated by employees' trust in the supervisor, while the relationship between initiating structure needed and received and OCBI was fully mediated by trust in the supervisor, and for OCBO was partially mediated.

Supporting Asian patients with metastatic breast cancer during ixabepilone therapy.

PubMed

Bourdeanu, Laura; Wong, Siu-Fun

2010-05-01

Ixabepilone is currently FDA-approved in metastatic breast cancer, and most patients in the registrational trials were Caucasian. Studies in Asian populations receiving other cytotoxic agents have revealed differential pharmacokinetics and clinical outcomes. As such, clinicians should understand the possible contributions of Asian ethnicity and culture to the clinical profile of ixabepilone. Studies in Asian patients receiving other chemotherapeutics reported altered toxicity profiles for myelosuppression, neurotoxicity and gastrointestinal symptoms. Encouragingly, the limited clinical data in Asian patients receiving ixabepilone suggest that efficacy and toxicity in these women resemble those reported in the ixabepilone registrational trials. The reader will better understand how Asian genetics and culture may influence treatment outcomes and patient attitudes toward therapy and interaction with caregivers. Management of ixabepilone-related adverse events is also discussed with an emphasis on special considerations for Asian patients. Awareness of possible altered drug response in Asian patients will aid clinicians in monitoring for toxicity, recognizing the need for dose modification and educating patients. Sensitivity to cultural aspects that are unique to Asians may improve adherence, reporting of adverse events and trust among Asian patients receiving ixabepilone.

Choice-making among Medicaid HCBS and ICF/MR recipients in six states.

PubMed

Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

2008-09-01

Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in non family settings in six states. Everyday choice in daily life and in support-related choice was considerably higher on average for HCBS than for ICF/MR recipients, but after controlling for level of intellectual disability, medical care needs, mobility, behavioral and psychiatric conditions, and self-reporting, we found that choice was more strongly associated with living in a congregate setting than whether that setting was HCBS- or ICF/MR-financed. Marked differences in choice were also evident between states.

Patterns of prophylactic gastrostomy tube placement in head and neck cancer patients: a consideration of the significance of social support and practice variation.

PubMed

Locher, Julie L; Bonner, James A; Carroll, William R; Caudell, Jimmy J; Allison, Jeroan J; Kilgore, Meredith L; Ritchie, Christine S; Tajeu, Gabriel S; Yuan, Ya; Roth, David L

2013-08-01

The purpose of this study was to examine factors associated with prophylactic placement of feeding tubes in head and neck cancer patients receiving radiation therapy as a part of treatment using multilevel models that account for patient-, physician-, and institution-level sources of variation. A retrospective analysis using binary logistic regression and hierarchical linear models was run to evaluate independent predictors of prophylactic feeding tube placement. Surveillance, Epidemiology, and End Results-Medicare data were used. Head and neck cancer patients diagnosed with locoregionally advanced stage disease from 2000 to 2005 were included in this study (N = 8,306). Across all models, prophylactic gastrostomy tube placement was found to be more likely in patients who had cancer of the larynx or oropharynx compared with those with cancer of the nasopharynx or oral cavity; who had regional instead of local cancer; who did not receive surgery as a part of treatment, but did receive chemotherapy; and who were divorced, separated, or widowed. Additionally, although practice variation was observed to occur, its overall contribution in predicting prophylactic gastrostomy tube placement was minimal. As health care enters an era of patient-centered care, further investigation of the potential role of social support (or lack of social support) in influencing treatment decisions of head and neck cancer patients and providers is warranted. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

47 CFR 22.936 - Dismissal of applications in cellular renewal proceedings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.936 Dismissal of applications... its principals has received or will receive any money or other consideration in excess of legitimate... principals has paid or will pay money or other consideration in excess of the legitimate and prudent expenses...

47 CFR 22.936 - Dismissal of applications in cellular renewal proceedings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.936 Dismissal of applications... its principals has received or will receive any money or other consideration in excess of legitimate... principals has paid or will pay money or other consideration in excess of the legitimate and prudent expenses...

47 CFR 22.936 - Dismissal of applications in cellular renewal proceedings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.936 Dismissal of applications... its principals has received or will receive any money or other consideration in excess of legitimate... principals has paid or will pay money or other consideration in excess of the legitimate and prudent expenses...

47 CFR 22.936 - Dismissal of applications in cellular renewal proceedings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.936 Dismissal of applications... its principals has received or will receive any money or other consideration in excess of legitimate... principals has paid or will pay money or other consideration in excess of the legitimate and prudent expenses...

47 CFR 22.936 - Dismissal of applications in cellular renewal proceedings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.936 Dismissal of applications... its principals has received or will receive any money or other consideration in excess of legitimate... principals has paid or will pay money or other consideration in excess of the legitimate and prudent expenses...

Controlling the morphology and performance of FO membrane via adjusting the atmosphere humidity during casting procedure

NASA Astrophysics Data System (ADS)

Zuo, Hao-Ran; Cao, Gui-Ping; Wang, Meng; Zhang, Huan-Huan; Song, Chen-Chen; Fang, Xu; Wang, Tao

2018-03-01

Forward osmosis (FO) has received great interest for its considerable potential in a wide range of fields. In this work, the morphology and performance of FO membrane were regulated by adjusting the atmosphere humidity (HC) of casting procedure. The polysulfone support layer was casted under various atmosphere humidity levels ranging from 40% to 80%. By multi-techniques such as SEM, AFM, and XPS, it was proved that the atmosphere humidity had modified the surface morphology and thickness of the skin layer in support layer, which contributed up to 90% of the structure parameter, resulting in distinct morphology, thickness, and cross-linking degree of active layer. The active layer with sparse bead-like wrinkles on the smooth surface of support layer casted at HC = 65% showed the highest water permeability [26.9 (L/m2 h MPa)] and considerable low salt permeability [0.0390 (L/m2 h)]. It was found that the water flux of FO-65 was 27% and 46% higher than that of FO-80 in AL-DS and AL-FS mode, respectively, and the salt rejection was as high as 98%. Our work highlighted the importance of considering the effect of atmosphere humidity during casting when design an FO membrane for appropriate performance.

Design considerations for a LORAN-C timing receiver in a hostile signal to noise environment

NASA Technical Reports Server (NTRS)

Porter, J. W.; Bowell, J. R.; Price, G. E.

1981-01-01

The environment in which a LORAN-C Timing Receiver may function effectively depends to a large extent on the techniques utilized to insure that interfering signals within the pass band of the unit are neutralized. The baseline performance manually operated timing receivers is discussed and the basic design considerations and necessary parameters for an automatic unit utilizing today's technology are established. Actual performance data is presented comparing the results obtained from a present generation timing receiver against a new generation microprocessor controlled automatic acquisition receiver. The achievements possible in a wide range of signal to noise situations are demonstrated.

Operational Use of GPS Navigation for Space Shuttle Entry

NASA Technical Reports Server (NTRS)

Goodman, John L.; Propst, Carolyn A.

2008-01-01

The STS-118 flight of the Space Shuttle Endeavour was the first shuttle mission flown with three Global Positioning System (GPS) receivers in place of the three legacy Tactical Air Navigation (TACAN) units. This marked the conclusion of a 15 year effort involving procurement, missionization, integration, and flight testing of a GPS receiver and a parallel effort to formulate and implement shuttle computer software changes to support GPS. The use of GPS data from a single receiver in parallel with TACAN during entry was successfully demonstrated by the orbiters Discovery and Atlantis during four shuttle missions in 2006 and 2007. This provided the confidence needed before flying the first all GPS, no TACAN flight with Endeavour. A significant number of lessons were learned concerning the integration of a software intensive navigation unit into a legacy avionics system. These lessons have been taken into consideration during vehicle design by other flight programs, including the vehicle that will replace the Space Shuttle, Orion.

Awareness and consideration of malnutrition among oncologists: Insights from an exploratory survey.

PubMed

Caccialanza, Riccardo; Cereda, Emanuele; Pinto, Carmine; Cotogni, Paolo; Farina, Gabriella; Gavazzi, Cecilia; Gandini, Chiara; Nardi, Mariateresa; Zagonel, Vittorina; Pedrazzoli, Paolo

2016-09-01

The attitude toward malnutrition varies considerably among oncologists and many malnourished cancer patients receive inadequate nutritional support. The aim of this brief report was to report the results of the exploratory national survey conducted by the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE) before publication of a consensus document aimed at evaluating current attitudes toward malnutrition and management of nutrition, among Italian medical oncologists. Between January and July 2015, the AIOM and the SINPE conducted a national web-based exploratory survey to investigate the attitude of oncologists toward malnutrition, and the management of nutritional support, before publication of an intersociety consensus document. Of the 2375 AIOM members, 135 (5.7%) participated in the survey, with a satisfactory distribution across all Italian regions. Nutritional assessment and support were routinely integrated into patient care for 38 (28%) responders. According to 66 (49%) participants, nutritional assessment was carried out only at the patients' request (n = 62), or not at all (n = 4). Availability of clinical nutritionists was reported by 88 (65%) participants. For 131 responders (97%), nutritional status was decisive (n = 63) or often crucial (n = 68) in assessing whether anticancer treatment was practicable or would be tolerated. The low response rate may reflect the lack of awareness and consideration of nutritional issues among Italian oncologists. Although malnutrition and nutritional support seemed to be perceived by the responders as relevant factors for the efficacy of oncologic treatments, it seems that nutritional care practices may well be inappropriate. The lack of collaboration between oncologists and clinical nutritionists may be the first obstacle to overcome. Educational intersociety initiatives aimed at improving nutritional support management for cancer patients in Italy appear urgently needed. Copyright © 2016 Elsevier Inc. All rights reserved.

On the viability of supporting institutional sharing of remote laboratory facilities

NASA Astrophysics Data System (ADS)

Lowe, David; Dang, Bridgette; Daniel, Keith; Murray, Stephen; Lindsay, Euan

2015-11-01

Laboratories are generally regarded as critical to engineering education, and yet educational institutions face significant challenges in developing and maintaining high-quality laboratory facilities. Remote laboratories are increasingly being explored as a partial solution to this challenge, with research showing that - for the right learning outcomes - they can be viable adjuncts or alternatives to conventional hands-on laboratories. One consequential opportunity arising from the inherent support for distributed access is the possibility of cross-institutional shared facilities. While both technical feasibility and pedagogic implications of remote laboratories have been well studied within the literature, the organisational and logistical issues associated with shared facilities have received limited consideration. This paper uses an existing national-scale laboratory sharing initiative, along with a related survey and laboratory sharing data, to analyse a range of factors that can affect engagement in laboratory sharing. The paper also discusses the implications for supporting ongoing laboratory sharing.

Transceiver Design for CMUT-Based Super-Resolution Ultrasound Imaging.

PubMed

Behnamfar, Parisa; Molavi, Reza; Mirabbasi, Shahriar

2016-04-01

A recently introduced structure for the capacitive micromachined ultrasonic transducers (CMUTs) has focused on the applications of the asymmetric mode of vibration and has shown promising results in construction of super-resolution ultrasound images. This paper presents the first implementation and experimental results of a transceiver circuit to interface such CMUT structures. The multiple input/multiple output receiver in this work supports both fundamental and asymmetric modes of operation and includes transimpedance amplifiers and low-power variable-gain stages. These circuit blocks are designed considering the trade-offs between gain, input impedance, noise, linearity and power consumption. The high-voltage transmitter can generate pulse voltages up to 60 V while occupying a considerably small area. The overall circuit is designed and laid out in a 0.35 μm CMOS process and a four-channel transceiver occupies 0.86 × 0.38 mm(2). The prototype chip is characterized in both electrical and mechanical domains. Measurement results show that each receiver channel has a nominal gain of 110 dBΩ with a 3 dB bandwidth of 9 MHz while consuming 1.02 mW from a 3.3 V supply. The receiver is also highly linear, with 1 dB compression point of minimum 1.05 V which is considerably higher than the previously reported designs. The transmitter consumes 98.1 mW from a 30 V supply while generating 1.38 MHz, 30 V pulses. The CMOS-CMUT system is tested in the transmit mode and shows full functionality in air medium.

Emotional and informational support for families during their child's illness.

PubMed

Sarajärvi, A; Haapamäki, M L; Paavilainen, E

2006-09-01

To describe and compare the support provided by nursing staff to families during their child's illness from the viewpoint of families and nurses. A survey method was used. Data were collected by questionnaires planned for families and staff separately. The study population consisted of families who visited paediatric outpatient clinics, families with hospitalized children (n = 344) and the paediatric nursing staff (n = 60). Almost half of the families had received adequate emotional and informational support from the nursing staff for their physical and psychological reactions. One-fifth of the families reported that they had not been supported at all during the child's hospitalization. According to families and nurses, the support was provided in the forms of discussion, listening and giving time. Families' and nurses' suggestions for development of support were related to the time resources of the staff, to the flow of information, to more client-centred attitudes, to being appreciated and listened to and to home care guidance. However, the pervasiveness of this problem in the international literature suggests that deeper consideration of possible underlying reasons for this phenomenon is called for.

An exploration of medical emergency team intervention at the end of life for people with advanced cancer.

PubMed

Brown, Christine; Drosdowsky, Allison; Krishnasamy, Meinir

2017-12-01

Recent advances in cancer therapies offer survival benefit when cure is no longer possible. The contribution of the Medical Emergency Teams (METs) in the context of advancing disease has received little empirical consideration. This study set out to explore MET intervention at the end of life for people with advanced cancer in an Australian comprehensive cancer centre, and its impact on quality of death. A retrospective medical chart review was undertaken to explore MET response for people with advanced (incurable) cancer nearing end of life. Occurrence of MET interventions at the end of life and a quality of death score were recorded for two randomly selected cohorts of patients, those who experienced a MET response within their last week of life (n = 50) and those who did not (n = 50). The cohort who did not receive MET intervention had a significantly higher (better) quality of death score when compared with patients who did receive a MET intervention (p = 0.01). Within the cohort who received a MET intervention, a subgroup (n = 19) where the MET influenced end-of-life decision-making had a significantly higher quality of death score (p = 0.02) than patients in the MET cohort (n = 31) where the MET did not influence end-of-life care. The contribution of the MET to end-of-life care for patients with cancer has not previously been reported. Further research is now needed to prospectively examine MET involvement at the end of life with consideration to quality of patient care and death, family experience, and support requirements of MET members. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autonomous Adaptive Low-Power Instrument Platform (AAL-PIP) for remote high latitude geospace data collection

NASA Astrophysics Data System (ADS)

Clauer, C. R.; Kim, H.; Deshpande, K.; Xu, Z.; Weimer, D.; Musko, S.; Crowley, G.; Fish, C.; Nealy, R.; Humphreys, T. E.; Bhatti, J. A.; Ridley, A. J.

2014-06-01

We present the development considerations and design for ground based instrumentation that is being deployed on the East Antarctic Plateau along a 40° magnetic meridian chain to investigate interhemispheric magnetically conjugate geomagnetic coupling and other space weather related phenomena. The stations are magnetically conjugate to geomagnetic stations along the west coast of Greenland. The autonomous adaptive low-power instrument platforms being deployed in the Antarctic are designed to operate unattended in remote locations for at least 5 years. They utilize solar power and AGM storage batteries for power, two-way Iridium satellite communication for data acquisition and program/operation modification, support fluxgate and induction magnetometers as well as dual-frequency gps receiver and an HF radio experiment. Size and weight considerations are considered to enable deployment by a small team using small aircraft. Considerable experience has been gained in the development and deployment of remote polar instrumentation that is reflected in the present generation of instrumentation discussed here. We conclude with the lessons learned from our experience in the design, deployment and operation of remote polar instrumentation.

An autonomous adaptive low-power instrument platform (AAL-PIP) for remote high-latitude geospace data collection

NASA Astrophysics Data System (ADS)

Clauer, C. R.; Kim, H.; Deshpande, K.; Xu, Z.; Weimer, D.; Musko, S.; Crowley, G.; Fish, C.; Nealy, R.; Humphreys, T. E.; Bhatti, J. A.; Ridley, A. J.

2014-10-01

We present the development considerations and design for ground-based instrumentation that is being deployed on the East Antarctic Plateau along a 40° magnetic meridian chain to investigate interhemispheric magnetically conjugate geomagnetic coupling and other space-weather-related phenomena. The stations are magnetically conjugate to geomagnetic stations along the west coast of Greenland. The autonomous adaptive low-power instrument platforms being deployed in the Antarctic are designed to operate unattended in remote locations for at least 5 years. They utilize solar power and AGM storage batteries for power, two-way Iridium satellite communication for data acquisition and program/operation modification, support fluxgate and induction magnetometers as well as a dual-frequency GPS receiver and a high-frequency (HF) radio experiment. Size and weight considerations are considered to enable deployment by a small team using small aircraft. Considerable experience has been gained in the development and deployment of remote polar instrumentation that is reflected in the present generation of instrumentation discussed here. We conclude with the lessons learned from our experience in the design, deployment and operation of remote polar instrumentation.

[Impact of attachment style, social support and the number of implantable cardioverter defibrillator (ICD) discharges on psychological strain of ICD patients].

PubMed

Simson, Udo; Perings, Christian; Plaskuda, Ariane; Schäfer, Ralf; Brehm, Michael; Bader, Doris; Tress, Wolfgang; Franz, Matthias

2006-12-01

OBJECTIVE It is well known fact, that the life of ICD patients is often affected by anxiety and depression. The number of ICD discharges is only a contributing factor explaining the variance of anxiety and depression. There have to be other factors that have more influence on the physical strain of ICD patients. In this study we examined the impact of attachment style and social support in addition to the number of ICD discharges. METHODS 119 out-patients at an out-patient ICD unit were examined consecutively with the following self report scales: (1) the State-Trait-Anxiety Inventory (STAI), (2) the Beck Depression Inventory (BDI), (3) a short form of a social support questionnaire (F-SOZU), (4) the Bielefeld Partnership Expectations Questionnaire (BFPE) and (5) a specifically designed questionnaire for the assessment of sociodemografic data. To determine the frequency and timing of the ICD discharges we analysed the ICD data. RESULTS 38 % of the ICD patients reported enhanced anxiety levels and 37 % reported enhanced depression levels. Only 38 % of the ICD patients received discharges at all. Elevated levels of anxiety and depression were found in patients who showed insecure attachment styles, low social support, long-term treatment in hospital and a higher number of ICD discharges. To explain the variance of anxiety we found social support, attachment style, and the number of ICD storms to be contributing factors. To explain the variance of depression we found social support and time spent in hospital in the previous year to be contributing factors. CONCLUSIONS Almost half of the ICD patients suffer considerably from anxiety and/or depression. These patients have to be identified and treated psychotherapeutically. Patients who show insecure attachment styles, receive low social support, undergo long-term treatment in hospital and receive a higher number of discharges, especially so called ICD storms, bear the highest risk to develop psychological strain. Attachment style and social support have even more impact on the development of anxiety and depression than the number of ICD discharges. It has to be shown in future studies whether psychotherapy can improve the quality of life of ICD patients.

Utilized social support and self-esteem mediate the relationship between perceived social support and suicide ideation. A test of a multiple mediator model.

PubMed

Kleiman, Evan M; Riskind, John H

2013-01-01

While perceived social support has received considerable research as a protective factor for suicide ideation, little attention has been given to the mechanisms that mediate its effects. We integrated two theoretical models, Joiner's (2005) interpersonal theory of suicide and Leary's (Leary, Tambor, Terdal, & Downs, 1995) sociometer theory of self-esteem to investigate two hypothesized mechanisms, utilization of social support and self-esteem. Specifically, we hypothesized that individuals must utilize the social support they perceive that would result in increased self-esteem, which in turn buffers them from suicide ideation. Participants were 172 college students who completed measures of social support, self-esteem, and suicide ideation. Tests of simple mediation indicate that utilization of social support and self-esteem may each individually help to mediate the perceived social support/suicide ideation relationship. Additionally, a test of multiple mediators using bootstrapping supported the hypothesized multiple-mediator model. The use of a cross-sectional design limited our ability to find true cause-and-effect relationships. Results suggested that utilized social support and self-esteem both operate as individual moderators in the social support/self-esteem relationship. Results further suggested, in a comprehensive model, that perceived social support buffers suicide ideation through utilization of social support and increases in self-esteem.

Dietary protein considerations to support active aging.

PubMed

Wall, Benjamin T; Cermak, Naomi M; van Loon, Luc J C

2014-11-01

Given our rapidly aging world-wide population, the loss of skeletal muscle mass with healthy aging (sarcopenia) represents an important societal and public health concern. Maintaining or adopting an active lifestyle alleviates age-related muscle loss to a certain extent. Over time, even small losses of muscle tissue can hinder the ability to maintain an active lifestyle and, as such, contribute to the development of frailty and metabolic disease. Considerable research focus has addressed the application of dietary protein supplementation to support exercise-induced gains in muscle mass in younger individuals. In contrast, the role of dietary protein in supporting the maintenance (or gain) of skeletal muscle mass in active older persons has received less attention. Older individuals display a blunted muscle protein synthetic response to dietary protein ingestion. However, this reduced anabolic response can largely be overcome when physical activity is performed in close temporal proximity to protein consumption. Moreover, recent evidence has helped elucidate the optimal type and amount of dietary protein that should be ingested by the older adult throughout the day in order to maximize the skeletal muscle adaptive response to physical activity. Evidence demonstrates that when these principles are adhered to, muscle maintenance or hypertrophy over prolonged periods can be further augmented in active older persons. The present review outlines the current understanding of the role that dietary protein occupies in the lifestyle of active older adults as a means to increase skeletal muscle mass, strength and function, and thus support healthier aging.

Space infrared telescope facility wide field and diffraction limited array camera (IRAC)

NASA Technical Reports Server (NTRS)

Fazio, G. G.

1986-01-01

IRAC focal plane detector technology was developed and studies of alternate focal plane configurations were supported. While any of the alternate focal planes under consideration would have a major impact on the Infrared Array Camera, it was possible to proceed with detector development and optical analysis research based on the proposed design since, to a large degree, the studies undertaken are generic to any SIRTF imaging instrument. Development of the proposed instrument was also important in a situation in which none of the alternate configurations has received the approval of the Science Working Group.

The Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products

PubMed Central

Berman, Jonathan; Radhakrishna, Tanya

2017-01-01

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals–artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis–have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. PMID:27573627

Psychometric properties of the Brand Personality Scale: evidence from a business school.

PubMed

Caruana, Albert; Pitt, Leyland F; Berthon, Pierre; Berthon, J-P

2007-06-01

The Brand Personality Scale has received considerable attention and has been frequently used and cited in the branding literature. This paper describes an investigation of the psychometric characteristics of the Brand Personality Scale in a business school context where umbrella branding is used. A sample (N=262) of students attending the MBA program of a major business school in eastern USA completed the scale. Results indicate problems with the scale's dimensionality, poor reliability, convergent and nomological validity of the Ruggedness dimension, and lack of support for discriminant validity. Managerial and research implications and limitations are noted.

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.

Resources and Costs Associated with the Treatment of Advanced and Metastatic Gastric Cancer in the Mexican Public Sector: A Patient Chart Review.

PubMed

Quintana, Miguel; Toriz, José A; Novick, Diego; Jones, Kyla; Botello, Brenda S; Silva, Juan Alejandro

2018-06-01

Little evidence is available on the management and cost of treating patients with advanced or metastatic gastric cancer (GC). This study evaluates patient characteristics, treatment patterns, and resource utilization for these patients in Mexico. Data were collected from three centers of investigation (tertiary level). Patients were ≥18 years of age, diagnosed between 1 January 2009 and 1 January 2015, had advanced or metastatic GC, received first-line fluoropyrimidine/platinum, and had ≥3 months follow-up after discontinuing first-line treatment. Data were summarized using descriptive statistics. The study sample totaled 180. Patients' mean age was 57.2 years (±12.4) and 57.0% were male; 151 (83.9%) patients received second-line chemotherapy. A total of 16 and 19 regimens were identified in first- and second-line therapy. Of the sample, 51 (28.3%) received third-line therapy, and <10% received more than three lines of active chemotherapy. Supportive care received in first- and second-line chemotherapy, included pain interventions (12.2 and 7.9%), nutritional support (3.3 and 1.3%), radiotherapy (6.1 and 16.6%), and transfusions (13.3 and 10.6%), respectively. Using Mexican Institute of Social Security (IMSS) tariffs, the average total cost per patient-month in first- and second-line therapy was US$1230 [95% confidence interval (CI) 1034-1425] and US$1192 (95% CI 913-1471), respectively. Administration and acquisition of chemotherapy comprised the majority of costs. This study shows considerable variation in first- and second-line chemotherapy regimens of patients with advanced or metastatic GC. Understanding GC treatment patterns in Mexico will help address unmet needs.

Paternal Incarceration and Support for Children in Fragile Families

PubMed Central

Geller, Amanda; Garfinkel, Irwin; Western, Bruce

2011-01-01

High U.S. incarceration rates have motivated recent research on the negative effects of imprisonment on later employment, earnings, and family relationships. Because most men in jail and prison are fathers, a large number of children may be placed at considerable risk by policies of incarceration. This article examines one dimension of the economic risk faced by children of incarcerated fathers: the reduction in the financial support that they receive. We use a population-based sample of urban children to examine the effects of incarceration on this support. Both cross-sectional and longitudinal regressions indicate that formerly incarcerated men are less likely to contribute to their families, and those who do contribute provide significantly less. The negative effects of incarceration on fathers’ financial support are due not only to the low earnings of formerly incarcerated men but also to their increased likelihood to live apart from their children. Men contribute far less through child support (formal or informal) than they do when they share their earnings within their household, suggesting that the destabilizing effects of incarceration on family relationships place children at significant economic disadvantage. PMID:21318455

Family policies in OECD countries: a comparative analysis.

PubMed

Thévenon, Olivier

2011-01-01

This article discusses the diversity of family policy models in 28 OECD countries in terms of the balance between their different objectives and the mix of instruments adopted to implement the policies. Cross-country policy differences are investigated by applying a principal component analysis to comprehensive country-level data from the OECD Family database covering variables such as parental leave conditions, childcare service provision, and financial support to families. The results find persistent differences in the family policy patterns embedded in different contexts of work-family "outcomes." Country classifications of family policy packages only partially corroborate categorizations in earlier studies, owing to considerable within-group heterogeneity and the presence of group outliers. The Nordic countries outdistance the others with comprehensive support to working parents with very young children. Anglo-Saxon countries provide much less support for working parents with very young children, and financial support is targeted on low-income and large families and focuses on preschool and early elementary education. Continental and Eastern European countries form a more heterogeneous group, while the support received by families in Southern Europe and in Asian countries is much lower in all its dimensions.

Optimizing the wireless power transfer over MIMO Channels

NASA Astrophysics Data System (ADS)

Wiedmann, Karsten; Weber, Tobias

2017-09-01

In this paper, the optimization of the power transfer over wireless channels having multiple-inputs and multiple-outputs (MIMO) is studied. Therefore, the transmitter, the receiver and the MIMO channel are modeled as multiports. The power transfer efficiency is described by a Rayleigh quotient, which is a function of the channel's scattering parameters and the incident waves from both transmitter and receiver side. This way, the power transfer efficiency can be maximized analytically by solving a generalized eigenvalue problem, which is deduced from the Rayleigh quotient. As a result, the maximum power transfer efficiency achievable over a given MIMO channel is obtained. This maximum can be used as a performance bound in order to benchmark wireless power transfer systems. Furthermore, the optimal operating point which achieves this maximum will be obtained. The optimal operating point will be described by the complex amplitudes of the optimal incident and reflected waves of the MIMO channel. This supports the design of the optimal transmitter and receiver multiports. The proposed method applies for arbitrary MIMO channels, taking transmitter-side and/or receiver-side cross-couplings in both near- and farfield scenarios into consideration. Special cases are briefly discussed in this paper in order to illustrate the method.

Increasing social support for depressed individuals: a cross-cultural assessment of an affect-expectancy approach.

PubMed

Siegel, Jason T; Alvaro, Eusebio M; Crano, William D; Lienemann, Brianna A; Hohman, Zachary P; O'Brien, Erin

2012-01-01

Depression is a mental illness affecting 121 million people. The Substance Abuse and Mental Health Services Administration recently launched a national, bilingual (English and Spanish) campaign to motivate young adults to support friends with mental illness. This article highlights and assesses the usefulness of two theoretically derived variables for increasing the social support received by all depressed individuals: (a) affect and (b) social support outcome expectations. In accord with the Substance Abuse and Mental Health Services Administration's bilingual campaign, the authors conducted two studies using intercepts at 2 swap meets in the U.S. Southwest. One study sample consisted of Spanish-dominant Hispanics, the other non-Hispanics. For both samples, results indicate that affect, social support outcome expectations, and their interaction accounted for more than 50% of the variance of social support intentions (67% in the Hispanic sample when familism was considered). Affect is commonplace in the helping behavior literature; results indicate social support outcome expectations deserve equal consideration. Moreover, an unexpected finding emerged: Perceiving a lack of willpower, need for attention, and lack of moral character to be the cause of depression resulted in increased sympathy among the Hispanic sample but increased anger among non-Hispanics.

Bending the rules: when deaf writers leave college.

PubMed

Biser, Eileen; Rubel, Linda; Toscano, Rose Marie

2007-01-01

On-the-job writing of deaf college graduates at all degree levels was investigated. Institutional databases and questionnaires to alumni and employers were the sources for information. Respondents were asked about editing assistance, sources and types of assistance, and perceptions of such assistance by employers and employees. Results of the study confirmed that deaf employees did considerable writing regardless of degree or type of job. Their self-reports indicated grammar as the major weakness. Additionally, employers stated that clarity, organization, and spelling were serious writing problems. The study also showed that deaf employees asked for and received editing assistance and that employers were willing to support the improvement of writing skills. Because error-free texts are expected in the workplace and editing assistance is sought and received, postsecondary institutions should mimic these practices by providing copyediting services and instruction in the ethics and practices of working with editors.

An algorithm for synchronizing a clock when the data are received over a network with an unstable delay

PubMed Central

Levine, Judah

2016-01-01

A method is presented for synchronizing the time of a clock to a remote time standard when the channel connecting the two has significant delay variation that can be described only statistically. The method compares the Allan deviation of the channel fluctuations to the free-running stability of the local clock, and computes the optimum interval between requests based on one of three selectable requirements: (1) choosing the highest possible accuracy, (2) choosing the best tradeoff of cost vs. accuracy, or (3) minimizing the number of requests to realize a specific accuracy. Once the interval between requests is chosen, the final step is to steer the local clock based on the received data. A typical adjustment algorithm, which supports both the statistical considerations based on the Allan deviation comparison and the timely detection of errors is included as an example. PMID:26529759

Education and employment outcomes of young adults with a history of developmental language disorder

PubMed Central

Durkin, Kevin; Toseeb, Umar; Botting, Nicola; Pickles, Andrew

2017-01-01

Abstract Background Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes. Aims To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age‐matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes? Methods & Procedures Participants included 84 individuals with DLD (67% males) and 88 age‐matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income. Outcomes & Results Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age‐matched peers was in work full time. Participants with DLD were much more likely to be in non‐professional occupations. However, when examining pay in relation to types of occupation, the groups’ incomes were broadly comparable. Conclusions & Implications At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD. PMID:29139196

Sodium reduction in New Zealand requires major behaviour change.

PubMed

Lofthouse, Catherine; Te Morenga, Lisa; McLean, Rachael

2016-10-01

This pilot study examined the feasibility of adherence to a low sodium diet in a sample of healthy New Zealand adults. It also addressed whether following a low sodium diet was accompanied by changes in intakes of other nutrients that influence cardiovascular risk. Eleven healthy adults provided dietary intake data and a 24-hour urine collection at baseline and follow-up. They then received nutritional counselling based on the World Health Organization recommendation for sodium intake (<2000 mg/day) and received ongoing nutritional support while undertaking a low sodium diet for four weeks. At the end of the four-week period, participants completed a semi-structured interview that elicited participants' opinions on barriers and facilitators to following a low sodium diet and explored changes in participants' dietary habits and behaviours. Thematic analysis revealed that adherence to a low sodium diet required substantial changes to participants' usual food purchasing and preparation habits. Participants reported that lack of control over the sodium content of meals eaten away from the home, the complex and time-consuming nature of interpreting nutrition information labels, and difficulty identifying suitable snacks were barriers to adherence. Detailed meal planning and cooking from scratch, using flavour replacements, reading food labels to identify low sodium foods, receiving support from other people and receiving tailored nutrition advice were facilitators. Mean sodium intake reduced over the period, accompanied by a decrease in mean intake of total fat. These factors suggest that sodium reduction in New Zealand adults was feasible. However, considerable changes to eating behaviours were required. Copyright © 2016 Elsevier Ltd. All rights reserved.

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 Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products.

PubMed

Berman, Jonathan; Radhakrishna, Tanya

2017-01-11

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals-artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis-have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. © The American Society of Tropical Medicine and Hygiene.

Improving quality of tuberculosis care in India.

PubMed

Pai, Madhukar; Satyanarayana, Srinath; Hopewell, Phil

2014-01-01

In India, the quality of care that tuberculosis (TB) patients receive varies considerably and is often not in accordance with the national and international standards. In this article, we provide an overview of the third (latest) edition of the International Standards of Tuberculosis Care (ISTC). These standards are supported by the existing World Health Organization guidelines and policy statements pertaining to TB care and have been endorsed by a number of international organizations. We call upon all health care providers in the country to practice TB care that is consistent with these standards, as well as the upcoming Standards for TB Care in India (STCI).

[Considerations about Acupuncture Treatment during Menstruation].

PubMed

Lin, Ying; Zhang, Hong

2016-04-01

A dispute about whether women are suitable to receive acupuncture treatment in the period of menstruation has existed for many years. There are some reports about acupuncture treatment induced abnormal menstruation in women experiencing menstruation. However, according to long-term clinical practice and current development of acupuncture therapy, the authors of the present paper hold that there are no absolute contradictions for acupuncture treatment of women during menstruation. Additionally, acupuncture induced menstrual disorder has no enough data support of large size example clinical trials. The key points of acupuncture administration for women during menstruation are: (1) reasonable selection of acupoints prescriptions, and (2) appropriate acupuncture needle manipulations, particularly avoiding strong stimulation.

Correlates of Quality of Life in New Migrants to Hong Kong from Mainland China.

PubMed

Wong, Winky K F; Chou, Kee-Lee; Chow, Nelson W S

2012-06-01

The concept of Quality of life (QOL) has received considerable attention from different disciplines. The aim of this study was to identify what are the correlates of QOL among Chinese new immigrants in Hong Kong. Data were collected through a cross-sectional survey among 449 Hong Kong new immigrants from Mainland China. Bivariate and multiple regression analyses were performed to examine the association between immigrants' QOL and their demographic characteristics, socio-economic factors, optimism, sense of control, perceived social support, perceived neighborhood disorder, collective efficacy, pre-migration planning, depressive symptoms and acculturation stress. Our findings demonstrated that depressive symptom is the most prominent factor in reducing immigrants' level of QOL, perceived social support and optimism are the two important factors that enhance the QOL of these depressed immigrants. Our results indicate that preventive measures must be developed, and professional counseling and psychological support services must be provided to new immigrants in Hong Kong, especially those who have depressive symptoms.

Dehumanization in organizational settings: some scientific and ethical considerations

PubMed Central

Christoff, Kalina

2014-01-01

Dehumanizing attitudes and behaviors frequently occur in organizational settings and are often viewed as an acceptable, and even necessary, strategy for pursuing personal and organizational goals. Here I examine a number of commonly held beliefs about dehumanization and argue that there is relatively little support for them in light of the evidence emerging from social psychological and neuroscientific research. Contrary to the commonly held belief that everyday forms of dehumanization are innocent and inconsequential, the evidence shows profoundly negative consequences for both victims and perpetrators. As well, the belief that suppressing empathy automatically leads to improved problem solving is not supported by the evidence. The more general belief that empathy interferes with problem solving receives partial support, but only in the case of mechanistic problem solving. Overall, I question the usefulness of dehumanization in organizational settings and argue that it can be replaced by superior strategies that are ethically more acceptable and do not entail the severely negative consequences associated with dehumanization. PMID:25309401

Exploring the digital technology preferences of teenagers and young adults (TYA) with cancer and survivors: a cross-sectional service evaluation questionnaire.

PubMed

Abrol, Esha; Groszmann, Mike; Pitman, Alexandra; Hough, Rachael; Taylor, Rachel M; Aref-Adib, Golnar

2017-12-01

Digital technology has the potential to support teenagers and young adults (TYAs) with cancer from the onset of their disease into survivorship. We aimed to establish (1) the current pattern of use of TYA digital technologies within our service-user population, and (2) their preferences regarding digital information and support within the service. A cross-sectional survey was administered as a paper and online self-completed questionnaire to TYAs aged 13-24 accessing outpatient, inpatient, and day care cancer services at a regional specialist centre over a 4-week period. One hundred two TYAs completed the survey (55.7% male; 39.8% female; 83.3% paper; 16.7% online; mean age 18.5 years [SD = 3.51]). Of the TYAs, 41.6% rated the importance of digital communication as "essential" to their lives. Half (51.0%) kept in contact with other patients they had met during treatment, and 12.0% contacted patients they had not met in person. Respondents wanted to receive clinical information online (66.3%) and use online chat rooms (54.3%). Future online services desired included virtual online groups (54.3%), online counselling or psychological support (43.5%), and receiving (66.3%) and sharing (48.9%) clinical information online. Young people with cancer are digital natives. A significant subgroup expressed a desire for digital resources from oncology services, though existing resources are also highly valued. Digital resources have potential to improve patient experience and engagement. There is considerable scope to develop digital resources with which TYAs can receive information and connect with both professionals and fellow patients, following diagnosis, through treatment and survivorship.

Safety in numbers? Tackling domestic abuse in couples and network therapies.

PubMed

Galvani, Sarah A

2007-03-01

Family, network or couples-based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa.

PubMed

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors-such as age, health status and coping styles-our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family's changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level.

Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial.

PubMed

Peek, Giles J; Mugford, Miranda; Tiruvoipati, Ravindranath; Wilson, Andrew; Allen, Elizabeth; Thalanany, Mariamma M; Hibbert, Clare L; Truesdale, Ann; Clemens, Felicity; Cooper, Nicola; Firmin, Richard K; Elbourne, Diana

2009-10-17

Severe acute respiratory failure in adults causes high mortality despite improvements in ventilation techniques and other treatments (eg, steroids, prone positioning, bronchoscopy, and inhaled nitric oxide). We aimed to delineate the safety, clinical efficacy, and cost-effectiveness of extracorporeal membrane oxygenation (ECMO) compared with conventional ventilation support. In this UK-based multicentre trial, we used an independent central randomisation service to randomly assign 180 adults in a 1:1 ratio to receive continued conventional management or referral to consideration for treatment by ECMO. Eligible patients were aged 18-65 years and had severe (Murray score >3.0 or pH <7.20) but potentially reversible respiratory failure. Exclusion criteria were: high pressure (>30 cm H(2)O of peak inspiratory pressure) or high FiO(2) (>0.8) ventilation for more than 7 days; intracranial bleeding; any other contraindication to limited heparinisation; or any contraindication to continuation of active treatment. The primary outcome was death or severe disability at 6 months after randomisation or before discharge from hospital. Primary analysis was by intention to treat. Only researchers who did the 6-month follow-up were masked to treatment assignment. Data about resource use and economic outcomes (quality-adjusted life-years) were collected. Studies of the key cost generating events were undertaken, and we did analyses of cost-utility at 6 months after randomisation and modelled lifetime cost-utility. This study is registered, number ISRCTN47279827. 766 patients were screened; 180 were enrolled and randomly allocated to consideration for treatment by ECMO (n=90 patients) or to receive conventional management (n=90). 68 (75%) patients actually received ECMO; 63% (57/90) of patients allocated to consideration for treatment by ECMO survived to 6 months without disability compared with 47% (41/87) of those allocated to conventional management (relative risk 0.69; 95% CI 0.05-0.97, p=0.03). Referral to consideration for treatment by ECMO led to a gain of 0.03 quality-adjusted life-years (QALYs) at 6-month follow-up [corrected]. A lifetime model predicted the cost per QALY of ECMO to be pound19 252 (95% CI 7622-59 200) at a discount rate of 3.5%. We recommend transferring of adult patients with severe but potentially reversible respiratory failure, whose Murray score exceeds 3.0 or who have a pH of less than 7.20 on optimum conventional management, to a centre with an ECMO-based management protocol to significantly improve survival without severe disability. This strategy is also likely to be cost effective in settings with similar services to those in the UK. UK NHS Health Technology Assessment, English National Specialist Commissioning Advisory Group, Scottish Department of Health, and Welsh Department of Health.

A record-based analysis of 803 patients treated for depression in psychiatric care.

PubMed

Rytsälä, H J; Melartin, T K; Leskelä, U S; Lestelä-Mielonen, P S; Sokero, T P; Isometsä, E T

2001-09-01

New antidepressants emerged and became widely used during the 1990s. The present study investigated quality-of-care problems in the treatment of depression in a current psychiatric setting. We investigated the treatment received for depression by all 803 inpatients or outpatients with a clinical diagnosis of ICD-10 depressive episode or recurrent depressive disorder in 1996 in the Peijas Medical Care District, which provides psychiatric services for citizens of Vantaa, a city in southern Finland. Most patients (84%) in the sample were found to have received antidepressants, generally in adequate, albeit low, doses. Inadequate antidepressant treatment was common only with tricyclic antidepressants. Most patients received a single antidepressant for extended periods; only 22% had 2 or more antidepressant trials. During the treatment period, disability pension was granted to 19% of those not already pensioned, two thirds (67%) of whom had received only 1 antidepressant trial prior to being granted a pension. The present study supports the emerging perception of improved quality of pharmacotherapy in psychiatric settings, with the exception of treatment with tricyclic antidepressants. Problems of quality of care now appear to be related to the suboptimal intensity and monitoring of the treatment provided. which may eventually result in considerable costs to society due to permanent disability.

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention.

PubMed

Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Sneddon, Anne; Scuffham, Paul A; Ryding, Elsa L; Jarrett, Vivian; Toohill, Jocelyn

2013-10-20

Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body's ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women's childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4-6 weeks after birth. This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women's childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Australian New Zealand Controlled Trials Registry ACTRN12612000526875.

Psychosocial impacts on caregivers of people living with AIDS.

PubMed

Orner, Phyllis

2006-04-01

Estimates show that by 2010 up to six million South Africans will be HIV-infected. Simultaneously, public health care resources are overstretched and communities and families are taking more responsibility for providing care. However, little work in South Africa has investigated the possible psychosocial impacts on caregivers. This study investigates psychosocial impacts at household level with reference to gender, programme, and policy implications. Forty-five in-depth interviews were held with primary caregivers of people living with AIDS (PWA). Participants were recruited using purposive and snowball sampling. Forty-three respondents were women, signifying that gender is an important issue in this context. Data were analysed using a grounded theory approach. Care giving placed considerable demands on caregivers, which was exacerbated by insufficient support, dire poverty and the added responsibilities of caring for other household members. Lack of basic resources was common and chronic, and care giving impacted negatively on employment and social life. Stigma and prejudice towards caregivers was common and exacerbated stress levels. Assessment of support received from various sources ranged widely. The lack of support was often debilitating. Respondents who felt supported linked this support to improved psychosocial status. Recommendations for policy on home-based care are outlined.

Survey of Information Sharing Related to the Occupational Considerations of Working Cancer Patients Between Occupational Physicians and Treating Physicians.

PubMed

Furuya, Yuko; Takahashi, Miyako; Tateishi, Seiichiro; Tomita, Makiko; Hiraoka, Kou; Shibata, Yoshiyuki; Mori, Koji

2016-06-07

Although a vital element in providing career support to workers with medical ailments is coordination between the worker, the treating physician, and the company (the occupational health staff), little is known about factors that promote or impede coordination between these parties. This study aims to demonstrate what kinds of actions by treating physicians promote or impede the occupational considerations made by occupational physicians. A total of 43 occupational physicians who had completed the postgraduate training course (4 years) at the University of Occupational and Environmental Health Japan and were current or former instructors at the Occupational Health Training Center were surveyed using a self-reported questionnaire form. The questionnaire asked about individual attributes (age, years of experience as an occupational physician, etc.) and actions taken by treating physicians that were useful in making occupational considerations in the workplace (good practice cases) or that impeded such considerations (trouble cases). Responses about cases were obtained as freely written descriptions. Case content was analyzed qualitatively according to the KJ method. During the survey period from December 17, 2013 to January 18, 2014, responses were received from 33 occupational physicians (valid response rate, 76.7%; mean age, 37.4±6.1 years). Of these, 60.6% exclusively specialized in occupational medicine. Respondents provided 32 good practice cases and 16 trouble cases. The timing of coordination was the period of rehabilitation in 35 of the 48 cases (72.9%). Actions by the treating physicians that influenced occupational considerations were divided into seven major categories: "providing treatment information," "providing physical information," "appropriateness of rehabilitation or occupational considerations," "consistency of information provided," "issuing documentation," "communication that was cognizant of the occupational physician's presence," and "providing information unknown to the worker." This study clarified the kind of actions by the treating physicians that were relevant to occupational support provided by occupational physicians. Additionally, this study clarified the need for information sharing with occupational physician and treating physician. The good practice cases and trouble cases presented by the respondents were inextricably linked, and actions by the treating physicians that are based on good practices are highly likely to lead to smooth information sharing and occupational considerations.

7 CFR 4284.950 - Award process.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agreement § 4284.950 Award process. (a) Selection of applications for funding and for potential funding. The Agency will select and rank applications for funding based on the score an application has received in... received in the same fiscal year. Higher scoring applications will receive first consideration for funding...

7 CFR 4284.950 - Award process.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agreement § 4284.950 Award process. (a) Selection of applications for funding and for potential funding. The Agency will select and rank applications for funding based on the score an application has received in... received in the same fiscal year. Higher scoring applications will receive first consideration for funding...

7 CFR 4284.950 - Award process.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agreement § 4284.950 Award process. (a) Selection of applications for funding and for potential funding. The Agency will select and rank applications for funding based on the score an application has received in... received in the same fiscal year. Higher scoring applications will receive first consideration for funding...

[Chronological analysis of individually linked data for patients with intractable disease receiving public financial aid for treatment].

PubMed

Shibazaki, Satomi; Nagai, Masaki; Fuchigami, Hiroshi; Nishina, Motoko; Ohta, Akiko; Kawamura, Takashi; Ohno, Yoshiyuki

2005-12-01

Nationwide surveys of intractable disease patients receiving public financial aid for treatment were performed by Research Committee for Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) 4 times in the past, in 1984, 1988, 1992 and 1997. The purpose of the present study was to clarify the features of continuance with intractable disease patients receiving public financial aid for treatment. Individual information collected by each nationwide survey was linked using the disease, the residence, the sex, and the birth date. The proportion of intractable disease patients according to receipt duration, kind of medical insurance, sex and age was calculated with reference to the disease and an estimation of the receipt persistence rate was calculated for every year. Moreover, in consideration of variation in the data, average receipt persistence rates over years were also calculated. According to observation on individual patient's follow up, the proportion for which financial aid was discontinued within four years was 25%, while 70% continued receiving aid for at least four years and some 55% for eight or nine years. The proportion of those who continue receiving support long-term is high about the so-called autoimmune diseases, such as systemic lupus erythematosus, Behçet's disease, and the aortic syndrome. In contrast, with diseases having a poor prognosis, such as fulminant hepatitis, amyloidosis, and amyotrophic lateral sclerosis, periods of continuance are short. The proportion needing long-term continuation is higher in women than in men, especially with diseases which have long been eligible for support. However, with diseases for which receipt was started recently, there is a tendency for persistence to be higher in men than in women. With reform of insurance systems, including the medical system for intractable diseases, it is predicted that receipt continuation will change with alteration of social factors, and it is necessary to monitor receipt continuation carefully from now on.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-02-05

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

The desire to survive: the adaptation process of adult cancer patients undergoing radiotherapy.

PubMed

Chao, Yu Huan; Wang, Shou-Yu; Hsu, Tsui Hua; Wang, Kai Wei K

2015-01-01

Radiotherapy is one of the primary treatment strategies for cancer. However, patients not only deal with the side-effects of radiotherapy, but they must also endure the psychological distress caused by cancer. This study explores how cancer patients adapt to the treatment process when receiving radiotherapy. This study used a grounded theory approach, and eight in-depth interviews were conducted with newly diagnosed cancer patients who received radiotherapy as a primary treatment. The core category that emerged from this study was "the desire to survive". The categories and subcategories that emerged from the data include facing unknown situations (e.g. searching for relevant information and decision-making considerations, and listening to healthcare professionals' suggestions), experiencing the pain of treatment (e.g. tolerating side-effects, tolerating inconvenience during the treatment, accepting support during the treatment, and adjusting lifestyles), and chances to extend life (e.g. accepting fate, determination to undergo the treatment, and adjusting negative emotions). The study results provide a better understanding of the experiences of cancer patients undergoing radiotherapy. Healthcare professionals should provide effective medical management for side-effects and psychological support to cancer patients during the journey of radiotherapy. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

An Environmental for Hardware-in-the-Loop Formation Navigation and Control

NASA Technical Reports Server (NTRS)

Burns, Rich; Naasz, Bo; Gaylor, Dave; Higinbotham, John

2004-01-01

Recent interest in formation flying satellite systems has spurred a considerable amount of research in the relative navigation and control of satellites. Development in this area has included new estimation and control algorithms as well as sensor and actuator development specifically geared toward the relative control problem. This paper describes a simulation facility, the Formation Flying Test Bed (FFTB) at NASA Goddard Space Flight Center, which allows engineers to test new algorithms for the formation flying problem with relevant GN&C hardware in a closed loop simulation. The FFTB currently supports the inclusion of GPS receiver hardware in the simulation loop. Support for satellite crosslink ranging technology is at a prototype stage. This closed-loop, hardware inclusive simulation capability permits testing of navigation and control software in the presence of the actual hardware with which the algorithms must interact. This capability provides the navigation or control developer with a perspective on how the algorithms perform as part of the closed-loop system. In this paper, the overall design and evolution of the FFTB are presented. Each component of the FFTB is then described. Interfaces between the components of the FFTB are shown and the interfaces to and between navigation and control software are described. Finally, an example of closed-loop formation control with GPS receivers in the loop is presented.

Receiver psychology turns 20: is it time for a broader approach?

PubMed Central

Miller, Cory T.; Bee, Mark A.

2013-01-01

Twenty years ago, a new conceptual paradigm known as ‘receiver psychology’ was introduced to explain the evolution of animal communication systems. This paradigm advanced the idea that psychological processes in the receiver's nervous system influence a signal's detectability, discriminability and memorability, and thereby serve as powerful sources of selection shaping signal design. While advancing our understanding of signal diversity, more recent studies make clear that receiver psychology, as a paradigm, has been structured too narrowly and does not incorporate many of the perceptual and cognitive processes of signal reception that operate between sensory transduction and a receiver's response. Consequently, the past two decades of research on receiver psychology have emphasized considerations of signal evolution but failed to ask key questions about the mechanisms of signal reception and their evolution. The primary aim of this essay is to advocate for a broader receiver psychology paradigm that more explicitly includes a research focus on receivers' psychological landscapes. We review recent experimental studies of hearing and sound communication to illustrate how considerations of several general perceptual and cognitive processes will facilitate future research on animal signalling systems. We also emphasize how a rigorous comparative approach to receiver psychology is critical to explicating the full range of perceptual and cognitive processes involved in receiving and responding to signals. PMID:24013277

Narrowing the gap: effects of intervention on developmental trajectories in autism.

PubMed

Klintwall, Lars; Eldevik, Sigmund; Eikeseth, Svein

2015-01-01

Although still a matter of some debate, there is a growing body of research supporting Early and Intensive Behavioral Intervention as the intervention of choice for children with autism. Learning rate is an alternative to change in standard scores as an outcome measure in studies of early intervention. Learning rates can be displayed graphically as developmental trajectories, which are easy to understand and avoid some of the counter-intuitive properties of changes in standard scores. The data used in this analysis were from 453 children with autism, previously described by Eldevik et al. Children receiving Early and Intensive Behavioral Intervention exhibited significantly steeper developmental trajectories than children in the control group, in both intelligence and adaptive behaviors. However, there was a considerable variability in individual learning rates within the group receiving Early and Intensive Behavioral Intervention. This variability could partly be explained by the intensity of the treatment, partly by children's intake intelligence quotient age-equivalents. Age at intake did not co-vary with learning rate. © The Author(s) 2013.

Dietary sodium in chronic kidney disease: a comprehensive approach.

PubMed

Wright, Julie A; Cavanaugh, Kerri L

2010-01-01

Despite existing guidelines, dietary sodium intake among people worldwide often exceeds recommended limits. Research evidence is growing in both animal and human studies showing indirect and direct adverse consequences of high dietary sodium on the kidney. In patients with kidney disease, dietary sodium may have important effects on proteinuria, efficacy of antiproteinuric pharmacologic therapy, hypertension control, maintaining an optimal volume status, and immunosuppressant therapy. Dietary sodium intake is an important consideration in patients with all stages of chronic kidney disease, including those receiving dialysis therapy or those who have received a kidney transplant. We review in detail the dietary sodium recommendations suggested by various organizations for patients with kidney disease. Potential barriers to successfully translating current sodium intake guidelines into practice include poor knowledge about the sodium content of food among both patients and providers, complex labeling information, patient preferences related to taste, and limited support for modifications in public policy. Finally, we offer existing and potential solutions that may assist providers in educating and empowering patients to effectively manage their dietary sodium intake.

How older black women perceive the effects of stigma and social support on engagement in HIV care.

PubMed

McDoom, M Maya; Bokhour, Barbara; Sullivan, Meg; Drainoni, Mari-Lynn

2015-02-01

As black women over age 50 represent a growing share of women living with HIV, understanding what helps them persist and engage in ongoing HIV care will become increasingly important. Delineating the specific roles of social support and stigma on HIV care experiences among this population remains unclear. We qualitatively examined how experiences with stigma and social support either facilitated or inhibited engagement in HIV care, from the perspective of older black women. Semi-structured interviews were conducted with 20 older black women currently receiving HIV care at primary care clinics in the Metropolitan Boston area. Women expressed that experiences with stigma and seeking support played an important role in evaluating the risks and benefits of engaging in care. Social support facilitated their ability to engage in care, while stigma interfered with their ability to engage in care throughout the course of their illness. Providers in particular, can facilitate engagement by understanding the changes in these women's lives as they struggle with stigma and disclosure while engaging in HIV care. The patient's experiences with social support and stigma and their perceptions about engagement are important considerations for medical teams to tailor efforts to engage older black women in regular HIV care.

Combating weight-based bullying in schools: is there public support for the use of litigation?

PubMed

Puhl, Rebecca; Luedicke, Joerg; King, Kelly M

2015-06-01

Bullying litigation is an emerging area of law that has increased in response to serious cases of bullying at school. Weight-based bullying is prevalent at school, but no research has examined the use of litigation to address this problem. We assessed public support for litigation approaches to address weight-based bullying at school, and whether support for litigation varies according to the reason why a student is bullied. A national sample of 994 adults (49% parents) completed an online questionnaire assessing their support for litigation approaches in response to hypothetical incidents of youth bullying. As many as two thirds of participants supported litigation against schools for failing to intervene and protect students from weight-based bullying. Litigation remedies received slightly higher support in response to bullying due to race or sexual orientation compared to body weight. Participants favored litigation approaches that target schools for inadequate intervention or a bully's parents on behalf of their child's actions. Our study offers novel findings about public and parental views of litigation as a potential approach to address weight-based (and other forms of) bullying, and introduces considerations about the potential role of litigation as part of broader remedies to address youth bullying. © 2015, American School Health Association.

Gift Giving and Receiving in Child-Centered Play Therapy: An Ethical Response

ERIC Educational Resources Information Center

Blanco, Pedro J.; Sheely-Moore, Angela I.

2012-01-01

Child-centered play therapists are often confronted with the challenge of receiving gifts from clients. This article highlights recommended strategies when faced with gift receiving, exemplified by actual ethical dilemmas encountered by child-centered play therapists. Ethical and therapeutic considerations of therapist gift giving to child clients…

Influence of Lifestyle Factors on Breast Cancer Risk

PubMed Central

Dieterich, Max; Stubert, Johannes; Reimer, Toralf; Erickson, Nicole; Berling, Anika

2014-01-01

Summary Breast Cancer (BC) is a life-changing event. Compared to other malignancies in women, BC has received considerably more public attention. Despite improved neoadjuvant, adjuvant, and palliative treatment strategies for each characteristic molecular BC subtype, recommendations for evidence-based preventive strategies for BC treatment are not given equivalent attention. This may be partly due to the fact that high-quality long-term prevention studies are still difficult to carry out and are thus underrepresented in international studies. The aim of this review is to discuss the most relevant lifestyle factors associated with BC and to identify and discuss the evidence supporting practical prevention strategies that can be used in everyday clinical practice. PMID:25759623

[Living arrangements and social networks of elders. A selection of findings from a NESTOR-Study].

PubMed

Knipscheer, C P; Dykstra, P A; van Tilburg, T G; de Jong-Gierveld, J

1998-06-01

This article presents an overview of the design and results of the NESTOR survey 'Living Arrangements and Social Networks of Older Adults', an empirical study, started in 1992, among a representative sample of 4495 people, aged 55-89, selected from the population registers of 11 municipalities in the Netherlands. Questions were asked about living arrangements, the composition and functions of social networks, and important transitions in the marital, parental and occupational careers. The results indicated a wide diversity in living arrangements and social networks, a diversity which is particularly visible among the young old. They not only have larger networks, but are also more likely to live alone, to be divorced and to participate in shared housing arrangements. The networks vary considerably in size, from 0 to more than 40 important relationships. The decrease in network size with age appears to be directly related to specific life events such as widowhood, physical handicaps, residential moves etc. About 2/3 of the relationships are family relationships: parents, children (in law), grandchildren (in law), brothers and sisters (in law), uncles and aunts. Older people tend to be in touch at least once a month with the majority of close family members. The intensity of supportive exchanges (giving and receiving instrumental and emotional support in the twelve relationships with the highest levels of contact) is moderate, however mostly in balance. Only the very old receive somewhat more instrumental support and give considerably less than the 'young-old'. We studied the shift in balance between giving and receiving over a period of 12 months among a small proportion of the sample, checking a central hypothesis of exchange theory. In some cases a new balance evolves. In others the relationship continues to exist for a number of reasons, despite the imbalance. Early life experiences appear to be important for later life outcomes. Those who experienced the divorce of their parents before the age of 15 or those whose parents lived apart permanently (e.g. unmarried mothers) have a smaller social network and feel more lonely. Marital history has an impact on patterns of informal and formal care. E.g., those respondents without a partner who have children are less likely to use formal care than those who are childless. Among divorced elderly the use of formal care not only varies between men and women but also differs according to the marriage in which the children are born, first or second marriage. Occupational history is strongly related to the income level of older women living alone.

Education and employment outcomes of young adults with a history of developmental language disorder.

PubMed

Conti-Ramsden, Gina; Durkin, Kevin; Toseeb, Umar; Botting, Nicola; Pickles, Andrew

2018-03-01

Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes. To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age-matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes? Participants included 84 individuals with DLD (67% males) and 88 age-matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income. Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age-matched peers was in work full time. Participants with DLD were much more likely to be in non-professional occupations. However, when examining pay in relation to types of occupation, the groups' incomes were broadly comparable. At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD. © 2017 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

[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.

26 CFR 1.6038A-2 - Requirement of return.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., formulas, inventions, models, patents, processes, trademarks, and other similar intangible property rights; (v) Consideration paid and received for technical, managerial, engineering, construction, scientific... of all property (including monetary consideration), rights, or obligations transferred from the...

PEPFAR support for the scaling up of collaborative TB/HIV activities.

PubMed

Howard, Andrea A; Gasana, Michel; Getahun, Haileyesus; Harries, Anthony; Lawn, Stephen D; Miller, Bess; Nelson, Lisa; Sitienei, Joseph; Coggin, William L

2012-08-15

The US President's Emergency Plan for AIDS Relief (PEPFAR) has supported a comprehensive package of care in which interventions to address HIV-related tuberculosis (TB) have received increased funding and support in recent years. PEPFAR's TB/HIV programming is based on the World Health Organization's 12-point policy for collaborative TB/HIV activities, which are integrated into PEPFAR annual guidance. PEPFAR implementing partners have provided crucial support to TB/HIV collaboration, and as a result, PEPFAR-supported countries in sub-Saharan Africa have made significant gains in HIV testing and counseling of TB patients and linkages to HIV care and treatment, intensified TB case finding, and TB infection control. PEPFAR's support of TB/HIV integration has also included significant investment in health systems, including improved laboratory services and educating and enlarging the workforce. The scale-up of antiretroviral therapy along with support of programs to increase HIV counseling and testing and improve linkage and retention in HIV care may have considerable impact on TB morbidity and mortality, if used synergistically with isoniazid preventive therapy, intensified case finding, and infection control. Issues to be addressed by future programming include accelerating implementation of isoniazid preventive therapy, increasing access and ensuring appropriate use of new TB diagnostics, supporting early initiation of antiretroviral therapy for HIV-infected TB patients, and strengthening systems to monitor and evaluate program implementation.

PEPFAR Support for the Scaling Up of Collaborative TB/HIV Activities

PubMed Central

Howard, Andrea A.; Gasana, Michel; Getahun, Haileyesus; Harries, Anthony; Lawn, Stephen D.; Miller, Bess; Nelson, Lisa; Sitienei, Joseph; Coggin, William L.

2014-01-01

The US President’s Emergency Plan for AIDS Relief (PEPFAR) has supported a comprehensive package of care in which interventions to address HIV-related tuberculosis (TB) have received increased funding and support in recent years. PEPFAR’s TB/HIV programming is based on the World Health Organization 12-point policy for collaborative TB/HIV activities, which are integrated into PEPFAR annual guidance. PEPFAR implementing partners have provided crucial support to TB/HIV collaboration, and as a result PEPFAR-supported countries in sub-Saharan Africa have made significant gains in HIV testing and counseling of TB patients and linkages to HIV care and treatment, intensified TB case finding, and TB infection control. PEPFAR’s support of TB/HIV integration has also included significant investment in health systems, including improved laboratory services and educating and enlarging the workforce. The scale-up of antiretroviral therapy along with support of programs to increase HIV counseling and testing and improve linkage and retention in HIV care may have considerable impact on TB morbidity and mortality, if used synergistically with isoniazid preventive therapy (IPT), intensified case finding and infection control. Issues to be addressed by future programming include accelerating implementation of IPT, increasing access and ensuring appropriate use of new TB diagnostics, supporting early initiation of antiretroviral therapy for HIV-infected TB patients, and strengthening systems to monitor and evaluate program implementation. PMID:22797735

Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints.

PubMed

McHugh, Neil; van Exel, Job; Mason, Helen; Godwin, Jon; Collins, Marissa; Donaldson, Cam; Baker, Rachel

2018-02-01

Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences. Survey questions were designed to investigate support for NICE EoL guidance at national and regional levels. These 'Decision Rule' and 'Treatment Choice' questions were administered to an online sample of 1496 UK respondents in May 2014. The same respondents answered questions designed to elicit their agreement with three viewpoints (previously identified and described) in relation to provision of EoL treatments for terminally ill patients. We report the findings of these choice questions and examine how they relate to each other and respondents' viewpoints. The Decision Rule questions described three policies: DA - a standard 'value for money' test, applied to all health technologies; DB - giving special consideration to all treatments for terminal illnesses; and DC - giving special consideration to specific categories of treatments for terminal illnesses e.g. life extension (as in NICE EoL guidance) or those that improve quality-of-life (QoL). Three Treatment Choices were presented: TA - improving QoL for patients with a non-terminal illness; TB - extending life for EoL patients; and TC - improving QoL at the EoL. DC received most support (45%) with most respondents giving special consideration to EoL only when treatments improved QoL. The most commonly preferred treatment choices were TA (51%) and TC (43%). Overall, this study challenges claims about public support for NICE's EoL guidance and the focus on life extension at EoL and substantiates existing evidence of plurality in societal values. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Using a Geographic Information System to Assess Site Suitability for Managed Aquifer Recharge using Stormwater Capture

NASA Astrophysics Data System (ADS)

Teo, E. K.; Harmon, R. E.; Beganskas, S.; Young, K. S.; Fisher, A. T.; Weir, W. B.; Lozano, S.

2015-12-01

We are completing a regional analysis of Santa Cruz and northern Monterey Counties, CA, to assess the conditions amenable to managed aquifer recharge using stormwater runoff. Communities and water supply agencies across CA are struggling to mitigate the ongoing drought and to develop secure and sustainable water supplies to support long-term municipal, agricultural, environmental and other needs. Enhanced storage of groundwater is an important part of this effort in many basins. This work is especially timely because of the recently enacted "Sustainable Groundwater Management Act" (SGMA), which requires the development of groundwater sustainability agencies and implementation of basin management plans in coming decades. Our analysis focuses specifically on the distributed collection of stormwater runoff, a water source that has typically been treated as a nuisance or waste, from drainages having an area on the order of 40-160 hectares. The first part of this project is a geographic information system (GIS) analysis using surface and subsurface data sets. Developing complete and accurate datasets across the study region required considerable effort to locate, assemble, co-register, patch, and reconcile information from many sources and scales. We have complete spatial coverage for surface data, but subsurface data is more limited in lateral extent. Sites that are most suitable for distributed stormwater capture supporting MAR have high soil infiltration capacity, are well-connected to an underlying aquifer with good transmissive and storage properties, and have space to receive MAR. Additional considerations include method of infiltration, slope, and land use and access. Based on initial consideration of surface data and slope, 7% of the complete study region appears to be "suitable or highly suitable" for MAR (in the top third of the rating system), but there is considerable spatial heterogeneity based on the distribution of shallow soils and bedrock geology.

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.

Experiences of and support for nurses as second victims of adverse nursing errors: a qualitative systematic review.

PubMed

Cabilan, C J; Kynoch, Kathryn

2017-09-01

Second victims are clinicians who have made adverse errors and feel traumatized by the experience. The current published literature on second victims is mainly representative of doctors, hence nurses' experiences are not fully depicted. This systematic review was necessary to understand the second victim experience for nurses, explore the support provided, and recommend appropriate support systems for nurses. To synthesize the best available evidence on nurses' experiences as second victims, and explore their experiences of the support they receive and the support they need. Participants were registered nurses who made adverse errors. The review included studies that described nurses' experiences as second victims and/or the support they received after making adverse errors. All studies conducted in any health care settings worldwide. The qualitative studies included were grounded theory, discourse analysis and phenomenology. A structured search strategy was used to locate all unpublished and published qualitative studies, but was limited to the English language, and published between 1980 and February 2017. The references of studies selected for eligibility screening were hand-searched for additional literature. Eligible studies were assessed by two independent reviewers for methodological quality using a standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI QARI). Themes and narrative statements were extracted from papers included in the review using the standardized data extraction tool from JBI QARI. Data synthesis was conducted using the Joanna Briggs Institute meta-aggregation approach. There were nine qualitative studies included in the review. The narratives of 284 nurses generated a total of 43 findings, which formed 15 categories based on similarity of meaning. Four synthesized findings were generated from the categories: (i) The error brings a considerable emotional burden to the nurse that can last for a long time. In some cases, the error can alter nurses' perspectives and disrupt workplace relations; (ii) The type of support received influences how the nurse will feel about the error. Often nurses choose to speak with colleagues who have had similar experiences. Strategies need to focus on helping them to overcome the negative emotions associated with being a second victim; (iii) After the error, nurses are confronted with the dilemma of disclosure. Disclosure is determined by the following factors: how nurses feel about the error, harm to the patient, the support available to the nurse, and how errors are dealt with in the past; and (iv) Reconciliation is every nurse's endeavor. Predominantly, this is achieved by accepting fallibility, followed by acts of restitution, such as making positive changes in practice and disclosure to attain closure (see "Summary of findings"). Adverse errors were distressing for nurses, but they did not always receive the support they needed from colleagues. The lack of support had a significant impact on nurses' decisions on whether to disclose the error and his/her recovery process. Therefore, a good support system is imperative in alleviating the emotional burden, promoting the disclosure process, and assisting nurses with reconciliation. This review also highlighted research gaps that encompass the characteristics of the support system preferred by nurses, and the scarcity of studies worldwide.

Evaluation of Quality of Life Following Placement of Self-Expanding Plastic Stents as a Bridge to Surgery in Patients Receiving Neoadjuvant Therapy for Esophageal Cancer

PubMed Central

Cannon, Robert M.; Brown, Russell E.; Ellis, Susan F.; Williams, Sharon; Scoggins, C.R.; Abbas, Abbas E.

2014-01-01

Purpose. To determine whether self-expanding plastic stent (SEPS) placement significantly improves quality of life and maintains optimal nutrition while allowing full-dose neoadjuvant therapy (NAT) in patients with esophageal cancer. Patients and Methods. A prospective, dual-institution, single-arm, phase II (http://ClinicalTrials.gov: NCT00727376) evaluation of esophageal cancer patients undergoing NAT prior to resection. All patients had a self-expanding polymer stent placed prior to NAT. The European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25, Functional Assessment of Cancer Therapy–Anorexia, and Functional Assessment of Cancer Therapy–General surveys were administered prior to stenting, within 1 week post-stent placement, and at the completion of neoadjuvant therapy. Results. Fifty-two patients were enrolled; 3 (5.8%) had stent migrations requiring replacement. There were no instances of esophageal erosion or perforation. All patients received some form of neoadjuvant therapy. Thirty-six (69%) received chemoradiation; 34 (93%) of these patients received the planned dose of chemotherapy, and 27 (75%) received the full planned dose of radiotherapy. There were 16 (31%) patients receiving chemotherapy alone; 12 (74%) of patients in the chemotherapy-alone group completed the planned dose of therapy. Conclusion. Placement of SEPS appears to provide significant improvement in quality of life related to dysphagia and eating restriction in patients with esophageal cancer undergoing neoadjuvant therapy. Consideration of SEPS instead of percutaneous feeding tube should be initiated as a first line in dysphagia palliation and NAT nutritional support. PMID:24567281

Responses to gestational weight management guidance: a thematic analysis of comments made by women in online parenting forums

PubMed Central

2014-01-01

Background The National Institute for Health and Clinical Excellence (NICE) published guidance on weight management in pregnancy in July 2010 (NICE public health guidance 27: 2010), and this received considerable press coverage across a range of media. This offered an opportunity to examine how gestational weight management guidance was received by UK women. Methods A thematic analysis was conducted of 400 posts made in UK-based parenting internet forums in the week following the publication of the NICE guidance. This allowed us to examine the naturally occurring comments from 202 women who posted about the guidance on public forums. Results Three main themes were identified and explored: i) Perceived control/responsibility ii) Risk perception iii) Confused messages. Conclusions Women differed in their perceptions of the level of control that they had over being overweight with some feeling responsible and motivated to maintain a healthy lifestyle. Others felt there were multiple factors influencing their weight issues beyond their control. There were reports of feeling guilty about the impact of weight on the growing baby and experiencing significant obesity stigma from the public and health professionals. Information about the risks of overweight and obesity in pregnancy were difficult messages for women to hear, and for health professionals to deliver. Women reported being confused by the messages that they received. Health messages need to be delivered sensitively to women, and health professionals need support and training to do this. Risk information should always be accompanied with clear advice and support to help women to manage their weight in pregnancy. PMID:24981024

Responses to gestational weight management guidance: a thematic analysis of comments made by women in online parenting forums.

PubMed

Arden, Madelynne A; Duxbury, Alexandra M S; Soltani, Hora

2014-06-30

The National Institute for Health and Clinical Excellence (NICE) published guidance on weight management in pregnancy in July 2010 (NICE public health guidance 27: 2010), and this received considerable press coverage across a range of media. This offered an opportunity to examine how gestational weight management guidance was received by UK women. A thematic analysis was conducted of 400 posts made in UK-based parenting internet forums in the week following the publication of the NICE guidance. This allowed us to examine the naturally occurring comments from 202 women who posted about the guidance on public forums. Three main themes were identified and explored: i) Perceived control/responsibility ii) Risk perception iii) Confused messages. Women differed in their perceptions of the level of control that they had over being overweight with some feeling responsible and motivated to maintain a healthy lifestyle. Others felt there were multiple factors influencing their weight issues beyond their control. There were reports of feeling guilty about the impact of weight on the growing baby and experiencing significant obesity stigma from the public and health professionals. Information about the risks of overweight and obesity in pregnancy were difficult messages for women to hear, and for health professionals to deliver. Women reported being confused by the messages that they received. Health messages need to be delivered sensitively to women, and health professionals need support and training to do this. Risk information should always be accompanied with clear advice and support to help women to manage their weight in pregnancy.

Allocating external financing for health: a discrete choice experiment of stakeholder preferences.

PubMed

Grépin, Karen A; Pinkstaff, Crossley B; Hole, Arne Risa; Henderson, Klara; Norheim, Ole Frithjof; Røttingen, John-Arne; Ottersen, Trygve

2018-02-01

Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how much weight should be placed on other country characteristics. Using an online discrete choice experiment designed to elicit preferences over country characteristics to guide decisions about the allocation of external financing for health, we find that stakeholders assign a great deal of importance to health inequalities and the burden of disease but put very little weight on income per capita. We also find considerable variation in preferences across stakeholders, with people from low- and middle-income countries putting more weight on the burden of disease and people from high-income countries putting more weight on health inequalities. These findings suggest that stakeholders put more weight on burden of disease and health inequalities than on income per capita in evaluating which countries should received external financing for health and that that people living in aid recipient may have different preferences than people living in donor countries. Donors may wish to take these differences in preferences in mind if they are reconsidering their aid allocation policies. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Experiences of the individual placement and support approach in persons with severe mental illness.

PubMed

Areberg, Cecilia; Björkman, Tommy; Bejerholm, Ulrika

2013-09-01

Across several research studies comparing the individual placement and support (IPS) approach to traditional vocational services, the approach has achieved employment outcomes superior to comparison conditions. However, to understand the efficacy of IPS, it is equally important to consider what is more or less effective as viewed by the IPS participants. To investigate participants' experiences of IPS participation and their experiences of receiving support from an employment specialist (ES). Interviews were conducted with 17 persons with severe mental illness. The interviews were subjected to qualitative content analysis. The principles of informed consent and the voluntary nature of participation were included as ethical considerations. Participation in IPS was associated with hope, meaning and an individualized support provided by the ES. The skills of the ES facilitated the relationship with the participant and the contact with the labour market. However, to make a change happen, everybody involved in IPS had to contribute. These findings have endorsed the guiding principles of IPS and emphasized the ES's role and skills during IPS as well as the participant's motivation. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

The development, evolution, and status of Holland's theory of vocational personalities: Reflections and future directions for counseling psychology.

PubMed

Nauta, Margaret M

2010-01-01

This article celebrates the 50th anniversary of the introduction of John L. Holland's (1959) theory of vocational personalities and work environments by describing the theory's development and evolution, its instrumentation, and its current status. Hallmarks of Holland's theory are its empirical testability and its user-friendliness. By constructing measures for operationalizing the theory's constructs, Holland and his colleagues helped ensure that the theory could be implemented in practice on a widespread basis. Empirical data offer considerable support for the existence of Holland's RIASEC types and their ordering among persons and environments. Although Holland's congruence hypotheses have received empirical support, congruence appears to have modest predictive power. Mixed support exists for Holland's hypotheses involving the secondary constructs of differentiation, consistency, and vocational identity. Evidence of the continued impact of Holland's theory on the field of counseling psychology, particularly in the area of interest assessment, can be seen from its frequent implementation in practice and its use by scholars. Ideas for future research and practice using Holland's theory are suggested.

Line segment extraction for large scale unorganized point clouds

NASA Astrophysics Data System (ADS)

Lin, Yangbin; Wang, Cheng; Cheng, Jun; Chen, Bili; Jia, Fukai; Chen, Zhonggui; Li, Jonathan

2015-04-01

Line segment detection in images is already a well-investigated topic, although it has received considerably less attention in 3D point clouds. Benefiting from current LiDAR devices, large-scale point clouds are becoming increasingly common. Most human-made objects have flat surfaces. Line segments that occur where pairs of planes intersect give important information regarding the geometric content of point clouds, which is especially useful for automatic building reconstruction and segmentation. This paper proposes a novel method that is capable of accurately extracting plane intersection line segments from large-scale raw scan points. The 3D line-support region, namely, a point set near a straight linear structure, is extracted simultaneously. The 3D line-support region is fitted by our Line-Segment-Half-Planes (LSHP) structure, which provides a geometric constraint for a line segment, making the line segment more reliable and accurate. We demonstrate our method on the point clouds of large-scale, complex, real-world scenes acquired by LiDAR devices. We also demonstrate the application of 3D line-support regions and their LSHP structures on urban scene abstraction.

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

Reasons and determinants for not receiving treatment for common mental disorders.

PubMed

van Beljouw, Ilse; Verhaak, Peter; Prins, Marijn; Cuijpers, Pim; Penninx, Brenda; Bensing, Jozien

2010-03-01

This study focused on patients in the general population whose anxiety or depressive disorder is untreated. It explored reasons for not receiving treatment and compared four groups of patients-three that did not receive treatment for different reasons (no problem perceived, no perceived need for care, and unmet need for care) and one that received treatment-regarding their predisposing, enabling, and need factors. Cross-sectional data were used for 743 primary care patients with current anxiety or depressive disorder from the Netherlands Study of Depression and Anxiety (NESDA). Diagnoses were confirmed with the Composite International Diagnostic Interview. Patients' perception of the presence of a mental problem, perceived need for care, service utilization, and reasons for not receiving treatment were assessed with the Perceived Need for Care Questionnaire. Forty-three percent of the respondents with a six-month anxiety or depression diagnosis did not receive treatment. Twenty-one percent of all respondents with depression or anxiety expressed a need for care but did not receive any. Preferring to manage the problem themselves was the most common reason for respondents to avoid seeking treatment. There were no significant differences in clinical need factors between treated patients and untreated patients with a perceived need for care. Compared with patients in the other two untreated groups, untreated patients with a perceived need for care were more hindered in regard to symptom severity, functional disability, and psychosocial functioning. General practitioners should pay considerable attention to patients whose need for care is unmet. Furthermore, findings support the implementation of patient empowerment in mental health care in order to contribute to easily accessible and patient-centered care.

Nesting doctoral students in collaborative North-South partnerships for health systems research.

PubMed

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

The European Union (EU) supports North-South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). The aim of this study was to explore the challenges of, and facilitating factors for, 'nesting' doctoral students in North-South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North-South projects. There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North-South partnerships as a contribution to the strengthening of local research capacity.

Airway Management Strategies for Brain-injured Patients Meeting Standard Criteria to Consider Extubation. A Prospective Cohort Study.

PubMed

McCredie, Victoria A; Ferguson, Niall D; Pinto, Ruxandra L; Adhikari, Neill K J; Fowler, Robert A; Chapman, Martin G; Burrell, Althea; Baker, Andrew J; Cook, Deborah J; Meade, Maureen O; Scales, Damon C

2017-01-01

Patients with acute brain injury are frequently capable of breathing spontaneously with minimal ventilatory support despite persistent neurological impairment. We sought to describe factors associated with extubation timing, success, and primary tracheostomy in these patients. We conducted a prospective multicenter observational cohort study in three academic hospitals in Toronto, Canada. Consecutive brain-injured adults receiving mechanical ventilation for at least 24 hours in three intensive care units were screened by study personnel daily for extubation consideration criteria. We monitored all patients until hospital discharge and used logistic regression models to examine associations with extubation failure and delayed extubation. Of 192 patients included, 152 (79%) were extubated and 40 (21%) received a tracheostomy without an extubation attempt. The rate of extubation failure within 72 hours was 32 of 152 (21%), which did not vary significantly between those extubated before (early; 6 of 37; 16.2%), within 24 hours (timely; 14 of 70; 20.0%), or more than 24 hours after meeting criteria to consider extubation (delayed; 12 of 45; 26.7%; P = 0.49). Delayed extubation was associated with lower a Glasgow Coma Scale (GCS) score at the time of consideration of extubation, absence of cough, and new positive sputum cultures. Factors independently associated with successful extubation were presence of cough (odds ratio [OR], 3.60; 95% confidence interval [CI], 1.42-9.09), fluid balance in prior 24 hours (OR, 0.75 per 1-L increase; 95% CI, 0.57-0.98), and age (OR, 0.97 per 10-yr increase; 95% CI, 0.95-0.99). A higher GCS score was not associated with successful extubation. Extubation success was predicted by younger age, presence of cough, and negative fluid balance, rather than GCS score at extubation. These results do not support prolonging intubation solely for low GCS score in brain-injured patients.

Automatic activation of alcohol cues by child maltreatment related words: a replication attempt in a different treatment setting.

PubMed

Potthast, Nadine; Neuner, Frank; Catani, Claudia

2017-01-03

A growing body of research attempts to clarify the underlying mechanisms of the association between emotional maltreatment and alcohol dependence (AD). In a preceding study, we found considerable support for a specific priming effect in subjects with AD and emotional abuse experiences receiving alcohol rehabilitation treatment. We concluded that maltreatment related cues can automatically activate an associative memory network comprising cues eliciting craving as well as alcohol-related responses. Generalizability of the results to other treatment settings remains unclear because of considerable differences in German treatment settings as well as insufficiently clarified influences of selection effects. As replication studies in other settings are necessary, the current study aimed to replicate the specific priming effect in a qualified detoxification sample. 22 AD subjects (n = 10 with emotional abuse vs. n = 12 without emotional abuse) participated in a priming experiment. Comparison data from 34 healthy control subjects were derived from the prior study. Contrary to our hypothesis, we did not find a specific priming effect. We could not replicate the result of an automatic network activation by maltreatment related words in a sample of subjects with AD and emotional abuse experiences receiving qualified detoxification treatment. This discrepancy might be attributed to reasons related to treatment settings as well as to methodological limitations. Future work is required to determine the generalizability of the specific priming effect before valid conclusions regarding automatic activation can be drawn.

Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.

PubMed

Miedema, Baukje; Easley, Julie

2012-06-01

The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization. Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces. A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers. The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.

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.

The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand.

PubMed

Turner, Nikki M; Charania, Nadia A; Chong, Angela; Stewart, Joanna; Taylor, Lynn

2017-01-01

Immunisation coverage rates vary considerably at the local level across New Zealand and challenges remain with effectively translating best available research evidence into public health practice. This study aimed to translate best practices from high performing general practices into strategies to improve childhood immunisation coverage among low performing practices. An intervention study was undertaken of general practices with low immunisation coverage rates and a high percentage of the enrolled population being of Māori ethnicity. Intervention groups received customised action plans and support for a 12 month period while control groups received 'business as usual' support. Structured interviews were conducted with key informants from all participating practices to understand current aspects related to childhood immunisation delivery and surveys were conducted to understand how the intervention worked. Collected data were thematically analysed. Ten sites were randomised to either intervention ( n  = 6) or control group ( n  = 4). Positive aspects of childhood immunisation delivery included high prioritisation at the practice and staff being pro-immunisation and knowledgeable. Key challenges experienced included inaccurate family contact information and discrepancies with referral processes to other providers. Other challenges noted were building rapport with families and vaccine hesitancy. The action plans included various strategies aimed to improve processes at the practice, contact and engagement with parents, and partnership development with local service providers. Creating customised action plans and providing support to providers were considered as helpful approaches when attempting to improve childhood immunisation coverage rates. Our study supports the notion that one strategy will not solely by itself improve childhood immunisation rates and highlights the importance of having a toolkit of strategies from which to draw from.

Mechanical ventilation during extracorporeal membrane oxygenation.

PubMed

Schmidt, Matthieu; Pellegrino, Vincent; Combes, Alain; Scheinkestel, Carlos; Cooper, D Jamie; Hodgson, Carol

2014-01-21

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed to a treatment effect in ECMO trials. Protective lung ventilation strategies established for non-ECMO-supported respiratory failure patients may not be optimal for more severe forms of respiratory failure requiring ECMO support. The influence of positive end-expiratory pressure on the reduction of the left ventricular compliance may be a matter of concern for patients receiving ECMO support for cardiac failure. The objectives of this review were to describe potential mechanisms for lung injury during ECMO for respiratory or cardiac failure, to assess the possible benefits from the use of ultra-protective lung ventilation strategies and to review published guidelines and expert opinions available on mechanical ventilation-specific management of patients requiring ECMO, including mode and ventilator settings. Articles were identified through a detailed search of PubMed, Ovid, Cochrane databases and Google Scholar. Additional references were retrieved from the selected studies. Growing evidence suggests that mechanical ventilation settings are important in ECMO patients to minimize further lung damage and improve outcomes. An ultra-protective ventilation strategy may be optimal for mechanical ventilation during ECMO for respiratory failure. The effects of airway pressure on right and left ventricular afterload should be considered during venoarterial ECMO support of cardiac failure. Future studies are needed to better understand the potential impact of invasive mechanical ventilation modes and settings on outcomes.

Mechanical ventilation during extracorporeal membrane oxygenation

PubMed Central

2014-01-01

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed to a treatment effect in ECMO trials. Protective lung ventilation strategies established for non-ECMO-supported respiratory failure patients may not be optimal for more severe forms of respiratory failure requiring ECMO support. The influence of positive end-expiratory pressure on the reduction of the left ventricular compliance may be a matter of concern for patients receiving ECMO support for cardiac failure. The objectives of this review were to describe potential mechanisms for lung injury during ECMO for respiratory or cardiac failure, to assess the possible benefits from the use of ultra-protective lung ventilation strategies and to review published guidelines and expert opinions available on mechanical ventilation-specific management of patients requiring ECMO, including mode and ventilator settings. Articles were identified through a detailed search of PubMed, Ovid, Cochrane databases and Google Scholar. Additional references were retrieved from the selected studies. Growing evidence suggests that mechanical ventilation settings are important in ECMO patients to minimize further lung damage and improve outcomes. An ultra-protective ventilation strategy may be optimal for mechanical ventilation during ECMO for respiratory failure. The effects of airway pressure on right and left ventricular afterload should be considered during venoarterial ECMO support of cardiac failure. Future studies are needed to better understand the potential impact of invasive mechanical ventilation modes and settings on outcomes. PMID:24447458

Prospective Randomized Phase II Parallel Study of Vinorelbine Maintenance Therapy versus Best Supportive Care in Advanced Non-Small Cell Lung Cancer.

PubMed

Khosravi, Adnan; Esfahani-Monfared, Zahra; Seifi, Sharareh; Khodadad, Kian

2017-01-01

Maintenance strategy has been used to improve survival in non-small cell lung cancer (NSCLC). We investigated whether switch maintenance therapy with vinorelbine improved progression free survival (PFS) after first-line chemotherapy with gemcitabine plus carboplatin. In this single blind, parallel, phase 2, randomized trial, patients with NSCLC pathology, age >18 years, Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0-2, and advanced stage (IIIB and IV) were treated with up to 6 cycles of gemcitabine 1250 mg/m 2 (day 1 and 8) plus carboplatin AUC 5 (day 1) every 3 weeks. Patients who did not show progression after first-line chemotherapy were randomly assigned to receive switch maintenance with vinorelbine (25 mg/m 2 , day 1, 15) or the best supportive care until disease progression. A total of 100 patients were registered, of whom 34 had a non-progressive response to first-line chemotherapy and randomly received maintenance vinorelbine (n=19) or best supportive care (n=15). The hazard ratio of PFS in the vinorelbine group relative to the best supportive care group was 1.097 (95% confidence interval = 0.479-2.510; P-value =0.827). There was no significant difference between the overall survival for the two groups (P=0.068). Switch maintenance strategies are beneficial, but defining the right candidates for treatment is a problem. Moreover, the trial designs do not always reflect the real-world considerations. Switch maintenance therapy with vinorelbine, though had tolerable toxicity, did not improve PFS in patients with NSCLC. Therefore, other agents should be considered in this setting.

Surgical Management of the Pediatric Cochlear Implant Patient.

ERIC Educational Resources Information Center

Cohen, Seth M.; Haynes, David S.

2003-01-01

This article discusses the surgical management of children receiving cochlear implants. It identifies preoperative considerations to select patients likely to benefit, contraindications, some new surgical techniques, complications, special considerations (otitis media, meningitis, head growth, inner ear malformations, and cochlear obstruction).…

Male caregivers of patients with breast and gynecologic cancer: experiences from caring for their spouses and partners.

PubMed

Lopez, Violeta; Copp, Gina; Molassiotis, Alexander

2012-01-01

There is considerable evidence demonstrating the negative effects of caregiving particularly in the areas of psychological well-being and quality of life of family caregivers of patients with cancer. However, there is little work on male caregivers' subjective experience of caring for family members with cancer, and little is known on how caregivers experience the caring over time. The objective of the study was to explore male spouses'/partners' experience of caring for their wives/partners with breast and gynecologic cancer over a 1-year period. An exploratory longitudinal qualitative descriptive design using face-to-face interviews of 15 spouses/partners was used in this study. Content analysis of the transcribed data was conducted to extract significant categories and themes. Varying degrees of interrelated cognitive, physical, and psychological impact were experienced by caregivers that extended to 12 months. Gender-specific attitudes prevented male caregivers from supporting their own self. Male caregivers dealt with problems that arose in the caregiving congruent with their masculinity, such as minimizing disruptions, focusing on tasks, and keeping their own stress to themselves. Male caregivers as a separate group with their own needs have not received much attention in the cancer literature, and their concerns and challenges may differ from those of female caregivers. Male caregivers' concerns and challenges must be taken into consideration when planning appropriate interventions to support them in their caregiving role.

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.

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa

PubMed Central

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors—such as age, health status and coping styles—our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family’s changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level. PMID:27741239

46 CFR 283.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... working capital. However, this policy also takes into consideration the operators' need to attract new... POLICY FOR OPERATORS RECEIVING OPERATING-DIFFERENTIAL SUBSIDY § 283.1 Purpose. (a) The rules of this part... marine. The policy contained herein takes into consideration the operators' contractual obligations to...

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.

Medical Student Perspectives of Active Learning: A Focus Group Study.

PubMed

Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

2017-01-01

Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

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

Kim, G.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

WE-A-304-02: Strategies and Technologies for Cranial Radiosurgery Planning: Gamma Knife

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

Schlesinger, D.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

Effect of photodynamic therapy on mouse platelets

NASA Astrophysics Data System (ADS)

Zhou, Chuannong; Chi, Shunji; Deng, Jinsheng; Zhang, Hua; Liang, Junlin; Ha, Xian-wen

1993-03-01

Normal mice received hematoporphyrin derivative (10 mg/kg iv) immediately, 24 or 48 hrs prior to red light irradiation. The blood was collected and the platelet-rich plasma was irradiated by red light (100 J/cm2). The platelets were fixed immediately, 8 or 16 hrs after irradiation, and processed for EM examination. In comparison with those of control mice, the platelets of all experimental mice showed structural changes: 16 hrs after irradiation all platelets were necrotized; 8 hrs after irradiation almost one fourth of the platelets were necrotized and the remaining were considerably damaged; immediately after irradiation a small number of platelets became necrotic and most other platelets were swollen and deformed, often with many cytoplasmic projections and considerable dilatation of the canalicular membrane system. Our findings provided a clear evidence that platelets are highly sensitive to PDT action and can be directly and rapidly injured by PDT even in the absence of vascular endothelial cells. Our results give firm support to the hypothesis that both endothelial cells and platelets may play an important role in the initiation of early vascular damage and microcirculatory alterations induced by PDT in vivo.

Link Analysis of High Throughput Spacecraft Communication Systems for Future Science Missions

NASA Technical Reports Server (NTRS)

Simons, Rainee N.

2015-01-01

NASA's plan to launch several spacecrafts into low Earth Orbit (LEO) to support science missions in the next ten years and beyond requires down link throughput on the order of several terabits per day. The ability to handle such a large volume of data far exceeds the capabilities of current systems. This paper proposes two solutions, first, a high data rate link between the LEO spacecraft and ground via relay satellites in geostationary orbit (GEO). Second, a high data rate direct to ground link from LEO. Next, the paper presents results from computer simulations carried out for both types of links taking into consideration spacecraft transmitter frequency, EIRP, and waveform; elevation angle dependent path loss through Earths atmosphere, and ground station receiver GT.

Link Analysis of High Throughput Spacecraft Communication Systems for Future Science Missions

NASA Technical Reports Server (NTRS)

Simons, Rainee N.

2015-01-01

NASA's plan to launch several spacecraft into low Earth Orbit (LEO) to support science missions in the next ten years and beyond requires down link throughput on the order of several terabits per day. The ability to handle such a large volume of data far exceeds the capabilities of current systems. This paper proposes two solutions, first, a high data rate link between the LEO spacecraft and ground via relay satellites in geostationary orbit (GEO). Second, a high data rate direct to ground link from LEO. Next, the paper presents results from computer simulations carried out for both types of links taking into consideration spacecraft transmitter frequency, EIRP, and waveform; elevation angle dependent path loss through Earths atmosphere, and ground station receiver GT.

Exporting the Buyers Health Care Action Group Purchasing Model: Lessons from Other Communities

PubMed Central

Christianson, Jon B; Feldman, Roger

2005-01-01

When first implemented in Minneapolis and St. Paul, Minnesota, the Buyers Health Care Action Group's (BHCAG) purchasing approach received considerable attention as an employer-managed, consumer-driven health care model embodying many of the principles of managed competition. First BHCAG and, later, a for-profit management company attempted to export this model to other communities. Their efforts were met with resistance from local hospitals and, in many cases, apathy by employers who were expected to be supportive. This experience underscores several difficulties that appear to be inherent in implementing purchasing models based on competing care systems. It also, once again, suggests caution in drawing lessons from community-level experiments in purchasing health care. PMID:15787957

Developing software to use parallel processing effectively. Final report, June-December 1987

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

Center, J.

1988-10-01

This report describes the difficulties involved in writing efficient parallel programs and describes the hardware and software support currently available for generating software that utilizes processing effectively. Historically, the processing rate of single-processor computers has increased by one order of magnitude every five years. However, this pace is slowing since electronic circuitry is coming up against physical barriers. Unfortunately, the complexity of engineering and research problems continues to require ever more processing power (far in excess of the maximum estimated 3 Gflops achievable by single-processor computers). For this reason, parallel-processing architectures are receiving considerable interest, since they offer high performancemore » more cheaply than a single-processor supercomputer, such as the Cray.« less

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 flexible framework for process-based hydraulic and water quality modeling of stormwater green infrastructure performance

EPA Science Inventory

Background Models that allow for design considerations of green infrastructure (GI) practices to control stormwater runoff and associated contaminants have received considerable attention in recent years. While popular, generally, the GI models are relatively simplistic. However,...

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

PubMed

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

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.

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.

A further experimental study of the antisilicotic effect of glutamate.

PubMed Central

Morosova, K I; Katsnelson, B A; Rotenberg YuS; Belobragina, G V

1984-01-01

Two groups of rats were exposed to quartz dust for six months and in addition one group was given drinking water containing 1.5% sodium glutamate while the second received only water. In the rats receiving glutamate we observed (a) evidence for a considerably reduced cytotoxic effect of the quartz on cells obtained by bronchopulmonary lavage, (b) a reduction in dust retention in the lungs, especially in the tracheobronchial lymph nodes, (c) a considerable reduction in the weight gain in the lungs and in their hydroxyproline and lipid contents, and (d) the inhibition of the formation of silicotic nodules. Polarographic studies of the oxygen consumption of peritoneal macrophages from rats receiving glutamate showed that glutamate prevents the adverse effects of quartz on mitochondrial oxidative processes. PMID:6093851

Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural Pakistan.

PubMed

Rabbani, Fauziah; Shipton, Leah; Aftab, Wafa; Sangrasi, Kashif; Perveen, Shagufta; Zahidie, Aysha

2016-08-17

Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision. Twenty-nine lady health supervisors enrolled in Nigraan completed open-ended structured surveys with questions exploring factors that affect their motivation. Thematic analysis was conducted using a conceptual framework categorizing motivating factors at individual, community, and health system levels. Supportive supervision, recognition, training, logistics, and salaries are community and health system motivating factors for lady health supervisors. Lady health supervisors are motivated by both their role in providing supportive supervision to lady health workers and by the supervisory support received from their coordinators and managers. Family support, autonomy, and altruism are individual level motivating factors. Health system factors, including supportive supervision, are crucial to improving lady health supervisor motivation. As health worker motivation influences their performance, evaluating the impact of health system interventions on community health worker motivation is important to improving the effectiveness of community health worker programs.

A piece of the action: Modulation of sensory-motor regions by action idioms and metaphors

PubMed Central

Desai, Rutvik H.; Conant, Lisa L.; Binder, Jeffrey R.; Park, Haeil; Seidenberg, Mark S.

2013-01-01

The idea that the conceptual system draws on sensory and motor systems has received considerable experimental support in recent years. Whether the tight coupling between sensory-motor and conceptual systems is modulated by factors such as context or task demands is a matter of controversy. Here, we tested the context sensitivity of this coupling by using action verbs in three different types of sentences in an fMRI study: literal action, apt but non-idiomatic action metaphors, and action idioms. Abstract sentences served as a baseline. The result showed involvement of sensory-motor areas for literal and metaphoric action sentences, but not for idiomatic ones. A trend of increasing sensory-motor activation from abstract to idiomatic to metaphoric to literal sentences was seen. These results support a gradual abstraction process whereby the reliance on sensory-motor systems is reduced as the abstractness of meaning as well as conventionalization is increased, highlighting the context sensitive nature of semantic processing. PMID:23891645

Altered brain-gut axis in autism: comorbidity or causative mechanisms?

PubMed

Mayer, Emeran A; Padua, David; Tillisch, Kirsten

2014-10-01

The concept that alterated communications between the gut microbiome and the brain may play an important role in human brain disorders has recently received considerable attention. This is the result of provocative preclinical and some clinical evidence supporting early hypotheses about such communication in health and disease. Gastrointestinal symptoms are a common comorbidity in patients with autism spectrum disorders (ASD), even though the underlying mechanisms are largely unknown. In addition, alteration in the composition and metabolic products of the gut microbiome has long been implicated as a possible causative mechanism contributing to ASD pathophysiology, and this hypothesis has been supported by several recently published evidence from rodent models of autism induced by prenatal insults to the mother. Recent evidence in one such model involving maternal infection, that is characterized by alterations in behavior, gut physiology, microbial composition, and related metabolite profile, suggests a possible benefit of probiotic treatment on several of the observed abnormal behaviors. © 2014 WILEY Periodicals, Inc.

A piece of the action: modulation of sensory-motor regions by action idioms and metaphors.

PubMed

Desai, Rutvik H; Conant, Lisa L; Binder, Jeffrey R; Park, Haeil; Seidenberg, Mark S

2013-12-01

The idea that the conceptual system draws on sensory and motor systems has received considerable experimental support in recent years. Whether the tight coupling between sensory-motor and conceptual systems is modulated by factors such as context or task demands is a matter of controversy. Here, we tested the context sensitivity of this coupling by using action verbs in three different types of sentences in an fMRI study: literal action, apt but non-idiomatic action metaphors, and action idioms. Abstract sentences served as a baseline. The result showed involvement of sensory-motor areas for literal and metaphoric action sentences, but not for idiomatic ones. A trend of increasing sensory-motor activation from abstract to idiomatic to metaphoric to literal sentences was seen. These results support a gradual abstraction process whereby the reliance on sensory-motor systems is reduced as the abstractness of meaning as well as conventionalization is increased, highlighting the context sensitive nature of semantic processing. © 2013.

"I'M OPENING MY ARMS RATHER THAN PUSHING AWAY:" PERCEIVED BENEFITS OF A MINDFULNESS-BASED INTERVENTION AMONG HOMELESS WOMEN AND YOUNG CHILDREN.

PubMed

Alhusen, Jeanne L; Norris-Shortle, Carole; Cosgrove, Kim; Marks, Lauren

2017-05-01

Family homelessness is associated with adverse outcomes in mothers and their young children. Evidence-based programs are needed to support the socioemotional needs of these families. The purpose of this qualitative study was to explore the perceived benefits of participating in a mindfulness program in mother-child dyads receiving services at a therapeutic nursery serving homeless children under the age of 3 years. A convenience sample of 17 predominantly African American mothers participated in in-depth qualitative interviews. Four themes were derived from the data regarding the perceived benefits of the mindfulness program: "me" time, maternal self-regulation, dyadic connectedness, and child well-being. Results demonstrate the perceived benefits of mindfulness on the parent-child relationship and have important implications for families at an increased risk of adverse outcomes. Because homelessness and residential instability confer considerable risk for young children, interventions to support effective parenting are critical. © 2017 Michigan Association for Infant Mental Health.

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

PubMed

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

2015-01-01

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

The perspectives of older Greek-Australians toward changes in the nature of family support: implications for family care policies.

PubMed

Walker, Ruth; Newman, Lareen; Tsianikas, Michael; Panagiotopoulos, Georgia; Hurley, Catherine

2013-01-01

Internationally, public policies encourage "aging in place," and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n = 27) and five focus groups (n = 63 total participants) with older Greek-Australians in modern Greek. While "cultures of care" remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.

Acceptability and Feasibility of HIV Self-Testing Among Transgender Women in San Francisco: A Mixed Methods Pilot Study.

PubMed

Lippman, Sheri A; Moran, Lissa; Sevelius, Jae; Castillo, Leslie S; Ventura, Angel; Treves-Kagan, Sarah; Buchbinder, Susan

2016-04-01

An estimated one in four transgender women (trans women) in the U.S. are infected with HIV. Rates of HIV testing are not commensurate with their risk, necessitating alternative strategies for early detection and care. We explored the feasibility and acceptability of HIV self-testing (HIVST) with 50 HIV-negative adult trans women in San Francisco. Participants received three self-test kits to perform once a month. Acceptability and behavioral surveys were collected as were 11 in-depth interviews (IDIs). Among 50 participants, 44 reported utilizing HIVST at least once; 94 % reported the test easy to use; 93 % said results were easy to read; and 91 % would recommend it to others. Most participants (68 %) preferred HIVST to clinic-based testing, although price was a key barrier to uptake. IDIs revealed a tension between desires for privacy versus support found at testing sites. HIVST for trans women was acceptable and feasible and requires careful consideration of linkage to support services.

The use of financial incentives in Australian general practice.

PubMed

Kecmanovic, Milica; Hall, Jane P

2015-05-18

To examine the uptake of financial incentive payments in general practice, and identify what types of practitioners are more likely to participate in these schemes. Analysis of data on general practitioners and GP registrars from the Medicine in Australia - Balancing Employment and Life (MABEL) longitudinal panel survey of medical practitioners in Australia, from 2008 to 2011. Income received by GPs from government incentive schemes and grants and factors associated with the likelihood of claiming such incentives. Around half of GPs reported receiving income from financial incentives in 2008, and there was a small fall in this proportion by 2011. There was considerable movement into and out of the incentives schemes, with more GPs exiting than taking up grants and payments. GPs working in larger practices with greater administrative support, GPs practising in rural areas and those who were principals or partners in practices were more likely to use grants and incentive payments. Administrative support available to GPs appears to be an increasingly important predictor of incentive use, suggesting that the administrative burden of claiming incentives is large and not always worth the effort. It is, therefore, crucial to consider such costs (especially relative to the size of the payment) when designing incentive payments. As market conditions are also likely to influence participation in incentive schemes, the impact of incentives can change over time and these schemes should be reviewed regularly.

Corticosterone predicts foraging behavior and parental care in macaroni penguins.

PubMed

Crossin, Glenn T; Trathan, Phil N; Phillips, Richard A; Gorman, Kristen B; Dawson, Alistair; Sakamoto, Kentaro Q; Williams, Tony D

2012-07-01

Corticosterone has received considerable attention as the principal hormonal mediator of allostasis or physiological stress in wild animals. More recently, it has also been implicated in the regulation of parental care in breeding birds, particularly with respect to individual variation in foraging behavior and provisioning effort. There is also evidence that prolactin can work either inversely or additively with corticosterone to achieve this. Here we test the hypothesis that endogenous corticosterone plays a key physiological role in the control of foraging behavior and parental care, using a combination of exogenous corticosterone treatment, time-depth telemetry, and physiological sampling of female macaroni penguins (Eudyptes chrysolophus) during the brood-guard period of chick rearing, while simultaneously monitoring patterns of prolactin secretion. Plasma corticosterone levels were significantly higher in females given exogenous implants relative to those receiving sham implants. Increased corticosterone levels were associated with significantly higher levels of foraging and diving activity and greater mass gain in implanted females. Elevated plasma corticosterone was also associated with an apparent fitness benefit in the form of increased chick mass. Plasma prolactin levels did not correlate with corticosterone levels at any time, nor was prolactin correlated with any measure of foraging behavior or parental care. Our results provide support for the corticosterone-adaptation hypothesis, which predicts that higher corticosterone levels support increased foraging activity and parental effort.

An Environment for Hardware-in-the-Loop Formation Navigation and Control Simulation

NASA Technical Reports Server (NTRS)

Burns, Rich

2004-01-01

Recent interest in formation flying satellite systems has spurred a considerable amount of research in the relative navigation and control of satellites. Development in this area has included new estimation and control algorithms as well as sensor and actuator development specifically geared toward the relative control problem. This paper describes a simulation facility, the Formation Flying Testbed (FFTB) at NASA's Goddard Space Flight Center, which allows engineers to test new algorithms for the formation flying problem with relevant GN&C hardware in a closed loop simulation. The FFTB currently supports the injection of GPS receiver hardware into the simulation loop, and support for satellite crosslink ranging technology is at a prototype stage. This closed-loop, hardware inclusive simulation capability permits testing of navigation and control software in the presence of the actual hardware with which the algorithms must interact. This capability provides the navigation or control developer with a perspective on how the algorithms perform as part of the closed-loop system. In this paper, the overall design and evolution of the FFTB are presented. Each component of the FFTB is then described in detail. Interfaces between the components of the FFTB are shown and the interfaces to and between navigation and control software are described in detail. Finally, an example of closed-loop formation control with GPS receivers in the loop is presented and results are analyzed.

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.

Interfacial contributions in lignocellulosic firber-reinforced polyurethane composites

Treesearch

Timothy G. Rials; Michael P. Wolcott; John M. Nassar

2001-01-01

Whereas lignocellulosic fibers have received considerable attention as a reinforcing agent in thermoplastic composites, their applicability to reactive polymer systems remains of considerable interest. The hydroxyl-rich nature of natural lignocellulosic fibers suggests that they are particularly useful in thermsetting systems such as polyurethanes. To further this...

23 CFR 650.709 - Special considerations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... candidates in States that have not previously been allocated discretionary bridge funds. In addition, consideration will be given to candidates that receive additional funds or contributions from local, State... share of the project. These funds or contributions may be used to reduce the total project cost for use...

River Rampage: Navigating Your Off-Site Adventure.

ERIC Educational Resources Information Center

Wheat, Ann; Munoz-Weingarten, Sandy

1996-01-01

The City of Phoenix offers a five-day river-based camping experience to at-risk and disabled teens. Describes how professional river outfitters are contracted to run the trips, staffing considerations, liability and safety considerations, and camper orientation. Evaluation showed that participants received lasting measurable benefits, including…

Multidisciplinary research in the space sciences

NASA Technical Reports Server (NTRS)

Broecker, W. S.; Flynn, G. W.

1983-01-01

Research activities were carried out in the following areas during this reporting period: (1) astrophysics; (2) climate and atmospheric modeling; and (3) climate applications of earth observations & geological studies. An ultra-low-noise 115 GHz receiver based upon a superconducting tunnel diode mixer has been designed and constructed. The first laboratory tests have yielded spectacular results: a single-sideband noise temperature of 75 K considerably more sensitive than any other receiver at this frequency. The receiver will replace that currently in use on the Columbia-GISS CO Sky Survey telescope. The 1.2 meter millimeter-wave telescope at Columbia University has been used to complete two large-scale surveys of molecular matter in the part of the inner galaxy which is visible from the Northern hemisphere (the first galactic quadrant); one of the distant galaxy and one of the solar neighborhood. The research conducted during the past year in the climate and atmospheric modeling programs has been focused on the development of appropriate atmospheric and upper ocean models, and preliminary applications of these models. Principal models are a one-dimensional radiative-convective model, a three-dimensional global climate model, and an upper ocean model. During the past year this project has focused on development of 2-channel satellite analysis methods and radiative transfer studies in support of multichannel analysis techniques.

Effects of saltcedar invasion and biological control on small mammals

USDA-ARS?s Scientific Manuscript database

Effects of invasive saltcedars (Tamarix spp.) on bird populations and communities have received considerable interest, but impacts on other vertebrate taxa have received less attention. Moreover, only one published study examined effects on vertebrates of biological control efforts directed at saltc...

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention

PubMed Central

2013-01-01

Background Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body’s ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women’s childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Methods/design Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4–6 weeks after birth. Discussion This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women’s childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Trial registration Australian New Zealand Controlled Trials Registry ACTRN12612000526875. PMID:24139191

Development of the parental needs scale for rare diseases: a tool for measuring the supportive care needs of parents caring for a child with a rare disease.

PubMed

Pelentsov, Lemuel J; Fielder, Andrea L; Laws, Thomas A; Esterman, Adrian J

2016-01-01

Children and families affected by rare diseases have received scant consideration from the medical, scientific, and political communities, with parents' needs especially having received little attention. Affected parents often have limited access to information and support and appropriate health care services. While scales to measure the needs of parents of children with chronic illnesses have been developed, there have been no previous attempts to develop a scale to assess the needs of parents of children with rare diseases. To develop a scale for measuring the supportive care needs of parents of children with rare diseases. A total of 301 responses to our Parental Needs Survey were randomly divided into two halves, one for exploratory factor analysis and the other for confirmatory factor analysis (CFA). After removing unsuitable items, exploratory factor analysis was undertaken to determine the factor structure of the data. CFA using structural equation modeling was then undertaken to confirm the factor structure. Seventy-two items were entered into the CFA, with a scree plot showing a likely four-factor solution. The results provided four independent subscales of parental needs: Understanding the disease (four items); Working with health professionals (four items); Emotional issues (three items); and Financial needs (three items). The structural equation modeling confirmed the suitability of the four-factor solution and demonstrated that the four subscales could be added to provide an overall scale of parental need. This is the first scale developed to measure the supportive care needs of parents of children with rare diseases. The scale is suitable for use in surveys to develop policy, in individual clinical assessments, and, potentially, for evaluating new programs. Measuring the supportive care needs of parents caring for a child with a rare disease will hopefully lead to better physical and psychological health outcomes for parents and their affected children.

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.

Making the Case for Laws That Improve Health: A Framework for Public Health Law Research

PubMed Central

Burris, Scott; Wagenaar, Alexander C; Swanson, Jeffrey; Ibrahim, Jennifer K; Wood, Jennifer; Mello, Michelle M

2010-01-01

Context: Public health law has received considerable attention in recent years and has become an essential field in public health. Public health law research, however, has received less attention. Methods: Expert commentary. Findings: This article explores public health law research, defined as the scientific study of the relation of law and legal practices to population health. The article offers a logic model of public health law research and a typology of approaches to studying the effects of law on public health. Research on the content and prevalence of public health laws, processes of adopting and implementing laws, and the extent to which and mechanisms through which law affects health outcomes can use methods drawn from epidemiology, economics, sociology, and other disciplines. The maturation of public health law research as a field depends on methodological rigor, adequate research funding, access to appropriate data sources, and policymakers’ use of research findings. Conclusions: Public health law research is a young field but holds great promise for supporting evidence-based policymaking that will improve population health. PMID:20579282

Dietary Sodium in Chronic Kidney Disease: A Comprehensive Approach

PubMed Central

Wright, Julie A.; Cavanaugh, Kerri L.

2010-01-01

Despite existing guidelines, dietary sodium intake among people worldwide often exceeds recommended limits. Research evidence is growing in both animal and human studies showing indirect and direct adverse consequences of high dietary sodium on the kidney. In patients with kidney disease, dietary sodium may have important effects on proteinuria, efficacy of antiproteinuric pharmacologic therapy, hypertension control, maintaining an optimal volume status, and immunosuppressant therapy. Dietary sodium intake is an important consideration in patients with all stages of chronic kidney disease, including those receiving dialysis therapy or those who have received a kidney transplant. We review in detail the dietary sodium recommendations suggested by various organizations for patients with kidney disease. Potential barriers to successfully translating current sodium intake guidelines into practice include poor knowledge about the sodium content of food among both patients and providers, complex labeling information, patient preferences related to taste, and limited support for modifications in public policy. Finally, we offer existing and potential solutions that may assist providers in educating and empowering patients to effectively manage their dietary sodium intake. PMID:20557489

Inner conflict in patients receiving oral anticancer agents: a qualitative study.

PubMed

Yagasaki, Kaori; Komatsu, Hiroko; Takahashi, Tsunehiro

2015-04-14

To explore the experiences of patients receiving oral anticancer agents. A qualitative study using semistructured interviews with a grounded theory approach. A university hospital in Japan. 14 patients with gastric cancer who managed their cancer with oral anticancer agents. Patients with cancer experienced inner conflict between rational belief and emotional resistance to taking medication due to confrontation with cancer, doubt regarding efficacy and concerns over potential harm attached to use of the agent. Although they perceived themselves as being adherent to medication, they reported partial non-adherent behaviours. The patients reassessed their lives through the experience of inner conflict and, ultimately, they recognised their role in medication therapy. Patients with cancer experienced inner conflict, in which considerable emotional resistance to taking their medication affected their occasional non-adherent behaviours. In patient-centred care, it is imperative that healthcare providers understand patients' inner conflict and inconsistency between their subjective view and behaviour to support patient adherence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

78 FR 16765 - Community Reinvestment Act; Interagency Questions and Answers Regarding Community Reinvestment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... lending test rating, and the other addresses the quantitative consideration given to a certain type of... activities would receive when examiners considered them, not the quantitative consideration that those... quantitative) in the institution's CRA evaluation. As a result, such financial institutions may have been...

Interfacial contributions in lignocellulosic fiber-reinforced polyurethane composites

Treesearch

Timothy G. Rials; Michael P. Wolcott; John M. Nassar

2001-01-01

Whereas lignocellulosic fibers have received considerable attention as a rein- forcing agent in thermoplastic composites, their applicability to reactive polymer systems remains of considerable interest. The hydroxyl-rich nature of natural lignocellulosic fibers suggests that they are particularly useful in thermosetting systems such as polyurethanes. To further this...

76 FR 23335 - Wilderness Stewardship Plan/Environmental Impact Statement, Sequoia and Kings Canyon National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-26

... planning and environmental impact analysis process required to inform consideration of alternative... 5, 1996. Based on an analysis of the numerous scoping comments received, and with consideration of a... proper food storage; party size; camping and campsites; human waste management; stock use; meadow...

Ethical Considerations in Filing Personal Bankruptcy: A Hypothetical Case Study

ERIC Educational Resources Information Center

Landry, Robert J., III

2012-01-01

A great deal of research by legal studies scholars pertains to employment law, international law, and corporate governance, as well as other fields including ethics and international law. The fields typically addressed are very important and rightfully receive considerable attention in the scholarship and textbooks. However, bankruptcy as a…

26 CFR 1.848-0 - Outline of regulations under section 848.

Code of Federal Regulations, 2010 CFR

2010-04-01

... certain reinsurance agreements. (b) Gross amount of premiums and other consideration. (1) General rule. (2... the payment of premiums. (iii) Retired lives reserves. (4) Deferred and uncollected premiums. (c... excluded from the gross amount of premiums and other consideration. (1) In general. (2) Amounts received or...

Acoustic transmitter and receiver performance in freshwater and estuarine environments

EPA Science Inventory

We report on the performance of passive acoustic receivers intended to detect the passage of 281 acoustically tagged migratory salmonids in two Oregon coastal watersheds. We found that ambient acoustic noise can vary considerably with location, and that “sync” pulses thought to ...

78 FR 43875 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... that the Commission received the following electric corporate filings: Docket Numbers: EC13-129-000... Expedited Consideration and Confidential Treatment. Filed Date: 7/12/13. Accession Number: 20130712-5183... Commission received the following electric rate filings: Docket Numbers: ER13-1970-000. Applicants: PJM...

78 FR 16847 - Combined Notice of Filings #2

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... that the Commission received the following electric corporate filings: Docket Numbers: EC13-79-000... Expedited Consideration and Confidential Treatment. Filed Date: 3/11/13. Accession Number: 20130311-5080.... ET 4/1/13. Take notice that the Commission received the following electric rate filings: Docket...

The development of an advanced generic solar dynamic heat receiver thermal model

NASA Technical Reports Server (NTRS)

Wu, Y. C.; Roschke, E. J.; Kohout, L.

1988-01-01

An advanced generic solar dynamic heat receiver thermal model under development which can analyze both orbital transient and orbital average conditions is discussed. This model can be used to study advanced receiver concepts, evaluate receiver concepts under development, analyze receiver thermal characteristics under various operational conditions, and evaluate solar dynamic system thermal performances in various orbit conditions. The model and the basic considerations that led to its creation are described, and results based on a set of baseline orbit, configuration, and operational conditions are presented to demonstrate the working of the receiver model.

Acoustic-optic spectrometer. 1: Noise contributions and system consideration

NASA Technical Reports Server (NTRS)

Chin, G.

1984-01-01

An acousto-optic spectrometer (AOS) used as an IF spectrometer to a heterodyne receiver is modeled as a total power multi-channel integrating receiver. Systematic noise contributions common to all total power, time integrating receivers, as well as noise terms unique to the use of optical elements and photo-detectors in an AOS are identified and discussed. In addition, degradation of signal-to-noise ratio of an unbalanced Dicke receiver compared to a balanced Dicke receiver is found to be due to gain calibration processing and is not an instrumental effect.

Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group.

PubMed

Halpern, M T; Cifaldi, M A; Kvien, T K

2009-06-01

Rheumatoid arthritis (RA) causes considerable disability and often results in loss of work capacity and productivity. This study evaluated the impact of adalimumab, a tumour necrosis factor antagonist with demonstrated efficacy in RA, on long-term employment. Data from an open-label extension study (DE033) of 486 RA patients receiving adalimumab monotherapy who previously did not respond to at least one disease-modifying antirheumatic drug (DMARD) and had baseline work status information were compared with data from 747 RA patients receiving DMARD treatment in a Norway-based longitudinal registry. Primary outcomes included the time patients continued working at least part time and the likelihood of stopping work. Secondary outcomes included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) responses and disease remission. Outcomes were compared 6, 12 and 24 months after enrolment. During a 24-month period, the 158 patients who received adalimumab and were working at baseline worked 7.32 months longer (95% CI 4.8 to 9.1) than did the 180 patients treated with DMARDs, controlling for differences in baseline characteristics. Regardless of baseline work status, patients receiving adalimumab worked 2.0 months longer (95% CI 1.3 to 2.6) and were significantly less likely to stop working than those receiving DMARDs (HR 0.36 (95% CI -0.30 to 0.42) for all patients and 0.36 (95% CI 0.15 to 0.85) for patients working at baseline, respectively). The patients who received adalimumab were also considerably more likely to achieve ACR responses and disease remission than DMARD-treated patients. Patients who achieved EULAR good response and remission were less likely to stop working, but this relationship was only seen in patients receiving DMARDs. Patients with RA who received adalimumab experienced considerably longer periods of work and continuous employment, and greater rates of clinical responses, than patients receiving DMARDs. The mechanism by which adalimumab decreases likelihood of stopping work seems to be different from that of DMARD treatment and independent of clinical responses.

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.

Assessment matters-mentors need support in their role.

PubMed

Bennett, Maggie; McGowan, Brian

In the UK the Nursing and Midwifery Council (NMC) standards to support learning and assessment in practice state that mentors are responsible and accountable for the assessment of pre-registration nursing students in practice. This study was undertaken to explore mentors' experience of assessing nursing students in practice post implementation of the NMC standards. Five focus groups were conducted with mentors (N=35) who had assessed adult pre-registration nursing students in the previous 12 months. The focus groups were recorded, transcribed and analysed to generate categories. Five categories were identified from the data: Changing roles and responsibilities; Exploring the past to understand the present; Just knowing; The odds; Time to mentor. The findings highlighted that mentors were aware of their role and responsibility for the assessment of students in practice. However, many felt this was a new responsibility and role in which they lacked experience. Some existing mentors felt that they may not have had the necessary preparation to effectively assess students in practice and identified their need for support. Given that mentors are expected to be competent assessors of students in practice and protect the public through gate-keeping professional registration, this study suggests that serious consideration should be given to how mentors are prepared and the ongoing support and education they receive in assessment.

Nutrition considerations in traumatic brain injury.

PubMed

Cook, Aaron M; Peppard, Amy; Magnuson, Barbara

The provision of adequate nutrition support for patients with traumatic brain injury (TBI) has been a clinical challenge for decades. The primary and secondary injuries create unique metabolic derangements along with accompanying issues such as optimal timing and route of nutrition, appropriate fluid and electrolytes, drug administration, rehabilitation, and dysphagia. Enteral nutrition is clearly established as the preferential route of nutrition support for this population vs parenteral nutrition. There appears to be a consensus on early initiation of enteral nutrition, but less definitive are recommendations on advancement timing and formula components. Nutrition therapies should include exact fluid resuscitation goals specific for TBI and strict electrolyte monitoring to avoid extreme fluid, electrolyte, or glucose shifts that could be detrimental to the patient. While the critical care patient often tolerates small bowel feeding, the long-term rehabilitation patient should transition to and tolerate gastric feeding. Drug-nutrient and adverse drug reactions such as diarrhea should be routinely evaluated in patients receiving enteral nutrition. Monitoring for dysphagia is critical to avoid the costly negative aspects associated with aspiration and to capitalize on quality of life and appropriate oral nutrition. Emphasizing the priority of early nutrition support within a multi-disciplinary team may be the critical key for successful provision and tolerance of nutrition support in the TBI population.

Considerations on Caring for Caregivers in an Aging Society.

PubMed

Sinha, Dr Samir K

2015-01-01

While it is anticipated that healthcare systems around the world will continue to rely heavily on family members and friends to provide unpaid care especially to meet the needs of our aging population, current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. This paper builds on Williams et al's assertion that many current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. Indeed, with the pool of available caregivers expected to actually shrink in the future, this paper therefore examines four key policy issues in greater depth that we can address to enable individuals to age in place and others to maintain and take on caregiving roles. Through the establishment of policies that support robust and longterm capacity planning; make clear what care recipients and caregivers can expect to receive in the form of government supports; appreciate the increasing diversity that is occurring among those taking on caregiving roles and those requiring care; and recognize the need to invest in strategies that combat social isolation, we may not only improve our future health and well-being but ensure we are also enabled to care for ourselves as we age.

Multi-GNSS PPP-RTK: From Large- to Small-Scale Networks

PubMed Central

Nadarajah, Nandakumaran; Wang, Kan; Choudhury, Mazher

2018-01-01

Precise point positioning (PPP) and its integer ambiguity resolution-enabled variant, PPP-RTK (real-time kinematic), can benefit enormously from the integration of multiple global navigation satellite systems (GNSS). In such a multi-GNSS landscape, the positioning convergence time is expected to be reduced considerably as compared to the one obtained by a single-GNSS setup. It is therefore the goal of the present contribution to provide numerical insights into the role taken by the multi-GNSS integration in delivering fast and high-precision positioning solutions (sub-decimeter and centimeter levels) using PPP-RTK. To that end, we employ the Curtin PPP-RTK platform and process data-sets of GPS, BeiDou Navigation Satellite System (BDS) and Galileo in stand-alone and combined forms. The data-sets are collected by various receiver types, ranging from high-end multi-frequency geodetic receivers to low-cost single-frequency mass-market receivers. The corresponding stations form a large-scale (Australia-wide) network as well as a small-scale network with inter-station distances less than 30 km. In case of the Australia-wide GPS-only ambiguity-float setup, 90% of the horizontal positioning errors (kinematic mode) are shown to become less than five centimeters after 103 min. The stated required time is reduced to 66 min for the corresponding GPS + BDS + Galieo setup. The time is further reduced to 15 min by applying single-receiver ambiguity resolution. The outcomes are supported by the positioning results of the small-scale network. PMID:29614040

Multi-GNSS PPP-RTK: From Large- to Small-Scale Networks.

PubMed

Nadarajah, Nandakumaran; Khodabandeh, Amir; Wang, Kan; Choudhury, Mazher; Teunissen, Peter J G

2018-04-03

Precise point positioning (PPP) and its integer ambiguity resolution-enabled variant, PPP-RTK (real-time kinematic), can benefit enormously from the integration of multiple global navigation satellite systems (GNSS). In such a multi-GNSS landscape, the positioning convergence time is expected to be reduced considerably as compared to the one obtained by a single-GNSS setup. It is therefore the goal of the present contribution to provide numerical insights into the role taken by the multi-GNSS integration in delivering fast and high-precision positioning solutions (sub-decimeter and centimeter levels) using PPP-RTK. To that end, we employ the Curtin PPP-RTK platform and process data-sets of GPS, BeiDou Navigation Satellite System (BDS) and Galileo in stand-alone and combined forms. The data-sets are collected by various receiver types, ranging from high-end multi-frequency geodetic receivers to low-cost single-frequency mass-market receivers. The corresponding stations form a large-scale (Australia-wide) network as well as a small-scale network with inter-station distances less than 30 km. In case of the Australia-wide GPS-only ambiguity-float setup, 90% of the horizontal positioning errors (kinematic mode) are shown to become less than five centimeters after 103 min. The stated required time is reduced to 66 min for the corresponding GPS + BDS + Galieo setup. The time is further reduced to 15 min by applying single-receiver ambiguity resolution. The outcomes are supported by the positioning results of the small-scale network.

Drug-drug interaction between methotrexate and levetiracetam resulting in delayed methotrexate elimination.

PubMed

Bain, Emily; Birhiray, Ruemu E; Reeves, David J

2014-02-01

To report a case of delayed methotrexate (MTX) elimination while receiving concomitant levetiracetam. A 46-year-old man with relapsed osteosarcoma of the base of the skull receiving high-dose MTX tolerated his first cycle of MTX with elimination to nontoxic MTX levels (≤0.1 µmol/L) within 90 hours. After hospital discharge, the patient experienced seizures secondary to brain metastasis and started on levetiracetam, which was continued as maintenance therapy. The patient experienced delayed MTX elimination during cycles 2, 3, and 4 while receiving levetiracetam. On average, elimination to nontoxic MTX levels took 130 hours (106-144 hours). Before the fifth cycle of MTX, lorazepam was substituted for the levetiracetam. MTX was eliminated to nontoxic levels within 95 hours. During all cycles, the patient received standard supportive care and serum creatinine remained stable. No other drugs known to interact with MTX were administered. This possible drug interaction has only been reported once in the pediatric population. With a score of 6 on the Drug Interaction Probability Scale for evaluating causation of drug interactions, it is probable that the delayed MTX elimination was caused by an interaction with levetiracetam. Coadministration of levetiracetam and MTX may result in delayed elimination of MTX, increasing the likelihood of toxicity. Consideration should be given to temporarily switching from levetiracetam to another antiepileptic (ie, lorazepam) to prevent this interaction. This is particularly important in those experiencing delayed elimination with prior cycles of concomitant MTX and levetiracetam or those at greater risk for MTX toxicity.

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.

Special Education Considerations in Student Discipline Procedures.

ERIC Educational Resources Information Center

Michigan State Dept. of Education, Lansing. Office of Special Education and Early Intervention Services.

This policy statement from the Michigan Department of Education interprets federal provisions and the laws of the state as they may pertain to children receiving special education services. It describes disciplinary procedures for students already receiving special education services, students not yet eligible for special education, students…

75 FR 18194 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

..., 2010. Take notice that the Commission received the following electric corporate filings: Docket Numbers... Generating Co. Pursuant to Section 203 of the Federal Power Act and Request for Expedited Consideration and.... Eastern Time on Thursday, April 22, 2010. Take notice that the Commission received the following electric...

75 FR 25223 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

..., 2010. Take notice that the Commission received the following electric corporate filings: Docket Numbers... Jurisdictional Facilities, Request for Confidential Treatment, and Request for Expedited Consideration of AG... Commission received the following electric rate filings: Docket Numbers: ER01-1099-014; ER02-1406-015; ER99...

The 2014 International Pressure Ulcer Guideline: methods and development.

PubMed

Haesler, Emily; Kottner, Jan; Cuddigan, Janet

2017-06-01

A discussion of the methodology used to develop the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. (2014). International experts representing National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance developed the second edition of this clinical guideline. Discussion paper - methodology. A comprehensive search for papers published up to July 2013 was conducted in 11 databases and identified 4286 studies. After critical appraisal, 356 studies were included and assigned a level of evidence. Guideline recommendations provide guidance on best practice in pressure ulcer prevention and treatment. Understanding the development process of a guideline increases the meaningfulness of recommendations to clinicians. Five hundred and seventy five recommendations arose from the research and its interpretation. The body of evidence supporting each recommendation was assigned a strength of evidence. A strength of recommendation was assigned to recommendation statements using the GRADE system. Recommendations are primarily supported by a body of evidence rated as C (87% of recommendations), representing low quality and/or indirect evidence (30%) and expert opinion (57%). Two hundred and forty seven recommendations (43%) received a strong recommendation ('Do it'). Recommendations were developed with consideration to research of the highest methodological quality evidence and studies that add to clinical insight and provide guidance for areas of care where minimal research has been conducted. Recommendations in the guideline reflect best practice and should be implemented with consideration to local context and resources and the individual's preferences and needs. © 2016 John Wiley & Sons Ltd.

Home care robot for socially supporting the elderly: focus group studies in three European countries to screen user attitudes and requirements.

PubMed

Zsiga, Katalin; Edelmayer, Georg; Rumeau, Pierre; Péter, Orsolya; Tóth, András; Fazekas, Gábor

2013-12-01

The growing number of elderly individuals presents new challenges for society. Many elderly individuals have physical or cognitive impairments and require support from caregivers. An attempt to overcome the limitations caused by the lack of human caregivers is the inclusion of assistive technology such as socially active robots. The Domeo-project of the Ambient Assisted Living Joint Programme of the European Union aims to develop a new companion robotic system that would allow assistance to the elderly. The requirements and attitude of the potential users and caregivers have been assessed in Austria, France and Hungary. The robot functions were demonstrated to the participants. Three focus groups were formed: potential end users, older caregivers and younger caregivers. The discussions were recorded and processed according to six aspects: (i) acceptability and privacy, (ii) pertinence of services, (iii) possible obstacles, (iv) motivation level to use the proposed services, (v) organizational issues and (vi) recommendations. Minor differences were observed between the countries, but there were considerable differences regarding the age of the participants. The younger caregivers want to be assured of the safety of their client and to receive immediate notification in case of an emergency. As for the elderly, the most important aspect is to gain a companion and a physical helper. Many of the recommendations can be taken into consideration during robot development, but some of them are not realistic at present.

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

Space Station logistics policy - Risk management from the top down

NASA Technical Reports Server (NTRS)

Paules, Granville; Graham, James L., Jr.

1990-01-01

Considerations are presented in the area of risk management specifically relating to logistics and system supportability. These considerations form a basis for confident application of concurrent engineering principles to a development program, aiming at simultaneous consideration of support and logistics requirements within the engineering process as the system concept and designs develop. It is shown that, by applying such a process, the chances of minimizing program logistics and supportability risk in the long term can be improved. The problem of analyzing and minimizing integrated logistics risk for the Space Station Freedom Program is discussed.

Lunar and Lagrangian Point L1 L2 CubeSat Communication and Navigation Considerations

NASA Technical Reports Server (NTRS)

Schaire, Scott; Wong, Yen F.; Altunc, Serhat; Bussey, George D.; Shelton, Marta; Folta, Dave; Gramling, Cheryl; Celeste, Peter; Anderson, Mike; Perrotto, Trish;

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.

Economic and demographic consequences of AIDS in Namibia: rapid assessment of the costs.

PubMed

Ojo, K; Delaney, M

1997-01-01

Recent announcements by the Government of Namibia to provide financial support to people living with AIDS (and their family members) have received considerable media attention. However, given the fact that government budgets are already stretched, and the need for resources to devote the prevention efforts remains, there is an urgent need to assign some values to the support the government is considering within the context of an explosive epidemic. It is against this background that this study attempts to provide a rapid assessment of the economic costs of HIV/AIDS in Namibia over the next 5 years of the First National Development Plan. The estimates include the direct and indirect costs. The direct costs are costs to the economy for inpatient and outpatient medical services, as well as the costs of support payments to people living with AIDS, their families and children orphaned by AIDS. Government and donor expenditure on national prevention and control efforts are also included. The study concludes that no sector of the Namibian economy will escape the impact of AIDS. The epidemic will definitely tax hospital, public health, private and community resources, and these substantial burdens underscore the need for coordinated long-term planning.

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.

Social support and responsiveness in online patient communities: impact on service quality perceptions.

PubMed

Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

2016-02-01

Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

20 CFR 404.502a - Notice of right to waiver consideration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Notice of right to waiver consideration. 404.502a Section 404.502a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... and the individual is receiving another type of payment from SSA (language about cross-program...

Design and analysis considerations in the Ebola_Tx trial evaluating convalescent plasma in the treatment of Ebola virus disease in Guinea during the 2014-2015 outbreak.

PubMed

Edwards, Tansy; Semple, Malcolm G; De Weggheleire, Anja; Claeys, Yves; De Crop, Maaike; Menten, Joris; Ravinetto, Raffaella; Temmerman, Sarah; Lynen, Lutgarde; Bah, Elhadj Ibrahima; Smith, Peter G; van Griensven, Johan

2016-02-01

The Ebola virus disease outbreak in 2014-2015 led to a huge caseload with a high case fatality rate. No specific treatments were available beyond supportive care for conditions such as dehydration and shock. Evaluation of treatment with convalescent plasma from Ebola survivors was identified as a priority. We evaluated this intervention in an emergency setting, where randomization was unacceptable. The original trial design was an open-label study comparing patients receiving convalescent plasma and supportive care to patients receiving supportive care alone. The comparison group comprised patients recruited at the start of the trial before convalescent plasma became available, as well as patients presenting during the trial for whom there was insufficient blood group-compatible plasma or no staffing capacity to provide additional transfusions. However, during the trial, convalescent plasma was available to treat all new patients. The design was changed to use a comparator group comprising patients previously treated at the same Ebola treatment center prior to the start of the trial. In the analysis, it was planned to adjust for any differences in prognostic variables between intervention and comparison groups, specifically baseline polymerase chain reaction cycle threshold and age. In addition, adjustment was planned for other potential confounders, identified in the analysis, such as patient presenting symptoms and time to treatment seeking. Because plasma treatment started up to 3 days after diagnosis and we could not define a similar time-point for the comparator group, patients who died before the third day after confirmation of diagnosis were excluded from both intervention and comparison groups in a per-protocol analysis. Some patients received additional experimental treatments soon after plasma treatment, and these were excluded. We also analyzed mortality including all patients from the time of confirmed diagnosis, irrespective of whether those in the trial series actually received plasma, as an intention-to-treat analysis. Per-protocol and intention-to-treat approaches gave similar conclusions. An important caveat in the interpretation of the findings is that it is unlikely that all potential sources of confounding, such as any variation in supportive care over time, were eliminated. Protocols and electronic data capture systems have now been extensively field-tested for emergency evaluation of treatment with convalescent plasma. Ongoing studies seek to quantify the level of neutralizing antibodies in different plasma donations to determine whether this influences the response and survival of treated patients. © The Author(s) 2016.

Moving from hospital into a care home--the nurse's role in supporting older people.

PubMed

Morgan, D; Reed, J; Palmer, A

1997-11-01

Discharge planning has received much attention in the nursing literature over the past few years, and there has been particular concern over the discharge of older people back into their domestic environment. The practical and logistical problems of managing such a discharge are considerable, but in this paper we argue that discharging older people from hospital to care homes is equally problematic, though in different ways. This is a neglected area of research, perhaps because discharge into a care home seems to present fewer organizational problems. There is, however, an extensive body of literature from a range of different disciplines which suggests that the loss of home and entry into a strange environment can be very stressful. This paper outlines this literature and explores the implications for nursing practice.

Personalization of Rule-based Web Services.

PubMed

Choi, Okkyung; Han, Sang Yong

2008-04-04

Nowadays Web users have clearly expressed their wishes to receive personalized services directly. Personalization is the way to tailor services directly to the immediate requirements of the user. However, the current Web Services System does not provide any features supporting this such as consideration of personalization of services and intelligent matchmaking. In this research a flexible, personalized Rule-based Web Services System to address these problems and to enable efficient search, discovery and construction across general Web documents and Semantic Web documents in a Web Services System is proposed. This system utilizes matchmaking among service requesters', service providers' and users' preferences using a Rule-based Search Method, and subsequently ranks search results. A prototype of efficient Web Services search and construction for the suggested system is developed based on the current work.

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

PubMed Central

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

1982-01-01

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

Institutional Educational Technology Policy and Strategy Documents: An Inequality Gaze

ERIC Educational Resources Information Center

Czerniewicz, Laura; Rother, Kyle

2018-01-01

Issues of inequality in higher education have received considerable attention in recent decades, but the intersection of inequality and educational technology at an institutional level has received little attention. This study aims to provide a perspective on institutional educational technology policy informed by current understandings of…

Accommodating Faculty Members Who Have Disabilities. Report

ERIC Educational Resources Information Center

American Association of University Professors, 2012

2012-01-01

In recent years the rights and responsibilities of students who have disabilities have received considerable attention. Professors routinely accommodate students with a front-row seat in class or extended time on an examination. Faculty members who have disabilities have received far less attention. This report from a subcommittee of Committee A…

20 CFR 632.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Payments received under the Trade Act of 1974; (11) Black Lung payments received under the Benefits Reform...: (1) Transfers or leases of such property for less than fair market value or for reduced consideration... American grantee share of its fair market value is not returned to the Federal Government or Native...

20 CFR 632.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Payments received under the Trade Act of 1974; (11) Black Lung payments received under the Benefits Reform...: (1) Transfers or leases of such property for less than fair market value or for reduced consideration... American grantee share of its fair market value is not returned to the Federal Government or Native...

7 CFR 17.6 - Discounts, fees, commissions and payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the supplier; (ii) Give the supplier a competitive advantage in relation to other potential suppliers... anything given in return for any consideration, services, or benefits received or to be received. (a... acted as a selling agent to obtain a contract even though the payment may be for services performed that...

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.

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.

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

Biological collections and ecological/environmental research: a review, some observations and a look to the future.

PubMed

Pyke, Graham H; Ehrlich, Paul R

2010-05-01

Housed worldwide, mostly in museums and herbaria, is a vast collection of biological specimens developed over centuries. These biological collections, and associated taxonomic and systematic research, have received considerable long-term public support. The work remaining in systematics has been expanding as the estimated total number of species of organisms on Earth has risen over recent decades, as have estimated numbers of undescribed species. Despite this increasing task, support for taxonomic and systematic research, and biological collections upon which such research is based, has declined over the last 30-40 years, while other areas of biological research have grown considerably, especially those that focus on environmental issues. Reflecting increases in research that deals with ecological questions (e.g. what determines species distribution and abundance) or environmental issues (e.g. toxic pollution), the level of research attempting to use biological collections in museums or herbaria in an ecological/environmental context has risen dramatically during about the last 20 years. The perceived relevance of biological collections, and hence the support they receive, should be enhanced if this trend continues and they are used prominently regarding such environmental issues as anthropogenic loss of biodiversity and associated ecosystem function, global climate change, and decay of the epidemiological environment. It is unclear, however, how best to use biological collections in the context of such ecological/environmental issues or how best to manage collections to facilitate such use. We demonstrate considerable and increasingly realized potential for research based on biological collections to contribute to ecological/environmental understanding. However, because biological collections were not originally intended for use regarding such issues and have inherent biases and limitations, they are proving more useful in some contexts than in others. Biological collections have, for example, been particularly useful as sources of information regarding variation in attributes of individuals (e.g. morphology, chemical composition) in relation to environmental variables, and provided important information in relation to species' distributions, but less useful in the contexts of habitat associations and population sizes. Changes to policies, strategies and procedures associated with biological collections could mitigate these biases and limitations, and hence make such collections more useful in the context of ecological/environmental issues. Haphazard and opportunistic collecting could be replaced with strategies for adding to existing collections that prioritize projects that use biological collections and include, besides taxonomy and systematics, a focus on significant environmental/ecological issues. Other potential changes include increased recording of the nature and extent of collecting effort and information associated with each specimen such as nearby habitat and other individuals observed but not collected. Such changes have begun to occur within some institutions. Institutions that house biological collections should, we think, pursue a mission of 'understanding the life of the planet to inform its stewardship' (Krishtalka & Humphrey, 2000), as such a mission would facilitate increased use of biological collections in an ecological/environmental context and hence lead to increased appreciation, encouragement and support from the public for these collections, their associated research, and the institutions that house them.

Breastfeeding booklet and proactive phone calls for increasing exclusive breastfeeding rates: RCT protocol.

PubMed

Zakarija-Grković, Irena; Puharić, Drita; Malički, Mario; Hoddinott, Pat

2017-01-01

Breastfeeding is associated with infant and maternal health benefits and considerable potential savings to health services. Despite this, only 37% of infants globally are exclusively breastfed for 6 months. Interventions are needed to improve breastfeeding rates. The aim of this study is to determine whether written breastfeeding information in pregnancy and proactive breastfeeding-focused support phone calls, provided by a health professional educated in breastfeeding management, increase exclusive breastfeeding rates at 3 months compared with general birth-related information with proactive support calls or standard care. This is a single-centre, randomised, controlled, three-arm, superiority study with blind outcome assessment. Eligible participants will include primigravidae with singleton pregnancies who speak Croatian, attending six primary care obstetric practices. We estimate a total sample size of 459, with computer generated stratified randomisation of 153 women per arm. Participants in the intervention and active control groups will receive booklets in pregnancy, phone calls 2 weeks later, and 2, 6 and 10 weeks after birth. The primary outcome will be the proportion of women exclusively breastfeeding at 3 months. Secondary outcomes will compare: infant feeding practices and attitudes, social support, breastfeeding difficulties, breastfeeding self efficacy and utilisation of breastfeeding support services. Follow-up at 6 months will compare exclusive and any breastfeeding and utilised support services. Analysis will be by intention to treat. This trial will contribute to future evidence syntheses identifying the most effective forms of breastfeeding support. © 2016 John Wiley & Sons Ltd.

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.

Promising non-pharmacological therapies in PD: Targeting late stage disease and the role of computer based cognitive training.

PubMed

Van de Weijer, S C F; Hommel, A L A J; Bloem, B R; Nonnekes, J; De Vries, N M

2018-01-01

Non-pharmacological interventions are increasingly being acknowledged as valuable treatment options to overcome or reduce functional problems in patients with Parkinson's disease (PD). There is a wide range of such non-pharmacological treatments for which the supportive evidence is emerging. Physiotherapy is one good example in this domain. However, there are also several promising non-pharmacological treatment strategies that have thus far received less research attention. Here, we describe two relatively new, but encouraging approaches. First, we focus on a hitherto largely overseen subgroup of PD, namely those with late-stage disease, a population that is often excluded from clinical studies. Importantly, the aims and therapeutic strategies in late-stage PD differ considerably from those in early-stage PD, and an emphasis on non-pharmacological management is particularly important for this vulnerable subgroup. Second, we focus on computer-based cognitive training, as an example of a relatively new intervention that includes innovative elements such as personalized training, artificial intelligence, and virtual reality. We review the latest evidence, practical considerations and future research perspectives, both for non-pharmacological approaches in late-stage PD and for computer-based cognitive training. Copyright © 2017. Published by Elsevier Ltd.

Randomization Does Not Help Much, Comparability Does

PubMed Central

Saint-Mont, Uwe

2015-01-01

According to R.A. Fisher, randomization “relieves the experimenter from the anxiety of considering innumerable causes by which the data may be disturbed.” Since, in particular, it is said to control for known and unknown nuisance factors that may considerably challenge the validity of a result, it has become very popular. This contribution challenges the received view. First, looking for quantitative support, we study a number of straightforward, mathematically simple models. They all demonstrate that the optimism surrounding randomization is questionable: In small to medium-sized samples, random allocation of units to treatments typically yields a considerable imbalance between the groups, i.e., confounding due to randomization is the rule rather than the exception. In the second part of this contribution, the reasoning is extended to a number of traditional arguments in favour of randomization. This discussion is rather non-technical, and sometimes touches on the rather fundamental Frequentist/Bayesian debate. However, the result of this analysis turns out to be quite similar: While the contribution of randomization remains doubtful, comparability contributes much to a compelling conclusion. Summing up, classical experimentation based on sound background theory and the systematic construction of exchangeable groups seems to be advisable. PMID:26193621

Particulate Matter Filtration Design Considerations for Crewed Spacecraft Life Support Systems

NASA Technical Reports Server (NTRS)

Agui, Juan H.; Vijayakumar, R.; Perry, Jay L.

2016-01-01

Particulate matter filtration is a key component of crewed spacecraft cabin ventilation and life support system (LSS) architectures. The basic particulate matter filtration functional requirements as they relate to an exploration vehicle LSS architecture are presented. Particulate matter filtration concepts are reviewed and design considerations are discussed. A concept for a particulate matter filtration architecture suitable for exploration missions is presented. The conceptual architecture considers the results from developmental work and incorporates best practice design considerations.

Women who receive continuous support during labour have reduced risk of caesarean, instrumental delivery or need for analgesia compared to usual care.

PubMed

McDonald, Susan

2013-04-01

Models of care supporting continuous support during labour were shown to be more likely to result in a spontaneous vaginal birth. Women receiving continuous support required less analgesia and were less likely to report negative feelings about the birth experience. Women receiving continuous support experienced shorter labours and their babies were less likely to have low 5-min Agpar scores. Therefore, such models of care should be considered for more extensive implementation in clinical practice settings.

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

Collaborative youth mental health service users, immigration, poverty, and family environment.

PubMed

Nadeau, Lucie; Lecompte, Vanessa; Johnson-Lafleur, Janique; Pontbriand, Annie; Rousseau, Cécile

2018-05-01

This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood. Participants in this study were 140 parent-child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area. Measures included in this study were collected at the initial phase of the longitudinal project (Time 0). Parents completed a sociodemographic questionnaire and the Family Environment Scale (FES), and both parents and children completed the Strength and Difficulties questionnaire (SDQ). Results suggest that the family environment, especially family conflicts, has a significant role in the MH problems of children seeking help in collaborative MH services. In this specific population, results also show a trend, but not a statistically significant association, between poverty or immigration and emotional and behavioral problems. They suggest as well that boys show more MH problems, although this could be a contamination effect (parents' perspective). The results support the importance of interventions that not only target the child symptomatology but also address family dynamics, especially conflicts. Collaborative care models may be particularly well suited to allow for a coherent consideration of family environmental factors in youth mental health and to support primary care settings in addressing these issues.

Pregnancy and antenatal care: the attitudes and experiences of Asian women.

PubMed

Woollett, A; Dosanjh-Matwala, N

1990-01-01

Asian women living in the East End of London were interviewed in English or in their own language to assess their attitudes to and experiences of pregnancy and antenatal care and to consider some factors which may influence their experiences, especially their fluency in English. In some respects Asian women's experiences were similar to those of non-Asian women reported in other studies, e.g. similar levels of nausea and lack of tie-up between nausea and negative reactions to pregnancy. However there were also some differences, e.g. Asian women expressed greater concern about the sex of the child and about eating 'cool' foods to counterbalance the hot state of pregnancy. Asian women were good patients: they attended antenatal clinics, read the leaflets provided and about half attended antenatal classes, although some were keener than others to seek information about pregnancy and childbirth and only a quarter bought books or watched videos. Less than half of the women were living in extended families and receiving support from in-laws in the traditional way. Those living in nuclear families received support from friends, neighbours and especially husbands. There were considerable individual differences in women's reactions and experiences. Women who spoke little or no English were less knowledgeable and had lived for a shorter time in the UK than women who were fluent in English. Leaflets in languages women can read and link workers at clinics helped some women.

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.

Mimetic Theory and Scapegoating in the Age of Cyberbullying: The Case of Phoebe Prince

ERIC Educational Resources Information Center

Norman, James O'Higgins; Connolly, Justin

2011-01-01

Whilst traditional forms of bullying have and continue to receive considerable attention in the literature, research on technology-enabled bullying remains in an embryonic stage and considerable deficits exist in our understanding of the nature, extent, dynamics and consequents of this new form of bullying. Of the limited studies that exist on…

Configuration study for a 30 GHz monolithic receive array: Technical assessment

NASA Technical Reports Server (NTRS)

Nester, W. H.; Cleaveland, B.; Edward, B.; Gotkis, S.; Hesserbacker, G.; Loh, J.; Mitchell, B.

1984-01-01

The current status of monolithic microwave integrated circuits (MMICs) in phased array feeds is discussed from the point of view of cost performance, reliability, and design considerations. Transitions to MMICs, compatible antenna radiating elements and reliability considerations are addressed. Hybrid antennas, feed array antenna technology, and offset reflectors versus phased arrays are examined.

Decision Making for Chinese Students to Receive Their Higher Education in the U.S.

ERIC Educational Resources Information Center

Chao, Chiangnan

2016-01-01

This study examines Chinese students' decision making considerations for coming to the U.S. for their higher education. Due to the large number of Chinese students in the U.S, it is an interesting topic for educators and researchers to explore the decision making considerations Chinese students choose for studying abroad. International student…

29 CFR 1650.205 - Consideration of evidence submitted as a result of notification of intent.

Code of Federal Regulations, 2010 CFR

2010-07-01

... notification of intent. 1650.205 Section 1650.205 Labor Regulations Relating to Labor (Continued) EQUAL...) Consideration of evidence. If, as a result of the notification of intent, EEOC receives notice that the debtor... time period, collection will be stayed until EEOC: (1) Considers the evidence presented by the debtor...

29 CFR 1650.205 - Consideration of evidence submitted as a result of notification of intent.

Code of Federal Regulations, 2011 CFR

2011-07-01

... notification of intent. 1650.205 Section 1650.205 Labor Regulations Relating to Labor (Continued) EQUAL...) Consideration of evidence. If, as a result of the notification of intent, EEOC receives notice that the debtor... time period, collection will be stayed until EEOC: (1) Considers the evidence presented by the debtor...

29 CFR 1650.205 - Consideration of evidence submitted as a result of notification of intent.

Code of Federal Regulations, 2012 CFR

2012-07-01

... notification of intent. 1650.205 Section 1650.205 Labor Regulations Relating to Labor (Continued) EQUAL...) Consideration of evidence. If, as a result of the notification of intent, EEOC receives notice that the debtor... time period, collection will be stayed until EEOC: (1) Considers the evidence presented by the debtor...

29 CFR 1650.205 - Consideration of evidence submitted as a result of notification of intent.

Code of Federal Regulations, 2013 CFR

2013-07-01

... notification of intent. 1650.205 Section 1650.205 Labor Regulations Relating to Labor (Continued) EQUAL...) Consideration of evidence. If, as a result of the notification of intent, EEOC receives notice that the debtor... time period, collection will be stayed until EEOC: (1) Considers the evidence presented by the debtor...

29 CFR 1650.205 - Consideration of evidence submitted as a result of notification of intent.

Code of Federal Regulations, 2014 CFR

2014-07-01

... notification of intent. 1650.205 Section 1650.205 Labor Regulations Relating to Labor (Continued) EQUAL...) Consideration of evidence. If, as a result of the notification of intent, EEOC receives notice that the debtor... time period, collection will be stayed until EEOC: (1) Considers the evidence presented by the debtor...

Do Schools Begin Too Early?

ERIC Educational Resources Information Center

Edwards, Finley

2012-01-01

School start times vary considerably, both across the nation and within individual communities, with some schools beginning earlier than 7:30 a.m. and others after 9:00 a.m. Proponents of later start times, who have received considerable media attention in recent years, argue that many students who have to wake up early for school do not get…

Nesting doctoral students in collaborative North–South partnerships for health systems research

PubMed Central

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L.; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E.; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

Background The European Union (EU) supports North–South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). Objective The aim of this study was to explore the challenges of, and facilitating factors for, ‘nesting’ doctoral students in North–South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. Design This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Results Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North–South projects. Conclusion There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North–South partnerships as a contribution to the strengthening of local research capacity. PMID:25030216

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.

Illegal Immigrants in Texas: Impact on Social Services and Related Considerations.

ERIC Educational Resources Information Center

Weintraub, Sidney

1984-01-01

The State of Texas receives more from taxes paid by undocumented persons than it costs the state to provide them with public services, such as education, health care, corrections, and welfare. However, six Texas cities together expended more to provide services to undocumented aliens than they received in taxes. (RDN)

Making Charter School Facilities More Affordable: State-driven Policy Approaches. Innovations in Education

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

Securing appropriate facilities can be a significant challenge for those intending to open a charter school. Although, like all public schools, charter schools receive per-pupil dollars from the state, they generally receive considerably less. Additionally, because traditional public schools rely on their district to provide their school…

Comorbid Psychopathology with Autism Spectrum Disorder in Children: An Overview

ERIC Educational Resources Information Center

Matson, Johnny L.; Nebel-Schwalm, Marie S.

2007-01-01

Comorbidity, the co-occurrence of two or more disorders in the same person, has been a topic receiving considerable attention in the child psychopathology literature overall. Despite many publications in the ADHD, depression and other child literatures, autism spectrum disorder has not received such scrutiny. The purpose of this review will be to…

Tiered Systems of Support: Practical Considerations for School Districts. Issue Focus

ERIC Educational Resources Information Center

MDRC, 2017

2017-01-01

Students learn or progress at their own paces. How can schools make sure that they get the help they need--and only the help they need? Many are turning to multi-tiered systems of support. This brief provides some practical considerations for schools contemplating tiered approaches.

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.

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…

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.

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

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.

Values Guide Us in Times of Uncertainty: DACA and Graduate Medical Education.

PubMed

Poll-Hunter, Norma I; Young, Geoffrey H; Shick, Matthew

2017-11-01

With a new administration and Congress, there is uncertainty surrounding the future of the Deferred Action for Childhood Arrivals (DACA) program. In light of this uncertainty, medical schools have tried to better understand how they can support trainees with DACA. In their article in this issue, Nakae and colleagues describe the issues often encountered by medical students with DACA as they prepare for residency and by the program directors who receive their applications. They offer recommendations for best practices to support these trainees. The authors of this Invited Commentary expand on these important considerations, based on their experiences at a national level. They argue that the core values in academic medicine should drive decision making, the student voice is critical, teamwork is essential, and wellness deserves attention. Academic medicine is part of a larger movement with partners across the health professions and higher education focused on advancing the values of access and opportunity for all. The authors of this Invited Commentary argue that remaining steadfast and committed to the core values in medicine will allow the academic medicine community to successfully navigate these uncertain times.

Evidence to support the use of vildagliptin monotherapy in the treatment of type 2 diabetes mellitus

PubMed Central

Dejager, Sylvie; Schweizer, Anja; Foley, James E

2012-01-01

The efficacy and safety of the dipeptidyl peptidase-4 inhibitor, vildagliptin, as monotherapy have been widely confirmed in a large body of clinical studies of up to 2 years’ duration in various populations with type 2 diabetes mellitus. This paper reviews the data supporting the use of vildagliptin in monotherapy. Consideration based on baseline glycated hemoglobin levels and age is given to patient segments where metformin is not appropriate. In addition, although prediabetes is not an indication, this manuscript briefly reviews some of the existing data showing that the mechanisms at work in diabetic populations are active in patients currently classified as prediabetic, with impaired glucose tolerance or impaired fasting glucose. Finally, the rationale for vildagliptin dosing frequency in monotherapy is discussed. In summary, this review aims to define where in community practice the use of vildagliptin as monotherapy is most desirable, focusing on segments of the population with type 2 diabetes mellitus that might receive the greatest benefit from vildagliptin in the management of their disease. PMID:22661900

Controlled Ecological Life Support Systems (CELSS) conceptual design option study

NASA Technical Reports Server (NTRS)

Oleson, Melvin; Olson, Richard L.

1986-01-01

Results are given of a study to explore options for the development of a Controlled Ecological Life Support System (CELSS) for a future Space Station. In addition, study results will benefit the design of other facilities such as the Life Sciences Research Facility, a ground-based CELSS demonstrator, and will be useful in planning longer range missions such as a lunar base or manned Mars mission. The objectives were to develop weight and cost estimates for one CELSS module selected from a set of preliminary plant growth unit (PGU) design options. Eleven Space Station CELSS module conceptual PGU designs were reviewed, components and subsystems identified and a sensitivity analysis performed. Areas where insufficient data is available were identified and divided into the categories of biological research, engineering research, and technology development. Topics which receive significant attention are lighting systems for the PGU, the use of automation within the CELSS system, and electric power requirements. Other areas examined include plant harvesting and processing, crop mix analysis, air circulation and atmosphere contaminant flow subsystems, thermal control considerations, utility routing including accessibility and maintenance, and nutrient subsystem design.

A Bibliometric Analysis of Research on Supported Ionic Liquid Membranes during the 1995–2015 Period: Study of the Main Applications and Trending Topics

PubMed Central

Abejón, Ricardo; Pérez-Acebo, Heriberto; Garea, Aurora

2017-01-01

A bibliometric analysis based on Scopus database was performed to identify the global research trends related to Supported Ionic Liquid Membranes (SILMs) during the time period from 1995 to 2015. This work tries to improve the understanding of the most relevant research topics and applications. The results from the analysis reveal that only after 2005 the research efforts focused on SILMs became significant, since the references found before that year are scarce. The most important research works on the four main application groups for SILMs defined in this work (carbon dioxide separation, other gas phase separations, pervaporation and liquid phase separations) were summarized in this paper. Carbon dioxide separation appeared as the application that has received by far the most attention according to the research trends during the analysed period. Comments about other significant applications that are gaining attention, such as the employment of SILMs in analytical tasks or their consideration for the production of fuel cells, have been included. PMID:29112172

[Who benefits from the night clinic? - Value of a part-time treatment facility].

PubMed

Stutz, Constanze; Kawohl, Wolfram; Platz, Christoph; Warnke, Ingeborg; Jäger, Matthias

2017-12-01

The night clinic which is part of the psychiatric department of the University of Zurich is a part-time treatment option with psychiatric treatment and support in the evening. This study aimed to characterize the patients and detect different functions of the treatment setting. Data of 253 patients covering a six-year period from 2008 up to 2013 were retrospectively assessed using descriptive methods. Subgroups according to the situation before admission and after discharge were compared. Patients admitted from home differed considerably from those who were transferred from a psychiatric ward concerning sociodemographic and clinical factors. They were more frequently single, unemployed, received disability funds and suffered from a psychotic disorder. They were also more likely to be discharged in a supported housing condition. The night clinic serves as an alternative to full inpatient treatment for individuals who have work as well as a rehabilitative option for homeless patients with severe mental illness. It contributes to a reduction of avoidance of inpatients stays for those groups of patients.

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

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.

Guide to the evaluation of human exposure to noise from large wind turbines

NASA Technical Reports Server (NTRS)

Stephens, D. G.; Shepherd, K. P.; Hubbard, H. H.; Grosveld, F.

1982-01-01

Guidance for evaluating human exposure to wind turbine noise is provided and includes consideration of the source characteristics, the propagation to the receiver location, and the exposure of the receiver to the noise. The criteria for evaluation of human exposure are based on comparisons of the noise at the receiver location with the human perception thresholds for wind turbine noise and noise-induced building vibrations in the presence of background noise.

Comparison of three underwater antennas for use in radiotelemetry

USGS Publications Warehouse

Beeman, J.W.; Grant, C.; Haner, P.V.

2004-01-01

The radiation patterns of three versions of underwater radiotelemetry antennas were measured to compare the relative reception ranges in the horizontal and vertical planes, which are important considerations when designing detection systems. The received signal strengths of an antenna made by stripping shielding from a section of coaxial cable (stripped coax) and by two versions of a dipole antenna were measured at several orientations relative to a dipole transmit antenna under controlled field conditions. The received signal strengths were greater when the transmit and receive antennas were parallel to each other than when they were perpendicular, indicating that a parallel orientation provides optimal detection range. The horizontal plane radiation pattern of the flexible, stripped coax antenna was similar to that of a rigid dipole antenna, but movement of underwater stripped coax antennas in field applications could affect the orientation of transmit and receive antennas in some applications, resulting in decreased range and variation in received signal strengths. Compared with a standard dipole, a dipole antenna armored by housing within a polyvinyl chloride fitting had a smaller radiation pattern in the horizontal plane but a larger radiation pattern in the vertical plane. Each of these types of underwater antenna can be useful, but detection ranges can be maximized by choosing an appropriate antenna after consideration of the location, relation between transmit and receive antenna orientations, radiation patterns, and overall antenna resiliency.

Informational Needs of Head and Neck Cancer Patients.

PubMed

Fang, Carolyn Y; Longacre, Margaret L; Manne, Sharon L; Ridge, John A; Lango, Miriam N; Burtness, Barbara A

2012-04-01

Treatment for head and neck squamous cell carcinoma (HNSCC) can lead to considerable functional impairment. As a result, HNSCC patients experience significant decrements in quality of life, high levels of emotional distress, deteriorations in interpersonal relations, and increased social isolation. Studies suggest that HNSCC patients may have extensive informational and psychosocial needs that are not being adequately addressed. However, few programs have been developed to address the needs of HNSCC patients. Therefore, we conducted a pilot study of HNSCC patients to: 1) characterize patients' informational needs; and 2) describe preferred formats and time points for receiving such information. The majority of participants desired additional information regarding treatment options, managing changes in swallowing and speaking, and staying healthy after treatment. Overall, patients with early-stage disease reported more informational needs compared to patients with advanced disease. Female patients were more likely to desire information about coping with emotional stress and anxiety than male patients. Younger patients (29-49 years) were more interested in receiving information about sexuality after cancer compared to their older (50+) counterparts. Although information was requested throughout the cancer trajectory, most patients preferred to receive such information at diagnosis or within 1-3 months post-treatment. The majority of patients reported having computer and Internet access, and they were most receptive to receiving information delivered via the Internet, from a DVD, or from pamphlets and booklets. The relatively high percentage of patients with computer and Internet access reflects a growing trend in the United States and supports the feasibility of disseminating health information to this patient population via Internet-based programs.

Medical Maximizing-Minimizing Preferences Predict Responses to Information about Prostate-Specific Antigen Screening.

PubMed

Scherer, Laura D; Kullgren, Jeffrey T; Caverly, Tanner; Scherer, Aaron M; Shaffer, Victoria A; Fagerlin, Angela; Zikmund-Fisher, Brian J

2018-06-01

The recently developed Medical Maximizer-Minimizer Scale (MMS) assesses individual differences in preferences for active v. passive medical treatment. We hypothesized that men's maximizing-minimizing preferences might have relevance in the case of prostate-specific antigen (PSA) screening, since there is considerable variability in men's preference for being screened even among men who are informed that harm is more likely than benefit. The current research examined whether MMS preferences predict how men respond to didactic information and narrative stories about PSA screening. US men 40+ years old ( N = 1208) participated in an online survey. Men viewed information about PSA screening in 3 phases and provided their preference for screening after each phase. Phase 1 described what PSA screening is. Phase 2 added didactic information about screening risks and benefits. Phase 3 added narrative stories; men were randomized to receive stories about 1) physical harm, 2) emotional harm, 3) overdiagnosis, or 4) all 3 stories. Participants also completed the validated MMS. After receiving basic information, 76.8% of men wanted PSA screening. After receiving information about risks and benefits, 54.8% wanted screening (a significant reduction, P < 0.001). Men who changed their preferences were significantly more likely to be minimizers than maximizers; most men with maximizing tendencies wanted screening after both the didactic information and narratives, whereas most men with minimizing tendencies did not want the test after receiving information. Men who prefer a more minimizing approach to medicine are more responsive to evidence supporting limiting or forgoing screening than men who prefer a maximizing approach.

Terahertz Heterodyne Receiver with an Electron-Heating Mixer and a Heterodyne Based on the Quantum-Cascade Laser

NASA Astrophysics Data System (ADS)

Seliverstov, S. V.; Anfertyev, V. A.; Tretyakov, I. V.; Ozheredov, I. A.; Solyankin, P. M.; Revin, L. S.; Vaks, V. L.; Rusova, A. A.; Goltsman, G. N.; Shkurinov, A. P.

2017-12-01

We study characteristics of the laboratory prototype of a terahertz heterodyne receiver with an electron-heating mixer and a heterodyne based on the quantum-cascade laser. The results obtained demonstrate the possibility to use this receiver as a basis for creation of a high-sensitivity terahertz spectrometer, which can be used in many basic and practical applications. A significant advantage of this receiver will be the possibility of placing the mixer and heterodyne in the same cryostat, which will reduce the device dimensions considerably. The obtained experimental results are analyzed, and methods of optimizing the parameters of the receiver are proposed.

Characteristics of psychiatric patients for whom financial considerations affect optimal treatment provision.

PubMed

West, Joyce C; Pingitore, David; Zarin, Deborah A

2002-12-01

This study assessed characteristics of psychiatric patients for whom financial considerations affected the provision of "optimal" treatment. Psychiatrists reported that for 33.8 percent of 1,228 patients from a national sample, financial considerations such as managed care limitations, the patient's personal finances, and limitations inherent in the public care system adversely affected the provision of optimal treatment. Patients were more likely to have their treatment adversely affected by financial considerations if they were more severely ill, had more than one behavioral health disorder or a psychosocial problem, or were receiving treatment under managed care arrangements. Patients for whom financial considerations affect the provision of optimal treatment represent a population for whom access to treatment may be particularly important.

Social Capital and Youth Transitions: Do Young People's Networks Improve Their Participation in Education and Training? Occasional Paper

ERIC Educational Resources Information Center

Semo, Ronnie; Karmel, Tom

2011-01-01

In recent times social capital has received considerable attention because it is seen as having the potential to address many of the problems facing modern society, including the poor educational outcomes of considerable numbers of young people. This paper uses data from the Longitudinal Surveys of Australian Youth (LSAY) to explore the…

Mental Health Services, Free Appropriate Public Education, and Students with Disabilities: Legal Considerations in Identifying, Evaluating, and Providing Services

ERIC Educational Resources Information Center

Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey

2018-01-01

In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…

Venography

MedlinePlus

... impaired kidney (renal) function should be given special consideration before receiving iodine-based contrast materials by vein or artery. Such patients are at risk for developing contrast-induced nephropathy, ...

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

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.

Sex Trafficking: Policies, Programs, and Services.

PubMed

Orme, Julie; Ross-Sheriff, Fariyal

2015-10-01

Sex trafficking (ST), a contemporary form of female slavery, is a human rights issue of critical concern to social work. The global response to ST has been substantial, and 166 countries have adopted anti-ST legislation. Despite considerable efforts to combat ST, the magnitude is increasing. To date, the majority of anti-ST efforts have focused on criminalization policies that target traffickers or purchasers of sexual services, who are predominantly male; prevention programming and services for predominantly female victims have received less support. Therapeutic services to assist pornography addicts and purchasers of sexual services are also necessary. In this article, authors examine current anti-ST policies, programs, and services, both domestically and globally, and present an innovative paradigm that addresses social inequities and emphasizes prevention programming. They conclude with a discussion of the paradigm's implications for social work policies, practices, and services.

Gendered Social Capital in a Johannesburg Township

PubMed Central

Myroniuk, Tyler W.

2016-01-01

Social capital research rarely takes a gendered approach. This article explores how black women and men from a marginalized community in Johannesburg, South Africa, rely on family, friends, and community members to survive and strategize for the future by utilizing social capital. The results from 30 semi-structured interviews and ego network mapping illustrate that gender moderates the type of social capital used and benefits associated with bonding and bridging social capital in important ways. This research builds upon knowledge of gendered advantages and disadvantages in social networks and informs researchers how women and men survive in pervasive poverty. I posit that identifying potential sources of support is an important consideration within social capital or any network research because the prospect of receiving assistance in the future undoubtedly alters the development of these individuals’ livelihood strategies. PMID:27773948

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.

76 FR 10899 - Proposed HHS Recommendation for Fluoride Concentration in Drinking Water for Prevention of Dental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... Drinking Water for Prevention of Dental Caries; Extension of Comment Period AGENCY: Office of the Secretary... dental caries while limiting the risk of dental fluorosis. The proposed recommendation was published in... caries has been extended to April 15, 2011. To receive consideration comments must be received no later...

Inbreeding among pen-reared quail

USGS Publications Warehouse

Nestler, R.B.; Nelson, A.L.

1945-01-01

The effect of inbreeding in wildlife species has received attention from several sources. Recently the 'inbreeding theory' as a possible explanation of cycles in game populations was given careful consideration by a group of wildlife experts and geneticists. Scott's symposium (1944) consisting of comments received from eight authorities revealed unanimity in a decision that inbreeding is not the causative factor.

Am I Just Not Good Enough? The Creation, Development and Questioning of a High Performance Coaching Identity

ERIC Educational Resources Information Center

Purdy, L. G.; Potrac, P.

2016-01-01

While the career experiences and trajectories of various sports workers have received increased scholarly attention, those of professional coaches have, in comparison, received scant consideration. This paper focuses on the career experiences of Maeve (a pseudonym), a high performance coach, and the critical incidents related to the creation,…

The first step in using a robot in brain injury rehabilitation: patients' and health-care professionals' perspective.

PubMed

Boman, Inga-Lill; Bartfai, Aniko

2015-01-01

To evaluate the usability of a mobile telepresence robot (MTR) in a hospital training apartment (HTA). The MTR was manoeuvred remotely and was used for communication when assessing independent living skills, and for security monitoring of cognitively impaired patients. Occupational therapists (OTs) and nurses received training in how to use the MTR. The nurses completed a questionnaire regarding their expectations of using the MTR. OTs and patients staying in the HTA were interviewed about their experiences of the MTR. Interviews and questionnaires were analysed qualitatively. The HTA patients were very satisfied with the MTR. The OTs and nurses reported generally positive experiences. The OT's found that assessment via the MTR was more neutral than being physically present. However, the use of the MTR implied considerable difficulties for health-care professionals. The main obstacle for the nurses was the need for fast and easy access in emergency situations while protecting the patients' integrity. The results indicate that the MTR could be a useful tool to support daily living skills and safety monitoring of HTA patients. However, when designing technology for multiple users, such as health-care professionals, the needs of all users, their routines and support services involved, should also be considered. Implications for Rehabilitation A mobile telepresence robot (MTR) can be a useful tool for assessments and communication in rehabilitation. The design of the robot has to allow easy use by remote users, particularly in emergency situations. When designing MTRs the needs of ALL users have to be taken into consideration.

Anti-fatigue activities of polysaccharides extracted from Hericium erinaceus.

PubMed

Liu, Jianqing; DU, Congxin; Wang, Yifei; Yu, Zhihua

2015-02-01

Hericium erinaceus (HEP) is a notable medicinal fungus grown in China and other oriental countries. Polysaccharides from HEP have recently attracted considerable attention due to their numerous physiological activities. The objective of this study was to evaluate the anti-fatigue activity of HEP in a mouse model. After one week of acclimation, mice were randomly divided into four groups: a control group, a low-dose HEP-treated group, a moderate-dose HEP-treated group, and a high-dose HEP-treated group. The treated groups received HEP (50, 100 and 200 mg/kg, ig), while the control group received saline solution. Following treatment for 28 days, the mice performed a forced swimming test until they were exhausted, then the exhaustive swimming time was recorded along with certain biochemical parameters related to fatigue, including blood lactic acid (BLA), serum urea nitrogen (SUN), tissue glycogen, superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA). These results suggested that HEP has significant anti-fatigue activity by decreasing BLA, SUN and MDA content, as well as increasing tissue glycogen content and antioxidant enzyme activity. Based on these results, this study provided theoretical support for the application of HEP in the field of sports nutrition.

An analysis of carrier phase jitter in an MPSK receiver utilizing map estimation. Ph.D. Thesis Semiannual Status Report, Jul. 1993 - Jan. 1994

NASA Technical Reports Server (NTRS)

Osborne, William P.

1994-01-01

The use of 8 and 16 PSK TCM to support satellite communications in an effort to achieve more bandwidth efficiency in a power-limited channel has been proposed. This project addresses the problem of carrier phase jitter in an M-PSK receiver utilizing the high SNR approximation to the maximum aposteriori estimation of carrier phase. In particular, numerical solutions to the 8 and 16 PSK self-noise and phase detector gain in the carrier tracking loop are presented. The effect of changing SNR on the loop noise bandwidth is also discussed. These data are then used to compute variance of phase error as a function of SNR. Simulation and hardware data are used to verify these calculations. The results show that there is a threshold in the variance of phase error versus SNR curves that is a strong function of SNR and a weak function of loop bandwidth. The M-PSK variance thresholds occur at SNR's in the range of practical interest for the use of 8 and 16-PSK TCM. This suggests that phase error variance is an important consideration in the design of these systems.

Optical digital to analog conversion performance analysis for indoor set-up conditions

NASA Astrophysics Data System (ADS)

Dobesch, Aleš; Alves, Luis Nero; Wilfert, Otakar; Ribeiro, Carlos Gaspar

2017-10-01

In visible light communication (VLC) the optical digital to analog conversion (ODAC) approach was proposed as a suitable driving technique able to overcome light-emitting diode's (LED) non-linear characteristic. This concept is analogous to an electrical digital-to-analog converter (EDAC). In other words, digital bits are binary weighted to represent an analog signal. The method supports elementary on-off based modulations able to exploit the essence of LED's non-linear characteristic allowing simultaneous lighting and communication. In the ODAC concept the reconstruction error does not simply rely upon the converter bit depth as in case of EDAC. It rather depends on communication system set-up and geometrical relation between emitter and receiver as well. The paper describes simulation results presenting the ODAC's error performance taking into account: the optical channel, the LED's half power angle (HPA) and the receiver field of view (FOV). The set-up under consideration examines indoor conditions for a square room with 4 m length and 3 m height, operating with one dominant wavelength (blue) and having walls with a reflection coefficient of 0.8. The achieved results reveal that reconstruction error increases for higher data rates as a result of interference due to multipath propagation.

Heat stroke leading to acute liver injury & failure: A case series from the Acute Liver Failure Study Group.

PubMed

Davis, Brian C; Tillman, Holly; Chung, Raymond T; Stravitz, Richard T; Reddy, Rajender; Fontana, Robert J; McGuire, Brendan; Davern, Timothy; Lee, William M

2017-04-01

In the United States, nearly 1000 annual cases of heat stroke are reported but the frequency and outcome of severe liver injury in such patients is not well described. The aim of this study was to describe cases of acute liver injury (ALI) or failure (ALF) caused by heat stroke in a large ALF registry. Amongst 2675 consecutive subjects enrolled in a prospective observational cohort of patients with ALI or ALF between January 1998 and April 2015, there were eight subjects with heat stroke. Five patients had ALF and three had ALI. Seven patients developed acute kidney injury, all eight had lactic acidosis and rhabdomyolysis. Six patients underwent cooling treatments, three received N-acetyl cysteine (NAC), three required mechanical ventilation, three required renal replacement therapy, two received vasopressors, one underwent liver transplantation, and two patients died-both within 48 hours of presentation. All cases occurred between May and August, mainly in healthy young men because of excessive exertion. Management of ALI and ALF secondary to heat stroke should focus on cooling protocols and supportive care, with consideration of liver transplantation in refractory patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of Olanzapine, Risperidone and Haloperidol on Prepulse Inhibition in Schizophrenia Patients: A Double-Blind, Randomized Controlled Trial

PubMed Central

Wynn, Jonathan K.; Green, Michael F.; Sprock, Joyce; Light, Gregory A.; Widmark, Clifford; Reist, Christopher; Erhart, Stephen; Marder, Stephen R.; Mintz, Jim; Braff, David L.

2009-01-01

Prepulse inhibition (PPI), whereby the startle eyeblink response is inhibited by a relatively weak non-startling stimulus preceding the powerful startle eliciting stimulus, is a measure of sensorimotor gating and has been shown to be deficient in schizophrenia patients. There is considerable interest in whether conventional and/or atypical antipsychotic medications can “normalize” PPI deficits in schizophrenia patients. 51 schizophrenia patients participated in a randomized, double-blind controlled trial on the effects of three commonly-prescribed antipsychotic medications (risperidone, olanzapine, or haloperidol) on PPI, startle habituation, and startle reactivity. Patients were tested at baseline, Week 4 and Week 8. Mixed model regression analyses revealed that olanzapine significantly improved PPI from Week 4 to Week 8, and that at Week 8 patients receiving olanzapine produced significantly greater PPI than those receiving risperidone, but not haloperidol. There were no effects of medication on startle habituation or startle reactivity. These results support the conclusion that olanzapine effectively increased PPI in schizophrenia patients, but that risperidone and haloperidol had no such effects. The results are discussed in terms of animal models, neural substrates, and treatment implications. PMID:17662577

Anti-fatigue activities of polysaccharides extracted from Hericium erinaceus

PubMed Central

LIU, JIANQING; DU, CONGXIN; WANG, YIFEI; YU, ZHIHUA

2015-01-01

Hericium erinaceus (HEP) is a notable medicinal fungus grown in China and other oriental countries. Polysaccharides from HEP have recently attracted considerable attention due to their numerous physiological activities. The objective of this study was to evaluate the anti-fatigue activity of HEP in a mouse model. After one week of acclimation, mice were randomly divided into four groups: a control group, a low-dose HEP-treated group, a moderate-dose HEP-treated group, and a high-dose HEP-treated group. The treated groups received HEP (50, 100 and 200 mg/kg, ig), while the control group received saline solution. Following treatment for 28 days, the mice performed a forced swimming test until they were exhausted, then the exhaustive swimming time was recorded along with certain biochemical parameters related to fatigue, including blood lactic acid (BLA), serum urea nitrogen (SUN), tissue glycogen, superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA). These results suggested that HEP has significant anti-fatigue activity by decreasing BLA, SUN and MDA content, as well as increasing tissue glycogen content and antioxidant enzyme activity. Based on these results, this study provided theoretical support for the application of HEP in the field of sports nutrition. PMID:25574220

Is being a medical educator a lonely business? The essence of social support.

PubMed

van den Berg, Joost W; Verberg, Christel P M; Scherpbier, Albert J J A; Jaarsma, A Debbie C; Lombarts, Kiki M J M H

2017-03-01

Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators. We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach. Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role. Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

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

Life sciences and Mars exploration

NASA Technical Reports Server (NTRS)

Sulzman, Frank M.; Rummel, John D.; Leveton, Lauren B.; Teeter, Ron

1990-01-01

The major life science considerations for Mars exploration missions are discussed. Radiation protection and countermeasures for zero gravity are discussed. Considerations of crew psychological health considerations and life support systems are addressed. Scientific opportunities presented by manned Mars missions are examined.

Competency-based medical education in two Sub-Saharan African medical schools

PubMed Central

Kiguli-Malwadde, Elsie; Olapade-Olaopa, E Oluwabunmi; Kiguli, Sarah; Chen, Candice; Sewankambo, Nelson K; Ogunniyi, Adesola O; Mukwaya, Solome; Omaswa, Francis

2014-01-01

Background Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME). Institutional reviews This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes are highlighted. Both schools used similar processes in developing their CBME curricula, with early and significant stakeholder involvement. Competencies were determined taking into consideration each country’s health and education systems. Final competency domains were similar between the two schools. Both schools established medical education departments to support their new curricula. New teaching methodologies and assessment methods were needed to support CBME, requiring investments in faculty training. Both schools received external funding to support CBME development and implementation. Conclusion CBME has emerged as an important change in medical education in Sub-Saharan Africa with schools adopting it as an approach to transformative medical education. Makerere University and the University of Ibadan have successfully adopted CBME and show that CBME can be implemented even for the low-resourced countries in Africa, supported by external investments to address the human resources gap. PMID:25525404

Breastfeeding and Social Media among First-Time African American Mothers

PubMed Central

Asiodu, Ifeyinwa V.; Waters, Catherine M.; Dailey, Dawn E.; Lee, Kathryn A.; Lyndon, Audrey

2015-01-01

Objective To describe the use of social media during the antepartum and postpartum periods among first-time African American mothers and their support persons. Design A qualitative critical ethnographic research design within the contexts of Family Life Course Development Theory and Black Feminist Theory. Setting Participants were recruited from community-based, public health, and home visiting programs. Participants A purposive sample was recruited, consisting of 14 pregnant African American women and eight support persons. Methods Pregnant and postpartum African American women and their support persons were interviewed separately during the antepartum and postpartum periods. Data were analyzed thematically. Results Participants frequently used social media for educational and social support and searched the internet for perinatal and parenting information. Most participants reported using at least one mobile application during their pregnancies and after giving birth. Social media were typically accessed through smartphones and/or computers using different websites and applications. While participants gleaned considerable information about infant development from these applications, they had difficulty finding and recalling information about infant feeding. Conclusion Social media are an important vehicle to disseminate infant feeding information; however, they are not currently being used to full potential. Our findings suggest that future interventions geared towards African American mothers and their support persons should include social media approaches. The way individuals gather, receive, and interpret information is dynamic. The increasing popularity and use of social media platforms offers the opportunity to create more innovative, targeted mobile health interventions for infant feeding and breastfeeding promotion. PMID:25712127

Maximum performance of solar heat engines: Discussion of thermodynamic availability and other second law considerations and their implications

NASA Astrophysics Data System (ADS)

Boehm, R. F.

1985-09-01

A review of thermodynamic principles is given in an effort to see if these concepts may indicate possibilities for improvements in solar central receiver power plants. Aspects related to rate limitations in cycles, thermodynamic availability of solar radiation, and sink temperature considerations are noted. It appears that considerably higher instantaneous plant efficiencies are possible by raising the maximum temperature and lowering the minimum temperature of the cycles. Of course, many practical engineering problems will have to be solved to realize the promised benefits.

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.

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.

A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care.

PubMed

Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard; Ollars, Chaitali Laura; Jensen, Anders Bonde

2017-04-08

Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. This study tested the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity and acceptability of the intervention as well as the assessment of contextual factors. The intervention reached 76 of 164 caregivers (46%). The interdisciplinary risk assessment and documentation of a support plan was conducted in 57 (75%) of the enrolled caregivers. Finally, a separate medical record was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. The intervention proved feasible and useful. Still, we identified barriers to the implementation which should be taken into consideration when planning implementation of a systematic risk and needs assessment and in the establishment of medical records for caregivers.

EDOS operations concept and development approach

NASA Technical Reports Server (NTRS)

Knoble, G.; Garman, C.; Alcott, G.; Ramchandani, C.; Silvers, J.

1994-01-01

The Earth Observing System (EOS) Data and Operations System (EDOS) is being developed by the National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC) for the capture, level zero processing, distribution, and backup archiving of high speed telemetry data received from EOS spacecraft. All data received will conform to the Consultative Committee for Space Data Standards (CCSDS) recommendations. The major EDOS goals are to: (1) minimize EOS program costs to implement and operate EDOS; (2) respond effectively to EOS growth requirements; and (3) maintain compatibility with existing and enhanced versions of NASA institutional systems required to support EOS spacecraft. In order to meet these goals, the following objectives have been defined for EDOS: (1) standardize EDOS interfaces to maximize utility for future requirements; (2) emphasize life-cycle cost (LCC) considerations (rather than procurement costs) in making design decisions and meeting reliability, maintainability, availability (RMA) and upgradability requirements; (3) implement data-driven operations to the maximum extent possible to minimize staffing requirements and to maximize system responsiveness; (4) provide a system capable of simultaneously supporting multiple spacecraft, each in different phases of their life-cycles; (5) provide for technology insertion features to accommodate growth and future LCC reductions during the operations phase; and (6) provide a system that is sufficiently robust to accommodate incremental performance upgrades while supporting operations. Operations concept working group meetings were facilitated to help develop the EDOS operations concept. This provided a cohesive concept that met with approval of responsible personnel from the start. This approach not only speeded up the development process by reducing review cycles, it also provided a medium for generating good ideas that were immediately molded into feasible concepts. The operations concept was then used as a basis for the EDOS specification. When it was felt that concept elements did not support detailed requirements, the facilitator process was used to resolve discrepancies or to add new concept elements to support the specification. This method provided an ongoing revisal of the operations concept and prevented large revisions at the end of the requirement analysis phase of system development.

Ethical considerations surrounding the response to Ebola: the Spanish experience.

PubMed

Royo-Bordonada, Miguel Ángel; García López, Fernando J

2016-08-18

The recent Ebola virus disease (EVD) outbreak, with 28,646 reported cases and 11,323 deaths, was declared a public health emergency of international interest by the World Health Organisation. In Spain, a single reported case triggered a public health crisis of a markedly media-centred nature. The approach to the first EVD epidemic has given rise to various ethical considerations around the world. We address the most relevant ethical considerations emanating from the management of EVD in Spain. Firstly, for reasons of global justice and humanitarian assistance, rich countries have the duty to support poorer countries in building up their core public-health capacities. Secondly, quarantine for high-risk contacts might have been a disproportionate and not properly justified measure, which could have contributed to stigmatising contacts and spreading panic. Thirdly, when the first secondary case was reported in Spain, it is doubtful whether informed consent requirements were strictly complied with when disclosing information concerning the alleged accident potentially causing the contagion. Moreover, this information was used by the Regional Health Minister to blame the patient, evading his responsibility to ensure safe medical procedures for health workers. Finally, the patient received convalescent plasma for compassionate use from a colleague of the first missionary repatriated, who also participated in a research study in Spain, despite having previously been denied the chance of being transferred to Spain to receive treatment. This fact highlights the asymmetry in the relationship between rich and poor countries. The management of this crisis highlighted the technical capacity of the health system and its professionals to respond effectively to public health emergencies caused by emerging diseases. This said, the failures in the protection of the EVD patient's privacy remind us that this aspect has to be borne in mind from the outset in crisis situations. Certain coercive measures, such as quarantine, should only be applied where there is some evidence that the benefit-risk balance could be favourable. Lastly, it is essential that research and interventions targeted at combating the fragility of the health systems in poor countries respond to reasons of global justice.

Shifting the Paradigm of Trauma Medicine to Positively Influence Critical Mortality Rates Following a Mass Casualty Event

DTIC Science & Technology

2009-06-01

rather than a hospital. It may mean expanding the scope of practice for certain professional types. For instance, nurses may provide services usually...pharmaceutical supplies” and “ nursing care” were distilled to a tactical to-do list and not given the full consideration that would be required to develop a...meeting the criteria to receive critical care will receive palliative care. The report defined inclusions and exclusion criteria to receive critical

Nuclear programs in India and Pakistan

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

Mian, Zia

India and Pakistan launched their respective nuclear programs in the 1940s and 1950s with considerable foreign technical support, especially from the United States Atoms for Peace Program. The technology and training that was acquired served as the platform for later nuclear weapon development efforts that included nuclear weapon testing in 1974 and in 1998 by India, and also in 1998 by Pakistan - which had illicitly acquired uranium enrichment technology especially from Europe and received assistance from China. As of 2013, both India and Pakistan were continuing to produce fissile material for weapons, in the case of India also formore » nuclear naval fuel, and were developing a diverse array of ballistic and cruise missiles. International efforts to restrain the South Asian nuclear build-up have been largely set aside over the past decade as Pakistani support became central for the U.S. war in Afghanistan and as U.S. geopolitical and economic interests in supporting the rise of India, in part as a counter to China, led to India being exempted both from U.S non-proliferation laws and international nuclear trade guidelines. In the absence of determined international action and with Pakistan blocking the start of talks on a fissile material cutoff treaty, nuclear weapon programs in South Asia are likely to keep growing for the foreseeable future.« less

Family ties: the multilevel effects of households and kinship on the networks of individuals.

PubMed

Koster, Jeremy

2018-04-01

Among social mammals, humans uniquely organize themselves into communities of households that are centred around enduring, predominantly monogamous unions of men and women. As a consequence of this social organization, individuals maintain social relationships both within and across households, and potentially there is conflict among household members about which social ties to prioritize or de-emphasize. Extending the logic of structural balance theory, I predict that there will be considerable overlap in the social networks of individual household members, resulting in a pattern of group-level reciprocity. To test this prediction, I advance the Group-Structured Social Relations Model, a generalized linear mixed model that tests for group-level effects in the inter-household social networks of individuals. The empirical data stem from social support interviews conducted in a community of indigenous Nicaraguan horticulturalists, and model results show high group-level reciprocity among households. Although support networks are organized around kinship, covariates that test predictions of kin selection models do not receive strong support, potentially because most kin-directed altruism occurs within households, not between households. In addition, the models show that households with high genetic relatedness in part from children born to adulterous relationships are less likely to assist each other.

Nuclear programs in India and Pakistan

NASA Astrophysics Data System (ADS)

Mian, Zia

2014-05-01

India and Pakistan launched their respective nuclear programs in the 1940s and 1950s with considerable foreign technical support, especially from the United States Atoms for Peace Program. The technology and training that was acquired served as the platform for later nuclear weapon development efforts that included nuclear weapon testing in 1974 and in 1998 by India, and also in 1998 by Pakistan - which had illicitly acquired uranium enrichment technology especially from Europe and received assistance from China. As of 2013, both India and Pakistan were continuing to produce fissile material for weapons, in the case of India also for nuclear naval fuel, and were developing a diverse array of ballistic and cruise missiles. International efforts to restrain the South Asian nuclear build-up have been largely set aside over the past decade as Pakistani support became central for the U.S. war in Afghanistan and as U.S. geopolitical and economic interests in supporting the rise of India, in part as a counter to China, led to India being exempted both from U.S non-proliferation laws and international nuclear trade guidelines. In the absence of determined international action and with Pakistan blocking the start of talks on a fissile material cutoff treaty, nuclear weapon programs in South Asia are likely to keep growing for the foreseeable future.

Postglacial recolonization in a cold climate specialist in western Europe: patterns of genetic diversity in the adder (Vipera berus) support the central-marginal hypothesis.

PubMed

Ursenbacher, Sylvain; Guillon, Michaël; Cubizolle, Hervé; Dupoué, Andréaz; Blouin-Demers, Gabriel; Lourdais, Olivier

2015-07-01

Understanding the impact of postglacial recolonization on genetic diversity is essential in explaining current patterns of genetic variation. The central-marginal hypothesis (CMH) predicts a reduction in genetic diversity from the core of the distribution to peripheral populations, as well as reduced connectivity between peripheral populations. While the CMH has received considerable empirical support, its broad applicability is still debated and alternative hypotheses predict different spatial patterns of genetic diversity. Using microsatellite markers, we analysed the genetic diversity of the adder (Vipera berus) in western Europe to reconstruct postglacial recolonization. Approximate Bayesian Computation (ABC) analyses suggested a postglacial recolonization from two routes: a western route from the Atlantic Coast up to Belgium and a central route from the Massif Central to the Alps. This cold-adapted species likely used two isolated glacial refugia in southern France, in permafrost-free areas during the last glacial maximum. Adder populations further from putative glacial refugia had lower genetic diversity and reduced connectivity; therefore, our results support the predictions of the CMH. Our study also illustrates the utility of highly variable nuclear markers, such as microsatellites, and ABC to test competing recolonization hypotheses. © 2015 John Wiley & Sons Ltd.

Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

PubMed

Behar-Horenstein, Linda S; Morris, Dustin R

2015-08-01

A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

The dynamic interplay of mourning and forgiveness in the early development of the self and psychic structure.

PubMed

Rankin, Eric D

2014-04-01

Mourning has received considerable attention in the psychoanalytic literature. Beginning with Freud's 1917 investigation, the central role of mourning in psychical development via identification has been articulated and subsequently elaborated upon by various authors (e.g., Klein, 1940; Schafer, 2005). Forgiveness, on the other hand, has until recently received considerably less attention, perhaps because of the strong religious and moral connotations often associated with it (Lansky, 2009a). Contemporary writers exploring the psychoanalytic implications of mourning and forgiveness, however, have suggested the importance of both in normal psychical development. The purpose of this paper is to propose an integrated model of mourning and forgiveness and explore its potential role in nascent infant development.

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.

Performance testing of lidar receivers

NASA Technical Reports Server (NTRS)

Shams, M. Y.

1986-01-01

In addition to the considerations about the different types of noise sources, dynamic range, and linearity of a lidar receiver, one requires information about the pulse shape retaining capabilities of the receiver. For this purpose, relatively precise information about the height resolution as well as the recovery time of the receiver, due both to large transients and to fast changes in the received signal, is required. As more and more analog receivers using fast analog to digital converters and transient recorders will be used in the future lidar systems, methods to test these devices are essential. The method proposed for this purpose is shown. Tests were carried out using LCW-10, LT-20, and FTVR-2 as optical parts of the optical pulse generator circuits. A commercial optical receiver, LNOR, and a transient recorder, VK 220-4, were parts of the receiver system.

Variation in resources needed to implement psychosocial support interventions for rural breast cancer survivors.

PubMed

Pisu, Maria; Meneses, Karen; Azuero, Andres; Benz, Rachel; Su, Xiaogang; McNees, Patrick

2016-04-01

Understanding how resources are used provides guidance to disseminating effective interventions. Here, we report data on implementation resources needed for the Rural Breast Cancer Survivors (RBCS) study that tested a telephone-delivered psychoeducational education and support intervention to survivors in rural Florida. Intervention resources included interventionists' time on one intake assessment (IA) call, three education calls (ED), one follow-up education call (FUE), six support (SUP) calls, and documentation time per survivor. Interventionists logged start and end times of each type of call. Average interventionist time in minutes was calculated by call type. Associations between interventionists' time and participants' characteristics including age, race/ethnicity, time since treatment, cancer treatment, depressive symptoms, education, income, employment, and support, was assessed using linear mixed models with repeated measures. Among 328 survivors, IA calls lasted 66.9 min (SD 21.7); ED lasted 50.6 (SD 16.7), 48.1 (SD 15.9), and 39.6 (SD 14.8); FUE lasted 24.7 (SD 14.8); and SUP 42.8 (SD 29.6) min. Documentation time was 18.4 min for IA, 23-27 for ED, 12.3 for FUE, and 23.0 for SUP. Interventionists spent significantly more time with participants with depressive symptoms, who already used other support, and who received SUP calls before the ED vs. after. There were no significant differences by time since or type of cancer treatment, or other personal characteristics. Resources vary by survivor characteristics. Careful consideration of mental health status or support available is warranted for planning implementation and dissemination of effective survivorship interventions on a broad scale.

Shipyard Standards Program Development Guide

DTIC Science & Technology

1992-10-01

Given the opportunity, designers will use designs that have worked for them in the past . Unfortunately, not all designers have the same experience base...standards formally approved by shipyard management? The subject of labor productivity standards has received considerable attention during the past decade. A...research into this consideration during the past decade. References [23], [24], [25], [26], and [27] have reported beneficial results obtained by getting the

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.

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…

Enterprise Considerations for Ports and Protocols

DTIC Science & Technology

2016-10-21

selected communications. These protocols are restricted to specific ports or addresses in the receiving web service. HTTPS is familiarly restricted...in use by the web services and applications that are connected to the network are required for interoperability and security. Policies specify the...network or reside at the end-points (i.e., web services or clients). ____________________________ Manuscript received June 1, 2016; revised July

Design of radar receivers

NASA Astrophysics Data System (ADS)

Sokolov, M. A.

This handbook treats the design and analysis of of pulsed radar receivers, with emphasis on elements (especially IC elements) that implement optimal and suboptimal algorithms. The design methodology is developed from the viewpoint of statistical communications theory. Particular consideration is given to the synthesis of single-channel and multichannel detectors, the design of analog and digital signal-processing devices, and the analysis of IF amplifiers.

Considerations for Using Personal Wi-Fi Enabled Devices as "Clickers" in a Large University Class

ERIC Educational Resources Information Center

Katz, Larry; Hallam, Megan C.; Duvall, Michael M.; Polsky, Zoe

2017-01-01

Interactive student response systems, commonly referred to as clickers, have increased in popularity in higher education classrooms as a means to improve engagement and enhance learning. Clicker systems come with handheld devices as well as a radio frequency receiver. A Wi-Fi connection to the receiver is possible, enabling students to use their…

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.

47 CFR 54.633 - Health care provider contribution.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund... providers receiving support under the Healthcare Connect Fund shall receive a 65 percent discount on the... provider contribution or for sustainability of the health care network supported by the Healthcare Connect...

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.

The effect of social support around pregnancy on postpartum depression among Canadian teen mothers and adult mothers in the maternity experiences survey.

PubMed

Kim, Theresa H M; Connolly, Jennifer A; Tamim, Hala

2014-05-07

Postpartum depression (PPD) is a mood disorder that affects 10-20 percent of women, and can begin any time during first year after delivery lasting for months. Social support may decrease risk of depression during pregnancy for women. However, literature shows that the amount of social support received during and after pregnancy is different for teen mothers and adult mothers. This study examined the effects of social support received during and after pregnancy on PPD among Canadian women and identified if the relationship was different for teen mothers compared to adult mothers. The study was based on secondary analysis of the Maternity Experiences Survey. A total of 6,421 women with singleton live births, aged 15 years and older were analyzed. Teen mothers were identified as 15-19 years old and adult mothers were identified as 20 years and older. The main outcome of the study was PPD, which was evaluated using the Edinburg Postnatal Depression Scale. The main independent variable was social support received during pregnancy and after birth. Logistic regression was computed to assess the relationship between social support and PPD after adjusting for confounding variables and age as an interaction term. Adjusted Odds Ratios and 95% Confidence Intervals were reported. PPD was experienced by 14.0% among teen mothers and 7.2% among adult mothers (p < .001). Overall, teen mothers reported receiving more support during pregnancy and after birth than adult mothers (p < .010). The relationship between social support and PPD did not significantly differ for teen compared to adult mothers. Both teen and adult mothers were approximately five times more likely to experience PPD if they received no support or minimal support after the birth of the baby (95% CI, 3.51-7.36). Receiving social support especially after birth is important for mothers of all ages to reduce the risk of PPD.

Social support and ambulatory blood pressure: an examination of both receiving and giving.

PubMed

Piferi, Rachel L; Lawler, Kathleen A

2006-11-01

The relationship between the social network and physical health has been studied extensively and it has consistently been shown that individuals live longer, have fewer physical symptoms of illness, and have lower blood pressure when they are a member of a social network than when they are isolated. Much of the research has focused on the benefits of receiving social support from the network and the effects of giving to others within the network have been neglected. The goal of the present research was to systematically investigate the relationship between giving and ambulatory blood pressure. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate were recorded every 30 min during the day and every 60 min at night during a 24-h period. Linear mixed models analyses revealed that lower systolic and diastolic blood pressure and mean arterial pressure were related to giving social support. Furthermore, correlational analyses revealed that participants with a higher tendency to give social support reported greater received social support, greater self-efficacy, greater self-esteem, less depression, and less stress than participants with a lower tendency to give social support to others. Structural equation modeling was also used to test a proposed model that giving and receiving social support represent separate pathways predicting blood pressure and health. From this study, it appears that giving social support may represent a unique construct from receiving social support and may exert a unique effect on health.

Sequential mediating effects of provided and received social support on trait emotional intelligence and subjective happiness: A longitudinal examination in Hong Kong Chinese university students.

PubMed

Ye, Jiawen; Yeung, Dannii Y; Liu, Elaine S C; Rochelle, Tina L

2018-04-03

Past research has often focused on the effects of emotional intelligence and received social support on subjective well-being yet paid limited attention to the effects of provided social support. This study adopted a longitudinal design to examine the sequential mediating effects of provided and received social support on the relationship between trait emotional intelligence and subjective happiness. A total of 214 Hong Kong Chinese undergraduates were asked to complete two assessments with a 6-month interval in between. The results of the sequential mediation analysis indicated that the trait emotional intelligence measured in Time 1 indirectly influenced the level of subjective happiness in Time 2 through a sequential pathway of social support provided for others in Time 1 and social support received from others in Time 2. These findings highlight the importance of trait emotional intelligence and the reciprocal exchanges of social support in the subjective well-being of university students. © 2018 International Union of Psychological Science.

Workplace breastfeeding support for hospital employees.

PubMed

Dodgson, Joan E; Chee, Yuet-Oi; Yap, Tian Sew

2004-07-01

Breastfeeding initiation rates have been steadily rising in Hong Kong, but most employed women wean prior to returning to work. While health care providers promote breastfeeding, women receive little support from employers. A few health care facilities offer some workplace breastfeeding support, but little is known about the specific types and amount of support that are offered. This paper reports a study whose aim was to describe workplace supports available to breastfeeding women employed by hospitals that provide maternity services in Hong Kong, and to determine if differences in workplace supports exist based on the hospitals' numbers of employees or funding source. In late 2001, a cross-sectional survey was completed by nurse managers or lactation consultants most knowledgeable about supports to breastfeeding employees in 19 hospitals. The number of workplace breastfeeding supports or Breastfeeding Support Score (M = 7.47; sd = 3.37) varied considerably. Mean Breastfeeding Support Score for government-funded hospitals was significantly higher (t = 2.31; P = 0.03) than for private hospitals. Of the 14 hospitals that had a designated space for using a breast pump, only five (26.3%) had a private room with a door that locked. Only two hospitals (11.1%) allowed employees to take breaks as needed to use a pump; employees in 10 (55.6%) had to use their meal and regular break times. Hospitals having a hospital-wide committee that addressed workplace breastfeeding issues had a more supportive environment for breastfeeding employees. Although all surveyed hospitals returned the questionnaire, the sample size was small. It was difficult to ensure accuracy and to differentiate subtle variations in the services provided using a self-report survey. Facilitating continued breastfeeding after employees' return to work requires that employers understand the needs of breastfeeding employees. Policy at the level of the employer and government is an essential component of creating a supportive environment.

Dependent, but not Perfectionistic, Dysfunctional Attitudes Predict Worsened Mood and Appraisals after Emotional Support from a Romantic Partner

PubMed Central

Felix, Steven A. M.; Hooker, Christine I.

2016-01-01

Background: Receiving emotional support from a romantic partner often leads to emotional costs via negative appraisals about the self and one's relationship, but it is unclear whether certain individuals are more susceptible to these costs. We evaluate whether the presence of perfectionistic and dependent dysfunctional attitudes leads to more negative effects of receiving emotional support from a romantic partner. Methods: Twenty-nine couples (27 men, 31 women; mean age 24.5) completed the Dysfunctional Attitudes Scale and then a daily online questionnaire by recording their mood, appraisals, and received emotional support. Mixed-effects regressions were used to evaluate whether perfectionistic and dependent dysfunctional attitudes moderated the relationship between emotional support receipt and subsequent mood and appraisals. Results: Perfectionism did not interact with emotional support but exerted a main effect of increasing negative moods and appraisals. Dependency interacted with emotional support such that those with more dependent attitudes reported greater negative next-day moods and appraisals as a function of emotional support. Conclusions: Individuals with dependent, but not perfectionistic, dysfunctional attitudes are more likely to experience emotional and cognitive costs after receiving emotional support. These costs may stem from activation or exacerbation of the attitudes specific to dependency, including need for acceptance, support, and approval of others. PMID:27790161

Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?

PubMed

Roberts, James R; Morella, Kristen; Dawley, Erin H; Madden, Christi A; Jacobson, Robert M; Pope, Charlene; Davis, Boyd; Thompson, David; O'Brien, Elizabeth S; Darden, Paul M

2018-05-11

Direct-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message. We distributed a survey to parents of 10-17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age. In 546 surveys from 11 practices, parents of females were more supportive of direct-to-teen text message reminders than were parents of males, (75% v. 60%, p < .001). The median age at which parents would allow direct text messages from physicians' offices was 14 in females compared to 15 in males, p = .049. We found a correlation between the child's age and the youngest age at which parents would allow a direct text message. Of the parents who permitted a text message directly to their adolescent, most reported an allowable age higher than their adolescent's current age until the age of 15. Our study suggests that direct-to-adolescent text messaging would be allowed by parents for older adolescents. This supports an intervention aimed at older adolescents, such as for receipt of MCV4 dose #2, delayed HPV vaccine series completion and annual influenza vaccination. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Patient Risk Model of Chemotherapy-Induced Febrile Neutropenia: Lessons Learned From the ANC Study Group.

PubMed

Lyman, Gary H; Poniewierski, Marek S

2017-12-01

Neutropenia and its complications, including febrile neutropenia (FN), represent major toxicities associated with cancer chemotherapy, resulting in considerable morbidity, mortality, and costs. The myeloid growth factors such as granulocyte colony-stimulating factor (G-CSF) have been shown to reduce the risk of neutropenia complications while enabling safe and effective chemotherapy dose intensity. Concerns about the high costs of these agents along with limited physician adherence to clinical practice guidelines, resulting in both overuse and underuse, has stimulated interest in models for individual patient risk assessment to guide appropriate use of G-CSF. In a model developed and validated by the ANC Study Group, half of patients were classified as high risk and half as low risk based on patient-, disease-, and treatment-related factors. This model has been further validated in an independent patient population. Physician-assessed risk of FN, as well as the decision to use prophylactic CSF, has been shown to correlate poorly with the FN risk estimated by the model. Additional modeling efforts in both adults and children receiving cancer treatment have been reported. Identification of patients at a high individual risk for FN and its consequences may offer the potential for optimal chemotherapy delivery and patient outcomes. Likewise, identification of patients at low risk for neutropenic events may reduce costs when such supportive care is not warranted. This article reviews and summarizes FN modeling studies and the opportunities for personalizing supportive care in patients receiving chemotherapy. Copyright © 2017 by the National Comprehensive Cancer Network.

Internet-Delivered, Family-Based Treatment for Early-Onset OCD: A Preliminary Case Series

PubMed Central

Comer, Jonathan S.; Furr, Jami M.; Cooper-Vince, Christine E.; Kerns, Caroline E.; Chan, Priscilla T.; Edson, Aubrey L.; Khanna, Muniya; Franklin, Martin E.; Garcia, Abbe M.; Freeman, Jennifer B.

2014-01-01

Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (MAge = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as “excellent.” The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care. PMID:24295036

Key Considerations of Community, Scalability, Supportability, Security, and Functionality in Selecting Open-Source Software in California Universities as Perceived by Technology Leaders

ERIC Educational Resources Information Center

Britton, Todd Alan

2014-01-01

Purpose: The purpose of this study was to examine the key considerations of community, scalability, supportability, security, and functionality for selecting open-source software in California universities as perceived by technology leaders. Methods: After a review of the cogent literature, the key conceptual framework categories were identified…

Effects of Social Supports on the Career Choice Consideration of Chinese Farmers: A Social Cognitive Perspective

ERIC Educational Resources Information Center

Zhao, Li

2012-01-01

Drawing from social cognitive career theory (Lent, Brown, & Hackett, 1994), this study explored social supports' influence on the career choice consideration of farmers during China's current process of urbanization. A questionnaire was designed based on interviews with 140 people and a pretest with a sample of 419 participants. A total of 628…

Ending Special Educators' Isolation

ERIC Educational Resources Information Center

Hansen, Spencer D.

2007-01-01

This article talks about the "special" support that special educators need from administrators. Special educators need the same type of support that regular teachers receive. Pairing regular and special education teachers allows special education teachers to contribute to and receive support from the other teachers in a school. Ensuring that…

Potential barriers to veterinary student access to counselling and other support systems: perceptions of staff and students at a UK veterinary school.

PubMed

Pickles, K J; Rhind, S M; Miller, R; Jackson, S; Allister, R; Philp, J; Waterhouse, L; Mellanby, R J

2012-02-04

Considerable evidence suggests that veterinary surgeons' mental health is often poorer than comparable populations and that the incidence of suicide is higher among veterinary surgeons than the general public. Veterinary students also appear to suffer from high levels of anxiety and stress, and may possess inadequate coping strategies when faced with adversity. Veterinary students may find it difficult to access central university support systems due to their heavy workload and geographical isolation on some veterinary campuses. A previous study of University of Edinburgh fourth-year veterinary students found that support services located several miles from the main veterinary campus was a barrier to students accessing counselling services. Consequently, a pilot project was initiated, which provided a counselling service at the University of Edinburgh's rural Easter Bush veterinary campus one afternoon a week during 2010. As part of the evaluation of this service, web-based questionnaires were delivered via e-mail to all veterinary staff and students towards the end of the 12-month pilot period to evaluate perceptions of barriers to student counselling and to investigate student-valued support services. Questionnaire responses were received from 35 per cent of veterinary students and 52 per cent of staff. Stigmatisation of being unable to cope was a potent inhibitor of seeking support within the veterinary environment, but counselling was perceived as valuable by the majority of staff and students. Provision of an on-site counselling service was considered important for increasing ease of access; however, students viewed friends and family as their most important support mechanism. Workload was cited as the main cause of veterinary student stress. The majority of staff and student respondents perceived veterinary students as having an increased need for counselling support compared with other students.

33 CFR 51.8 - Relevant considerations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; qualification for reenlistment; capability to adjust to military service; and family or personal problems. (c... received; promotions and demotions; prior military service and type of discharge; records of unauthorized...

The Relation of Perceived and Received Social Support to Mental Health among First Responders: A Meta-Analytic Review

ERIC Educational Resources Information Center

Prati, Gabriele; Pietrantoni, Luca

2010-01-01

There are plenty of theories that may support the protective role of social support in the aftermath of potentially traumatic events. This meta-analytic review examined the role of received and perceived social support in promoting mental health among first responders (e.g., firefighters, police officers, and paramedics or emergency medical…

Nursing teams: behind the charts.

PubMed

Bae, Sung-Heui; Farasat, Alireza; Nikolaev, Alex; Seo, Jin Young; Foltz-Ramos, Kelly; Fabry, Donna; Castner, Jessica

2017-07-01

To examine the nature and characteristics of both received and provided mutual support in a social network within an acute care hospital unit. Current evidence regarding the social network in the health care workforce reveals the nature of social ties. Most studies of social network-related support that measured the characteristics of social support used self-reported perception from workers receiving support. There is a gap in studies that focus on back-up behaviour. The evaluation included a social network analysis of a nursing unit employing 54 staff members. A 12 item electronic survey was administered. Descriptive statistics were calculated using the Statistical Package for the Social Sciences. Social network analyses were carried out using ucinet, r 3.2.3 and gephi. Based on the study findings, as providers of mutual support the nursing staff claimed to give their peers more help than these peers gave them credit for. Those who worked overtime provided more mutual support. Mutual support is a key teamwork characteristic, essential to quality and safety in hospital nursing teams that can be evaluated using social network analysis. Because of a discrepancy regarding receiving and providing help, examining both receiver and provider networks is a superior approach to understanding mutual support. © 2017 John Wiley & Sons Ltd.

Respiratory Support for Very Low Birth Weight Infants Receiving Dexamethasone.

PubMed

Virkud, Yamini V; Hornik, Christoph P; Benjamin, Daniel K; Laughon, Matthew M; Clark, Reese H; Greenberg, Rachel G; Smith, P Brian

2017-04-01

To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration. This is an observational study of infants discharged from one of 290 neonatal intensive care units from 2003 to 2010. The cohort included very low birth weight (<1500 g birth weight) infants born at ≤32 weeks gestational age. The main outcome was respiratory support at time of exposure to dexamethasone. Significant respiratory support was defined as invasive respiratory support (conventional or high-frequency ventilation) with a fraction of inspired oxygen (FiO 2 ) > 0.3. Of 81 292 infants; 7093 (9%) received dexamethasone. At the time that dexamethasone was initiated, 4604 (65%) of infants were on significant respiratory support. In accordance with the American Academy of Pediatrics recommendations, a majority of infants were on significant respiratory support when receiving dexamethasone, yet a substantial number of infants still received dexamethasone on less than significant respiratory support. Further research on reducing dexamethasone use in premature infants is required to decrease the risk of neurodevelopmental impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

Shortcomings of adherence counselling provided to caregivers of children receiving antiretroviral therapy in rural South Africa.

PubMed

Coetzee, Bronwyne; Kagee, Ashraf; Bland, Ruth

2016-03-01

In order to achieve optimal benefits of antiretroviral therapy (ART), caregivers of children receiving ART are required to attend routine clinic visits monthly and administer medication to the child as prescribed. Yet, the level of adherence to these behaviours varies considerably in many settings. As a way to achieve optimal adherence in rural KwaZulu-Natal, caregivers are required to attend routine counselling sessions at HIV treatment clinics that are centred on imparting information, motivation, and behavioural skills related to medication administration. According to the information-motivation-behavioural skills model, information related to adherence, motivation, and behavioural skills are necessary and fundamental determinants of adherence to ART. The purpose of the study was to observe and document the content of adherence counselling sessions that caregivers attending rural clinics in KwaZulu Natal receive. We observed 25 adherence counselling sessions, which lasted on average 8.1 minutes. Counselling typically consisted of counsellors recording patient attendance, reporting CD4 count and viral load results to caregivers, emphasising dose times, and asking caregivers to name their medications and dosage amounts. Patients were seldom asked to demonstrate how they measure the medication. They were also not probed for problems regarding treatment, even when an unsuppressed VL was reported to a caregiver. This paper calls attention to the sub-optimal level of counselling provided to patients on ART and the urgent need to standardise and improve the training, support, and debriefing provided to counsellors.

The New Jersey Medicaid ACO Demonstration Project: seeking opportunities for better care and lower costs among complex low-income patients.

PubMed

Cantor, Joel C; Chakravarty, Sujoy; Tong, Jian; Yedidia, Michael J; Lontok, Oliver; DeLia, Derek

2014-12-01

A small but growing number of states are turning to accountable care concepts to improve their Medicaid programs. In 2011 New Jersey enacted the Medicaid Accountable Care Organization (ACO) Demonstration Project to offer local provider coalitions the opportunity to share any savings they generate. Impetus came from initiatives in Camden that aim to reduce costs through improved care coordination among hospital high users and that have received considerable media attention and substantial federal and private grant support. Though broadly similar to Medicare and commercial ACOs, the New Jersey demonstration addresses the unique concerns faced by Medicaid populations. Using hospital all-payer billing data, we estimate savings from care improvement efforts among inpatient and emergency department high users in thirteen communities that are candidates for participation in the New Jersey demonstration. We also examine their characteristics to inform Medicaid accountable care strategies. We find substantial variation in the share of high-user hospital patients across the study communities and high rates of avoidable use and costs among these patients. The potential savings among Medicaid enrollees are considerable, particularly if Medicaid ACOs can develop ways to successfully address the high burden of chronic illness and behavioral health conditions prevalent in the prospective demonstration communities. Copyright © 2014 by Duke University Press.

Biodiversity of cyanobacteria and green algae on monuments in the Mediterranean Basin: an overview.

PubMed

Macedo, Maria Filomena; Miller, Ana Zélia; Dionísio, Amélia; Saiz-Jimenez, Cesareo

2009-11-01

The presence and deteriorating action of micro-organisms on monuments and stone works of art have received considerable attention in the last few years. Knowledge of the microbial populations living on stone materials is the starting point for successful conservation treatment and control. This paper reviews the literature on cyanobacteria and chlorophyta that cause deterioration of stone cultural heritage (outdoor monuments and stone works of art) in European countries of the Mediterranean Basin. Some 45 case studies from 32 scientific papers published between 1976 and 2009 were analysed. Six lithotypes were considered: marble, limestone, travertine, dolomite, sandstone and granite. A wide range of stone monuments in the Mediterranean Basin support considerable colonization of cyanobacteria and chlorophyta, showing notable biodiversity. About 172 taxa have been described by different authors, including 37 genera of cyanobacteria and 48 genera of chlorophyta. The most widespread and commonly reported taxa on the stone cultural heritage in the Mediterranean Basin are, among cyanobacteria, Gloeocapsa, Phormidium and Chroococcus and, among chlorophyta, Chlorella, Stichococcus and Chlorococcum. The results suggest that cyanobacteria and chlorophyta colonize a wide variety of substrata and that this is related primarily to the physical characteristics of the stone surface, microclimate and environmental conditions and secondarily to the lithotype.

Practical considerations for transitioning early childhood interventions to scale: lessons from the Saving Brains portfolio.

PubMed

Radner, James M; Ferrer, Marvin J S; McMahon, Dominique; Shankar, Anuraj H; Silver, Karlee L

2018-05-01

Small pilot studies of young children have frequently shown promise, but very few have been successfully scaled to the regional or national levels. How can we ensure that these promising approaches move from a suite of pilots to full-scale implementation that can deliver sustainable impact for hundreds of millions of children? To elucidate concrete lessons learned and suggestions on accelerating the transition to impact at scale, we reviewed the Saving Brains portfolio to better understand three points: (1) the extent to which useful signals of impact could be extracted from data at the seed phase, (2) the ways in which innovators (project leaders) were approaching human resource challenges critical for scaling, and (3) the multisector diversity of the portfolio and the way innovators entered partnerships. The findings suggest key considerations for transitioning early childhood development interventions to scale and sustainability: strong entrepreneurial leadership, rigorous measurement and active use of data in support of adaptive learning, and champions acting at subnational levels. Together, these can enable flexible, iterative learning that can make the scaling process an opportunity to increase the level of benefit each child receives from an intervention. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

Use of mobile devices in community health care: barriers and solutions to implementation.

PubMed

Turner, Christopher

2016-02-01

Mobile devices allow clinicians to access electronic clinical systems away from traditional base locations. They have contributed to increased productivity and efficiency, and clinical staff also cite benefits to patient care. A selection of NHS trusts have participated in a national pilot to explore the benefits and drawbacks of this technology. Clinical engagement with frontline staff is essential to ensure the staff feel valued, listened to, and fully involved to ensure any change to existing practice is successful. Moreover, the training needs of the workforce require careful consideration. The provision of information technology (IT) support services is fundamental to ensure that staff receive the necessary assistance with any functionality issues they may experience with mobile devices to minimise the effect on clinical practice. Variability in internet connectivity may present as a challenge to clinical staff, and the benefits of complimentary offline working solutions should be considered. Barriers to the successful use of mobile devices should be reported as this may have a negative clinical effect on the safe delivery of patient care. Clinical staff need to be mindful of their obligations in relation to information governance, and should appreciate that the same consideration needs to be given to both paper and electronic records.

Sexual and reproductive health care for adolescents: legal rights and policy challenges.

PubMed

English, Abigail

2007-12-01

Laws developed over the past half century have significantly improved adolescents' access to essential sexual and reproductive health care. These laws allow many adolescent minors to give their own consent, protect confidentiality, and provide financial support for the care. The consent requirements for adolescents to receive health care are contained primarily in state court decisions and in statutes known as "state minor consent laws," which are based on either the minor's status or the services sought. Confidentiality protections for adolescents' health information are contained in these minor consent laws, in the federal medical privacy regulations known as the "HIPAA Privacy Rule," and in state medical privacy laws. Other significant laws include statutes providing for the emancipation of minors, court decisions delineating the mature minor doctrine, regulations protecting adolescents' access to confidential family planning services in publicly funded programs, and court decisions interpreting the constitutional right of privacy. Special considerations apply to consent and confidentiality questions pertaining to family planning, contraception, and pregnancy-related care for minors. In addition to the explicit provisions of state minor consent laws, many of the most important considerations are articulated in court decisions based on the constitutional right of privacy and the confidentiality requirements that are part of the federal Title X Family Planning Program and Medicaid.

Social Support, Social Loss and Positive and Negative Psychological Functioning.

ERIC Educational Resources Information Center

McGowan, John R.

While the relationship between stressful life events, social support, and health outcomes has received much attention, efforts to quantify social support and directly examine specific ameliorative effects have resulted in mixed findings. Direct and mediational effects of two psychometrically validated measures of perceived and received social…

47 CFR 54.422 - Annual reporting for eligible telecommunications carriers that receive low-income support.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Annual reporting for eligible telecommunications carriers that receive low-income support. 54.422 Section 54.422 Telecommunication FEDERAL... Support for Low-Income Consumers § 54.422 Annual reporting for eligible telecommunications carriers that...

47 CFR 54.422 - Annual reporting for eligible telecommunications carriers that receive low-income support.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Annual reporting for eligible telecommunications carriers that receive low-income support. 54.422 Section 54.422 Telecommunication FEDERAL... Support for Low-Income Consumers § 54.422 Annual reporting for eligible telecommunications carriers that...

47 CFR 54.422 - Annual reporting for eligible telecommunications carriers that receive low-income support.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Annual reporting for eligible telecommunications carriers that receive low-income support. 54.422 Section 54.422 Telecommunication FEDERAL... Support for Low-Income Consumers § 54.422 Annual reporting for eligible telecommunications carriers that...

Perceptions of Non-Native EFL Teachers' on L1 Use in L2 Classrooms: Implications for Language Program Development

ERIC Educational Resources Information Center

Debreli, Emre

2016-01-01

The study of L1 (first language) use in L2 (second language) classrooms has long received attention in the literature. Despite the considerable amount of research that has been conducted on the phenomenon, the focus has often been on the advantages and disadvantages. Considerably, less research has been conducted regarding the non-native L2…

AAFE man-made noise experiment project. Volume 3: Appendices

NASA Technical Reports Server (NTRS)

1974-01-01

Management and operational considerations involved in the project to measure man-made electromagnetic noise at earth orbital altitudes are discussed. The subjects considered are: (1) launch and orbit of the Scout D vehicles, (2) experiment management, (3) receiver scanning considerations, (4) data handling, and (5) threshold measurements. The storage requirements for a high resolution, complete data storage library are defined. Mathematical models of signal detection probability are developed.

Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

PubMed

Hohl, Diana Hilda; Knoll, Nina; Wiedemann, Amelie; Keller, Jan; Scholz, Urte; Schrader, Mark; Burkert, Silke

2016-04-01

To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

Support System for Solar Receivers

NASA Technical Reports Server (NTRS)

Kiceniuk, T.

1985-01-01

Hinged split-ring mounts insure safe support of heavy receivers. In addition to safer operation and damage-free mounting system provides more accurate focusing, and small incremental adjustments of ring more easily made.

47 CFR 73.277 - Permissible transmissions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... undertakes to supply, or receives consideration for supplying, on its main channel a functional music, background music, or other subscription service (including storecasting) for reception in the place or places...

47 CFR 73.277 - Permissible transmissions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... undertakes to supply, or receives consideration for supplying, on its main channel a functional music, background music, or other subscription service (including storecasting) for reception in the place or places...

47 CFR 73.277 - Permissible transmissions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... undertakes to supply, or receives consideration for supplying, on its main channel a functional music, background music, or other subscription service (including storecasting) for reception in the place or places...

47 CFR 73.277 - Permissible transmissions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... undertakes to supply, or receives consideration for supplying, on its main channel a functional music, background music, or other subscription service (including storecasting) for reception in the place or places...

47 CFR 73.277 - Permissible transmissions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... undertakes to supply, or receives consideration for supplying, on its main channel a functional music, background music, or other subscription service (including storecasting) for reception in the place or places...

On Fast Post-Processing of Global Positioning System Simulator Truth Data and Receiver Measurements and Solutions Data

NASA Technical Reports Server (NTRS)

Kizhner, Semion; Day, John H. (Technical Monitor)

2000-01-01

Post-Processing of data related to a Global Positioning System (GPS) simulation is an important activity in qualification of a GPS receiver for space flight. Because a GPS simulator is a critical resource it is desirable to move off the pertinent simulation data from the simulator as soon as a test is completed. The simulator data files are usually moved to a Personal Computer (PC), where the post-processing of the receiver logged measurements and solutions data and simulated data is performed. Typically post-processing is accomplished using PC-based commercial software languages and tools. Because of commercial software systems generality their general-purpose functions are notoriously slow and more than often are the bottleneck problem even for short duration experiments. For example, it may take 8 hours to post-process data from a 6-hour simulation. There is a need to do post-processing faster, especially in order to use the previous test results as feedback for a next simulation setup. This paper demonstrates that a fast software linear interpolation algorithm is applicable to a large class of engineering problems, like GPS simulation data post-processing, where computational time is a critical resource and is one of the most important considerations. An approach is developed that allows to speed-up post-processing by an order of magnitude. It is based on improving the post-processing bottleneck interpolation algorithm using apriori information that is specific to the GPS simulation application. The presented post-processing scheme was used in support of a few successful space flight missions carrying GPS receivers. A future approach to solving the post-processing performance problem using Field Programmable Gate Array (FPGA) technology is described.

Special article: Creation of a guide for the transfer of care of the malignant hyperthermia patient from ambulatory surgery centers to receiving hospital facilities.

PubMed

Larach, Marilyn Green; Dirksen, Sharon J Hirshey; Belani, Kumar G; Brandom, Barbara W; Metz, Keith M; Policastro, Michael A; Rosenberg, Henry; Valedon, Arnaldo; Watson, Charles B

2012-01-01

Volatile anesthetics and/or succinylcholine may trigger a potentially lethal malignant hyperthermia (MH) event requiring critical care crisis management. If the MH triggering anesthetic is given in an ambulatory surgical center (ASC), then the patient will need to be transferred to a receiving hospital. Before May 2010, there was no clinical guide regarding the development of a specific transfer plan for MH patients in an ASC. MECHANISM BY WHICH THE STATEMENT WAS GENERATED: A consensual process lasting 18 months among 13 representatives of the Malignant Hyperthermia Association of the United States, the Ambulatory Surgery Foundation, the Society for Ambulatory Anesthesia, the Society for Academic Emergency Medicine, and the National Association of Emergency Medical Technicians led to the creation of this guide. EVIDENCE FOR THE STATEMENT: Most of the guide is based on the clinical experience and scientific expertise of the 13 representatives. The list of representatives appears in Appendix 1. The recommendation that IV dantrolene should be initiated pending transfer is also supported by clinical research demonstrating that the likelihood of significant MH complications doubles for every 30-minute delay in dantrolene administration (Anesth Analg 2010;110:498-507). This guide includes a list of potential clinical problems and therapeutic interventions to assist each ASC in the development of its own unique MH transfer plan. Points to consider include receiving health care facility capabilities, indicators of patient stability and necessary report data, transport team considerations and capabilities, implementation of transfer decisions, and coordination of communication among the ASC, the receiving hospital, and the transport team. See Appendix 2 for the guide.

26 CFR 1.6045-4 - Information reporting on real estate transactions with dates of closing on or after January 1, 1991.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) for money, indebtedness, property other than money, or services. The term “sale or exchange” shall... total consideration (in money, services and property), received or to be received in connection with the... (h)(2)(ii) of this section), to a foundation. Thus, a transfer of an unaffixed mobile home that is...

26 CFR 1.6045-4 - Information reporting on real estate transactions with dates of closing on or after January 1, 1991.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) for money, indebtedness, property other than money, or services. The term “sale or exchange” shall... total consideration (in money, services and property), received or to be received in connection with the... (h)(2)(ii) of this section), to a foundation. Thus, a transfer of an unaffixed mobile home that is...

26 CFR 1.6045-4 - Information reporting on real estate transactions with dates of closing on or after January 1, 1991.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) for money, indebtedness, property other than money, or services. The term “sale or exchange” shall... total consideration (in money, services and property), received or to be received in connection with the... (h)(2)(ii) of this section), to a foundation. Thus, a transfer of an unaffixed mobile home that is...

26 CFR 1.6045-4 - Information reporting on real estate transactions with dates of closing on or after January 1, 1991.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) for money, indebtedness, property other than money, or services. The term “sale or exchange” shall... total consideration (in money, services and property), received or to be received in connection with the... (h)(2)(ii) of this section), to a foundation. Thus, a transfer of an unaffixed mobile home that is...

Research instrumentation for tornado electromagnetics emissions detection

NASA Technical Reports Server (NTRS)

Jenkins, H. H.; Wilson, C. S.

1977-01-01

Instrumentation for receiving, processing, and recording HF/VHF electromagnetic emissions from severe weather activity is described. Both airborne and ground-based instrumentation units are described on system and subsystem levels. Design considerations, design decisions, and the rationale behind the decisions are given. Performance characteristics are summarized and recommendations for improvements are given. The objectives, procedures, and test results of the following are presented: (1) airborne flight test in the Midwest U.S.A. (Spring 1975) and at the Kennedy Space Center, Florida (Summer 1975); (2) ground-based data collected in North Georgia (Summer/Fall 1975); and (3) airborne flight test in the Midwest (late Spring 1976) and at the Kennedy Space Center, Florida (Summer 1976). The Midwest tests concentrated on severe weather with tornadic activity; the Florida and Georgia tests monitored air mass convective thunderstorm characteristics. Supporting ground truth data from weather radars and sferics DF nets are described.

Neglected chaos in international stock markets: Bayesian analysis of the joint return-volatility dynamical system

NASA Astrophysics Data System (ADS)

Tsionas, Mike G.; Michaelides, Panayotis G.

2017-09-01

We use a novel Bayesian inference procedure for the Lyapunov exponent in the dynamical system of returns and their unobserved volatility. In the dynamical system, computation of largest Lyapunov exponent by traditional methods is impossible as the stochastic nature has to be taken explicitly into account due to unobserved volatility. We apply the new techniques to daily stock return data for a group of six countries, namely USA, UK, Switzerland, Netherlands, Germany and France, from 2003 to 2014, by means of Sequential Monte Carlo for Bayesian inference. The evidence points to the direction that there is indeed noisy chaos both before and after the recent financial crisis. However, when a much simpler model is examined where the interaction between returns and volatility is not taken into consideration jointly, the hypothesis of chaotic dynamics does not receive much support by the data ("neglected chaos").

IMPACT OF WATER PH ON ZEBRA MUSSEL MORTALITY

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

Daniel P. Molloy

2002-10-15

The experiments conducted this past quarter have suggested that the bacterium Pseudomonas fluorescens strain CL0145A is effective at killing zebra mussels throughout the entire range of pH values tested (7.2 to 8.6). Highest mortality was achieved at pH values characteristic of preferred zebra mussel waterbodies, i.e., hard waters with a range of 7.8 to 8.6. In all water types tested, however, ranging from very soft to very hard, considerable mussel kill was achieved (83 to 99% mean mortality), suggesting that regardless of the pH or hardness of the treated water, significant mussel kill can be achieved upon treatment with P.more » fluorescens strain CL0145A. These results further support the concept that this bacterium has significant potential for use as a zebra mussel control agent in power plant pipes receiving waters with a wide range of physical and chemical characteristics.« less

Children who murder: a review.

PubMed

Shumaker, D M; Prinz, R J

2000-06-01

Despite considerable research on juvenile homicide, pre-adolescent homicide offenders have received less attention. This paper reviews the existing literature on preteen murderers in order to characterize the current state of research knowledge about this population, and draws on some of the work on adolescent homicide as well. The analysis of this literature considers historical context, methodological issues, previous attempts to classify youthful homicide offenders, and predictors of preteen homicidal behavior. While there is a high degree of heterogeneity within this population, several developmental similarities emerged across cases that were associated with the perpetration of homicide by preteens. A high percentage of preteen homicide offenders come from homes characterized by physical abuse, domestic violence, poor or absent parenting, and overall instability. Gun availability may have been a facilitating factor. Support for different etiologies of preteen versus adolescent homicide is weak. Recommendations for future research directions are offered.

Understanding occupational therapy students' attitudes, intentions, and behaviors regarding community service.

PubMed

Hoppes, Steve; Hellman, Chan M

2007-01-01

Community-based practice has always been a central domain of occupational therapy, and evidence supporting its increasing importance is growing. Preparing occupational therapy students for community practice has received considerable attention in professional literature, but students' voices have seldom been heard concerning this issue. This study sought to investigate attitudes, intentions, and behaviors regarding community service among occupational therapy students enrolled in one professional program using the Community Service Attitudes Survey. We present the Theory of Planned Behavior as a conceptual framework linking students' attitudes and intentions with behaviors. Results indicate that these occupational therapy students' attitudes and intentions regarding community service tended to be more strongly positive than those of their counterparts in other allied health disciplines; however, the community service behaviors of occupational therapy students were not significantly different from those of other allied health students, possibly because occupational therapy students perceived high costs to community service.

Reconciling Marriage and Care after Stroke.

PubMed

Anderson, Sharon; Keating, Norah; Wilson, Donna

2017-09-01

Most research on stroke's impact on couples has focused on the transition to caregiving/receiving. Despite considerable evidence that marriage is the primary source of support in the face of chronic conditions, little is known about what happens to marriage in the context of care after stroke. To address this gap, we undertook a qualitative grounded-theory study of 18 couples in which one partner had experienced a stroke. Findings revealed two interrelated themes of the couple processes: working out care, which involved discovering and addressing disruptions in day-to-day activities; and rethinking marriage, which involved determining the meaning of their relationship within the new context of care and disability. Three distinct types of marriages evolved from these processes: reconfirmed around their pre-stroke marriage; recalibrated around care; and a parallel relationship, "his" and "her" marriage. Our findings highlight the need to consider relationship dynamics in addition to knowledge about stroke and care.

Role of oxidative stress in epileptic seizures

PubMed Central

Shin, Eun-Joo; Jeong, Ji Hoon; Chung, Yoon Hee; Kim, Won-Ki; Ko, Kwang-Ho; Bach, Jae-Hyung; Hong, Jau-Shyong; Yoneda, Yukio; Kim, Hyoung-Chun

2013-01-01

Oxidative stress resulting from excessive free-radical release is likely implicated in the initiation and progression of epilepsy. Therefore, antioxidant therapies aimed at reducing oxidative stress have received considerable attention in epilepsy treatment. However, much evidence suggests that oxidative stress does not always have the same pattern in all seizures models. Thus, this review provides an overview aimed at achieving a better understanding of this issue. We summarize work regarding seizure models (i.e., genetically epilepsy-prone rats, kainic acid, pilocarpine, pentylenetetrazol, and trimethyltin), oxidative stress as an etiologic factor in epileptic seizures (i.e., impairment of antioxidant systems, mitochondrial dysfunction, involvement of redox-active metals, arachidonic acid pathway activation, and aging), and antioxidant strategies for seizure treatment. Combined, this review highlights pharmacological mechanisms associated with oxidative stress in epileptic seizures and the potential for neuroprotection in epilepsy that targets oxidative stress and is supported by effective antioxidant treatment. PMID:21672578

Distal technologies and type 1 diabetes management.

PubMed

Duke, Danny C; Barry, Samantha; Wagner, David V; Speight, Jane; Choudhary, Pratik; Harris, Michael A

2018-02-01

Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Oxidative modifications, mitochondrial dysfunction, and impaired protein degradation in Parkinson's disease: how neurons are lost in the Bermuda triangle.

PubMed

Malkus, Kristen A; Tsika, Elpida; Ischiropoulos, Harry

2009-06-05

While numerous hypotheses have been proposed to explain the molecular mechanisms underlying the pathogenesis of neurodegenerative diseases, the theory of oxidative stress has received considerable support. Although many correlations have been established and encouraging evidence has been obtained, conclusive proof of causation for the oxidative stress hypothesis is lacking and potential cures have not emerged. Therefore it is likely that other factors, possibly in coordination with oxidative stress, contribute to neuron death. Using Parkinson's disease (PD) as the paradigm, this review explores the hypothesis that oxidative modifications, mitochondrial functional disruption, and impairment of protein degradation constitute three interrelated molecular pathways that execute neuron death. These intertwined events are the consequence of environmental exposure, genetic factors, and endogenous risks and constitute a "Bermuda triangle" that may be considered the underlying cause of neurodegenerative pathogenesis.

Oxidative modifications, mitochondrial dysfunction, and impaired protein degradation in Parkinson's disease: how neurons are lost in the Bermuda triangle

PubMed Central

Malkus, Kristen A; Tsika, Elpida; Ischiropoulos, Harry

2009-01-01

While numerous hypotheses have been proposed to explain the molecular mechanisms underlying the pathogenesis of neurodegenerative diseases, the theory of oxidative stress has received considerable support. Although many correlations have been established and encouraging evidence has been obtained, conclusive proof of causation for the oxidative stress hypothesis is lacking and potential cures have not emerged. Therefore it is likely that other factors, possibly in coordination with oxidative stress, contribute to neuron death. Using Parkinson's disease (PD) as the paradigm, this review explores the hypothesis that oxidative modifications, mitochondrial functional disruption, and impairment of protein degradation constitute three interrelated molecular pathways that execute neuron death. These intertwined events are the consequence of environmental exposure, genetic factors, and endogenous risks and constitute a "Bermuda triangle" that may be considered the underlying cause of neurodegenerative pathogenesis. PMID:19500376

Prayer beliefs and change in life satisfaction over time.

PubMed

Krause, Neal; Hayward, R David

2013-06-01

A considerable number of studies have focused on the relationship between prayer, health, and well-being. But the influence of some types of prayer (e.g., petitionary prayer) has received more attention than others. The purpose of this study is to examine an overlooked aspect of prayer: trust-based prayer beliefs. People with this orientation believe that God knows that best way to answer a prayer and He selects the best time to provide an answer. Three main findings emerge from data that were provided by a nationwide longitudinal survey of older people reveals. First, the results reveal that Conservative Protestants are more likely to endorse trust-based prayer beliefs. Second, the findings suggest that these prayer beliefs tend to be reinforced through prayer groups and informal support from fellow church members. Third, the data indicate that stronger trust-based prayer beliefs are associated with a greater sense of life satisfaction over time.

Prayer Beliefs and Change in Life Satisfaction over Time

PubMed Central

Krause, Neal; Hayward, R. David

2012-01-01

A considerable number of studies have focused on the relationship between prayer, health, and well-being. But the influence of some types of prayer (e.g., petitionary prayer) has received more attention than others. The purpose of this study is to examine an overlooked aspect of prayer: trust-based prayer beliefs. People with this orientation believe that God knows that best way to answer a prayer and He selects the best time to provide an answer. Three main findings emerge from data that were provided by a nationwide longitudinal survey of older people reveals. First, the results reveal that Conservative Protestants are more likely to endorse trust-based prayer beliefs. Second, the findings suggest that these prayer beliefs tend to be reinforced through prayer groups and informal support from fellow church members. Third, the data indicate that stronger trust-based prayer beliefs are associated with a greater sense of life satisfaction over time. PMID:23117927

Molecular mechanisms underlying chemopreventive potential of curcumin: Current challenges and future perspectives.

PubMed

Kumar, Gaurav; Mittal, Sonam; Sak, Katrin; Tuli, Hardeep Singh

2016-03-01

In recent years, natural compounds have received considerable attention in preventing and curing most dreadful diseases including cancer. The reason behind the use of natural compounds in chemoprevention is associated with fewer numbers of side effects than conventional chemotherapeutics. Curcumin (diferuloylmethane, PubMed CID: 969516), a naturally occurring polyphenol, is derived from turmeric, which is used as a common Indian spice. It governs numerous intracellular targets, including proteins involved in antioxidant response, immune response, apoptosis, cell cycle regulation and tumor progression. A huge mass of available studies strongly supports the use of Curcumin as a chemopreventive drug. However, the main challenge encountered is the low bioavailability of Curcumin. This extensive review covers various therapeutic interactions of Curcumin with its recognized cellular targets involved in cancer treatment, strategies to overcome the bioavailability issue and adverse effects associated with Curcumin consumption. Copyright © 2016 Elsevier Inc. All rights reserved.

The Faint Young Sun Paradox in the Context of Modern Cosmology

NASA Astrophysics Data System (ADS)

Dumin, Yu. V.

2015-09-01

The Faint Young Sun Paradox comes from the fact that solar luminosity (2-4)x10^9 years ago was insufficient to support the Earth's temperature necessary for the efficient development of geological and biological evolution (particularly, for the existence of considerable volumes of liquid water). It remains unclear by now if the so-called greenhouse effect on the Earth can resolve this problem. An interesting alternative explanation was put forward recently by M.Krizek (New Astron. 2012, 17, 1), who suggested that planetary orbits expand with time due to the local Hubble effect, caused by the uniformly-distributed Dark Energy. Then, under a reasonable value of the local Hubble constant, it is easy to explain why the Earth was receiving an approximately constant amount of solar irradiation for a long period in the past and will continue to do so for a quite long time in future.

A community-based approach to trials of aerobic exercise in aging and Alzheimer’s disease

PubMed Central

Vidoni, Eric D.; Van Sciver, Angela; Johnson, David K.; He, Jinghua; Honea, Robyn; Haines, Brian; Goodwin, Jami; Laubinger, M. Pat; Anderson, Heather S.; Kluding, Patricia M.; Donnelly, Joseph E.; Billinger, Sandra A.; Burns, Jeffrey M.

2012-01-01

The benefits of exercise for aging have received considerable attention in both the popular and academic press. The putative benefits of exercise for maximizing cognitive function and supporting brain health have great potential for combating Alzheimer’s disease (AD). Aerobic exercise offers a low-cost, low-risk intervention that is widely available and may have disease modifying effects. Demonstrating aerobic exercise alters the AD process would have enormous public health implications. The purpose of this paper is to a report the protocol of a current, community-based pilot study of aerobic exercise for AD to guide future investigation. This manuscript provides 1) an overview of possible benefits of exercise in those with dementia, 2) a rationale and recommendations for implementation of a community-based approach, 3) recommendation for implementation of similar study protocols, 4) unique challenges in conducting an exercise trial in AD. PMID:22903151

Enhancement of computer system for applications software branch

NASA Technical Reports Server (NTRS)

Bykat, Alex

1987-01-01

Presented is a compilation of the history of a two-month project concerned with a survey, evaluation, and specification of a new computer system for the Applications Software Branch of the Software and Data Management Division of Information and Electronic Systems Laboratory of Marshall Space Flight Center, NASA. Information gathering consisted of discussions and surveys of branch activities, evaluation of computer manufacturer literature, and presentations by vendors. Information gathering was followed by evaluation of their systems. The criteria of the latter were: the (tentative) architecture selected for the new system, type of network architecture supported, software tools, and to some extent the price. The information received from the vendors, as well as additional research, lead to detailed design of a suitable system. This design included considerations of hardware and software environments as well as personnel issues such as training. Design of the system culminated in a recommendation for a new computing system for the Branch.

Operation of a single-channel, sequential Navstar GPS receiver in a helicopter mission environment

NASA Technical Reports Server (NTRS)

Edwards, F. G.; Hamlin, J. R.

1984-01-01

It is pointed out that the future utilization of the Navstar Global Positioning System (GPS) by civil helicopters will provide an enhanced performance not obtainable with current navigations systems. GPS will supply properly equipped users with extremely accurate three-dimensional position and velocity information anywhere in the world. Preliminary studies have been conducted to investigate differential GPS concept mechanizations and cost, and to theoretically predict navigation performance and the impact of degradation of the GPS C/A code for national security considerations. The obtained results are encouraging, but certain improvements are needed. As a second step in the program, a single-channel sequential GPS navigator was installed and operated in the NASA SH-3G helicopter. A series of flight tests were conducted. It is found that performance of the Navstar GPS Z-set is quite acceptable to support area navigation and nonprecision approach operations.

10. VIEW EAST (93 DEGREES) OF RCA COMMUNICATION RECEIVING STATION. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. VIEW EAST (93 DEGREES) OF RCA COMMUNICATION RECEIVING STATION. WOOD FRAMING SUPPORTED STANDOFF INSULATORS AND ANTENNA WIRES COMING FROM THE FIELD INTO THE BUILDING. BOLT ON FOUNDATION POLES SUPPORTED SATELLITE ANTENNAS, METAL CAP AND POSTS AT LEFT PROTECTED CONDUIT SUPPLYING POWER TO SATELLITE ANTENNA MOTORS. - Marconi Radio Sites, Receiving, Point Reyes Station, Marin County, CA

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.

Optimization of MLS receivers for multipath environments

NASA Technical Reports Server (NTRS)

Mcalpine, G. A.; Highfill, J. H., III

1976-01-01

The design of a microwave landing system (MLS) aircraft receiver, capable of optimal performance in multipath environments found in air terminal areas, is reported. Special attention was given to the angle tracking problem of the receiver and includes tracking system design considerations, study and application of locally optimum estimation involving multipath adaptive reception and then envelope processing, and microcomputer system design. Results show processing is competitive in this application with i-f signal processing performance-wise and is much more simple and cheaper. A summary of the signal model is given.

32 CFR 174.10 - Consideration for economic development conveyances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Consideration for economic development... Property § 174.10 Consideration for economic development conveyances. (a) For conveyances made pursuant to... the date of the initial transfer of property shall be used to support economic redevelopment of, or...

32 CFR 174.10 - Consideration for economic development conveyances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Consideration for economic development... Property § 174.10 Consideration for economic development conveyances. (a) For conveyances made pursuant to... the date of the initial transfer of property shall be used to support economic redevelopment of, or...

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

PubMed Central

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

Background 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. Objectives To assess whether CBMDR-TBC project’s support improved treatment initiation. Methods 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. Results 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. Conclusion 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. PMID:29596434

A National Description of Treatment among United States Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

PubMed

Danielson, Melissa L; Visser, Susanna N; Chronis-Tuscano, Andrea; DuPaul, George J

2018-01-01

To characterize lifetime and current rates of attention-deficit/hyperactivity disorder (ADHD) treatments among US children and adolescents with current ADHD and describe the association of these treatments with demographic and clinical factors. Data are from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a follow-back survey of parents from the 2011-2012 National Survey of Children's Health. Weighted analyses focused on receipt of ADHD treatment among children aged 4-17 years with current ADHD (n = 2495) by 4 treatment types: medication, school supports, psychosocial interventions, and alternative treatments. Medication and school supports were the most common treatments received, with two-thirds of children and adolescents with ADHD currently receiving each treatment. Social skills training was the most common psychosocial treatment ever received (39%), followed by parent training (31%), peer intervention (30%), and cognitive behavioral therapy (20%). Among alternative treatments, 9% were currently taking dietary supplements, and 11% had ever received neurofeedback. Most children (67%) had received at least 2 of the following: current medication treatment, current school supports, or lifetime psychosocial treatment; 7% had received none of these 3 treatment types. A majority of school-aged children and adolescents with ADHD received medication treatment and school supports, whereas fewer received recommended psychosocial interventions. Efforts to increase access to psychosocial treatments may help close gaps in service use by groups currently less likely to receive treatment, which is important to ensure that the millions of school-aged US children diagnosed with ADHD receive quality treatment. Published by Elsevier Inc.

Evaluating Restorative Justice Circles of Support and Accountability: Can Social Support Overcome Structural Barriers?

PubMed

Bohmert, Miriam Northcutt; Duwe, Grant; Hipple, Natalie Kroovand

2018-02-01

In a climate in which stigmatic shaming is increasing for sex offenders as they leave prison, restorative justice practices have emerged as a promising approach to sex offender reentry success and have been shown to reduce recidivism. Criminologists and restorative justice advocates believe that providing ex-offenders with social support that they may not otherwise have is crucial to reducing recidivism. This case study describes the expressive and instrumental social support required and received, and its relationship to key outcomes, by sex offenders who participated in Circles of Support and Accountability (COSAs), a restorative justice, reentry program in Minnesota. In-depth interviews with re-entering sex offenders and program volunteers revealed that 75% of offenders reported weak to moderate levels of social support leaving prison, 70% reported receiving instrumental support in COSAs, and 100% reported receiving expressive support. Findings inform work on social support, structural barriers, and restorative justice programming during sex offender reentry.

Design of fluidized-bed fermentors

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

Andrews, G.F.; Przezdziecki, J.

1986-06-01

Designing a fluidized-bed bioreactor requires choosing the best support particle (if any). Effectiveness factors (proportional to reactor volumetric productivity) are derived for flocs, solid spherical supports, porous supports, and adsorbent supports. The derivation demonstrates a mathematical procedure for reducing the diffusion/uptake equations for many components (substrates and inhibitory products) to a single equation, and for identifying the limiting component. With solid supports there exists a film thickness that maximizes the effectiveness, and the design objective is to keep the film near this optimum throughout the bed. This involves consideration of the effect of support particle density and film growth onmore » bed stratification. Other considerations in packing support particles are obtaining reasonable values for bed height and diameter, minimizing mass transfer resistance between liquid and biomass, and preventing surface shear from stripping off the biomass. 20 references.« less

The moderating role of social support on the relationship between impulsivity and suicide risk.

PubMed

Kleiman, Evan M; Riskind, John H; Schaefer, Karen E; Weingarden, Hilary

2012-01-01

Suicide is the second leading cause of death among college students. There has been considerable research into risk factors for suicide, such as impulsivity, but considerably less research on protective factors. The present study examines the role that social support plays in the relationship between impulsivity and suicide risk. Participants were 169 undergraduates who completed self-report measures of impulsivity and social support. Suicide risk was assessed using an interview measure. Social support moderates the relationship between impulsivity and suicide risk, such that those who are highly impulsive are less likely to be at risk for suicide if they also have high levels of social support. Social support can be a useful buffer to suicide risk for at-risk individuals who are highly impulsive.

The relationship between women's experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India.

PubMed

Diamond-Smith, Nadia; Sudhinaraset, May; Melo, Jason; Murthy, Nirmala

2016-09-01

a growing body of literature has highlighted the prevalence of mistreatment that women experience around the globe during childbirth, including verbal and physical abuse, neglect, lack of support, and disrespect. Much of this has been qualitative. Research around the world suggests that support during childbirth can improve health outcomes and behaviours, and improve experiences. Support can be instrumental, informational, or emotional, and can be provided by a variety of people including family (husbands, mothers) or health providers of various professional levels. This study explores women's reported experiences of mistreatment during childbirth quantitatively, and how these varied by specific types of support available and provided by specific individuals. participants were women age 16-30 who had delivered infants in a health facility in the previous five years and were living in slums of Lucknow India. Data were collected on their experiences of mistreatment, the types of support they received, and who provided that support. women who reported lack of support were more likely to report mistreatment. Lack of support in regards to discussions with providers and provider information were most strongly associated with a higher mistreatment score. Women who received any type of support from their husband or a health worker were significantly more likely to report lower mistreatment scores. Receiving informational support from a mother/mother-in-law or emotional support from a health worker was also associated with lower mistreatment scores. However, receiving emotional support from a friend/neighbour/other family member was associated with a higher mistreatment score. women rely on different people to provide different types of support during childbirth in this setting. Some of these individuals provide specific types of support that ultimately improve a woman's overall experience of her childbirth. Interventions aiming to reduce mistreatment to women during childbirth should consider the important role of increasing support for women, and who might be the most appropriate person to provide the most essential types of support through this process. Copyright © 2016. Published by Elsevier Ltd.

The roles of family, culture, and social cognitive variables in the career interests and goals of Asian American college students.

PubMed

Hui, Kayi; Lent, Robert W

2018-01-01

Although family and cultural factors have been assumed to play important roles in the career development of Asian Americans, theory-driven research on this topic remains limited. We examined culturally relevant factors that may contribute to Asian Americans' consideration of fields in which they are overrepresented (e.g., science, technology, engineering) and underrepresented (e.g., education, social science). Drawing from social cognitive career theory, a culture-specific, social cognitive model of career interests and choice was tested in Holland's (1997) Investigative (I) and Social (S) themes. A sample of 802 Asian American undergraduates completed measures of family support, self-efficacy, outcome expectations, interest, and career choice consideration in relation to both Holland themes. Two indicators of acculturation/enculturation (adherence to Asian values and generation status in the United States) were also obtained. The model accounted for a substantial amount of variance in Asian American college students' career consideration in both themes. Family support and acculturation played varying roles, depending on the Holland theme. For example, family support was linked to career choice consideration both directly (in the S theme) and indirectly, via other predictors (in both themes). Contrary to expectations, the acculturation variables did not moderate the relation of family support or interest to career consideration in either theme. We discuss the implications of these findings for efforts to understand and facilitate the career development of Asian American college students. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Forms of Social Support in the Workplace for Individuals with Visual Impairments

ERIC Educational Resources Information Center

Papakonstantinou, Doxa; Papadopoulos, Konstantinos

2010-01-01

In this study, the authors explored the forms of social support, both positive and negative, that individuals with visual impairments receive in the workplace. This study was a follow-up to the authors' previous study (Papakonstantinou & Papadopoulos, 2009) that investigated the various forms of positive and negative social support received by…

A matter of tradeoffs: reintroduction as a multiple objective decision

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Folk, Martin J.; Runge, Michael C.

2013-01-01

Decision making in guidance of reintroduction efforts is made challenging by the substantial scientific uncertainty typically involved. However, a less recognized challenge is that the management objectives are often numerous and complex. Decision makers managing reintroduction efforts are often concerned with more than just how to maximize the probability of reintroduction success from a population perspective. Decision makers are also weighing other concerns such as budget limitations, public support and/or opposition, impacts on the ecosystem, and the need to consider not just a single reintroduction effort, but conservation of the entire species. Multiple objective decision analysis is a powerful tool for formal analysis of such complex decisions. We demonstrate the use of multiple objective decision analysis in the case of the Florida non-migratory whooping crane reintroduction effort. In this case, the State of Florida was considering whether to resume releases of captive-reared crane chicks into the non-migratory whooping crane population in that state. Management objectives under consideration included maximizing the probability of successful population establishment, minimizing costs, maximizing public relations benefits, maximizing the number of birds available for alternative reintroduction efforts, and maximizing learning about the demographic patterns of reintroduced whooping cranes. The State of Florida engaged in a collaborative process with their management partners, first, to evaluate and characterize important uncertainties about system behavior, and next, to formally evaluate the tradeoffs between objectives using the Simple Multi-Attribute Rating Technique (SMART). The recommendation resulting from this process, to continue releases of cranes at a moderate intensity, was adopted by the State of Florida in late 2008. Although continued releases did not receive support from the International Whooping Crane Recovery Team, this approach does provide a template for the formal, transparent consideration of multiple, potentially competing, objectives in reintroduction decision making.

Infrastructure to Support Ultra High Throughput Biodosimetry Screening after a Radiological Event

PubMed Central

Garty, G.; Karam, P.A.; Brenner, D. J.

2011-01-01

Purpose After a large-scale radiological event, there will be a pressing need to assess, within a few days, the radiation doses received by tens or hundreds of thousands of individuals. This is for triage, to prevent treatment locations from being overwhelmed, in what is sure to be a resource limited scenario, as well as to facilitate dose-dependent treatment decisions. In addition there are psychosocial considerations, in that active reassurance of minimal exposure is a potentially effective antidote to mass panic, as well as long-term considerations, to facilitate later studies of cancer and other long-term disease risks. Materials and Methods As described elsewhere in this issue, we are developing a Rapid Automated Biodosimetry Tool (RABiT). The RABiT allows high throughput analysis of thousands of blood samples per day, providing a dose estimate that can be used to support clinical triage and treatment decisions. Results Development of the RABiT has motivated us to consider the logistics of incorporating such a system into the existing emergency response scenarios of a large metropolitan area. We present here a view of how one or more centralized biodosimetry readout devices might be incorporated into an infrastructure in which fingerstick blood samples are taken at many distributed locations within an affected city or region and transported to centralized locations. Conclusions High throughput biodosimetry systems offer the opportunity to perform biodosimetric assessments on a large number of persons. As such systems reach a high level of maturity, emergency response scenarios will need to be tweaked to make use of these powerful tools. This can be done relatively easily within the framework of current scenarios. PMID:21675819

Understanding the essential elements of work-based learning and its relevance to everyday clinical practice.

PubMed

Williams, Caroline

2010-09-01

To critically review the work-based learning literature and explore the implications of the findings for the development of work-based learning programmes. With NHS budgets under increasing pressure, and challenges to the impact of classroom-based learning on patient outcomes, work-based learning is likely to come under increased scrutiny as a potential solution. Evidence from higher education institutions suggests that work-based learning can improve practice, but in many cases it is perceived as little more than on-the-job training to perform tasks. The CINAHL database was searched using the keywords work-based learning, work-place learning and practice-based learning. Those articles that had a focus on post-registration nursing were selected and critically reviewed. Using the review of the literature, three key issues were explored. Work-based learning has the potential to change practice. Learning how to learn and critical reflection are key features. For effective work-based learning nurses need to take control of their own learning, receive support to critically reflect on their practice and be empowered to make changes to that practice. A critical review of the literature has identified essential considerations for the implementation of work-based learning. A change in culture from classroom to work-based learning requires careful planning and consideration of learning cultures. To enable effective work-based learning, nurse managers need to develop a learning culture in their workplace. They should ensure that skilled facilitation is provided to support staff with critical reflection and effecting changes in practice. CONTRIBUTION TO NEW KNOWLEDGE: This paper has identified three key issues that need to be considered in the development of work-based learning programmes. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease.

PubMed

Mittelman, Mary S; Haley, William E; Clay, Olivio J; Roth, David L

2006-11-14

To determine the effectiveness of a counseling and support intervention for spouse caregivers in delaying time to nursing home placement of patients with Alzheimer disease (AD), and identify the mechanisms through which the intervention accomplished this goal. We conducted a randomized controlled trial of an enhanced counseling and support intervention compared to usual care. Participants were a referred volunteer sample of 406 spouse caregivers of community-dwelling patients who had enrolled in the study over a 9.5-year period. The intervention consisted of six sessions of individual and family counseling, support group participation, and continuous availability of ad hoc telephone counseling. Structured questionnaires were administered at baseline and at regular follow-up intervals, every 4 months for the first year and every 6 months thereafter. Cox proportional hazard models were used to test the effects of the intervention on the time to nursing home placement for the patients after controlling for multiple time-invariant and time-dependent predictors of placement. Patients whose spouses received the intervention experienced a 28.3% reduction in the rate of nursing home placement compared with usual care controls (hazard ratio = 0.717 after covariate adjustment, p = 0.025). The difference in model-predicted median time to placement was 557 days. Improvements in caregivers' satisfaction with social support, response to patient behavior problems, and symptoms of depression collectively accounted for 61.2% of the intervention's beneficial impact on placement. Greater access to effective programs of counseling and support could yield considerable benefits for caregivers, patients with Alzheimer disease, and society.

Breastfeeding and use of social media among first-time African American mothers.

PubMed

Asiodu, Ifeyinwa V; Waters, Catherine M; Dailey, Dawn E; Lee, Kathryn A; Lyndon, Audrey

2015-01-01

To describe the use of social media during the antepartum and postpartum periods among first-time African American mothers and their support persons. A qualitative critical ethnographic research design within the contexts of family life course development theory and Black feminist theory. Participants were recruited from community-based, public health, and home visiting programs. A purposive sample was recruited, consisting of 14 pregnant African American women and eight support persons. Pregnant and postpartum African American women and their support persons were interviewed separately during the antepartum and postpartum periods. Data were analyzed thematically. Participants frequently used social media for education and social support and searched the Internet for perinatal and parenting information. Most participants reported using at least one mobile application during their pregnancies and after giving birth. Social media were typically accessed through smartphones and/or computers using different websites and applications. Although participants gleaned considerable information about infant development from these applications, they had difficulty finding and recalling information about infant feeding. Social media are an important vehicle to disseminate infant feeding information; however, they are not currently being used to full potential. Our findings suggest that future interventions geared toward African American mothers and their support persons should include social media approaches. The way individuals gather, receive, and interpret information is dynamic. The increasing popularity and use of social media platforms offers the opportunity to create more innovative, targeted mobile health interventions for infant feeding and breastfeeding promotion. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Ethical considerations with the management of congenital central hypoventilation syndrome.

PubMed

Massie, John; Gillam, Lynn

2015-05-01

Congenital central hypoventilation syndrome (CCHS) is a well-recognized disorder of the autonomic nervous system caused by mutations in the PHOX2B gene. The most characteristic feature is failure of ventilatory control, resulting in the need for respiratory support while asleep, and in some cases when awake also. Most cases present in infancy or early childhood. Technological advances allow patients with mild to moderate phenotypesto receive adequate support by non-invasive ventilation (NIV), or diaphragm pacing (or combination of the two) avoiding the need for long-term ventilation by tracheostomy. Daytime functioning of patients with CCHS who require sleep-time ventilation only is expected to be good, with some additional surveillance to ensure they don't accidentally fall asleep without respiratory support available. Some children with CCHS have other complications, such as Hirschprung's disease, learning difficulties, and cardiac arrhythmias (leading in some instances to heart block and the requirement for a pacemaker). In a few cases, patients can develop neurogenic malignancies. Parents bear a significant burden for the care of their child with CCHS including provision of NIV at home, close monitoring, and regular surveillance for complications. Information about patients with CCHS comes from databases in the United States and Europe, but these don't include infants or children for whom ventilator support was not offered. In this paper we use a case study to explore the ethical issues of provision of treatment, or non-treatment, of children with CCHS. © 2014 Wiley Periodicals, Inc.

Psychosocial impact of dysthymia: a study among married patients.

PubMed

Subodh, B N; Avasthi, A; Chakrabarti, S

2008-07-01

Unlike major depression, the psychosocial impact of dysthymia has received far less research attention. This study attempted to assess the psychosocial consequences of dysthymia. The sample consisted of 30 married patients with DSM-IV dysthymic disorder and a matched control group of 30 married patients with recurrent major depressive disorder (RDD), diagnosed using structured interviews. Apart from ratings of severity of depression, assessments of psychosocial impact included quality of life (QOL), disability, perceived social support and marital adjustment. Psychosocial parameters were evaluated using vernacular versions of well-validated scales previously used in similar populations. Matched normal/medically ill controls were derived from Indian studies which had assessed the same parameters using the same instruments. Patients with dysthymia were significantly impaired on measures of QOL, disability, social support and marital adjustment compared to normal/medically ill controls. On the other hand, the two groups of dysthymia and RDD were comparable on these measures apart from significantly lower social support among patients with dysthymia. Duration of illness and severity of depression emerged as the most important correlates, particularly of impaired QOL and disability levels. Small hospital-based sample, normal/medically ill controls derived from other studies and cross-sectional assessments were the major limitations. Dysthymia had considerable adverse psychosocial impact in terms of QOL, functioning (disability), social support and marital adjustment. Severity and chronicity appeared to be important mediators of this negative psychosocial impact. Increased awareness, improved recognition and adequate treatment might help negate some of the untoward social consequences of this condition.

Decadal-Scale Forecasting of Climate Drivers for Marine Applications.

PubMed

Salinger, J; Hobday, A J; Matear, R J; O'Kane, T J; Risbey, J S; Dunstan, P; Eveson, J P; Fulton, E A; Feng, M; Plagányi, É E; Poloczanska, E S; Marshall, A G; Thompson, P A

Climate influences marine ecosystems on a range of time scales, from weather-scale (days) through to climate-scale (hundreds of years). Understanding of interannual to decadal climate variability and impacts on marine industries has received less attention. Predictability up to 10 years ahead may come from large-scale climate modes in the ocean that can persist over these time scales. In Australia the key drivers of climate variability affecting the marine environment are the Southern Annular Mode, the Indian Ocean Dipole, the El Niño/Southern Oscillation, and the Interdecadal Pacific Oscillation, each has phases that are associated with different ocean circulation patterns and regional environmental variables. The roles of these drivers are illustrated with three case studies of extreme events-a marine heatwave in Western Australia, a coral bleaching of the Great Barrier Reef, and flooding in Queensland. Statistical and dynamical approaches are described to generate forecasts of climate drivers that can subsequently be translated to useful information for marine end users making decisions at these time scales. Considerable investment is still needed to support decadal forecasting including improvement of ocean-atmosphere models, enhancement of observing systems on all scales to support initiation of forecasting models, collection of important biological data, and integration of forecasts into decision support tools. Collaboration between forecast developers and marine resource sectors-fisheries, aquaculture, tourism, biodiversity management, infrastructure-is needed to support forecast-based tactical and strategic decisions that reduce environmental risk over annual to decadal time scales. © 2016 Elsevier Ltd. All rights reserved.

Synergistic effects of social support and self-efficacy on dietary motivation predicting fruit and vegetable intake.

PubMed

Reyes Fernández, Benjamín; Warner, Lisa Marie; Knoll, Nina; Montenegro Montenegro, Esteban; Schwarzer, Ralf

2015-04-01

Self-efficacy and social support are considered relevant predictors of fruit and vegetable intake. This study examines whether the effect of self-efficacy on fruit and vegetable intake is mediated by intention and whether this motivational process is moderated by received dietary social support. A longitudinal study with two measurement points in time, four weeks apart, on fruit and vegetable intake was carried out with 473 students aged 19 years on average (52% women). In a conditional process analysis, dietary intention was specified as a mediator between self-efficacy and fruit and vegetable intake, whereas received dietary support was specified as a moderator of the self-efficacy-intention association, controlling for baseline fruit and vegetable intake. Self-efficacy was positively associated with fruit and vegetable intake four weeks later, and intention mediated this process. Moreover, an interaction between received dietary support and self-efficacy on intention emerged. The effect of self-efficacy on fruit and vegetable intake was fully mediated by intention. Moreover, received support exhibited a moderating role within the motivational process: high dietary support appeared to accentuate the positive relationship between self-efficacy and dietary intention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adolescent perspectives on social support received in the aftermath of sexual abuse: a qualitative study.

PubMed

Schönbucher, Verena; Maier, Thomas; Mohler-Kuo, Meichun; Schnyder, Ulrich; Landolt, Markus A

2014-04-01

The extent and quality of social support provided to young survivors of sexual abuse (SA) have only rarely been examined. This qualitative study aimed to investigate adolescent perspectives on social support received in the aftermath of SA. A total of 26 sexually victimized adolescents (15-18 years old) participated in a qualitative face-to-face, in-depth interview that focused on perceived social support. Qualitative content analysis was conducted as per Mayring (2008) using the qualitative data analysis program ATLAS.ti. In addition, quantitative correlational analyses were conducted to identify characteristics of SA and their associations with perceived social support. Although participants perceived parental support as the most necessary type of support, they were much more satisfied with support from peers. In particular, adolescents stated that they wished they had received more emotional support from their parents in order to better cope with the abuse. About half of participants reported having received counseling, and counseling was seen as very helpful in dealing with the consequences of SA. Only a few adolescents mentioned their school as a source of support. Intra-familial abuse, younger victim age at the time of abuse, an adult perpetrator, and severe abuse were all negatively associated with satisfaction with perceived support. Our results suggest that support for young survivors of SA needs to be improved. Prevention of SA needs particular focus on improving parental reactions to SA, facilitating access to professional support, and raising teacher awareness of the importance of their role in the provision of support for sexually victimized children.

Thermo-mechanical and optical optimization of the molten salt receiver for a given heliostat field

NASA Astrophysics Data System (ADS)

Augsburger, Germain; Das, Apurba K.; Boschek, Erik; Clark, Michael M.

2016-05-01

The tower type molten salt solar thermal power plant has proven to be advantageous over other utility scale solar power plant configurations due to its scalability and provision of storage, thereby improving the dispatchability. The configuration consists of a molten salt central receiver (MSCR) located atop an optimally located tower within a heliostat field with thousands of mirrors. The MSCR receives the concentrated energy from the heliostat field which heats a molten salt heat transfer fluid for thermal storage and utilization in producing steam as and when required for power generation. The MSCR heat transfer surface consists of banks of tangent tubes arranged in panels. The combined cost of the heliostat field and the receiver is 40%-50% of the total plant cost, which calls for optimization to maximize their utilization. Several previous studies have looked into the optimum solar power plant size based on various site conditions. However, the combined optimization of the receiver and the heliostat field has not been reported before. This study looks into the optimum configuration of the receiver for a given heliostat field. An in-house tool has been developed to select and rank a few receiver surface configurations (typically <50) from a list of hundreds of thousands of possible options. The operating limits which the heliostat field needs to obey are defined for the ranked surface configurations based on several different design considerations (e.g. mechanical integrity, corrosion limits). The thermal output of the receiver configurations for a given heliostat field is maximized. A combined rank indicating the optimum configurations in descending order of preference is presented based on the performance and various other practical considerations (e.g. total surface area, cost of material, ability of aiming strategies to distribute the flux). The methodology thus provided can be used as a guideline to arrive at an optimum receiver configuration for a given heliostat field.

The Impact of Living with Klinefelter Syndrome: A Qualitative Exploration of Adolescents and Adults.

PubMed

Turriff, Amy; Macnamara, Ellen; Levy, Howard P; Biesecker, Barbara

2017-08-01

Klinefelter syndrome (XXY) is a common yet significantly underdiagnosed condition with considerable medical, psychological and social implications. Many health care providers lack familiarity with XXY, resulting in medical management challenges and a limited understanding of the personal impact of the condition. Genetic counselors benefit from understanding the challenges adolescents and men with XXY face to effectively address their medical and psychosocial needs. The purpose of this study was to understand the impact of living with XXY as an adolescent or an adult. Individuals aged 14 to 75 years with self-reported XXY were recruited from online support networks to complete a web-based survey that included open-ended questions. Open-ended responses were coded and analyzed thematically (n = 169 to 210 for each open-ended question). Over half of respondents to the open-ended questions reported challenges in finding health care providers who are knowledgeable about XXY, with many describing an extensive diagnostic odyssey and relief when receiving a diagnosis. Individuals sought support coping with the challenges they face and acknowledgement of the positive aspects of XXY. Recommendations are made for how genetic counseling can enhance quality of life for individuals living with XXY.

Preliminary Findings: Issues in Surface Movement

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Denning, Rebecca; Obradovich, Jodi; Billings, Charles; Woods, David

1999-01-01

The final report for the grant is presented. The recent goals for this project have been: (1) To identify common surface movement challenges which affect the airlines and Air Traffic Control; (2) To map out possible solutions to these challenges; (3) To start generalizing about the information we are receiving so that major, abstract categories of challenges and potential solutions will begin to emerge. In particular, there are several areas of opportunity which are beginning to emerge from the data, dealing with the need for: (1) Tools to support information exchange regarding priorities (both within an individual airline and between the ATC tower and airlines). Such priorities include both concerns affecting departure throughput as well as the ordering of departures to accommodate other airline considerations; (2) Planning tools to help ATC and airline Ramp staff deal with information about priorities; (3) Implementation of strategies to enable greater flexibility in queueing flights for departures; (4) Tools to provide better coordination and situation awareness during taxiing (within an airline as well as between airlines and between the airlines); (5) Tools to support planning and to deal with the interactions between departures and arrivals. Thus far, the initial interviews and observations at three airlines and two ATC facilities have been completed.

Review of gynecologic and reproductive care for women with developmental disabilities.

PubMed

Abells, Dara; Kirkham, Yolanda A; Ornstein, Melanie P

2016-10-01

Care for women with developmental disabilities requires special consideration for unique needs related to their cognitive and physical abilities. These women and their caregivers require more support and guidance during reproductive health care. We review the literature and provide expert opinion surrounding gynecological issues for women with developmental disabilities to support healthcare providers better understand and care for this population. Women with developmental disabilities are more vulnerable to abuse and experience poorer gynecological healthcare outcomes. Many women with developmental disabilities are fertile and participate in sexual activity without adequate knowledge. They are at higher risk of pregnancy and birth complications. They are less likely to receive appropriate preventive screening. The review highlights important issues and practice suggestions related to the reproductive health care of women with developmental disabilities. Topics include clinic visits, menstruation, sexuality, sexual abuse, sexual health education, contraception, sexually transmitted infections, pregnancy, labor and delivery, and cancer screening/prevention. We emphasize the need for an individualized, comprehensive approach for these patients and review perceived and actual barriers to care. More education is needed on the aforementioned topics for women with developmental disabilities, their caregivers, and their providers.

Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics.

PubMed

Ganatra, B; Kalyanwala, S; Elul, B; Coyaji, K; Tewari, S

2010-01-01

We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed.

Integrating Journalism Into Health Promotion: Creating and Disseminating Community Narratives.

PubMed

Brown, Louis D; Berryhill, Joseph C; Jones, Eric C

2018-06-01

Media coverage of mental health and other social issues often relies on episodic narratives that suggest individualistic causes and solutions, while reinforcing negative stereotypes. Community narratives can provide empowering alternatives, serving as media advocacy tools used to shape the policy debate on a social issue. This article provides health promotion researchers and practitioners with guidance on how to develop and disseminate community narratives to broaden awareness of social issues and build support for particular programs and policy solutions. To exemplify the community narrative development process and highlight important considerations, this article examines a narrative from a mental health consumer-run organization. In the narrative, people with mental health problems help one another while operating a nonprofit organization, thereby countering stigmatizing media portrayals of people with mental illness as dangerous and incompetent. The community narrative frame supports the use of consumer-run organizations, which are not well-known and receive little funding despite evidence of effectiveness. The article concludes by reviewing challenges to disseminating community narratives, such as creating a product of interest to media outlets, and potential solutions, such as engaging media representatives through community health partnerships and using social media to draw attention to the narratives.

Do men’s faces really signal heritable immunocompetence?

PubMed Central

2013-01-01

In the literature on human mate choice, masculine facial morphology is often proposed to be an intersexual signal of heritable immunocompetence, and hence an important component of men’s attractiveness. This hypothesis has received considerable research attention, and is increasingly treated as plausible and well supported. In this article, we propose that the strength of the evidence for the immunocompetence hypothesis is somewhat overstated, and that a number of difficulties have been under-acknowledged. Such difficulties include (1) the tentative nature of the evidence regarding masculinity and disease in humans, (2) the complex and uncertain picture emerging from the animal literature on sexual ornaments and immunity, (3) the absence of consistent, cross-cultural support for the predictions of the immunocompetence hypothesis regarding preferences for masculinized stimuli, and (4) evidence that facial masculinity contributes very little, if anything, to overall attractiveness in real men. Furthermore, alternative explanations for patterns of preferences, in particular the proposal that masculinity is primarily an intrasexual signal, have been neglected. We suggest that immunocompetence perspectives on masculinity, whilst appealing in many ways, should still be regarded as speculative, and that other perspectives–and other traits–should be the subject of greater attention for researchers studying human mate preferences. PMID:23555177

Combining neuropsychological and cognitive-behavioral approaches for treating psychological sequelae of acquired brain injury.

PubMed

Doering, Bettina; Exner, Cornelia

2011-03-01

Acquired brain injury (ABI) does not only result in physical and cognitive impairments, but may also entail behavioral-emotional difficulties and mental disorders. Although neuropsychological approaches target the rehabilitation of cognitive deficits, the treatment of emotional and behavioral sequelae has received less consideration. This review argues for the integration of cognitive-behavioral approaches into the rehabilitation process and examines respective recent research. Cognitive-behavioral interventions have been investigated in the treatment of behavioral disturbances and mental disorders after ABI. They have also been targeted at supporting adaptive coping with chronic injury-related impairments. Problem-solving approaches of cognitive behavioral therapy may work as meta-models or framework for the rehabilitative process. Unfortunately, most studies reviewed employed methodologically weak designs, which limit convincing conclusions. Still, positive intervention effects have been demonstrated concerning specific outcome measures. Whether these changes also translate into increased psychosocial functioning or quality of life remains unclear. Methodologically sound evidence for cognitive-behavioral interventions after ABI is limited, but preliminary results support the effectiveness of these interventions in the treatment of behavioral disorders and emotional disturbances after ABI. Integrating neuropsychological and cognitive-behavioral approaches may therefore prove beneficial to the rehabilitation process.

Essential SpaceWire Hardware Capabilities for a Robust Network

NASA Technical Reports Server (NTRS)

Birmingham, Michael; Krimchansky, Alexander; Anderson, William; Lombardi, Matthew

2016-01-01

The Geostationary Operational Environmental Satellite R-Series Program (GOES-R) mission is a joint program between National Oceanic & Atmospheric Administration (NOAA) and National Aeronautics & Space Administration (NASA) Goddard Space Flight Center (GSFC). GOES-R project selected SpaceWire as the best solution to satisfy the desire for simple and flexible instrument to spacecraft command and telemetry communications. GOES-R development and integration is complete and the observatory is scheduled for launch October 2016. The spacecraft design was required to support redundant SpaceWire links for each instrument side, as well as to route the fewest number of connections through a Slip Ring Assembly necessary to support Solar pointing instruments. The final design utilized two different router designs. The SpaceWire standard alone does not ensure the most practical or reliable network. On GOES-R a few key hardware capabilities were identified that merit serious consideration for future designs. Primarily these capabilities address persistent port stalls and the prevention of receive buffer overflows. Workarounds were necessary to overcome shortcomings that could be avoided in future designs if they utilize the capabilities, discussed in this paper, above and beyond the requirements of the SpaceWire standard.

Why do we need an oral health care policy in Canada?

PubMed

Leake, James L

2006-05-01

Although health care is a right of citizenship, severe inequities in oral health and access to care persist. This paper provides information on the financing, organization and delivery of oral health services in Canada. It concludes that dental care has largely fallen out of consideration as health care. The increasing costs of dental insurance and disparities in oral health and access to care threaten the system"s sustainability. The legislation that allows the insured to receive tax-free care and requires all taxpayers to subsidize that expenditure is socially unjust. Unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research. However, never before have we had the opportunity presented by high levels of oral health, the extensive resources already allocated to oral health care, plus the support of other organizations to allow us to consider what else we might do. One of the first steps would be to establish new models for the delivery of preventive measures and care that reach out to those who do not now enjoy access.

Arthropod phylogeny based on eight molecular loci and morphology

NASA Technical Reports Server (NTRS)

Giribet, G.; Edgecombe, G. D.; Wheeler, W. C.

2001-01-01

The interrelationships of major clades within the Arthropoda remain one of the most contentious issues in systematics, which has traditionally been the domain of morphologists. A growing body of DNA sequences and other types of molecular data has revitalized study of arthropod phylogeny and has inspired new considerations of character evolution. Novel hypotheses such as a crustacean-hexapod affinity were based on analyses of single or few genes and limited taxon sampling, but have received recent support from mitochondrial gene order, and eye and brain ultrastructure and neurogenesis. Here we assess relationships within Arthropoda based on a synthesis of all well sampled molecular loci together with a comprehensive data set of morphological, developmental, ultrastructural and gene-order characters. The molecular data include sequences of three nuclear ribosomal genes, three nuclear protein-coding genes, and two mitochondrial genes (one protein coding, one ribosomal). We devised new optimization procedures and constructed a parallel computer cluster with 256 central processing units to analyse molecular data on a scale not previously possible. The optimal 'total evidence' cladogram supports the crustacean-hexapod clade, recognizes pycnogonids as sister to other euarthropods, and indicates monophyly of Myriapoda and Mandibulata.

Integrated Knowledge Translation and Grant Development: Addressing the Research Practice Gap through Stakeholder-informed Research.

PubMed

Henderson, Joanna; Brownlie, Elizabeth; Rosenkranz, Susan; Chaim, Gloria; Beitchman, Joseph

2013-11-01

We describe our stakeholder engagement process for grant application development that occurred as part of our integrated knowledge translation plan and make recommendations for researchers. In phase 1, a stakeholder consultation group was developed. In phase 2, surveys regarding knowledge gathering, research agenda, and research collaboration preferences were sent to 333 cross-sectoral youth-serving organizations in Ontario, including family and consumer organizations. In phase 1, 28 stakeholders from six sectors participated in the consultation group and provided input on multiple aspects of the proposal. Through this process, 19 stakeholders adopted formal roles within the project. In phase 2, 206 surveys were received (response rate = 62%). Survey responses supported the grant focus (concurrent youth mental health and substance use problems). Respondents also prioritized project goals and provided specific feedback on research and knowledge translation. Finally, although some stakeholders chose greater involvement, most survey respondents indicated a preference for a moderate level of participation in research rather than full team membership. Despite short timelines and feasibility challenges, stakeholders can be meaningfully engaged in and contribute to the grant proposal development process. Consideration is needed for the practical challenges that stakeholder organizations face in supporting and participating in research.

Parenting children with Down syndrome: Societal influences

PubMed Central

Huiracocha, Lourdes; Almeida, Carlos; Huiracocha, Karina; Arteaga, Jorge; Arteaga, Andrea

2017-01-01

Most studies of parenting children with Down syndrome (DS) have been conducted in industrialized countries. They suggest that sensitive communication on the part of professionals, and social support, can lead to acceptance and positive adjustments in the family. This study examined the impact of a diagnosis of DS on Ecuadorian families, in particular at how the diagnosis had been communicated and received, as well as the feelings and experiences which followed. Despite considerable progress in recent years, Ecuador is still marked by discriminatory attitudes which affect children with disabilities and their families, and by the persistence of widespread poverty. This qualitative study, conducted in Cuenca, Ecuador’s third largest city, is based on a focus group discussion and four in-depth interviews with Ecuadorian parents of DS children attending a specialist center in the city. The study shows that, reflecting the effects of status differences and lack of appropriate training, professionals rarely communicate a DS diagnosis in an appropriate manner. Further, it is shown that lack of social support, and the widespread stigmatization confronting children with DS and their families, hinder development of positive and empowering adjustments that would best serve the child’s and the family’s interest. PMID:29110530

Outcomes from personal budgets in mental health: service users' experiences in three English local authorities.

PubMed

Larsen, John; Tew, Jerry; Hamilton, Sarah; Manthorpe, Jill; Pinfold, Vanessa; Szymczynska, Paulina; Clewett, Naomi

2015-08-01

In England, personal budgets are offered to eligible people with severe mental health problems to enable them to purchase what is helpful for their quality of life or recovery. However, in-depth insight into people's own perceptions of the outcomes is lacking. To investigate people's own reporting of outcomes from using personal budgets in relation to social care needs arising from severe mental health problems. A convenience sample of 47 individuals receiving personal budgets was recruited from three English local authorities. In-depth semi-structured interviews were subject to thematic framework analysis. Most participants identified positive outcomes across domains interconnected through individual life circumstances, with mental health and wellbeing, social participation and relationships, and confidence and skills most commonly reported. Some needed more support than others to identify goals and make use of the personal budget to take a more active part in the society. Personal budgets can enable people to achieve outcomes that are relevant to them in the context of their lives, particularly through enhancing their wellbeing and social participation. Consideration should be given to distinguishing those individuals potentially requiring more support for engagement from those who can engage more independently to identify and pursue their goals.

[Role of long-term follow-up in management of late-onset post-hematopoietic stem cell transplant complications].

PubMed

Asano-Mori, Yuki

As the number of long-term survivors after allogeneic hematopoietic stem cell transplantation (HSCT) has increased owing to advances in transplantation and supportive care techniques, the health and welfare of these survivors have come into focus. However, they are still at risks for various complications, including chronic graft-versus-host disease, infectious diseases, and secondary cancers even in the late period, which can not only interfere with the patient's quality of life (QOL) but also lead to death. The importance of long-term follow-up (LTFU) and management have been recently recognized, and nationwide systems to promote LTFU care in patients receiving HSCT, such as medical fee revision, publication of a LTFU guideline unique to Japan, and preparation of patient pocketbook, is under consideration. The number of medical facilities at LTFU outpatient clinic is also increasing; therefore, an optimal comprehensive support system may be established sooner or later. However, self-management by patients is essential to overcome late complications as well as to improve QOL after HSCT. Healthcare professionals should collaborate and continue to make the greatest possible efforts to educate patients regarding the risks of late complications and their prevention.

Gender differences among prisoners in drug treatment.

PubMed

Langan, N P; Pelissier, B M

2001-01-01

Nearly all prison-based substance abuse treatment programs have been designed with male prisoners in mind. Administering these male-oriented programs to women prisoners has been the standard correctional practice. Recently, this practice has received considerable criticism. Critics argue that female prisoners have special needs that are not met by programs originally designed for male prisoners. However, most of the empirical support for the existence of such special needs rely on two inappropriate samples: prisoners who are not in treatment and treatment participants who are not incarcerated. Findings from these two different groups may not be generalizable to the population of prisoners in treatment. This paper directly addresses this generalizability problem with an examination of gender differences among 1,326 male and 318 female federal prisoners who were enrolled in a substance abuse treatment program. Women used drugs more frequently, used harder drugs, and used them for different reasons than men. Women also confronted more difficulties than men in areas linked to substance abuse such as educational background, childhood family environment, adult social environment, mental health, and physical health. We find support for the argument that substance abuse treatment programs which were originally designed for men may be inappropriate for the treatment of women.

Detection and localization of damage using empirical mode decomposition and multilevel support vector machine

NASA Astrophysics Data System (ADS)

Dushyanth, N. D.; Suma, M. N.; Latte, Mrityanjaya V.

2016-03-01

Damage in the structure may raise a significant amount of maintenance cost and serious safety problems. Hence detection of the damage at its early stage is of prime importance. The main contribution pursued in this investigation is to propose a generic optimal methodology to improve the accuracy of positioning of the flaw in a structure. This novel approach involves a two-step process. The first step essentially aims at extracting the damage-sensitive features from the received signal, and these extracted features are often termed the damage index or damage indices, serving as an indicator to know whether the damage is present or not. In particular, a multilevel SVM (support vector machine) plays a vital role in the distinction of faulty and healthy structures. Formerly, when a structure is unveiled as a damaged structure, in the subsequent step, the position of the damage is identified using Hilbert-Huang transform. The proposed algorithm has been evaluated in both simulation and experimental tests on a 6061 aluminum plate with dimensions 300 mm × 300 mm × 5 mm which accordingly yield considerable improvement in the accuracy of estimating the position of the flaw.

Regulation to Create Environments Conducive to Physical Activity: Understanding the Barriers and Facilitators at the Australian State Government Level

PubMed Central

Shill, Jane; Mavoa, Helen; Crammond, Brad; Loff, Bebe; Peeters, Anna; Lawrence, Mark; Allender, Steven; Sacks, Gary; Swinburn, Boyd A.

2012-01-01

Introduction Policy and regulatory interventions aimed at creating environments more conducive to physical activity (PA) are an important component of strategies to improve population levels of PA. However, many potentially effective policies are not being broadly implemented. This study sought to identify potential policy/regulatory interventions targeting PA environments, and barriers/facilitators to their implementation at the Australian state/territory government level. Methods In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organisations (n = 40) to examine participants': 1) suggestions for regulatory interventions to create environments more conducive to PA; 2) support for preselected regulatory interventions derived from a literature review. Thematic and constant comparative analyses were conducted. Results Policy interventions most commonly suggested by participants fell into two areas: 1) urban planning and provision of infrastructure to promote active travel; 2) discouraging the use of private motorised vehicles. Of the eleven preselected interventions presented to participants, interventions relating to walkability/cycling and PA facilities received greatest support. Interventions involving subsidisation (of public transport, PA-equipment) and the provision of more public transport infrastructure received least support. These were perceived as not economically viable or unlikely to increase PA levels. Dominant barriers were: the powerful ‘road lobby’, weaknesses in the planning system and the cost of potential interventions. Facilitators were: the provision of evidence, collaboration across sectors, and synergies with climate change/environment agendas. Conclusion This study points to how difficult it will be to achieve policy change when there is a powerful ‘road lobby’ and government investment prioritises road infrastructure over PA-promoting infrastructure. It highlights the pivotal role of the planning and transport sectors in implementing PA-promoting policy, however suggests the need for clearer guidelines and responsibilities for state and local government levels in these areas. Health outcomes need to be given more direct consideration and greater priority within non-health sectors. PMID:23028434

Toward shared care for people with cancer: developing the model with patients and GPs.

PubMed

Hall, Susan J; Samuel, Leslie M; Murchie, Peter

2011-10-01

The number of people surviving cancer for extended periods is increasing. Consequently, due to workload and quality issues, there is considerable interest in alternatives to traditional secondary care-led cancer follow-up. To explore the views of potential recipients of shared follow-up of cancer. To conduct a modelling exercise for shared follow-up and to explore the opinions and experiences of both the patients and GPs involved. Semi-structured audio-taped telephone or face-to-face interviews were conducted with 18 patients with a range of cancers currently attending for structured follow-up in secondary care. Six GPs and five patients (four with melanoma and one with stable metastatic colorectal cancer) took part in a shared follow-up modelling exercise. During the modelling exercise, the GPs attended 4 review meetings, which included brief training seminars, and at the conclusion 10 individuals took part in semi-structured audio-taped telephone or face-to-face interviews. Many rural patients, and some urban patients, would appreciate follow-up being available nearer to home with the associated benefits of time saved and easier parking and continuity of care. Patients have concerns related to the level of extra training received by the GP and loss of contact with their consultant. GPs have concerns about gaining and maintaining the clinical skills needed to conduct follow-up, especially if the numbers of patients seen are small. They also have concerns about lack of support from other GPs, and some administrative and organizational issues. Many patients would be willing to have GPs share their cancer follow-up with the caveat that they had received extra training and were appropriately supported by secondary care specialists. Patients attending shared care clinics appreciated a local service and longer appointment times. GPs stress the importance of maintaining their own clinical skills and reliable clinical and administrative support from secondary care.

Impact of an educational DVD on anxiety and glycaemic control in women diagnosed with gestational diabetes mellitus (GDM): A randomised controlled trial.

PubMed

Draffin, Claire R; Alderdice, Fiona A; McCance, David R; Maresh, Michael; Harper, Roy; Patterson, Christopher C; Bernatavicius, Giovanna; Brennan, Sarah F; Gough, Aisling; McSorley, Oonagh; Holmes, Valerie A

2017-04-01

The diagnosis of gestational diabetes mellitus (GDM) during pregnancy can lead to anxiety. This study evaluated the impact of an innovative patient-centred educational DVD on anxiety and glycaemic control in women newly diagnosed with GDM. 150 multi-ethnic women, aged 19-44years, from three UK hospitals were randomised to either usual care plus DVD (DVD group, n=77) or usual care alone (control group, n=73) at GDM diagnosis. Primary outcomes were anxiety (State-Trait Anxiety Inventory) and mean 1-h postprandial capillary self-monitored blood glucose for all meals, on day prior to follow-up. No significant difference between the DVD and control group were reported, for anxiety (37.7±11.7 vs 36.2±10.9; mean difference after adjustment for covariates (95% CI) 2.5 (-0.8, 5.9) or for mean 1-h postprandial glucose for all meals (6.9±0.9 vs 7.0±1.2mmol/L; -0.2 (-0.5, 0.2). However, the DVD group had significantly lower postprandial breakfast glucose compared to the control group (6.8±1.2 vs 7.4±1.9mmol/L; -0.5 (-1.1, -<0.1; p=0.04). The results in this trial did not highlight any differences between those who received the intervention and those who received usual care. It is possible that women already felt supported by their frequent attendance at specialist clinics for monitoring and advice. Healthcare professional and family support are key elements to empowering women with GDM and require further consideration in future interventions. Nonetheless, educational resources such as this will be beneficial to help support women given the current resource and time implications of the year on year rises in the incidence of gestational diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

An Examination of the Support Families Receive and Parent Perceptions of How Helpful These Supports Are in Meeting the Needs of Their Children and Families.

ERIC Educational Resources Information Center

Lehman, Constance M.

Two-hundred and fifty parents of children with emotional or behavioral disorders residing in Oregon were surveyed concerning the nature and extent of support they received. Parents were affiliated with the Oregon Family Support Network, a statewide, parent-run, information and family advocacy organization. One hundred usable surveys were returned.…

Psychosocial support and cognitive deficits in adults with schizophrenia.

PubMed

Dalagdi, Aikaterini; Arvaniti, Aikaterini; Papatriantafyllou, John; Xenitidis, Kiriakos; Samakouri, Maria; Livaditis, Miltos

2014-08-01

In recent decades there has been an increasing interest in cognitive deficits in schizophrenia. However, only a few studies have examined the impact of psychosocial support on the prevention of cognitive deterioration in patients who suffer from schizophrenia. The aims of the present study are: (1) to confirm the presence of cognitive deficits among patients with schizophrenia; (2) to explore any correlations between such deficits and a range of clinical and/or demographic characteristics of the patients; and (3) to investigate any association between cognitive deficits and psychosocial support. A total of 118 patients with schizophrenia (the patient group) and 102 healthy volunteers (the control group) had a cognitive assessment using a battery of neuropsychological tests. The patients were allocated to one of the following groups: (1) patients under routine outpatient follow-up; or (2) patients receiving or having recently received intensive psychosocial support, in addition to follow-up. This included daily participation in vocational and recreational activities provided by dedicated mental health day centers. The findings of the neuropsychological testing of individuals in all groups were compared, after controlling for clinical or demographic factors. The scores in the neuropsychological tests were lower overall in the patients group compared to healthy volunteers. Within the patients group, those receiving/having received psychosocial support had higher scores compared to those on routine follow-up alone. There were no significant differences between patients currently receiving psychosocial support and those having received it in the past. Lower education, age and illness duration (but not severity of positive or negative symptoms) were factors associated with lower test scores. The study provides some evidence that psychosocial support may be beneficial for the cognitive functioning of patients with schizophrenia and this benefit may be a lasting one. © The Author(s) 2013.

78 FR 34392 - Guidance for Industry and Food and Drug Administration Staff: Technical Considerations for Pen...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

...] Guidance for Industry and Food and Drug Administration Staff: Technical Considerations for Pen, Jet, and... availability of a final guidance document entitled ``Technical Considerations for Pen, Jet, and Related... developing information to support a marketing application for a pen, jet, or related injector device intended...

28 CFR 345.33 - Waiting list hiring exceptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reason other than formal education, vocational training, drug abuse or similar formal programs). For... preference, and does not receive consideration for accelerated promotion back to the grade held at time of...

42 CFR 136.117 - Amendment of regulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... House of Representatives. (c) Publish the proposed revisions or amendments in the Federal Register as... consideration of all comments received, publish the regulations in the Federal Register in final form not less...

42 CFR 136.117 - Amendment of regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... House of Representatives. (c) Publish the proposed revisions or amendments in the Federal Register as... consideration of all comments received, publish the regulations in the Federal Register in final form not less...

7 CFR 3560.707 - Program participation and corrective actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... tenant, who has received unauthorized assistance, may continue to participate in the project if they have the legal and financial capabilities to do so. Approval considerations for such forbearance and...

Privacy-Preserving Patient-Centric Clinical Decision Support System on Naïve Bayesian Classification.

PubMed

Liu, Ximeng; Lu, Rongxing; Ma, Jianfeng; Chen, Le; Qin, Baodong

2016-03-01

Clinical decision support system, which uses advanced data mining techniques to help clinician make proper decisions, has received considerable attention recently. The advantages of clinical decision support system include not only improving diagnosis accuracy but also reducing diagnosis time. Specifically, with large amounts of clinical data generated everyday, naïve Bayesian classification can be utilized to excavate valuable information to improve a clinical decision support system. Although the clinical decision support system is quite promising, the flourish of the system still faces many challenges including information security and privacy concerns. In this paper, we propose a new privacy-preserving patient-centric clinical decision support system, which helps clinician complementary to diagnose the risk of patients' disease in a privacy-preserving way. In the proposed system, the past patients' historical data are stored in cloud and can be used to train the naïve Bayesian classifier without leaking any individual patient medical data, and then the trained classifier can be applied to compute the disease risk for new coming patients and also allow these patients to retrieve the top- k disease names according to their own preferences. Specifically, to protect the privacy of past patients' historical data, a new cryptographic tool called additive homomorphic proxy aggregation scheme is designed. Moreover, to leverage the leakage of naïve Bayesian classifier, we introduce a privacy-preserving top- k disease names retrieval protocol in our system. Detailed privacy analysis ensures that patient's information is private and will not be leaked out during the disease diagnosis phase. In addition, performance evaluation via extensive simulations also demonstrates that our system can efficiently calculate patient's disease risk with high accuracy in a privacy-preserving way.

Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE).

PubMed

Caccialanza, Riccardo; Pedrazzoli, Paolo; Cereda, Emanuele; Gavazzi, Cecilia; Pinto, Carmine; Paccagnella, Agostino; Beretta, Giordano Domenico; Nardi, Mariateresa; Laviano, Alessandro; Zagonel, Vittorina

2016-01-01

Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. "Alternative hypocaloric anti-cancer diets" (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients.

Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE)

PubMed Central

Caccialanza, Riccardo; Pedrazzoli, Paolo; Cereda, Emanuele; Gavazzi, Cecilia; Pinto, Carmine; Paccagnella, Agostino; Beretta, Giordano Domenico; Nardi, Mariateresa; Laviano, Alessandro; Zagonel, Vittorina

2016-01-01

Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. “Alternative hypocaloric anti-cancer diets” (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients. PMID:26819635

Meeting the psychological needs of community-living stroke patients and carers: a study of third sector provision.

PubMed

Morris, Reg

2016-01-01

To elucidate how community stroke staff in a major third sector organisation experienced their role and understood and responded to clients' psychological needs. In stage 1, three focus groups of 28 staff in total were recorded, transcribed and analysed using inductive thematic analysis. Themes were authenticated by new staff groups. In stage 2, these themes informed the construction of a questionnaire delivered through the organisation's intranet by "Survey Monkey". Five themes emerged from the focus groups: background and context; perceptions of clients' psychological issues; approaches to meeting psychological needs; the experience of working with psychological needs and sources of support; aspirations for future development. Four themes were used in constructing the questionnaire. Responses from 144 staff with diverse qualifications and experience were received; over half encountered 16 (of 35) psychological issues at least once per week. Stroke survivors' needs predominated over carers' needs. Skills used to address psychological problems were identified, also training and support needs and future aspirations. Support needs included information, training and access to specialist consultants. Psychological issues were central in the work of third sector community stroke staff; psychological skills were routinely used. Attention to means of supporting and developing these skills is required. Service leaders and commissioners should be aware that third sector community stroke staff frequently deal with a diverse range of psychological issues and perceive psychological care as central. Service leaders should consider providing training in assessment and management of mood and cognition, risk assessment and management and basic counselling. Staff should be provided with access to specialist consultation and better information about psychological aspects of referrals. There is uncertainty about key methods for supporting the delivery of psychological care (supervision, mentoring and peer support) which requires consideration.

Humidifier disinfectant lung injury, how do we approach the issues?

PubMed Central

Hong, Sang-Bum; Do, Kyung-Hyun; Chung, Seockhoon; Lee, Eun; Choi, Jihyun

2016-01-01

A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone/methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies. PMID:27608716

Quality improvements in diabetes care, how holistic have they been? A case-study from the United Kingdom

PubMed Central

2014-01-01

Aims As quality in diabetes care includes patient centred support for self-management, investigating patients’ experiences upon diagnosis can help improve access to this element of care among diverse populations. This research explored this care in the context of recent national quality improvement initiatives which support self-management. Methods South Asian and White European patients over 16 years with a recent (< 1 year) diagnosis of diabetes were recruited from 18 General Practitioner (GP) practices in three UK locations - Luton, West London and Leicester. A semi-structured qualitative interview was conducted with 47 patients. Results Twenty one out of 47 (45%) reported unmet support and information needs at diagnosis. Although there was a small proportion of participants (8 out of 47, 17% of all respondents) who felt they did not require any help or support with managing their diabetes because their GP had provided comprehensive and efficient care, there was an equal number who voiced a negative view of the care they had received to date. This concerned information giving, support and communication, suggesting that recently implemented national quality improvement interventions may not have been successful in improving all aspects of diabetes care, particularly those encouraging self-management. The emerging analysis led to consideration of concordance as an important concept through which to understand inequalities and improve access to quality diabetes care. In order to encourage self-management from the start, care providers need to be cognisant that patients are not homogeneous and be responsive to their different information needs and emotional responses to diagnosis. Conclusions In order to support self-management and deliver patient centred care in diverse populations, care providers will need to be adaptable to individual needs around diagnosis. PMID:24731304

Low-Radiation Cellular Inductive Powering of Rodent Wireless Brain Interfaces: Methodology and Design Guide.

PubMed

Soltani, Nima; Aliroteh, Miaad S; Salam, M Tariqus; Perez Velazquez, Jose Luis; Genov, Roman

2016-08-01

This paper presents a general methodology of inductive power delivery in wireless chronic rodent electrophysiology applications. The focus is on such systems design considerations under the following key constraints: maximum power delivery under the allowable specific absorption rate (SAR), low cost and spatial scalability. The methodology includes inductive coil design considerations within a low-frequency ferrite-core-free power transfer link which includes a scalable coil-array power transmitter floor and a single-coil implanted or worn power receiver. A specific design example is presented that includes the concept of low-SAR cellular single-transmitter-coil powering through dynamic tracking of a magnet-less receiver spatial location. The transmitter coil instantaneous supply current is monitored using a small number of low-cost electronic components. A drop in its value indicates the proximity of the receiver due to the reflected impedance of the latter. Only the transmitter coil nearest to the receiver is activated. Operating at the low frequency of 1.5 MHz, the inductive powering floor delivers a maximum of 15.9 W below the IEEE C95 SAR limit, which is over three times greater than that in other recently reported designs. The power transfer efficiency of 39% and 13% at the nominal and maximum distances of 8 cm and 11 cm, respectively, is maintained.

The statistical analysis of received time-series signals from the laser illumination of remote objects through turbulence

NASA Astrophysics Data System (ADS)

Chandler, Susan; Lukesh, Gordon

2006-11-01

Ground-to-space illumination experiments, such as the Floodbeam I (FBE I, 1993), Floodbeam II (FBE II, 1996) and Active Imaging Testbed (AIT, 1999), fielded by the Imaging Branch of the United States Air Force Research Laboratory at Starfire Optical Range (SOR) on Kirtland AFB, NM, obtained considerable information from these highly successful experiments. While the experiments were primarily aimed at collecting focal/pupil plane data, the authors recognized during data reduction that the received time-series signals from the integrated full receiver focal plane data contains considerable hitherto unexploited information. For more than 10 years the authors have investigated the exploitation of data contained within the time-series signal from ground-to-space experiments. Results have been presented at numerous SPIE and EOS Remote Sensing Meetings. In July 2005, the authors were honored as invited speakers at the XIIth Symposium "Atmosphere and Ocean Optics; Atmospheric Physics" Tomsk, Russia. The authors were invited to return to Tomsk in 2006 however a serious automobile accident precluded attendance. This paper, requested for publication, provides an important summary of recent results.

Partner support and maternal depression in the context of the Iowa floods.

PubMed

Brock, Rebecca L; O'Hara, Michael W; Hart, Kimberly J; McCabe, Jennifer E; Williamson, J Austin; Laplante, David P; Yu, Chunbo; King, Suzanne

2014-12-01

A systematic investigation of the role of prenatal partner support in perinatal maternal depression was conducted. Separate facets of partner support were examined (i.e., received support and support adequacy) and a multidimensional model of support was applied to investigate the effects of distinct types of support (i.e., informational, physical comfort, emotional/esteem, and tangible support). Both main and stress-buffering models of partner support were tested in the context of prenatal maternal stress resulting from exposure to a natural disaster. Questionnaire data were analyzed from 145 partnered women using growth curve analytic techniques. Results indicate that received support interacts with maternal flood stress during pregnancy to weaken the association between stress and trajectories of maternal depression from pregnancy to 30 months postpartum. Support adequacy did not interact with stress, but was associated with levels of depressive symptoms controlling for maternal stress and received support. Results demonstrate the distinct roles of various facets and types of support for a more refined explanatory model of prenatal partner support and perinatal maternal depression. Results inform both main effect and stress buffering models of partner support as they apply to the etiology of perinatal maternal depression, and highlight the importance of promoting partner support during pregnancy that matches support preferences.

Characteristics of Mild Cognitive Impairment Using the Thai Version of the Consortium to Establish a Registry for Alzheimer's Disease Tests: A Multivariate and Machine Learning Study.

PubMed

Tunvirachaisakul, Chavit; Supasitthumrong, Thitiporn; Tangwongchai, Sookjareon; Hemrunroj, Solaphat; Chuchuen, Phenphichcha; Tawankanjanachot, Itthipol; Likitchareon, Yuthachai; Phanthumchinda, Kamman; Sriswasdi, Sira; Maes, Michael

2018-04-04

The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) developed a neuropsychological battery (CERAD-NP) to screen patients with Alzheimer's dementia. Mild cognitive impairment (MCI) has received attention as a pre-dementia stage. To delineate the CERAD-NP features of MCI and their clinical utility to externally validate MCI diagnosis. The study included 60 patients with MCI, diagnosed using the Clinical Dementia Rating, and 63 normal controls. Data were analysed employing receiver operating characteristic analysis, Linear Support Vector Machine, Random Forest, Adaptive Boosting, Neural Network models, and t-distributed stochastic neighbour embedding (t-SNE). MCI patients were best discriminated from normal controls using a combination of Wordlist Recall, Wordlist Memory, and Verbal Fluency Test. Machine learning showed that the CERAD features learned from MCI patients and controls were not strongly predictive of the diagnosis (maximal cross-validation 77.2%), whilst t-SNE showed that there is a considerable overlap between MCI and controls. The most important features of the CERAD-NP differentiating MCI from normal controls indicate impairments in episodic and semantic memory and recall. While these features significantly discriminate MCI patients from normal controls, the tests are not predictive of MCI. © 2018 S. Karger AG, Basel.

Life Course Status and Exchanges of Support between Young Adults and Parents

ERIC Educational Resources Information Center

Bucx, Freek; van Wel, Frits; Knijn, Trudie

2012-01-01

The authors investigated intergenerational support exchanges in relation to young adults' life course status. In a sample of 2,022 young adults (ages 18-34 years) in The Netherlands, single young adults reported receiving more advice from parents than married young adults, and those with children of their own received more practical support.…

Support Service Use and Interest in Support Services among Lung Cancer Patients

PubMed Central

Mosher, Catherine E.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Einhorn, Lawrence H.; Birdas, Thomas J.; Kesler, Kenneth A.; Champion, Victoria L.

2013-01-01

Summary Objectives This study examined support service use and interest in support services among lung cancer patients (N = 165) at two comprehensive medical centers in the midwestern United States. Materials and Methods Patients completed an assessment of support service use (i.e., receipt of mental health services, complementary and alternative medicine [CAM], and help from a spiritual leader), interest in support services, and physical and psychological symptoms. Results Only 40% of patients with significant anxiety and depressive symptoms and 28% of the entire sample reported current mental health service use. However, nearly half (47%) of all patients were receiving support from a spiritual leader. Having late-stage lung cancer and a religious affiliation predicted receipt of spiritual support. Few patients who were not receiving mental health services or spiritual support were interested in these services (range = 4% to 18%). Conversely, although interest in CAM was expressed by a substantial minority of patients (27%) who were not using these services, rates of CAM use were relatively low (22%). Conclusion Findings suggest that distressed lung cancer patients underuse mental health services, but many patients receive help from spiritual leaders. Given the lack of interest in mental health services among patients who are not receiving them, efforts are needed to enhance palatability of services and identify and reduce barriers to evidence-based service use. PMID:23932457

Social support received by women with intellectual and developmental disabilities during pregnancy and childbirth: An exploratory qualitative study.

PubMed

Potvin, Lynne A; Brown, Hilary K; Cobigo, Virginie

2016-06-01

this study aims to contribute to the development of a conceptual framework that will inform maternity care improvements for expectant mothers with intellectual and developmental disabilities (IDD) by exploring the structure, functions, and perceived quality of social support received by women with IDD during pregnancy and childbirth. using a grounded theory approach, we conducted an exploratory study set in Ontario, Canada in 2015. the sample included four adult women with IDD who had given birth in the last five years. data were collected using semi-structured interviews. the structure of social support received by women with IDD consisted of both formal and informal sources, but few or no friendships. Women with IDD reported high levels of informational and instrumental support and low levels of emotional support and social companionship. However, a high level of available support was not always perceived as beneficial. Emergent core categories suggest that social support is perceived as most effective when three conditions are met: (1) support is accessible, (2) support is provided by individuals expressing positive attitudes towards the pregnancy, and (3) autonomy is valued. our study confirms and identifies important gaps in the social support received by expectant mothers with IDD. Women with IDD currently lack accessible informational support, emotional support, and social companionship during pregnancy and childbirth. Additional findings regarding the structure and functions of social support are presented, and a preliminary conceptual framework of effective social support during pregnancy and childbirth, as perceived by women with IDD is also proposed. Findings suggest that increasing support accessibility should be a social and clinical priority; however, maternity care providers should be aware of stigmatizing attitudes and respect the autonomy of pregnant women with IDD as they prepare for motherhood. Copyright © 2016 Elsevier Ltd. All rights reserved.

15 CFR 200.110 - Priorities and time of completion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... calibrations and other tests will generally be made in the order in which confirmed requests are received... considerably longer, particularly if their abnormal behavior requires reruns to check reliability. The customer...

78 FR 15405 - Internal Revenue Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... be received on or before May 10, 2013 to be assured of consideration. ADDRESSES: Direct all written... have been properly computed. The form is also used for the basis election of section 1016(c)(1...

Nutrition and Hyperglycemia Management in the Inpatient Setting (Meals on Demand, Parenteral, or Enteral Nutrition).

PubMed

Drincic, Andjela T; Knezevich, Jon T; Akkireddy, Padmaja

2017-08-01

The goal of this paper is to provide the latest evidence and expert recommendations for management of hospitalized patients with diabetes or hyperglycemia receiving enteral (EN), parenteral (PN) nutrition support or, those with unrestricted oral diet, consuming meals on demand. Patients with and without diabetes mellitus commonly develop hyperglycemia while receiving EN or PN support, placing them at increased risk of adverse outcomes, including in-hospital mortality. Very little new evidence is available in the form of randomized controlled trials (RCT) to guide the glycemic management of these patients. Reduction in the dextrose concentration within parenteral nutrition as well as selection of an enteral formula that diminishes the carbohydrate exposure to a patient receiving enteral nutrition are common strategies utilized in practice. No specific insulin regimen has been shown to be superior in the management of patients receiving EN or PN nutrition support. For those receiving oral nutrition, new challenges have been introduced with the most recent practice allowing patients to eat meals on demand, leading to extreme variability in carbohydrate exposure and risk of hypo and hyperglycemia. Synchronization of nutrition delivery with the astute use of intravenous or subcutaneous insulin therapy to match the physiologic action of insulin in patients receiving nutritional support should be implemented to improve glycemic control in hospitalized patients. Further RCTs are needed to evaluate glycemic and other clinical outcomes of patients receiving nutritional support. For patients eating meals on demand, development of hospital guidelines and policies are needed, ensuring optimization and coordination of meal insulin delivery in order to facilitate patient safety.

Disciplining Bioethics: Towards a Standard of Methodological Rigor in Bioethics Research

PubMed Central

Adler, Daniel; Shaul, Randi Zlotnik

2012-01-01

Contemporary bioethics research is often described as multi- or interdisciplinary. Disciplines are characterized, in part, by their methods. Thus, when bioethics research draws on a variety of methods, it crosses disciplinary boundaries. Yet each discipline has its own standard of rigor—so when multiple disciplinary perspectives are considered, what constitutes rigor? This question has received inadequate attention, as there is considerable disagreement regarding the disciplinary status of bioethics. This disagreement has presented five challenges to bioethics research. Addressing them requires consideration of the main types of cross-disciplinary research, and consideration of proposals aiming to ensure rigor in bioethics research. PMID:22686634

Empirically-supported and non-empirically supported therapies for bulimia nervosa: retrospective patient ratings

PubMed Central

2013-01-01

Background Empirically supported therapies for bulimia nervosa include cognitive behaviour therapy and interpersonal therapy. Whilst these treatments have been shown to be effective in multiple randomised controlled trials, little research has investigated how they are perceived by patients who receive them. This study investigated whether empirically-supported psychological therapies (ESTs) are associated with superior self-rated treatment outcomes in clients with Bulimia Nervosa (BN). Results 98 adults who had received psychological therapy for BN in the United Kingdom completed a questionnaire which retrospectively assessed the specific contents of their psychological therapy and self-rated treatment outcomes. Around half the sample, fifty three participants reported receiving an EST. Fifty of these received Cognitive Behaviour Therapy (CBT) and three Interpersonal Therapy (IPT). Where therapy met expert criteria for Cognitive Behaviour Therapy for Bulimia Nervosa (CBT-BN, an EST) participants reported superior treatment outcomes than those who appeared to receive non-specialist cognitive-behavioural therapy. However, self-rated treatment outcomes were similar overall between those whose therapy met criteria for ESTs and those whose therapy did not. Conclusions The findings offer tentative support for the perceived helpfulness of CBT-BN as evaluated in controlled research trials. Cognitive-behavioural therapies for BN, as they are delivered in the UK, may not necessarily be perceived as more beneficial by clients with BN than psychological therapies which currently have less empirical support. PMID:24999419

The Disability Discrimination Act, a necessary, but not sufficient safeguard for people with progressive conditions in the workplace? The experiences of younger people with Parkinson's disease.

PubMed

Banks, Pauline; Lawrence, Maggie

2006-01-15

This study explored the impact of Parkinson's disease (PD) on employment from the perspective of affected individuals. Particular attention was paid to factors that may affect the duration of employment after onset/diagnosis. Data were collected in two phases, i) a postal survey (n = 339), and ii) one to one interviews (n = 24). Four out of five participants reported that PD had made work difficult for them, only 15.3% had worked for more than five years post-diagnosis at the time of the survey. Several participants reported having experienced considerable stress prior to leaving work. Factors that precipitated withdrawal from the labour market included severity of symptoms, lack of support in the workplace, and opportunities for 'early retirement'. Factors associated with maintaining employment included age at diagnosis, support received from employers, and manipulation of drug therapy. It can be very difficult for people with PD to continue in paid employment for more than a few years post diagnosis. The relatively low level of contact between people with PD who were in employment and health professionals suggest that employment retention is not seen as major role for this group of professionals. There is a need for positive action to support people with progressive conditions in the workplace.

Getting women to hospital is not enough: a qualitative study of access to emergency obstetric care in Bangladesh.

PubMed

Pitchforth, E; van Teijlingen, E; Graham, W; Dixon-Woods, M; Chowdhury, M

2006-06-01

To explore what happened to poor women in Bangladesh once they reached a hospital providing comprehensive emergency obstetric care (EmOC) and to identify support mechanisms. Mixed methods qualitative study. Large government medical college hospital in Bangladesh. Providers and users of EmOC. Ethnographic observation in obstetrics unit including interviews with staff and women using the unit and their carers. Women had to mobilise significant financial and social resources to fund out of pocket expenses. Poorer women faced greater challenges in receiving treatment as relatives were less able to raise the necessary cash. The official financial support mechanism was bureaucratic and largely unsuitable in emergency situations. Doctors operated a less formal "poor fund" system to help the poorest women. There was no formal assessment of poverty; rather, doctors made "adjudications" of women's need for support based on severity of condition and presence of friends and relatives. Limited resources led to a "wait and see" policy that meant women's condition could deteriorate before help was provided. Greater consideration must be given to what happens at health facilities to ensure that (1) using EmOC does not further impoverish families; and (2) the ability to pay does not influence treatment. Developing alternative finance mechanisms to reduce the burden of out of pocket expenses is crucial but challenging. Increased investment in EmOC must be accompanied by an increased focus on equity.

Plant blindness and the implications for plant conservation.

PubMed

Balding, Mung; Williams, Kathryn J H

2016-12-01

Plant conservation initiatives lag behind and receive considerably less funding than animal conservation projects. We explored a potential reason for this bias: a tendency among humans to neither notice nor value plants in the environment. Experimental research and surveys have demonstrated higher preference for, superior recall of, and better visual detection of animals compared with plants. This bias has been attributed to perceptual factors such as lack of motion by plants and the tendency of plants to visually blend together but also to cultural factors such as a greater focus on animals in formal biological education. In contrast, ethnographic research reveals that many social groups have strong bonds with plants, including nonhierarchical kinship relationships. We argue that plant blindness is common, but not inevitable. If immersed in a plant-affiliated culture, the individual will experience language and practices that enhance capacity to detect, recall, and value plants, something less likely to occur in zoocentric societies. Therefore, conservation programs can contribute to reducing this bias. We considered strategies that might reduce this bias and encourage plant conservation behavior. Psychological research demonstrates that people are more likely to support conservation of species that have human-like characteristics and that support for conservation can be increased by encouraging people to practice empathy and anthropomorphism of nonhuman species. We argue that support for plant conservation may be garnered through strategies that promote identification and empathy with plants. © 2016 Society for Conservation Biology.

X-ray optics made from thin plastic foils

NASA Astrophysics Data System (ADS)

Schnopper, H. W.; Barbera, M.; Ingram, R.; Silver, E.; Romaine, S.; Bandler, S.; Murray, S.; Christensen, F. E.; Hussain, A.; Collura, A.

2000-10-01

New design concepts and materials can be used to produce lightweight, thin foil approximations, to Wolter I and other X-ray optics. Structures are designed around a central hub and spacers that connect two (or three) spoked wheels. Figure defining, thin pins span the distance between the wheels. Thin, metal coated or multilayered, plastic foils can be formed into full cones, cylinders or spirals for X-ray telescopes or lenses. High resolution X-ray scattering data were obtained for single foils at Cu K (8 KeV). Multi-energy (0.28 - 8 KeV) data were obtained with a multichannel plate imager in a 17 m beam line with a point-to-point focusing, cylindrical X-ray lens with 14 shells. The largest shell has a diameter of 175 mm and a length of 100 mm. Typical images have a FWHM of 20 arcsec. The results indicate that a 60 cm diameter, 4.65 m focal length X-ray telescope can have an HPD of considerably less than 2 arcmin. This research is supported, in part by NASA Grant NAG5-5268, ONR Grant N00014-95-1-1248, and by institutional funding from the Smithsonian Astrophysical Observatory. The SAO multilayer facility receives support from NASA Grant NAG5-5095. This work made use of the MRSEC Shared Experimental Facilities at MIT supported by NSF Grant DMR94-00334.

Economic aspects of a therapy and support service for people with long-term stroke and aphasia.

PubMed

van der Gaag, Anna; Brooks, Richard

2008-01-01

This paper considers some economic aspects of a therapy and support service for people with stroke and aphasia. This material was part of a broader evaluation of the service, which is reported elsewhere (van der Gaag et al. 2005, van der Gaag and Mowles 2005). The purpose of this part of the study was to investigate the feasibility of undertaking economic appraisal in a voluntary sector service providing therapy for people with aphasia and their families. The costs of delivering therapy and support services were calculated. These costs were compared with the costs of equivalent services in the National Health Service (NHS). The EQ-5D health-related quality of life instrument was used to calculate quality-adjusted life years (QALYs). The cost of delivering therapy was lower than expected for a customized service of this nature. The study generated cost data for delivering therapy services, allowing some comparisons to be made with equivalent services in NHS settings. QALY data were generated for a sample of 25 clients on one of the programmes. The economics of speech and language therapy service delivery have received scant attention in the published literature. The paper argues that decision-making about methods of service delivery can be aided by the explicit consideration of the costs and consequences of different programmes.

Supporting self and others: from staff nurse to nurse consultant. Part 6: giving and receiving feedback.

PubMed

Fowler, John

This series of articles explores various ways of supporting staff who work in the fast-moving and ever-changing health service. In previous articles, John Fowler, an experienced nursing lecturer, author and consultant examined the importance of developing a supportive working culture and the role of preceptorship, mentoring and clinical supervision. This article examines how giving and receiving feedback can be a supportive experience.

Concentric tube support assembly

DOEpatents

Rubio, Mark F.; Glessner, John C.

2012-09-04

An assembly (45) includes a plurality of separate pie-shaped segments (72) forming a disk (70) around a central region (48) for retaining a plurality of tubes (46) in a concentrically spaced apart configuration. Each segment includes a support member (94) radially extending along an upstream face (96) of the segment and a plurality of annularly curved support arms (98) transversely attached to the support member and radially spaced apart from one another away from the central region for receiving respective upstream end portions of the tubes in arc-shaped spaces (100) between the arms. Each segment also includes a radial passageway (102) formed in the support member for receiving a fluid segment portion (106) and a plurality of annular passageways (104) formed in the support arms for receiving respective arm portions (108) of the fluid segment portion from the radial passageway and for conducting the respective arm portions into corresponding annular spaces (47) formed between the tubes retained by the disk.

Who Receives Confrontation in Recovery Houses and when is it Experienced as Supportive?

PubMed Central

Polcin, Douglas L.

2008-01-01

The Alcohol and Drug Confrontation Scale (ADCS) is a 72-item instrument that measures a construct of confrontation defined as warnings about potential harm associated with alcohol and drug use. This analysis describes the characteristics of individuals entering residential recovery homes (N=323) who received confrontation and when it was experienced as supportive. A large proportion reported receiving at least one confrontational statement (80%), most commonly from family/friends (71%). Individuals who did and did not receive confrontation did not differ by demographics, but those receiving confrontation had more recent substance use, higher perceived costs of sobriety and more severe family and psychiatric problems. Differences were noted in confrontation from the criminal justice system versus family/friends. Overall, residents experienced confrontation as supportive regardless of who confronted them. Residents who experienced confrontation the most helpful were those with higher levels of substance use and those who believed maintaining sobriety would be difficult. PMID:20011678

Quasi-experimental designs in practice-based research settings: design and implementation considerations.

PubMed

Handley, Margaret A; Schillinger, Dean; Shiboski, Stephen

2011-01-01

Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain elements of randomization such that they can be considered "controlled" trials. Methodological design elements and practical implementation considerations for two quasi-experimental design approaches that have considerable promise in PBR settings--the stepped-wedge design, and a variant of this design, a wait-list cross-over design, are presented along with a case study from a recent PBR intervention for patients with diabetes. PBR-relevant design features include: creation of a cohort over time that collects control data but allows all participants (clusters or patients) to receive the intervention; staggered introduction of clusters; multiple data collection points; and one-way cross-over into the intervention arm. Practical considerations include: randomization versus stratification, training run in phases; and extended time period for overall study completion. Several design features of practice based research studies can be adapted to local circumstances yet retain elements to improve methodological rigor. Studies that utilize these methods, such as the stepped-wedge design and the wait-list cross-over design, can increase the evidence base for controlled studies conducted within the complex environment of PBR.

Architectural Considerations for Highly Scalable Computing to Support On-demand Video Analytics

DTIC Science & Technology

2017-04-19

enforcement . The system was tested in the wild using video files as well as a commercial Video Management System supporting more than 100 surveillance...research were used to implement a distributed on-demand video analytics system that was prototyped for the use of forensics investigators in law...cameras as video sources. The architectural considerations of this system are presented. Issues to be reckoned with in implementing a scalable

75 FR 9493 - Commission Statement in Support of Convergence and Global Accounting Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

...The Securities and Exchange Commission (the ``Commission'') is publishing this statement to provide an update regarding its consideration of global accounting standards, including its continued support for the convergence of U.S. Generally Accepted Accounting Principles (``U.S. GAAP'') and International Financial Reporting Standards (``IFRS'') and the implications of convergence with respect to the Commission's ongoing consideration of incorporating IFRS into the financial reporting system for U.S. issuers.