Sample records for studies provide initial

  1. Comparing Web-Based Provider-Initiated and Patient-Initiated Survivorship Care Planning for Cancer Patients: A Randomized Controlled Trial

    PubMed Central

    Tolbert, Elliott; Hannum, Susan M; Radhakrishnan, Archana; Zorn, Kelsey; Blackford, Amanda; Greco, Stephen; Smith, Karen; Snyder, Claire F

    2016-01-01

    Background Survivorship care plans (SCPs) are intended to facilitate communication and coordination between patients, oncologists, and primary care providers. Most SCP initiatives have focused on oncology providers initiating the SCP process, but time and resource barriers have limited uptake. Objective This trial compares the feasibility and value of 2 Web-based SCP tools: provider-initiated versus patient-initiated. Methods This mixed-methods study recruited clinicians from 2 academically-affiliated community oncology practices. Eligible patients were treated by a participating oncologist, had nonmetastatic cancer, completed acute treatment ≤ 2 months before enrollment, and had no evidence of disease. Patients were randomized 1:1 to either provider-initiated or patient-initiated SCPs—both are Web-based tools. We conducted qualitative interviews with providers at baseline and follow-up and with patients 2 months after enrollment. In addition, patients were administered the Preparing for Life as a (New) Survivor (PLANS) and Cancer Survivors’ Unmet Needs (CaSUN) surveys at baseline and 2 months. Results A total of 40 providers were approached for the study, of whom 13 (33%) enrolled. Providers or clinic staff required researcher assistance to identify eligible patients; 41 patients were randomized, of whom 25 completed follow-up (61%; 13 provider-initiated, 12 patient-initiated). Of the 25, 11 (44%) had initiated the SCP; 5 (20%) provided the SCP to their primary care provider. On the Preparing for Life as a (New) Survivor and Cancer Survivors’ Unmet Needs, patients in both arms tended to report high knowledge and confidence and few unmet needs. In qualitative interviews, providers and patients discussed SCPs’ value. Conclusions Regardless of patient- versus provider-initiated templates and the Web-based design of these tools, barriers to survivorship care planning persist. Further efforts should emphasize workflow functions for identifying and completing SCPs—regardless of the SCP form used. Trial Registration ClinicalTrials.gov NCT02405819; https://clinicaltrials.gov/ct2/show/NCT02405819 (Archived by WebCite at http://www.webcitation.org/6jWqcWOvK) PMID:28410187

  2. The views and experiences of nurses and midwives in the provision and management of provider-initiated HIV testing and counseling: a systematic review of qualitative evidence.

    PubMed

    Evans, Catrin; Nalubega, Sylivia; McLuskey, John; Darlington, Nicola; Croston, Michelle; Bath-Hextall, Fiona

    2016-01-15

    Global progress towards HIV prevention and care is contingent upon increasing the number of those aware of their status through HIV testing. Provider-initiated HIV testing and counseling is recommended globally as a strategy to enhance uptake of HIV testing and is primarily conducted by nurses and midwives. Research shows that provider-initiated HIV testing and counseling implementation is sub-optimal. The reasons for this are unclear. The review aimed to explore nurses' and midwives' views and experiences of the provision and management of provider-initiated HIV testing and counseling. All cadres of nurses and midwives were considered, including those who undertake routine HIV testing as part of a diverse role and those who are specifically trained as HIV counselors. Types of phenomenon of interest: The review sought to understand the views and experiences of the provision and management of provider-initiated HIV testing and counseling (including perceptions, opinions, beliefs, practices and strategies related to HIV testing and its implementation in practice). The review included only provider-initiated HIV testing and counseling. It excluded all other models of HIV testing. The review included all countries and all healthcare settings. Types of studies: This review considered all forms of qualitative study design and methodology. Qualitative elements of a mixed method study were included if they were presented separately within the publication. A three-step search strategy was utilized. Eight databases were searched for papers published from 1996 to October 2014, followed by hand searching of reference lists. Only studies published in the English language were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled using a pragmatic meta-aggregative approach and the Joanna Briggs Institute Qualitative Assessment and Review Instrument software. This review included 21 publications from 18 research studies, representing a wide range of countries and healthcare settings. There were 245 findings which were aggregated into 12 categories and five synthesized findings. 1. Nurses/midwives are supportive of provider-initiated HIV testing and counseling if it is perceived to enhance patient care and to align with perceived professional roles. 2. Nurses'/midwives' ability to perform provider-initiated HIV testing and counseling well requires an appropriate infrastructure and adequate human and material resources. 3. At the organizational level, nurses'/midwives' engagement with provider-initiated HIV testing and counseling is facilitated by an inclusive management structure, alongside the provision of ongoing training and clinical supervision. Provider-initiated HIV testing and counseling is hindered by difficulties in fitting it into existing workloads and routines. 4. Nurses/midwives perceive that good quality care in provider-initiated HIV testing and counseling involves finding a balance between public health needs and individual patient needs. Good care requires time and the ability to apply a patient centred approach. 5. The emotional work involved in provider-initiated HIV testing and counseling can be stressful. Nurses/Midwives may require support to deal with complex moral and ethical issues. This review shows that provider-initiated HIV testing and counseling is supported by nurses/midwives who strive to implement it according to principles of good care and a patient centered approach. Nurses/midwives face multiple operational, infra-structural, resource and ethical challenges in the implementation of provider-initiated HIV testing and counseling. The implementation process for provider-initiated HIV testing and counseling would benefit from using a quality improvement framework. Nurses/midwives undertaking provider-initiated HIV testing and counseling require management support, ongoing training and adequate infrastructure/resources. Additional guidance is required on legal/ethical issues in testing of children and in third party disclosure. Operational research is required to determine an optimal skill mix and optimal methods of integrating provider-initiated HIV testing and counseling into existing work routines. The Joanna Briggs Institute.

  3. Predictors of provider- initiated HIV testing and counseling refusal by outpatient department clients in Wolaita zone, Southern Ethiopia: a case control study.

    PubMed

    Facha, Wolde; Kassahun, Wondewosen; Workicho, Abdulhalik

    2016-08-12

    Despite different strategies designed to rapidly identify HIV infected individuals, majority of HIV-infected people are unaware of their sero-status in developing countries. The objective of this study was to assess predictors of provider-initiated HIV testing and counseling (PITC) refusal by outpatient department (OPD) clients in Wolaita zone, Southern Ethiopia. Facility based unmatched case control study was conducted on outpatient department clients in randomly selected seven health facilities in Wolaita zone, Southern Ethiopia in February 2012. A total of 291 participants (97 cases and 194 controls) were included in our study. Cases were patients who refused HIV test while controls were patients who tested for HIV after provider-initiated HIV testing and counseling (PITC) recommendation by outpatient department (OPD) clinicians. We used both quantitative and qualitative methods of data collection. Pretested interviewer administered questionnaires were used to collect quantitative data by trained nurses, and in-depth interview with 14 OPD clinicians was conducted by principal investigator to supplement quantitative findings. Bivariate and multivariate analyses were done to identify independent predictors of provider-initiated HIV testing and counseling refusal by OPD clients. Study participants who had stigmatizing attitude [AOR = 6.09, (95 % CI: 1.70, 21.76)], who had perceived risk for HIV infection [AOR = 5.23, (95 % CI: 2.22, 12.32)], who did not perceive the benefits of provider-initiated HIV testing and counseling [AOR = 4.64, (95 % CI: 1.79, 12.01)], who did not get minimum recommended pretest information from their providers [AOR = 2.98, (95 % CI: 1.06, 8.35)], who ever not heard of provider-initiated HIV testing and counseling service [AOR = 2.41, (95 % CI: 1.14, 5.09)], and who were from urban area [AOR = 2.40, (95 % CI = 1.26, 4.57)] were more likely to refuse provider-initiated HIV testing and counseling service than their counterparts. Knowledge on HIV/AIDS, attitude towards people living with HIV/AIDS and perceived risk for HIV infection by clients were the major barriers for provider-initiated HIV testing and counseling acceptance. Health professionals working at outpatient department should give due attention to overcome these barriers so as to enhance HIV testing acceptance by their clients.

  4. Making Learning Visible in Initial Teacher Education: A Pedagogical Characterisation Scheme

    ERIC Educational Resources Information Center

    Taylor, Peter G.; Low, Ee Ling; Lim, Kam Ming; Hui, Chenri

    2013-01-01

    This paper reports the development of a scheme of characterising pedagogical practices in initial teacher education classes. The scheme is intended to provide baseline data on classroom pedagogical practices in Singapore's sole provider of initial teacher education (ITE). This study is original in that the research team has found no reports of…

  5. Correlates of HPV vaccine initiation and provider recommendation among male adolescents, 2014 NIS-Teen.

    PubMed

    Landis, Kathryn; Bednarczyk, Robert A; Gaydos, Laura M

    2018-05-08

    Vaccination is a safe and effective way to prevent Human Papillomavirus (HPV) infection and related cancers; however, HPV vaccine uptake remains low in the US. After the 2011 Advisory Committee on Immunization Practices (ACIP) recommendation for routine HPV vaccination of adolescent males, several studies have examined predictors for initiating the vaccine series in this population of interest, particularly with regard to provider recommendations. This study examined racial and ethnic differences for HPV vaccine initiation and provider recommendation in male adolescents. Based on prior HPV vaccine uptake estimates and healthcare utilization data, we hypothesized that minority adolescents would be more likely to initiate HPV vaccines, but less likely to receive a provider recommendation compared to white counterparts. We analyzed the 2014 National Immunization Survey-Teen (NIS-Teen), which included 10,753 male adolescents with provider-verified vaccination data in 50 US states, using multivariate logistic regression models to evaluate racial/ethnic differences in HPV vaccine initiation and provider recommendation. The odds of HPV vaccine initiation were 76 percent higher for Hispanic adolescents and 43 percent higher for non-Hispanic Other or Multiple race adolescents compared to white adolescents. Approximately half of parents reported receiving a provider recommendation for vaccination, with no significant difference in the odds of receiving a provider recommendation across racial/ethnic groups. Despite similar frequency of recommendations across racial and ethnic groups, male adolescents who are racial/ethnic minorities are more likely to initiate vaccination. Future research should focus on developing tailored interventions to increase HPV vaccine receipt among males of all racial/ethnic groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Barriers to and acceptability of provider-initiated HIV testing and counselling and adopting HIV-prevention behaviours in rural Uganda: a qualitative study.

    PubMed

    Kiene, Susan M; Sileo, Katelyn; Wanyenze, Rhoda K; Lule, Haruna; Bateganya, Moses H; Jasperse, Joseph; Nantaba, Harriet; Jayaratne, Kia

    2015-02-01

    In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings. © The Author(s) 2013.

  7. Distinct Mechanisms of Transcription Initiation by RNA Polymerases I and II.

    PubMed

    Engel, Christoph; Neyer, Simon; Cramer, Patrick

    2018-05-20

    RNA polymerases I and II (Pol I and Pol II) are the eukaryotic enzymes that catalyze DNA-dependent synthesis of ribosomal RNA and messenger RNA, respectively. Recent work shows that the transcribing forms of both enzymes are similar and the fundamental mechanisms of RNA chain elongation are conserved. However, the mechanisms of transcription initiation and its regulation differ between Pol I and Pol II. Recent structural studies of Pol I complexes with transcription initiation factors provided insights into how the polymerase recognizes its specific promoter DNA, how it may open DNA, and how initiation may be regulated. Comparison with the well-studied Pol II initiation system reveals a distinct architecture of the initiation complex and visualizes promoter- and gene-class-specific aspects of transcription initiation. On the basis of new structural studies, we derive a model of the Pol I transcription cycle and provide a molecular movie of Pol I transcription that can be used for teaching.

  8. Using the knowledge-to-action framework to guide the timing of dialysis initiation.

    PubMed

    Sood, Manish M; Manns, Braden; Nesrallah, Gihad

    2014-05-01

    The optimal time at which to initiate chronic dialysis remains unknown. Using a contemporary knowledge translation approach (the knowledge-to-action framework), a pan-Canadian collaboration (CANN-NET) set out to study the scope of the problem, then develop and disseminate evidence-based guidelines addressing the timing of dialysis initiation. The purpose of this review is to summarize the key findings and describe the planned Canadian knowledge translation strategy for improving knowledge and practices pertaining to the timing dialysis initiation. New research has provided considerable insights regarding the initiation of dialysis. A Canadian cohort study identified significant variation in the estimated glomerular filtration rate level at dialysis initiation, and a survey of providers identified related knowledge gaps that might be amenable to knowledge translation interventions. A recent knowledge synthesis/guideline concluded that early dialysis initiation is costly, and provides no measureable clinical benefits. A systematic knowledge translation intervention including a multifaceted approach may aid in reducing variation in practice and improving the quality of care. Utilizing the knowledge-to-action framework, we identified practice variation and key barriers to the optimal timing for dialysis initiation that may be amenable to knowledge translation strategies.

  9. From Birth to School: Early Childhood Initiatives and Third-Grade Outcomes in North Carolina

    ERIC Educational Resources Information Center

    Ladd, Helen F.; Muschkin, Clara G.; Dodge, Kenneth A.

    2014-01-01

    This study examines the community-wide effects of two statewide early childhood policy initiatives in North Carolina. One initiative provides funding to improve the quality of child care services at the county level for all children between the ages of 0 to 5, and the other provides funding for preschool slots for disadvantaged four-year-olds.…

  10. HPV vaccination: Population approaches for improving rates.

    PubMed

    Oliver, Kristin; Frawley, Alean; Garland, Elizabeth

    2016-06-02

    To review the literature on interventions to increase HPV vaccinations and assess whether The Community Preventive Services Task Force recommendations are supported by current evidence. We used a PubMed search to identify studies that assessed interventions that looked at provider assessment and feedback, provider reminders, client reminder and recall, and clinic based education programs. Of the 13 studies identified, 8 included client reminder and recall interventions, 4 included provider assessment and feedback and/or provider reminders and 2 included clinic based education. 11 of the 13 studies demonstrated a positive effect on HPV vaccine initiation or completion. Provider assessment and feedback studies were more likely to report a positive effect on HPV vaccine initiation than on series completion, while client reminder recall interventions more frequently produced an effect on series completion than on initiation. There is evidence to support the application of the Community Preventive Services Task Force recommendations specifically to HPV vaccination both for client reminder and recall programs and for provider assessment and feedback interventions. Multiple targeted approaches will be needed to substantially impact HPV vaccine rates.

  11. The Indiana Science Initiative: Lessons from a Classroom Observation Study

    ERIC Educational Resources Information Center

    Cook, Nicole D.; Walker, William S.; Weaver, Gabriela C.; Sorge, Brandon H.

    2015-01-01

    The Indiana Science Initiative (ISI) is a systemic effort to reform K-8 science education. The program provides teachers with professional development, reform-oriented science modules, and materials support. To examine the impact of the initiative's professional development, a participant observation study was conducted in the program's pilot…

  12. Identifying Effective Strategies to Providing Technical Support to One-to-One Programs

    ERIC Educational Resources Information Center

    Thomas, Mark W.

    2013-01-01

    The problem of this study was that while one-to-one initiatives in the K-12 environment are growing, the technical support personnel that work in these environments are experiencing problems supporting these initiatives. The purposes of this study were to: (a) identify common problems of providing technical support in a one-to-one laptop program,…

  13. Diagnostic colonoscopy: performance measurement study.

    PubMed

    Kuznets, Naomi

    2002-07-01

    This is the fifth of a series of best practices studies undertaken by the Performance Measurement Initiative (PMI), the centerpiece of the Institute for Quality Improvement (IQI), a not-for-profit quality improvement subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC) (Performance Measurement Initiative, 1999a, 1999b, 2000a, 2000b). The IQI was created to offer clinical performance measurement and improvement opportunities to ambulatory health care organizations and others interested in quality patient care. The purpose of the study was to provide opportunities to initiate clinical performance measurement on key processes and outcomes for this procedure and use this information for clinical quality improvement. This article provides performance measurement information on how organizations that have demonstrated and validated differences in clinical practice can have similar outcomes, but at a dramatically lower cost. The intent of the article is to provide organizations with alternatives in practice to provide a better value to their patients.

  14. Motivation and Training Initiation: Evidence from Poland

    ERIC Educational Resources Information Center

    Mielniczuk, Emilia; Laguna, Mariola

    2017-01-01

    Purpose: Based on the self-determination theory and the model of action phases, the present study aims to provide insight into motivational factors that are important for training initiation. It investigates the relations between three types of motivation (intrinsic, extrinsic and amotivation) and training initiation: intention to initiate new…

  15. Integration and Analysis of Neighbor Discovery and Link Quality Estimation in Wireless Sensor Networks

    PubMed Central

    Radi, Marjan; Dezfouli, Behnam; Abu Bakar, Kamalrulnizam; Abd Razak, Shukor

    2014-01-01

    Network connectivity and link quality information are the fundamental requirements of wireless sensor network protocols to perform their desired functionality. Most of the existing discovery protocols have only focused on the neighbor discovery problem, while a few number of them provide an integrated neighbor search and link estimation. As these protocols require a careful parameter adjustment before network deployment, they cannot provide scalable and accurate network initialization in large-scale dense wireless sensor networks with random topology. Furthermore, performance of these protocols has not entirely been evaluated yet. In this paper, we perform a comprehensive simulation study on the efficiency of employing adaptive protocols compared to the existing nonadaptive protocols for initializing sensor networks with random topology. In this regard, we propose adaptive network initialization protocols which integrate the initial neighbor discovery with link quality estimation process to initialize large-scale dense wireless sensor networks without requiring any parameter adjustment before network deployment. To the best of our knowledge, this work is the first attempt to provide a detailed simulation study on the performance of integrated neighbor discovery and link quality estimation protocols for initializing sensor networks. This study can help system designers to determine the most appropriate approach for different applications. PMID:24678277

  16. I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia

    PubMed Central

    Johnson, David R; Ziersch, Anna M; Burgess, Teresa

    2008-01-01

    Introduction Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees. Methods Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically. Results Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service. Conclusion GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide. PMID:18687150

  17. Evaluation of the Massachusetts Expanded Learning Time (ELT) Initiative: Final Study Findings

    ERIC Educational Resources Information Center

    Checkoway, Amy; Gamse, Beth; Velez, Melissa; Linkow, Tamara

    2013-01-01

    The Massachusetts Expanded Learning Time (ELT) initiative provides grants to selected schools to redesign their schedules by adding 300-plus instructional hours to the school year to improve outcomes, broaden enrichment opportunities, and provide teachers with more planning and professional development time. The Massachusetts Department of…

  18. 2003 status report on transit intelligent vehicle initiative studies

    DOT National Transportation Integrated Search

    2003-06-01

    This 2003 Status Report provides an overview and updates on studies in the transit Intelligent Vehicle Initiative (IVI) area. IVI emphasizes the significant and continuing role of drivers in roadway safety. IVI is aimed at accelerating the developmen...

  19. Flight service specialist initial qualifications course : content validation of FAA Academy course 50232.

    DOT National Transportation Integrated Search

    1991-04-01

    This study evaluates the content validity of the Initial Qualifications Course provided to flight service specialists (FSS) by the FAA Academy. The purpose of FSS Initial Qualifications Course (FAA Academy course 50232) is to predict the student's pr...

  20. "It Is Not Easy": Challenges for Provider-Initiated HIV Testing and Counseling in Flanders, Belgium

    ERIC Educational Resources Information Center

    Manirankunda, Lazare; Loos, Jasna; Debackaere, Pieterjan; Nostlinger, Christiana

    2012-01-01

    This study identified physicians' HIV testing practices and their barriers toward implementing provider-initiated HIV testing and counseling (PITC) for Sub-Saharan African migrants (SAM) in Flanders, Belgium. In-depth interviews were conducted on a purposive sample of 20 physicians (ten GPs and ten internists). GPs performed mainly…

  1. Recommendations for Professional Development Necessary for iPad Integration

    ERIC Educational Resources Information Center

    Fenton, Diana

    2017-01-01

    With the recent adoptions of 1:1 technology initiatives, such as the iPads in schools, it is urgent to provide appropriate professional development opportunities for teachers to maximize student use of the technology. This study provides vital information on the professional development needs of teachers for initial integration of technology with…

  2. Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

    PubMed

    Wolcott, Vickee; Agarwal, Ritu; Nelson, D Alan

    2017-04-06

    Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it? We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients. The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system. We used a negative binomial regression model on over 25 million observations to determine the adjusted association between provider-initiated and provider-response messaging and subsequent messaging by their patients in this population over a 4-year period. Prior provider-initiated and response messaging levels were associated with new patient messaging when controlling for the patient's health care utilization and diagnoses, with the strongest association for high provider-response messaging level. Patients whose providers were highly responsive to the messages of other patients initiated 334% more secure messages (P<.001) than patients with providers who did not personally respond to other patients' messages. Our results indicate that provider messaging usage levels and types thereof predict their patients' subsequent communication behavior. The findings suggest the need for more study into the factors associated with provider messaging to fully understand the mechanisms of this relationship. ©Vickee Wolcott, Ritu Agarwal, D. Alan Nelson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.04.2017.

  3. Energy Reporting Practices among Top Energy Intensive Industries in Malaysia

    NASA Astrophysics Data System (ADS)

    Tasrip, N. E.; Mat Husin, N.; Alrazi, B.

    2016-03-01

    This study content analyses the energy content in the corporate report of top 30 Malaysian energy-intensive companies. Motivated by the gap among prior corporate social responsibility and environmental reporting studies in respect of energy, this study provides evidence of Malaysian companies’ initiative to reduce energy consumption. While the evidence suggests that not all 30 companies have reported energy-related information, the findings provide an overview on the response of energy intensive companies in relation to Malaysian government initiatives on energy.

  4. First-contact care with a medical vs chiropractic provider after consultation with a swiss telemedicine provider: comparison of outcomes, patient satisfaction, and health care costs in spinal, hip, and shoulder pain patients.

    PubMed

    Houweling, Taco A W; Braga, Andrea V; Hausheer, Thomas; Vogelsang, Marco; Peterson, Cynthia; Humphreys, B Kim

    2015-09-01

    The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland. A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider. The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient's Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368). Spinal, hip, and shoulder pain patients had clinically similar pain relief, greater satisfaction levels, and lower overall cost if they initiated care with DCs, when compared with those who initiated care with MDs. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  5. Framing Innovation: The Impact of the Superintendent's Technology Infrastructure Decisions on the Acceptance of Large-Scale Technology Initiatives

    ERIC Educational Resources Information Center

    Arnold, Erik P.

    2014-01-01

    A multiple-case qualitative study of five school districts that had implemented various large-scale technology initiatives was conducted to describe what superintendents do to gain acceptance of those initiatives. The large-scale technology initiatives in the five participating districts included 1:1 District-Provided Device laptop and tablet…

  6. Pilot study of pharmacist-assisted delivery of pharmacogenetic testing in a primary care setting.

    PubMed

    Haga, Susanne B; LaPointe, Nancy M Allen; Cho, Alex; Reed, Shelby D; Mills, Rachel; Moaddeb, Jivan; Ginsburg, Geoffrey S

    2014-09-01

    To describe the rationale and design of a pilot program to implement and evaluate pharmacogenetic (PGx) testing in a primary care setting. Several factors have impeded the uptake of PGx testing, including lack of provider knowledge and challenges with operationalizing PGx testing in a clinical practice setting. We plan to compare two strategies for the implementation of PGx testing: a pharmacist-initiated testing arm compared with a physician-initiated PGx testing arm. Providers in both groups will be required to attend an introduction to PGx seminar. Anticipated results: We anticipate that providers in the pharmacist-initiated group will be more likely to order PGx testing than providers in the physician-initiated group. Overall, we aim to generate data that will inform an effective delivery model for PGx testing and to facilitate a seamless integration of PGx testing in primary care practices.

  7. Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

  8. History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA.

    PubMed

    Mittal, Maria Luisa; Vashishtha, Devesh; Sun, Shelly; Jain, Sonia; Cuevas-Mota, Jazmine; Garfein, Richard; Strathdee, Steffanie A; Werb, Dan

    2017-10-03

    Medication-assisted treatment (MAT) remains the gold standard for the treatment of opioid use disorder. MAT also reduces the frequency of injecting among people who inject drugs (PWID). Relatedly, data suggest that PWID play a key role in the initiation of others into drug injecting by exposing injecting practices to injection-naïve drug users. Our primary objective was to test whether a history of MAT enrollment is associated with a reduced odds of PWID providing injection initiation assistance. Preventing Injecting by Modifying Existing Responses (PRIMER; NIDA DP2-DA040256-01), is a multi-site cohort study assessing the impact of socio-structural factors on the risk that PWID provide injection initiation assistance. Data were drawn from a participating cohort of PWID in San Diego, CA. The primary outcome was reporting ever providing injection initiation assistance; the primary predictor was reporting ever being enrolled in MAT. Logistic regression was used to model associations between MAT enrollment and ever initiating others into injecting while adjusting for potential confounders. Participants (n = 354) were predominantly male (n = 249, 70%). Thirty-eight percent (n = 135) of participants reported ever initiating others into injection drug use. In multivariate analysis, participants who reported a history of MAT enrollment had significantly decreased odds of ever providing injection initiation assistance (Adjusted Odds Ratio [AOR]: 0.62, 95% Confidence Interval [CI]: 0.39-0.99). These preliminary findings suggest an association between MAT enrollment and a lower odds that male PWID report providing injection initiation assistance to injection-naïve drug users. Further research is needed to identify the pathways by which MAT enrollment may impact the risk that PWID initiate others into drug injecting.

  9. A Study of the Intent to Fully Utilize Electronic Personal Health Records in the Context of Privacy and Trust

    ERIC Educational Resources Information Center

    Richards, Rhonda J.

    2012-01-01

    Government initiatives called for electronic health records for each individual healthcare consumer by 2014. The purpose of the initiatives is to provide for the common exchange of clinical information between healthcare consumers, healthcare providers, third-party payers and public healthcare officials. This exchange of healthcare information…

  10. Concept Mapping for Planning and Evaluation of a Community-Based Initiative

    ERIC Educational Resources Information Center

    Chiu, Korinne

    2012-01-01

    Community-based initiatives address community issues by providing a multi-agency approach to prevention and intervention services (Connell et al.,1995). When incorporating multiple agencies, it can be challenging to obtain multiple perspectives and gaining consensus on the priorities and direction for these initiatives. This study employed a…

  11. Workplace Education Initiative: Case Studies and Observations.

    ERIC Educational Resources Information Center

    Astrein, Bruce; And Others

    Seven workplace education projects funded in the first year of the Massachusetts Workplace Education Initiative are reported. This report includes both general observations and specific information in case studies of the projects. Overall information is provided on students served, the importance of partnerships, the emphasis on…

  12. Dynamics of representational change: entropy, action, and cognition.

    PubMed

    Stephen, Damian G; Dixon, James A; Isenhower, Robert W

    2009-12-01

    Explaining how the cognitive system can create new structures has been a major challenge for cognitive science. Self-organization from the theory of nonlinear dynamics offers an account of this remarkable phenomenon. Two studies provide an initial test of the hypothesis that the emergence of new cognitive structure follows the same universal principles as emergence in other domains (e.g., fluids, lasers). In both studies, participants initially solved gear-system problems by manually tracing the force across a system of gears. Subsequently, they discovered that the gears form an alternating sequence, thereby demonstrating a new cognitive structure. In both studies, dynamical analyses of action during problem solving predicted the spontaneous emergence of the new cognitive structure. Study 1 showed that a peak in entropy, followed by negentropy, key indicators of self-organization, predicted discovery of alternation. Study 2 replicated these effects, and showed that increasing environmental entropy accelerated discovery, a classic prediction from dynamics. Additional analyses based on the relationship between phase transitions and power-law behavior provide converging evidence. The studies provide an initial demonstration of the emergence of cognitive structure through self-organization.

  13. Barriers to Early Initiation and Continuation of Breastfeeding in a Tertiary care Institute of Haryana: A Qualitative Study in Nursing Care Providers.

    PubMed

    Majra, Jai Pal; Silan, Vijay Kumar

    2016-09-01

    Ever increasing institutional deliveries in India has shifted the responsibility of timely initiation and continuation of breastfeeding from peripheral health workers and families to the nursing care providers of health facilities where the births take place. While institutional deliveries have increased to 72.6%, only 44.6% of the newborns enjoy early breastfeeding in India. To study the barriers to early initiation of breastfeeding in institutional delivery. A total 34 nursing care providers were selected randomly and five Focus Group Discussions (FGDs) were carried out. This Qualitative Study was conducted through FGDs among the nursing care providers of a tertiary care institute in the Indian State of Haryana, India. The analyses continued throughout the group discussions as the newly emerged themes were tested in the subsequent discussion. FGDs transcripts were analysed to enhance the robustness of the emerged domain. Major barriers to initiation of breast feeding identified included: lack of awareness regarding proper technique of breastfeeding and benefits of colostrum; breast abnormality like inverted/retracted nipples; obstetric/neonatal complications requiring specialised care; and cultural practices like giving pre-lacteals and gender discrimination. It was further reported that the manpower has not been rationalised with ever increasing number of institutional deliveries. The respondents though willing to promote early initiation and continuation of breastfeeding felt excessive workload as one of the major barriers due to multi-tasking nature of their job. The new challenges to the early initiation and continuation of breastfeeding are emerging due to change in the place of delivery which needs to be addressed at the policy level.

  14. Perceived Support Provided by Teachers and Classmates and Students' Self-Reported Academic Initiative

    ERIC Educational Resources Information Center

    Danielsen, Anne G.; Wiium, Nora; Wilhelmsen, Britt U.; Wold, Bente

    2010-01-01

    The aim of this study was to examine how perceived support provided by teachers and classmates in the school class environment related to students' academic initiative. Data were from a stratified sample of 13-year-old students (n = 1591) from the Norwegian part of the World Health Organization's survey of Health Behaviour in School-aged Children…

  15. Do Perceived Academic Competence and School Satisfaction Mediate the Relationships between Perceived Support Provided by Teachers and Classmates, and Academic Initiative?

    ERIC Educational Resources Information Center

    Danielsen, Anne G.; Breivik, Kyrre; Wold, Bente

    2011-01-01

    The aim of the study was twofold: (1) to examine how psychosocial support provided by teachers and classmates related to students' self-regulated learning as expressed through self-reported academic initiative, and (2) whether academic competence and school satisfaction mediated these relationships. The data were from a nationally representative…

  16. Estimated reductions in provider-initiated preterm births and hospital length of stay under a universal acetylsalicylic acid prophylaxis strategy: a retrospective cohort study

    PubMed Central

    Ray, Joel G.; Bartsch, Emily; Park, Alison L.; Shah, Prakesh S.; Dzakpasu, Susie

    2017-01-01

    Background: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. Methods: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay. We projected the potential number of cases reduced and corresponding hospital length of stay if ASA prophylaxis lowered cases of preeclampsia and intrauterine growth restriction by a relative risk reduction (RRR) of 10% (lowest) or 53% (highest), as suggested by randomized clinical trials. Results: Of the 269 303 singleton live births and stillbirths in our cohort, 4495 (1.7%) were provider-initiated preterm births. Of the 4495, 1512 (33.6%) had a diagnosis of preeclampsia and/or intrauterine growth restriction. The mean maternal length of stay was 2.0 (95% confidence interval [CI] 2.0-2.0) days among term births unaffected by either condition and 7.3 (95% CI 6.1-8.6) days among provider-initiated preterm births with both conditions. The corresponding values for mean newborn length of stay were 1.9 (95% CI 1.8-1.9) days and 21.8 (95% CI 17.4-26.2) days. If ASA conferred a 53% RRR against preeclampsia and/or intrauterine growth restriction, 3365 maternal and 11 591 newborn days in hospital would be averted. If ASA conferred a 10% RRR, 635 maternal and 2187 newborn days in hospital would be averted. Interpretation: A universal ASA prophylaxis strategy could substantially reduce the burden of long maternal and newborn hospital stays associated with provider-initiated preterm birth. However, until there is compelling evidence that administration of ASA to all, or most, pregnant women reduces the risk of preeclampsia and/or intrauterine growth restriction, clinicians should continue to follow current clinical practice guidelines. PMID:28646095

  17. Teachers' Personal Learning Networks (PLNs): Exploring the Nature of Self-Initiated Professional Learning Online

    ERIC Educational Resources Information Center

    Tour, Ekaterina

    2017-01-01

    In the field of Literacy Studies, online spaces have been recognised as providing many opportunities for spontaneous and self-initiated learning. While some progress has been made in understanding these important learning experiences, little attention has been paid to teachers' self-initiated professional learning. Contributing to the debates…

  18. Baseline antenna design for space exploration initiative

    NASA Technical Reports Server (NTRS)

    Chen, Y. L.; Nasir, M. A.; Lee, S. W.; Zaman, Afroz

    1993-01-01

    A key element of the future NASA Space Exploration Initiative (SEI) mission is the lunar and Mars telecommunication system. This system will provide voice, image, and data transmission to monitor unmanned missions to conduct experiments, and to provide radiometric data for navigation. In the later half of 1991, a study was conducted on antennas for the Mars Exploration Communication. Six antenna configurations were examined: three reflector and three phased array. The conclusion was that due to wide-angle scan requirement, and multiple simultaneous tracking beams, phased arrays are more suitable. For most part, this report studies phased array antenna designs for two different applications for Space Exploration Initiative. It also studies one design for a tri-reflector type antenna. These antennas will be based on a Mars orbiting satellite.

  19. Self-initiated object-location memory in young and older adults.

    PubMed

    Berger-Mandelbaum, Anat; Magen, Hagit

    2017-11-20

    The present study explored self-initiated object-location memory in ecological contexts, as aspect of memory that is largely absent from the research literature. Young and older adults memorized objects-location associations they selected themselves or object-location associations provided to them, and elaborated on the strategy they used when selecting the locations themselves. Retrieval took place 30 min and 1 month after encoding. The results showed an age-related decline in self-initiated and provided object-location memory. Older adults benefited from self-initiation more than young adults when tested after 30 min, while the benefit was equal when tested after 1 month. Furthermore, elaboration enhanced memory only in older adults, and only after 30 min. Both age groups used deep encoding strategies on the majority of the trials, but their percentage was lower in older adults. Overall, the study demonstrated the processes involved in self-initiated object-location memory, which is an essential part of everyday functioning.

  20. Study Provides Insights into Diagnosis, Treatment of Rare Immune Disease: Autoimmmune Lymphoproliferative Syndrome ...

    MedlinePlus

    ... Award Negotiation & Initial Award After Award Foreign Grants Management Getting Your Initial International Award Actions You Can Take as the Project Leader on a Foreign Grant Subawards for Foreign ...

  1. Sea otters in captivity: applications and implications of husbandry development, public display, scientific research and management, and rescue and rehabilitation for sea otter conservation

    USGS Publications Warehouse

    VanBlaricom, Glenn R.; Belting, Traci F.; Triggs, Lisa H.

    2015-01-01

    Studies of sea otters in captivity began in 1932, producing important insights for conservation. Soviet (initiated in 1932) and United States (1951) studies provided information on captive otter husbandry, setting the stage for eventual large-scale translocations as tools for population restoration. Early studies also informed effective housing of animals in zoos and aquaria, with sea otters first publicly displayed in 1954. Surveys credited displayed otters in convincing the public of conservation values. After early studies, initial scientific data for captive sea otters in aquaria came from work initiated in 1956, and from dedicated research facilities beginning in 1968. Significant achievements have been made in studies of behavior, physiology, reproduction, and high-priority management issues. Larger-scale projects involving translocation and oil spill response provided extensive insights into stress reactions, water quality issues in captivity, and effects of oil spills.

  2. Learning at Air Navigation Services after Initial Training

    ERIC Educational Resources Information Center

    Teperi, Anna-Maria; Leppanen, Anneli

    2010-01-01

    Purpose: This study aims to find out the means used for individual, group and organizational learning at work at one air navigation service provider after the initial training period. The study also aims to find out what practices need to be improved to enhance learning at work. Design/methodology/approach: The data for the study were collected…

  3. Sharing health data in Belgium: A home care case study using the Vitalink platform.

    PubMed

    De Backere, Femke; Bonte, Pieter; Verstichel, Stijn; Ongenae, Femke; De Turck, Filip

    2018-01-01

    In 2013, the Flemish Government launched the Vitalink platform. This initiative focuses on the sharing of health and welfare data to support primary healthcare. In this paper, the objectives and mission of the Vitalink initiative are discussed. Security and privacy measures are reviewed, and the technical implementation of the Vitalink platform is presented. Through a case study, the possibility of interaction with cloud solutions for healthcare is also investigated upon; this was initially not the focus of Vitalink. The Vitalink initiative provides support for secure data sharing in primary healthcare, which in the long term will improve the efficiency of care and will decrease costs. Based on the results of the case study, Vitalink allowed cloud solutions or applications not providing end-to-end security to use their system. The most important lesson learned during this research was the need for firm regulations and stipulations for cloud solutions to interact with the Vitalink platform. However, these are currently still vague.

  4. The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families.

    PubMed

    Wong, Sabrina T; Lynam, M Judith; Khan, Koushambhi B; Scott, Lorine; Loock, Christine

    2012-10-04

    The Responsive Interdisciplinary Child-Community Health Education and Research (RICHER) initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC) model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for 'at risk' children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1) access to health care for children and families with multiple forms of disadvantage and 2) patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach. This was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86) and thematic analyses of patient interview data (n=7) were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment. Respondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider's interpersonal style (e.g., being treated as an equal), was very important. Even after controlling for parents' education and ethnicity, the provider's interpersonal style remained positively associated with parent-reported empowerment (p<0.01). This model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can better meet the health and health care needs of people, especially those who are vulnerable due to multiple intersecting social determinants of health. Positive interpersonal communication from providers can play a key role in facilitating situations where individuals have an opportunity to experience success in managing their and their family's health.

  5. Stop identity cue as a cue to language identity

    NASA Astrophysics Data System (ADS)

    Castonguay, Paula Lisa

    The purpose of the present study was to determine whether language membership could potentially be cued by the acoustic-phonetic detail of word-initial stops and retained all the way through the process of lexical access to aid in language identification. Of particular interest were language-specific differences in CE and CF word-initial stops. Experiment 1 consisted of an interlingual homophone production task. The purpose of this study was to examine how word-initial stop consonants differ in terms of acoustic properties in Canadian English (CE) and Canadian French (CF) interlingual homophones. The analyses from the bilingual speakers in Experiment 1 indicate that bilinguals do produce language-specific differences in CE and CF word-initial stops, and that closure duration, voice onset time, and burst spectral SD may provide cues to language identity in CE and CF stops. Experiment 2 consisted of a Phoneme and Language Categorization task. The purpose of this study was to examine how stop identity cues, such as VOT and closure duration, influence a listener to identify word-initial stop consonants as belonging to Canadian English (CE) or Canadian French (CF). The RTs from the bilingual listeners in this study indicate that bilinguals do perceive language-specific differences in CE and CF word-initial stops, and that voice onset time may provide cues to phoneme and language membership in CE and CF stops. Experiment 3 consisted of a Phonological-Semantic priming task. The purpose of this study was to examine how subphonetic variations, such as changes in the VOT, affect lexical access. The results of Experiment 3 suggest that language-specific cues, such as VOT, affects the composition of the bilingual cohort and that the extent to which English and/or French words are activated is dependent on the language-specific cues present in a word. The findings of this study enhanced our theoretical understanding of lexical structure and lexical access in bilingual speakers. In addition, this study provides further insight on cross-language effects at the subphonetic level.

  6. Mapping telemedicine efforts: surveying regional initiatives in Denmark.

    PubMed

    Kierkegaard, Patrick

    2015-05-01

    The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies are being utilized? What medical disciplines are being supported using telemedicine systems? All data were surveyed from the Telemedicinsk Landkort, a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. The results of this study suggest that a growing numbers of telemedicine initiatives are currently in operation across Denmark but that considerable variations exist in terms of regional efforts as the number of operational telemedicine projects varied from region to region. The results of this study provide a timely picture of the factors that are shaping the telemedicine landscape of Denmark and suggest potential strategies to help policymakers increase and improve national telemedicine deployment.

  7. Achieving effective learning effects in the blended course: a combined approach of online self-regulated learning and collaborative learning with initiation.

    PubMed

    Tsai, Chia-Wen

    2011-09-01

    In many countries, undergraduates are required to take at least one introductory computer course to enhance their computer literacy and computing skills. However, the application software education in Taiwan can hardly be deemed as effective in developing students' practical computing skills. The author applied online self-regulated learning (SRL) and collaborative learning (CL) with initiation in a blended computing course and examined the effects of different combinations on enhancing students' computing skills. Four classes, comprising 221 students, participated in this study. The online SRL and CL with initiation (G1, n = 53), online CL with initiation (G2, n = 68), and online CL without initiation (G3, n = 68) were experimental groups, and the last class, receiving traditional lecture (G4, n = 32), was the control group. The results of this study show that students who received the intervention of online SRL and CL with initiation attained significantly best grades for practical computing skills, whereas those that received the traditional lectures had statistically poorest grades among the four classes. The implications for schools and educators who plan to provide online or blended learning for their students, particularly in computing courses, are also provided in this study.

  8. Evaluating Teachers' Professional Development Initiatives: Towards an Extended Evaluative Framework

    ERIC Educational Resources Information Center

    Merchie, Emmelien; Tuytens, Melissa; Devos, Geert; Vanderlinde, Ruben

    2018-01-01

    Evaluating teachers' professional development initiatives (PDI) is one of the main challenges for the teacher professionalisation field. Although different studies have focused on the effectiveness of PDI, the obtained effects and evaluative methods have been found to be widely divergent. By means of a narrative review, this study provides an…

  9. An Exploratory Multiple-Case Study of the Experiences of Participants in Self-Initiated Peer Support Groups among School Leaders

    ERIC Educational Resources Information Center

    House, Collette R.

    2016-01-01

    School leaders commonly face issues of loneliness, isolation, burnout, and depression. The purpose of this qualitative multiple-case study was to explore self-initiated peer support group participation for professional impact and personal impact on school leaders facing issues of loneliness, isolation, stress, and burnout. This study provides an…

  10. Internationalization in Canadian Higher Education: A Case Study of the Gap between Official Discourses and On-the-Ground Realities

    ERIC Educational Resources Information Center

    Larsen, Marianne A.

    2015-01-01

    This case study about one university's internationalization initiative, known as North Goes South, provides a nuanced and finely grained understanding of what internationalization looks like in practice. The study was guided by a desire to probe the perceived impact of a Canadian-East African internationalization initiative on students, faculty,…

  11. Personal Development Planning in Initial Teacher Training: A Case Study from Post-Compulsory Education

    ERIC Educational Resources Information Center

    Thompson, Ron; Hallwood, Linda; Clements, Christine; Rivron, Helen

    2009-01-01

    This paper provides a case study of personal development planning (PDP) within an initial teacher training course for the post-compulsory sector, delivered through a large consortium in the north of England. The paper reviews conceptual and empirical studies of PDP in higher education and reports on the practice and perceptions of students and…

  12. Design and initial results from a supported education initiative: the Kansas Consumer as Provider program.

    PubMed

    McDiarmid, Diane; Rapp, Charles; Ratzlaff, Sarah

    2005-01-01

    Despite increased attention to consumer-providers, there remains a lack of models that prepare, support, and sustain consumers in provider roles. This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers. CAP fosters a partnership between colleges and community mental health centers where students experience classroom and internship activities. Outcome from a 2-year longitudinal study on CAP graduates indicates increased employability, especially in social services field, and higher post-secondary educational involvement.

  13. What Factors are Associated with Consumer Initiation of Shared Decision Making in Mental Health Visits?

    PubMed

    Matthias, Marianne S; Fukui, Sadaaki; Salyers, Michelle P

    2017-01-01

    Understanding consumer initiation of shared decision making (SDM) is critical to improving SDM in mental health consultations, particularly because providers do not always invite consumer participation in treatment decisions. This study examined the association between consumer initiation of nine elements of SDM as measured by the SDM scale, and measures of consumer illness self-management and the consumer-provider relationship. In 63 mental health visits, three SDM elements were associated with self-management or relationship factors: discussion of consumer goals, treatment alternatives, and pros and cons of a decision. Limitations, implications, and future directions are discussed.

  14. The Access Vermont Initiative: An Investigation of Team Development in Two Vermont Catchment Areas Providing Services to Children with Severe Emotional Disturbances and Their Families.

    ERIC Educational Resources Information Center

    Fox, Barbara J.; Wright, Leanne M.

    This study was designed to document the processes and dynamics of two multidisciplinary teams under the Access Vermont program, which provides services for children and youth with serious emotional disabilities and their families. In both cases, local interagency teams in the largely rural catchment areas developed plans for an initiative focused…

  15. Corporate social responsibility initiatives addressing social exclusion in Bangladesh.

    PubMed

    Werner, Wendy J

    2009-08-01

    The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships- collectively labelled corporate social responsibility (CSR) initiatives-may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation.

  16. Identification and initial response to children's exposure to intimate partner violence: a qualitative synthesis of the perspectives of children, mothers and professionals.

    PubMed

    Lewis, Natalia V; Feder, Gene S; Howarth, Emma; Szilassy, Eszter; McTavish, Jill R; MacMillan, Harriet L; Wathen, Nadine

    2018-04-28

    To synthesise evidence on the acceptable identification and initial response to children's exposure to intimate partner violence (IPV) from the perspectives of providers and recipients of healthcare and social services. We conducted a thematic synthesis of qualitative research, appraised the included studies with the modified Critical Appraisal Skills Programme checklist and undertook a sensitivity analysis of the studies scored above 15. We searched eight electronic databases, checked references and citations and contacted authors of the included studies. We included qualitative studies with children, parents and providers of healthcare or social services about their experiences of identification or initial responses to children's exposure to IPV. Papers that have not been peer-reviewed were excluded as well as non-English papers. Searches identified 2039 records; 11 studies met inclusion criteria. Integrated perspectives of 42 children, 212 mothers and 251 professionals showed that sufficient training and support for professionals, good patient-professional relationship and supportive environment for patient/clients need to be in place before enquiry/disclosure of children's exposure to IPV should occur. Providers and recipients of care favour a phased enquiry about IPV initiated by healthcare professionals, which focuses on 'safety at home' and is integrated into the context of the consultation or visit. Participants agreed that an acceptable initial response prioritises child safety and includes emotional support, education about IPV and signposting to IPV services. Participants had conflicting perspectives on what constitutes acceptable engagement with children and management of safety. Sensitivity analysis produced similar results. Healthcare and social service professionals should receive sufficient training and ongoing individual and system-level support to provide acceptable identification of and initial response to children's exposure to IPV. Ideal identification and responses should use a phased approach to enquiry and the WHO Listen, Inquire about needs and concerns, Validate, Enhance safety and Support principles integrated into a trauma-informed and violence-informed model of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Developing and Implementing a Food Insecurity Screening Initiative for Adult Patients Living With Type 2 Diabetes.

    PubMed

    Thomas, Brittany; Fitzpatrick, Sandra; Sidani, Souraya; Gucciardi, Enza

    2018-06-01

    Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto. A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes. Interviews with 10 patients and a focus group with 15 care providers elicited feedback on the relevance and acceptance of the food insecurity screening questions and a care algorithm. Subsequently, 5 care providers at 4 sites implemented the screening initiative over 2 weeks, screening 33 patients. After implementation, 7 patients and 5 care providers were interviewed to assess the acceptability and feasibility of the screening initiative. Our findings demonstrate that patients are willing to share their experiences of food insecurity, despite the sensitivity of this topic. Screening elicited information about how patients cope with food insecurity and how this affects their ability to self-manage diabetes. Care providers found this information helpful in directing their care and support for patients. Using a standardized, respectful method of assessing food insecurity can better equip health-care providers to support food-insecure patients with diabetes self-management. Further evaluation of this initiative is needed to determine how food insecurity screening can affect patients' self-management and related health outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Academic Skills Rovers: A Just in Time Peer Support Initiative for Academic Skills and Literacy Development

    ERIC Educational Resources Information Center

    Copeman, Peter; Keightley, Polly

    2014-01-01

    In 2013 the University of Canberra (UC) initiated a program of peer-assisted academic skills help, the Academic Skills Rovers program, with the goal of providing drop-in peer learning support to students at campus locations where they congregate to study. The Academic Skills Rovers were initially recruited from the teacher education discipline,…

  19. Designing seasonal initial attack resource deployment and dispatch rules using a two-stage stochastic programming procedure

    Treesearch

    Yu Wei; Michael Bevers; Erin J. Belval

    2015-01-01

    Initial attack dispatch rules can help shorten fire suppression response times by providing easy-to-follow recommendations based on fire weather, discovery time, location, and other factors that may influence fire behavior and the appropriate response. A new procedure is combined with a stochastic programming model and tested in this study for designing initial attack...

  20. Student-Initiated Use of Technology--Friend and Foe

    ERIC Educational Resources Information Center

    Wiklund, Matilda; Andersson, Annika

    2018-01-01

    A multitude of different technologies are used in school today. Some are provided by the school and others are brought by the individual teacher or student. In addition, different applications are available. In this study the focus is on student-initiated uses of technology and how it conditions learning. Based on a case study with surveys,…

  1. Timely initiation of breastfeeding and associated factors among mothers of infants under 12 months in South Gondar zone, Amhara regional state, Ethiopia; 2013.

    PubMed

    Mekonen, Liyew; Seifu, Wubareg; Shiferaw, Zemenu

    2018-01-01

    Timely initiation of breastfeeding is defined as putting the newborn to the breast within one hour of birth. Significant benefits in reducing neonatal mortality and morbidity can be attained with effective promotion of timely initiation of breastfeeding and exclusive breastfeeding during the first months of life. Therefore, this study was conducted to assess timely initiation of breastfeeding and associated factors among mothers in South Gondar, Amhara regional state, Northern Ethiopia. A community based cross-sectional study was employed. A multistage stratified sampling technique was used to select the sample of 845 mothers with 97.4% response rate. Moreover, data were collected by face to face interview using a semi structured questionnaire. The prevalence of timely initiation of breastfeeding was 48.7% (54.7% in urban and 25.1% in rural areas). The odds of initiation of breastfeeding within one hour was higher for urban mothers (Adjusted Odds Ratio [AOR] 2.1; 95% Confidence Interval [CI] 1.4, 3.3), multiparous mothers (AOR 2.8; 95% CI 2.0, 3.8), mothers who had antenatal care (AOR 3.2; 95% CI 2.0, 5.2), mothers delivered in health institution (AOR 3.1; 95% CI 2.2, 4.6) and mothers delivered vaginally (AOR 4.1; 95% CI 1.7, 9.8) than their respective counterparts. This study depicts the rate of timely initiation of breastfeeding was low in south Gondar zone. Factors which were positively associated with timely initiation of breastfeeding include urban residence, multiparity, having antenatal care, mother deliver in health institution and vaginal mode of delivery. Therefore, South Gondar health office and healthcare providers have to provide breastfeeding information during antenatal care by giving special emphasis to rural and primiparous mothers in which timely initiation of breastfeeding is poorly practiced. Further study is needed to assess the implementation of policies on timely initiation of breastfeeding.

  2. A cluster randomized trial of provider-initiated (Opt-out) HIV counseling and testing of tuberculosis patients in South Africa

    PubMed Central

    Pope, Diana S.; DeLuca, Andrea N.; Kali, Paula; Hausler, Harry; Sheard, Carol; Hoosain, Ebrahim; Chaudhary, Mohammed A.; Celentano, David D.; Chaisson, Richard E.

    2008-01-01

    Objective To determine whether implementation of provider-initiated HIV counseling would increase the proportion of tuberculosis patients that received HIV counseling and testing. Design Cluster-randomized trial with clinic as unit of randomization Setting Twenty, medium-sized primary care TB clinics in the Nelson Mandela Metropolitan Municipality, Port Elizabeth, Eastern Cape Province, South Africa Subjects A total of 754 adults (≥ 18 years) newly registered as tuberculosis patients the twenty study clinics Intervention Implementation of provider-initiated HIV counseling and testing. Main outcome measures Percentage of TB patients HIV counseled and tested. Secondary Percentage of patients HIV test positive and percentage of those that received cotrimoxazole and who were referred for HIV care. Results A total of 754 adults newly registered as tuberculosis patients were enrolled. In clinics randomly assigned to implement provider-initiated HIV counseling and testing, 20.7% (73/352) patients were counseled versus 7.7% (31/402) in the control clinics (p = 0.011), and 20.2 % (n = 71) versus 6.5% (n = 26) underwent HIV testing (p = 0.009). Of those patients counseled, 97% in the intervention clinics accepted testing versus 79% in control clinics (p =0.12). The proportion of patients identified as HIV-infected in intervention clinics was 8.5% versus 2.5% in control clinics (p=0.044). Fewer than 40% of patients with a positive HIV test were prescribed cotrimoxazole or referred for HIV care in either study arm. Conclusions Provider-initiated HIV counseling significantly increased the proportion of adult TB patients that received HIV counseling and testing, but the magnitude of the effect was small. Additional interventions to optimize HIV testing for TB patients urgently need to be evaluated. PMID:18520677

  3. A cluster-randomized trial of provider-initiated (opt-out) HIV counseling and testing of tuberculosis patients in South Africa.

    PubMed

    Pope, Diana S; Deluca, Andrea N; Kali, Paula; Hausler, Harry; Sheard, Carol; Hoosain, Ebrahim; Chaudhary, Mohammad A; Celentano, David D; Chaisson, Richard E

    2008-06-01

    To determine whether implementation of provider-initiated human immunodeficiency virus (HIV) counseling would increase the proportion of tuberculosis (TB) patients who received HIV counseling and testing. Cluster-randomized trial with clinic as the unit of randomization. Twenty, medium-sized primary care TB clinics in the Nelson Mandela Metropolitan Municipality, Port Elizabeth, Eastern Cape Province, South Africa. A total of 754 adults (18 years and older) newly registered as TB patients in the 20 study clinics. Implementation of provider-initiated HIV counseling and testing. Percentage of TB patients HIV counseled and tested. SECONDARY: Percentage of patients with HIV test positive, and percentage of those who received cotrimoxazole and who were referred for HIV care. : A total of 754 adults newly registered as TB patients were enrolled. In clinics randomly assigned to implement provider-initiated HIV counseling and testing, 20.7% (73/352) patients were counseled versus 7.7% (31/402) in the control clinics (P = 0.011), and 20.2% (n = 71) versus 6.5% (n = 26) underwent HIV testing (P = 0.009). Of those patients counseled, 97% in the intervention clinics accepted testing versus 79% in control clinics (P = 0.12). The proportion of patients identified as HIV infected in intervention clinics was 8.5% versus 2.5% in control clinics (P = 0.044). Fewer than 40% of patients with a positive HIV test were prescribed cotrimoxazole or referred for HIV care in either study arm. Provider-initiated HIV counseling significantly increased the proportion of adult TB patients who received HIV counseling and testing, but the magnitude of the effect was small. Additional interventions to optimize HIV testing for TB patients urgently need to be evaluated.

  4. Conceptual data modeling of wildlife response indicators to ecosystem change in the Arctic

    USGS Publications Warehouse

    Walworth, Dennis; Pearce, John M.

    2015-08-06

    Large research studies are often challenged to effectively expose and document the types of information being collected and the reasons for data collection across what are often a diverse cadre of investigators of differing disciplines. We applied concepts from the field of information or data modeling to the U.S. Geological Survey (USGS) Changing Arctic Ecosystems (CAE) initiative to prototype an application of information modeling. The USGS CAE initiative is collecting information from marine and terrestrial environments in Alaska to identify and understand the links between rapid physical changes in the Arctic and response of wildlife populations to these ecosystem changes. An associated need is to understand how data collection strategies are informing the overall science initiative and facilitating communication of those strategies to a wide audience. We explored the use of conceptual data modeling to provide a method by which to document, describe, and visually communicate both enterprise and study level data; provide a simple means to analyze commonalities and differences in data acquisition strategies between studies; and provide a tool for discussing those strategies among researchers and managers.

  5. Polarization observables in few nucleon systems with CLAS

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

    Zachariou, Nicholas

    The CEBAF Large Acceptance Spectrometer (CLAS), housed in Hall-B at the Thomas Jefferson National Accelerator Facility provides us with the experimental tools to study strongly-interacting matter and its dynamics in the transition from hadronic to partonic degrees of freedom in nuclear interactions. In this paper we discuss the progress made in understanding the relevant degrees of freedom using polarisation observables of deuteron photodisintegration in the few-GeV photon-energy region. We also address progress made in studying the interaction between Hyperons and Nucleons via polarisation observables, utilising high-statistics experiments that provided us with the large data samples needed to study final-state interactions,more » as well as perform detailed studies on initial-state effects. The polarisation observables presented here provide us with unique experimental tools to study the underlying dynamics of both initial and final-state interactions, as well as the information needed to disentangle signal from background contributions.« less

  6. Polarization observables in few nucleon systems with CLAS

    DOE PAGES

    Zachariou, Nicholas

    2017-12-01

    The CEBAF Large Acceptance Spectrometer (CLAS), housed in Hall-B at the Thomas Jefferson National Accelerator Facility provides us with the experimental tools to study strongly-interacting matter and its dynamics in the transition from hadronic to partonic degrees of freedom in nuclear interactions. In this paper we discuss the progress made in understanding the relevant degrees of freedom using polarisation observables of deuteron photodisintegration in the few-GeV photon-energy region. We also address progress made in studying the interaction between Hyperons and Nucleons via polarisation observables, utilising high-statistics experiments that provided us with the large data samples needed to study final-state interactions,more » as well as perform detailed studies on initial-state effects. The polarisation observables presented here provide us with unique experimental tools to study the underlying dynamics of both initial and final-state interactions, as well as the information needed to disentangle signal from background contributions.« less

  7. Green initiative impact on stock prices: A quantitative study of the clean energy industry

    NASA Astrophysics Data System (ADS)

    Jurisich, John M.

    The purpose of this quantitative ex post facto research study was to explore the relationship between green initiative expense disclosures and stock prices of 46 NASDAQ listed Clean Edge Green Energy global companies from 2007 to 2010. The independent variables were sales and marketing, environmental, customer and supplier, community, and corporate governance practices that were correlated with the dependent variable in the study of stock prices. Expense disclosures were examined in an effort to measure the impact of green initiative programs and to expose the interrelationships between green initiative expense disclosures and fluctuations of stock prices. The data for the research was secondary data from existing annual reports. A statistically significant relationship was revealed between environmental practices and changes in stock prices. The study results also provided substantial evidence for leadership and managerial decision making to reduce or increase green initiative practices to maximize shareholder wealth of their respective organizations.

  8. Establishment of the New Ecuadorian Solar Physics Phenomena Division

    NASA Astrophysics Data System (ADS)

    Lopez, E. D.

    2014-02-01

    Crucial physical phenomena occur in the equatorial atmosphere and ionosphere, which are currently understudied and poorly understood. Thus, scientific campaigns for monitoring the equatorial region are required in order to provide the necessary data for the physical models. Ecuador is located in strategic geographical position where these studies can be performed, providing quality data for the scientific community working in understanding the nature of these physical systems. The Quito Astronomical Observatory of National Polytechnic School is moving in this direction by promoting research in space sciences for the study of the equatorial zone. With the participation and the valuable collaboration of international initiatives such us AWESOME, MAGDAS, SAVNET and CALLISTO, the Quito Observatory is establishing a new space physics division on the basis of the International Space Weather Initiative. In this contribution, the above initiative is presented by inviting leaders of other scientific projects to deploy its instruments and to work with us providing the necessary support to the creation of this new strategic research center

  9. What Factors are Associated with Consumer Initiation of Shared Decision Making in Mental Health Visits?

    PubMed Central

    Matthias, Marianne S.; Fukui, Sadaaki; Salyers, Michelle P.

    2016-01-01

    Understanding consumer initiation of shared decision making (SDM) is critical to improving SDM in mental health consultations, particularly because providers do not always invite consumer participation in treatment decisions. This study examined the association between consumer initiation of nine elements of SDM as measured by the SDM scale, and measures of consumer illness self-management and the consumer-provider relationship. In 63 mental health visits, three SDM elements were associated with self-management or relationship factors: discussion of consumer goals, treatment alternatives, and pros and cons of a decision. Limitations, implications, and future directions are discussed. PMID:26427999

  10. Predictors of early breastfeeding initiation among mothers of children under 24 months of age in rural part of West Ethiopia.

    PubMed

    Hailemariam, Tsedeke Wolde; Adeba, Emiru; Sufa, Alem

    2015-10-21

    The World Health Organization recommends initiation of breastfeeding within the first hour after childbirth. In developing countries alone, early initiation of breastfeeding could save as many as 1.45 million lives each year by reducing deaths mainly due to diarrheal disorders and lower respiratory tract infections in children. The current study aimed to determine the rate and the predictors of breastfeeding initiation in East Wollega Zones of West Ethiopia. A community-based, cross-sectional study was conducted from April to May 2014 among 594 mothers who had children less than 24 months. Multi stage cluster sampling method was used to select the study population. Eligible mothers were invited to interview using pretested questionnaires to gather data regarding sociodemographics, health-related variables, breastfeeding initiation, and current breastfeeding practices. A multivariable logistic regression analysis was used to identify independent predictors of early initiation of breastfeeding after controlling for confounding variables. A sample of 593 mothers was included in the study. Breastfeeding was initiated by 83.1 % of mothers within the first hour of childbirth. Being a housewife (AOR (95 % CI) = 2.48 (1.54- 3.99)) and infant received colostrum (AOR (95 % CI) =2.22 (1.08-4.55)) were significant positive predictors for early breastfeeding initiation as revealed by logistic regression. The multivariable logistic regression analysis showed that the mothers who had no radio and/or TV in the household (AOR (95 % CI = 0.55 (0.35-0.88)), were not exposure to health information (AOR (95 % CI) = 0.44 (0.25-0.75)), and infants were provided with prelacteal feeds (AOR (95 % CI)=0.30 (0.14-0.65)) were less likely to initiate breastfeeding. The rate of timely initiation of breastfeeding was high. Breastfeeding promotion program is essential to encourage the practice of timely initiation of breastfeeding, and reduce the practice of providing prelacteal feeds within three days of life. Thus appropriate health information is vital to boost early initiation of breastfeeding.

  11. FAST TRACK COMMUNICATION: Soliton solutions of the KP equation with V-shape initial waves

    NASA Astrophysics Data System (ADS)

    Kodama, Y.; Oikawa, M.; Tsuji, H.

    2009-08-01

    We consider the initial value problems of the Kadomtsev-Petviashvili (KP) equation for symmetric V-shape initial waves consisting of two semi-infinite line solitons with the same amplitude. Those are particularly important for studies of large amplitude waves such as tsunami in shallow water. Numerical simulations show that the solutions of the initial value problem approach asymptotically to certain exact solutions of the KP equation found recently in [1]. We then use a chord diagram to explain the asymptotic result. This provides an analytical method to study asymptotic behavior for the initial value problem of the KP equation. We also demonstrate a real experiment of shallow water waves which may represent the solution discussed in this communication.

  12. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    PubMed

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  13. Trends in provider-initiated versus spontaneous preterm deliveries, 2004–2013

    PubMed Central

    Ada, Melissa L.; Hacker, Michele R.; Golen, Toni H.; Haviland, Miriam J.; Shainker, Scott A.; Burris, Heather H.

    2017-01-01

    Objectives 1) To estimate the proportion of preterm deliveries at a tertiary perinatal center that were provider-initiated vs. spontaneous before and after a 2009 policy to reduce elective early-term deliveries. 2) To evaluate if shifts in type of preterm delivery varied by race/ethnicity. Methods We performed a retrospective cohort study of preterm deliveries over a 10-year period, 2004–2013, including detailed review of 929 of 5,566 preterm deliveries to designate each delivery as provider-initiated or spontaneous. We dichotomized the time period into early (2004–2009) and late (2010–2013). We used log-binomial regression to calculate adjusted risk ratios. Results Of the 46,981 deliveries, 5,566 (11.8%) were preterm, with a significant reduction in the overall incidence of preterm delivery from 12.3% to 11.2% (P=0.0003). Among the 929 preterm deliveries analyzed, there was a reduction in the proportion of provider-initiated deliveries from 48.3% to 41.8% that was not statistically significant. The proportion of provider-initiated preterm deliveries among black, but not white, women declined from 50.8% to 39.7% (adjusted RR: 0.66; 95%CI: 0.45–0.97). This coincided with a larger reduction in overall preterm deliveries among black women (16.2% to 12.8%) vs. white women (12.3% to 11.2%) (P interaction=0.038). By 2013, the incidence of preterm deliveries had decreased for both black (12.1%) and white women (11.4%) and the difference was no longer statistically significant (P=0.7). Conclusion We found a reduction in preterm deliveries after a policy targeted at reducing elective early-term deliveries in 2009 that coincided with reductions in the proportion of provider-initiated preterm deliveries, especially among black women. PMID:28749488

  14. Integrating Science and Technology: Using Technological Pedagogical Content Knowledge as a Framework to Study the Practices of Science Teachers

    ERIC Educational Resources Information Center

    Pringle, Rose M.; Dawson, Kara; Ritzhaupt, Albert D.

    2015-01-01

    In this study, we examined how teachers involved in a yearlong technology integration initiative planned to enact technological, pedagogical, and content practices in science lessons. These science teachers, engaged in an initiative to integrate educational technology in inquiry-based science lessons, provided a total of 525 lesson plans for this…

  15. One to One Computing: A Summary of the Quantitative Results from the Berkshire Wireless Learning Initiative

    ERIC Educational Resources Information Center

    Bebell, Damian; Kay, Rachel

    2010-01-01

    This paper examines the educational impacts of the Berkshire Wireless Learning Initiative (BWLI), a pilot program that provided 1:1 technology access to all students and teachers across five public and private middle schools in western Massachusetts. Using a pre/post comparative study design, the current study explores a wide range of program…

  16. Engaging with Quality Improvement Initiatives: A Descriptive Study of Learning in the Complex and Dynamic Context of Everyday Life for Family Child Care Providers

    ERIC Educational Resources Information Center

    Tonyan, Holli A.; Nuttall, Joce; Torres, Jeannette; Bridgewater, Jessie

    2017-01-01

    Research Findings: This article reports on family child care providers' views about their engagement with professional development programs, including providers who were and were not participating in Quality Rating and Improvement Systems in Los Angeles, California. Most providers participating in the study were taking active steps to improve…

  17. Geologic constraints on the setting and dynamics of subduction initiation

    NASA Astrophysics Data System (ADS)

    Encarnacion, John; Keenan, Timothy

    2017-04-01

    Understanding where and how subduction zones have and can initiate is important because, besides being a critical step in the plate tectonic system, it can provide insight into the complex interactions of crust and mantle rheology, forces acting on the plates, strain, metamorphic reactions, and erosional and depositional processes at the surface. Insight into the possibilities of where and how subduction zones start has been provided by numerical and analog modeling. All sites for subduction initiation are potential weak zones in the lithosphere and include the continent-ocean boundary, oceanic arc-oceanic crust boundary, oceanic transform faults and fracture zones, oceanic detachment faults, and active or recently extinct oceanic ridges/spreading centers. Within the constraints of modeling, it has also been shown that the forces involved in the initiation of subduction can be largely horizontal (induced by a collision, say, or through 'ridge push') or vertical (driven by density contrasts). The latter scenario is often referred to as "spontaneous" subduction initiation, whereas the former situation may be called "forced"or "induced" subduction initiation. It is prudent, however, not to assume that "what can happen, did happen." So, the challenge for geologists is to infer from the rock record, through structural mapping, thermochronology, thermobarometry, geochemistry, paleomagnetics, and sedimentological studies, how any given subduction zone began. Even with a complete data set, it is not always possible to fully constrain the specific geologic setting or dynamics involved in the initiation of a given subduction zone. One can, however, often rule out certain scenarios, increasing the probability of others. Part of the geologic record of subduction initiation preserved at some subduction zones are so-called "metamorphic soles," which include high-temperature (T) and high-pressure (P) metamorphosed oceanic crust that was underthrust to asthenospheric mantle depths, metamorphosed, and then preserved in the hanging wall of the eventual subduction zone. These metamorphic soles may preserve important information bearing on the timing of subduction initiation, the evolving P and T conditions during subduction initiation, and, importantly, the protolith age of the initially subducted crust. The latter parameter—the age of the initially subducted oceanic crust at the time of subduction initiation—is an important constraint that has been lacking in many previous geologic studies of subduction initiation. Recent work on metamorphic soles has provided new information on subduction initiation, including the possibility of rapidly converting oceanic divergent boundaries into subduction zones.

  18. A manned lunar outpost. Design considerations for three key elements in an initial manned lunar outpost

    NASA Technical Reports Server (NTRS)

    Bell, Larry; Trotti, Guillermo; Brown, Jeff; Bhattacharya, Nilajan; Moore, Nathan; Polette, Tom; Toups, Larry

    1988-01-01

    The Initial Manned Lunar Outpost (IMLO) is proposed as the initial permanent base for manned activities on the Moon. The study concentrated on identifying the equipment, support systems, and initial base configuration necessary to accomplish the various science, industrial and exploration activities planned. The primary concepts of the MLO were the use of hard modules for habitation areas creating a flexible, modular transportation system; designing a multi-functional vehicle; and using an overhead radiation protection system. The transportation system, dubbed the Lunar Mobile Surface Transport System (LMSTS), carries the hard modules to the surface of the moon and provides a method to move them to the desired location through the use of interchangeable pallets. The avionics pallets are changed-out with wheel and hitch pallets, transforming the LMSTS into a "tractor trailer" used with the Multi-Functional Vehicle (MFV). The modules are placed under the Regolith Support Structure (RSS) which provides a stable environment and radiation protection for the entire base. The overhead structure was chosen over simply burying the modules to provide a study on the advantages and disadvantages of this type of system. The advantages include easy access to the exterior of the modules, providing a protected area for vehicles and equipment used in EVA, and creating an area of constant temperature. Disadvantages include a need for prefabrication of structural components, including the preconstruction and construction phases of the initial MLO. The design approach taken considered existing and near-term materials and technology only, without the consideration of possible future building technologies.

  19. Visualizing polynucleotide polymerase machines at work

    PubMed Central

    Steitz, Thomas A

    2006-01-01

    The structures of T7 RNA polymerase (T7 RNAP) captured in the initiation and elongation phases of transcription, that of φ29 DNA polymerase bound to a primer protein and those of the multisubunit RNAPs bound to initiating factors provide insights into how these proteins can initiate RNA synthesis and synthesize 6–10 nucleotides while remaining bound to the site of initiation. Structural insight into the translocation of the product transcript and the separation of the downstream duplex DNA is provided by the structures of the four states of nucleotide incorporation. Single molecule and biochemical studies show a distribution of primer terminus positions that is altered by the binding of NTP and PPi ligands. This article reviews the insights that imaging the structure of polynucleotide polymerases at different steps of the polymerization reaction has provided on the mechanisms of the polymerization reaction. Movies are shown that allow the direct visualization of the conformational changes that the polymerases undergo during the different steps of polymerization. PMID:16900098

  20. Patient-initiated Electronic Messages and Quality of Care for Patients With Diabetes and Hypertension in a Large Fee-for-Service Medical Group: Results From a Natural Experiment.

    PubMed

    McClellan, Sean R; Panattoni, Laura; Chan, Albert S; Tai-Seale, Ming

    2016-03-01

    Few studies have examined the association between patient-initiated electronic messaging (e-messaging) and clinical outcomes in fee-for-service settings. To estimate the association between patient-initiated e-messages and quality of care among patients with diabetes and hypertension. Longitudinal observational study from 2009 to 2013. In March 2011, the medical group eliminated a $60/year patient user fee for e-messaging and established a provider payment of $3-5 per patient-initiated e-message. Quality of care for patients initiating e-messages was compared before and after March 2011, relative to nonmessaging patients. Propensity score weighting accounted for differences between e-messaging and nonmessaging patients in generalized estimating equations. Large multispecialty practice in California compensating providers' fee-for-service. Patients with diabetes (N=4232) or hypertension (N=15,463) who had activated their online portal but not e-messaged before e-messaging became free. Quality of care included HEDIS-based process measures for hemoglobin (Hb) A1c, blood pressure, low-density lipoprotein (LDL), nephropathy, and retinopathy tests, and outcome measures for HbA1c, blood pressure, and LDL. E-messaging was measured as counts of patient-initiated e-message threads sent to providers. Patients were categorized into quartiles by e-messaging frequency. The probability of annually completing indicated tests increased by 1%-7% for e-messaging patients, depending on the outcome and e-messaging frequency. E-messaging was associated with small improvements in HbA1c and LDL for some patients with diabetes. Patient-initiated e-messaging may increase the likelihood of completing recommended tests, but may not be sufficient to improve clinical outcomes for most patients with diabetes or hypertension without additional interventions.

  1. Effects of reward sensitivity and regional brain volumes on substance use initiation in adolescence

    PubMed Central

    Collins, Paul; Muetzel, Ryan; Schissel, Ann; Lim, Kelvin O.; Luciana, Monica

    2015-01-01

    This longitudinal study examines associations between baseline individual differences and developmental changes in reward [i.e. behavioral approach system (BAS)] sensitivity and relevant brain structures’ volumes to prospective substance use initiation during adolescence. A community sample of adolescents ages 15–18 with no prior substance use was assessed for substance use initiation (i.e. initiation of regular alcohol use and/or any use of other substances) during a 2-year follow-up period and for alcohol use frequency in the last year of the follow-up. Longitudinal ‘increases’ in BAS sensitivity were associated with substance use initiation and increased alcohol use frequency during the follow-up. Moreover, adolescents with smaller left nucleus accumbens at baseline were more likely to initiate substance use during the follow-up period. This study provides support for the link between developmental increases in reward sensitivity and substance use initiation in adolescence. The study also emphasizes the potential importance of individual differences in volumes of subcortical regions and their structural development for substance use initiation during adolescence. PMID:24526186

  2. The effect of compressor-administered defibrillation on peri-shock pauses in a simulated cardiac arrest scenario.

    PubMed

    Glick, Joshua; Lehman, Erik; Terndrup, Thomas

    2014-03-01

    Coordination of the tasks of performing chest compressions and defibrillation can lead to communication challenges that may prolong time spent off the chest. The purpose of this study was to determine whether defibrillation provided by the provider performing chest compressions led to a decrease in peri-shock pauses as compared to defibrillation administered by a second provider, in a simulated cardiac arrest scenario. This was a randomized, controlled study measuring pauses in chest compressions for defibrillation in a simulated cardiac arrest model. We approached hospital providers with current CPR certification for participation between July, 2011 and October, 2011. Volunteers were randomized to control (facilitator-administered defibrillation) or experimental (compressor-administered defibrillation) groups. All participants completed one minute of chest compressions on a mannequin in a shockable rhythm prior to administration of defibrillation. We measured and compared pauses for defibrillation in both groups. Out of 200 total participants, we analyzed data from 197 defibrillations. Compressor-initiated defibrillation resulted in a significantly lower pre-shock hands-off time (0.57 s; 95% CI: 0.47-0.67) compared to facilitator-initiated defibrillation (1.49 s; 95% CI: 1.35-1.64). Furthermore, compressor-initiated defibrillation resulted in a significantly lower peri-shock hands-off time (2.77 s; 95% CI: 2.58-2.95) compared to facilitator-initiated defibrillation (4.25 s; 95% CI: 4.08-4.43). Assigning the responsibility for shock delivery to the provider performing compressions encourages continuous compressions throughout the charging period and decreases total time spent off the chest. However, as this was a simulation-based study, clinical implementation is necessary to further evaluate these potential benefits.

  3. A pilot study to improve adherence among MS patients who discontinue treatment against medical advice.

    PubMed

    Bruce, Jared; Bruce, Amanda; Lynch, Sharon; Strober, Lauren; O'Bryan, Sean; Sobotka, Deborah; Thelen, Joan; Ness, Abigail; Glusman, Morgan; Goggin, Kathy; Bradley-Ewing, Andrea; Catley, Delwyn

    2016-04-01

    Between 30 and 50% of MS patients may prematurely discontinue disease modifying therapies. Little research has examined how to best talk with patients who have discontinued treatment against medical advice. The aim of this pilot study was to determine whether telephone counseling increases disease modifying therapy (DMT) re-initiation among nonadherent patients with multiple sclerosis (MS). Participants were eligible if they had relapsing-remitting disease, had stopped taking a DMT, and had no plan to re-initiate treatment despite a provider recommendation. Following a baseline assessment, 81 patients were randomly assigned to either five 20 min, weekly sessions of Motivational Interviewing/Cognitive Behavioral Therapy (MI-CBT) or Treatment as Usual (TAU) with brief education. At 10 weeks, patients initially assigned to TAU switched over to MI-CBT. Compared to patients in the TAU group, patients undergoing MI-CBT were significantly more likely to indicate they were re-initiating DMT (41.7 vs. 14.3%). These significant results were replicated among patients crossing over from TAU to MI-CBT. Treatment satisfaction was high, with 97% of participants reporting that they would recommend MI-CBT to other patients with MS. Results of this pilot study provide initial support for the use of MI-CBT among MS patients who have discontinued treatment against medical advice.Clinicaltrials.gov: NCT01925690.

  4. Vertical integration of teaching in Australian general practice--a survey of regional training providers.

    PubMed

    Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

    2011-06-06

    To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

  5. Canadian adolescent mothers' perceptions of influences on breastfeeding decisions: a qualitative descriptive study.

    PubMed

    Nesbitt, Sherry A; Campbell, Karen A; Jack, Susan M; Robinson, Heather; Piehl, Kathleen; Bogdan, Janice C

    2012-12-12

    There is increased recognition of the importance of breastfeeding at a national level as evidenced by the increased number of Canadian mothers initiating breastfeeding. However, adolescent mothers (<19 years), compared to all other mothers, have lower rates of breastfeeding initiation and duration. The purpose of this study was to examine the facilitating influences and barriers to initiating, and continuing breastfeeding, as perceived by adolescent mothers in Durham Region, Ontario, Canada. The principles of interpretive description guided this qualitative study. A purposeful, homogenous sample of 16 adolescent mothers (15-19 years) were recruited to complete individual, semi-structured, face-to-face interviews. Conventional content analysis was used to code data, identify concepts and synthesize them into overall themes. Adolescent mothers in this study expressed that the decision to breastfeed was made prenatally and while partner and family member opinions about breastfeeding initiation were influential, the decision was made independently. Mothers were primarily motivated to initiate breastfeeding due to the health benefits for the infant. Lower breastfeeding duration rates were found among mothers who decided to only "try" breastfeeding when compared to the mothers who committed to breastfeeding. Influences on continued breastfeeding included: 1) the impact of breastfeeding on social and intimate relationships; 2) the availability of social support; 3) the physical demands of breastfeeding; 4) mothers' knowledge of breastfeeding practices and benefits; and 5) mothers' perceived sense of comfort in breastfeeding. The results of this study provide health care providers new conceptual insight and understanding of the factors that influence adolescents' decisions to "try" breastfeeding and to continue providing breastmilk to their infants. Professional implications drawn from this study include active engagement of adolescents in the pre and postnatal periods, including early assessment of potential barriers surrounding breastfeeding decisions. This early professional interaction highlights the professional as a form of support, and allows for sharing of evidence-informed breastfeeding information and practical breastfeeding skills. Inclusion of adolescents' positive social support networks should be emphasized in professional breastfeeding support. Motivational interviewing is a promising prenatal strategy to influence behavior change and reduce ambivalence in decision-making about breastfeeding, creating opportunities for health care providers to tailor interventions.

  6. Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

    PubMed Central

    Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

    2011-01-01

    This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

  7. Improving the Standards-Based Management-Recognition initiative to provide high-quality, equitable maternal health services in Malawi: an implementation research protocol.

    PubMed

    Mumtaz, Zubia; Salway, Sarah; Nyagero, Josephat; Osur, Joachim; Chirwa, Ellen; Kachale, Fannie; Saunders, Duncan

    2016-01-01

    The Government of Malawi is seeking evidence to improve implementation of its flagship quality of care improvement initiative-the Standards Based Management-Recognition for Reproductive Health (SBM-R(RH)). This implementation study will assess the quality of maternal healthcare in facilities where the SBM-R(RH) initiative has been employed, identify factors that support or undermine effectiveness of the initiative and develop strategies to further enhance its operation. Data will be collected in 4 interlinked modules using quantitative and qualitative research methods. Module 1 will develop the programme theory underlying the SBM-R(RH) initiative, using document review and in-depth interviews with policymakers and programme managers. Module 2 will quantitatively assess the quality and equity of maternal healthcare provided in facilities where the SBM-R(RH) initiative has been implemented, using the Malawi Integrated Performance Standards for Reproductive Health. Module 3 will conduct an organisational ethnography to explore the structures and processes through which SBM-R(RH) is currently operationalised. Barriers and facilitators will be identified. Module 4 will involve coordinated co-production of knowledge by researchers, policymakers and the public, to identify and test strategies to improve implementation of the initiative. The research outcomes will provide empirical evidence of strategies that will enhance the facilitators and address the barriers to effective implementation of the initiative. It will also contribute to the theoretical advances in the emerging science of implementation research.

  8. Effectiveness of community outreach and engagement in recruitment success for a prebirth cohort.

    PubMed

    Tigges, Beth B; Kaar, Jill L; Erbstein, Nancy; Silberman, Pamela; Winseck, Kate; Lopez-Class, Maria; Burbacher, Thomas M

    2017-06-01

    We describe the effectiveness of community outreach and engagement in supporting recruitment for the US National Children's Vanguard Study between 2009 and 2012. Thirty-seven study locations used 1 of 4 strategies to recruit 18-49-year-old pregnant or trying to conceive women: (1) Initial Vanguard Study used household-based recruitment; (2) Direct Outreach emphasized self-referral; (3) Enhanced Household-Based Recruitment enhanced Initial Vanguard Study strategies; and (4) Provider-Based Recruitment recruited through healthcare providers. Outreach and engagement included advance letters, interactions with healthcare providers, participation in community events, contacts with community organizations, and media outreach. After 1-2 years, 41%-74% of 9844 study-eligible women had heard about the National Children's Vanguard Study when first approached. Women who heard were 1.5-3 times more likely to consent. Hearing via word-of-mouth or the media most frequently predicted consent. The more sources women heard from the higher the odds of consent. We conclude that tailored outreach and engagement facilitate recruitment in cohort studies.

  9. Interpersonal Complementarity in the Mental Health Intake: A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Rosen, Daniel C.; Miller, Alisa B.; Nakash, Ora; Halperin, Lucila; Alegria, Margarita

    2012-01-01

    The study examined which socio-demographic differences between clients and providers influenced interpersonal complementarity during an initial intake session; that is, behaviors that facilitate harmonious interactions between client and provider. Complementarity was assessed using blinded ratings of 114 videotaped intake sessions by trained…

  10. Contraception Initiation in the Emergency Department: A Pilot Study on Providers' Knowledge, Attitudes, and Practices.

    PubMed

    Liles, Iyanna; Haddad, Lisa B; Lathrop, Eva; Hankin, Abigail

    2016-05-01

    Almost half of all pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-age females seek care in the emergency department (ED), are at risk of pregnancy, and are amenable to contraceptive services in this setting. Through a pilot study, we sought to assess ED providers' current practices; attitudes; and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC), as well as barriers with respect to contraception initiation. ED physicians and associate providers in Georgia were e-mailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple-choice questions to assess study objectives. Descriptive statistics were generated as well as univariate analyses using χ(2) and Fisher exact tests. A total of 1232 providers were e-mailed, with 119 questionnaires completed. Participants were predominantly physicians (80%), men (59%), and individuals younger than 45 years (59%). Common practices were referrals (96%), EC prescriptions (77%), and non-EC prescriptions (40%). Common barriers were perceived as low likelihood for follow-up (63%), risk of complications (58%), and adverse effects (51%). More than 70% of participants correctly identified the highly effective contraceptive methods, 3% identified the correct maximum EC initiation time, and 42% correctly recognized pregnancy as a higher risk than hormonal contraception use for pulmonary embolism. Most ED providers in this pilot study referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers in this study had an incorrect understanding of the efficacy, risks, and eligibility associated with contraceptive methods. This lack of understanding may affect patient access and be a barrier to patient care.

  11. Mapping of initiatives to increase membership in mutual health organizations in Benin.

    PubMed

    Turcotte-Tremblay, Anne-Marie; Haddad, Slim; Yacoubou, Ismaïlou; Fournier, Pierre

    2012-12-05

    Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between MHO stakeholders would be useful to devise innovative strategies, avoid repeating unsuccessful ones, and develop a coordinated plan to promote MHOs.

  12. Analytic Closed-Form Solution of a Mixed Layer Model for Stratocumulus Clouds

    NASA Astrophysics Data System (ADS)

    Akyurek, Bengu Ozge

    Stratocumulus clouds play an important role in climate cooling and are hard to predict using global climate and weather forecast models. Thus, previous studies in the literature use observations and numerical simulation tools, such as large-eddy simulation (LES), to solve the governing equations for the evolution of stratocumulus clouds. In contrast to the previous works, this work provides an analytic closed-form solution to the cloud thickness evolution of stratocumulus clouds in a mixed-layer model framework. With a focus on application over coastal lands, the diurnal cycle of cloud thickness and whether or not clouds dissipate are of particular interest. An analytic solution enables the sensitivity analysis of implicitly interdependent variables and extrema analysis of cloud variables that are hard to achieve using numerical solutions. In this work, the sensitivity of inversion height, cloud-base height, and cloud thickness with respect to initial and boundary conditions, such as Bowen ratio, subsidence, surface temperature, and initial inversion height, are studied. A critical initial cloud thickness value that can be dissipated pre- and post-sunrise is provided. Furthermore, an extrema analysis is provided to obtain the minima and maxima of the inversion height and cloud thickness within 24 h. The proposed solution is validated against LES results under the same initial and boundary conditions. Then, the proposed analytic framework is extended to incorporate multiple vertical columns that are coupled by advection through wind flow. This enables a bridge between the micro-scale and the mesoscale relations. The effect of advection on cloud evolution is studied and a sensitivity analysis is provided.

  13. Alcohol Behaviors and Deviant Behaviors among Adolescents in a Rural State.

    ERIC Educational Resources Information Center

    Nagy, Stephen; Dunn, Michael S.

    1999-01-01

    Study provides a descriptive profile of alcohol consumption patterns of adolescents in a southern state from four time periods over the past decade. Also examines the relationship between alcohol initiation and binge drinking behaviors and sexual initiation, pregnancy, multiple sex partners, and violence. Regression analyses showed very modest…

  14. Washington State Student Achievement Initiative Policy Study: Final Report

    ERIC Educational Resources Information Center

    Jenkins, Davis; Wachen, John; Moore, Colleen; Shulock, Nancy

    2012-01-01

    In 2007, the Washington State Board for Community and Technical Colleges launched a performance funding policy called the Student Achievement Initiative (SAI) both to improve public accountability by more accurately describing what students achieve from enrolling in community colleges and to provide incentives to colleges through financial rewards…

  15. Discourses of Inclusion in Initial Teacher Education: Unravelling a New Zealand "Number Eight Wire" Knot

    ERIC Educational Resources Information Center

    O'Neill, John; Bourke, Roseanna; Kearney, Alison

    2009-01-01

    Institutional politics and diversity of ideological positions create challenges for teaching staff with polarised beliefs about inclusive education. This paper provides a methodological justification for a longitudinal study of the experience of developing an integrated "inclusive education" curriculum in one initial teacher education…

  16. Community Partnerships: Integrating Early Education with Childcare

    ERIC Educational Resources Information Center

    Broadhead, Pat; Armistead, Jo

    2007-01-01

    This study reports on research into a Local Authority initiative in York, in North Yorkshire which aimed to establish early education and childcare partnerships between its 51 primary schools and local early-years providers from the community-voluntary and private sectors in close geographical proximity to the schools. The initiative was named…

  17. Hampton Roads climate impact quantification initiative : baseline assessment of the transportation assets & overview of economic analyses useful in quantifying impacts

    DOT National Transportation Integrated Search

    2016-09-13

    The Hampton Roads Climate Impact Quantification Initiative (HRCIQI) is a multi-part study sponsored by the U.S. Department of Transportation (DOT) Climate Change Center with the goals that include developing a cost tool that provides methods for volu...

  18. The Descriptive Study of the Head Start Early Learning Mentor Coach Initiative, Volume 1: Final Report. OPRE Report 2014-05a

    ERIC Educational Resources Information Center

    Howard, Eboni C.; Rankin, Victoria E.; Fishman, Mike; Hawkinson, Laura E.; McGroder, Sharon M.; Helsel, Fiona K.; Farber, Jonathan; Tuchman, Ariana; Wille, Jessica

    2014-01-01

    The purpose of this study was to describe the coaching that occurred at Head Start (HS) grantees as a result of the Early Learning Mentor Coach (ELMC) initiative. This provided a unique opportunity to describe the different dimensions of coaching within HS settings from the perspective of multiple stakeholders--administrators, coaches, and staff.…

  19. To Get-to-Know-You or Not to Get-to-Know-You: A Two Phase Study of Initial Engagement Activities

    ERIC Educational Resources Information Center

    Sawyer, J. Kanan; Braz, Mary E.; Babcock, Jennifer L.

    2009-01-01

    In the pedagogy of classroom engagement, most instructors have become vastly familiar with first day of class Get-to-Know-You exercises. While entertaining, the empirical value of these exercises is not well established. The present analysis provides a data driven study of the utility of initial engagement activities, including a generalized…

  20. Pit initiation on nitinol in simulated physiological solutions.

    PubMed

    Pound, Bruce G

    2018-05-01

    Inclusions appear to play a crucial role in the initiation of pitting on nitinol, but the reason remains unclear. Furthermore, it has not been established whether the type of inclusion is a central factor. In this study, potentiodynamic polarization together with scanning electron microscopy and energy dispersive X-ray spectroscopy were used to provide more insight into the initiation of pits on electropolished nitinol wire. Corrosion was limited to a single primary pit on each of the few wire samples that exhibited breakdown. The pit contained numerous Ti 2 NiO x inclusions, but secondary pits that developed within the primary pit provided evidence that these inclusions were the sites of pit initiation. Although several theories have been proposed to account for pit initiation at inclusions in mechanically polished and electropolished nitinol, titanium depletion in the adjacent alloy matrix appears to provide the most viable explanation. The key factor appears to be the size of the inclusion and therefore the extent of titanium depletion in the alloy matrix. The type of inclusion evidently plays a secondary role at most. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1605-1610, 2018. © 2017 Wiley Periodicals, Inc.

  1. Critical Parameters of the Initiation Zone for Spontaneous Dynamic Rupture Propagation

    NASA Astrophysics Data System (ADS)

    Galis, M.; Pelties, C.; Kristek, J.; Moczo, P.; Ampuero, J. P.; Mai, P. M.

    2014-12-01

    Numerical simulations of rupture propagation are used to study both earthquake source physics and earthquake ground motion. Under linear slip-weakening friction, artificial procedures are needed to initiate a self-sustained rupture. The concept of an overstressed asperity is often applied, in which the asperity is characterized by its size, shape and overstress. The physical properties of the initiation zone may have significant impact on the resulting dynamic rupture propagation. A trial-and-error approach is often necessary for successful initiation because 2D and 3D theoretical criteria for estimating the critical size of the initiation zone do not provide general rules for designing 3D numerical simulations. Therefore, it is desirable to define guidelines for efficient initiation with minimal artificial effects on rupture propagation. We perform an extensive parameter study using numerical simulations of 3D dynamic rupture propagation assuming a planar fault to examine the critical size of square, circular and elliptical initiation zones as a function of asperity overstress and background stress. For a fixed overstress, we discover that the area of the initiation zone is more important for the nucleation process than its shape. Comparing our numerical results with published theoretical estimates, we find that the estimates by Uenishi & Rice (2004) are applicable to configurations with low background stress and small overstress. None of the published estimates are consistent with numerical results for configurations with high background stress. We therefore derive new equations to estimate the initiation zone size in environments with high background stress. Our results provide guidelines for defining the size of the initiation zone and overstress with minimal effects on the subsequent spontaneous rupture propagation.

  2. Parent-Child Center Short-Term Assessment Study. Final Report.

    ERIC Educational Resources Information Center

    Hubbell, Ruth; Barrett, Barbara

    A short-term descriptive assessment, this study provides summary data on the Parent-Child Center (PCC) comprehensive early childhood intervention programs initiated in 1967 and operated by the Administration for Children, Youth, and Families. PCCs provide low income families with children under three with social service, health, and educational…

  3. 'Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation.

    PubMed

    Damon, Will; Small, Will; Anderson, Solanna; Maher, Lisa; Wood, Evan; Kerr, Thomas; McNeil, Ryan

    2017-03-01

    Patient attrition is common among people enrolled in methadone maintenance treatment (MMT) programs and most pronounced during the first year of treatment. However, the experiences of patients initiating MMT have been overlooked in the literature. This study explores experiences of MMT initiation among MMT patients, focusing on contextual influences on MMT initiation and perceptions of MMT and their subsequent influence on treatment retention. Semi-structured qualitative interviews were conducted with 39 MMT patients in Vancouver, Canada. Individuals reporting enrolment in MMT were recruited from within two ongoing cohort studies comprised of people who use drugs. Interview transcripts were analysed using an inductive and iterative approach. Two groups of MMT initiators were identified: (i) 'crisis initiators' prescribed methadone following critical transition events, such as incarceration or pregnancy; and (ii) 'everyday initiators' enrolled in MMT as part of routine healthcare utilisation. While most 'crisis initiators' and some 'everyday initiators' described experiencing coercion during MMT initiation, 'crisis initiators' were further subjected to the coercive leveraging of their vulnerability to motivate 'consent' for MMT. 'Crisis initiators' developed negative views towards MMT and were more likely to discontinue treatment. Long-standing patient-provider relationships and open dialogue were associated with more positive views regarding MMT, regardless of the circumstances of initiation. Findings underscore the need for clear and effective communication regarding treatment regimens and expectations during MMT initiation. Furthermore, training in trauma-informed care may help reduce perceptions of coercion and rates of early treatment termination. [Damon W, Small W, Anderson S, Maher L, Wood E, Kerr T, McNeil R. Crisis' and 'everyday' initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation. Drug Alcohol Rev 2017;36:253-260]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  4. A Review of Empirical Analyses of Disinvestment Initiatives.

    PubMed

    Chambers, James D; Salem, Mark N; D'Cruz, Brittany N; Subedi, Prasun; Kamal-Bahl, Sachin J; Neumann, Peter J

    Disinvesting in low-value health care services provides opportunities for investment in higher value care and thus an increase in health care efficiency. To identify international experience with disinvestment initiatives and to review empirical analyses of disinvestment initiatives. We performed a literature search using the PubMed database to identify international experience with disinvestment initiatives. We also reviewed empirical analyses of disinvestment initiatives. We identified 26 unique disinvestment initiatives implemented across 11 countries. Nineteen addressed multiple intervention types, six addressed only drugs, and one addressed only devices. We reviewed 18 empirical analyses of disinvestment initiatives: 7 reported that the initiative was successful, 8 reported that the initiative was unsuccessful, and 3 reported that findings were mixed; that is, the study considered multiple services and reported a decrease in the use of some but not others. Thirty-seven low-value services were evaluated across the 18 empirical analyses, for 14 (38%) of which the disinvestment initiative led to a decline in use. Six of the seven studies that reported the disinvestment initiative to be successful included an attempt to promote the disinvestment initiative among participating clinicians. The success of disinvestment initiatives has been mixed, with fewer than half the identified empirical studies reporting that use of the low-value service was reduced. Our findings suggest that promotion of the disinvestment initiative among clinicians is a key component to the success of the disinvestment initiative. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Feasibility Study of Economics and Performance of Solar Photovoltaics at the Vincent Mullins Landfill in Tucson, Arizona. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

    Steen, M.; Lisell, L.; Mosey, G.

    2013-01-01

    The U.S. Environmental Protection Agency (EPA), in accordance with the RE-Powering America's Land initiative, selected the Vincent Mullins Landfill in Tucson, Arizona, for a feasibility study of renewable energy production. Under the RE-Powering America's Land initiative, the EPA provided funding to the National Renewable Energy Laboratory (NREL) to support the study. NREL provided technical assistance for this project but did not assess environmental conditions at the site beyond those related to the performance of a photovoltaic (PV) system. The purpose of this report is to assess the site for a possible PV installation and estimate the cost and performance ofmore » different PV configurations, as well as to recommend financing options that could assist in the implementation of a PV system. In addition to the Vincent Mullins site, four similar landfills in Tucson are included as part of this study.« less

  6. A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

    PubMed

    Mohanraj, Rani; Kumar, Shuba; Manikandan, Sarojini; Kannaiyan, Veerapandian; Vijayakumar, Lakshmi

    2014-08-01

    Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

  7. Health education for a breast and cervical cancer screening program: using the ecological model to assess local initiatives.

    PubMed

    Holden, D J; Moore, K S; Holliday, J L

    1998-06-01

    This study investigates the development and implementation of health education strategies at the local level for a statewide breast and cervical cancer control program. Baseline data on these initiatives were collected from 88 local screening programs in North Carolina. Using the ecological model as a framework, health education initiatives were assessed and analyzed to determine the level of activity occurring at the local level and the comprehensiveness of programs. Types and levels of interventions used are described and initial analysis is provided of the impact these strategies are having on recruiting women from target populations into these screening programs. Specific examples illustrating the variety of interventions used at the individual, network, organizational and community levels, and the impact of certain variables, such as the use of local health education staff, on the comprehensiveness of interventions utilized, are provided. The importance to practitioners of establishing process indicators in assessing local initiatives and challenges to conducting evaluations of these strategies are also discussed.

  8. Improving the Collection of Race, Ethnicity, and Language Data to Reduce Healthcare Disparities: A Case Study from an Academic Medical Center

    PubMed Central

    Lee, Wei-Chen; Veeranki, Sreenivas P.; Serag, Hani; Eschbach, Karl; Smith, Kenneth D.

    2016-01-01

    Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program. We also present a plan to address some of the challenges that arose during the course of the project. Our experience at an academic medical center can provide guidance about the likely challenges similar institutions may expect when they implement new initiatives to collect REAL data, particularly challenges regarding scope, personnel, and other resource needs. PMID:27843424

  9. Enhancing Infant Mental Health Using a Capacity-Building Model: A Case Study of a Process Evaluation of the "Ready, Steady, Grow" Initiative

    ERIC Educational Resources Information Center

    O'Farrelly, Christine; Guerin, Suzanne; Victory, Gerard

    2017-01-01

    Infant mental health (IMH) is best promoted through a continuum of services underpinned by strong service capacity. However, service providers often lack fundamental IMH knowledge and skills. Using the Ready, Steady, Grow (RSG) initiative as a case study of a capacity-building model (P., Hawe, L., King, M., Noort, C., Jordens, & B., Llyod,…

  10. What Will Be the Impact of Programs of Study? A Preliminary Assessment Based on Similar Previous Initiatives, State Plans for Implementation, and Career Development Theory

    ERIC Educational Resources Information Center

    Lewis, Morgan V.; Kosine, Natalie R.

    2008-01-01

    This publication provides background to inform the implementation of Programs of Study (POS) as required by grantees of funds authorized under the Carl D. Perkins Career and Technical Education Improvement Act of 2006. The report is a review of the evidence on the effectiveness of previous similar initiatives and an examination of the implications…

  11. Immediate use of prosody and context in predicting a syntactic structure.

    PubMed

    Nakamura, Chie; Arai, Manabu; Mazuka, Reiko

    2012-11-01

    Numerous studies have reported an effect of prosodic information on parsing but whether prosody can impact even the initial parsing decision is still not evident. In a visual world eye-tracking experiment, we investigated the influence of contrastive intonation and visual context on processing temporarily ambiguous relative clause sentences in Japanese. Our results showed that listeners used the prosodic cue to make a structural prediction before hearing disambiguating information. Importantly, the effect was limited to cases where the visual scene provided an appropriate context for the prosodic cue, thus eliminating the explanation that listeners have simply associated marked prosodic information with a less frequent structure. Furthermore, the influence of the prosodic information was also evident following disambiguating information, in a way that reflected the initial analysis. The current study demonstrates that prosody, when provided with an appropriate context, influences the initial syntactic analysis and also the subsequent cost at disambiguating information. The results also provide first evidence for pre-head structural prediction driven by prosodic and contextual information with a head-final construction. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Video self-modeling in children with autism: a pilot study validating prerequisite skills and extending the utilization of VSM across skill sets.

    PubMed

    Williamson, Robert L; Casey, Laura B; Robertson, Janna Siegel; Buggey, Tom

    2013-01-01

    Given the recent interest in the use of video self-modeling (VSM) to provide instruction within iPod apps and other pieces of handheld mobile assistive technologies, investigating appropriate prerequisite skills for effective use of this intervention is particularly timely and relevant. To provide additional information regarding the efficacy of VSM for students with autism and to provide insights into any possible prerequisite skills students may require for such efficacy, the authors investigated the use of VSM in increasing the instances of effective initiations of interpersonal greetings for three students with autism that exhibited different pre-intervention abilities. Results showed that only one of the three participants showed an increase in self-initiated greetings following the viewing of videos edited to show each participant self-modeling a greeting when entering his or her classroom. Due to the differences in initial skill sets between the three children, this finding supports anecdotally observed student prerequisite abilities mentioned in previous studies that may be required to effectively utilize video based teaching methods.

  13. Development of, and initial validity evidence for, the referee self-efficacy scale: a multistudy report.

    PubMed

    Myers, Nicholas D; Feltz, Deborah L; Guillén, Félix; Dithurbide, Lori

    2012-12-01

    The purpose of this multistudy report was to develop, and then to provide initial validity evidence for measures derived from, the Referee Self-Efficacy Scale. Data were collected from referees (N = 1609) in the United States (n = 978) and Spain (n = 631). In Study 1 (n = 512), a single-group exploratory structural equation model provided evidence for four factors: game knowledge, decision making, pressure, and communication. In Study 2 (n = 1153), multiple-group confirmatory factor analytic models provided evidence for partial factorial invariance by country, level of competition, team gender, and sport refereed. In Study 3 (n = 456), potential sources of referee self-efficacy information combined to account for a moderate or large amount of variance in each dimension of referee self-efficacy with years of referee experience, highest level refereed, physical/mental preparation, and environmental comfort, each exerting at least two statistically significant direct effects.

  14. Logistic regression trees for initial selection of interesting loci in case-control studies

    PubMed Central

    Nickolov, Radoslav Z; Milanov, Valentin B

    2007-01-01

    Modern genetic epidemiology faces the challenge of dealing with hundreds of thousands of genetic markers. The selection of a small initial subset of interesting markers for further investigation can greatly facilitate genetic studies. In this contribution we suggest the use of a logistic regression tree algorithm known as logistic tree with unbiased selection. Using the simulated data provided for Genetic Analysis Workshop 15, we show how this algorithm, with incorporation of multifactor dimensionality reduction method, can reduce an initial large pool of markers to a small set that includes the interesting markers with high probability. PMID:18466557

  15. Local status and power in area-based health improvement partnerships.

    PubMed

    Powell, Katie; Thurston, Miranda; Bloyce, Daniel

    2014-11-01

    Area-based initiatives have formed an important part of public policy towards more socio-economically deprived areas in many countries. Co-ordinating service provision within and across sectors has been a common feature of these initiatives. Despite sustained policy interest in area-based initiatives, little empirical work has explored relations between area-based initiative providers, and partnership development within this context remains under-theorised. This article addresses both of these gaps by exploring partnerships as a social and developmental process, drawing on concepts from figurational sociology to explain how provider relations develop within an area-based initiative. Qualitative methods were used to explore, prospectively, the development of an area-based initiative targeted at a town in the north west of England. A central finding was that although effective delivery of area-based initiatives is premised on a high level of co-ordination between service providers, the pattern of interdependencies between providers limits the frequency and effectiveness of co-operation. In particular, the interdependency of area-based initiative providers with others in their organisation (what is termed here as 'organisational pull') constrained the ways in which they worked with providers outside of their own organisations. 'Local' status, which could be earned over time, enabled some providers to exert greater control over the way in which provider relations developed during the course of the initiative. These findings demonstrate how historically constituted social networks, within which all providers are embedded, shape partnership development. The theoretical insight developed here suggests a need for more realistic expectations among policymakers about how and to what extent provider partnerships can be managed. © The Author(s) 2014.

  16. Paradise nearly Gained. Volume 1: Developing the Frontline Management Initiative.

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    The Frontline Management Initiative (FMI) provides a framework for competency-based development of frontline managers in Australian enterprises. The FMI's impact on businesses was examined in a national study that included the following activities: focus groups; a national survey of management development and targeted national survey of FMI users;…

  17. Library Specifications for a New Circulation System for Concordia University Libraries.

    ERIC Educational Resources Information Center

    Tallon, James

    This study of library requirements for a new circulation system is organized into three sections: (1) items required for initial implementation in July 1982; (2) items relating to notice generation and activity statistics, with implementation expected by fall 1982; and (3) items provided in the system as initially implemented, with additional…

  18. Ethics Education in Initial Teacher Education: Pre-Service Provision in England

    ERIC Educational Resources Information Center

    Walters, Sue; Heilbronn, Ruth; Daly, Caroline

    2018-01-01

    Ethics education exists in most professions internationally, yet is less prevalent in teacher education. This article reports on research exploring how ethics education is provided in university courses of initial teacher education (ITE) in England that was conducted as the second phase of an international survey study which considered the…

  19. The Bring Your Own Technology Initiative: An Examination of Teachers' Adoption

    ERIC Educational Resources Information Center

    Cardoza, Yanet; Tunks, Jeanne

    2014-01-01

    This case study explored teachers' concerns, use, and actual practices in their adoption of the Bring Your Own Technology (BYOT) initiative. Participants were 12 secondary teachers in a private school setting. The Concerns-Based Adoption Model tools provided data: Stages of Concern Questionnaire (SoCQ), Levels of Use interview, and the Innovation…

  20. Factors in the Spread of Continuing Training in the European Community.

    ERIC Educational Resources Information Center

    Aventur, Francois; Campo, Christian; Moebus, Martine

    1999-01-01

    A study compared 17 European countries' initial and continuing vocational training systems. Two kinds of continuing training (CT)--that which is initiated by the employer and that which is intiated by the individual--provide an indicator for comparing the different situations observed throughout the European Community. The two forms are mutually…

  1. Marketing an Alternate Model for Science and Mathematics Initial Teacher Education

    ERIC Educational Resources Information Center

    Seen, Andrew; Fraser, Sharon P.; Beswick, Kim; Penson, Margaret; Whannell, Robert

    2016-01-01

    An innovative initial teacher education undergraduate degree has been offered for the first time in 2016 at an Australian University. The degree provides for qualification as a secondary science and mathematics teacher through the completion of a four-year-integrated science, mathematics and education program of study where the synergies available…

  2. Sustainability of Foundation-Funded Grant Programs beyond Initial Funding: A Multicase Study at Selective Liberal Arts Colleges

    ERIC Educational Resources Information Center

    Lechuga, Deborah Chang

    2010-01-01

    College and university leaders must remain responsive to their environments by promoting institutional innovation and change. External grant-funders, such as foundations, view themselves as initiators of change. Foundations can provide the necessary tools to jump start innovation within colleges and universities. However, despite the best…

  3. Using Initial, Derived, and Terminal Credibility to Help Students Understand How They Are Perceived by Others

    ERIC Educational Resources Information Center

    Berry, Marcia

    2018-01-01

    Courses: Public Speaking, Interpersonal Communication, Organizational Communication, Introduction to Communication Studies, Business Communication. Objectives: The goal for this activity is not only to provide students with an understanding of their initial, derived, and terminal credibility when relating a personal, edifying story but also to…

  4. Early College, Early Success: Early College High School Initiative Impact Study

    ERIC Educational Resources Information Center

    Berger, Andrea; Turk-Bicakci, Lori; Garet, Michael; Song, Mengli; Knudson, Joel; Haxton, Clarisse; Zeiser, Kristina; Hoshen, Gur; Ford, Jennifer; Stephan, Jennifer; Keating, Kaeli; Cassidy, Lauren

    2013-01-01

    In 2002, the Bill & Melinda Gates Foundation launched the Early College High School Initiative (ECHSI) with the primary goal of increasing the opportunity for underserved students to earn a postsecondary credential. To achieve this goal, Early Colleges provide underserved students with exposure to, and support in, college while they are in…

  5. Used Nuclear Fuel Loading and Structural Performance Under Normal Conditions of Transport- Demonstration of Approach and Results on Used Fuel Performance Characterization

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

    Adkins, Harold; Geelhood, Ken; Koeppel, Brian

    2013-09-30

    This document addresses Oak Ridge National Laboratory milestone M2FT-13OR0822015 Demonstration of Approach and Results on Used Nuclear Fuel Performance Characterization. This report provides results of the initial demonstration of the modeling capability developed to perform preliminary deterministic evaluations of moderate-to-high burnup used nuclear fuel (UNF) mechanical performance under normal conditions of storage (NCS) and normal conditions of transport (NCT) conditions. This report also provides results from the sensitivity studies that have been performed. Finally, discussion on the long-term goals and objectives of this initiative are provided.

  6. Newborn screening for metabolic disorders: parental perceptions of the initial communication of results.

    PubMed

    Buchbinder, Mara; Timmermans, Stefan

    2012-08-01

    Positive newborn screening (NBS) results cause significant parental distress, but little is known about how parents find out about children's screening results and what they are told. This qualitative, exploratory study reports on parents' perceptions of the initial communication of NBS results. Participants included the parents of 75 infants referred to a metabolic clinic in California over a 3-year period (2007-2010). Parents provided information about the initial communication of NBS results during audiotaped clinical encounters and open-ended interviews. Transcripts were analyzed inductively using thematic coding. Responses fell into 3 primary themes: sources of news delivery, providing information, and mitigation strategies. The findings suggest that health care providers have access to a range of communicative resources to buffer the impact of positive screening results that may be mobilized in future interventions. Recommendations for improving the communication process and future research directions are discussed.

  7. Processes that initiate turbidity currents and their influence on turbidites: A marine geology perspective

    USGS Publications Warehouse

    Piper, David J.W.; Normark, William R.

    2009-01-01

    How the processes that initiate turbidity currents influence turbidite deposition is poorly understood, and many discussions in the literature rely on concepts that are overly simplistic. Marine geological studies provide information on the initiation and flow path of turbidity currents, including their response to gradient. In case studies of late Quaternary turbidites on the eastern Canadian and western U.S. margins, initiation processes are inferred either from real-time data for historical flows or indirectly from the age and contemporary paleogeography, erosional features, and depositional record. Three major types of initiation process are recognized: transformation of failed sediment, hyperpycnal flow from rivers or ice margins, and resuspension of sediment near the shelf edge by oceanographic processes. Many high-concentration flows result from hyperpycnal supply of hyperconcentrated bedload, or liquefaction failure of coarse-grained sediment, and most tend to deposit in slope conduits and on gradients < 0.5° at the base of slope and on the mid fan. Highly turbulent flows, from transformation of retrogressive failures and from ignitive flows that are triggered by oceanographic processes, tend to cannibalize these more proximal sediments and redeposit them on lower gradients on the basin plain. Such conduit flushing provides most of the sediment in large turbidites. Initiation mechanism exerts a strong control on the duration of turbidity flows. In most basins, there is a complex feedback between different types of turbidity-current initiation, the transformation of the flows, and the associated slope morphology. As a result, there is no simple relationship between initiating process and type of deposit.

  8. Sulfonylureas and risk of falls and fractures among nursing home residents with type 2 diabetes mellitus.

    PubMed

    Lapane, Kate L; Jesdale, Bill M; Dubé, Catherine E; Pimentel, Camilla B; Rajpathak, Swapnil N

    2015-08-01

    Although sulfonylureas increase the risk of hypoglycemia which may lead to fall-associated fractures, studies quantifying the association between sulfonylureas and falls and/or fractures are sparse and existing studies have yielded inconsistent results. Our objective is to evaluate the extent to which sulfonylurea use was associated with fractures and falls among nursing home residents with type 2 diabetes mellitus. We performed a propensity-matched retrospective new user cohort study of 12,327 Medicare Parts A/B/D eligible long-stay NH residents. Medicare Part D data provided information on sulfonylurea and biguanide use initiated as monotherapy (nsulfonylurea=5807 and nbiguanide=6151) after NH entry. Medicare hospitalizations were used to identify hypoglycemic events (ICD-9-CM codes 250.8, 251.1, 251.2) and fall-associated fractures (ICD-9-CM codes 800, 804, 812-817, 820, 823, 824). Minimum Data Set 2.0 (2008-2010) provided information on falls and potential confounders. Cox models conducted on propensity-matched samples provided adjusted hazard ratio (aHR) estimates and 95% confidence intervals (CI). Falls were common (37.4 per 100 person-years). Fractures were not associated with initiation of sulfonylureas. Sulfonylurea initiation was associated with an excess risk of falls among residents with moderate activities of daily living limitations (aHR: 1.13; 95% CI: 1.00-1.26), but not among those with minimal limitations or dependence in activities of daily living. Nursing home residents with moderate limitations in activities of daily living are at increased risk of falls upon initiation of sulfonylureas. Initiating sulfonylurea use in NH residents must be done with caution. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Associations Between Medication Class and Subsequent Augmentation of Depression Treatment in Privately Insured US Adults.

    PubMed

    Ameli, Omid; Soria-Saucedo, Rene; Smith, Eric G; Cabral, Howard J; Soley-Bori, Marina; Kazis, Lewis E

    2017-06-01

    Treatment augmentation is an important clinical decision in the pharmacotherapy for depression, yet few studies have examined the rates of treatment augmentation by medication class. The aim of this study was to examine which initial pharmacotherapies for depression are more likely than others to result in subsequent treatment augmentation. This study is a retrospective cohort analysis of administrative data of 214,705 privately insured US adults between the age of 18 and 64 years who were diagnosed with a new episode of depression in 2009. Propensity score-adjusted logistic regression and Cox regression were used to model the effect of the class of initial monotherapy on treatment augmentation. Risk adjustors included depression severity, comorbidities, provider type, insurance, and demographic characteristics. The class of initial monotherapy and the health care provider type were the main independent variables of interest. The outcome was the augmentation of monotherapy. Thirty-four percent of individuals received treatment augmentation. Compared with selective serotonin reuptake inhibitor monotherapy, second-generation antipsychotics as the initial treatment were associated with significant increase in the likelihood of augmentation compared with the other classes (hazards ratio, 2.59; 95% confidence interval [CI], 2.51-2.68). This result was corroborated after propensity score adjustment (odds ratio, 2.85; 95% CI, 2.70-3.00) when comparing second-generation antipsychotics to the other classes of pharmacotherapy. The other significant predictor of treatment augmentation was the provider type. Mental health specialists were 27% more likely to augment a treatment compared with generalists (hazards ratio, 1.27; 95% CI, 1.25-1.30). The type of initial antidepressant therapy is associated with the chances of treatment augmentation. Second-generation antipsychotics progressed to augmentation more rapidly than the other classes.

  10. Prevalence and risk factors related to preterm birth in Brazil.

    PubMed

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Theme-Filha, Mariza; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Gama, Silvana Granado

    2016-10-17

    The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil. Data are from the 2011-2012 "Birth in Brazil" study, which used a national population-based sample of 23,940 women. We analyzed the variables following a three-level hierarchical methodology. For each level, we performed non-conditional multiple logistic regression for both spontaneous and provider-initiated preterm birth. The rate of preterm birth was 11.5 %, (95 % confidence 10.3 % to 12.9 %) 60.7 % spontaneous - with spontaneous onset of labor or premature preterm rupture of membranes - and 39.3 % provider-initiated, with more than 90 % of the last group being pre-labor cesarean deliveries. Socio-demographic factors associated with spontaneous preterm birth were adolescent pregnancy, low total years of schooling, and inadequate prenatal care. Other risk factors were previous preterm birth (OR 3.74; 95 % CI 2.92-4.79), multiple pregnancy (OR 16.42; 95 % CI 10.56-25.53), abruptio placentae (OR 2.38; 95 % CI 1.27-4.47) and infections (OR 4.89; 95 % CI 1.72-13.88). In contrast, provider-initiated preterm birth was associated with private childbirth healthcare (OR 1.47; 95 % CI 1.09-1.97), advanced-age pregnancy (OR 1.27; 95 % CI 1.01-1.59), two or more prior cesarean deliveries (OR 1.64; 95 % CI 1.19-2.26), multiple pregnancy (OR 20.29; 95 % CI 12.58-32.72) and any maternal or fetal pathology (OR 6.84; 95 % CI 5.56-8.42). The high proportion of provider-initiated preterm birth and its association with prior cesarean deliveries and all of the studied maternal/fetal pathologies suggest that a reduction of this type of prematurity may be possible. The association of spontaneous preterm birth with socially-disadvantaged groups reaffirms that the reduction of social and health inequalities should continue to be a national priority.

  11. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    PubMed

    Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

    2012-01-01

    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.

  12. Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.

    PubMed

    Shah, Svati H; Arnett, Donna; Houser, Steven R; Ginsburg, Geoffrey S; MacRae, Calum; Mital, Seema; Loscalzo, Joseph; Hall, Jennifer L

    2016-01-12

    The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation. © 2016 American Heart Association, Inc.

  13. Radical Initiated Hydrosilylation on Silicon Nanocrystal Surfaces: An Evaluation of Functional Group Tolerance and Mechanistic Study.

    PubMed

    Yang, Zhenyu; Gonzalez, Christina M; Purkait, Tapas K; Iqbal, Muhammad; Meldrum, Al; Veinot, Jonathan G C

    2015-09-29

    Hydrosilylation is among the most common methods used for modifying silicon surface chemistry. It provides a wide range of surface functionalities and effective passivation of surface sites. Herein, we report a systematic study of radical initiated hydrosilylation of silicon nanocrystal (SiNC) surfaces using two common radical initiators (i.e., 2,2'-azobis(2-methylpropionitrile) and benzoyl peroxide). Compared to other widely applied hydrosilylation methods (e.g., thermal, photochemical, and catalytic), the radical initiator based approach is particle size independent, requires comparatively low reaction temperatures, and yields monolayer surface passivation after short reaction times. The effects of differing functional groups (i.e., alkene, alkyne, carboxylic acid, and ester) on the radical initiated hydrosilylation are also explored. The results indicate functionalization occurs and results in the formation of monolayer passivated surfaces.

  14. Carcinogen-induced mutations in the mouse c-Ha-ras gene provide evidence of multiple pathways for tumor progression.

    PubMed Central

    Brown, K; Buchmann, A; Balmain, A

    1990-01-01

    A number of mouse skin tumors initiated by the carcinogens N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), methylnitrosourea (MNU), 3-methylcholanthrene (MCA), and 7,12-dimethylbenz[a]anthracene (DMBA) have been shown to contain activated Ha-ras genes. In each case, the point mutations responsible for activation have been characterized. Results presented demonstrate the carcinogen-specific nature of these ras mutations. For each initiating agent, a distinct spectrum of mutations is observed. Most importantly, the distribution of ras gene mutations is found to differ between benign papillomas and carcinomas, suggesting that molecular events occurring at the time of initiation influence the probability with which papillomas progress to malignancy. This study provides molecular evidence in support of the existence of subsets of papillomas with differing progression frequencies. Thus, the alkylating agents MNNG and MNU induced exclusively G ---- A transitions at codon 12, with this mutation being found predominantly in papillomas. MCA initiation produced both codon 13 G ---- T and codon 61 A ---- T transversions in papillomas; only the G ---- T mutation, however, was found in carcinomas. These findings provide strong evidence that the mutational activation of Ha-ras occurs as a result of the initiation process and that the nature of the initiating event can affect the probability of progression to malignancy. Images PMID:2105486

  15. Quality of Provider-Participant Relationships and Enhancement of Adolescent Social Skills

    ERIC Educational Resources Information Center

    Sale, Elizabeth; Bellamy, Nikki; Springer, J. Fred; Wang, Min Qi

    2008-01-01

    This study adds to the limited research on the potential importance of the quality of the relationship between adult prevention service providers and youth participants in enhancing social skills and strengthening prevention outcomes. Study subjects were drawn from seven prevention programs funded under a Youth Mentoring Initiative by the Center…

  16. Shining lights: studies that have most influenced the understanding of health promotion's financial impact.

    PubMed

    Golaszewski, T

    2001-01-01

    To examine the literature from the past 20 years and identify those studies that support the economic merit of health promotion. A panel of experts was used to identify the top studies supporting the purpose of this article. Studies were chosen based on the following criteria: the study (1) examined the relationship between health risks and financial outcomes, or health promotion programs and financial outcomes; (2) provided strong and compelling financial data supporting the worth of health promotion; (3) had a high-quality methodology; (4) answered an important question or replicated important findings with superior methodology; and (5) represented U.S.-based initiatives published since 1980. After initially nominating a group of studies for consideration, panelists rated each on a scale from 1 to 3 representing their opinion of importance. Studies rating the highest were included for this discussion. Studies were analyzed by population characteristics, design, statistical tests, limitations, and results. This information was summarized for each identified article. A relationship between modifiable health risk factors and health care costs is supported by research. Health promotion interventions appear to provide positive financial returns, most notably for health care costs and absenteeism reduction. Private sector initiatives seem to be driving economic-based research. Overall, health promotion shows promising results for providing financial advantages for its sponsors; however, if this discipline is to show its true worth, considerable funding is needed from government or philanthropic sources to cover the substantial costs of quality research.

  17. Space exploration initiative (SEI) logistics support lessons from the DoD

    NASA Astrophysics Data System (ADS)

    Cox, John R.; McCoy, Walbert G.; Jenkins, Terence

    Proven and innovative logistics management approaches and techniques used for developing and supporting DoD and Strategic Defense Initiative Office (SDIO) systems are described on the basis of input from DoD to the SEI Synthesis Group; SDIO-developed logistics initiatives, innovative tools, and methodologies; and logistics planning support provided to the NASA/Johnson Planet Surface System Office. The approach is tailored for lunar/Martian surface operations, and provides guidelines for the development and management of a crucial element of the SEI logistics support program. A case study is presented which shows how incorporation of DoD's proven and innovative logistics management approach, tools, and techniques can substantially benefit early logistics planning for SEI, while also implementing many of DoD's recommendations for SEI.

  18. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    PubMed Central

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  19. Initial animal studies of a wireless, batteryless, MEMS implant for cardiovascular applications.

    PubMed

    Najafi, Nader; Ludomirsky, Achiau

    2004-03-01

    This paper reports the results of the initial animal studies of a wireless, batteryless, implantable pressure sensor using microelectromechanical systems (MEMS) technology. The animal studies were acute and proved the functional feasibility of using MEMS technology for wireless bio sensing. The results are very encouraging and surpassed the majority of the application's requirements, including high sampling speed and high resolution. Based on the lessons learned, second generation wireless sensors are being developed that will provide total system solution.

  20. MEASURING COERCION TO PARTICIPATE IN RESEARCH WITHIN A DOUBLY VULNERABLE POPULATION: INITIAL DEVELOPMENT OF THE COERCION ASSESSMENT SCALE

    PubMed Central

    Dugosh, Karen Leggett; Festinger, David S.; Croft, Jason R.; Marlowe, Douglas B.

    2011-01-01

    Despite many efforts aimed to ensure that research participation is autonomous and not coerced, there exists no reliable and valid measure of perceived coercion for the doubly vulnerable population of substance-abusing offenders. The current study describes the development and initial validation of an instrument measuring perceived coercion to participate in research among substance-abusing offenders. The results indicated that a substantial number of individuals report feeling coerced to participate in the study. In addition, the instrument has adequate levels of internal consistency, a one-dimensional factor structure, and evidence of discriminative validity. This study provides initial support for the instrument’s validity and clinical utility. PMID:20235867

  1. Long-term impact of a chef on school lunch consumption: findings from a 2-year pilot study in Boston middle schools.

    PubMed

    Cohen, Juliana F W; Smit, Liesbeth A; Parker, Ellen; Austin, S Bryn; Frazier, A Lindsay; Economos, Christina D; Rimm, Eric B

    2012-06-01

    School cafeterias can play an important role in providing healthy meals. Although schools participating in the National School Lunch Program are required to meet minimum program standards, advocates recommend that innovations be sought to enhance menu dietary quality. This study evaluated the Chef Initiative, a 2-year pilot study in two Boston middle schools, designed to increase the availability and consumption of healthier school foods. Between 2007 and 2009, a professional chef trained cafeteria staff to prepare healthier school lunches (ie, more whole grains, fresh/frozen fruits and vegetables, and less sugar, salt, saturated fats, and trans fats). Meal nutrient compositions were monitored from 2007 to 2009, and a plate waste study conducted in the spring of 2009 compared food selection and consumption patterns among students at Chef Initiative schools, with students receiving standard school lunches at two matched control schools. Paired t tests and descriptive statistics were used to examine differences in menus and mixed-model analysis of variance was used to analyze differences in students' food selection and consumption between Chef Initiative and control schools. Overall, the Chef Initiative schools provided healthier lunches and the percent of foods consumed at Chef Initiative and control schools were similar (61.6% vs 57.3%; P=0.63). Of the areas targeted, there was greater whole-grain selection and vegetable consumption; 51% more students selected whole grains (P=0.02) and students consumed 0.36 more vegetable servings/day (P=0.01) at Chef Initiative schools. The potential of chefs collaborating with cafeteria staff to improve the availability, selection, and consumption of healthier meals is promising. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  2. Is there a weekend bias in clutch-initiation dates from citizen science? Implications for studies of avian breeding phenology.

    PubMed

    Cooper, Caren B

    2014-09-01

    Accurate phenology data, such as the timing of migration and reproduction, is important for understanding how climate change influences birds. Given contradictory findings among localized studies regarding mismatches in timing of reproduction and peak food supply, broader-scale information is needed to understand how whole species respond to environmental change. Citizen science-participation of the public in genuine research-increases the geographic scale of research. Recent studies, however, showed weekend bias in reported first-arrival dates for migratory songbirds in databases created by citizen-science projects. I investigated whether weekend bias existed for clutch-initiation dates for common species in US citizen-science projects. Participants visited nests on Saturdays more frequently than other days. When participants visited nests during the laying stage, biased timing of visits did not translate into bias in estimated clutch-initiation dates, based on back-dating with the assumption of one egg laid per day. Participants, however, only visited nests during the laying stage for 25% of attempts of cup-nesting species and 58% of attempts in nest boxes. In some years, in lieu of visit data, participants provided their own estimates of clutch-initiation dates and were asked "did you visit the nest during the laying period?" Those participants who answered the question provided estimates of clutch-initiation dates with no day-of-week bias, irrespective of their answer. Those who did not answer the question were more likely to estimate clutch initiation on a Saturday. Data from citizen-science projects are useful in phenological studies when temporal biases can be checked and corrected through protocols and/or analytical methods.

  3. Is there a weekend bias in clutch-initiation dates from citizen science? Implications for studies of avian breeding phenology

    NASA Astrophysics Data System (ADS)

    Cooper, Caren B.

    2014-09-01

    Accurate phenology data, such as the timing of migration and reproduction, is important for understanding how climate change influences birds. Given contradictory findings among localized studies regarding mismatches in timing of reproduction and peak food supply, broader-scale information is needed to understand how whole species respond to environmental change. Citizen science—participation of the public in genuine research—increases the geographic scale of research. Recent studies, however, showed weekend bias in reported first-arrival dates for migratory songbirds in databases created by citizen-science projects. I investigated whether weekend bias existed for clutch-initiation dates for common species in US citizen-science projects. Participants visited nests on Saturdays more frequently than other days. When participants visited nests during the laying stage, biased timing of visits did not translate into bias in estimated clutch-initiation dates, based on back-dating with the assumption of one egg laid per day. Participants, however, only visited nests during the laying stage for 25 % of attempts of cup-nesting species and 58 % of attempts in nest boxes. In some years, in lieu of visit data, participants provided their own estimates of clutch-initiation dates and were asked "did you visit the nest during the laying period?" Those participants who answered the question provided estimates of clutch-initiation dates with no day-of-week bias, irrespective of their answer. Those who did not answer the question were more likely to estimate clutch initiation on a Saturday. Data from citizen-science projects are useful in phenological studies when temporal biases can be checked and corrected through protocols and/or analytical methods.

  4. The Effects of Residency and Body Size on Contest Initiation and Outcome in the Territorial Dragon, Ctenophorus decresii

    PubMed Central

    Umbers, Kate D. L.; Osborne, Louise; Keogh, J. Scott

    2012-01-01

    Empirical studies of the determinants of contests have been attempting to unravel the complexity of animal contest behaviour for decades. This complexity requires that experiments incorporate multiple determinants into studies to tease apart their relative effects. In this study we examined the complex contest behaviour of the tawny dragon (Ctenophorus decresii), a territorial agamid lizard, with the specific aim of defining the factors that determine contest outcome. We manipulated the relative size and residency status of lizards in contests to weight their importance in determining contest outcome. We found that size, residency and initiating a fight were all important in determining outcomes of fights. We also tested whether residency or size was important in predicting the status of lizard that initiated a fight. We found that residency was the most important factor in predicting fight initiation. We discuss the effects of size and residency status in context of previous studies on contests in tawny dragons and other animals. Our study provides manipulative behavioural data in support of the overriding effects of residency on initiation fights and winning them. PMID:23077558

  5. Outcomes of a care coordinated service model for persons with severe and persistent mental illness: A qualitative study.

    PubMed

    Isaacs, Anton N; Sutton, Keith; Dalziel, Kim; Maybery, Darryl

    2017-02-01

    Owing to difficulties faced by individuals with severe and persistent mental illness (SPMI) in accessing multiple services, the Australian Government trialed a care coordinated service model called the Partners in Recovery (PIR) initiative. A total of 45 stakeholders in Gippsland were asked what difference the initiative had made. The PIR initiative benefited not only clients and carers but also service providers. It addressed an unmet need in service delivery for individuals with SPMI. The PIR initiative has filled a gap in delivery of care for individuals with SPMI in Gippsland.

  6. Impact of the Adalimumab Patient Support Program's Care Coach Calls on Persistence and Adherence in Canada: An Observational Retrospective Cohort Study.

    PubMed

    Marshall, John K; Bessette, Louis; Thorne, Carter; Shear, Neil H; Lebovic, Gerald; Gerega, Sebastien K; Millson, Brad; Oraichi, Driss; Gaetano, Tania; Gazel, Sandra; Latour, Martin G; Laliberté, Marie-Claude

    2018-03-01

    Adalimumab (ADA) is a tumor necrosis factor-α inhibitor indicated for use in various immune-mediated inflammatory diseases. Patients receiving ADA in Canada are eligible to enroll in the AbbVie Care's Patient Support Program (PSP), which provides personalized services, including tailored interventions in the form of nurse-provided care coach calls (CCCs), with the goal of improving patients' experiences and outcomes. The primary objective of this study was to evaluate the impact of PSP services, including CCCs and patient characteristics, on persistence with and adherence to ADA for those patients enrolled in the PSP. A secondary objective was to estimate the effect of initial CCCs on treatment-initiation abandonment (ie, failure to initiate therapy after enrollment in the PSP). An observational retrospective cohort study was conducted. A patient linkage algorithm based on probabilistic matching was developed to link the AbbVie Care PSP database to the QuintilesIMS longitudinal pharmacy transaction database. Patients who started ADA therapy between July 2010 and August 2014 were selected, and their prescriptions were evaluated for 12 months after the date of ADA start to calculate days until drug discontinuation, that is, the end of persistence, defined as >90 days without therapy. Cox proportional hazards modeling was used for estimating hazard ratios for the association between persistence and patient characteristics and each PSP service. Adherence, measured by medication possession ratio, was calculated, and multivariate logistic regression provided adjusted odds ratios for the relationship between being adherent (medication possession ratio ≥80%) and patient characteristics and each PSP service. Treatment-initiation abandonment among patients who received an initial CCC compared with those who did not was analyzed using the χ 2 test. Analysis of 10,857 linked patients yielded statistically significant differences in the hazard ratio of discontinuation and the likelihood of being adherent across multiple variables between patients who received CCCs in comparison to patients who did not. Patients receiving CCCs were found to have a 72% decreased risk for therapy discontinuation (hazard ratio = 0.282; P < 0.0001), and a greater likelihood of being adherent (odds ratio = 1.483; P < 0.0001), when compared with those patients who did not receive CCCs. The rate of treatment-initiation abandonment was significantly higher in patients who did not receive initial CCCs (P < 0.0001). Ongoing CCCs, provided by AbbVie Care PSP, were associated with greater patient persistence and adherence over the first 12 months of treatment, while initial CCCs were associated with a lower rate of treatment-initiation abandonment. Results may inform the planning of interventions aimed at improving treatment adherence and patient outcomes. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Human exposure assessment and the National Toxicology Program.

    PubMed Central

    Lucier, G W; Schecter, A

    1998-01-01

    The National Institute of Environmental Health Sciences/National Toxicology Program (NIEHS/NTP) is developing a new interagency initiative in exposure assessment. This initiative involves the NIEHS, the Centers for Disease Control and Prevention through its National Center for Environmental Health, the National Institute for Occupational Safety and Health, the EPA, and other participating institutes and agencies of the NTP. This initiative will benefit public health and priority setting in a number of ways. First, as discussed above, it will strengthen the scientific foundation for risk assessments by the development of more credible exposure/response relationships in people by improving cross-species extrapolation, the development of biologically based dose-response models, and the identification of sensitive subpopulations and for "margin of exposure" based estimates of risk. Second, it will provide the kind of information necessary for deciding which chemicals should be studied with the limited resources available for toxicological testing. For example, there are 85,000 chemicals in commerce today, and the NTP can only provide toxicological evaluations on 10-20 per year. Third, we would use the information obtained from the exposure initiative to focus our research on mixtures that are actually present in people's bodies. Fourth, we would obtain information on the kinds and amount of chemicals in children and other potentially sensitive subpopulations. Determinations of whether additional safety factors need to be applied to children must rest, in part, upon comparative exposure analyses between children and adults. Fifth, this initiative, taken together with the environmental genome initiative, will provide the science base essential for meaningful studies on gene/environment interactions, particularly for strengthening the evaluation of epidemiology studies. Sixth, efficacy of public health policies aimed at reducing human exposure to chemical agents could be evaluated in a more meaningful way if body burden data were available over time, including remediation around Superfund sites and efforts to achieve environmental justice. The exposure assessment initiative is needed to address public health needs. It is feasible because of recent advances in analytical technology and molecular biology, and it is an example of how different agencies can work together to better fulfill their respective missions. Images Figure 1 Figure 2 PMID:9755136

  8. Canadian adolescent mothers’ perceptions of influences on breastfeeding decisions: a qualitative descriptive study

    PubMed Central

    2012-01-01

    Background There is increased recognition of the importance of breastfeeding at a national level as evidenced by the increased number of Canadian mothers initiating breastfeeding. However, adolescent mothers (<19 years), compared to all other mothers, have lower rates of breastfeeding initiation and duration. The purpose of this study was to examine the facilitating influences and barriers to initiating, and continuing breastfeeding, as perceived by adolescent mothers in Durham Region, Ontario, Canada. Methods The principles of interpretive description guided this qualitative study. A purposeful, homogenous sample of 16 adolescent mothers (15–19 years) were recruited to complete individual, semi-structured, face-to-face interviews. Conventional content analysis was used to code data, identify concepts and synthesize them into overall themes. Results Adolescent mothers in this study expressed that the decision to breastfeed was made prenatally and while partner and family member opinions about breastfeeding initiation were influential, the decision was made independently. Mothers were primarily motivated to initiate breastfeeding due to the health benefits for the infant. Lower breastfeeding duration rates were found among mothers who decided to only “try” breastfeeding when compared to the mothers who committed to breastfeeding. Influences on continued breastfeeding included: 1) the impact of breastfeeding on social and intimate relationships; 2) the availability of social support; 3) the physical demands of breastfeeding; 4) mothers’ knowledge of breastfeeding practices and benefits; and 5) mothers’ perceived sense of comfort in breastfeeding. Conclusions The results of this study provide health care providers new conceptual insight and understanding of the factors that influence adolescents’ decisions to “try” breastfeeding and to continue providing breastmilk to their infants. Professional implications drawn from this study include active engagement of adolescents in the pre and postnatal periods, including early assessment of potential barriers surrounding breastfeeding decisions. This early professional interaction highlights the professional as a form of support, and allows for sharing of evidence-informed breastfeeding information and practical breastfeeding skills. Inclusion of adolescents’ positive social support networks should be emphasized in professional breastfeeding support. Motivational interviewing is a promising prenatal strategy to influence behavior change and reduce ambivalence in decision-making about breastfeeding, creating opportunities for health care providers to tailor interventions. PMID:23234260

  9. Differentiating osteomyelitis from bone infarction in sickle cell disease.

    PubMed

    Wong, A L; Sakamoto, K M; Johnson, E E

    2001-02-01

    This brief review discusses one possible approach to evaluating the sickle cell patient with bone pain. The major differential diagnoses include osteomyelitis and bone infarction. Based on previous studies, we provide an approach to assessing and treating patients with the possible diagnosis of osteomyelitis. An algorithm has been provided, which emphasizes the importance of the initial history and physical examination. Specific radiographic studies are recommended to aid in making the initial assessment and to determine whether the patient has an infarct or osteomyelitis. Differentiating osteomyelitis from infarction in sickle cell patients remains a challenge for the pediatrician. This algorithm can be used as a guide for physicians who evaluate such patients in the acute care setting.

  10. Provider-Initiated Patient Satisfaction Reporting Yields Improved Physician Ratings Relative to Online Rating Websites.

    PubMed

    Ricciardi, Benjamin F; Waddell, Brad S; Nodzo, Scott R; Lange, Jeffrey; Nocon, Allina A; Amundsen, Spencer; Tarity, T David; McLawhorn, Alexander S

    2017-09-01

    Recently, providers have begun to publicly report the results of patient satisfaction surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party surveys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics. The authors identified 12 institutions that provided publicly available patient satisfaction outcomes derived from third-party surveys for their orthopedic surgeons as of August 2016. Orthopedic surgeons at these institutions were eligible for inclusion (N=340 surgeons). Provider characteristics were recorded from publicly available data. Four high-traffic commercial online physician rating websites were identified: Healthgrades.com, UCompareHealthCare.com, Vitals.com, and RateMDs.com. For each surgeon, overall ratings (on a scale of 1-5), total number of ratings, and percentage of negative ratings were compared between provider-initiated internal ratings and each commercial online website. Associations between baseline factors and overall physician ratings and negative ratings were assessed. Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satisfaction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites. A greater number of years in practice had a weak association with lower internal ratings, and an academic practice setting and a location in the Northeast were protective factors for negative physician ratings. Compared with commercial online physician rating websites, provider-initiated patient satisfaction ratings of orthopedic surgeons appear to be more favorable, with greater numbers of responses. [Orthopedics. 2017; 40(5):304-310.]. Copyright 2017, SLACK Incorporated.

  11. Massachusetts Expanded Learning Time (ELT) Initiative. Case Studies 2010-2011

    ERIC Educational Resources Information Center

    Caven, Meghan; Checkoway, Amy; Fisman, Lianne; Gamse, Beth; Fountain, Alyssa Rulf

    2012-01-01

    The Massachusetts Expanded Learning Time (ELT) initiative was launched in 2005, and it provides grants to selected schools across multiple districts to increase instructional time by at least 300 hours per academic year. Participating schools receive an additional $1,300 per student to lengthen the day and/or year. Schools are expected to use the…

  12. Brief Report: Testing the Impairment of Initiation Processes Hypothesis in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Carmo, Joana C.; Duarte, Elsa; Souza, Cristiane; Pinho, Sandra; Filipe, Carlos N.

    2017-01-01

    In the present study we aim at providing further evidences for the validity of an initiation processes impairment in autism spectrum disorder (ASD). We applied different verbal fluency tasks designed to decrease or enhance this limitation. A group of high-functioning individuals with ASD and a group of typically developed individuals matched for…

  13. Constructing Education for Sustainable Development: The Secondary School Geography Curriculum and Initial Teacher Training

    ERIC Educational Resources Information Center

    Firth, Roger; Winter, Christine

    2007-01-01

    If education is a solution in working toward a sustainable future then initial teacher training (ITT) provides a strategic opportunity for ensuring that all teachers are able to teach for sustainability when they begin their teaching careers. This paper reports on a study of how four Postgraduate Certificate of Education (PGCE) student teachers…

  14. Defying Borders: Transforming Learning Through Collaborative Feminist Organizing and Interdisciplinary, Transnational Pedagogy

    ERIC Educational Resources Information Center

    Carney, T.; Geertsema-Sligh, M.; Savage, A.; Sluis, A.

    2012-01-01

    The authors provide a case study of how a group of faculty members was able to initiate transformation in student learning and institutional structures at a small university in the Midwestern U.S. through the introduction of collaborative feminist organizing and pedagogy. It details faculty-led initiatives that set the stage for innovative…

  15. The Illinois Articulation Initiative Major Fields Panels' Recommendations for Business, Clinical Laboratory Science, Education--Early Childhood, Education--Elementary, Education--Secondary, Music, Nursing, Psychology.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    Developed by the Illinois Articulation Initiative (IAI), this report provides recommendations for improving articulation through state high schools, community colleges, and institutions of higher education. The recommendations are presented by field of study for business, clinical laboratory science, early childhood education, elementary…

  16. Finding Common Ground: Use of a Geographically-Framed Landscape Template as an Integrating Platform for an International Education Initiative

    ERIC Educational Resources Information Center

    Brierley, Gary; Li, Xilai; Qiao, Youming; Huang, He Qing; Wang, Zhaoyin

    2018-01-01

    This situated case study outlines how a place-based landscape template provided an integrative platform for the environmental arm of a cross-disciplinary international education initiative, the Three Brothers Project, wherein geographers at the University of Auckland worked alongside engineers at Tsinghua University in Beijing to support…

  17. Gaining Insights from a Case Study of High School Student Performance in Dual-Credit College Chemistry Courses

    ERIC Educational Resources Information Center

    White, Jacob; Hopkins, Robert; Shockley, Denise

    2014-01-01

    This report describes student performance in a state-level initiative that provided first-year college coursework in chemistry to high school students. Upon successful completion of the coursework, students received both high school and college credit. In this initiative, high school teachers team taught college-level chemistry courses in…

  18. Implementation as a Focus of Consultation to Evaluate Academic Tutoring Services in an Urban School District: A Case Study Example

    ERIC Educational Resources Information Center

    Morrison, Julie Q.; English, Sarah Baker

    2012-01-01

    This article describes a multiagency initiative to evaluate academic tutoring services by focusing on the processes that contribute to effective program implementation. Community-based tutoring service providers serving students in the Cincinnati Public Schools (OH) partnered to initiate a "Seal of Approval" process for promoting…

  19. Developing a Scale for Perceptions of Competency in Teaching Quality

    ERIC Educational Resources Information Center

    Tasci, Guntay; Atar, Burcu

    2016-01-01

    The purpose of this study was to develop a measurement instrument for determining pre-service teachers' perceptions of competency in providing quality teaching. The initial phase of the instrument was consisted of 54 items that were composed based on theory and literature. The initial form was applied to 232 pre-service teachers. An exploratory…

  20. Japan's long-term care policy for older people: the emergence of innovative "mobilisation" initiatives following the 2005 reforms.

    PubMed

    Hayashi, Mayumi

    2015-04-01

    Japan leads the global race for solutions to the increasing long-term care demand from an ageing population. Initial responses in 2000 saw the launch of the public Long-Term Care Insurance (LTCI) system which witnessed an unexpectedly substantial uptake - with doubts raised about financial viability and sustainability. The post-2005 LTCI reform led to the adoption of innovations - including the "mobilisation" of active, older volunteers to support their frailer peers. This strategy, within the wider government's "2025 Vision" to provide total care for the entire older population, sought to secure financial viability and sustainability. Drawing on qualitative in-depth interviews with 21 provider organisations this study will examine three "mobilisation" schemes and identify those factors contributing to overall strengths while acknowledging complexities, diversities and challenges the schemes encountered. Initial literature written by mobilisation proponents may have been overly optimistic: this study seeks to balance such views through providing an understanding and analysis of these mobilisation schemes' realities. The findings will provide insights and suggest more caution to policy-makers intending to promote such schemes - in both Japan and in countries considering doing so. Furthermore, more evaluation is required to obtain evidence to support financial feasibility and sustainability. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. A note on blowup of smooth solutions for relativistic Euler equations with infinite initial energy

    NASA Astrophysics Data System (ADS)

    Dong, Jianwei; Zhu, Junhui

    2018-04-01

    We study the singularity formation of smooth solutions of the relativistic Euler equations in (3+1)-dimensional spacetime for infinite initial energy. We prove that the smooth solution blows up in finite time provided that the radial component of the initial generalized momentum is sufficiently large without the conditions M(0)>0 and s2<1/3c2 , which were two key constraints stated in Pan and Smoller (Commun Math Phys 262:729-755, 2006).

  2. Financial preconditions for successful community initiatives for the uninsured.

    PubMed

    Song, Paula H; Smith, Dean G

    2007-01-01

    Community-based initiatives are increasingly being implemented as a strategy to address the health needs of the community, with a growing body of evidence on successes of various initiatives. This study addresses financial status indicators (preconditions) that might predict where community-based initiatives might have a better chance for success. We evaluated five community-based initiatives funded by the Communities in Charge (CIC) program sponsored by the Robert Wood Johnson Foundation. These initiatives focus on increasing access by easing financial barriers to care for the uninsured. At each site, we collected information on financial status indicators and interviewed key personnel from health services delivery and financing organizations. With full acknowledgment of the caveats associated with generalizations based on a small number of observations, we suggest four financial preconditions associated with successful initiation of CIC programs: (1) uncompensated care levels that negatively affect profitability, (2) reasonable financial stability of providers, (3) stable health insurance market, and (4) the potential to create new sources of funding. In general, sites that demonstrate successful program initiation are financially stressed enough by uncompensated care to gain the attention of local healthcare providers. However, they are not so strained and so concerned about revenue sources that they cannot afford to participate in the initiative. In addition to political and managerial indicators, we suggest that planning for community-based initiatives should include financial indicators of current health services delivery and financing organizations and consideration of whether they meet preconditions for success.

  3. Fasting plasma glucose as initial screening for diabetes and prediabetes in irish adults: The Diabetes Mellitus and Vascular health initiative (DMVhi).

    PubMed

    Sinnott, Margaret; Kinsley, Brendan T; Jackson, Abaigeal D; Walsh, Cathal; O'Grady, Tony; Nolan, John J; Gaffney, Peter; Boran, Gerard; Kelleher, Cecily; Carr, Bernadette

    2015-01-01

    Type 2 diabetes has a long pre clinical asymptomatic phase. Early detection may delay or arrest disease progression. The Diabetes Mellitus and Vascular health initiative (DMVhi) was initiated as a prospective longitudinal cohort study on the prevalence of undiagnosed Type 2 diabetes and prediabetes, diabetes risk and cardiovascular risk in a cohort of Irish adults aged 45-75 years. Members of the largest Irish private health insurance provider aged 45 to 75 years were invited to participate in the study. already diagnosed with diabetes or taking oral hypoglycaemic agents. Participants completed a detailed medical questionnaire, had weight, height, waist and hip circumference and blood pressure measured. Fasting blood samples were taken for fasting plasma glucose (FPG). Those with FPG in the impaired fasting glucose (IFG) range had a 75gm oral glucose tolerance test performed. 122,531 subjects were invited to participate. 29,144 (24%) completed the study. The prevalence of undiagnosed diabetes was 1.8%, of impaired fasting glucose (IFG) was 7.1% and of impaired glucose tolerance (IGT) was 2.9%. Dysglycaemia increased among those aged 45-54, 55-64 and 65-75 years in both males (10.6%, 18.5%, 21.7% respectively) and females (4.3%, 8.6%, 10.9% respectively). Undiagnosed T2D, IFG and IGT were all associated with gender, age, blood pressure, BMI, abdominal obesity, family history of diabetes and triglyceride levels. Using FPG as initial screening may underestimate the prevalence of T2D in the study population. This study is the largest screening study for diabetes and prediabetes in the Irish population. Follow up of this cohort will provide data on progression to diabetes and on cardiovascular outcomes.

  4. Rethinking sexual initiation: pathways to identity formation among gay and bisexual Mexican male youth.

    PubMed

    Carrillo, Héctor; Fontdevila, Jorge

    2011-12-01

    The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzes the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation--one heavily-based on gender roles, one based on homosociality, and one based on object choice--which inform the men's interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups.

  5. Mathematical Creativity, Cohen Forcing, and Evolving Systems: Elements for a Case Study on Paul Cohen

    ERIC Educational Resources Information Center

    Dickman, Benjamin

    2013-01-01

    The Evolving Systems approach to case studies due initially to Piaget-contemporary Howard Gruber, and complemented by subsequent work on sociocultural factors developed by Mihaly Csikszentmihalyi and others, provides an inroad for examining creative achievements in a variety of domains. This paper provides a proof of concept for how one might…

  6. The Effects of Head Start Health Services: Report of the Head Start Health Evaluation. Volume I and II.

    ERIC Educational Resources Information Center

    Fosburg, Linda B.; And Others

    In 1977, a longitudinal study was initiated to assess the effectiveness of health services provided by Head Start. The study provided for 10 domains: pediatric health examinations, health history recordings, dental evaluation, anthropometric assessment, diet and nutrition assessment, and hematology evaluations, as well as for developmental,…

  7. Correlates of human papillomavirus vaccination rates in low-income, minority adolescents: a multicenter study.

    PubMed

    Perkins, Rebecca B; Brogly, Susan B; Adams, William G; Freund, Karen M

    2012-08-01

    Low rates of human papillomavirus (HPV) vaccination in low-income, minority adolescents may exacerbate racial disparities in cervical cancer incidence. Using electronic medical record data and chart abstraction, we examined correlates of HPV vaccine series initiation and completion among 7702 low-income and minority adolescents aged 11-21 receiving primary care at one of seven medical centers between May 1, 2007, and June 30, 2009. Our population included 61% African Americans, 13% Caucasians, 15% Latinas, and 11% other races; 90% receive public insurance (e.g., Medicaid). We used logistic regression to estimate the associations between vaccine initiation and completion and age, race/ethnicity, number of contacts with the healthcare system, provider documentation, and clinical site of care. Of the 41% of adolescent girls who initiated HPV vaccination, 20% completed the series. A higher proportion of girls aged 11-<13 (46%) and 13-<18 (47%) initiated vaccination than those aged 18-21 (28%). In adjusted analyses, receipt of other recommended adolescent vaccines was associated with vaccine initiation, and increased contact with the medical system was associated with both initiation and completion of the series. Conversely, provider failure to document risky health behaviors predicted nonvaccination. Manual review of a subset of unvaccinated patients' charts revealed no documentation of vaccine discussions in 67% of cases. Fewer than half of low-income and minority adolescents receiving health maintenance services initiated HPV vaccination, and only 20% completed the series. Provider failure to discuss vaccination with their patients appears to be an important contributor to nonvaccination. Future research should focus on improving both initiation and completion of HPV vaccination in high-risk adolescents.

  8. Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation

    PubMed Central

    Laguna, Mariola; Purc, Ewelina

    2016-01-01

    The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans’ formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning. PMID:27909414

  9. Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation.

    PubMed

    Laguna, Mariola; Purc, Ewelina

    2016-01-01

    The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans' formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning.

  10. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  11. Initial Validation of the Mental Health Provider Stigma Inventory

    ERIC Educational Resources Information Center

    Kennedy, Stephanie C.; Abell, Neil; Mennicke, Annelise

    2017-01-01

    Objective: To conduct an initial validation of the mental health provider stigma inventory (MHPSI). The MHPSI assesses stigma within the service provider--client relationship on three domains--namely, attitudes, behaviors, and coworker influence. Methods: Initial validation of the MHPSI was conducted with a sample of 212 mental health employees…

  12. The implementation of an AR (augmented reality) approach to support mammographic interpretation training: an initial feasibility study

    NASA Astrophysics Data System (ADS)

    Tang, Qiang; Chen, Yan; Gale, Alastair G.

    2017-03-01

    Appropriate feedback plays an important role in optimising mammographic interpretation training whilst also ensuring good interpretation performance. The traditional keyboard, mouse and workstation technical approach has a critical limitation in providing supplementary image-related information and providing complex feedback in real time. Augmented Reality (AR) provides a possible superior approach in this situation, as feedback can be provided directly overlaying the displayed mammographic images so making a generic approach which can also be vendor neutral. In this study, radiological feedback was dynamically remapped virtually into the real world, using perspective transformation, in order to provide a richer user experience in mammographic interpretation training. This is an initial attempt of an AR approach to dynamically superimpose pre-defined feedback information of a DICOM image on top of a radiologist's view, whilst the radiologist is examining images on a clinical workstation. The study demonstrates the feasibility of the approach, although there are limitations on interactive operations which are due to the hardware used. The results of this fully functional approach provide appropriate feedback/image correspondence in a simulated mammographic interpretation environment. Thus, it is argued that employing AR is a feasible way to provide rich feedback in the delivery of mammographic interpretation training.

  13. Variations in thematic mapper spectra of soil related to tillage and crop residue management - Initial evaluation

    NASA Technical Reports Server (NTRS)

    Seeley, M. W.; Ruschy, D. L.; Linden, D. R.

    1983-01-01

    A cooperative research project was initiated in 1982 to study differences in thematic mapper spectral characteristics caused by variable tillage and crop residue practices. Initial evaluations of radiometric data suggest that spectral separability of variably tilled soils can be confounded by moisture and weathering effects. Separability of bare tilled soils from those with significant amounts of corn residue is enhanced by wet conditions, but still possible under dry conditions when recent tillage operations have occurred. In addition, thematic mapper data may provide an alternative method to study the radiant energy balance at the soil surface in conjunction with variable tillage systems.

  14. Exploring cultural differences in feedback processes and perceived instructiveness during clerkships: replicating a Dutch study in Indonesia.

    PubMed

    Suhoyo, Yoyo; van Hell, Elisabeth A; Prihatiningsih, Titi S; Kuks, Jan B M; Cohen-Schotanus, Janke

    2014-03-01

    Cultural differences between countries may entail differences in feedback processes. By replicating a Dutch study in Indonesia, we analysed whether differences in processes influenced the perceived instructiveness of feedback. Over a two-week period, Indonesian students (n = 215) recorded feedback moments during clerkships, noting who provided the feedback, whether the feedback was based on observations, who initiated the feedback, and its perceived instructiveness. Data were compared with the earlier Dutch study and analysed with χ(2) tests, t-tests and multilevel techniques. Cultural differences were explored using Hofstede's Model, with Indonesia and the Netherlands differing on "power distance" and "individualism." Perceived instructiveness of feedback did not differ significantly between both countries. However, significant differences were found in feedback provider, observation and initiative. Indonesian students perceived feedback as more instructive if provided by specialists and initiated jointly by the supervisor and student (βresidents = -0.201, p < 0.001 and βjoint = 0.193, p = 0.001). Dutch students appreciated feedback more when it was based on observation. We obtained empirical evidence that one model of feedback does not necessarily translate to another culture. Further research is necessary to unravel other possible influences of culture in implementing feedback procedures in different countries.

  15. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

    PubMed

    Gros, Daniel F

    2014-12-15

    Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. Published by Elsevier Ireland Ltd.

  16. The spectral properties of uranium hexafluoride and its thermal decomposition products

    NASA Technical Reports Server (NTRS)

    Krascella, N. L.

    1976-01-01

    This investigation was initiated to provide basic spectral data for gases of interest to the plasma core reactor concept. The attenuation of vacuum ultraviolet (VUV) radiation by helium at pressures up to 20 atm over path lengths of about 61 cm and in the approximate wavelength range between 80 and 300 nm was studied. Measurements were also conducted to provide basic VUV data with respect to UF6 and UF6/argon mixtures in the wavelength range between 80 and 120 nm. Finally, an investigation was initiated to provide basic spectral emission and absorption data for UF6 and possible thermal decomposition products of UF6 at elevated temperatures.

  17. Corporate Social Responsibility Initiatives Addressing Social Exclusion in Bangladesh

    PubMed Central

    2009-01-01

    The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships—collectively labelled corporate social responsibility (CSR) initiatives—may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation. PMID:19761088

  18. Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study.

    PubMed

    Smith, Alan D

    2011-01-01

    A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

  19. Sexual history taking and sexually transmitted infection screening in patients initiating erectile dysfunction medication therapy.

    PubMed

    Holman, Katherine M; Carr, James Andrew; Baddley, John W; Hook, Edward W

    2013-11-01

    Erectile dysfunction medications are being prescribed frequently; however, little is known about the amount of sexual health screening occurring in this setting. A retrospective cohort study evaluating sexual health and sexually transmitted infection screening occurring in veterans receiving initial erectile dysfunction medication prescription was conducted. A total of 252 patients received initial erectile dysfunction medication prescriptions between October 1, 2009, and December 31, 2009; had at least 1 health care provider visit 12 months before the date of initial prescription; and had no documentation of previous erectile dysfunction medication use. Approximately 3% of these patients had any aspect of a sexual history recorded in the 24 months surrounding initial erectile dysfunction medication prescription. Sexually transmitted infection screening was 9.9% for syphilis, 4.8% for HIV, and 4.3% for gonorrhea/chlamydia before prescription, with only a slight increase in HIV screening after prescription. Minimal sexual health assessment is being performed during the time surrounding initial prescription of erectile dysfunction medication. Further work needs to evaluate patient and provider barriers to basic elements of sexual health care, such as taking sexual histories or screening for sexually transmitted infections.

  20. Screening HIV-Infected Patients with Low CD4 Counts for Cryptococcal Antigenemia prior to Initiation of Antiretroviral Therapy: Cost Effectiveness of Alternative Screening Strategies in South Africa.

    PubMed

    Larson, Bruce A; Rockers, Peter C; Bonawitz, Rachael; Sriruttan, Charlotte; Glencross, Deborah K; Cassim, Naseem; Coetzee, Lindi M; Greene, Gregory S; Chiller, Tom M; Vallabhaneni, Snigdha; Long, Lawrence; van Rensburg, Craig; Govender, Nelesh P

    2016-01-01

    In 2015 South Africa established a national cryptococcal antigenemia (CrAg) screening policy targeted at HIV-infected patients with CD4+ T-lymphocyte (CD4) counts <100 cells/ μl who are not yet on antiretroviral treatment (ART). Two screening strategies are included in national guidelines: reflex screening, where a CrAg test is performed on remnant blood samples from CD4 testing; and provider-initiated screening, where providers order a CrAg test after a patient returns for CD4 test results. The objective of this study was to compare costs and effectiveness of these two screening strategies. We developed a decision analytic model to compare reflex and provider-initiated screening in terms of programmatic and health outcomes (number screened, number identified for preemptive treatment, lives saved, and discounted years of life saved) and screening and treatment costs (2015 USD). We estimated a base case with prevalence and other parameters based on data collected during CrAg screening pilot projects integrated into routine HIV care in Gauteng, Free State, and Western Cape Provinces. We conducted sensitivity analyses to explore how results change with underlying parameter assumptions. In the base case, for each 100,000 CD4 tests, the reflex strategy compared to the provider-initiated strategy has higher screening costs ($37,536 higher) but lower treatment costs ($55,165 lower), so overall costs of screening and treatment are $17,629 less with the reflex strategy. The reflex strategy saves more lives (30 lives, 647 additional years of life saved). Sensitivity analyses suggest that reflex screening dominates provider-initiated screening (lower total costs and more lives saved) or saves additional lives for small additional costs (< $125 per life year) across a wide range of conditions (CrAg prevalence, patient and provider behavior, patient survival without treatment, and effectiveness of preemptive fluconazole treatment). In countries with substantial numbers of people with untreated, advanced HIV disease such as South Africa, CrAg screening before initiation of ART has the potential to reduce cryptococcal meningitis and save lives. Reflex screening compared to provider-initiated screening saves more lives and is likely to be cost saving or have low additional costs per additional year of life saved.

  1. Screening HIV-Infected Patients with Low CD4 Counts for Cryptococcal Antigenemia prior to Initiation of Antiretroviral Therapy: Cost Effectiveness of Alternative Screening Strategies in South Africa

    PubMed Central

    Rockers, Peter C.; Bonawitz, Rachael; Sriruttan, Charlotte; Glencross, Deborah K.; Cassim, Naseem; Coetzee, Lindi M.; Greene, Gregory S.; Chiller, Tom M.; Vallabhaneni, Snigdha; Long, Lawrence; van Rensburg, Craig; Govender, Nelesh P.

    2016-01-01

    Background In 2015 South Africa established a national cryptococcal antigenemia (CrAg) screening policy targeted at HIV-infected patients with CD4+ T-lymphocyte (CD4) counts <100 cells/ μl who are not yet on antiretroviral treatment (ART). Two screening strategies are included in national guidelines: reflex screening, where a CrAg test is performed on remnant blood samples from CD4 testing; and provider-initiated screening, where providers order a CrAg test after a patient returns for CD4 test results. The objective of this study was to compare costs and effectiveness of these two screening strategies. Methods We developed a decision analytic model to compare reflex and provider-initiated screening in terms of programmatic and health outcomes (number screened, number identified for preemptive treatment, lives saved, and discounted years of life saved) and screening and treatment costs (2015 USD). We estimated a base case with prevalence and other parameters based on data collected during CrAg screening pilot projects integrated into routine HIV care in Gauteng, Free State, and Western Cape Provinces. We conducted sensitivity analyses to explore how results change with underlying parameter assumptions. Results In the base case, for each 100,000 CD4 tests, the reflex strategy compared to the provider-initiated strategy has higher screening costs ($37,536 higher) but lower treatment costs ($55,165 lower), so overall costs of screening and treatment are $17,629 less with the reflex strategy. The reflex strategy saves more lives (30 lives, 647 additional years of life saved). Sensitivity analyses suggest that reflex screening dominates provider-initiated screening (lower total costs and more lives saved) or saves additional lives for small additional costs (< $125 per life year) across a wide range of conditions (CrAg prevalence, patient and provider behavior, patient survival without treatment, and effectiveness of preemptive fluconazole treatment). Conclusions In countries with substantial numbers of people with untreated, advanced HIV disease such as South Africa, CrAg screening before initiation of ART has the potential to reduce cryptococcal meningitis and save lives. Reflex screening compared to provider-initiated screening saves more lives and is likely to be cost saving or have low additional costs per additional year of life saved. PMID:27390864

  2. Mapping of initiatives to increase membership in mutual health organizations in Benin

    PubMed Central

    2012-01-01

    Introduction Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. Methods A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. Results MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. Conclusions The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between MHO stakeholders would be useful to devise innovative strategies, avoid repeating unsuccessful ones, and develop a coordinated plan to promote MHOs. PMID:23217438

  3. Attitudes of healthcare providers towards non-initiation and withdrawal of neonatal resuscitation for preterm infants in Mongolia.

    PubMed

    McAdams, Ryan M; Erdenebileg, Ariuntsatsral; Batra, Maneesh; Gerelmaa, Zagd

    2012-09-01

    Antenatal parental counselling by healthcare providers is recommended to inform parents and assist with decision-making before the birth of a child with anticipated poor prognosis. In the setting of a low-income country, like Mongolia, attitudes of healthcare providers towards resuscitation of high-risk newborns are unknown. The purpose of this study was to examine the attitudes of healthcare providers regarding ethical decisions pertaining to non-initiation and withdrawal of neonatal resuscitation in Mongolia. A questionnaire on attitudes towards decision-making for non-initiation and withdrawal of neonatal resuscitation was administered to 113 healthcare providers attending neonatal resuscitation training courses in 2009 in Ulaanbaatar, the capital and the largest city of Mongolia where -40% of deliveries in the country occur. The questionnaire was developed in English and translated into Mongolian and included multiple choices and free-text responses. Participation was voluntary, and anonymity of the participants was strictly maintained. In total, 113 sets of questionnaire were completed by Mongolian healthcare providers, including neonatologists, paediatricians, neonatal and obstetrical nurses, and midwives, with 100% response rate. Ninety-six percent of respondents were women, with 73% of participants from Ulaanbaatar and 27% (all midwives) from the countryside. The majority (96%) of healthcare providers stated they attempt pre-delivery counselling to discuss potential poor outcomes when mothers present with preterm labour. However, most (90%) healthcare providers stated they feel uncomfortable discussing not initiating or withdrawing neonatal resuscitation for a baby born alive with little chance of survival. Religious beliefs and concerns about long-term pain for the baby were the most common reasons for not initiating neonatal resuscitation or withdrawing care for a baby born too premature or with congenital birth-defects. Most Mongolian healthcare providers provide antenatal counselling to parents regarding neonatal resuscitation. Additional research is needed to determine if the above-said difficulty with counselling stems from deficiencies in communication training and whether these same counselling-related issues exist in other countries. Future educational efforts in teaching neonatal resuscitation in Mongolia should incorporate culturally-sensitive training on antenatal counselling.

  4. Initial treatment seeking from professional health care providers for eating disorders: A review and synthesis of potential barriers to and facilitators of "first contact".

    PubMed

    Regan, Pamela; Cachelin, Fary M; Minnick, Alyssa M

    2017-03-01

    The objective of this study is to provide a comprehensive review of empirical research exploring barriers to and facilitators of initial treatment seeking ("first contact") from professional health care providers by adults and young adults with eating disorders (EDs). A search of databases PsycINFO and MEDLINE using the terms "treatment" and "eating disorder*" yielded 9,468 peer-reviewed articles published from January 1945 to June 2016. Screening identified 31 articles meeting the following criteria: (1) participants were 16 or older and presented with a self-reported or clinically diagnosed ED; (2) studies focused on (a) initial treatment seeking (b) for an ED (c) from professional health care providers; (3) articles were empirical, and (4) peer reviewed. Quantitative studies revealed few consistent correlates of treatment seeking, perhaps because most variables were examined in only one or two investigations. Variables with some degree of predictive utility (i.e., produced significant results in multiple studies) were age (older), ethnicity (nonethnic minority), ED type (anorexia, purging BN), specific ED-related behaviors (i.e., purging), and time spent on a treatment waitlist following referral (less). Although BMI was one of the most investigated variables, it did not predict treatment seeking. Qualitative studies revealed the following perceived barriers: (1) personal feelings of shame/fear, (2) ED-related beliefs/perceptions, (3) lack of access/availability, and (4) aspects of the treatment process. Perceived facilitators included (1) health-related concerns, (2) emotional distress, and (3) social support. Implications for clinical practice and areas for further research are discussed. Results highlight the need for shared definitions and methodologies across studies of treatment seeking. © 2017 Wiley Periodicals, Inc.

  5. Measuring verbal communication in initial physical therapy encounters.

    PubMed

    Roberts, Lisa C; Whittle, Christopher T; Cleland, Jennifer; Wald, Mike

    2013-04-01

    Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician. The purpose of this study was to measure verbal communication between physical therapists and patients with back pain during their initial consultation and trial management of the data using a novel, Web-based application. A cross-sectional study was conducted. Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio recorded, and categorized using the Medical Communications Behavior System. Data were managed using Synote, a freely available application enabling synchronization of audio recordings with transcripts and coded notes. In this sample, physical therapists spoke for 49.5% of the encounter and patients for 33.1%. Providers and patients spent little time overtly discussing emotions (1.4% and 0.9%, respectively). More-experienced clinicians used more "history/background probes," more "advice/suggestion," and less "restatement" than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients (7.6% compared with 2.6%). Although studies measuring actual behavior are considered to be the gold standard, audio recordings do not enable nonverbal behaviors to be recorded. This study investigated a method for measuring the verbal content of clinical encounters in a physical therapy outpatient setting. The study has directly contributed to developing a research-friendly version of the application (i.e., Synote Researcher). Given the pivotal role of communication in ensuring a positive experience and outcome for both patient and provider, investing time in further developing communication skills should be an on-going priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in sex and provider experience.

  6. Culturally competent library services and related factors among health sciences librarians: an exploratory study.

    PubMed

    Mi, Misa; Zhang, Yingting

    2017-04-01

    This study investigated the current state of health sciences libraries' provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites ( p =0.04). Those who spoke another language in addition to English had higher self-rated cultural competency ( p =0.01) than those who only spoke English. These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians' perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds.

  7. Culturally competent library services and related factors among health sciences librarians: an exploratory study

    PubMed Central

    Mi, Misa; Zhang, Yingting

    2017-01-01

    Objective This study investigated the current state of health sciences libraries’ provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. Methods This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Results Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites (p=0.04). Those who spoke another language in addition to English had higher self-rated cultural competency (p=0.01) than those who only spoke English. Conclusions These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians’ perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds. PMID:28377675

  8. Baseline genetic associations in the Parkinson's Progression Markers Initiative (PPMI).

    PubMed

    Nalls, Mike A; Keller, Margaux F; Hernandez, Dena G; Chen, Lan; Stone, David J; Singleton, Andrew B

    2016-01-01

    The Parkinson's Progression Marker Initiative is an international multicenter study whose main goal is investigating markers for Parkinson's disease (PD) progression as part of a path to a treatment for the disease. This manuscript describes the baseline genetic architecture of this study, providing not only a catalog of disease-linked variants and mutations, but also quantitative measures with which to adjust for population structure. Three hundred eighty-three newly diagnosed typical PD cases, 65 atypical PD and 178 healthy controls, from the Parkinson's Progression Marker Initiative study have been genotyped on the NeuroX or Immunochip arrays. These data are freely available to all researchers interested in pursuing PD research within the Parkinson's Progression Marker Initiative. The Parkinson's Progression Marker Initiative represents a study population with low genetic heterogeneity. We recapitulate known PD associations from large-scale genome-wide association studies and refine genetic risk score models for PD predictability (area under the curve, ∼0.74). We show the presence of six LRRK2 p.G2019S and nine GBA p.N370S mutation carriers. The Parkinson's Progression Marker Initiative study and its genetic data are useful in studies of PD biomarkers. The genetic architecture described here will be useful in the analysis of myriad biological and clinical traits within this study. © 2015 International Parkinson and Movement Disorder Society.

  9. Federal Highway Administration 100-year coating study.

    DOT National Transportation Integrated Search

    2012-11-01

    The Federal Highway Administration 100-Year Coating Study was initiated in August 2009 to search for durable : coating systems at a reasonable cost. The objective of the study was to identify and evaluate coating materials that can : provide 100 year...

  10. Translocation of the neonicotinoid seed treatment clothianidin in maize

    PubMed Central

    Krupke, Christian H.

    2017-01-01

    Neonicotinoid seed treatments, typically clothianidin or thiamethoxam, are routinely applied to >80% of maize (corn) seed grown in North America where they are marketed as a targeted pesticide delivery system. Despite this widespread use, the amount of compound translocated into plant tissue from the initial seed treatment to provide protection has not been reported. Our two year field study compared concentrations of clothianidin seed treatments in maize to that of maize without neonicotinoid seed treatments and found neonicotinoids present in root tissues up to 34 days post planting. Plant-bound clothianidin concentrations followed an exponential decay pattern with initially high values followed by a rapid decrease within the first ~20 days post planting. A maximum of 1.34% of the initial seed treatment was successfully recovered from plant tissues in both study years and a maximum of 0.26% was recovered from root tissue. Our findings show neonicotinoid seed treatments may provide protection from some early season secondary maize pests. However, the proportion of the neonicotinoid seed treatment clothianidin translocated into plant tissues throughout the growing season is low overall and this observation may provide a mechanism to explain reports of inconsistent efficacy of this pest management approach and increasing detections of environmental neonicotinoids. PMID:28282441

  11. Space Biology Initiative. Trade Studies, volume 2

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The six studies which are the subjects of this report are entitled: Design Modularity and Commonality; Modification of Existing Hardware (COTS) vs. New Hardware Build Cost Analysis; Automation Cost vs. Crew Utilization; Hardware Miniaturization versus Cost; Space Station Freedom/Spacelab Modules Compatibility vs. Cost; and Prototype Utilization in the Development of Space Hardware. The product of these six studies was intended to provide a knowledge base and methodology that enables equipment produced for the Space Biology Initiative program to meet specific design and functional requirements in the most efficient and cost effective form consistent with overall mission integration parameters. Each study promulgates rules of thumb, formulas, and matrices that serves as a handbook for the use and guidance of designers and engineers in design, development, and procurement of Space Biology Initiative (SBI) hardware and software.

  12. Space Biology Initiative. Trade Studies, volume 1

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The six studies which are addressed are entitled: Design Modularity and Commonality; Modification of Existing Hardware (COTS) vs. New Hardware Build Cost Analysis; Automation Cost vs. Crew Utilization; Hardware Miniaturization versus Cost; Space Station Freedom/Spacelab Modules Compatibility vs. Cost; and Prototype Utilization in the Development of Space Hardware. The product of these six studies was intended to provide a knowledge base and methodology that enables equipment produced for the Space Biology Initiative program to meet specific design and functional requirements in the most efficient and cost effective form consistent with overall mission integration parameters. Each study promulgates rules of thumb, formulas, and matrices that serves has a handbook for the use and guidance of designers and engineers in design, development, and procurement of Space Biology Initiative (SBI) hardware and software.

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

    KRASNITZ,A.; VENUGOPALAN,R.

    The dynamics of low-x partons in the transverse plane of a high-energy nuclear collision is classical, and therefore admits a fully non-perturbative numerical treatment. The authors report results of a recent study estimating the initial energy density in the central region of a collision. Preliminary estimates of the number of gluons per unit rapidity, and the initial transverse momentum distribution of gluons, are also provided.

  14. Students with Special Needs and 1:1 Computing: A Teacher's Perspective

    ERIC Educational Resources Information Center

    Corn, Jenifer; Tagsold, Jennifer T.; Argueta, Rodolfo

    2012-01-01

    To better understand the growing trend of 1:1 learning, researchers conducted an evaluation of a laptop initiative in 18 North Carolina high schools. The goal of the study was to provide information about the value of the initiative to enhance student learning, as well as to identify challenges to the successful implementation of 1:1 programs,…

  15. The Workplace Experiences of Beginning Teachers in Three Countries: A Message for Initial Teacher Education from the Field

    ERIC Educational Resources Information Center

    du Plessis, Anna Elizabeth; Sunde, Eva

    2017-01-01

    Previous research indicates that beginning teachers are not fully prepared for what awaits them in the workforce. This study highlights the value of partnerships among higher education providers, schools and employers and links the experiences of beginning teachers to initial teacher education (ITE). Real-life experiences from the field provide…

  16. An Initial Look at the Quality of Life of Malaysian Families That Include Children with Disabilities

    ERIC Educational Resources Information Center

    Clark, M.; Brown, R.; Karrapaya, R.

    2012-01-01

    Background: While there is a growing body of literature in the quality of life of families that include children with disabilities, the majority of research has been conducted in western countries. The present study provides an initial exploration of the quality of life of Malaysian families that include children with developmental/intellectual…

  17. Designing a Feasibility Study: A Starting Point for Considering New Management Initiatives for Working Parents.

    ERIC Educational Resources Information Center

    Friedman, Dana E.

    This brief paper was prepared as a starting point for employers considering the adoption of a new management initiative for working parents. It is not an exhaustive outline of all considerations in the decision-making process, nor does it provide solutions to all the known pitfalls. It does, however, suggest the potential scope and complexity of…

  18. "Distance Learning" or "Learning at a Distance"? Case Study of an Education Initiative to Deliver an In-Service Bachelors Degree in Zambia

    ERIC Educational Resources Information Center

    Smith, Christopher J.

    2010-01-01

    In 1998, as part of what was then Zambia's Department of Technical Education and Vocational Training's (DTEVT) human resources capacity building initiative, under the Ministry of Science, Technology and Vocational Training (MSTVT), donor funding was secured to provide degree-level training for key teachers and managers within the technical…

  19. Effectiveness of Video Self-Modeling to Promote Social Initiations by 3-Year-Olds with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Buggey, Tom

    2012-01-01

    Video Self-Modeling (VSM) provides individuals the opportunity to view themselves performing a task beyond their present functioning level through the careful editing of videos. In this study, a single-case multiple-baseline design was used to determine whether VSM would facilitate social initiations across three young children (M = 3 years 10…

  20. Teaching Our Own Babies: Teachers' Life Journeys into Community-Based Initial Education in Indigenous Oaxaca, Mexico

    ERIC Educational Resources Information Center

    Meyer, Lois M.

    2016-01-01

    In an era when U.S. and Mexican teachers are valued more for their academic achievements than their community-based knowledge and local/ethnic identity (e.g. Teach for America, or its off-shoot, Teach for Mexico), this study provides initial results of a one-year (2011-2012) intensive professional development experience (called a…

  1. Ensuring New Zealand's Future Prosperity: A Professional Learning Development Initiative to Bridge the Gap between Theory and Practice

    ERIC Educational Resources Information Center

    Kennedy, I.; Smith, P.; Sexton, S. S.

    2015-01-01

    This paper reports on a study investigating the effectiveness of a new professional learning development (PLD) initiative in New Zealand, The Sir Paul Callaghan Science Academy (The Academy). The Academy is designed to provide primary and intermediate (students aged 5 to 13) classroom teachers with the knowledge, materials and support needed for…

  2. The value of case reports in human teratology.

    PubMed

    Goldberg, J D; Golbus, M S

    1986-03-01

    Birth defects caused by human teratogens are an important and potentially preventable cause of perinatal morbidity and mortality. Case reports provide an initial suggestion that a specific agent may be a human teratogen and provide the basis for further study. This review discusses the importance of case reports in human teratology and provides guidance in evaluating new case reports.

  3. The power of the drug, nature of support, and their impact on homeless youth.

    PubMed

    Hudson, Angela L; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

    2009-10-01

    The purpose of this study was to explore homeless youths' perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 drug-using homeless youth. The results provided insight into the lives of drug-using homeless youth. The most commonly used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth.

  4. The Power of the Drug, Nature of Support, and their Impact on Homeless Youth

    PubMed Central

    Hudson, Angela L.; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

    2010-01-01

    The purpose of this study was to explore homeless youths’ perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 homeless drug-using youth. The results provided insight into the lives of drug-using homeless youth. Most commonly-used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth. PMID:20155605

  5. Key principles of community-based natural resource management: a synthesis and interpretation of identified effective approaches for managing the commons.

    PubMed

    Gruber, James S

    2010-01-01

    This article examines recent research on approaches to community-based environmental and natural resource management and reviews the commonalities and differences between these interdisciplinary and multistakeholder initiatives. To identify the most effective characteristics of Community-based natural resource management (CBNRM), I collected a multiplicity of perspectives from research teams and then grouped findings into a matrix of organizational principles and key characteristics. The matrix was initially vetted (or "field tested") by applying numerous case studies that were previously submitted to the World Bank International Workshop on CBNRM. These practitioner case studies were then compared and contrasted with the findings of the research teams. It is hoped that the developed matrix may be useful to researchers in further focusing research, understanding core characteristics of effective and sustainable CBNRM, providing practitioners with a framework for developing new CBNRM initiatives for managing the commons, and providing a potential resource for academic institutions during their evaluation of their practitioner-focused environmental management and leadership curriculum.

  6. Combat Wound Initiative program.

    PubMed

    Stojadinovic, Alexander; Elster, Eric; Potter, Benjamin K; Davis, Thomas A; Tadaki, Doug K; Brown, Trevor S; Ahlers, Stephen; Attinger, Christopher E; Andersen, Romney C; Burris, David; Centeno, Jose; Champion, Hunter; Crumbley, David R; Denobile, John; Duga, Michael; Dunne, James R; Eberhardt, John; Ennis, William J; Forsberg, Jonathan A; Hawksworth, Jason; Helling, Thomas S; Lazarus, Gerald S; Milner, Stephen M; Mullick, Florabel G; Owner, Christopher R; Pasquina, Paul F; Patel, Chirag R; Peoples, George E; Nissan, Aviram; Ring, Michael; Sandberg, Glenn D; Schaden, Wolfgang; Schultz, Gregory S; Scofield, Tom; Shawen, Scott B; Sheppard, Forest R; Stannard, James P; Weina, Peter J; Zenilman, Jonathan M

    2010-07-01

    The Combat Wound Initiative (CWI) program is a collaborative, multidisciplinary, and interservice public-private partnership that provides personalized, state-of-the-art, and complex wound care via targeted clinical and translational research. The CWI uses a bench-to-bedside approach to translational research, including the rapid development of a human extracorporeal shock wave therapy (ESWT) study in complex wounds after establishing the potential efficacy, biologic mechanisms, and safety of this treatment modality in a murine model. Additional clinical trials include the prospective use of clinical data, serum and wound biomarkers, and wound gene expression profiles to predict wound healing/failure and additional clinical patient outcomes following combat-related trauma. These clinical research data are analyzed using machine-based learning algorithms to develop predictive treatment models to guide clinical decision-making. Future CWI directions include additional clinical trials and study centers and the refinement and deployment of our genetically driven, personalized medicine initiative to provide patient-specific care across multiple medical disciplines, with an emphasis on combat casualty care.

  7. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

    USGS Publications Warehouse

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

    2016-01-01

    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  8. Doula care supports near-universal breastfeeding initiation among diverse, low-income women.

    PubMed

    Kozhimannil, Katy B; Attanasio, Laura B; Hardeman, Rachel R; O'Brien, Michelle

    2013-01-01

    Breastfeeding initiation rates in the United States have risen in recent years. However, there are notable disparities by socioeconomic status and race/ethnicity. Previous research has suggested that care from a doula (a trained professional who provides nonmedical support during the perinatal period) may increase breastfeeding initiation. The goal of this analysis was to study whether doula support may be associated with breastfeeding initiation among low-income, diverse women. We compared breastfeeding initiation rates (means and 95% confidence intervals) for 1069 women who received doula care from Everyday Miracles, a Minnesota-based organization that employs a diverse group of certified doulas, to a state-based sample of women with Medicaid coverage who gave birth in 2009 or 2010 and participated in the Minnesota Pregnancy Risk Assessment Monitoring System survey (weighted n = 51,721). Women who had doula-supported births had near-universal breastfeeding initiation (97.9%), compared with 80.8% of the general Medicaid population. Among African American women, 92.7% of those with doula support initiated breastfeeding, compared with 70.3% of the general Medicaid population. These results suggest that access to culturally appropriate doula care may facilitate higher rates of breastfeeding initiation. When supported in their nonmedical needs by birth doulas, the diverse, low-income patients of midwives and other maternity care providers may have a greater likelihood of initiating breastfeeding and experiencing the maternal and infant health benefits associated with breastfeeding. © 2013 by the American College of Nurse-Midwives.

  9. Interprofessional Care and Teamwork in the ICU.

    PubMed

    Donovan, Anne L; Aldrich, J Matthew; Gross, A Kendall; Barchas, Denise M; Thornton, Kevin C; Schell-Chaple, Hildy M; Gropper, Michael A; Lipshutz, Angela K M

    2018-06-01

    We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles. Original articles, review articles, and systematic reviews were considered. Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles. "Interprofessional care" refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils, end-of-life care, coordinated sedation awakening and spontaneous breathing trials, intrahospital transport, and transitions of care. A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.

  10. Evaluation and lessons learned from an undergraduate service learning course providing youth-focused relationship education.

    PubMed

    McElwain, Alyssa; Finnegan, Vanessa; Whittaker, Angela; Kerpelman, Jennifer; Adler-Baeder, Francesca; Duke, Adrienne

    2016-10-01

    Adolescent romantic relationships are known to have a significant impact on individual well-being and development. However, few teens experience formal education about the knowledge and skills necessary for building healthy romantic relationships. In response, a statewide relationship education initiative was developed at a large university in a Southeastern state. Undergraduates who enrolled in a service learning course in Human Development and Family Studies partnered with this initiative and implemented a relationship education program targeting high school students. A service learning model is used in this initiative because it offers opportunities for students' professional development and experiential learning. The present article provides a formative and illustrative summative evaluation of the service learning program. Specifically, the primary aims of this paper are to 1) provide an overview of the service learning course components; 2) describe preparation of the service learning students and their implementation of the relationship education program; 3) discuss challenges and lessons learned; and 4) offer initial evidence of effectiveness by showing change in targeted outcomes for the high school student recipients of the relationship education program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Integrated Flight Performance Analysis of a Launch Abort System Concept

    NASA Technical Reports Server (NTRS)

    Tartabini, Paul V.

    2007-01-01

    This paper describes initial flight performance analyses conducted early in the Orion Project to support concept feasibility studies for the Crew Exploration Vehicle s Launch Abort System (LAS). Key performance requirements that significantly affect abort capability are presented. These requirements have implications on sizing the Abort Motor, tailoring its thrust profile to meet escape requirements for both launch pad and high drag/high dynamic pressure ascent aborts. Additional performance considerations are provided for the Attitude Control Motor, a key element of the Orion LAS design that eliminates the need for ballast and provides performance robustness over a passive control approach. Finally, performance of the LAS jettison function is discussed, along with implications on Jettison Motor sizing and the timing of the jettison event during a nominal mission. These studies provide an initial understanding of LAS performance that will continue to evolve as the Orion design is matured.

  12. Mesoscale Simulation Data for Initializing Fast-Time Wake Transport and Decay Models

    NASA Technical Reports Server (NTRS)

    Ahmad, Nashat N.; Proctor, Fred H.; Vanvalkenburg, Randal L.; Pruis, Mathew J.; LimonDuparcmeur, Fanny M.

    2012-01-01

    The fast-time wake transport and decay models require vertical profiles of crosswinds, potential temperature and the eddy dissipation rate as initial conditions. These inputs are normally obtained from various field sensors. In case of data-denied scenarios or operational use, these initial conditions can be provided by mesoscale model simulations. In this study, the vertical profiles of potential temperature from a mesoscale model were used as initial conditions for the fast-time wake models. The mesoscale model simulations were compared against available observations and the wake model predictions were compared with the Lidar measurements from three wake vortex field experiments.

  13. Electrical initiation of an energetic nanolaminate film

    DOEpatents

    Tringe, Joseph W.; Gash, Alexander E.; Barbee, Jr., Troy W.

    2010-03-30

    A heating apparatus comprising an energetic nanolaminate film that produces heat when initiated, a power source that provides an electric current, and a control that initiates the energetic nanolaminate film by directing the electric current to the energetic nanolaminate film and joule heating the energetic nanolaminate film to an initiation temperature. Also a method of heating comprising providing an energetic nanolaminate film that produces heat when initiated, and initiating the energetic nanolaminate film by directing an electric current to the energetic nanolaminate film and joule heating the energetic nanolaminate film to an initiation temperature.

  14. Spatial pattern recognition of seismic events in South West Colombia

    NASA Astrophysics Data System (ADS)

    Benítez, Hernán D.; Flórez, Juan F.; Duque, Diana P.; Benavides, Alberto; Lucía Baquero, Olga; Quintero, Jiber

    2013-09-01

    Recognition of seismogenic zones in geographical regions supports seismic hazard studies. This recognition is usually based on visual, qualitative and subjective analysis of data. Spatial pattern recognition provides a well founded means to obtain relevant information from large amounts of data. The purpose of this work is to identify and classify spatial patterns in instrumental data of the South West Colombian seismic database. In this research, clustering tendency analysis validates whether seismic database possesses a clustering structure. A non-supervised fuzzy clustering algorithm creates groups of seismic events. Given the sensitivity of fuzzy clustering algorithms to centroid initial positions, we proposed a methodology to initialize centroids that generates stable partitions with respect to centroid initialization. As a result of this work, a public software tool provides the user with the routines developed for clustering methodology. The analysis of the seismogenic zones obtained reveals meaningful spatial patterns in South-West Colombia. The clustering analysis provides a quantitative location and dispersion of seismogenic zones that facilitates seismological interpretations of seismic activities in South West Colombia.

  15. Trust in the workplace: factors affecting trust formation between team members.

    PubMed

    Spector, Michele D; Jones, Gwen E

    2004-06-01

    The authors used survey data from 127 professional-level employees working in 8 industries to assess the effects of respondent's trusting stance and (a) the trustee's organization membership (internal or external), (b) the hierarchical relationship (supervisor or peer), and (c) the gender of the trustee, on initial trust level for a new project team member. The authors found that trusting stance was positively related to initial trust level. The authors also found an interaction effect between respondent gender and trustee gender on initial trust. Specifically, male initial trust level was higher for a new male team member and lower for a new female team member. The present study provided additional understanding of the formation of initial trust levels and its importance for team functioning.

  16. Exploding the Myths: Caregiving in America. A Study by the Subcommittee on Human Services of the Select Committee on Aging. House of Representatives, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    The purpose of this Congressional study is to underscore the continuing contribution of the family in providing care to the frail and disabled elderly. This study has been developed to distill information that currently exists, to provide new data based on national estimates and to highlight both public and private sector initiatives targeted at…

  17. A trauma outreach program provided by a level I trauma center is an effective way to initiate peer review at referring hospitals and foster process improvements.

    PubMed

    Byrnes, Matthew C; Irwin, Eric; Becker, Leslie; Thorson, Melissa; Beilman, Greg; Horst, Patrick; Croston, Kevin

    2010-04-01

    The initial care of critically injured patients has profound effects on ultimate outcomes. The "golden hour" of trauma care is often provided by rural hospitals before definitive transfer. There are, however, no standardized methods for providing educational feedback to these hospitals for the purposes of performance improvement. We hypothesized that an outreach program would stimulate peer review and identify systematic deficiencies in the care of patients with injuries. We developed a quality improvement program aimed at providing educational feedback to hospitals that referred patients to our American College of Surgeons-verified level I trauma center. We traveled to each referral center to provide feedback on the initial treatment and ultimate outcome of patients that were transferred to us. These feedback sessions were presented in the format of case presentations and case discussions. The outreach program was presented at each hospital every 3 months to 6 months. Nine hospitals were included in our program. We received 334 patients in transfer from these hospitals during the study period. Formal peer review that focused on trauma patients increased from 14% of hospitals to 100% of hospitals after institution of the program. Eighty-five percent of hospitals thought that the care of patients with injuries was improved as a result of the program. Eighty-five percent of hospitals developed process improvement initiatives as a result of the program. A formal outreach program can stimulate peer review at rural hospitals, provide continuing education in the care of patients with injuries, and foster process improvements at referring hospitals.

  18. Near-atomic resolution visualization of human transcription promoter opening

    PubMed Central

    He, Yuan; Yan, Chunli; Fang, Jie; Inouye, Carla; Tjian, Robert; Ivanov, Ivaylo; Nogales, Eva

    2016-01-01

    In eukaryotic transcription initiation, a large multi-subunit pre-initiation complex (PIC) that assembles at the core promoter is required for the opening of the duplex DNA and identification of the start site for transcription by RNA polymerase II. Here we use cryo-electron microscropy (cryo-EM) to determine near-atomic resolution structures of the human PIC in a closed state (engaged with duplex DNA), an open state (engaged with a transcription bubble), and an initially transcribing complex (containing six base pairs of DNA–RNA hybrid). Our studies provide structures for previously uncharacterized components of the PIC, such as TFIIE and TFIIH, and segments of TFIIA, TFIIB and TFIIF. Comparison of the different structures reveals the sequential conformational changes that accompany the transition from each state to the next throughout the transcription initiation process. This analysis illustrates the key role of TFIIB in transcription bubble stabilization and provides strong structural support for a translocase activity of XPB. PMID:27193682

  19. Strand invasion structures in the inverted repeat of Candida albicans mitochondrial DNA reveal a role for homologous recombination in replication.

    PubMed

    Gerhold, Joachim M; Aun, Anu; Sedman, Tiina; Jõers, Priit; Sedman, Juhan

    2010-09-24

    Molecular recombination and transcription are proposed mechanisms to initiate mitochondrial DNA (mtDNA) replication in yeast. We conducted a comprehensive analysis of mtDNA from the yeast Candida albicans. Two-dimensional agarose gel electrophoresis of mtDNA intermediates reveals no bubble structures diagnostic of specific replication origins, but rather supports recombination-driven replication initiation of mtDNA in yeast. Specific species of Y structures together with DNA copy number analyses of a C. albicans mutant strain provide evidence that a region in a mainly noncoding inverted repeat is predominantly involved in replication initiation via homologous recombination. Our further findings show that the C. albicans mtDNA forms a complex branched network that does not contain detectable amounts of circular molecules. We provide topological evidence for recombination-driven mtDNA replication initiation and introduce C. albicans as a suitable model organism to study wild-type mtDNA maintenance in yeast. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Arms control and The President's Strategic Defense Initiative

    NASA Astrophysics Data System (ADS)

    Bon, J. J.

    1985-04-01

    The President's Strategic Defense Initiative (SDI) provides the hope for eliminating the threat from ballistic missiles. This study evaluates the impact of SDI on existing and future arms control agreements. Because new or modified space-related treaties are a probable result of the SDI, this study concludes that the best single strategy for arms control negotiations is to preserve overall US interests and maintain open technological options vice severely limiting any space technology that might some day become part of a space-based defensive system.

  1. Patient-centered medical home implementation and primary care provider turnover.

    PubMed

    Sylling, Philip W; Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Batten, Adam J; Helfrich, Christian D; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

    2014-12-01

    The Veterans Health Administration (VHA) began implementing a patient-centered medical home (PCMH) model of care delivery in April 2010 through its Patient Aligned Care Team (PACT) initiative. PACT represents a substantial system reengineering of VHA primary care and its potential effect on primary care provider (PCP) turnover is an important but unexplored relationship. This study examined the association between a system-wide PCMH implementation and PCP turnover. This was a retrospective, longitudinal study of VHA-employed PCPs spanning 29 calendar quarters before PACT and eight quarters of PACT implementation. PCP employment periods were identified from administrative data and turnover was defined by an indicator on the last quarter of each uncensored period. An interrupted time series model was used to estimate the association between PACT and turnover, adjusting for secular trend and seasonality, provider and job characteristics, and local unemployment. We calculated average marginal effects (AME), which reflected the change in turnover probability associated with PACT implementation. The quarterly rate of PCP turnover was 3.06% before PACT and 3.38% after initiation of PACT. In adjusted analysis, PACT was associated with a modest increase in turnover (AME=4.0 additional PCPs per 1000 PCPs per quarter, P=0.004). Models with interaction terms suggested that the PACT-related change in turnover was increasing in provider age and experience. PACT was associated with a modest increase in PCP turnover, concentrated among older and more experienced providers, during initial implementation. Our findings suggest that policymakers should evaluate potential workforce effects when implementing PCMH.

  2. FRA/Volpe Center trespass prevention research study

    DOT National Transportation Integrated Search

    2011-11-08

    Presentation on the Trespass Prevention Research Study. The project was initiated in August 2009 with the goal of eliminating trespasser incidents and fatalities and to provide national guidance on trespass mitigation. The city of West Palm Beach Flo...

  3. An exploratory analysis of contraceptive method choice and symptoms of depression in adolescent females initiating prescription contraception.

    PubMed

    Francis, Jenny; Presser, Liandra; Malbon, Katherine; Braun-Courville, Debra; Linares, Lourdes Oriana

    2015-04-01

    We examine the association between depressive symptoms and contraceptive method choice among adolescents initiating prescription contraception. This cross-sectional study analyzes baseline data of 220 urban, minority adolescent females (ages 15-19 years) presenting for prescription contraceptive initiation at a comprehensive, free-of-cost, adolescent health center in New York City. All participants met with a health care provider who provided standard contraception counseling before initiating contraception. Each participant then selected a short- or long-acting contraceptive: a 3-month supply of the pill, patch, ring or a medroxyprogesterone acetate depot injection (short-acting), or placement/referral for an intrauterine device (IUD; long-acting). We assess the independent association between contraceptive method selection and symptoms of depression [assessed by the Center for Epidemiological Studies - Depression (CES-D) scale]. Ten percent (n=21/220) of adolescent females selected an IUD. Bivariate analysis revealed that those with elevated levels of depressive symptoms were more likely to select an IUD as compared to those with minimal symptoms (mean CES-D score 20 vs. 13; t=3.052, p=.003). In multivariate logistic regressions, adolescent females had increased odds of selecting an IUD if they reported moderate to severe depressive symptoms (adjusted odds ratio=4.93; confidence interval, 1.53-15.83; p=.007) after controlling for ethnicity/race, education, number of lifetime partners and gravidity. Inner-city, minority adolescents with elevated symptoms of depression who present for prescription contraceptive initiation may be more likely to select an IUD rather than shorter-acting methods. By recognizing adolescent females with depressive symptoms, providers can strategize their approach to effective contraception counseling. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Initial outcomes of provider-initiated routine HIV testing and counseling during outpatient care at a rural Ugandan hospital: risky sexual behavior, partner HIV testing, disclosure, and HIV care seeking.

    PubMed

    Kiene, Susan M; Bateganya, Moses; Wanyenze, Rhoda; Lule, Haruna; Nantaba, Harriet; Stein, Michael D

    2010-02-01

    Provider-initiated routine HIV testing is being scaled up throughout the world, however, little is known about the outcomes of routine HIV testing on subsequent behavior. This study examined the initial outcomes of provider-initiated routine HIV testing at a rural Ugandan hospital regarding partner HIV testing, sexual risk behavior, disclosure, and HIV care seeking. In a prospective cohort study, 245 outpatients receiving routine HIV testing completed baseline and 3-month follow-up interviews. After receiving routine HIV testing the percentage of participants engaging in risky sex decreased from 70.1% to 50.3% among HIV-negative and from 75.0% to 53.5% among HIV-positive participants, the percentage knowing their partner(s)' HIV status increased from 18.7% to 34.3% of HIV-negative and from 14.3% to 35.7% of HIV-positive participants. Among those reporting risky sex at baseline, HIV-positive participants were more likely to eliminate risky sex in general and specifically to become abstinent at follow-up than were HIV-negative participants. Similarly, unmarried participants who were risky at baseline were more likely to become safe in general, become abstinent, and start 100% condom use than were married/cohabitating participants. Rates of disclosure were high. Over 85% of those who tested HIV positive enrolled in care. Routine HIV testing in this setting may promote earlier HIV diagnosis and access to care but leads to only modest reductions in risky sexual behavior. To fully realize the potential HIV prevention benefits of routine HIV testing an emphasis on tailored risk-reduction counseling may be necessary.

  5. Lunar Transportation Facilities and Operations Study, option 1

    NASA Astrophysics Data System (ADS)

    1991-05-01

    Throughout the Option I period of the Lunar Transportation Facilities and Operations Study (LTFOS), McDonnell Douglas Space Systems Company - Kennedy Space Center (MDSSC-KSC) provided support to both the Planetary Surface Systems (PSS) Office at the National Aeronautics and Space Administration (NASA) at the Johnson Space Center and to the Flight and Ground Systems Projects Office (Payload Projects Management) at the Kennedy Space Center. The primary objective of the Option I phase of the study was to assist the above NASA centers in developing Space Exploration Initiative (SEI) concepts. MDSSC-KSC conducted three analyses which provided launch and landing detail to the proposed exploration concepts. One analysis, the Lunar Ejecta Assessment, was conducted to determine the effects of launch and landing a vehicle in a dusty environment. A second analysis, the Thermal/Micrometeoroid Protection Trade Study, was refined to determine the impacts that Reference Architecture Option 5A would have on thermal/micrometeoroid protection approaches. The third analysis, the Centaur Prelaunch Procedure Analysis, used a Centaur prelaunch test and checkout flow to identify key considerations that would be important if a Lunar Excursion Vehicle (LEV) was to use an expander cycle liquid oxygen-liquid hydrogen engine. Several 'quick look' assessments were also conducted. One quick look assessment, the Storable Propellant Quick Look Assessment, was conducted to identify design considerations that should be made if storable propellants were to be used instead of liquid oxygen and liquid hydrogen. The LEV Servicer Maintenance Analysis provided an early look at the effort required to maintain an LEV Servicer on the lunar surface. Also, support was provided to the PSS Logistics Manager to develop initial LEV Servicer cost inputs. Consideration was given to the advanced development that must be provided to accomplish a lunar and/or Mars mission. MDSS-KSC also provided support to both MASE and PSS by reviewing and commenting on architecture documents and concept definitions to ensure adequate considerations were given to the launch and landing function of an exploration initiative.

  6. Lunar Transportation Facilities and Operations Study, option 1

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Throughout the Option I period of the Lunar Transportation Facilities and Operations Study (LTFOS), McDonnell Douglas Space Systems Company - Kennedy Space Center (MDSSC-KSC) provided support to both the Planetary Surface Systems (PSS) Office at the National Aeronautics and Space Administration (NASA) at the Johnson Space Center and to the Flight and Ground Systems Projects Office (Payload Projects Management) at the Kennedy Space Center. The primary objective of the Option I phase of the study was to assist the above NASA centers in developing Space Exploration Initiative (SEI) concepts. MDSSC-KSC conducted three analyses which provided launch and landing detail to the proposed exploration concepts. One analysis, the Lunar Ejecta Assessment, was conducted to determine the effects of launch and landing a vehicle in a dusty environment. A second analysis, the Thermal/Micrometeoroid Protection Trade Study, was refined to determine the impacts that Reference Architecture Option 5A would have on thermal/micrometeoroid protection approaches. The third analysis, the Centaur Prelaunch Procedure Analysis, used a Centaur prelaunch test and checkout flow to identify key considerations that would be important if a Lunar Excursion Vehicle (LEV) was to use an expander cycle liquid oxygen-liquid hydrogen engine. Several 'quick look' assessments were also conducted. One quick look assessment, the Storable Propellant Quick Look Assessment, was conducted to identify design considerations that should be made if storable propellants were to be used instead of liquid oxygen and liquid hydrogen. The LEV Servicer Maintenance Analysis provided an early look at the effort required to maintain an LEV Servicer on the lunar surface. Also, support was provided to the PSS Logistics Manager to develop initial LEV Servicer cost inputs. Consideration was given to the advanced development that must be provided to accomplish a lunar and/or Mars mission. MDSS-KSC also provided support to both MASE and PSS by reviewing and commenting on architecture documents and concept definitions to ensure adequate considerations were given to the launch and landing function of an exploration initiative.

  7. Linking Workplace Aggression to Employee Well-Being and Work: The Moderating Role of Family-Supportive Supervisor Behaviors (FSSB).

    PubMed

    Yragui, Nanette L; Demsky, Caitlin A; Hammer, Leslie B; Van Dyck, Sarah; Neradilek, Moni B

    2017-04-01

    The present study examined the moderating effects of family-supportive supervisor behaviors (FSSB) on the relationship between two types of workplace aggression (i.e., patient-initiated physical aggression and coworker-initiated psychological aggression) and employee well-being and work outcomes. Data were obtained from a field sample of 417 healthcare workers in two psychiatric hospitals. Hypotheses were tested using moderated multiple regression analyses. Psychiatric care providers' perceptions of FSSB moderated the relationship between patient-initiated physical aggression and physical symptoms, exhaustion and cynicism. In addition, FSSB moderated the relationship between coworker-initiated psychological aggression and physical symptoms and turnover intentions. Based on our findings, family-supportive supervision is a plausible boundary condition for the relationship between workplace aggression and well-being and work outcomes. This study suggests that, in addition to directly addressing aggression prevention and reduction, family-supportive supervision is a trainable resource that healthcare organizations should facilitate to improve employee work and well-being in settings with high workplace aggression. This is the first study to examine the role of FSSB in influencing the relationship between two forms of workplace aggression: patient-initiated physical and coworker- initiated psychological aggression and employee outcomes.

  8. Phytoextraction of initial cutting of Salix matsudana for Cd and Cu.

    PubMed

    Wang, Wen-Wen; Cheng, Liu Ke; Hao, Jie Wei; Guan, Xin; Tian, Xing-Jun

    2016-06-27

    Salix species are widely used as vegetation filters because of their flourishing root system and fast growth rate. However, studies have yet to determine whether the root system functions in vegetable filters with mixed heavy metal (HM) pollution or whether initial cutting participates in the phytoextraction of HMs. This study aims to determine the function of the root system and initial cutting as vegetation filters in the absorption and accumulation of Cd and Cu. Thick (>1 cm in diameter) and fine (<1 cm in diameter) initial cuttings of Salix matsudana were planted in a nutrient solution with single and mixed (Cd + Cu) treatments. The roots of several initial cuttings were removed daily to eradicate rhizofiltration. Results revealed that the existence of the root system altered distribution and interaction of Cd and Cu in plant organs and enhanced tolerance and phytoextraction capacity of plants. The initial cuttings could also absorb and accumulate HMs in the early growth stages of willow without roots. Cu inhibited the plant absorption and accumulation of Cd and promoted Cd transport to shoots. Cd inhibited the Cu absorption of the root system. Our study provided essential data regarding woody species as vegetation filters of HM pollution.

  9. Comparative Initial and Sustained Engagement in Web-based Training by Behavioral Healthcare Providers in New York State.

    PubMed

    Talley, Rachel; Chiang, I-Chin; Covell, Nancy H; Dixon, Lisa

    2018-06-01

    Improved dissemination is critical to implementation of evidence-based practice in community behavioral healthcare settings. Web-based training modalities are a promising strategy for dissemination of evidence-based practice in community behavioral health settings. Initial and sustained engagement of these modalities in large, multidisciplinary community provider samples is not well understood. This study evaluates comparative engagement and user preferences by provider type in a web-based training platform in a large, multidisciplinary community sample of behavioral health staff in New York State. Workforce make-up among platform registrants was compared to the general NYS behavioral health workforce. Training completion by functional job type was compared to characterize user engagement and preferences. Frequently completed modules were classified by credit and requirement incentives. High initial training engagement across professional role was demonstrated, with significant differences in initial and sustained engagement by professional role. The most frequently completed modules across functional job types contained credit or requirement incentives. The analysis demonstrated that high engagement of a web-based training in a multidisciplinary provider audience can be achieved without tailoring content to specific professional roles. Overlap between frequently completed modules and incentives suggests a role for incentives in promoting engagement of web-based training. These findings further the understanding of strategies to promote large-scale dissemination of evidence-based practice in community behavioral health settings.

  10. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

    PubMed

    Gotovac, Sandra; Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-04-01

    The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.

  11. Rethinking Sexual Initiation: Pathways to Identity Formation among Gay and Bisexual Mexican Male Youth

    PubMed Central

    Carrillo, Héctor; Fontdevila, Jorge

    2010-01-01

    The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzed the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation-- one heavily-based on gender roles, one based on homosociality, and one based on object choice-- which inform the men’s interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups. PMID:20838869

  12. Continuous Subcutaneous Insulin Infusion in Children: A Pilot Study Validating a Protocol to Avoid Hypoglycemia at Initiation.

    PubMed

    Manousaki, Despoina; Deladoëy, Johnny; Geoffroy, Louis; Olivier, Patricia

    2017-01-01

    The occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII) in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children. We assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM) before and after CSII initiation (±3 days). After CSII initiation, there was no difference in the rates of hypoglycemic events expressed as relative rates (RRs) per person-reading (RR = 0.85, p  = 0.52, 95% CI 0.52-1.39), as well as in the number of prolonged hypoglycemic events (>1 h) per day (RR = 1.12, p  = 0.56, 95% CI 0.75-1.68). We observed only a trend toward prolonged episodes of hyperglycemia after pump initiation (RR = 1.52, p  = 0.06, 95% CI 0.97-2.35). Our study is the first to assess, through CGM and in a prospective way, the impact of a CSII initiation protocol on glycemic values. Our protocol provides a safe model to avoid hypoglycemia at CSII initiation in children. www.ClinicalTrials.gov, identifier NCT01840358.

  13. Age at First Use and Later Substance Use Disorder: Shared Genetic and Environmental Pathways for Nicotine, Alcohol, and Cannabis

    PubMed Central

    Richmond-Rakerd, Leah S.; Slutske, Wendy S.; Lynskey, Michael T.; Agrawal, Arpana; Madden, Pamela A.F.; Bucholz, Kathleen K.; Heath, Andrew C.; Statham, Dixie J.; Martin, Nicholas G.

    2016-01-01

    Behavioral genetic studies have provided insights into why early substance use initiation is associated with increased risk for disorder. Few genetically-informative studies, however, have operationalized initiation as the timing of first use and simultaneously modeled the timing of initiation and problematic use of multiple substances. Such research can help capture the risk associated with early initiation and determine the extent to which genetic and environmental risk generalizes across substances. This study utilized a behavior genetic approach to examine the relation between the age of substance use initiation and symptoms of substance use disorder. Participants were 7,285 monozygotic and dizygotic twins (40% male, mean age at interview=30.6) from the Australian Twin Registry who reported on their ages of tobacco, alcohol, and cannabis initiation and symptoms of DSM-IV nicotine dependence, alcohol use disorder, and cannabis use disorder. Biometric modeling was conducted to (a) determine the structure of genetic and environmental influences on initiation and disorder and (b) examine their genetic and environmental overlap. The latent structure of initiation differed across men and women. The familial covariance between initiation and disorder was genetic among men and genetic and environmental among women, suggesting that the relation between first substance use and disorder is partly explained by a shared liability. After accounting for familial overlap, significant unique environmental correlations were observed, indicating that the age of initiation of multiple drugs may directly increase risk for substance-related problems. Results support the utility of conceptualizing initiation in terms of age and of adopting a multivariate approach. PMID:27537477

  14. Field Operations For The "Intelligent River" Observation System: A Basin-wide Water Quality Observation System In The Savannah River Basin And Platform Supporting Related Diverse Initiatives.

    NASA Astrophysics Data System (ADS)

    Sutton, A.; Koons, M.; O'Brien-Gayes, P.; Moorer, R.; Hallstrom, J.; Post, C.; Gayes, P. T.

    2017-12-01

    The Intelligent River (IR) initiative is an NSF sponsored study developing new data management technology for a range of basin-scale applications. The technology developed by Florida Atlantic and Clemson University established a network of real-time reporting water quality sondes; from the mountains to the estuary of the Savannah River basin. Coastal Carolina University led the field operations campaign. Ancillary studies, student projects and initiatives benefitted from the associated instrumentation, infrastructure and operational support of the IR program. This provided a vehicle for students to participate in fieldwork across the watershed and pursue individual interests. Student projects included: 1) a Multibeam sonar survey investigating channel morphology in the area of an IR sensor station and 2) field tests of developing techniques for acquiring and assimilating flood velocity data into model systems associated with a separate NSF Rapid award. The multibeam survey within the lower Savannah basin exhibited a range of complexity in bathymetry, bedforms and bottom habitat in the vicinity of one of the water quality stations. The complex morphology and bottom habitat reflect complex flow patterns, localized areas of depositional and erosive tendencies providing a valuable context for considering point-source water quality time series. Micro- Lagrangian drifters developed by ISENSE at Florida Atlantic University, a sled mounted ADCP, and particle tracking from imagery collected by a photogrammetric drone were tested and used to develop methodology for establishing velocity, direction and discharge levels to validate, initialize and assimilate data into advance models systems during future flood events. The prospect of expanding wide scale observing systems can serve as a platform to integrate small and large-scale cooperative studies across disciplines as well as basic and applied research interests. Such initiatives provide opportunities for embedded education and experience for students that add to the understanding of broad integrated complex systems.

  15. Initiation & completion rates of hepatitis A vaccination among US pediatric populations born between 2005 and 2009.

    PubMed

    Weiss, Thomas; Zhang, Dongmu; Borse, Nagesh N; Walter, Emmanuel B

    2015-11-27

    To estimate hepatitis A vaccine series initiation and completion rates, assess time to vaccination, identify missed opportunities for the hepatitis A vaccine series, and examine factors associated with hepatitis A vaccine series initiation and completion. We conducted a retrospective, observational study using three healthcare claims databases separately. The study population was comprised of children born between years 2005 and 2009 that were continuously enrolled for at least three and a half years from the date of birth. Every child was followed from date of birth for three and a half years for hepatitis A vaccination. There were 93,735 eligible children from Clinformatics Data Mart, 202,513 from MarketScan Commercial, and 207,545 from MarketScan Medicaid. The overall hepatitis A vaccine series initiation rate was 63.8-79.4% and completion rate was 45.1-66.8% across the three databases. About 62.8-90.1% of the children who never initiated hepatitis A vaccine had at least one well visit from 1 year to three and a half years old. Children were more likely to initiate and complete the hepatitis A vaccine series if they were from more recent birth cohorts, from states with a hepatitis A vaccination recommendation prior to the ACIP universal recommendation, from states with daycare/school entry requirements, were enrolled in an HMO health plan, had pediatricians as primary providers, had more doctor's office/well visits and received MMR/Varicella vaccines. In this study, approximately one in every three to five children remained unvaccinated against hepatitis A. Although the hepatitis A vaccine series initiation and completion improved from 2005 to 2009, vaccine coverage has stabilized in recent years. It is important for providers to identify every opportunity for hepatitis A vaccination and to assure that children get protection from this vaccine-preventable disease. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Smoke and mirrors: how Massachusetts diverted millions in tobacco tax revenues.

    PubMed

    Ritch, Wendy A; Begay, Michael E

    2002-07-01

    This study examines the politics of appropriating Question 1 tobacco tax revenues in the first budget year after Massachusetts voters passed the ballot initiative in 1992. The initiative increased the tobacco tax on cigarettes by 25 cents per pack and on smokeless tobacco by 25% of the wholesale price. Data were collected from newspapers, letters, memoranda, budgets, press releases, legislative floor debates, government documents, legislative journals, personal interviews, and tobacco industry documents that were downloaded from the Tobacco Archives internet site. During the first budget year, programmes mentioned by the initiative that were not exclusively tobacco related accounted for 27% of total Question 1 expenditures, while 50% of the revenues were allocated for programmes that were neither mentioned by the initiative nor provided any tobacco education, prevention, and cessation services. Only 23% of Question 1 funds were appropriated for programmes that provided exclusively tobacco education, prevention, and cessation services. Question 1 revenues were also used to supplant funding for pre-existing programmes, which was explicitly prohibited by the initiative. The first budget year became the template for Question 1 appropriations in subsequent fiscal years. Politics did not end after voters passed Question 1. Public health advocates lacked a strategy and budget plan to influence the appropriation of Question 1 funds after the passage of this ballot initiative.

  17. Smoke and mirrors: how Massachusetts diverted millions in tobacco tax revenues.

    PubMed

    Ritch, W A; Begay, M E

    2001-12-01

    This study examines the politics of appropriating Question 1 tobacco tax revenues in the first budget year after Massachusetts voters passed the ballot initiative in 1992. The initiative increased the tobacco tax on cigarettes by 25 cents per pack and on smokeless tobacco by 25% of the wholesale price. Data were collected from newspapers, letters, memoranda, budgets, press releases, legislative floor debates, government documents, legislative journals, personal interviews, and tobacco industry documents that were downloaded from the Tobacco Archives internet site. During the first budget year, programmes mentioned by the initiative that were not exclusively tobacco related accounted for 27% of total Question 1 expenditures, while 50% of the revenues were allocated for programmes that were neither mentioned by the initiative nor provided any tobacco education, prevention, and cessation services. Only 23% of Question 1 funds were appropriated for programmes that provided exclusively tobacco education, prevention, and cessation services. Question 1 revenues were also used to supplant funding for pre-existing programmes, which was explicitly prohibited by the initiative. The first budget year became the template for Question 1 appropriations in subsequent fiscal years. Politics did not end after voters passed Question 1. Public health advocates lacked a strategy and budget plan to influence the appropriation of Question 1 funds after the passage of this ballot initiative.

  18. Assessing the Affective Features of Psychopathy in Adolescence: A Further Validation of the Inventory of Callous and Unemotional Traits

    ERIC Educational Resources Information Center

    Roose, Annelore; Bijttebier, Patricia; Decoene, Stefaan; Claes, Laurence; Frick, Paul J.

    2010-01-01

    To provide an extended assessment of the affective features of psychopathy, Frick developed the Inventory of Callous and Unemotional Traits (ICU), which is a multi-informant questionnaire. Previous studies have provided initial support for the self-report version. The aim of the present study is to investigate the validity of self- as well as…

  19. HISTORY OF GERM CELL MUTAGENESIS

    EPA Science Inventory

    Much of the early work on germ cell mutation analysis was conducted with nonmammalian species, but this historical overview will begin with the rodent studies that provided quantitative data on induced mutations. The initial studies of mutation induction utilized the newly develo...

  20. Phase A design study of microgravity fluoride fiber puller

    NASA Technical Reports Server (NTRS)

    Workman, Gary L.; Smith, Guy A.; Kosten, Susan

    1994-01-01

    Improved transmission properties for fluoride fibers due to space processing has great potential for commercial benefits. Phase A design study will determine conceptual feasibility and provide initial definition of the technical requirements and design issues for space.

  1. The effect of distance to provider on employee response to changes in mental health benefits.

    PubMed

    Lindrooth, Richard C; Lo Sasso, Anthony T; Lurie, Ithai Z

    2006-10-01

    We assess whether distance to provider moderates the effect of a change in mental health benefits on treatment initiation of employees of a large US-based company for psychiatric disorders. Mental health treatment administrative claims data plus eligibility information provided by a Fortune 50 company for the years 1995-1998 are used for the analysis. The effect of distance is measured using the relative effect of the initiative on residents living far from providers compared to those living close to providers. We model the probability of treatment initiation using a random effects logit specification. We find that the effect of distance to provider has the potential to over-shadow other incentives to initiate treatment, especially at distances greater than 4 miles. These results lend further support to the notion that geographic dispersion of providers should be an important consideration when forming a selective contracting network. Copyright (c) 2006 John Wiley & Sons, Ltd.

  2. The onset and evolution of fatigue-induced abnormal grain growth in nanocrystalline Ni–Fe

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

    Furnish, T. A.; Mehta, A.; Van Campen, D.

    Conventional structural metals suffer from fatigue-crack initiation through dislocation activity which forms persistent slip bands leading to notch-like extrusions and intrusions. Ultrafine-grained and nanocrystalline metals can potentially exhibit superior fatigue-crack initiation resistance by suppressing these cumulative dislocation activities. Prior studies on these metals have confirmed improved high-cycle fatigue performance. In the case of nano-grained metals, analyses of subsurface crack initiation sites have indicated that the crack nucleation is associated with abnormally large grains. But, these post-mortem analyses have led to only speculation about when abnormal grain growth occurs (e.g., during fatigue, after crack initiation, or during crack growth). In thismore » study, a recently developed synchrotron X-ray diffraction technique was used to detect the onset and progression of abnormal grain growth during stress-controlled fatigue loading. Our study provides the first direct evidence that the grain coarsening is cyclically induced and occurs well before final fatigue failure—our results indicate that the first half of the fatigue life was spent prior to the detectable onset of abnormal grain growth, while the second half was spent coarsening the nanocrystalline structure and cyclically deforming the abnormally large grains until crack initiation. Post-mortem fractography, coupled with cycle-dependent diffraction data, provides the first details regarding the kinetics of this abnormal grain growth process during high-cycle fatigue testing. Finally, precession electron diffraction images collected in a transmission electron microscope after the in situ fatigue experiment also confirm the X-ray evidence that the abnormally large grains contain substantial misorientation gradients and sub-grain boundaries.« less

  3. The onset and evolution of fatigue-induced abnormal grain growth in nanocrystalline Ni–Fe

    DOE PAGES

    Furnish, T. A.; Mehta, A.; Van Campen, D.; ...

    2016-10-11

    Conventional structural metals suffer from fatigue-crack initiation through dislocation activity which forms persistent slip bands leading to notch-like extrusions and intrusions. Ultrafine-grained and nanocrystalline metals can potentially exhibit superior fatigue-crack initiation resistance by suppressing these cumulative dislocation activities. Prior studies on these metals have confirmed improved high-cycle fatigue performance. In the case of nano-grained metals, analyses of subsurface crack initiation sites have indicated that the crack nucleation is associated with abnormally large grains. But, these post-mortem analyses have led to only speculation about when abnormal grain growth occurs (e.g., during fatigue, after crack initiation, or during crack growth). In thismore » study, a recently developed synchrotron X-ray diffraction technique was used to detect the onset and progression of abnormal grain growth during stress-controlled fatigue loading. Our study provides the first direct evidence that the grain coarsening is cyclically induced and occurs well before final fatigue failure—our results indicate that the first half of the fatigue life was spent prior to the detectable onset of abnormal grain growth, while the second half was spent coarsening the nanocrystalline structure and cyclically deforming the abnormally large grains until crack initiation. Post-mortem fractography, coupled with cycle-dependent diffraction data, provides the first details regarding the kinetics of this abnormal grain growth process during high-cycle fatigue testing. Finally, precession electron diffraction images collected in a transmission electron microscope after the in situ fatigue experiment also confirm the X-ray evidence that the abnormally large grains contain substantial misorientation gradients and sub-grain boundaries.« less

  4. The Childhood Obesity Declines Project: Implications for Research and Evaluation Approaches.

    PubMed

    Young-Hyman, Deborah; Morris, Kathryn; Kettel Khan, Laura; Dawkins-Lyn, Nicola; Dooyema, Carrie; Harris, Carole; Jernigan, Jan; Ottley, Phyllis; Kauh, Tina

    2018-03-01

    Childhood obesity remains prevalent and is increasing in some disadvantaged populations. Numerous research, policy and community initiatives are undertaken to impact this pandemic. Understudied are natural experiments. The need to learn from these efforts is paramount. Resulting evidence may not be readily available to inform future research, community initiatives, and policy development/implementation. We discuss the implications of using an adaptation of the Systematic Screening and Assessment (SSA) method to evaluate the Childhood Obesity Declines (COBD) project. The project examined successful initiatives, programs and policies in four diverse communities which were concurrent with significant declines in child obesity. In the context of other research designs and evaluation schemas, rationale for use of SSA is presented. Evidence generated by this method is highlighted and guidance suggested for evaluation of future studies of community-based childhood obesity prevention initiatives. Support for the role of stakeholder collaboratives, in particular the National Collaborative on Childhood Obesity Research, as a synergistic vehicle to accelerate research on childhood obesity is discussed. SSA mapped active processes and provided contextual understanding of multi-level/component simultaneous efforts to reduce rates of childhood obesity in community settings. Initiatives, programs and policies were not necessarily coordinated. And although direct attribution of intervention/initiative/policy components could not be made, the what, by who, how, to whom was temporally associated with statistically significant reductions in childhood obesity. SSA provides evidence for context and processes which are not often evaluated in other data analytic methods. SSA provides an additional tool to layer with other evaluation approaches.

  5. Please Ask Gently: Using Culturally Targeted Communication Strategies to Initiate End-of-Life Care Discussions With Older Chinese Americans.

    PubMed

    Chi, Han-Lin; Cataldo, Janine; Ho, Evelyn Y; Rehm, Roberta S

    2018-01-01

    Health-care providers (HCPs) find facilitating end-of-life (EOL) care discussions challenging, especially with patients whose ethnicities differ from their own. Currently, there is little guidance on how to initiate and facilitate such discussions with older Chinese Americans (≥55 years) and their families. To explore communication strategies for HCPs to initiate EOL care discussions with older Chinese Americans in the San Francisco Bay Area. This qualitative (focused) ethnographic study included field observations and individual semistructured interviews with 14 community-dwelling older Chinese Americans who lived independently at home, 9 adult children, and 7 HCPs. Responses were analyzed using open coding, memos, and comparison across participants. The study participants emphasized the importance of assessing readiness for early EOL care discussions. All recommended using indirect communication approaches to determine older Chinese Americans' readiness. Indirect communication can be culturally targeted and applied at both system-wide (ie, health-care system) and individual (ie, HCP) levels. To institutionalize the practice, health-care facilities should implement EOL care discussion inquiries as part of routine during check-in or intake questionnaires. In individual practice, using depersonalized communication strategies to initiate the discussion was recommended to determine older Chinese Americans' readiness. Assessing readiness should be an essential and necessary action for early EOL care discussions. Culturally targeted assessment of older Chinese Americans includes using indirect communication approaches to initiate an EOL care discussion to determine their readiness. In addition to health-care system integration, providers should implement and evaluate proposed EOL discussion initiation prompts with their older Chinese American patients.

  6. Increasing the health promotion practices of workplaces in Australia with a proactive telephone-based intervention.

    PubMed

    Daly, Justine; Licata, Milly; Gillham, Karen; Wiggers, John

    2005-01-01

    The aim of this study was to explore the potential effectiveness of a proactive telephone-based intervention in increasing workplace adoption of health promotion initiatives. A telephone-based direct marketing strategy was used to contact a sample of Australian workplaces to encourage the adoption of health promotion initiatives. Workplaces were offered free services and resources designed to facilitate adoption of health promotion initiatives. A total of 227 (71%) workplaces provided informed consent to participate in both baseline and 4-year follow-up surveys. Significant increases were evident for seven of the eight health promotion initiatives. The findings of this study suggest that a proactive telephone-based intervention has the potential to be effective in increasing the prevalence of health promotion initiatives across a range of health topics in a large population of workplaces. Given the capacity to reach an entire population of workplaces, this approach represents a promising means of achieving the established potential of workplace health promotion.

  7. Structural Basis of Mitochondrial Transcription Initiation.

    PubMed

    Hillen, Hauke S; Morozov, Yaroslav I; Sarfallah, Azadeh; Temiakov, Dmitry; Cramer, Patrick

    2017-11-16

    Transcription in human mitochondria is driven by a single-subunit, factor-dependent RNA polymerase (mtRNAP). Despite its critical role in both expression and replication of the mitochondrial genome, transcription initiation by mtRNAP remains poorly understood. Here, we report crystal structures of human mitochondrial transcription initiation complexes assembled on both light and heavy strand promoters. The structures reveal how transcription factors TFAM and TFB2M assist mtRNAP to achieve promoter-dependent initiation. TFAM tethers the N-terminal region of mtRNAP to recruit the polymerase to the promoter whereas TFB2M induces structural changes in mtRNAP to enable promoter opening and trapping of the DNA non-template strand. Structural comparisons demonstrate that the initiation mechanism in mitochondria is distinct from that in the well-studied nuclear, bacterial, or bacteriophage transcription systems but that similarities are found on the topological and conceptual level. These results provide a framework for studying the regulation of gene expression and DNA replication in mitochondria. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Evaluating a community-based program to improve healthcare quality: research design for the Aligning Forces for Quality initiative.

    PubMed

    Scanlon, Dennis P; Alexander, Jeffrey A; Beich, Jeff; Christianson, Jon B; Hasnain-Wynia, Romana; McHugh, Megan C; Mittler, Jessica N; Shi, Yunfeng; Bodenschatz, Laura J

    2012-09-01

    The Aligning Forces for Quality (AF4Q) initiative is the Robert Wood Johnson Foundation's (RWJF's) signature effort to increase the overall quality of healthcare in targeted communities throughout the country. In addition to sponsoring this 16-site, complex program, the RWJF funds an independent scientific evaluation to support objective research on the initiative's effectiveness and contributions to basic knowledge in 5 core programmatic areas. The research design, data, and challenges faced in the evaluation of this 10-year initiative are discussed. A descriptive overview of the evaluation research design for a multi-site, community based, healthcare quality improvement initiative is provided. The multiphase research design employed by the evaluation team is discussed. Evaluation provides formative feedback to the RWJF, participants, and other interested audiences in real time; develops approaches to assess innovative and under-studied interventions; furthers the analysis and understanding of effective community-based collaborative work in healthcare; and helps to differentiate the various facilitators, barriers, and contextual dimensions that affect the implementation and outcomes of community-based health interventions. The AF4Q initiative is arguably the largest community-level healthcare improvement demonstration in the United States to date; it is being implemented at a time of rapid change in national healthcare policy. The implementation of large-scale, multi-site initiatives is becoming an increasingly common approach for addressing problems in healthcare. The evaluation research design for the AF4Q initiative, and the lessons learned from its approach, may be valuable to others tasked with evaluating similar community-based initiatives.

  9. Initial Assessment of a Variable-Camber Continuous Trailing-Edge Flap System on a Rigid Wing for Drag Reduction in Subsonic Cruise

    NASA Technical Reports Server (NTRS)

    Ippolito, Corey; Nguyen, Nhan; Totah, Joe; Trinh, Khanh; Ting, Eric

    2013-01-01

    In this paper, we describe an initial optimization study of a Variable-Camber Continuous Trailing-Edge Flap (VCCTEF) system. The VCCTEF provides a light-weight control system for aircraft with long flexible wings, providing efficient high-lift capability for takeoff and landing, and greater efficiency with reduced drag at cruising flight by considering the effects of aeroelastic wing deformations in the control law. The VCCTEF system is comprised of a large number of distributed and individually-actuatable control surfaces that are constrained in movement relative to neighboring surfaces, and are non-trivially coupled through structural aeroelastic dynamics. Minimzation of drag results in a constrained, coupled, non-linear optimization over a high-dimension search space. In this paper, we describe the modeling, analysis, and optimization of the VCCTEF system control inputs for minimum drag in cruise. The purpose of this initial study is to quantify the expected benefits of the system concept. The scope of this analysis is limited to consideration of a rigid wing without structural flexibility in a steady-state cruise condition at various fuel weights. For analysis, we developed an optimization engine that couples geometric synthesis with vortex-lattice analysis to automate the optimization procedure. In this paper, we present and describe the VCCTEF system concept, optimization approach and tools, run-time performance, and results of the optimization at 20%, 50%, and 80% fuel load. This initial limited-scope study finds the VCCTEF system can potentially gain nearly 10% reduction in cruise drag, provides greater drag savings at lower operating weight, and efficiency is negatively impacted by the severity of relative constraints between control surfaces.

  10. White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study - teen.

    PubMed

    Warner, Echo L; Ding, Qian; Pappas, Lisa M; Henry, Kevin; Kepka, Deanna

    2017-12-01

    Human Papillomavirus (HPV) vaccination coverage is below national goals in the United States. Research is needed to inform strategically designed interventions that target sociodemographic groups with underutilization of HPV vaccination. Secondary data analysis of the National Immunization Survey-Teen 2013 measured association of sociodemographic factors (e.g., ethnicity/race, insurance) with HPV vaccination among females and males ages 13-17 (N = 18,959). Chi-square and multivariable Poisson regressions were conducted using survey-weighted statistics. Having a mother ≥35 years, a mother with some college, being of "Other" ethnicity/race, and having no providers who order vaccines from health departments was negatively associated with females initiating HPV vaccination. Having a mother with some college, being of Non-Hispanic White or "Other" ethnicity/race, and having some or no providers who order vaccines from health departments was negatively associated with males initiating HPV vaccination. These same factors were negatively associated with males completing HPV vaccination with the exception of "Other" ethnicity/race. In contrast, having an unmarried mother, being ages 15-17, having a hospital based provider, and receiving other adolescent vaccinations were positively associated with females initiating and completing HPV vaccination. Having an unmarried mother, health insurance that is not employer or union sponsored, and influenza and meningitis vaccinations was positively associated with male's initiating HPV vaccination. For males, being 15 or 17 years old and having other adolescent vaccinations was positively associated with vaccine completion. All findings p ≤ 0.05. Future HPV vaccination interventions may benefit from targeting certain sociodemographic groups that were negatively associated with HPV vaccination in this study.

  11. A case study: the initiative to improve RN scheduling at Hamilton Health Sciences.

    PubMed

    Wallace, Laurel-Anne; Pierson, Sharon

    2008-01-01

    In 2003, Hamilton Health Sciences embarked on an initiative to improve and standardize nursing schedules and scheduling practices. The scheduling project was one of several initiatives undertaken by a corporate-wide Nursing Resource Group established to enhance the work environment and patient care and to ensure appropriate utilization of nursing resources across the organization's five hospitals. This article focuses on major activities undertaken in the scheduling initiative. The step-by-step approach described, plus examples of the scheduling resources developed and samples of extended-tour schedules, will all provide insight, potential strategies and practical help for nursing administrators, human resources (HR) personnel and others interested in improving nurse scheduling.

  12. Second Chances: Investigating Athletes’ Experiences of Talent Transfer

    PubMed Central

    2015-01-01

    Talent transfer initiatives seek to transfer talented, mature individuals from one sport to another. Unfortunately talent transfer initiatives seem to lack an evidence-based direction and a rigorous exploration of the mechanisms underpinning the approach. The purpose of this exploratory study was to identify the factors which successfully transferring athletes cite as facilitative of talent transfer. In contrast to the anthropometric and performance variables that underpin current talent transfer initiatives, participants identified a range of psycho-behavioral and environmental factors as key to successful transfer. We argue that further research into the mechanisms of talent transfer is needed in order to provide a strong evidence base for the methodologies employed in these initiatives. PMID:26600303

  13. Second Chances: Investigating Athletes' Experiences of Talent Transfer.

    PubMed

    MacNamara, Áine; Collins, Dave

    2015-01-01

    Talent transfer initiatives seek to transfer talented, mature individuals from one sport to another. Unfortunately talent transfer initiatives seem to lack an evidence-based direction and a rigorous exploration of the mechanisms underpinning the approach. The purpose of this exploratory study was to identify the factors which successfully transferring athletes cite as facilitative of talent transfer. In contrast to the anthropometric and performance variables that underpin current talent transfer initiatives, participants identified a range of psycho-behavioral and environmental factors as key to successful transfer. We argue that further research into the mechanisms of talent transfer is needed in order to provide a strong evidence base for the methodologies employed in these initiatives.

  14. Ontogeny of the Maize Shoot Apical Meristem[W][OA

    PubMed Central

    Takacs, Elizabeth M.; Li, Jie; Du, Chuanlong; Ponnala, Lalit; Janick-Buckner, Diane; Yu, Jianming; Muehlbauer, Gary J.; Schnable, Patrick S.; Timmermans, Marja C.P.; Sun, Qi; Nettleton, Dan; Scanlon, Michael J.

    2012-01-01

    The maize (Zea mays) shoot apical meristem (SAM) arises early in embryogenesis and functions during stem cell maintenance and organogenesis to generate all the aboveground organs of the plant. Despite its integral role in maize shoot development, little is known about the molecular mechanisms of SAM initiation. Laser microdissection of apical domains from developing maize embryos and seedlings was combined with RNA sequencing for transcriptomic analyses of SAM ontogeny. Molecular markers of key events during maize embryogenesis are described, and comprehensive transcriptional data from six stages in maize shoot development are generated. Transcriptomic profiling before and after SAM initiation indicates that organogenesis precedes stem cell maintenance in maize; analyses of the first three lateral organs elaborated from maize embryos provides insight into their homology and to the identity of the single maize cotyledon. Compared with the newly initiated SAM, the mature SAM is enriched for transcripts that function in transcriptional regulation, hormonal signaling, and transport. Comparisons of shoot meristems initiating juvenile leaves, adult leaves, and husk leaves illustrate differences in phase-specific (juvenile versus adult) and meristem-specific (SAM versus lateral meristem) transcript accumulation during maize shoot development. This study provides insight into the molecular genetics of SAM initiation and function in maize. PMID:22911570

  15. Association of Frontline Worker-Provided Services with Change in Block-Level Complementary Feeding Indicators: An Ecological Analysis from Bihar, India

    PubMed Central

    Das, Aritra; Mahapatra, Sanchita; Sai Mala, Guntur; Chaudhuri, Indrajit; Mahapatra, Tanmay

    2016-01-01

    Background Insufficiencies in complementary feeding put infants and young children at increased risk of undernutrition. Till now, most Indian studies have looked at the individual level determinants of complementary feeding practices. We aimed to evaluate the association of frontline worker (FLW) provided nutritional counselling services, with change in community level indicators of complementary feeding practices among 9–11 month old children over time. Methods The study data was obtained from five rounds of ‘Lot Quality Assurance Sampling’ survey in eight districts of Bihar, an impoverished Indian state. The surveys were conducted as evaluation exercises for the ‘Integrated Family Health Initiative (IFHI)’–a multi-faceted program aimed at improving the maternal and child health outcomes in Bihar. The main outcome indicators were—current breastfeeding, age-appropriate minimum frequency of semi-solid food, age-appropriate minimum quantity of semi-solid food, initiation of complementary feeding at the right age, and dietary diversity. Repeated measures analysis was performed to determine the association of changes in the outcome indicators with coverage of FLW-provided counselling services. Results Visits by FLW, advices on age-appropriate frequency and handwashing were significant predictors of receiving age-appropriate frequency of feeding. The determinants of receiving age-appropriate quantity were—advices on age appropriate frequency and advices on handwashing. Receiving food support from AWC and FLW visits were significantly associated with initiating complementary feeding at the right age. Conclusions The present study identified the critical elements among the different types of FLW-provided services. The study findings, from an economically and socially underdeveloped region of India, would inform the relevant programs about the nutritional counselling services that need to be emphasized upon for reducing the burden of childhood malnutrition. PMID:27832211

  16. Who Is Influencing Whom? Latino Parent–Child Request Interactions and Product Purchases in Food Retail Environments

    PubMed Central

    Castro, Iana A.; Calderon, Joanna; Ayala, Guadalupe X.

    2017-01-01

    This study examines Latino parent–child interactions about foods and beverages requested in food retail environments in San Diego, CA. It seeks to extend our understanding of parent–child request interactions and purchases by studying how the number of product request interactions and purchases differ based on four factors that have been understudied in previous parent–child interaction research: parent gender, child gender, product healthfulness, and who initiated the request interaction (parent or child). By unobtrusively observing Latino parent–child dyads for the duration of a brief shopping trip, we found that parent and child gender are related to the number of request interactions initiated by parents and children. For gender-specific child-initiated request interactions, sons initiated more request interactions with fathers while daughters initiated more request interactions with mothers. Most request interactions were for products that were categorized as calorie dense, and a higher percentage of these products were purchased as a result of parent-initiated (vs. child-initiated) request interactions. The results provide important considerations for practitioners and researchers working on improving nutrition and reducing obesity. Assumptions about who is influencing whom in food store request interactions are challenged, requiring more research. PMID:29081718

  17. Physics perspectives of heavy-ion collisions at very high energy

    DOE PAGES

    Chang, Ning-bo; Cao, ShanShan; Chen, Bao-yi; ...

    2016-01-15

    We expect heavy-ion collisions at very high colliding energies to produce a quark-gluon plasma (QGP) at the highest temperature obtainable in a laboratory setting. Experimental studies of these reactions can provide an unprecedented range of information on properties of the QGP at high temperatures. We also report theoretical investigations of the physics perspectives of heavy-ion collisions at a future high-energy collider. These include initial parton production, collective expansion of the dense medium, jet quenching, heavy-quark transport, dissociation and regeneration of quarkonia, photon and dilepton production. Here, we illustrate the potential of future experimental studies of the initial particle production andmore » formation of QGP at the highest temperature to provide constraints on properties of strongly interaction matter.« less

  18. 76 FR 61365 - Bundled Payments for Care Improvement Initiative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ..., better health care, and reduced expenditures through continuous improvement for Medicare, Medicaid and... and patient experience when health care providers work in a coordinated and patient-centered manner... initiative. This initiative seeks proposals from health care providers who wish to align incentives between...

  19. Stromal cells can contribute oncogenic signals

    NASA Technical Reports Server (NTRS)

    Tlsty, T. D.

    2001-01-01

    The majority of studies of neoplastic transformation have focused attention on events that occur within transformed cells. These cell autonomous events result in the disruption of molecular pathways that regulate basic activities of the cells such as proliferation, death, movement and genomic integrity. Other studies have addressed the microenvironment of tumor cells and documented its importance in supporting tumor progression. Recent work has begun to expand on these initial studies of tumor microenvironment and now provide novel insights into the possible initiation and progression of malignant cells. This review will address the transforming effect of stromal cells on epithelial components. Copyright 2001 Academic Press.

  20. Development of a multimodal transportation educational virtual appliance (MTEVA) to study congestion during extreme tropical events.

    DOT National Transportation Integrated Search

    2011-11-28

    In this study, a prototype Multimodal Transportation Educational Virtual Appliance (MTEVA) is developed to assist in transportation and cyberinfrastructure undergraduate education. This initial version of the MTEVA provides a graphical user interface...

  1. Potentials of Mobile Technology for K-12 Education: An Investigation of iPod Touch Use for English Language Learners in the United States

    ERIC Educational Resources Information Center

    Liu, Min; Navarrete, Cesar C.; Wivagg, Jennifer

    2014-01-01

    This case study investigated a m-learning initiative by a large school district in the United States to provide iPod touch devices 24/7 to teachers and students of English Language Learners. We described the initiative and presented the research findings of its implementation for two years at elementary and middle school levels. The results…

  2. Sifting, sorting and saturating data in a grounded theory study of information use by practice nurses: a worked example.

    PubMed

    Hoare, Karen J; Mills, Jane; Francis, Karen

    2012-12-01

    The terminology used to analyse data in a grounded theory study can be confusing. Different grounded theorists use a variety of terms which all have similar meanings. In the following study, we use terms adopted by Charmaz including: initial, focused and axial coding. Initial codes are used to analyse data with an emphasis on identifying gerunds, a verb acting as a noun. If initial codes are relevant to the developing theory, they are grouped with similar codes into categories. Categories become saturated when there are no new codes identified in the data. Axial codes are used to link categories together into a grounded theory process. Memo writing accompanies this data sifting and sorting. The following article explains how one initial code became a category providing a worked example of the grounded theory method of constant comparative analysis. The interplay between coding and categorization is facilitated by the constant comparative method. © 2012 Wiley Publishing Asia Pty Ltd.

  3. Clinical Development of a Cytomegalovirus DNA Vaccine: From Product Concept to Pivotal Phase 3 Trial.

    PubMed

    Smith, Larry R; Wloch, Mary K; Chaplin, Jennifer A; Gerber, Michele; Rolland, Alain P

    2013-09-25

    2013 marks a milestone year for plasmid DNA vaccine development as a first-in-class cytomegalovirus (CMV) DNA vaccine enters pivotal phase 3 testing. This vaccine consists of two plasmids expressing CMV antigens glycoprotein B (gB) and phosphoprotein 65 (pp65) formulated with a CRL1005 poloxamer and benzalkonium chloride (BAK) delivery system designed to enhance plasmid expression. The vaccine's planned initial indication under investigation is for prevention of CMV reactivation in CMV-seropositive (CMV⁺) recipients of an allogeneic hematopoietic stem cell transplant (HCT). A randomized, double-blind placebo-controlled phase 2 proof-of-concept study provided initial evidence of the safety of this product in CMV⁺ HCT recipients who underwent immune ablation conditioning regimens. This study revealed a significant reduction in viral load endpoints and increased frequencies of pp65-specific interferon-γ-producing T cells in vaccine recipients compared to placebo recipients. The results of this endpoint-defining trial provided the basis for defining the primary and secondary endpoints of a global phase 3 trial in HCT recipients. A case study is presented here describing the development history of this vaccine from product concept to initiation of the phase 3 trial.

  4. Towards a comparable carbon footprint for local initiatives: The FP7 project TESS

    NASA Astrophysics Data System (ADS)

    Reusser, Dominik E.; Kropp, Jürgen P.

    2014-05-01

    TESS (Towards European Societal Sustainability -- www.tess-transition.eu) is a three-year, European-wide research project. It aims to reach an understanding of the potential for community-led initiatives to help deliver a truly sustainable, low-carbon future. Transitions to low-carbon societies take place at multiple and complementary scales. Transition processes are highly dependent on the innovative potential of community-based initiatives and their articulation with appropriate institutional architecture. Community-based initiatives are potentially more adaptable and less constrained by current structural circumstances than top-down policies and can give impetus to large-scale and technology driven changes. TESS will provide an understanding on the upscaling possibilities of such high-potential community-based initiatives by addressing two main questions: What is the impact of community-based initiatives in terms of carbon reduction potential and economic effect? What institutional structures (values, policies and mechanisms) support these initiatives in persisting beyond the initial phase and moving into an acceleration phase, spreading desired impacts? Answers will be provided through (1) a novel measuring, reporting and verification (MRV) framework for benchmarking community-based initiatives. This will enable quantifiable, comparable and standardised evaluation, and (2) the identification of success factors for the emergence, persistence and diffusion of promising initiatives, including online initiatives. We will identify these initiatives through case studies across regions and sectors and produce a systemic understanding of their impact on societal transitions towards sustainability. Our research will be integrated and transdisciplinary, with the unique opportunity to bring together social and natural scientists to foster a transition towards European societal sustainability. Our work will feed into and extend the Climate Adapt database to facilitate reconciliation of mitigation and adaptation and connect to Europe wide evaluation approaches such as the Common Monitoring and Evaluation Framework (CMEF) of the Rural Development Programmes. The poster will show the current state of the initiative selection process and of the method development.

  5. Value of Spaceborne Remotely Sensed Data Products in the Context of the Launch Phase of an On-Site Inspection

    NASA Astrophysics Data System (ADS)

    Labak, P.; Rowlands, A.; Malich, G.; Charlton, A.; Schultz-Fellenz, E. S.; Craven, J.

    2016-12-01

    The availability of data and the ability to effectively interpret those data in the context of an alleged Treaty violation are critical to operations during the launch phase of an inspection. The launch phase encompasses the time when the initial inspection plan is being developed and finalised; this document will set the scene for the inspection and will propose mission activities for the critical first three days of an inspection. While authenticated data products from the CTBT International Data Centre form the basis of the initial inspection plan, other data types, provided as national technical means, can also be used to inform the development of the initial inspection plan. In this context, remotely sensed data and derived products acquired from sensors on satellites feature prominently. Given the environmental setting, optical and/or radar sensors have the potential to provide valuable information to guide mission activities. Such data could provide more than mere backdrops to mapping products. While recognising time constraints and the difficulties associated with integrating data from disparate optical and radar sensors, this abstract uses case studies to illustrate the types of derived data products from sapecborne sensors that have the potential to inform inspectors during the preparation of the initial inspection plan.

  6. Deciphering DNA replication dynamics in eukaryotic cell populations in relation with their averaged chromatin conformations

    NASA Astrophysics Data System (ADS)

    Goldar, A.; Arneodo, A.; Audit, B.; Argoul, F.; Rappailles, A.; Guilbaud, G.; Petryk, N.; Kahli, M.; Hyrien, O.

    2016-03-01

    We propose a non-local model of DNA replication that takes into account the observed uncertainty on the position and time of replication initiation in eukaryote cell populations. By picturing replication initiation as a two-state system and considering all possible transition configurations, and by taking into account the chromatin’s fractal dimension, we derive an analytical expression for the rate of replication initiation. This model predicts with no free parameter the temporal profiles of initiation rate, replication fork density and fraction of replicated DNA, in quantitative agreement with corresponding experimental data from both S. cerevisiae and human cells and provides a quantitative estimate of initiation site redundancy. This study shows that, to a large extent, the program that regulates the dynamics of eukaryotic DNA replication is a collective phenomenon that emerges from the stochastic nature of replication origins initiation.

  7. Effects of Moist Convection on Hurricane Predictability

    NASA Technical Reports Server (NTRS)

    Zhang, Fuqing; Sippel, Jason A.

    2008-01-01

    This study exemplifies inherent uncertainties in deterministic prediction of hurricane formation and intensity. Such uncertainties could ultimately limit the predictability of hurricanes at all time scales. In particular, this study highlights the predictability limit due to the effects on moist convection of initial-condition errors with amplitudes far smaller than those of any observation or analysis system. Not only can small and arguably unobservable differences in the initial conditions result in different routes to tropical cyclogenesis, but they can also determine whether or not a tropical disturbance will significantly develop. The details of how the initial vortex is built can depend on chaotic interactions of mesoscale features, such as cold pools from moist convection, whose timing and placement may significantly vary with minute initial differences. Inherent uncertainties in hurricane forecasts illustrate the need for developing advanced ensemble prediction systems to provide event-dependent probabilistic forecasts and risk assessment.

  8. Therapist adherence to a motivational-interviewing intervention improves treatment entry for substance-misusing adolescents with low problem perception.

    PubMed

    Smith, Douglas C; Hall, James A; Jang, Mijin; Arndt, Stephan

    2009-01-01

    This study evaluated whether adherence to the Strengths-Oriented Referral for Teens (SORT) model, a motivational interviewing (MI)-consistent intervention addressing ambivalence about attending treatment, positively predicted adolescents' initial-session attendance. Therapist adherence was rated in 54 audiotaped SORT sessions by coders who were blind to treatment-entry status. Higher adherence scores reflected greater use of MI and solution focused language, discussion of client strengths, and dialogue with families on treatment need and options. Therapist adherence during adolescent segments interacted with adolescent problem perception. Predicted probabilities of attending initial sessions increased for low-problem-perception adolescents at increasingly higher therapist adherence. Although replication studies are needed, the SORT model of providing MI-consistent debriefing following initial assessments appears to be a promising approach for increasing treatment entry. Initial support for the treatment-matching hypothesis was found for substance-misusing adolescents contemplating treatment entry.

  9. How does low temperature coupled with different pressures affect initiation mechanisms and subsequent decompositions in nitramine explosive HMX?

    PubMed

    Wu, Qiong; Xiong, Guolin; Zhu, Weihua; Xiao, Heming

    2015-09-21

    We have performed ab initio molecular dynamics simulations to study coupling effects of temperature (534-873 K) and pressure (1-20 GPa) on the initiation mechanisms and subsequent chemical decompositions of nitramine explosive 1,3,5,7-tetranitro-1,3,5,7-tetrazocane (HMX). A new initiation decomposition mechanism of HMX was found to be the unimolecular C-H bond breaking, and this mechanism was independent of the coupling effects of different temperatures and pressures. The formed hydrogen radicals could promote subsequent decompositions of HMX. Subsequent decompositions were very sensitive to the pressure at low temperatures (534 and 608 K), while the temperature became the foremost factor that affected the decomposition at a high temperature (873 K) instead of the pressure. Our study may provide a new insight into understanding the coupling effects of the temperature and pressure on the initiation decomposition mechanisms of nitramine explosives.

  10. Comparison of the inertial properties and forces required to initiate movement for three gait trainers.

    PubMed

    Paleg, Ginny; Huang, Morris; Vasquez Gabela, Stephanie C; Sprigle, Stephen; Livingstone, Roslyn

    2016-01-01

    The purpose of this study was to evaluate the inertial properties and forces required to initiate movement on two different surfaces in a sample of three commonly prescribed gait trainers. Tests were conducted in a laboratory setting to compare the Prime Engineering KidWalk, Rifton Pacer, and Snug Seat Mustang with and without a weighted anthropometric test dummy configured to the weight and proportions of a 4-year-old child. The Pacer was the lightest and the KidWalk the heaviest while footprints of the three gait trainers were similar. Weight was borne fairly evenly on the four casters of the Pacer and Mustang while 85% of the weight was borne on the large wheels of the mid-wheel drive KidWalk. These differences in frame style, wheel, and caster style and overall mass impact inertial properties and forces required to initiate movement. Test results suggest that initiation forces on tile were equivalent for the Pacer and KidWalk while the Mustang had the highest initiation force. Initiation forces on carpet were lowest for the KidWalk and highest for the Mustang. This initial study of inertia and movement initiation forces may provide added information for clinicians to consider when selecting a gait trainer for their clients.

  11. Investigation of heat transfer in zirconium potassium perchlorate at low temperature: A study of the failure mechanism of the NASA standard initiator

    NASA Technical Reports Server (NTRS)

    Varghese, Philip L.

    1989-01-01

    The objective of this work was to study the reasons for the failure of pyrotechnic initiators at very low temperatures (10 to 100 K). A two-dimensional model of the NASA standard initiator was constructed to model heat transfer from the electrically heated stainless steel bridgewire to the zirconium potassium perchlorate explosive charge and the alumina charge cup. Temperature dependent properties were used in the model to simulate initiator performance over a wide range of initial temperatures (10 to 500 K). A search of the thermophysical property data base showed that pure alumina has a very high thermal conductivity at low temperatures. It had been assumed to act as a thermal insulator in all previous analyses. Rapid heat transfer from the bridgewire to the alumina at low initial temperatures was shown to cause failure of the initiators if the wire did not also make good contact with the zirconium potassium perchlorate charge. The mode is able to reproduce the results of the tests that had been conducted to investigate the cause for failure. It also provides an explanation for previously puzzling results and suggests simple design changes that will increase reliability at very low initial temperatures.

  12. The 5′ Untranslated Region of the Human T-Cell Lymphotropic Virus Type 1 mRNA Enables Cap-Independent Translation Initiation

    PubMed Central

    Olivares, Eduardo; Landry, Dori M.; Cáceres, C. Joaquín; Pino, Karla; Rossi, Federico; Navarrete, Camilo; Huidobro-Toro, Juan Pablo; Thompson, Sunnie R.

    2014-01-01

    ABSTRACT The human T-cell leukemia virus type 1 (HTLV-1) is a complex human retrovirus that causes adult T cell leukemia and of HTLV-associated myelopathy/tropical spastic paraparesis. The mRNA of some complex retroviruses, including the human and simian immunodeficiency viruses (HIV and SIV), can initiate translation using a canonical cap-dependent mechanism or through an internal ribosome entry site (IRES). In this study, we present strong evidence showing that like HIV-1 and SIV, the 5′-untranslated region (5′UTR) of the HTLV-1 full-length mRNA harbors an IRES. Cap-independent translational activity was evaluated and demonstrated using dual luciferase bicistronic mRNAs in rabbit reticulocyte lysate, in mammalian cell culture, and in Xenopus laevis oocytes. Characterization of the HTLV-1 IRES shows that its activity is dependent on the ribosomal protein S25 (RPS25) and that its function is highly sensitive to the drug edeine. Together, these findings suggest that the 5′UTR of the HTLV-1 full-length mRNA enables internal recruitment of the eukaryotic translation initiation complex. However, the recognition of the initiation codon requires ribosome scanning. These results suggest that, after internal recruitment by the HTLV-1 IRES, a scanning step takes place for the 40S ribosomal subunit to be positioned at the translation initiation codon. IMPORTANCE The mechanism by which retroviral mRNAs recruit the 40S ribosomal subunit internally is not understood. This study provides new insights into the mechanism of translation initiation used by the human T-cell lymphotropic virus type 1 (HTLV-1). The results show that the HTLV-1 mRNA can initiate translation via a noncanonical mechanism mediated by an internal ribosome entry site (IRES). This study also provides evidence showing the involvement of cellular proteins in HTLV-1 IRES-mediated translation initiation. Together, the data presented in this report significantly contribute to the understanding of HTLV-1 gene expression. PMID:24623421

  13. An analysis of e-business adoption by Indonesian manufacturing SMEs: A conceptual framework

    NASA Astrophysics Data System (ADS)

    Saptadi, Singgih; Pratama, Hanggar; Sudirman, Iman; Aisha, Atya Nur; Bernadhi, Brav Deva

    2017-11-01

    Many researches had shown IT contribution to business. Considering the contribution of SMEs to Indonesia economy, improving the competitiveness of SMEs is a concern in Indonesia development. Many studies had shown many IT projects failed to provide business performance. So, it is important to understand the pattern of e-business that provides business performances of a company. Using business process approach, we had studied SMEs' e-business initiatives in the form of "which business processes that had been supported with IT" by SMEs and business performances that SMEs gained from these e-business initiatives. But, we have not studied the intensity of implemented IT for SMEs' business processes. This paper presents a conceptual framework that relates the business performance and the intensity of e-business adoption. We also propose some antecedents that may relate to the intensity of e-business adoption.

  14. The prescription opioid epidemic: a review of qualitative studies on the progression from initial use to abuse

    PubMed Central

    Cicero, Theodore J.; Ellis, Matthew S.

    2017-01-01

    Most research designed to answer the “why” of the prescription opioid epidemic has relied on structured interviews, which rigidly attempt to capture the complex reasons people use opioids. In contrast this systematic literature review focuses on peer-reviewed studies that have used a qualitative approach to examine the development of an opioid-use disorder from the point of initial exposure. Rather than simply providing a “high,” opioids reportedly relieve psychological/emotional problems or provide an escape from life stressors. As use continues, avoidance of withdrawal sickness becomes an overriding concern, with all other benefits playing minor roles in persistent use. These studies indicate that terms used in structured interviews, such as “nontherapeutic use” or variations thereof, poorly capture the complex range of needs opioids satisfy. Both quantitative/structured studies and more qualitative ones, as well as more focused studies, have an important role in better informing prevention and treatment efforts. PMID:29302223

  15. The Role of Childcare Providers in the Prevention of Childhood Overweight

    ERIC Educational Resources Information Center

    Sellers, Kathleen; Russo, Theresa J.; Baker, Ida; Dennison, Barbara A.

    2005-01-01

    Childhood overweight has received increased national attention as a social and health problem. Childcare providers play an increasingly prominent role in the lives of young children and are therefore important in initiating change. This qualitative study determined the role of childcare professionals in the prevention of childhood overweight.…

  16. Vocational Education and Training Providers in Competitive Training Markets

    ERIC Educational Resources Information Center

    Ferrier, Fran; Dumbrell, Tom; Burke, Gerald

    2008-01-01

    This study explores the experiences and initiatives of vocational education and training (VET) providers in three areas: (1) Income sources and mixes; (2) "Thin markets" in VET; and (3) Research and development. Practices and policies are evolving in these three areas. The report contributes to a deeper understanding of the scope and…

  17. Institutional Assessment and the Intellectual Work of Teaching and Learning in First-Year Composition

    ERIC Educational Resources Information Center

    Donnelli-Sallee, Emily

    2013-01-01

    Institutional assessment initiatives can provide opportunities to make the intellectual work of teaching and learning in composition studies more visible. Reciprocally, the scholarship of teaching and learning's situatedness within disciplinary norms and values can enhance institutional assessments, providing a check on the tendency to rely…

  18. Institutionalized Children in Russia: Grouping the Regions by the Scale of the Phenomenon

    ERIC Educational Resources Information Center

    Kazakova, A. Yu.

    2018-01-01

    This study provides an initial classification of information on the social and geographic distribution of children's residential care institutions in Russia, and it characterizes the relationship between this information and the level of criminalization and victimization of minors. We provide data on the number of such residential care facilities…

  19. Naturally Occurring Opportunities for Preschool Children with or without Disabilities To Make Choices.

    ERIC Educational Resources Information Center

    Jolivette, Kristine; Stichter, Janine Peck; Sibilsky, Sara; Scott, Terrance M.; Ridgley, Robyn

    2002-01-01

    A study involving 14 preschool children (7 with disabilities) found that the children with disabilities were provided with more choices than the children without disabilities. Children both with and without disabilities, however, initiated choice making opportunities at the same rate. Female children were provided with more opportunities to make…

  20. Competencies for Food Graduate Careers: Developing a Language Tool

    ERIC Educational Resources Information Center

    Weston, Emma; Crilly, Jim; Mossop, Liz; Foster, Tim

    2017-01-01

    Unlike many other graduate career pathways in the UK, the food industry does not have a cohesive competency framework to support employers, students and degree providers. Food sciences-based technical graduates are a significant proportion of the industry's graduate intake; this study aims to provide such a framework. Initial work involving a…

  1. The Skills to Pay the Bills: An Evaluation of an Effort to Help Nonprofits Manage Their Finances

    ERIC Educational Resources Information Center

    Walker, Karen; Grossman, Jean; Andrews, Kristine; Carrington, Nicholas; Rojas, Angela

    2015-01-01

    This study examines a Wallace Foundation-sponsored initiative aimed at improving the financial management skills and practices of 25 Chicago afterschool providers through training and coaching. Two models for this professional development were provided and each produced long-lasting improvements. Moreover, organizations receiving the…

  2. A Computerized Task Inventory System for Providing Curriculum Content. [Carpentry]. Final Report.

    ERIC Educational Resources Information Center

    Hill, Clair S.

    The pilot study was designed to develop a system for analyzing and providing task inventories for carpentry curriculum development. An initial task inventory of 174 statements was constructed from available published sources, including only those tasks thought to be performed by incumbent workers in residential carpentry in Arizona. The tasks were…

  3. An Initial Study of the Sensitivity of Aircraft Vortex Spacing System (AVOSS) Spacing Sensitivity to Weather and Configuration Input Parameters

    NASA Technical Reports Server (NTRS)

    Riddick, Stephen E.; Hinton, David A.

    2000-01-01

    A study has been performed on a computer code modeling an aircraft wake vortex spacing system during final approach. This code represents an initial engineering model of a system to calculate reduced approach separation criteria needed to increase airport productivity. This report evaluates model sensitivity toward various weather conditions (crosswind, crosswind variance, turbulent kinetic energy, and thermal gradient), code configurations (approach corridor option, and wake demise definition), and post-processing techniques (rounding of provided spacing values, and controller time variance).

  4. Common Operating Picture: UAV Security Study

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This initial communication security study is a top-level assessment of basic security issues related to the operation of Unmanned Aerial Vehicles (UAVs) in the National Airspace System (NAS). Security considerations will include information relating to the use of International Civil Aviation Organization (ICAO) Aeronautical Telecommunications Network (ATN) protocols and applications identifying their maturity, as well as the use of IPV4 and a version of mobile IPV6. The purpose of this assessment is to provide an initial analysis of the security implications of introducing UAVs into the NAS.

  5. The human genome project: Prospects and implications for clinical medicine

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

    Green, E.D.; Waterston, R.H.

    1991-10-09

    The recently initiated human genome project is a large international effort to elucidate the genetic architecture of the genomes of man and several model organisms. The initial phases of this endeavor involve the establishment of rough blueprints (maps) of the genetic landscape of these genomes, with the long-term goal of determining their precise nucleotide sequences and identifying the genes. The knowledge gained by these studies will provide a vital tool for the study of many biologic processes and will have a profound impact on clinical medicine.

  6. Age at first use and later substance use disorder: Shared genetic and environmental pathways for nicotine, alcohol, and cannabis.

    PubMed

    Richmond-Rakerd, Leah S; Slutske, Wendy S; Lynskey, Michael T; Agrawal, Arpana; Madden, Pamela A F; Bucholz, Kathleen K; Heath, Andrew C; Statham, Dixie J; Martin, Nicholas G

    2016-10-01

    Behavioral genetic studies have provided insights into why early substance use initiation is associated with increased risk for disorder. Few genetically informative studies, however, have operationalized initiation as the timing of first use and simultaneously modeled the timing of initiation and problematic use of multiple substances. Such research can help capture the risk associated with early initiation and determine the extent to which genetic and environmental risk generalizes across substances. This study utilized a behavior genetic approach to examine the relation between the age of substance use initiation and symptoms of substance use disorder. Participants were 7,285 monozygotic and dizygotic twins (40% male, mean age at interview = 30.6 years) from the Australian Twin Registry who reported on their ages of tobacco, alcohol, and cannabis initiation and symptoms of Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) nicotine dependence, alcohol use disorder, and cannabis use disorder. Biometric modeling was conducted to (a) determine the structure of genetic and environmental influences on initiation and disorder and (b) examine their genetic and environmental overlap. The latent structure of initiation differed across men and women. The familial covariance between initiation and disorder was genetic among men and genetic and environmental among women, suggesting that the relation between first substance use and disorder is partly explained by a shared liability. After accounting for familial overlap, significant unique environmental correlations were observed, indicating that the age of initiation of multiple drugs may directly increase risk for substance-related problems. Results support the utility of conceptualizing initiation in terms of age and of adopting a multivariate approach. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Trials, tribulations, and triumphs of a pilot initiative to optimize the management of wounds complicated by diabetes within the home.

    PubMed

    Hodgins, Marilyn J; Logan, Susan M; Price, Karla; Thompson, Carol

    2014-01-01

    To support home health care nurses in their efforts to optimize the management of patients with wounds complicated by diabetes, an initiative was introduced that incorporated a standardized assessment tool, electronic data entry, and the provision of written treatment recommendations with supporting rationale prepared by nurses with expertise in diabetes and wound care. A pilot study was conducted that provided preliminary evidence of the feasibility of this initiative as well as its potential effect on outcomes for patients, nurses, and the home care program.

  8. EPA RE-Powering Mapper Feasibility Studies

    EPA Pesticide Factsheets

    The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. As part of the RE-Powering America's Land Initiative, the EPA and the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) evaluated the feasibility of developing renewable energy production on Superfund, brownfields, and former landfill or mining sites. These reports pair EPA's expertise on contaminated sites with the renewable energy expertise of NREL.

  9. Electronic propensity rules in Li-H+ collisions involving initial and/or final oriented states

    NASA Astrophysics Data System (ADS)

    Salas, P. J.

    2000-12-01

    Electronic excitation and capture processes are studied in collisions involving systems with only one active electron such as the alkaline (Li)-proton in the medium-energy region (0.1-15 keV). Using the semiclassical impact parameter method, the probabilities and the orientation parameter are calculated for transitions between initial and/or final oriented states. The results show a strong asymmetry in the probabilities depending on the orientation of the initial and/or final states. An intuitive view of the processes, by means of the concepts of propensity and velocity matching rules, is provided.

  10. Patient-Focused Drug Development: A New Direction for Collaboration.

    PubMed

    Perfetto, Eleanor M; Burke, Laurie; Oehrlein, Elisabeth M; Epstein, Robert S

    2015-01-01

    Patient-Focused Drug Development (PFDD) is a new initiative from the Food and Drug Administration (FDA) intended to bring patient perspectives into an earlier stage of product development. The goal is that patients will be able to provide context for benefit-risk assessments and input to review divisions, and also aid in the development of new assessment tools, study endpoints, and risk communications. This paper provides a summary on what is known to date about FDA's PFDD initiative and describes implications for patients, researchers, payers, and the biopharmaceutical industry. It also provides a roadmap for stakeholders to consider in defining their role in and in shaping PFDD's direction, and for expanding PFDD principles to conditions beyond the current 20 under FDA consideration. A search was conducted of the peer-reviewed and gray literature using PubMed and Google. This included laws, FDA guidance documents, the peer-reviewed literature, and FDA presentations for content relevant to the search term "patient-focused drug development." Currently, FDA activities within PFDD are limited to gaining patient insights through 20 disease-specific meetings. However, many stakeholders see the initiative much more generally as representing a broad shift toward patient centeredness in biopharmaceutical product development. Depending upon the trajectory taken and whether or not all PFDD aims are eventually addressed, the initiative has the potential to change product development in fundamental ways. Further research should explore how patient input on disease manifestation and treatment options is best ascertained from patients and documented before initiating and during drug development.

  11. FDA Consumer Nutrition Knowledge Survey. Report II, 1975. A Nationwide Study of Food Shopper's Knowledge, Beliefs, Attitudes and Reported Behavior Regarding Food and Nutrition. Factors Related to Nutrition Labeling.

    ERIC Educational Resources Information Center

    Abelson, Herbert; And Others

    During 1973, a nationwide study for the Food and Drug Administration (FDA) was conducted which provided information on nutrition knowledge, beliefs about nutrition, and first reactions to nutrition labeling among food shoppers. This initial research provided a baseline measurement of nutrition knowledge and attitudes among consumers, and in 1975…

  12. Bureau of Reclamation Hydropower Lease of Power Privilege: Case Studies and Considerations

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

    Curtis, Taylor L.; Levine, Aaron L.; McLaughlin, Kathleen

    This report analyzes the U.S. Bureau of Reclamation's (Reclamation) lease of power privilege (LOPP) regulatory process for a nonfederal entity to use a Reclamation jurisdictional dam or conduit for power generation. Recent federal initiatives encouraging hydropower development at federally-owned facilities coupled with Reclamation's hydroelectric potential has led to an increased interest in powering Reclamation dams and conduits through the LOPP process. During the last five years, 23 of the 36 total LOPP projects (76 MW) have been initiated and are at some phase of the development process. Resource assessments analyzed in this report identify over 360 MW of hydroelectric potentialmore » at Reclamation-owned dams and conduits. This report provides considerations from Reclamation staff involved in the LOPP regulatory process and developers that have received an LOPP and are currently generating hydropower at a Reclamation dam or conduit. The authors also analyze LOPP regulatory processing timelines before and after the implementation of federal initiatives to streamline the LOPP process and provide case studies of hydropower projects that have obtained an LOPP.« less

  13. Clinical manifestations of treatment-naive patients with acquired immunodeficiency syndrome and responses to highly active antiretroviral therapy in the Taipei Veterans General Hospital: a 5-year prospective study.

    PubMed

    Hsu, Shih-Fen; Yang, Su-Pen; Chan, Yu-Jiun; Wang, Yung-Wei

    2011-06-01

    Taipei Veterans General Hospital, one of the medical centers in Taiwan, has provided highly active antiretroviral therapy (HAART) to human immunodeficiency virus/AIDS patients for more than 10 years. Five years ago, we began a prospective follow-up of our patients' clinical manifestations and responses to HAART by collecting their clinical data. In this study, we analyzed the morbidity, mortality, and responses to HAART of treatment-naive AIDS patients. The purpose was to provide local data that may be valuable in Taiwan. Study cases were enrolled from January 1, 2004, to February 28, 2009, with inclusion criteria of newly diagnosed AIDS during hospitalization and being naive to HAART. Antiretroviral therapy was initiated. To evaluate the clinical responses to HAART, we excluded patients who were pregnant, died within 1 month after confirmation of an AIDS diagnosis, failed to initiate HAART, or were lost to follow-up for more than 6 months. Plasma viral loads and CD4(+) counts were quantified by reverse-transcriptase polymerase chain reaction and flow cytometry, respectively. Statistical analysis was performed using SPSS statistical software. A total of 49 patients were enrolled and 45 patients fulfilled the inclusion criteria for evaluating the efficacy of HAART. At 3 months, 12 months, and 30 months after the initiation of HAART, 64.4% (29 of 45), 88.2% (30 of 34), and 93.8% (15 of 16) had undetectable plasma viral loads, respectively, and 37.8% (17 of 45), 73.5% (25 of 34), and 81.2% (13 of 16) had CD4(+) counts of more than 200 cells/μL, respectively. Median CD4(+) counts increased from baseline at Month 3 by 171 cells/μL and at Month 30 by 375 cells/μL. The overall mortality was 22.4% (11 of 49). The virologic and immunologic responses after initiating HAART in this study demonstrated our achievements in providing care and treatment for AIDS patients during this 5-year period, which provides a strong evidence of the efficacy of HAART. Copyright © 2011. Published by Elsevier B.V.

  14. Investigating the 3-D Subduction Initiation Processes at Transform Faults and Passive Margins

    NASA Astrophysics Data System (ADS)

    Peng, H.; Leng, W.

    2017-12-01

    Studying the processes of subduction initiation is a key for understanding the Wilson cycle and improving the theory of plate tectonics. Previous studies investigated subduction initiation with geological synthesis and geodynamic modeling methods, discovering that subduction intends to initiate at the transform faults close to oceanic arcs, and that its evolutionary processes and surface volcanic expressions are controlled by plate strength. However, these studies are mainly conducted with 2-D models, which cannot deal with lateral heterogeneities of crustal thickness and strength along the plate interfaces. Here we extend the 2-D model to a 3-D parallel subduction model with high computational efficiency. With the new model, we study the dynamic controlling factors, morphology evolutionary processes and surface expressions for subduction initiation with lateral heterogeneities of material properties along transform faults and passive margins. We find that lateral lithospheric heterogeneities control the starting point of the subduction initiation along the newly formed trenches and the propagation speed for the trench formation. New subduction tends to firstly initiate at the property changing point along the transform faults or passive margins. Such finds may be applied to explain the formation process of the Izu-Bonin-Mariana (IBM) subduction zone in the western Pacific and the Scotia subduction zone at the south end of the South America. Our results enhance our understanding for the formation of new trenches and help to provide geodynamic modeling explanations for the observed remnant slabs in the upper mantle and the surface volcanic expressions.

  15. Impact of a clinical trial initiative on clinical trial enrollment in a multidisciplinary prostate cancer clinic.

    PubMed

    Madsen, Lydia T; Kuban, Deborah A; Choi, Seungtaek; Davis, John W; Kim, Jeri; Lee, Andrew K; Domain, Delora; Levy, Larry; Pisters, Louis L; Pettaway, Curtis A; Ward, John F; Logothetis, Christopher; Hoffman, Karen E

    2014-07-01

    Clinical oncology trials are hampered by low accrual rates, with fewer than 5% of adult patients with cancer treated on study. Clinical trial enrollment was evaluated at The University of Texas MD Anderson Cancer Center's Multidisciplinary Prostate Cancer Clinic (MPCC) to assess whether a clinical trial initiative, introduced in 2006, impacted enrollment. The trial initiative included posting trial-specific information in clinic, educating patients about appropriate clinical trial options during the treatment recommendation discussion, and providing patients with trial-specific educational information. The investigators evaluated the frequency of clinical trial enrollment for men with newly diagnosed prostate cancer seen in the MPCC from 2004 to 2008. Logistic regression evaluated the impact of patient characteristics and the clinical trial initiative on trial enrollment. The median age of the 1370 men was 64 years; 32% had low-risk, 49% had intermediate-risk, and 19% had high-risk disease. Overall, 74% enrolled in at least one trial and 29% enrolled in more than one trial. Trial enrollment increased from 39% before the initiative (127/326) to 84% (880/1044) after the trial initiative. Patient enrollment increased in laboratory studies (from 25% to 80%), quality-of-life studies (from 10% to 26%), and studies evaluating investigational treatments and systemic agents (from 6% to 15%) after the trial initiative. In multivariate analysis, younger men (P<.001) and men seen after implementation of the clinical trial initiative (P<.001) were more likely to enroll in trials. Clinical trial enrollment in the MPCC was substantially higher than that seen nationally in adult patients with cancer, and enrollment rates increased after the introduction of a clinical trial initiative. Copyright © 2014 by the National Comprehensive Cancer Network.

  16. Directions for lunar construction - A derivation of requirements from a construction scenario analysis

    NASA Technical Reports Server (NTRS)

    Dias, William S.; Matijevic, Jacob R.; Venkataraman, Subramani T.; Smith, Jeffrey H.; Lindemann, Randel A.; Levin, Richard R.

    1992-01-01

    This paper provides an initial trade-off study among several lunar construction options available to the Space Exploration Initiative. The relative time effectiveness of Extra-Vehicular Activity (EVA), Intra-Vehicular Activity (IVA), and Earth-based remote control assembly and construction methods are studied. Also considered is whether there is any construction time savings to building roads in advance, or surveying the construction sites with orbiters or rovers in advance. The study was conducted by adding detail to a potentially real scenario - a nuclear power plant - and applying time multipliers for the various control options and terrain alternatives, provided by roboticists among the authors. The authors conclude that IVA is a faster construction method than either EVA or construction conducted remotely from Earth. Surveying proposed sites in advance, with orbiters and rovers, provides a significant time savings through adding to certainty, and therefore may be cost effective. Developing a heavy-lift launch capability and minimizing assembly and construction processes by landing large payloads is probably worthwhile to the degree possible, as construction activities would use a large amount of surface operations time.

  17. A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results

    PubMed Central

    Pevnick, Joshua M.; Fuller, Garth; Duncan, Ray; Spiegel, Brennan M. R.

    2016-01-01

    Background Personal fitness trackers (PFT) have substantial potential to improve healthcare. Objective To quantify and characterize early adopters who shared their PFT data with providers. Methods We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not. Results A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8%) uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption. Conclusion Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing. PMID:27846287

  18. Aboriginal child and adolescent mental health: a rural worker training model.

    PubMed

    Bartik, Warren; Dixon, Angela; Dart, Katrina

    2007-04-01

    The Third National Mental Health Plan places a strong emphasis on the development of an Aboriginal mental health workforce. This paper documents the establishment, implementation and initial evaluation of the Aboriginal and Torres Strait Islander Child and Adolescent Mental Health Traineeship Program, a partnership initiative involving Hunter New England Area Health Service (HNEAHS), Hunter New England Aboriginal Mental Health (HNEAMH) and the Department of Psychological Medicine at the Children's Hospital at Westmead (CHW), with guidance and input from additional collaborators. The program includes: (i) employment as a child and adolescent mental health worker and professional support and supervision through HNEAHS; (ii) a mentoring program provided through HNEAMH; (iii) formal academic studies in Aboriginal Mental Health; and (iv) a clinical education and supervision program conducted through the Department of Psychological Medicine, CHW. Initial feedback suggests that this is a promising program to train Aboriginal child and adolescent mental health workers. Further evaluation will provide information about its viability and effectiveness in providing an integrated, collaborative child and adolescent mental health service for Aboriginal and Torres Strait Islander children and their families.

  19. Utah DOT weather responsive traffic signal timing.

    DOT National Transportation Integrated Search

    1996-01-01

    This report provides background and summary of the scope of work for the pooled fund study, Durability of Geosynthetics for Highway Applications. Status and a summary of initial test results for each of the tasks in this study, as well as a sum...

  20. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review

    PubMed Central

    Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-01-01

    Introduction The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. PMID:29662521

  1. Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD.

    PubMed

    Patel, Ayush; Medhekar, Rohan; Ochoa-Perez, Melissa; Aparasu, Rajender R; Chan, Wenyaw; Sherer, Jeffrey T; Alonzo, Joy; Chen, Hua

    2017-07-01

    Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty). The associations between provider type and practice variations were further determined by multivariate logistic regression accounting for patient demographic characteristics, region, insurance type, and prior mental health care utilizations. Of the 66,719 children identified, 75.8% were diagnosed by PCPs, 2.6% by child psychiatrists, and 21.6% by physicians whose specialty was unknown. Child psychiatrists were less likely than PCPs to initiate ADHD medication immediately after the diagnosis. However, once the ADHD treatment was initiated, they were more likely to prescribe psychotropic polytherapy even after analyses accounted for the comorbid psychiatric disorders identified. Only one-third of ADHD cases identified by both PCPs and child psychiatrists have met the HEDIS quality measure for ADHD medication-related follow-up visits. Differences were found by physician type in care of children with ADHD. Additional studies are needed to understand clinical consequences of these differences and the implications for care coordination across provider specialties.

  2. Collaborative Business Planning in Initial Vocational Education and Training

    ERIC Educational Resources Information Center

    Laine, Kati; Hämäläinen, Raija

    2015-01-01

    There is a growing demand to enhance entrepreneurship. This study aims at producing knowledge that can assist teachers in designing and supporting collaborative learning of entrepreneurship in vocational education. A qualitative case study approach was adopted. The outcome of this study provides a better understanding of the factors that hinder…

  3. 33 CFR 263.17 - Planning, design and construction procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... recommendations. Public notices are not required when a feasibility study is terminated without submittal of a DPR...) WASH DC 20314, depending on the study authority, as provided for in § 263.16(a). (a) Initiation of... sufficient justification for authorizing a feasibility study. Reporting officers are to notify the Division...

  4. 33 CFR 263.17 - Planning, design and construction procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... recommendations. Public notices are not required when a feasibility study is terminated without submittal of a DPR...) WASH DC 20314, depending on the study authority, as provided for in § 263.16(a). (a) Initiation of... sufficient justification for authorizing a feasibility study. Reporting officers are to notify the Division...

  5. How Students Create Motivationally Supportive Learning Environments for Themselves: The Concept of Agentic Engagement

    ERIC Educational Resources Information Center

    Reeve, Johnmarshall

    2013-01-01

    The present study introduced "agentic engagement" as a newly proposed student-initiated pathway to greater achievement and greater motivational support. Study 1 developed the brief, construct-congruent, and psychometrically strong Agentic Engagement Scale. Study 2 provided evidence for the scale's construct and predictive validity, as…

  6. The human genetic history of the Americas: the final frontier.

    PubMed

    O'Rourke, Dennis H; Raff, Jennifer A

    2010-02-23

    The Americas, the last continents to be entered by modern humans, were colonized during the late Pleistocene via a land bridge across what is now the Bering strait. However, the timing and nature of the initial colonization events remain contentious. The Asian origin of the earliest Americans has been amply established by numerous classical marker studies of the mid-twentieth century. More recently, mtDNA sequences, Y-chromosome and autosomal marker studies have provided a higher level of resolution in confirming the Asian origin of indigenous Americans and provided more precise time estimates for the emergence of Native Americans. But these data raise many additional questions regarding source populations, number and size of colonizing groups and the points of entry to the Americas. Rapidly accumulating molecular data from populations throughout the Americas, increased use of demographic models to test alternative colonization scenarios, and evaluation of the concordance of archaeological, paleoenvironmental and genetic data provide optimism for a fuller understanding of the initial colonization of the Americas. Copyright 2010 Elsevier Ltd. All rights reserved.

  7. Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

    PubMed

    Afifi, Ladan; Shinkai, Kanade

    2017-03-01

    Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

  8. Master Logic Diagram: An Approach to Identify Initiating Events of HTGRs

    NASA Astrophysics Data System (ADS)

    Purba, J. H.

    2018-02-01

    Initiating events of a nuclear power plant being evaluated need to be firstly identified prior to applying probabilistic safety assessment on that plant. Various types of master logic diagrams (MLDs) have been proposedforsearching initiating events of the next generation of nuclear power plants, which have limited data and operating experiences. Those MLDs are different in the number of steps or levels and different in the basis for developing them. This study proposed another type of MLD approach to find high temperature gas cooled reactor (HTGR) initiating events. It consists of five functional steps starting from the top event representing the final objective of the safety functions to the basic event representing the goal of the MLD development, which is an initiating event. The application of the proposed approach to search for two HTGR initiating events, i.e. power turbine generator trip and loss of offsite power, is provided. The results confirmed that the proposed MLD is feasiblefor finding HTGR initiating events.

  9. The Impact of Menthol Cigarettes on Smoking Initiation among Non-Smoking Young Females in Japan

    PubMed Central

    Connolly, Gregory N.; Behm, Ilan; Osaki, Yoneatsu; Wayne, Geoffrey F.

    2011-01-01

    Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry’s actions—increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females. PMID:21318010

  10. Using quality improvement to promote breast-feeding in a local health department.

    PubMed

    Wright, Sarah S; Lea, C Suzanne; Holloman, Roxanne; Cornett, Amanda; Harrison, Lisa Macon; Randolph, Greg D

    2012-01-01

    In 2008, breast-feeding initiation and continuation rates in Beaufort County, North Carolina, were lower than statewide rates. A quality improvement (QI) project was initiated to increase breast-feeding rates by enhancing the overall environment that supports breast-feeding at the Beaufort County Health Department. This case study describes one of the first QI initiatives implemented through the North Carolina Center for Public Health Quality QI training program, conducted in 2009. The aim of this project was to improve the health and wellness of mothers and infants in Beaufort County by promoting breast-feeding among Beaufort County Health Department Women, Infants and Children (WIC) clients. Using QI tools, 4 new approaches to breast-feeding promotion were tested and implemented: creating a nurturing location to breast-feed while at the health department, actively telephoning new mothers to provide breast-feeding support, incentivizing adoption of educational messages by providing a breast-feeding tote bag, and promoting new WIC food packages. These enhancements involved staff in QI planning and implementation and correlated with improved breast-feeding initiation for WIC clients during the year following project completion.

  11. The impact of menthol cigarettes on smoking initiation among non-smoking young females in Japan.

    PubMed

    Connolly, Gregory N; Behm, Ilan; Osaki, Yoneatsu; Wayne, Geoffrey F

    2011-01-01

    Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry's actions-increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females.

  12. [Effect of the Baby Friendly Hospital Initiative on the duration of exclusive breastfeeding in Kinshasa: A cluster randomized trial].

    PubMed

    Babakazo, P; Donnen, P; Mapatano, M A; Lulebo, A; Okitolonda, E

    2015-10-01

    Despite numerous advantages of breastfeeding, in Democratic Republic of the Congo, the rate of children exclusively breastfed up to six months remains low. The lack of breastfeeding support received by mothers from health care providers is an important factor of early cessation of breastfeeding. This study aimed to evaluate the effect of the training of health care providers, in the Baby Friendly Hospital Initiative, on the duration of exclusive breastfeeding (EBF) in Kinshasa. A total of 422 mothers, recruited during the first antenatal care visit in 12 maternities and followed up to six months after delivery, were included in a cluster randomized trial. In the experimental group, health care providers were trained using the "20-Hour Course For Maternity Staff". Cox proportional hazards model was used to determine the effect of the intervention on the duration of EBF. The rate of EBF at six months was 2.8%; the median duration of EBF was 10.9 weeks (IQR 4.3 to 14.9). The hazard of discontinuing EBF before six month was 1.4 times higher in the control group (adjusted HR [95%CI]=1.40 (1.10-1.78), P=0.007). In this study, training of health care providers in the Baby Friendly Hospital Initiative was associated with a significant improvement in the duration of EBF. Extending this training to different maternities could improve the coverage of EBF in Kinshasa. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. The Mediator Complex and Transcription Elongation

    PubMed Central

    Conaway, Ronald C.; Conaway, Joan Weliky

    2013-01-01

    Background Mediator is an evolutionarily conserved multisubunit RNA polymerase II (Pol II) coregulatory complex. Although Mediator was initially found to play a critical role in regulation of the initiation of Pol II transcription, recent studies have brought to light an expanded role for Mediator at post-initiation stages of transcription. Scope of review We provide a brief description of the structure of Mediator and its function in the regulation of Pol II transcription initiation, and we summarize recent findings implicating Mediator in the regulation of various stages of Pol II transcription elongation. Major conclusions Emerging evidence is revealing new roles for Mediator in nearly all stages of Pol II transcription, including initiation, promoter escape, elongation, pre-mRNA processing, and termination. General significance Mediator plays a central role in the regulation of gene expression by impacting nearly all stages of mRNA synthesis. PMID:22983086

  14. Influence of temporal pressure constraint on the biomechanical organization of gait initiation made with or without an obstacle to clear.

    PubMed

    Yiou, Eric; Fourcade, Paul; Artico, Romain; Caderby, Teddy

    2016-06-01

    Many daily motor tasks have to be performed under a temporal pressure constraint. This study aimed to explore the influence of such constraint on motor performance and postural stability during gait initiation. Young healthy participants initiated gait at maximal velocity under two conditions of temporal pressure: in the low-pressure condition, gait was self-initiated (self-initiated condition, SI); in the high-pressure condition, it was initiated as soon as possible after an acoustic signal (reaction-time condition, RT). Gait was initiated with and without an environmental constraint in the form of an obstacle to be cleared placed in front of participants. Results showed that the duration of postural adjustments preceding swing heel-off ("anticipatory postural adjustments", APAs) was shorter, while their amplitude was larger in RT compared to SI. These larger APAs allowed the participants to reach equivalent postural stability and motor performance in both RT and SI. In addition, the duration of the execution phase of gait initiation increased greatly in the condition with an obstacle to be cleared (OBST) compared to the condition without an obstacle (NO OBST), thereby increasing lateral instability and thus involving larger mediolateral APA. Similar effects of temporal pressure were obtained in NO OBST and OBST. This study shows the adaptability of the postural system to temporal pressure in healthy young adults initiating gait. The outcome of this study may provide a basis for better understanding the aetiology of balance impairments with the risk of falling in frail populations while performing daily complex tasks involving a whole-body progression.

  15. Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study.

    PubMed

    Dalton, Madeline A; Sargent, James D; Beach, Michael L; Titus-Ernstoff, Linda; Gibson, Jennifer J; Ahrens, M Bridget; Tickle, Jennifer J; Heatherton, Todd F

    2003-07-26

    Exposure to smoking in movies has been linked with adolescent smoking initiation in cross-sectional studies. We undertook a prospective study to ascertain whether exposure to smoking in movies predicts smoking initiation. We assessed exposure to smoking shown in movies in 3547 adolescents, aged 10-14 years, who reported in a baseline survey that they had never tried smoking. Exposure to smoking in movies was estimated for individual respondents on the basis of the number of smoking occurrences viewed in unique samples of 50 movies, which were randomly selected from a larger sample pool of popular contemporary movies. We successfully re-contacted 2603 (73%) students 13-26 months later for a follow-up interview to determine whether they had initiated smoking. Overall, 10% (n=259) of students initiated smoking during the follow-up period. In the highest quartile of exposure to movie smoking, 17% (107) of students had initiated smoking, compared with only 3% (22) in the lowest quartile. After controlling for baseline characteristics, adolescents in the highest quartile of exposure to movie smoking were 2.71 (95% CI 1.73-4.25) times more likely to initiate smoking compared with those in the lowest quartile. The effect of exposure to movie smoking was stronger in adolescents with non-smoking parents than in those whose parent smoked. In this cohort, 52.2% (30.0-67.3) of smoking initiation can be attributed to exposure to smoking in movies. Our results provide strong evidence that viewing smoking in movies promotes smoking initiation among adolescents.

  16. Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART.

    PubMed

    Hoffman, Susie; Tymejczyk, Olga; Kulkarni, Sarah; Lahuerta, Maria; Gadisa, Tsigereda; Remien, Robert H; Melaku, Zenebe; Nash, Denis; Elul, Batya

    2017-12-01

    Stigma harms the mental health of HIV-positive individuals and reduces adherence to antiretroviral therapy (ART), but less is known about stigma and other outcomes across the HIV care continuum. Among 1180 Ethiopian adults initiating ART at 6 urban HIV clinics, we examined the relationship of internalized, anticipated, and enacted stigma to HIV care-related outcomes ascertained by interview (repeat HIV-positive testing, provider vs. self-referred testing, missed clinic visit before ART initiation, eagerness to begin ART), and by abstraction of routinely collected clinical data (late ART initiation, 3-month gap in care following ART initiation). Logistic regression was used to assess the association of each type of stigma with each outcome, adjusting for potential confounders. Scoring higher on each stigma domain was associated with 50%-90% higher odds of repeat HIV-positive testing. High internalized stigma was associated with higher odds of provider vs. self-referred test [adjusted odds ratio (aOR)high vs. low: 1.7; 95% confidence interval (CI): 1.3 to 2.2]. Higher anticipated stigma was associated with lower eagerness to begin ART (aORhigh vs. low: 0.55; 0.35-0.87; aORmedium vs. low: 0.45; 95% CI: 0.30 to 0.69). Any enacted stigma was associated with higher odds of a missed visit (aORany vs. none 1.8; 1.2-2.8). Stigma was not associated with late ART-initiation or with a subsequent gap in care. These findings provide further evidence of the importance of measuring and addressing stigma across the entire care continuum. Future work should test hypotheses about specific stigma domains and outcomes in prospective intervention or observational studies.

  17. Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process.

    PubMed

    Effing, Tanja W; Lenferink, Anke; Buckman, Julie; Spicer, Deborah; Cafarella, Paul A; Burt, Morton G; Bassett, Katherine L; van Ommeren, Clara; Anesbury, Sally; van der Valk, Paul D L P M; Frith, Peter A; van der Palen, Job

    2014-11-01

    Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD without severe comorbidities. Because of overlap in symptoms, a self-treatment (ST) approach that focuses solely on traditional symptoms of COPD is inadequate for patients with COPD and comorbidities. The COPE-III SM intervention combines (I) patient-initiated action plans that are tailored to the individual's co-morbid disease(s), and (II) ongoing nurse support. In this paper we provide information regarding the integration of information from two previous COPD SM studies (COPE I and II) in the development of the current COPE-III ST approach. COPE-III ST materials include daily symptom diaries and action plans that take patient's common comorbidities [chronic heart failure (CHF), anxiety, depression, ischaemic heart disease (IHD), and diabetes] into account. The comorbid diary and action plans components were developed in collaboration with multiple disease-experts. Previous SM studies have highlighted some essential topics that need to be considered when developing a SM or ST approach: 'when to initiate ST', 'how to optimize materials and safety', and 'how to achieve behavioural change'. In the COPE-III study, ST is initiated after a significant change in symptoms. This is consistent with the COPE-II approach and was implemented because disease symptoms are often present even when patients are stable. We have tried to ensure patient safety by providing an easily accessible case-manager to patients throughout their involvement in the study. Furthermore, a psychologist has ensured the use of behavioural change techniques throughout the intervention. We should continue to learn from our experiences with SM interventions to further optimize future SM and ST interventions. The use of materials that are suitable for different levels of patient literacy and the training of health care providers are other points of improvement.

  18. The successful implementation of STEM initiatives in lower income schools

    NASA Astrophysics Data System (ADS)

    Bakshi, Leena

    The purpose of this study was to examine the leadership strategies utilized by superintendents, district administrators and school principals and the impact of these identified strategies on implementing STEM initiatives specifically for lower-income students. This study set out to determine (a) What role does district leadership play in the implementation of STEM initiatives in lower income secondary schools; (b) What internal systems of accountability exist in successful lower income secondary schools' STEM programs; (c) What leadership strategies are used to implement STEM curriculum initiatives; (d) How do school and district leadership support staff in order to achieve student engagement in STEM Initiative curriculum. This study used a mixed-methods approach to determine the impact of leadership strategies utilized by superintendents, district administrators and school principals on implementing STEM initiatives. Quantitative data analyzed survey questionnaires to determine the degree of correlation between the school districts that have demonstrated the successful implementation of STEM initiatives at the school and district levels. Qualitative data was collected using highly structured participant interviews and purposeful sampling of four district superintendents, one district-level administrator and five school leaders to capture the key strategies in implementing STEM initiatives in lower income secondary schools. Through the process of triangulation, the results of the study revealed that superintendents and principals should consider the characteristics of effective STEM initiatives that have shown a considerable degree of correlation with positive outcomes for lower income students. These included the leadership strategies of personnel's making decisions about the district's and school's instructional direction and an emphasis on the conceptual development of scientific principles using the Next Generation Science Standards coupled with the Common Core State Standards across the grade levels. It also emphasized the importance of establishing community partnerships as a primary resource. This study highlighted the criteria district and school leadership should include in implementing STEM initiatives and designing professional development models that result in meaningful instructional practices of STEM curriculum for secondary lower income students. Overall, this study provides insight for superintendents, district leaders and school administrators that can play an integral role in implementing STEM initiatives with access for socioeconomically disadvantaged students.

  19. The 31 Initiatives: A Study in Air Force - Army Cooperation

    DTIC Science & Technology

    1987-01-01

    Monroe, which supplied many docnments from the Papers of General Wiliiam DePuy and other files concerning the TAC- TRADOC Dialogue. MSgt. Roger Jernigan...Charles A. Gabriel and John T. Chain, Jr., who took time from their busy schedules to read and comment on the manuscript. v I viii i...fighting issues affecting both services. The expense of new weapons provided additional incentive 1 THE 31 INITIATIVES for the services to avoid duplication

  20. Styrene-terminated polysulfone oligomers as matrix material for graphite reinforced composites: An initial study

    NASA Technical Reports Server (NTRS)

    Garcia, Dana; Bowles, Kenneth J.; Vannucci, Raymond D.

    1987-01-01

    Styrene terminated polysulfone oligomers are part of an oligomeric class of compounds with end groups capable of thermal polymerization. These materials can be used as matrices for graphite reinforced composites. The initial evaluation of styrene terminated polysulfone oligomer based composites are summarized in terms of fabrication methods, and mechanical and environmental properties. In addition, a description and evaluation is provided of the NASA/Industry Fellowship Program for Technology Transfer.

  1. Analysis of gene expression as relevant to cancer cells and circulating tumour cells.

    PubMed

    Friel, Anne M; Crown, John; O'Driscoll, Lorraine

    2011-01-01

    Current literature provides significant evidence to support the concept that there are limited subpopulations of cells within a solid tumour that have increased tumour-initiating potential relative to the total tumour population. Such tumour-initiating cells have been identified in leukaemia and in a variety of solid tumours using different combinations of cell surface markers, suggesting that a tumour-initiating cell heterogeneity exists for each specific tumour. These studies have been extended to endometrial cancer; and herein we present several experimental approaches, both in vitro and in vivo, that can be used to determine whether such populations exist, and if so, to characterize them. These methods are adaptable to the investigation of tumour-initiating cells from other tumour types.

  2. Silibinin inhibits translation initiation: implications for anticancer therapy.

    PubMed

    Lin, Chen-Ju; Sukarieh, Rami; Pelletier, Jerry

    2009-06-01

    Silibinin is a nontoxic flavonoid reported to have anticancer properties. In this study, we show that silibinin exhibits antiproliferative activity on MCF-7 breast cancer cells. Exposure to silibinin leads to a concentration-dependent decrease in global protein synthesis associated with reduced levels of eukaryotic initiation factor 4F complex. Moreover, polysome profile analysis of silibinin-treated cells shows a decrease in polysome content and translation of cyclin D1 mRNA. Silibinin exerts its effects on translation initiation by inhibiting the mammalian target of rapamycin signaling pathway by acting upstream of TSC2. Our results show that silibinin blocks mammalian target of rapamycin signaling with a concomitant reduction in translation initiation, thus providing a possible molecular mechanism of how silibinin can inhibit growth of transformed cells.

  3. Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings.

    PubMed

    Melo, J S; Garfein, R S; Hayashi, K; Milloy, M J; DeBeck, K; Sun, S; Jain, S; Strathdee, S A; Werb, D

    2018-01-01

    The prevention of drug injecting is often cited as a justification for the deployment of law enforcement and for the continuation of drug criminalization policies. We sought to characterize the impact of law enforcement interactions on the risk that people who inject drugs (PWID) report assisting others with injection initiation in three North American countries. Cross-sectional data from PWID participating in cohort studies in three cities (San Diego, USA; Tijuana, Mexico; Vancouver, Canada) were pooled (August 2014-December 2016). The dependent variable was defined as recently (i.e., past six months) providing injection initiation assistance; the primary independent variable was the frequency of recent law enforcement interactions, defined categorically (0 vs. 1 vs. 2-5 vs. ≥6). We employed multivariable logistic regression analyses to assess this relationship while controlling for potential confounders. Among 2122 participants, 87 (4.1%) reported recently providing injection initiation assistance, and 802 (37.8%) reported recent law enforcement interactions. Reporting either one or more than five recent interactions with law enforcement was not significantly associated with injection initiation assistance. Reporting 2-5 law enforcement interactions was associated with initiation assistance (Adjusted Odds Ratio=1.74, 95% Confidence Interval: 1.01-3.02). Reporting interactions with law enforcement was not associated with a reduced likelihood that PWID reported initiating others into injection drug use. Instead, we identified a positive association between reporting law enforcement interactions and injection initiation assistance among PWID in multiple settings. These findings raise concerns regarding the effectiveness of drug law enforcement to deter injection drug use initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. The information gained from witnesses' responses to an initial "blank" lineup.

    PubMed

    Palmer, Matthew A; Brewer, Neil; Weber, Nathan

    2012-10-01

    Wells ("The psychology of lineup identifications," Journal of Applied Social Psychology, 1984, 14, 89-103) proposed that a blank lineup (an initial lineup of known-to-be-innocent foils) can be used to screen eyewitnesses; witnesses who chose from a blank lineup (initial choosers) were more likely to make an error on a second lineup that contained a suspect than were witnesses who rejected a blank lineup (initial nonchoosers). Recent technological advances (e.g., computer-administered lineups) may overcome many of the practical difficulties cited as a barrier to the use of blank lineups. Our research extended knowledge about the blank lineup procedure by investigating the underlying causes of the difference in identification performance between initial choosers and initial nonchoosers. Studies 1a and 1b (total, N = 303) demonstrated that initial choosers were more likely to reject a second lineup than initial nonchoosers and witnesses who did not view a blank lineup, implying that cognitive biases (e.g., confirmation bias and commitment effects) influenced initial choosers' identification decisions. In Study 2 (N = 200), responses on a forced-choice identification test provided evidence that initial choosers have, on average, poorer memories for the culprit than do initial nonchoosers. We also investigated the usefulness of blank lineups for interpreting identification evidence. Diagnosticity ratios suggested that suspect identifications made by initial nonchoosers (cf. initial choosers) should have a greater impact on estimates of the likely guilt of the suspect. Furthermore, for initial nonchoosers, higher confidence in blank lineup rejections was associated with higher diagnosticity for subsequent suspect identifications. These results have implications for policy to guide the collection and interpretation of identification evidence. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  5. Factors affecting breast-feeding initiation in Greece: What is important?

    PubMed

    Tavoulari, Evangelia-Filothei; Benetou, Vassiliki; Vlastarakos, Petros V; Andriopoulou, Eirini; Kreatsas, George; Linos, Athena

    2015-02-01

    to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece. cross-sectional study. Tertiary University Hospital, maternity ward. 428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth. 71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation. maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast-feeding initiation. focus should be given to pregnant women with higher BMI at the beginning of pregnancy, and women who had undergone caesarean section. Breast-feeding information and encouragement should be provided to all women in the maternity ward, along with the dedicated practice of rooming-in, in order to promote and increase breast-feeding initiation rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Perspectives on Smoking Initiation and Maintenance: A Qualitative Exploration among Singapore Youth.

    PubMed

    Subramaniam, Mythily; Shahwan, Shazana; Fauziana, Restria; Satghare, Pratika; Picco, Louisa; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2015-07-31

    Studies among adolescents have shown that several important interpersonal, intrapersonal and environmental factors are associated with smoking behaviour. The current qualitative research project aimed to explore the determinants of smoking initiation and maintenance, from a youth perspective, among young people who smoked, living in a multi-ethnic Asian country. Focus group discussions (FGDs) were conducted with youths in Singapore in youth-friendly and accessible locations. Young people, from a variety of social contexts-varying on age, gender, ethnicity and educational level, were included in the study. All FGDs were conducted in English and participants were recruited using a mix of network and purposive sampling. All FGDs were audio recorded and transcribed verbatim. The data were analyzed using qualitative content analysis, allowing themes to emerge from the data with the goal of answering the research question. Ninety-one youth smokers (54 males, 37 females), aged between 14 to 29 years, participated in the study. The majority were males (59%) and of Chinese ethnicity (52%). Participants identified multiple personal, social, and familial influences on young adults' smoking behaviors. Peer and family influences, as well as risk minimization, played a key role in smoking initiation and maintenance. While young people were aware of policies that restricted smoking, these did not directly affect their decision to start smoking. The theory of triadic influence provided a promising theoretical framework to understand smoking initiation and maintenance in a sample of young adult smokers from a multi-ethnic Asian country. It also provides actionable information for initiatives to prevent smoking in young people, which includes their perspectives and emphasizes an inclusive approach without stigmatizing those who smoke.

  7. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

    PubMed

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2007-11-16

    As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public engagement, and provided a concrete plan to operationalize a strategy for improving public involvement in this, and other, wait time initiatives.

  8. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

    PubMed Central

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2007-01-01

    Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public engagement, and provided a concrete plan to operationalize a strategy for improving public involvement in this, and other, wait time initiatives. PMID:18021393

  9. Promoting Professionalism through Family Day Care Networks: A Study of Child Care, Inc.'s Neighborhood Child Care Initiatives Project, New York City.

    ERIC Educational Resources Information Center

    Larner, Mary; Chaudry, Nina

    This report describes the characteristics and activities of family day care networks and their role in providing professional support to family day care providers. The introduction explains the rationale for these networks and focuses on the work conducted by Child Care, Inc., in New York City, to develop them. Chapter 2 provides a background to…

  10. Perceived barriers and attitudes of health care providers towards Provider-Initiated HIV Testing and Counseling in Mbeya region, southern highland zone of Tanzania.

    PubMed

    Ntuli, A Kapologwe; Kabengula, Julieth S; Msuya, Sia E

    2011-01-01

    Provider-initiated testing and counseling (PITC) is a routine HIV testing and counseling, it encompases two strategies including; diagnostic HIV testing and HIV screening. In Tanzania PITC started in 2007, to date it is almost through out the country. This study aimed at assessing the perceived barriers and attitudes of health care providers towards PITC services. A cross sectional study was conducted for one month between April and May, 2010 in the goverment health care facilities of the Mbeya City Council. A multi-stage sampling technique was used to select both health facilities and health care providers. A total of 402 (95%) subjects were interviewed. Their mean (±SD) age was 41±9.5 years, where majority (65%) were females. All the participants reported to be aware about PITC services. However, about 35% of them had negative attitude towards PITC services. Various perceived barriers to effective PITC provision were reported, including; too many patients (57.7%) and inadequate space (46%) for PITC provision. Although PITC is an effective strategy for identification of unrecognized HIV infections, there is still missed opportunity which occurs at the health facilities, as some of health care providers had negative attitude and others faces various barriers in offering the PITC service.

  11. National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities.

    PubMed

    Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi

    2015-01-01

    In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  12. Redding Responder phase I final report.

    DOT National Transportation Integrated Search

    2005-12-19

    The Redding Responder Study was initiated as a component of the Redding Incident : Management Enhancement (RIME) Program. The goals of the RIME program are to leverage : technology and communications deployments for emergency communication providers ...

  13. Using Enviro-Pod low altitude imagery to inventory building surface materials for an acid rain study - A Baltimore example

    NASA Technical Reports Server (NTRS)

    Ellefsen, Richard; Coffland, Bruce

    1987-01-01

    Low altitude, oblique and vertical color photography taken from EPA's Enviro-Pod Ka 85 camera system has provided the data for taking an inventory of building surface materials in a test area of downtown Baltimore. Photography was acquired from a gridded flight plan to provide views of all sides of buildings. Color, texture, and linear detail are employed in the photo interpretation aided by contextual reference to a classification of building construction type developed in an earlier study. The work could potentially support a materials inventory initiated by the National Acid Precipitation Assessment Program (NAPAP) by scientists from EPA, Geological Survey, and the Department of Energy. Initial results show the method to be viable. Discrete surface materials such as brick, both bare and painted, stone, and metal are identified.

  14. Ribosome profiling: a Hi-Def monitor for protein synthesis at the genome-wide scale

    PubMed Central

    Michel, Audrey M; Baranov, Pavel V

    2013-01-01

    Ribosome profiling or ribo-seq is a new technique that provides genome-wide information on protein synthesis (GWIPS) in vivo. It is based on the deep sequencing of ribosome protected mRNA fragments allowing the measurement of ribosome density along all RNA molecules present in the cell. At the same time, the high resolution of this technique allows detailed analysis of ribosome density on individual RNAs. Since its invention, the ribosome profiling technique has been utilized in a range of studies in both prokaryotic and eukaryotic organisms. Several studies have adapted and refined the original ribosome profiling protocol for studying specific aspects of translation. Ribosome profiling of initiating ribosomes has been used to map sites of translation initiation. These studies revealed the surprisingly complex organization of translation initiation sites in eukaryotes. Multiple initiation sites are responsible for the generation of N-terminally extended and truncated isoforms of known proteins as well as for the translation of numerous open reading frames (ORFs), upstream of protein coding ORFs. Ribosome profiling of elongating ribosomes has been used for measuring differential gene expression at the level of translation, the identification of novel protein coding genes and ribosome pausing. It has also provided data for developing quantitative models of translation. Although only a dozen or so ribosome profiling datasets have been published so far, they have already dramatically changed our understanding of translational control and have led to new hypotheses regarding the origin of protein coding genes. © 2013 John Wiley & Sons, Ltd. PMID:23696005

  15. Experimental Model of Biofilm Implant-Related Osteomyelitis To Test Combination Biomaterials Using Biofilms as Initial Inocula

    PubMed Central

    Williams, Dustin L.; Haymond, Bryan S.; Woodbury, Kassie L.; Beck, J. Peter; Moore, David E.; Epperson, R. Tyler; Bloebaum, Roy D.

    2012-01-01

    Currently, the majority of animal models that are used to study biofilm-related infections utilize planktonic bacterial cells as initial inocula to produce positive signals of infection in biomaterials studies. However, the use of planktonic cells has potentially led to inconsistent results in infection outcomes. In this study, well-established biofilms of methicillin-resistant Staphylococcus aureus (MRSA) were grown and used as initial inocula in an animal model of a Type IIIB open fracture. The goal of the work was to establish, for the first time, a repeatable model of biofilm implant-related osteomyelitis wherein biofilms were used as initial inocula to test combination biomaterials. Results showed that 100% of animals that were treated with biofilms developed osteomyelitis, whereas 0% of animals not treated with biofilm developed infection. The development of this experimental model may lead to an important shift in biofilm and biomaterials research by showing that when biofilms are used as initial inocula, they may provide additional insights into how biofilm-related infections in the clinic develop and how they can be treated with combination biomaterials to eradicate and/or prevent biofilm formation. PMID:22492534

  16. Experimental model of biofilm implant-related osteomyelitis to test combination biomaterials using biofilms as initial inocula.

    PubMed

    Williams, Dustin L; Haymond, Bryan S; Woodbury, Kassie L; Beck, J Peter; Moore, David E; Epperson, R Tyler; Bloebaum, Roy D

    2012-07-01

    Currently, the majority of animal models that are used to study biofilm-related infections use planktonic bacterial cells as initial inocula to produce positive signals of infection in biomaterials studies. However, the use of planktonic cells has potentially led to inconsistent results in infection outcomes. In this study, well-established biofilms of methicillin-resistant Staphylococcus aureus were grown and used as initial inocula in an animal model of a Type IIIB open fracture. The goal of the work was to establish, for the first time, a repeatable model of biofilm implant-related osteomyelitis, wherein biofilms were used as initial inocula to test combination biomaterials. Results showed that 100% of animals that were treated with biofilms developed osteomyelitis, whereas 0% of animals not treated with biofilm developed infection. The development of this experimental model may lead to an important shift in biofilm and biomaterials research by showing that when biofilms are used as initial inocula, they may provide additional insights into how biofilm-related infections in the clinic develop and how they can be treated with combination biomaterials to eradicate and/or prevent biofilm formation. Copyright © 2012 Wiley Periodicals, Inc.

  17. Stability of nitrate-ion concentrations in simulated deposition samples used for quality-assurance activities by the U.S. Geological Survey

    USGS Publications Warehouse

    Willoughby, T.C.; See, R.B.; Schroder, L.J.

    1989-01-01

    Three experiments were conducted to determine the stability of nitrate-ion concentrations in simulated deposition samples. In the four experiment-A solutions, nitric acid provided nitrate-ion concentrations ranging from 0.6 to 10.0 mg/L and that had pH values ranging from 3.8 to 5.0. In the five experiment-B solutions, sodium nitrate provided nitrate-ion concentrations ranging from 0.5 to 3.0 mg/L. The pH was adjusted to about 4.5 for each of the solutions by addition of sulfuric acid. In the four experiment-C solutions, nitric acid provided nitrate-ion concentrations ranging from 0.5 to 3.0 mg/L. Major cation and anion concentrations were added to each solution to simulate natural deposition. Aliquots were removed from the 13 original solutions and analyzed by ion chromatography about once a week for 100 days to determine if any changes occurred in nitrate-ion concentrations throughout the study period. No substantial changes were observed in the nitrate-ion concentrations in solutions that had initial concentrations below 4.0 mg/L in experiments A and B, although most of the measured nitrate-ion concentrations for the 100-day study were below the initial concentrations. In experiment C, changes in nitrate-ion concentrations were much more pronounced; the measured nitrate-ion concentrations for the study period were less than the initial concentrations for 62 of the 67 analyses. (USGS)

  18. Factors Associated With Contraceptive Method Choice and Initiation in Adolescents and Young Women.

    PubMed

    Cohen, Rebecca; Sheeder, Jeanelle; Kane, Meghan; Teal, Stephanie B

    2017-10-01

    The purpose of the study was to identify factors associated with uptake of contraceptive implants or intrauterine devices (IUDs) by adolescents and young women. For this prospective cohort study, we recruited English-speaking female contraceptive initiators aged 14-24 years attending a Title X-supported, youth-focused clinic. Immediately prior to their visits, participants completed surveys assessing demographic and reproductive characteristics and awareness of, interest in, and intent to initiate specific contraceptive methods. Participants also answered questions about their social contacts' contraceptive experiences. Following the visit, participants reported the method initiated and the perceived importance of provider counseling. We used a multivariable regression model to ascertain factors associated with initiation of an IUD, an implant, or a short-acting reversible method. We enrolled 1,048 contraceptive initiators: 277 initiated short-acting methods, 384 IUDs, and 387 implants. High previsit personal acceptability of the method was associated with choosing that method for both implants and IUDs. Knowing someone who uses a specific method and likes it was predictive of personal acceptability of that method (IUD adjusted odds ratio: 10.9, 95% confidence interval: 3.8-31.1; implant adjusted odds ratio: 7.0, 95% confidence interval: 2.3-21.0). However, 10.4% of those initiating IUDs and 14.2% of those initiating implants had never heard of the method before their appointment. Even women with previsit intent to initiate a specific method found importance in contraceptive counseling. Previsit personal acceptability, which was associated with social contacts' experiences, was the strongest predictor of specific method uptake in our study. However, counseling informed the decisions of those with low previsit awareness and supported patients with formed intent. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Barriers and enablers to a physician-delivered educational initiative to reduce low-acuity visits to the pediatric emergency department.

    PubMed

    Huyer, Gregory; Chreim, Samia; Michalowski, Wojtek; Farion, Ken J

    2018-01-01

    Use of the pediatric emergency department (PED) for low-acuity health issues is a growing problem, contributing to overcrowding, longer waits and higher health system costs. This study examines an educational initiative aimed at reducing low-acuity PED visits. The initiative, implemented at an academic pediatric hospital, saw PED physicians share a pamphlet with caregivers to educate them about appropriate PED use and alternatives. Despite early impacts, the initiative was not sustained. This study analyzes the barriers and enablers to physician participation in the initiative, and offers strategies to improve implementation and sustainability of similar future initiatives. Forty-two PED physicians were invited to participate in a semi-structured individual interview assessing their views about low-acuity visits, their pamphlet use, barriers and enablers to pamphlet use, and the initiative's potential for reducing low-acuity visits. Suggestions were solicited for improving the initiative and reducing low-acuity visits. Constant comparative method was used during analysis. Codes were developed inductively and iteratively, then grouped according to the Theoretical Domains Framework (TDF). Efforts to ensure study credibility included seeking participant feedback on the findings. Twenty-three PED physicians were interviewed (55%). Barriers and enablers for pamphlet use were identified and grouped according to five of the 14 TDF domains: social/professional role and identity; beliefs about consequences; environmental context and resources; social influences; and emotions. The TDF provided an effective approach to identify the key elements influencing physician participation in the educational initiative. This information will help inform behavior change interventions to improve the implementation of similar future initiatives that involve physicians as the primary educators of caregivers.

  20. Pollution Response Systems Analysis

    DOT National Transportation Integrated Search

    1978-01-01

    This study was initiated as part of the U.S. Coast Guard effort to provide adequate response within six hours for a spill of up to 100,000 ton of oil in U.S. waters. The guidelines and assumptions for the study are described, and partial results are ...

  1. An Electronic Medical Record Alert Intervention to Improve HPV Vaccination Among Eligible Male College Students at a University Student Health Center.

    PubMed

    Martin, Suzanne; Warner, Echo L; Kirchhoff, Anne C; Mooney, Ryan; Martel, Laura; Kepka, Deanna

    2018-02-16

    This pilot study aims to improve HPV vaccination for college aged males at a student health center. The first part of the study consisted of a focus group that assessed the barriers and facilitators of HPV vaccination among healthcare providers and clinic staff (N = 16). Providers reported missed opportunities for HPV vaccination. For the second part of the study, providers and staff reviewed medical records of patients ages 18-26 with student health insurance and with < 3 doses of the HPV vaccine at baseline (12/1/2014 to 7/31/2015) and follow-up (12/1/2015 to 7/31/2016). A computer-automated EMR alert was generated in the medical record of eligible male patients (N = 386). Z-scores were estimated for two-sample proportions to measure change in HPV vaccine rates at baseline and follow-up for males and females. HPV vaccine initiation rates increased among males (baseline: 5.2% follow-up: 25.1%, p < 0.001). This study shows that EMR alerts improved HPV vaccine initiation rates among insured college-aged males.

  2. The Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS): Establishing a New Interdisciplinary Self-Assessment for Health Providers.

    PubMed

    Bidell, Markus P

    2017-01-01

    These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), a new interdisciplinary LGBT clinical self-assessment for health and mental health providers. Research participants were voluntarily recruited in the United States and United Kingdom and included trainees, clinicians, and educators from applied psychology, counseling, psychotherapy, and primary care medicine. Study 1 (N = 602) used exploratory and confirmatory factor analytic techniques, revealing an 18-item three-factor structure (Clinical Preparedness, Attitudinal Awareness, and Basic Knowledge). Study 2 established internal consistency for the overall LGBT-DOCSS (α = .86) and for each of the three subscales (Clinical Preparedness = .88, Attitudinal Awareness = .80, and Basic Knowledge = .83) and 2-week test-retest reliability (.87). In study 3 (N = 564), participant criteria (sexual orientation and education level) and four established scales that measured LGBT prejudice, assessment skills, and social desirability were used to support initial content and discriminant validity. Psychometric properties, limitations, and recommendations are discussed.

  3. Influence of caffeine consumption on 7,12-dimethylbenz(a)anthracene-induced mammary gland tumorigenesis in female rats fed a chemically defined diet containing standard and high levels of unsaturated fat.

    PubMed

    Welsch, C W; DeHoog, J V

    1988-04-15

    The effect of caffeine (430-500 mg/liter of drinking water) on the initiation and promotion phases of 7,12-dimethylbenz(a)anthracene (DMBA)-induced mammary gland tumorigenesis in female Sprague-Dawley rats fed a chemically defined diet containing standard (5%) or high (20%) levels of fat (corn oil) was examined. In the initiation studies, caffeine and the standard or high fat diet treatments were provided for 34 days, from 24-29 days of age to 58-63 days of age. Three days prior to termination of caffeine-fat diet treatments, each rat received a single dose of DMBA. In the promotion studies, caffeine and the standard or high fat diets were provided commencing 3 days after a single dose of DMBA (at 56-61 days of age) and until termination of the study. Caffeine consumption, during the initiation phase significantly (P less than 0.05) reduced mammary carcinoma multiplicity (number of tumors/rat), in rats fed either a standard or high fat diet. In the promotion studies, prolonged consumption of caffeine in rats fed either a standard or high fat diet did not significantly effect mammary carcinoma multiplicity. In the early stages of promotion, an apparent increase in mammary carcinoma multiplicity was observed; this increase in mammary carcinoma multiplicity did not, however, reach the 5% level of statistical probability. When caffeine was administered during both the initiation and promotion phases, no significant effect on mammary carcinoma multiplicity was observed. Treatment of rats during the initiation or promotion phases with caffeinated coffee (via drinking water) mimicked the mammary tumor modulating activities of caffeine. Decaffeinated coffee consumption did not effect either the initiation or promotion phases of this tumorigenic process. In both the initiation and promotion studies, caffeine and/or coffee consumption did not significantly affect the incidence of mammary carcinomas (percentage of rats bearing mammary carcinomas) or the mean latency period of mammary tumor appearance. Thus, in female rats fed a chemically defined standard or high fat diet, caffeine consumption can significantly influence chemical carcinogenesis of the mammary gland; an effect that is dependent upon the duration and time-span of caffeine administration.

  4. Antecedents and outcomes of marijuana use initiation during adolescence.

    PubMed

    Ellickson, Phyllis L; Tucker, Joan S; Klein, David J; Saner, Hilary

    2004-11-01

    This study identified similarities and differences in risk factors for marijuana use initiation from grades 7 to 8, grades 8 to 9, and grades 9 to 10, and examined differences between earlier initiates, later initiates, and nonusers on various problem behaviors at grade 10. Longitudinal data were used to examine predictors and outcomes associated with marijuana initiation from grade 7 (N = 1,955) to grade 10 (N = 909). Participants completed yearly surveys to assess problem behaviors, social influences, and marijuana-related attitudes and behavior. Earlier initiates were more likely than later initiates to exhibit problem-related marijuana use, hard drug use, polydrug use, poor grades, and low academic intentions at grade 10. Across ages, initiation was predicted by smoking, frequency of marijuana offers, and poor grades. Results provided some evidence for a shift from familial to peer influence on marijuana initiation with increasing age. Marijuana-related beliefs were relatively weak predictors of initiation at all ages after controlling for pro-marijuana social influences and engagement in other types of substance use and delinquent behavior. Results emphasize the importance of early intervention and identify a wide range of potentially modifiable risk factors that may be targeted.

  5. Systematic Review of Smoking Initiation among Asian Adolescents, 20052015: Utilizing the Frameworks of Triadic Influence and Planned Behavior.

    PubMed

    Talip, Tajidah; Murang, Zaidah; Kifli, Nurolaini; Naing, Lin

    2016-01-01

    A recent WHO data report on mortality attributable to tobacco use including cigarette smoking indicated a very high burden of deaths in Asia and that people often initiate smoking as early as young adolescents. The objectives of this study were to systematically review peerreviewed articles on cigarette smoking initiation among Asian adolescents and to develop a conceptual model of factors influencing smoking initiation by integrating all relevant factors based on existing data. Following a PRISMA guideline, a systematic review of articles published between 2005 and June 2015 was conducted using 5 databases on cigarette smoking initiation among adolescents (aged 1019 years) living in Asia. We summarized the main findings of each study according to our research questions and data that emerged during the data extraction process. Analysis and categorization were based on the TTI and TPB models and classification of factors extracted from the study, were as follows: personal factors, social factors, broader environmental factors, mediators, and intention to initiate smoking and smoking behavior. Of 1,227 identified studies, only 20 were included in this review. Our findings found that the mean age of cigarette smoking initiation ranged from 10 to 14 years and those who are more likely to initiate smoking are male, older adolescents, adolescents with low parental SES, individuals with low parental monitoring, low parental education level and having no discussion on smoking at home, those living in public housing and those exhibiting healthrisk behavior. Our study also revealed that the risk of smoking initiation increased when they are exposed to smokers, influenced by peers, exposed to tobacco advertisements, receive pocket money, have lack of knowledge about smoking, have poor school performance, have a family conflict and have psychological problems. The conceptual model developed demonstrated complex networks of factors influencing initiation. This systematic review presents various factors influencing smoking initiation of the Asian adolescents and provides a conceptual framework to further analyze factors. Future studies should have a standard measure of smoking initiation, should analyze interactions and the intensity of relationships between different factors or variables in the conceptual model. This will in turn consolidate the understanding of the different factors affecting smoking initiation and will help to improve interventions in this area.

  6. Image processing for stripper harvested cotton trash content measurement a progress report

    USDA-ARS?s Scientific Manuscript database

    This study was initiated to provide the basis for obtaining on-line information as to the levels of the various types of gin trash. The objective is to provide the ginner with knowledge of the quantity of the various trash components in the raw uncleaned seed cotton. This information is currently no...

  7. Principal Investigator and Department Administrator Perceptions of Services Provided by Offices of Research Administration at Research Universities

    ERIC Educational Resources Information Center

    Cole, Kimberley W.

    2010-01-01

    The purpose of this research study was to determine what service attributes were perceived as important factors for a successful Office of Research Administration (ORA) to provide to principal investigators and department administrators. Initially established more than 50 years ago, The Office of Research Administration (ORA) has evolved into an…

  8. Empirical Inquiry Into Teacher Centers. Teacher Education Forum; Volume 3, Number 13.

    ERIC Educational Resources Information Center

    Ruchkin, Judith P.

    This report represents a summary of a larger, on-going investigation in teacher education committed to providing a detailed description of the differences found in teacher center and noncenter programs. Part one describes the design, and then summarizes the findings, of the initial phase of the center study by providing the answers to the six…

  9. A Review of Methods and Instruments Used in State and Local School Readiness Evaluations. Issues & Answers. REL 2007-No. 004

    ERIC Educational Resources Information Center

    Brown, Glyn; Scott-Little, Catherine; Amwake, Lynn; Wynn, Lucy

    2007-01-01

    The report provides detailed information about the methods and instruments used to evaluate school readiness initiatives, discusses important considerations in selecting instruments, and provides resources and recommendations that may be helpful to those who are designing and implementing school readiness evaluations. Study results indicate that…

  10. Treatment Patterns and Early Outcomes of ALK-Positive Non-Small Cell Lung Cancer Patients Receiving Ceritinib: A Chart Review Study.

    PubMed

    Bendaly, Edmond; Dalal, Anand A; Culver, Kenneth; Galebach, Philip; Bocharova, Iryna; Foster, Rebekah; Sasane, Medha; Macalalad, Alexander R; Guérin, Annie

    2017-05-01

    This study aimed to provide the first real-world description of the characteristics, treatments, dosing patterns, and early outcomes of patients with ALK-positive non-small cell lung cancer (NSCLC) who received ceritinib in US clinical practice. US oncologists provided data from medical charts of adult patients diagnosed with locally advanced or metastatic ALK-positive NSCLC who received ceritinib following crizotinib. Patient characteristics, treatment patterns, ceritinib dosing, early outcomes, and occurrence of gastrointestinal adverse events (AEs) by dose and instructions on food intake were assessed, and Kaplan-Meier analysis was used to describe clinician-defined progression-free survival (PFS) on ceritinib. Medical charts of 58 ALK-positive NSCLC patients treated with ceritinib were reviewed (median age 63 years; 41% male; 21% with prior chemotherapy experience). At ceritinib initiation, 44 patients had multiple distant metastases, most commonly in the liver (60%), bone (53%), and brain (38%). Initial ceritinib dose varied: 71% received 750 mg, 19% 600 mg, and 10% 450 mg. Although median follow-up after ceritinib initiation was short (3.8 months), most patients achieved either a complete or partial response (69%) on ceritinib, regardless of metastatic sites present at initiation or initial dose. Median PFS on ceritinib was 12.9 months. 17% of patients had a gastrointestinal AE reported during follow-up. The majority of events occurred in patients instructed to fast; no patients instructed to take a lower dose of ceritinib with food reported gastrointestinal AEs. These early findings of ceritinib use in clinical practice suggest that ceritinib is effective at treating crizotinib-experienced ALK-positive NSCLC patients, regardless of metastatic sites or initial dose, and dosing ceritinib with food may lead to fewer gastrointestinal AEs. Future studies with larger sample size and longer follow-up are warranted, including an ongoing randomized trial to assess the gastrointestinal tolerability of ceritinib 450 and 600 mg with low-fat meals. Novartis Pharmaceutical Corporation.

  11. Massachusetts Child Psychiatry Access Project 2.0: A Case Study in Child Psychiatry Access Program Redesign.

    PubMed

    Sarvet, Barry D; Ravech, Marcy; Straus, John H

    2017-10-01

    The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign. The redesign process is described, moving from an initial strategic assessment of program and the planning of structural and functional changes, through transition and implementation. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Co-Optimization of Fuels & Engines (Co-Optima) Initiative: Recent Progress on Light-Duty Boosted Spark-Ignition Fuels/Engines

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

    Farrell, John

    This presentation reports recent progress on light-duty boosted spark-ignition fuels/engines being developed under the Co-Optimization of Fuels and Engines initiative (Co-Optima). Co-Optima is focused on identifying fuel properties that optimize engine performance, independent of composition, allowing the market to define the best means to blend and provide these fuels. However, in support of this, we are pursuing a systematic study of blendstocks to identify a broad range of feasible options, with the objective of identifying blendstocks that can provide target ranges of key fuel properties, identifying trade-offs on consistent and comprehensive basis, and sharing information with stakeholders.

  13. Unintended Consequences of Evidence-Based Treatment Policy Reform: Is Implementation the Goal or the Strategy for Higher Quality Care?

    PubMed

    Park, Alayna L; Tsai, Katherine H; Guan, Karen; Chorpita, Bruce F

    2018-02-14

    This study examined patterns of evidence-based treatment (EBT) delivery following a county-wide EBT reform initiative. Data were gathered from 60 youth and their 21 providers, who were instructed to deliver therapy as they normally would under the EBT initiative. Results showed limited applicability of county-supported EBTs to this service sample, and that most youth did not receive traditional delivery of EBTs. Findings suggest that it may be unrealistic to expect providers to deliver EBTs with fidelity with all clients, and that EBT implementation may be best thought of as a strategy for improving mental health services rather than a goal.

  14. Collision Avoidance for Airport Traffic Concept Evaluation

    NASA Technical Reports Server (NTRS)

    Jones, Denise R.; Prinzel, Lawrence J., III; Otero, Sharon D.; Barker, Glover D.

    2009-01-01

    An initial Collision Avoidance for Airport Traffic (CAAT) concept for the Terminal Maneuvering Area (TMA) was evaluated in a simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. CAAT is being designed to enhance surface situation awareness and provide cockpit alerts of potential conflicts during runway, taxi, and low altitude air-to-air operations. The purpose of the study was to evaluate the initial concept for an aircraft-based method of conflict detection and resolution (CD&R) in the TMA focusing on conflict detection algorithms and alerting display concepts. This paper gives an overview of the CD&R concept, simulation study, and test results.

  15. Non-injection Drug Use and Injection Initiation Assistance among People Who Inject Drugs in Tijuana, Mexico.

    PubMed

    Ben Hamida, Amen; Rafful, Claudia; Jain, Sonia; Sun, Shelly; Gonzalez-Zuniga, Patricia; Rangel, Gudelia; Strathdee, Steffanie A; Werb, Dan

    2018-02-01

    Although most people who inject drugs (PWID) report receiving assistance during injection initiation events, little research has focused on risk factors among PWID for providing injection initiation assistance. We therefore sought to determine the influence of non-injection drug use among PWID on their risk to initiate others. We used generalized estimating equation (GEE) models on longitudinal data among a prospective cohort of PWID in Tijuana, Mexico (Proyecto El Cuete IV), while controlling for potential confounders. At baseline, 534 participants provided data on injection initiation assistance. Overall, 14% reported ever initiating others, with 4% reporting this behavior recently (i.e., in the past 6 months). In a multivariable GEE model, recent non-injection drug use was independently associated with providing injection initiation assistance (adjusted odds ratio [AOR] = 2.42, 95% confidence interval [CI] = 1.39-4.20). Further, in subanalyses examining specific drug types, recent non-injection use of cocaine (AOR = 9.31, 95% CI = 3.98-21.78), heroin (AOR = 4.00, 95% CI = 1.88-8.54), and methamphetamine (AOR = 2.03, 95% CI = 1.16-3.55) were all significantly associated with reporting providing injection initiation assistance. Our findings may have important implications for the development of interventional approaches to reduce injection initiation and related harms. Further research is needed to validate findings and inform future approaches to preventing entry into drug injecting.

  16. Factors associated with difficulty achieving initial control with crotalidae polyvalent immune fab antivenom in snakebite patients.

    PubMed

    Yin, Shan; Kokko, Jamie; Lavonas, Eric; Mlynarchek, Sara; Bogdan, Greg; Schaeffer, Tammi

    2011-01-01

    The prescribing information for Crotalidae Fab antivenom (FabAV) instructs clinicians to administer FabAV until initial control of the envenomation syndrome is achieved. Risk factors for difficulty achieving initial control are not known. The study aim was to identify factors present before administration of antivenom associated with difficulty achieving initial control. The authors conducted a retrospective study of all patients presenting to any one of 17 centers and receiving FabAV from 2002 to 2004. Demographic and historical information, as well as data about nine specific venom effects, were collected prior to the administration of antivenom. An expert panel used standard criteria to determine if initial control was achieved. The patient group that had difficulty achieving initial control was compared to the group that achieved initial control, and adjusted odds ratios were calculated using stepwise logistic regression. A total of 247 patients were included in the final analysis. The majority of patients were envenomated on the upper extremity and were young males. A total of 203 patients (82.2%) achieved initial control. In univariate analysis, thrombocytopenia, bleeding, neurologic effects, and a severe bite were significantly associated with difficulty achieving initial control. After logistic regression, the presence of neurologic effects and thrombocytopenia remained significantly associated with difficulty achieving initial control. When both factors were present, the patient was 13.8 times more likely to have difficulty achieving initial control. A number of factors were present before the administration of FabAV that were independently associated with difficulty achieving initial control of the envenomation syndrome. Predicting which patients will have difficulty achieving initial control has important ramifications for patient disposition and may provide insight into the mechanisms for lack of antivenom efficacy. © 2010 by the Society for Academic Emergency Medicine.

  17. Culturally Safe Health Initiatives for Indigenous Peoples in Canada: A Scoping Review.

    PubMed

    Brooks-Cleator, Lauren; Phillipps, Breanna; Giles, Audrey

    2018-01-01

    Background Cultural safety has the potential to improve the health disparities between Indigenous and non-Indigenous Canadians, yet practical applications of the concept are lacking in the literature. Purpose This study aims to identify the key components of culturally safe health initiatives for the Indigenous population of Canada to refine its application in health-care settings. Methods We conducted a scoping review of the literature pertaining to culturally safe health promotion programs, initiatives, services, or care for the Indigenous population in Canada. Our initial search yielded 501 publications, but after full review of 44 publications, 30 were included in the review. After charting the data, we used thematic analysis to identify themes in the data. Results We identified six themes: collaboration/partnerships, power sharing, address the broader context of the patient's life, safe environment, organizational and individual level self-reflection, and training for health-care providers. Conclusion While it is important to recognize that the provision of culturally safe initiatives depend on the specific interaction between the health-care provider and the patient, having a common understanding of the components of cultural safety, such as those that we identified through this research, will help in the transition of cultural safety from theory into practice.

  18. Assessing Tuberculosis Case Fatality Ratio: A Meta-Analysis

    PubMed Central

    Straetemans, Masja; Glaziou, Philippe; Bierrenbach, Ana L.; Sismanidis, Charalambos; van der Werf, Marieke J.

    2011-01-01

    Background Recently, the tuberculosis (TB) Task Force Impact Measurement acknowledged the need to review the assumptions underlying the TB mortality estimates published annually by the World Health Organization (WHO). TB mortality is indirectly measured by multiplying estimated TB incidence with estimated case fatality ratio (CFR). We conducted a meta-analysis to estimate the TB case fatality ratio in TB patients having initiated TB treatment. Methods We searched for eligible studies in the PubMed and Embase databases through March 4th 2011 and by reference listing of relevant review articles. Main analyses included the estimation of the pooled percentages of: a) TB patients dying due to TB after having initiated TB treatment and b) TB patients dying during TB treatment. Pooled percentages were estimated using random effects regression models on the combined patient population from all studies. Main Results We identified 69 relevant studies of which 22 provided data on mortality due to TB and 59 provided data on mortality during TB treatment. Among HIV infected persons the pooled percentage of TB patients dying due to TB was 9.2% (95% Confidence Interval (CI): 3.7%–14.7%) and among HIV uninfected persons 3.0% (95% CI: −1.2%–7.4%) based on the results of eight and three studies respectively providing data for this analyses. The pooled percentage of TB patients dying during TB treatment was 18.8% (95% CI: 14.8%–22.8%) among HIV infected patients and 3.5% (95% CI: 2.0%–4.92%) among HIV uninfected patients based on the results of 27 and 19 studies respectively. Conclusion The results of the literature review are useful in generating prior distributions of CFR in countries with vital registration systems and have contributed towards revised estimates of TB mortality This literature review did not provide us with all data needed for a valid estimation of TB CFR in TB patients initiating TB treatment. PMID:21738585

  19. Enhancing practice improvement by facilitating practitioner interactivity: new roles for providers of continuing medical education.

    PubMed

    Parboosingh, I John; Reed, Virginia A; Caldwell Palmer, James; Bernstein, Henry H

    2011-01-01

    Research into networking and interactivity among practitioners is providing new information that has the potential to enhance the effectiveness of practice improvement initiatives. This commentary reviews the evidence that practitioner interactivity can facilitate emergent learning and behavior change that lead to practice improvements. Insights from learning theories provide a framework for understanding emergent learning as the product of interactions between individuals in trusted relationships, such as occurs in communities of practice. This framework helps explain why some groups respond more favorably to improvement initiatives than others. Failure to take advantage of practitioner interactivity may explain in part the disappointingly low mean rates of practice improvement reported in studies of the effectiveness of practice improvement projects. Examples of improvement models in primary care settings that explicitly use relationship building and facilitation techniques to enhance practitioner interactivity are provided. Ingredients of a curriculum to teach relationship building in communities of practice and facilitation skills to enhance learning in small group education sessions are explored. Sufficient evidence exists to support the roles of relationships and interactivity in practice improvement initiatives such that we recommend the development of training programs to teach these skills to CME providers. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  20. Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.

    PubMed

    Leeman, Jennifer; Blitstein, Jonathan L; Goetz, Joshua; Moore, Alexis; Tessman, Nell; Wiecha, Jean L

    2016-08-11

    Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs. The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths. We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative. Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan. We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions.

  1. Neuropsychological sex differences associated with age of initiated use among young adult cannabis users.

    PubMed

    Crane, Natania A; Schuster, Randi Melissa; Mermelstein, Robin J; Gonzalez, Raul

    2015-01-01

    Earlier initiation of cannabis use is associated with poorer neuropsychological functioning across several domains. Given well-documented sex differences in neuromaturation during adolescence, initiation of cannabis use during this time may affect neuropsychological functioning differently for males and females. In the current study, we examined sex differences in the relationship between age of initiated cannabis use and neuropsychological performance after controlling for amount of lifetime cannabis use in 44 male and 25 female young adult cannabis users. We found that an earlier age of initiated use was related to poorer episodic memory, especially immediate recall, in females, but not in males. On the other hand, we found that, surprisingly, an earlier age of initiated use was associated with better decision making overall. However, exploratory analyses found sex-specific factors associated with decision making and age of initiated use, specifically that attention-deficit/hyperactivity disorder (ADHD) symptoms in females may drive the relationship between an earlier age of initiated use and better decision making. Further, an earlier age of initiated use was associated with less education, a lower IQ, and fewer years of mother's education for females, but more lifetime cannabis use for males. Taken together, our findings suggest there are sex differences in the associations between age of initiated cannabis use and neuropsychological functioning. The current study provides preliminary evidence that males and females may have different neuropsychological vulnerabilities that place them at risk for initiating cannabis use and continued cannabis use, highlighting the importance of examining the impact of cannabis on neuropsychological functioning separately for males and females.

  2. Patient-initiated online support groups: motives for initiation, extent of success and success factors.

    PubMed

    van Uden-Kraan, Cornelia F; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R; van de Laar, Mart A F J

    2010-01-01

    We studied the success and success factors of online support groups (OSGs) for patients, and the motives and goals of people who start such groups. We interviewed 23 webmasters of OSGs for patients with breast cancer, fibromyalgia and arthritis. The majority were women (n = 20) and most were patients (n = 21). Analysis of the interviews revealed that webmasters had altruistic and intrinsic motives for initiating an online support group. They defined success as the fulfilment of the goals they had in mind when they initiated their groups. To be able to make a group successful, decisions about its organization and management need to be coherent with these goals. Most webmasters stressed that promoting the group, keeping it alive and moderating the messages were vital success factors during the evolution stage. Management of the OSGs took up much of the webmasters' time and energy. On average webmasters were occupied with the group for 10-15 hours a week. Our study provides an overview of the pros and cons of differing decisions that have to be made when initiating an OSG.

  3. Feasibility Study of Economics and Performance of Biopower at the Chanute Air Force Base in Rantoul, Illinois. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

    Scarlata, C.; Mosey, G.

    2013-05-01

    The U.S. Environmental Protection Agency (EPA), in accordance with the RE-Powering America's Land initiative, selected the Former Chanute Air Force Base site in Rantoul, Illinois, for a feasibility study of renewable energy production. The National Renewable Energy Laboratory (NREL) was contacted to provide technical assistance for this project. The purpose of this study was to assess the site for a possible biopower system installation and estimate the cost, performance, and impacts of different biopower options.

  4. Feasibility Study of Economics and Performance of Biomass Power Generation at the Former Farmland Industries Site in Lawrence, Kansas. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

    Tomberlin, G.; Mosey, G.

    2013-03-01

    Under the RE-Powering America's Land initiative, the U.S. Environmental Protection Agency (EPA) provided funding to the National Renewable Energy Laboratory (NREL) to support a feasibility study of biomass renewable energy generation at the former Farmland Industries site in Lawrence, Kansas. Feasibility assessment team members conducted a site assessment to gather information integral to this feasibility study. Information such as biomass resources, transmission availability, on-site uses for heat and power, community acceptance, and ground conditions were considered.

  5. Integration of DNA barcoding for the initial recordings of Lessepsian fishes: a case study of the Indo-Pacific slender ponyfish Equulites elongatus.

    PubMed

    Sakinan, S; Karahan, A; Ok, M

    2017-03-01

    In this study, the DNA barcode of a regional Lessepsian sighting of the slender ponyfish Equulites elongatus is integrated with morphometric and meristic descriptors as a case study to address further identification problems in the Mediterranean Sea. The study also aims to contribute to the regional mitochondrial cytochrome oxidase I information pool, to support other potential uses. The initial sighting of E. elongatus from the north-eastern Mediterranean coast of Turkey is provided from a trawl survey on 3 June 2015, where 76 specimens were captured during a 15 min tow. © 2016 The Fisheries Society of the British Isles.

  6. 24 CFR 125.201 - Administrative Enforcement Initiative.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Initiative. 125.201 Section 125.201 Housing and Urban Development Regulations Relating to Housing and Urban... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.201 Administrative Enforcement Initiative. The Administrative Enforcement Initiative provides funding to State and local fair housing agencies administering...

  7. TOLNet - A Tropospheric Ozone Lidar Profiling Network for Satellite Continuity and Process Studies

    NASA Technical Reports Server (NTRS)

    Newchurch, Michael J.; Kuang, Shi; Wang, Lihua; LeBlanc, Thierry; Alvarez II, Raul J.; Langford, Andrew O.; Senff, Christoph J.; Brown, Steve; Johnson, Bryan; Burris, John F.; hide

    2015-01-01

    NASA initiated an interagency ozone lidar observation network under the name TOLNet to promote cooperative multiple-station ozone-lidar observations to provide highly time-resolved (few minutes) tropospheric-ozone vertical profiles useful for air-quality studies, model evaluation, and satellite validation.

  8. An Investigation of an Intervention to Promote Inference Generation by Adolescent Poor Comprehenders

    ERIC Educational Resources Information Center

    Denton, Carolyn A.; York, Mary J.; Francis, David J.; Haring, Christa; Ahmed, Yusra; Bidulescu, Adrian

    2017-01-01

    This brief experimental study investigated the initial promise of an intervention designed to promote inference generation in adolescents with reading comprehension difficulties. The intervention, provided for nine sessions, included multisyllable word study, teacher explanation and modeling of inference generation and other comprehension…

  9. 78 FR 63987 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... document and provide initial assessment of selected Responsible Fatherhood and Healthy Marriage grant...-up Survey (for Responsible Fatherhood study participants) (20) Follow-up Survey (for Healthy Marriage...) RF Follow-up survey Study participants 1,600 1 0.75 1,200 Healthy Marriage Grantee Impact Evaluation...

  10. Ethics, Corporate Social Responsibility, and Sustainability Education in AACSB Undergraduate and Graduate Marketing Curricula: A Benchmark Study

    ERIC Educational Resources Information Center

    Nicholls, Jeananne; Hair, Joseph F., Jr.; Ragland, Charles B.; Schimmel, Kurt E.

    2013-01-01

    AACSB International advocates integration of ethics, corporate social responsibility, and sustainability in all business school disciplines. This study provides an overview of the implementation of these three topics in teaching initiatives and assessment in business schools accredited by AACSB International. Since no comprehensive studies have…

  11. Mother-to-Infant and Father-to-Infant Initial Emotional Involvement

    ERIC Educational Resources Information Center

    Figueiredo, Barbara; Costa, Raquel; Pacheco, Alexandra; Pais, Alvaro

    2007-01-01

    While infant attachment has been largely studied, parental attachment is still relatively unknown, especially when referred to fathers. However, it is mainly recognised that parents' emotional involvement with the newborn contributes to the quality of the interaction and the care they provide. The aim of this study was to study mother-to-infant…

  12. A Mental Health Training Format for Adult Education Teachers

    ERIC Educational Resources Information Center

    Meek, Fiona; Specht, Jacqueline; Rodger, Susan

    2017-01-01

    The present study investigated the needs of adult education staff pertaining to adult students' mental health issues within a local school board. The study utilized mixed-methods design and was divided into progression of three separate studies. An initial focus group was conducted to identify the 12 participants' concerns and provide a direction…

  13. A Modeling and Verification Study of Summer Precipitation Systems Using NASA Surface Initialization Datasets

    NASA Technical Reports Server (NTRS)

    Jonathan L. Case; Kumar, Sujay V.; Srikishen, Jayanthi; Jedlovec, Gary J.

    2010-01-01

    One of the most challenging weather forecast problems in the southeastern U.S. is daily summertime pulse-type convection. During the summer, atmospheric flow and forcing are generally weak in this region; thus, convection typically initiates in response to local forcing along sea/lake breezes, and other discontinuities often related to horizontal gradients in surface heating rates. Numerical simulations of pulse convection usually have low skill, even in local predictions at high resolution, due to the inherent chaotic nature of these precipitation systems. Forecast errors can arise from assumptions within parameterization schemes, model resolution limitations, and uncertainties in both the initial state of the atmosphere and land surface variables such as soil moisture and temperature. For this study, it is hypothesized that high-resolution, consistent representations of surface properties such as soil moisture, soil temperature, and sea surface temperature (SST) are necessary to better simulate the interactions between the surface and atmosphere, and ultimately improve predictions of summertime pulse convection. This paper describes a sensitivity experiment using the Weather Research and Forecasting (WRF) model. Interpolated land and ocean surface fields from a large-scale model are replaced with high-resolution datasets provided by unique NASA assets in an experimental simulation: the Land Information System (LIS) and Moderate Resolution Imaging Spectroradiometer (MODIS) SSTs. The LIS is run in an offline mode for several years at the same grid resolution as the WRF model to provide compatible land surface initial conditions in an equilibrium state. The MODIS SSTs provide detailed analyses of SSTs over the oceans and large lakes compared to current operational products. The WRF model runs initialized with the LIS+MODIS datasets result in a reduction in the overprediction of rainfall areas; however, the skill is almost equally as low in both experiments using traditional verification methodologies. Output from object-based verification within NCAR s Meteorological Evaluation Tools reveals that the WRF runs initialized with LIS+MODIS data consistently generated precipitation objects that better matched observed precipitation objects, especially at higher precipitation intensities. The LIS+MODIS runs produced on average a 4% increase in matched precipitation areas and a simultaneous 4% decrease in unmatched areas during three months of daily simulations.

  14. Utility Incentives for Combined Heat and Power

    EPA Pesticide Factsheets

    This report describes the results of EPA's research and analysis into utility incentives for CHP. It provides information about utility-initiated policies, programs, and incentives for CHP systems, and includes case studies and tools and resources.

  15. Factors influencing adolescent girls' decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong.

    PubMed

    Lee, Albert; Ho, Mandy; Cheung, Calvin Ka Man; Keung, Vera Mei Wen

    2014-09-08

    Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination. This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant's personal and family factors as well as their knowledge and attitude towards cervical cancer prevention. The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant. Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would facilitate uptake rate of HPV vaccine as students have expressed their wishes that school should provide more information on prevention of cancer. School and community education on cancer prevention would help adolescents to have better understanding of the seriousness of cancer.

  16. A mathematical basis for plant patterning derived from physico-chemical phenomena.

    PubMed

    Beleyur, Thejasvi; Abdul Kareem, Valiya Kadavu; Shaji, Anil; Prasad, Kalika

    2013-04-01

    The position of leaves and flowers along the stem axis generates a specific pattern, known as phyllotaxis. A growing body of evidence emerging from recent computational modeling and experimental studies suggests that regulators controlling phyllotaxis are chemical, e.g. the plant growth hormone auxin and its dynamic accumulation pattern by polar auxin transport, and physical, e.g. mechanical properties of the cell. Here we present comprehensive views on how chemical and physical properties of cells regulate the pattern of leaf initiation. We further compare different computational modeling studies to understand their scope in reproducing the observed patterns. Despite a plethora of experimental studies on phyllotaxis, understanding of molecular mechanisms of pattern initiation in plants remains fragmentary. Live imaging of growth dynamics and physicochemical properties at the shoot apex of mutants displaying stable changes from one pattern to another should provide mechanistic insights into organ initiation patterns. Copyright © 2013 WILEY Periodicals, Inc.

  17. Design and Implementation of a Multi-Strategy, Collegewide Program of Evaluation and Planning: The Mercy College Self-Study Project.

    ERIC Educational Resources Information Center

    Kraetzer, Mary C.; And Others

    The rationale, strategies, and methods of The Mercy College Self-Study Project are considered, and evaluation instruments are provided. This program of institutional evaluation and planning was initiated in 1980 and consists of: standardized surveys, a 10-year longitudinal (panel) study, and academic department self-studies. Questionnaires…

  18. Convenient stability criteria for difference approximations of hyperbolic initial-boundary value problems

    NASA Technical Reports Server (NTRS)

    Goldberg, M.; Tadmor, E.

    1985-01-01

    New convenient stability criteria are provided in this paper for a large class of finite difference approximations to initial-boundary value problems associated with the hyperbolic system u sub t = au sub x + Bu + f in the quarter plane x or = 0, t or = 0. Using the new criteria, stability is easily established for numerous combinations of well known basic schemes and boundary conditins, thus generalizing many special cases studied in recent literature.

  19. Convenient stability criteria for difference approximations of hyperbolic initial-boundary value problems

    NASA Technical Reports Server (NTRS)

    Goldberg, M.; Tadmor, E.

    1983-01-01

    New convenient stability criteria are provided in this paper for a large class of finite difference approximations to initial-boundary value problems associated with the hyperbolic system u sub t = au sub x + Bu + f in the quarter plane x or = 0, t or = 0. Using the new criteria, stability is easily established for numerous combinations of well known basic schemes and boundary conditions, thus generalizing many special cases studied in recent literature.

  20. The UNESCO biosphere reserve concept as a tool for urban sustainability: the CUBES Cape Town case study.

    PubMed

    Stanvliet, R; Jackson, J; Davis, G; De Swardt, C; Mokhoele, J; Thom, Q; Lane, B D

    2004-06-01

    The Cape Town Case Study (CTCS) was a multi-institutional collaborative project initiated by CUBES, a knowledge networking initiative of UNESCO's Ecological Sciences Division and the Earth Institute at Columbia University. Cape Town was selected as a CUBES site on the basis of its high biological and cultural significance, together with its demonstrated leadership in promoting urban sustainability. The CTCS was conducted by the Cape Town Urban Biosphere Group, a cross-disciplinary group of specialists drawn from national, provincial, municipal, and civil society institutions, mandated to examine the potential value of the UNESCO Biosphere Reserve concept as a tool for environmental management, social inclusion, and poverty alleviation in Cape Town. This article provides a contextualization of the CTCS and its collaborative process. It also reviews the biosphere reserve concept relative to urban sustainability objectives and proposes a more functional application of that concept in an urban context. A detailed analysis of key initiatives at the interface of conservation and poverty alleviation is provided in table format. Drawing on an examination of successful sustainability initiatives in Cape Town, specific recommendations are made for future application of the biosphere reserve concept in an urban context, as well as a model by which urban areas might affiliate with the UNESCO World Network of Biosphere Reserves, and criteria for such affiliation.

  1. The influence of children's pain memories on subsequent pain experience.

    PubMed

    Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

    2012-08-01

    Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels

    PubMed Central

    Rankin, Kristin M.; Gavin, Loretta; Moran, John W.; Kroelinger, Charlan D.; Vladutiu, Catherine J.; Goodman, David A.; Sappenfield, William M.

    2018-01-01

    Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists’ contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes. PMID:27423235

  3. Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels.

    PubMed

    Rankin, Kristin M; Gavin, Loretta; Moran, John W; Kroelinger, Charlan D; Vladutiu, Catherine J; Goodman, David A; Sappenfield, William M

    2016-11-01

    Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

  4. Completing the Picture: Importance of Considering Participatory Mapping for REDD+ Measurement, Reporting and Verification (MRV)

    PubMed Central

    Rafanoharana, Serge; Boissière, Manuel; Wijaya, Arief; Wardhana, Wahyu

    2016-01-01

    Remote sensing has been widely used for mapping land cover and is considered key to monitoring changes in forest areas in the REDD+ Measurement, Reporting and Verification (MRV) system. But Remote Sensing as a desk study cannot capture the whole picture; it also requires ground checking. Therefore, complementing remote sensing analysis using participatory mapping can help provide information for an initial forest cover assessment, gain better understanding of how local land use might affect changes, and provide a way to engage local communities in REDD+. Our study looked at the potential of participatory mapping in providing complementary information for remotely sensed maps. The research sites were located in different ecological and socio-economic contexts in the provinces of Papua, West Kalimantan and Central Java, Indonesia. Twenty-one maps of land cover and land use were drawn with local community participation during focus group discussions in seven villages. These maps, covering a total of 270,000ha, were used to add information to maps developed using remote sensing, adding 39 land covers to the eight from our initial desk assessment. They also provided additional information on drivers of land use and land cover change, resource areas, territory claims and land status, which we were able to correlate to understand changes in forest cover. Incorporating participatory mapping in the REDD+ MRV protocol would help with initial remotely sensed land classifications, stratify an area for ground checks and measurement plots, and add other valuable social data not visible at the RS scale. Ultimately, it would provide a forum for local communities to discuss REDD+ activities and develop a better understanding of REDD+. PMID:27977685

  5. Phase B - final definition and preliminary design study for the initial Atmospheric Cloud Physics Laboratory (ACPL): A spacelab mission payload. Work breakdown structure for phase C/D DR-MA-06 (preliminary issue)

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The Work Breakdown Structure (WBS) and Dictionary (DR-MA-06) for initial and subsequent flights of the Atmospheric Cloud Physics Laboratory (ACPL) is presented. An attempt is made to identify specific equipment and components in each of the eleven subsystems; they are listed under the appropriate subdivisions of the WBS. The reader is cautioned that some of these components are likely to change substantially during the course of the study, and the list provided should only be considered representative.

  6. Demand behavior and empathic accuracy in observed conflict interactions in couples.

    PubMed

    Hinnekens, Céline; Ickes, William; Schryver, Maarten De; Verhofstadt, Lesley L

    2016-01-01

    The study reported in this research note sought to extend the research on motivated empathic accuracy by exploring whether intimate partners who are highly motivated to induce change in their partner during conflicts will be more empathically accurate than partners who are less motivated. In a laboratory experiment, the partners within 26 cohabiting couples were randomly assigned the role of conflict initiator. The partners provided questionnaire data, participated in a videotaped conflict interaction, and completed a video-review task. More blaming behavior was associated with higher levels of empathic accuracy, irrespective of whether one was the conflict initiator or not. The results also showed a two-way interaction indicating that initiators who applied more pressure on their partners to change were less empathically accurate than initiators who applied less pressure, whereas their partners could counter this pressure when they could accurately "read" the initiator's thoughts and feelings.

  7. 76 FR 64083 - Loveland Area Projects-2025 Power Marketing Initiative Proposal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ..., with amendments to key marketing plan principles. This Federal Register notice initiates Western's... published in the Federal Register (51 FR 4012, January 31, 1986) and provided the marketing plan principles... provided customers the opportunity to review current marketing plan principles and provide informal input...

  8. Provider-to-Provider Electronic Communication in the Era of Meaningful Use: A Review of the Evidence

    PubMed Central

    Walsh, Colin; Siegler, Eugenia L; Cheston, Erin; O'Donnell, Heather; Collins, Sarah; Stein, Daniel; Vawdrey, David K.; Stetson, Peter D.

    2014-01-01

    Background Electronic communication between providers occurs daily in clinical practice but has not been well studied. Purpose To assess the impact of provider-to-provider electronic communication tools on communication and healthcare outcomes through literature review. Data sources OVID Medline, Pubmed, Google Scholar, CINAHL, and Academic Search Premier. Study Selection Publication in English language peer-reviewed journals. Studies provided quantitative provider-to-provider communication data, provider satisfaction statistics, or EHR communication data. Data Extraction Literature review. Data Synthesis Two reviewers conducted the title review to determine eligible studies from initial search results. Three reviewers independently reviewed titles, abstracts, and full text (where appropriate) against inclusion and exclusion criteria. Limitations Small number of eligible studies; few described trial design (20%). Homogeneous provider-type (physicians). English-only studies. Conclusions Of twenty-five included studies, all focused on physicians; most were observational (68%). Most (60%) described electronic specialist referral tools. Although overall use has been measured, there were no studies of the effectiveness of intra-EHR messaging. Literature describing the effectiveness of provider-to-provider electronic communications is sparse and narrow in scope. Complex care, such as that envisioned for the Patient Centered Medical Home, necessitates further research. PMID:24101544

  9. Parents' perceived obstacles to pediatric clinical trial participation: Findings from the clinical trials transformation initiative.

    PubMed

    Greenberg, Rachel G; Gamel, Breck; Bloom, Diane; Bradley, John; Jafri, Hasan S; Hinton, Denise; Nambiar, Sumathi; Wheeler, Chris; Tiernan, Rosemary; Smith, P Brian; Roberts, Jamie; Benjamin, Daniel K

    2018-03-01

    Enrollment of children into pediatric clinical trials remains challenging. More effective strategies to improve recruitment of children into trials are needed. This study used in-depth qualitative interviews with parents who were approached to enroll their children in a clinical trial in order to gain an understanding of the barriers to pediatric clinical trial participation. Twenty-four parents whose children had been offered the opportunity to participate in a clinical trial were interviewed: 19 whose children had participated in at least 1 clinical trial and 5 who had declined participation in any trial. Each study aspect, from the initial explanation of the study to the end of the study, can affect the willingness of parents to consent to the proposed study and future studies. Establishing trust, appropriate timing, a transparent discussion of risks and benefits oriented to the layperson, and providing motivation for children to participate were key factors that impacted parents' decisions. In order for clinical trial accrual to be successful, parents' priorities and considerations must be a central focus, beginning with initial trial design. The recommendations from the parents who participated in this study can be used to support budget allocations that ensure adequate training of study staff and improved staffing on nights and weekends. Studies of parent responses in outpatient settings and additional inpatient settings will provide valuable information on the consent process from the child's and parent's perspectives. Further studies are needed to explore whether implementation of such strategies will result in improved recruitment for pediatric clinical trials.

  10. Drug Use and Sex Work Among At-risk Women: A Qualitative Study of Initial Factors.

    PubMed

    Roshanfekr, Payam; Noori, Roya; Dejman, Masoumeh; Fathi Geshnigani, Zahra; Rafiey, Hassan

    2015-06-01

    In recent years, there has been an increasing interest in performing research on drug use and sex work among at-risk women. Although there is a well-documented literature of the initial reasons associated with drug use and sex work among women, there is, however, a paucity of information in this area in Iran. This study aimed to explore the initial reasons associated with drug use and sex work in a group of female treatment seekers, who presented health-related risk behaviors, in Tehran, Iran. This qualitative study enrolled a total of 65 at-risk women, from five women-specific drug clinics, who participated in the study in 2011. Individual in-depth interviews were conducted. Focus group interviews were conducted with 10 key informants. All interviews were audio-taped and thematically written. The recorded data were analyzed using ATLASti qualitative research software version 10. The median age of the sample was 34 years. In addition, 44.6% of subjects were opiate users, and 55.4% were users of opiates and methamphetamine. Sex work was the main source of income for almost half of the sample. The most frequently reported reasons, associated with initial drug use, were extrinsic motivations, including the drug-using family, friends or social networks. Intrinsic motivations, including curiosity and individual willingness to use drugs, were other initial reasons. The most frequently reported reasons, associated with initial sex work, included the need to purchase drugs and financial problems. The study findings demonstrated a number of reasons associated with initial drug use and sex work. The role of sex work in providing drugs necessitates education and prevention. Special treatment programs should be implemented to prevent sex work among at-risk women in Iran.

  11. Conduits to care: call lights and patients' perceptions of communication.

    PubMed

    Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

    2017-01-01

    Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

  12. Initial Probabilistic Evaluation of Reactor Pressure Vessel Fracture with Grizzly and Raven

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

    Spencer, Benjamin; Hoffman, William; Sen, Sonat

    2015-10-01

    The Grizzly code is being developed with the goal of creating a general tool that can be applied to study a variety of degradation mechanisms in nuclear power plant components. The first application of Grizzly has been to study fracture in embrittled reactor pressure vessels (RPVs). Grizzly can be used to model the thermal/mechanical response of an RPV under transient conditions that would be observed in a pressurized thermal shock (PTS) scenario. The global response of the vessel provides boundary conditions for local models of the material in the vicinity of a flaw. Fracture domain integrals are computed to obtainmore » stress intensity factors, which can in turn be used to assess whether a fracture would initiate at a pre-existing flaw. These capabilities have been demonstrated previously. A typical RPV is likely to contain a large population of pre-existing flaws introduced during the manufacturing process. This flaw population is characterized stastistically through probability density functions of the flaw distributions. The use of probabilistic techniques is necessary to assess the likelihood of crack initiation during a transient event. This report documents initial work to perform probabilistic analysis of RPV fracture during a PTS event using a combination of the RAVEN risk analysis code and Grizzly. This work is limited in scope, considering only a single flaw with deterministic geometry, but with uncertainty introduced in the parameters that influence fracture toughness. These results are benchmarked against equivalent models run in the FAVOR code. When fully developed, the RAVEN/Grizzly methodology for modeling probabilistic fracture in RPVs will provide a general capability that can be used to consider a wider variety of vessel and flaw conditions that are difficult to consider with current tools. In addition, this will provide access to advanced probabilistic techniques provided by RAVEN, including adaptive sampling and parallelism, which can dramatically decrease run times.« less

  13. The DoD's High Performance Computing Modernization Program - Ensuing the National Earth Systems Prediction Capability Becomes Operational

    NASA Astrophysics Data System (ADS)

    Burnett, W.

    2016-12-01

    The Department of Defense's (DoD) High Performance Computing Modernization Program (HPCMP) provides high performance computing to address the most significant challenges in computational resources, software application support and nationwide research and engineering networks. Today, the HPCMP has a critical role in ensuring the National Earth System Prediction Capability (N-ESPC) achieves initial operational status in 2019. A 2015 study commissioned by the HPCMP found that N-ESPC computational requirements will exceed interconnect bandwidth capacity due to the additional load from data assimilation and passing connecting data between ensemble codes. Memory bandwidth and I/O bandwidth will continue to be significant bottlenecks for the Navy's Hybrid Coordinate Ocean Model (HYCOM) scalability - by far the major driver of computing resource requirements in the N-ESPC. The study also found that few of the N-ESPC model developers have detailed plans to ensure their respective codes scale through 2024. Three HPCMP initiatives are designed to directly address and support these issues: Productivity Enhancement, Technology, Transfer and Training (PETTT), the HPCMP Applications Software Initiative (HASI), and Frontier Projects. PETTT supports code conversion by providing assistance, expertise and training in scalable and high-end computing architectures. HASI addresses the continuing need for modern application software that executes effectively and efficiently on next-generation high-performance computers. Frontier Projects enable research and development that could not be achieved using typical HPCMP resources by providing multi-disciplinary teams access to exceptional amounts of high performance computing resources. Finally, the Navy's DoD Supercomputing Resource Center (DSRC) currently operates a 6 Petabyte system, of which Naval Oceanography receives 15% of operational computational system use, or approximately 1 Petabyte of the processing capability. The DSRC will provide the DoD with future computing assets to initially operate the N-ESPC in 2019. This talk will further describe how DoD's HPCMP will ensure N-ESPC becomes operational, efficiently and effectively, using next-generation high performance computing.

  14. Culture, management and finances as key aspects for healthy workplace initiatives.

    PubMed

    Waterworth, Pippa; Pescud, Melanie; Chappell, Stacie; Davies, Christina; Roche, Dee; Shilton, Trevor; Ledger, Melissa; Slevin, Terry; Rosenberg, Michael

    2018-02-01

    The aim of this study was to qualitatively explore the barriers and enablers to implementing healthy workplace initiatives in a sample of workplaces based in Perth, Western Australia. In-depth interviews were conducted with representatives from 31 organizations representing small, medium and large businesses in the Perth metropolitan area which reported having healthy workplace initiatives. In total, 43 factors were mentioned as influencing the implementation of healthy workplace initiatives. Factors appearing to exert the most influence on the implementation of health promoting initiatives in this sample were culture; support from managers and staff; collaboration with industry providers; financial resources circumstances and the physical environment. These factors appeared to be mutually reinforcing and interconnected. Findings suggest there may be merit in applying an organizational development lens to the implementation of workplace health promotion initiatives as this could assist in leveraging enablers and minimizing barriers. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. ‘Crisis’ and ‘Everyday’ Initiators: A Qualitative Study of Coercion and Agency in the Context of Methadone Maintenance Treatment Initiation

    PubMed Central

    Damon, Will; Small, Will; Anderson, Solanna; Maher, Lisa; Wood, Evan; Kerr, Thomas; McNeil, Ryan

    2016-01-01

    Introduction and Aims Patient attrition is common among people enrolled in methadone maintenance treatment (MMT) programs and most pronounced during the first year of treatment. However, the experiences of patients initiating MMT have been overlooked in the literature. This study explores experiences of MMT initiation among MMT patients, focusing on contextual influences on MMT initiation and perceptions of MMT and their subsequent influence on treatment retention. Design and Methods Semi-structured qualitative interviews were conducted with 39 MMT patients in Vancouver, Canada. Individuals reporting enrolment in MMT were recruited from within two ongoing cohort studies comprised of people who use drugs. Interview transcripts were analysed using an inductive and iterative approach. Results Two groups of MMT initiators were identified: (i) ‘crisis initiators’ prescribed methadone following critical transition events, such as incarceration or pregnancy; and (ii) ‘everyday initiators’ enrolled in MMT as part of routine healthcare utilisation. While most ‘crisis initiators’ and some ‘everyday initiators’ described experiencing coercion during MMT initiation, ‘crisis initiators’ were further subjected to the coercive leveraging of their vulnerability to motivate ‘consent’ for MMT. ‘Crisis initiators’ developed negative views towards MMT and were more likely to discontinue treatment. Long-standing patient– provider relationships and open dialogue were associated with more positive views regarding MMT, regardless of the circumstances of initiation. Discussion and Conclusion Findings underscore the need for clear and effective communication regarding treatment regimens and expectations during MMT initiation. Furthermore, training in trauma-informed care may help reduce perceptions of coercion and rates of early treatment termination. PMID:27126765

  16. An assessment of prospects for international cooperation on the Space Exploration Initiative

    NASA Technical Reports Server (NTRS)

    Cline, Lynn F. H.; Rosendhal, Jeffrey D.

    1991-01-01

    This paper discusses the unique characteristics of the Space Exploration Initiative (SEI) which will have to be taken into account if the Initiative is to become an international one; the technical capabilities offered by prospective international partners; the political and economic prospects for proceeding with the Initiative both in the United States and elsewhere; and the advantages and disadvantages of various possible approaches to international cooperation on SEI. SEI preparatory activities are likely to extend over a several-year period. Such an extended preparatory period should provide the time needed for coordinating studies, for identifing interests and potential contributions, and for resolving the numerous planning, budgeting, organizational and political issues which will have to be dealt with if such a complex undertaking is to be successfully internationalized.

  17. Structural Confirmation of a Bent and Open Model for the Initiation Complex of T7 RNA Polymerase

    PubMed Central

    Turingan, Rosemary S.; Liu, Cuihua; Hawkins, Mary E.; Martin, Craig T.

    2008-01-01

    T7 RNA polymerase is known to induce bending of its promoter DNA upon binding, as evidenced by gel-shift assays and by recent end-to-end fluorescence energy transfer distance measurements. Crystal structures of promoter-bound and initially transcribing complexes, however, lack downstream DNA, providing no information on the overall path of the DNA through the protein. Crystal structures of the elongation complex do include downstream DNA and provide valuable guidance in the design of models for the complete melted bubble structure at initiation. In the current study, we test a specific structural model for the initiation complex, obtained by alignment of the C-terminal regions of the protein structures from both initiation and elongation and then simple transferal of the downstream DNA from the elongation complex onto the initiation complex. FRET measurement of distances from a point upstream on the promoter DNA to various points along the downstream helix reproduce the expected helical periodicity in the distances and support the model’s orientation and phasing of the downstream DNA. The model also makes predictions about the extent of melting downstream of the active site. By monitoring fluorescent base analogs incorporated at various positions in the DNA we have mapped the downstream edge of the bubble, confirming the model. The initially melted bubble, in the absence of substrate, encompasses 7–8 bases and is sufficient to allow synthesis of a 3 base transcript before further melting is required. The results demonstrate that despite massive changes in the N-terminal portion of the protein and in the DNA upstream of the active site, the DNA downstream of the active site is virtually identical in both initiation and elongation complexes. PMID:17253774

  18. Clinical Decision Support Improves Initial Dosing and Monitoring of Tobramycin and Amikacin

    PubMed Central

    Cox, Zachary L.; Nelsen, Cori L.; Waitman, Lemuel R.; McCoy, Jacob A.; Peterson, Josh F.

    2010-01-01

    Purpose Clinical decision support (CDS) systems could be valuable tools in reducing aminoglycoside prescribing errors. We evaluated the impact of CDS on initial dosing, interval, and pharmacokinetic outcomes of amikacin and tobramycin therapy. Methods A complex CDS advisor to provide guidance on initial dosing and monitoring, using both traditional and extended interval dosing strategies, was integrated into computerized provider order entry (CPOE) and compared to a control group which featured close pharmacy monitoring of all aminoglycoside orders. A random sample of 118 patients from an academic, tertiary care medical center prescribed amikacin and tobramycin prior to advisor implementation was compared to 98 patients admitted following advisor implementation. Primary outcome was an initial dose within 10% of a dose calculated to be adherent to published dose guidelines. Secondary outcomes were a guideline-adherent interval, trough and peak concentrations in goal range, and incidence of nephrotoxicity. Results Of 216 patients studied, 97 were prescribed amikacin and 119 were prescribed tobramycin. The primary outcome of initial dosing consistent with guideline-based care increased from 40% in the pre-advisor arm to 80% in the post-advisor arm (p<0.001), with a number needed to treat of 3 patients to prevent one incorrect dose. Correct initial interval based on renal function also increased from 63% to 87% (p<0.001). The changes in initial dosing and interval resulted in an increase of trough concentrations in the goal range from 59% pre-advisor to 89% post-advisor implementation (p=0.0004). There was no significant difference in peak concentrations in goal range or incidence of nephrotoxicity (25% vs. 17%, p=0.2). Conclusion An advisor for aminoglycoside dosing and monitoring integrated into CPOE significantly improves initial dosing, selection of interval, and trough concentrations at goal compared to unassisted physician dosing. PMID:21411805

  19. An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

    PubMed

    Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

    2014-12-30

    The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

  20. Leaderless Transcripts and Small Proteins Are Common Features of the Mycobacterial Translational Landscape

    PubMed Central

    Lapierre, Pascal; Mir, Mushtaq; Chase, Michael R.; Pyle, Margaret M.; Gawande, Richa; Ahmad, Rushdy; Sarracino, David A.; Ioerger, Thomas R.; Fortune, Sarah M.; Derbyshire, Keith M.; Wade, Joseph T.; Gray, Todd A.

    2015-01-01

    RNA-seq technologies have provided significant insight into the transcription networks of mycobacteria. However, such studies provide no definitive information on the translational landscape. Here, we use a combination of high-throughput transcriptome and proteome-profiling approaches to more rigorously understand protein expression in two mycobacterial species. RNA-seq and ribosome profiling in Mycobacterium smegmatis, and transcription start site (TSS) mapping and N-terminal peptide mass spectrometry in Mycobacterium tuberculosis, provide complementary, empirical datasets to examine the congruence of transcription and translation in the Mycobacterium genus. We find that nearly one-quarter of mycobacterial transcripts are leaderless, lacking a 5’ untranslated region (UTR) and Shine-Dalgarno ribosome-binding site. Our data indicate that leaderless translation is a major feature of mycobacterial genomes and is comparably robust to leadered initiation. Using translational reporters to systematically probe the cis-sequence requirements of leaderless translation initiation in mycobacteria, we find that an ATG or GTG at the mRNA 5’ end is both necessary and sufficient. This criterion, together with our ribosome occupancy data, suggests that mycobacteria encode hundreds of small, unannotated proteins at the 5’ ends of transcripts. The conservation of small proteins in both mycobacterial species tested suggests that some play important roles in mycobacterial physiology. Our translational-reporter system further indicates that mycobacterial leadered translation initiation requires a Shine Dalgarno site in the 5’ UTR and that ATG, GTG, TTG, and ATT codons can robustly initiate translation. Our combined approaches provide the first comprehensive view of mycobacterial gene structures and their non-canonical mechanisms of protein expression. PMID:26536359

  1. Leaderless Transcripts and Small Proteins Are Common Features of the Mycobacterial Translational Landscape.

    PubMed

    Shell, Scarlet S; Wang, Jing; Lapierre, Pascal; Mir, Mushtaq; Chase, Michael R; Pyle, Margaret M; Gawande, Richa; Ahmad, Rushdy; Sarracino, David A; Ioerger, Thomas R; Fortune, Sarah M; Derbyshire, Keith M; Wade, Joseph T; Gray, Todd A

    2015-11-01

    RNA-seq technologies have provided significant insight into the transcription networks of mycobacteria. However, such studies provide no definitive information on the translational landscape. Here, we use a combination of high-throughput transcriptome and proteome-profiling approaches to more rigorously understand protein expression in two mycobacterial species. RNA-seq and ribosome profiling in Mycobacterium smegmatis, and transcription start site (TSS) mapping and N-terminal peptide mass spectrometry in Mycobacterium tuberculosis, provide complementary, empirical datasets to examine the congruence of transcription and translation in the Mycobacterium genus. We find that nearly one-quarter of mycobacterial transcripts are leaderless, lacking a 5' untranslated region (UTR) and Shine-Dalgarno ribosome-binding site. Our data indicate that leaderless translation is a major feature of mycobacterial genomes and is comparably robust to leadered initiation. Using translational reporters to systematically probe the cis-sequence requirements of leaderless translation initiation in mycobacteria, we find that an ATG or GTG at the mRNA 5' end is both necessary and sufficient. This criterion, together with our ribosome occupancy data, suggests that mycobacteria encode hundreds of small, unannotated proteins at the 5' ends of transcripts. The conservation of small proteins in both mycobacterial species tested suggests that some play important roles in mycobacterial physiology. Our translational-reporter system further indicates that mycobacterial leadered translation initiation requires a Shine Dalgarno site in the 5' UTR and that ATG, GTG, TTG, and ATT codons can robustly initiate translation. Our combined approaches provide the first comprehensive view of mycobacterial gene structures and their non-canonical mechanisms of protein expression.

  2. Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis - a qualitative study from Tamil Nadu, India.

    PubMed

    Nielsen, Karoline Kragelund; Rheinländer, Thilde; Kapur, Anil; Damm, Peter; Seshiah, Veerasamy; Bygbjerg, Ib C

    2017-08-01

    In 2007, universal screening for gestational diabetes mellitus (GDM) was introduced in Tamil Nadu, India. To identify factors hindering or facilitating timely initiation and completion of the GDM screening and diagnosis process, our study investigated how pregnant women in rural and urban Tamil Nadu access and navigate different GDM related health services. The study was carried out in two settings: an urban private diabetes centre and a rural government primary health centre. Observations of the process of screening and diagnosis at the health centres as well as semi-structured interviews with 30 pregnant women and nine health care providers were conducted. Data was analysed using qualitative content analysis. There were significant differences in the process of GDM screening and diagnosis in the urban and rural settings. Several factors hindering or facilitating timely initiation and completion of the process were identified. Timely attendance required awareness, motivation and opportunity to attend. Women had to attend the health centre at the right time and sometimes at the right gestational age to initiate the test, wait to complete the test and obtain the test report in time to initiate further action. All these steps and requirements were influenced by factors within and outside the health system such as getting right information from health care providers, clinic timings, characteristics of the test, availability of transport, social network and support, and social norms and cultural practices. Minimising and aligning complex stepwise processes of prenatal care and GDM screening delivery and attention to the factors influencing it are important for further improving and expanding GDM screening and related services, not only in Tamil Nadu but in other similar low and middle income settings. This study stresses the importance of guidelines and diagnostic criteria which are simple and feasible on the ground.

  3. Lightning Initiation Forecasting: An Operational Dual-Polarimetric Radar Technique

    NASA Technical Reports Server (NTRS)

    Woodard, Crystal J.; Carey, L. D.; Petersen, W. A.; Roeder, W. P.

    2011-01-01

    The objective of this NASA MSFC and NOAA CSTAR funded study is to develop and test operational forecast algorithms for the prediction of lightning initiation utilizing the C-band dual-polarimetric radar, UAHuntsville's Advanced Radar for Meteorological and Operational Research (ARMOR). Although there is a rich research history of radar signatures associated with lightning initiation, few studies have utilized dual-polarimetric radar signatures (e.g., Z(sub dr) columns) and capabilities (e.g., fuzzy-logic particle identification [PID] of precipitation ice) in an operational algorithm for first flash forecasting. The specific goal of this study is to develop and test polarimetric techniques that enhance the performance of current operational radar reflectivity based first flash algorithms. Improving lightning watch and warning performance will positively impact personnel safety in both work and leisure environments. Advanced warnings can provide space shuttle launch managers time to respond appropriately to secure equipment and personnel, while they can also provide appropriate warnings for spectators and players of leisure sporting events to seek safe shelter. Through the analysis of eight case dates, consisting of 35 pulse-type thunderstorms and 20 non-thunderstorm case studies, lightning initiation forecast techniques were developed and tested. The hypothesis is that the additional dual-polarimetric information could potentially reduce false alarms while maintaining high probability of detection and increasing lead-time for the prediction of the first lightning flash relative to reflectivity-only based techniques. To test the hypothesis, various physically-based techniques using polarimetric variables and/or PID categories, which are strongly correlated to initial storm electrification (e.g., large precipitation ice production via drop freezing), were benchmarked against the operational reflectivity-only based approaches to find the best compromise between forecast skill and lead-time. Forecast skill is determined by statistical analysis of probability of detection (POD), false alarm ratio (FAR), Operational Utility Index (OUI), and critical success index (CSI).

  4. 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

  5. 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.

  6. Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

    PubMed

    Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

    2017-07-01

    Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

  7. A Predictive Study of Pre-Service Teachers and Success in Final Student Internship

    ERIC Educational Resources Information Center

    Ingle, Karen M.

    2017-01-01

    Student teaching provides the final pre-service clinical teaching experience of an initial teacher preparation program. Research that specifically studies the pre-service student teacher and predictive factors of student teaching is limited. Identifying predictive factors that contribute to the success of student interns' student teaching…

  8. A Literature Review of Academic Library Web Page Studies

    ERIC Educational Resources Information Center

    Blummer, Barbara

    2007-01-01

    In the early 1990s, numerous academic libraries adopted the web as a communication tool with users. The literature on academic library websites includes research on both design and navigation. Early studies typically focused on design characteristics, since websites initially merely provided information on the services and collections available in…

  9. Evaluation of Training Programs for Rural Development

    ERIC Educational Resources Information Center

    Indira, A.

    2008-01-01

    An Evaluation of the "Impact Assessment of the Training Programs" of a National Level Training Institution in India was conducted using the Kirkpatrick Method (KP Method). The studied Institution takes up research, provides training, offers consultancy and initiates action in the rural sector of India. The evaluation study used a…

  10. Employment Projections and Program Priorities. AIR 1999 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Rosenthal, Dan; Collier, Kitty

    This study compared occupational projections for Alabama with graduation rates in corresponding academic programs to provide a context for state and institutional policy decisions on new program initiatives and to comply with recent program viability legislation. The study examined number of degrees conferred, employment projections, and…

  11. Design of Affectively Evocative Smart Ambient Media for Learning

    ERIC Educational Resources Information Center

    Kwok, Ron Chi-Wai; Cheng, Shuk Han; Ip, Horace Ho-Shing; Kong, Joseph Siu-Lung

    2011-01-01

    This study proposes a teaching and research initiative, named SAMAL (Smart AMbience for Affective Learning) that will provide a unique ambient mediated environment for integrating cognitive and affective approaches to enhance learning. Also, this study illustrates a design of SAMAL classroom with affectively evocative scenarios for learning de…

  12. Teacher Curriculum Work Center: A Descriptive Study.

    ERIC Educational Resources Information Center

    Feiman, Sharon

    This monograph is one of a continuing series initiated to provide materials for teachers, parents, school administrators, and governmental decision-makers that might encourage reexamination of a range of evaluation issues and perspectives about schools and schooling. This monograph is a descriptive study of the Teacher Curriculum Work Center,…

  13. AN INTEGRATED SYNTHESIS OF KEY AND POLICY RELEVANT FINDINGS FROM EPA'S SUPERSITES PROGRAM AND RELATED STUDIES

    EPA Science Inventory

    This presentation provides an overview and initial insights into the findings based on results from EPA's PM Supersites Program and related studies. Many key atmospheric sciences findings have been identified through the research conducted during the last five years as part of t...

  14. Supporting School Leaders in Blended Learning with Blended Learning

    ERIC Educational Resources Information Center

    Acree, Lauren; Gibson, Theresa; Mangum, Nancy; Wolf, Mary Ann; Kellogg, Shaun; Branon, Suzanne

    2017-01-01

    This study provides a mixed-methods case-study design evaluation of the Leadership in Blended Learning (LBL) program. The LBL program uses blended approaches, including face-to-face and online, to prepare school leaders to implement blended learning initiatives in their schools. This evaluation found that the program designers effectively…

  15. Approaches to the Secondary School Literature Curriculum.

    ERIC Educational Resources Information Center

    Anderson, Philip M.

    The origins of modern English teaching can be found in the Uniform Lists provided by eastern colleges, beginning in 1874, for college entrance examinations. The study of literature was informed by the arguments of Matthew Arnold, who maintained that the purpose of literature study was initiation into, and maintenance of, "high…

  16. The relationship between local clean indoor air policies and smoking initiation in Minnesota youth

    PubMed Central

    Forster, Jean L.; Erickson, Darin J.; Lytle, Leslie A.; Schillo, Barbara

    2009-01-01

    Background While clean indoor air (CIA) policies are intended to reduce exposure to secondhand smoke in the workplace, restrictions in public workplaces have the potential to discourage youth smoking. There is growing evidence from cross-sectional and ecologic studies, but limited evidence from longitudinal studies that this is so. Objective To evaluate the association between local clean indoor air (CIA) policies and smoking initiation among Minnesota youth over time. Design, setting, and subjects A cohort of 4233 Minnesota youths, ages 11 to 16 at baseline, was interviewed via telephone for six years (2000 – 2006). Individual, family, and community level variables were collected from participants every six months. A generalized linear mixed model was used to assess the relationship between smoking initiation and CIA policies over time. The analysis was controlled for potential confounders at the individual- and community-level. Results Youth living in an area without a CIA policy were 8% more likely to initiate smoking (OR=1.08 CI: 1.00 – 1.16) compared to youth living in an area with a local CIA policy, after adjustment for multilevel covariates. Conclusion Local CIA policies accounted for a small, but significant, reduction in youth smoking initiation among Minnesota youth in this cohort. This study provides additional support for use of CIA policies to prevent exposure to secondhand smoke and smoking initiation in youth. PMID:19103639

  17. Critical and Social Literacy Practices from the Scottish Adult Literacy Experience: Resisting Deficit Approaches to Learning

    ERIC Educational Resources Information Center

    Crowther, Jim; Tett, Lyn

    2011-01-01

    Scotland provides an interesting context for studying adult literacy in that it is one of the few countries that explicitly acknowledge the idea of literacy as a social practice. By drawing on two initiatives we illustrate literacy learning derived from a mixture of social practice and critical literacy perspectives. Together they provide insights…

  18. Non-contact image processing for gin trash sensors in stripper harvested cotton with burr and fine trash correction

    USDA-ARS?s Scientific Manuscript database

    This study was initiated to provide the basis for obtaining online information as to the levels of the various types of gin trash. The objective is to provide the ginner with knowledge of the quantity of the various trash components in the raw uncleaned seed cotton. This information is currently not...

  19. Income Inequality and the Online Reading Gap: Teaching Our Way to Success With Online Research and Comprehension

    ERIC Educational Resources Information Center

    Leu, Donald J.; Forzani, Elena; Kennedy, Clint

    2015-01-01

    A recent study in "Reading Research Quarterly" provided evidence that an online reading achievement gap, based on income inequality, exists that is separate and independent from the well-known achievement gap in offline reading. This column briefly reviews the evidence and provides an initial set of instructional suggestions that may be…

  20. A Qualitative Study of the Lived Experiences of Disabled Post-Transition Students in Higher Education Institutions in Northern Ireland

    ERIC Educational Resources Information Center

    Redpath, Jennifer; Kearney, Patricia; Nicholl, Peter; Mulvenna, Maurice; Wallace, Jonathan; Martin, Suzanne

    2013-01-01

    This article provides a systematic analysis of 13 in-depth interviews of disabled students from universities in Northern Ireland. Undertaken as part of the Uni4U initiative, the findings presented describe barriers experienced by students with disabilities to participation in higher education. The students provided comments concerning their…

  1. Hard gains through soft contracts: productive engagement of private providers in tuberculosis control.

    PubMed Central

    Lönnroth, Knut; Uplekar, Mukund; Blanc, Léopold

    2006-01-01

    Over the past decade, there has been a rapid increase in the number of initiatives involving "for-profit" private health care providers in national tuberculosis (TB) control efforts. We reviewed 15 such initiatives with respect to contractual arrangements, quality of care and success achieved in TB control. In seven initiatives, the National TB Programme (NTP) interacted directly with for-profit providers; while in the remaining eight, the NTP collaborated with for-profit providers through intermediary not-for-profit nongovernmental organizations. All but one of the initiatives used relational "drugs-for-performance contracts" to engage for-profit providers, i.e. drugs were provided free of charge by the NTP emphasizing that providers dispense them free of charge to patients and follow national guidelines for diagnosis and treatment. We found that 90% (range 61-96%) of new smear-positive pulmonary TB cases were successfully treated across all initiatives and TB case detection rates increased between 10% and 36%. We conclude that for-profit providers can be effectively involved in TB control through informal, but well defined drugs-for-performance contracts. The contracting party should be able to reach a common understanding concerning goals and role division with for-profit providers and monitor them for content and quality. Relational drugs-for-performance contracts minimize the need for handling the legal and financial aspects of classical contracting. We opine that further analysis is required to assess if such "soft" contracts are sufficient to scale up private for-profit provider involvement in TB control and other priority health interventions. PMID:17143461

  2. Psychological factors related to nurses' intentions to initiate an antipsychotic or psychosocial intervention with nursing home residents.

    PubMed

    Ludwin, Brian M; Meeks, Suzanne

    2018-05-03

    This study examined the validity of a psychological model for understanding nursing home providers' treatment choices when managing challenging dementia-related behaviors. Ninety-nine nurses from 26 long-term care facilities responded to a case study with their intentions to initiate an antipsychotic or psychosocial intervention and completed self-report measures of their attitudes, descriptive norms, self-efficacy, and outcome expectancies. The multi-level modeling results demonstrated that nurses with more positive outcome expectancies for the effect of an antipsychotic on resident behavior, and those with more positive attitudes towards antipsychotics, had greater intentions to initiate an antipsychotic. Intentions to initiate a psychosocial intervention were greater when nurses perceived a lower prevalence of antipsychotics and in facilities with nurses who collectively had higher self-efficacy to implement such interventions. The findings offer partial support for the proposed model and possible intervention targets to improve psychosocial intervention use and antipsychotic prescribing. Published by Elsevier Inc.

  3. R-rated Movie Viewing, Growth in Sensation Seeking and Alcohol Initiation: Reciprocal and Moderation Effects

    PubMed Central

    Stoolmiller, Mike; Gerrard, Meg; Worth, Keilah A.; Gibbons, Frederick X.

    2010-01-01

    The current study employed parallel process and discrete time hazard regressions to examine the interplay among exposure to R-rated movies, sensation seeking, and initiation of alcohol use in a national U.S. sample (N=6255) of adolescents, ages 10–14, who were followed over four waves spanning 2 years. There was a short-term reciprocal relation between watching R-rated movies and sensation seeking, but over the 2-year observation period, exposure to R-rated movies was associated with increases in sensation seeking and not vice versa. Sensation seeking also moderated the effect of watching R-rated movies on initiation of alcohol consumption such that exposure was associated with greater increases in initiation of alcohol use among low sensation than among high sensation seeking adolescents. The study provides empirical evidence of an environmental media effect on sensation seeking, and important new information about the relations among sensation seeking, media exposure, and adolescent alcohol use. PMID:19655251

  4. R-rated movie viewing, growth in sensation seeking and alcohol initiation: reciprocal and moderation effects.

    PubMed

    Stoolmiller, Mike; Gerrard, Meg; Sargent, James D; Worth, Keilah A; Gibbons, Frederick X

    2010-03-01

    The current study employed parallel process and discrete time hazard regressions to examine the interplay among exposure to R-rated movies, sensation seeking, and initiation of alcohol use in a national U.S. sample (N = 6255) of adolescents, ages 10-14, who were followed over four waves spanning 2 years. There was a short-term reciprocal relation between watching R-rated movies and sensation seeking, but over the 2-year observation period, exposure to R-rated movies was associated with increases in sensation seeking and not vice versa. Sensation seeking also moderated the effect of watching R-rated movies on initiation of alcohol consumption such that exposure was associated with greater increases in initiation of alcohol use among low sensation than among high sensation seeking adolescents. The study provides empirical evidence of an environmental media effect on sensation seeking, and important new information about the relations among sensation seeking, media exposure, and adolescent alcohol use.

  5. Dynamics of coherent states in regular and chaotic regimes of the non-integrable Dicke model

    NASA Astrophysics Data System (ADS)

    Lerma-Hernández, S.; Chávez-Carlos, J.; Bastarrachea-Magnani, M. A.; López-del-Carpio, B.; Hirsch, J. G.

    2018-04-01

    The quantum dynamics of initial coherent states is studied in the Dicke model and correlated with the dynamics, regular or chaotic, of their classical limit. Analytical expressions for the survival probability, i.e. the probability of finding the system in its initial state at time t, are provided in the regular regions of the model. The results for regular regimes are compared with those of the chaotic ones. It is found that initial coherent states in regular regions have a much longer equilibration time than those located in chaotic regions. The properties of the distributions for the initial coherent states in the Hamiltonian eigenbasis are also studied. It is found that for regular states the components with no negligible contribution are organized in sequences of energy levels distributed according to Gaussian functions. In the case of chaotic coherent states, the energy components do not have a simple structure and the number of participating energy levels is larger than in the regular cases.

  6. The Early College High School Initiative: An Overview of Five Evaluation Years

    ERIC Educational Resources Information Center

    Berger, Andrea; Adelman, Nancy; Cole, Susan

    2010-01-01

    In 2002, the Bill & Melinda Gates Foundation started the Early College High School Initiative (ECHSI). Through this initiative, more than 200 Early College Schools (ECSs) opened by fall 2009. All of the schools aim to provide underserved students access to college classes while in high school. This article will provide an overview of the first 6…

  7. Initial data sets for the Schwarzschild spacetime

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

    Gomez-Lobo, Alfonso Garcia-Parrado; Kroon, Juan A. Valiente; School of Mathematical Sciences, Queen Mary, University of London, Mile End Road, London E1 4NS

    2007-01-15

    A characterization of initial data sets for the Schwarzschild spacetime is provided. This characterization is obtained by performing a 3+1 decomposition of a certain invariant characterization of the Schwarzschild spacetime given in terms of concomitants of the Weyl tensor. This procedure renders a set of necessary conditions--which can be written in terms of the electric and magnetic parts of the Weyl tensor and their concomitants--for an initial data set to be a Schwarzschild initial data set. Our approach also provides a formula for a static Killing initial data set candidate--a KID candidate. Sufficient conditions for an initial data set tomore » be a Schwarzschild initial data set are obtained by supplementing the necessary conditions with the requirement that the initial data set possesses a stationary Killing initial data set of the form given by our KID candidate. Thus, we obtain an algorithmic procedure of checking whether a given initial data set is Schwarzschildean or not.« less

  8. Reducing roughness in rehabilitated asphalt concrete (AC) pavements

    DOT National Transportation Integrated Search

    1998-12-01

    A recently completed study entitled, "The Investigation of Development of Pavement Roughness" (FHWA-RD-97-147), initiated by the Long Term Pavement Performance (LTPP) program, provides an answer to the question of how much different rehabilitation tr...

  9. Human Factors in Railroad Operations : Initial Studies

    DOT National Transportation Integrated Search

    1972-01-01

    This report summarizes the progress of a year's work in providing support in human factors to the Federal Railroad Administration. The principal topics include: (a) a description of the locomotive engineer's job, particularly with regard to its inher...

  10. OKI evaluation of intelligent transportation system

    DOT National Transportation Integrated Search

    2000-06-01

    The Advanced Regional Traffic Interactive Management & Information System (ARTIMIS) is one of the earliest ITS systems deployed in the US with preliminary studies being initiated in the late 1980s and early 1990s. ARTIMIS provides traffic management ...

  11. Evaluation of the service performance of bridge components.

    DOT National Transportation Integrated Search

    2004-08-01

    This study was initiated to provide review of common bridges to determine the performance of their components. Seven bridge types were selected that constituted 85 % of the Kentucky Transportation Cabinet (KYTC) bridge inventory. 319 bridges were ins...

  12. Computerization of material test data reporting system : interim report.

    DOT National Transportation Integrated Search

    1973-09-01

    This study was initiated to provide an integrated system of reporting, storing, and retrieving of construction and material test data using computerized (storage-retrieval) and quality control techniques. The findings reported in this interim report ...

  13. Measurements in liquid fuel sprays

    NASA Technical Reports Server (NTRS)

    Chigier, N.; Mao, C. P.

    1985-01-01

    A ground test facility is being established at NASA Lewis Research Center to simulate the environmental and flight conditions needed to study adverse weather effects. One of the most important components is the water spray system which consists of many nozzles fitted on spray bars. Water is injected through air-assisted atomizers to generate uniform size drops to simulate icing in clouds. The primary objective is to provide experimental data on drop size distribution over a wide range of operating conditions. Correlation equations for mean drop size and initial injection parameters are being determined to assist in the design and modification of the Altitude Wind Tunnel. Special emphasis is being placed on the study of the aerodynamic structure of the air-assisted atomizer sprays. Detailed measurements of the variation of drop size distribution and velocity as a function of time and space are being made. Accurate initial and boundary conditions are being provided for computer model evaluation.

  14. Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine.

    PubMed

    Coustasse, Alberto; Cunningham, Brian; Deslich, Stacie; Willson, Eric; Meadows, Pamela

    2015-01-01

    Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption.

  15. A modeling analysis program for the JPL table mountain Io sodium cloud

    NASA Technical Reports Server (NTRS)

    Smyth, W. H.; Goldberg, B. A.

    1985-01-01

    Progress and achievements in the first year are discussed in three main areas: (1) review and assessment of the massive JPL Table Mountain Io sodium cloud data set, (2) formulation and execution of a plan to perform further processing of this data set, and (3) initiation of modeling activities. The complete 1976-79 and 1981 data sets are reviewed. Particular emphasis is placed on the superior 1981 Region B/C images which provide a rich base of information for studying the structure and escape of gases from Io as well as possible east-west and magnetic longitudinal asymmetries in the plasma torus. A data processing plan is developed and is undertaken by the Multimission Image Processing Laboratory of JPL for the purpose of providing a more refined and complete data set for our modeling studies in the second year. Modeling priorities are formulated and initial progress in achieving these goals is reported.

  16. Lacustrine flow (divers, side scan sonar, hydrogeology, water penetrating radar) used to understand the location of a drowned person

    NASA Astrophysics Data System (ADS)

    Ruffell, Alastair

    2014-05-01

    An unusual application of hydrological understanding to a police search is described. The lacustrine search for a missing person provided reports of bottom-water currents in the lake and contradictory indications from cadaver dogs. A hydrological model of the area was developed using pre-existing information from side scan sonar, a desktop hydrogeological study and deployment of water penetrating radar (WPR). These provided a hydrological theory for the initial search involving subaqueous groundwater flow, focused on an area of bedrock surrounded by sediment, on the lake floor. The work shows the value a hydrological explanation has to a police search operation (equally to search and rescue). With hindsight, the desktop study should have preceded the search, allowing better understanding of water conditions. The ultimate reason for lacustrine flow in this location is still not proven, but the hydrological model explained the problems encountered in the initial search.

  17. Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings – a systematic review

    PubMed Central

    Govindasamy, Darshini; Meghij, Jamilah; Negussi, Eyerusalem Kebede; Baggaley, Rachel Clare; Ford, Nathan; Kranzer, Katharina

    2014-01-01

    Introduction Several approaches have been taken to reduce pre-antiretroviral therapy (ART) losses between HIV testing and ART initiation in low- and middle-income countries, but a systematic assessment of the evidence has not yet been undertaken. The aim of this systematic review is to assess the potential for interventions to improve or facilitate linkage to or retention in pre-ART care and initiation of ART in low- and middle-income settings. Methods An electronic search was conducted on Medline, Embase, Global Health, Web of Science and conference databases to identify studies describing interventions aimed at improving linkage to or retention in pre-ART care or initiation of ART. Additional searches were conducted to identify on-going trials on this topic, and experts in the field were contacted. An assessment of the risk of bias was conducted. Interventions were categorized according to key domains in the existing literature. Results A total of 11,129 potentially relevant citations were identified, of which 24 were eligible for inclusion, with the majority (n=21) from sub-Saharan Africa. In addition, 15 on-going trials were identified. The most common interventions described under key domains included: health system interventions (i.e. integration in the setting of antenatal care); patient convenience and accessibility (i.e. point-of-care CD4 count (POC) testing with immediate results, home-based ART initiation); behaviour interventions and peer support (i.e. improved communication, patient referral and education) and incentives (i.e. food support). Several interventions showed favourable outcomes: integration of care and peer supporters increased enrolment into HIV care, medical incentives increased pre-ART retention, POC CD4 testing and food incentives increased completion of ART eligibility screening and ART initiation. Most studies focused on the general adult patient population or pregnant women. The majority of published studies were observational cohort studies, subject to an unclear risk of bias. Conclusions Findings suggest that streamlining services to minimize patient visits, providing adequate medical and peer support, and providing incentives may decrease attrition, but the quality of the current evidence base is low. Few studies have investigated combined interventions, or assessed the impact of interventions across the HIV cascade. Results from on-going trials investigating POC CD4 count testing, patient navigation, rapid ART initiation and mobile phone technology may fill the quality of evidence gap. Further high-quality studies on key population groups are required, with interventions informed by previously reported barriers to care. PMID:25095831

  18. The enduring importance of animal modelsin understanding periodontal disease

    PubMed Central

    Hajishengallis, George; Lamont, Richard J; Graves, Dana T

    2015-01-01

    Whereas no single animal model can reproduce the complexity of periodontitis, different aspects of the disease can be addressed by distinct models. Despite their limitations, animal models are essential for testing the biological significance of in vitro findings and for establishing cause-and-effect relationships relevant to clinical observations, which are typically correlative. We provide evidence that animal-based studies have generated a durable framework for dissecting the mechanistic basis of periodontitis. These studies have solidified the etiologic role of bacteria in initiating the inflammatory response that leads to periodontal bone loss and have identified key mediators (IL-1, TNF, prostaglandins, complement, RANKL) that induce inflammatory breakdown. Moreover, animal studies suggest that dysbiosis, rather than individual bacterial species, are important in initiating periodontal bone loss and have introduced the concept that organisms previously considered commensals can play important roles as accessory pathogens or pathobionts. These studies have also provided insight as to how systemic conditions, such as diabetes or leukocyte adhesion deficiency, contribute to tissue destruction. In addition, animal studies have identified and been useful in testing therapeutic targets. PMID:25574929

  19. Practical recommendations for the evaluation of improvement initiatives

    PubMed Central

    Parry, Gareth; Coly, Astou; Goldmann, Don; Rowe, Alexander K; Chattu, Vijay; Logiudice, Deneil; Rabrenovic, Mihajlo; Nambiar, Bejoy

    2018-01-01

    Abstract A lack of clear guidance for funders, evaluators and improvers on what to include in evaluation proposals can lead to evaluation designs that do not answer the questions stakeholders want to know. These evaluation designs may not match the iterative nature of improvement and may be imposed onto an initiative in a way that is impractical from the perspective of improvers and the communities with whom they work. Consequently, the results of evaluations are often controversial, and attribution remains poorly understood. Improvement initiatives are iterative, adaptive and context-specific. Evaluation approaches and designs must align with these features, specifically in their ability to consider complexity, to evolve as the initiative adapts over time and to understand the interaction with local context. Improvement initiatives often identify broadly defined change concepts and provide tools for care teams to tailor these in more detail to local conditions. Correspondingly, recommendations for evaluation are best provided as broad guidance, to be tailored to the specifics of the initiative. In this paper, we provide practical guidance and recommendations that funders and evaluators can use when developing an evaluation plan for improvement initiatives that seeks to: identify the questions stakeholders want to address; develop the initial program theory of the initiative; identify high-priority areas to measure progress over time; describe the context the initiative will be applied within; and identify experimental or observational designs that will address attribution. PMID:29447410

  20. A comparison of treatment effectiveness between the CAD/CAM method and the manual method for managing adolescent idiopathic scoliosis.

    PubMed

    Wong, M S; Cheng, J C Y; Lo, K H

    2005-04-01

    The treatment effectiveness of the CAD/CAM method and the manual method in managing adolescent idiopathic scoliosis (AIS) was compared. Forty subjects were recruited with twenty subjects for each method. The clinical parameters namely Cobb's angle and apical vertebral rotation were evaluated at the pre-brace and the immediate in-brace visits. The results demonstrated that orthotic treatments rendered by the CAD/CAM method and the conventional manual method were effective in providing initial control of Cobb's angle. Significant decreases (p < 0.05) were found between the pre-brace and immediate in-brace visits for both methods. The mean reductions of Cobb's angle were 12.8 degrees (41.9%) for the CAD/CAM method and 9.8 degrees (32.1%) for the manual method. An initial control of the apical vertebral rotation was not shown in this study. In the comparison between the CAD/CAM method and the manual method, no significant difference was found in the control of Cobb's angle and apical vertebral rotation. The current study demonstrated that the CAD/CAM method can provide similar result in the initial stage of treatment as compared with the manual method.

  1. Polythiophene thin films by surface-initiated polymerization: Mechanistic and structural studies

    DOE PAGES

    Youm, Sang Gil; Hwang, Euiyong; Chavez, Carlos A.; ...

    2016-06-15

    The ability to control nanoscale morphology and molecular organization in organic semiconducting polymer thin films is an important prerequisite for enhancing the efficiency of organic thin-film devices including organic light-emitting and photovoltaic devices. The current “top-down” paradigm for making such devices is based on utilizing solution-based processing (e.g., spin-casting) of soluble semiconducting polymers. This approach typically provides only modest control over nanoscale molecular organization and polymer chain alignment. A promising alternative to using solutions of presynthesized semiconducting polymers pursues instead a “bottom-up” approach to prepare surface-grafted semiconducting polymer thin films by surface-initiated polymerization of small-molecule monomers. Herein, we describe themore » development of an efficient method to prepare polythiophene thin films utilizing surface-initiated Kumada catalyst transfer polymerization. In this study, we provided evidence that the surface-initiated polymerization occurs by the highly robust controlled (quasi-“living”) chain-growth mechanism. Further optimization of this method enabled reliable preparation of polythiophene thin films with thickness up to 100 nm. Extensive structural studies of the resulting thin films using X-ray and neutron scattering methods as well as ultraviolet photoemission spectroscopy revealed detailed information on molecular organization and the bulk morphology of the films, and enabled further optimization of the polymerization protocol. One of the remarkable findings was that surface-initiated polymerization delivers polymer thin films showing complex molecular organization, where polythiophene chains assemble into lateral crystalline domains of about 3.2 nm size, with individual polymer chains folded to form in-plane aligned and densely packed oligomeric segments (7-8 thiophene units per each segment) within each domain. Achieving such a complex mesoscale organization is virtually impossible with traditional methods relying on solution processing of presynthesized polymers. Another significant advantage of surface-confined polymer thin films is their remarkable stability toward organic solvents and other processing conditions. In addition to controlled bulk morphology, uniform molecular organization, and stability, a unique feature of the surface-initiated polymerization is that it can be used for the preparation of large-area uniformly nanopatterned polymer thin films. Lastly, this was demonstrated using a combination of particle lithography and surface-initiated polymerization. In general, surface-initiated polymerization is not limited to polythiophene but can be also expanded toward other classes of semiconducting polymers and copolymers.« less

  2. A Web-Based and Print-Based Computer-Tailored Physical Activity Intervention for Prostate and Colorectal Cancer Survivors: A Comparison of User Characteristics and Intervention Use

    PubMed Central

    Bolman, Catherine; Peels, Denise Astrid; Volders, Esmee; de Vries, Hein; Lechner, Lilian

    2017-01-01

    Background Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer. The rapidly increasing number of cancer survivors, resulting from aging and improved cancer care, emphasizes the importance to develop and provide low cost, easy accessible PA programs. Such programs could be provided through the Internet, but that could result in the exclusion of cancer survivors not familiar with the Internet. Therefore, we developed a computer-tailored PA intervention for prostate and colorectal cancer survivors in which both Web-based and print materials are provided, and participants can choose their own preferred delivery mode. Objective The aim of this study was to assess participants’ characteristics related to delivery mode and use of intervention materials. Methods We studied characteristics of participants using Web-based and printed intervention materials in a randomized controlled trial (RCT). Prostate and colorectal cancer survivors recruited from hospitals were randomized to OncoActive (computer-tailored PA intervention) or a usual-care control group. OncoActive participants received both Web-based and printed materials. Participants were classified into initial print- or Web-based participants based on their preferred mode of completion of the first questionnaire, which was needed for the computer-tailored PA advice. Intervention material use during the remainder of the intervention was compared for initial print- or Web-based participants. Additionally, participants were classified into those using only print materials and those using Web-based materials. Differences in participant characteristics and intervention material use were studied through analysis of variance (ANOVAs), chi-square tests, and logistic regressions. Results The majority of the participants in the intervention group were classified as initial Web-based participants (170/249, 68.3%), and 84.9% (191/249) used Web-based intervention materials. Dropout was low (15/249, 6.0%) and differed between initial Web-based (4/170, 2.4%) and print-based (11/79, 14%) participants. Participants were less likely to start Web-based with higher age (odds ratio [OR]=0.93), longer time since last treatment (OR=0.87), and higher fatigue (OR=0.96), and more likely with higher education (OR=4.08) and having completed treatments (OR=5.58). Those who were older (OR=0.93) and post treatment for a longer time (OR=0.86) were less likely to use Web-based intervention materials. Initial print-based participants predominantly used print-based materials, whereas initial Web-based participants used both print- and Web-based materials. Conclusions To our knowledge, this is one of the first studies that assessed participant characteristics related to delivery mode in an intervention in which participants had a free choice of delivery modes. Use of print-based materials among the initial Web-based participants was substantial, indicating the importance of print-based materials. According to our findings, it may be important to offer Web- and print-based materials alongside each other. Providing Web-based materials only may exclude older, less educated, more fatigued, or currently treated participants; these groups are especially more vulnerable and could benefit most from PA interventions. PMID:28835353

  3. A qualitative study of methamphetamine initiation in Cape Town, South Africa

    PubMed Central

    Hobkirk, Andréa L.; Watt, Melissa H.; Myers, Bronwyn; Skinner, Donald; Meade, Christina S.

    2015-01-01

    Background Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals’ initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. Methods In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. Results On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered “trendy”, which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. Conclusion The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills. PMID:26614737

  4. A qualitative study of methamphetamine initiation in Cape Town, South Africa.

    PubMed

    Hobkirk, Andréa L; Watt, Melissa H; Myers, Bronwyn; Skinner, Donald; Meade, Christina S

    2016-04-01

    Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals' initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered "trendy", which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Baseline data for evaluating development trajectory and provision of ecosystem services of created fringing oyster reefs in Vermilion Bay, Louisiana

    USGS Publications Warehouse

    La Peyre, Megan K.; Schwarting, Lindsay; Miller, Shea

    2013-01-01

    Understanding the time frame in which ecosystem services (that is, water quality maintenance, shoreline protection, habitat provision) are expected to be provided is important when restoration projects are being designed and implemented. Restoration of three-dimensional shell habitats in coastal Louisiana and elsewhere presents a valuable and potentially self-sustaining approach to providing shoreline protection, enhancing nekton habitat, and providing water quality maintenance. As with most restoration projects, the development of expected different ecosystem services often occurs over varying time frames, with some services provided immediately and others taking longer to develop. This project was designed initially to compare the provision and development of ecosystem services by created fringing shoreline reefs in subtidal and intertidal environments in Vermilion Bay, Louisiana. Specifically, the goal was to test the null hypothesis that over time, the oyster recruitment and development of a sustainable oyster reef community would be similar at both intertidal and subtidal reef bases, and these sustainable reefs would in time provide similar shoreline stabilization, nekton habitat, and water quality services over similar time frames. Because the ecosystem services hypothesized to be provided by oyster reefs reflect long-term processes, fully testing the above-stated null hypothesis requires a longer-time frame than this project allowed. As such, this project was designed to provide the initial data on reef development and provision of ecosystem services, to identify services that may develop immediately, and to provide baseline data to allow for longer-term follow up studies tracking reef development over time. Unfortunately, these initially created reef bases (subtidal, intertidal) were not constructed as planned because of the Deepwater Horizon oil spill in April 2010, which resulted in reef duplicates being created 6 months apart. Further confounding the project were additional construction and restoration projects along the same shorelines which occurred between 2011 and June 2012. Because of constant activity near and around the reefs and continuing construction, development trajectories could not be compared among reef types at this time. This report presents the data collected at the sites over 3 years (2010–2012), describing only conditions and trends. In addition, these data provide an extensive and detailed dataset documenting initial conditions and initial ecosystem changes which will prove valuable in future data collection and analyses of reef development at this site. Data collection characterized the local water quality conditions (salinity, temperature, total suspended sediments, dissolved oxygen, chlorophyll a), adjacent marsh vegetation, soils, and shoreline position along the project shoreline at Vermilion Bay. During the study, marsh vegetation and soil characteristics were similar across the study area and did not change over time. Shoreline movement indicated shoreline loss at all sites, which varied by reefs. Water quality conditions followed expected seasonal patterns for this region, and no significant nonseasonal changes were measured throughout the study period. Despite oyster recruitment in fall 2010 and 2011, few if any oysters survived from the 2010 year class to 2012. At the last sampling of this project, some oysters recruited in fall 2011 survived through 2012, resulting in an on-reef density of 18.3 ± 2.1 individuals per square meter (mean size: 85.6 ± 2.2 millimeters). Because project goals were to compare reef development and provision of ecosystem services over time, as well as many of the processes identified for monitoring reflect long-term processes, results and data are presented only qualitatively, and trends or observations should be interpreted cautiously at this point. Measurable system responses to reef establishment require more time than was available for this study. These data provide a valuable baseline that can be ultimately used to help inform site selections for future restoration projects as well to further investigate the development trajectories of ecosystem provision of created reefs in this region.

  6. Initialization of hydrodynamics in relativistic heavy ion collisions with an energy-momentum transport model

    NASA Astrophysics Data System (ADS)

    Naboka, V. Yu.; Akkelin, S. V.; Karpenko, Iu. A.; Sinyukov, Yu. M.

    2015-01-01

    A key ingredient of hydrodynamical modeling of relativistic heavy ion collisions is thermal initial conditions, an input that is the consequence of a prethermal dynamics which is not completely understood yet. In the paper we employ a recently developed energy-momentum transport model of the prethermal stage to study influence of the alternative initial states in nucleus-nucleus collisions on flow and energy density distributions of the matter at the starting time of hydrodynamics. In particular, the dependence of the results on isotropic and anisotropic initial states is analyzed. It is found that at the thermalization time the transverse flow is larger and the maximal energy density is higher for the longitudinally squeezed initial momentum distributions. The results are also sensitive to the relaxation time parameter, equation of state at the thermalization time, and transverse profile of initial energy density distribution: Gaussian approximation, Glauber Monte Carlo profiles, etc. Also, test results ensure that the numerical code based on the energy-momentum transport model is capable of providing both averaged and fluctuating initial conditions for the hydrodynamic simulations of relativistic nuclear collisions.

  7. Reconstitution of a nanomachine driving the assembly of proteins into bacterial outer membranes

    NASA Astrophysics Data System (ADS)

    Shen, Hsin-Hui; Leyton, Denisse L.; Shiota, Takuya; Belousoff, Matthew J.; Noinaj, Nicholas; Lu, Jingxiong; Holt, Stephen A.; Tan, Khershing; Selkrig, Joel; Webb, Chaille T.; Buchanan, Susan K.; Martin, Lisandra L.; Lithgow, Trevor

    2014-10-01

    In biological membranes, various protein secretion devices function as nanomachines, and measuring the internal movements of their component parts is a major technological challenge. The translocation and assembly module (TAM) is a nanomachine required for virulence of bacterial pathogens. We have reconstituted a membrane containing the TAM onto a gold surface for characterization by quartz crystal microbalance with dissipation (QCM-D) and magnetic contrast neutron reflectrometry (MCNR). The MCNR studies provided structural resolution down to 1 Å, enabling accurate measurement of protein domains projecting from the membrane layer. Here we show that dynamic movements within the TamA component of the TAM are initiated in the presence of a substrate protein, Ag43, and that these movements recapitulate an initial stage in membrane protein assembly. The reconstituted system provides a powerful new means to study molecular movements in biological membranes, and the technology is widely applicable to studying the dynamics of diverse cellular nanomachines.

  8. Addressing prospective elementary teachers' mathematics subject matter knowledge through action research

    NASA Astrophysics Data System (ADS)

    Hourigan, Mairéad; O'Donoghue, John

    2015-01-01

    There is international dissatisfaction regarding the standard of mathematics subject matter knowledge (MSMK) evident among both qualified and prospective elementary teachers. Ireland is no exception. Following increasing anecdotal evidence of prospective elementary teachers in one Irish College of Education (provider of initial teacher education programme) demonstrating weaknesses in this regard, this study sought to examine and address the issue through two cycles of action research. The examination of the nature of prospective teachers' MSMK (as well as related beliefs in the main study) informed the design and implementation of an intervention to address the issue. A mixed method approach was taken throughout. In both cycles, Shapiro's criteria were used as a conceptual framework for the evaluation of the initiative. This paper focuses on the perceived and actual effects of the intervention on participants' MSMK. As well as its contribution at a local and national level, the study provides an Irish perspective on approaches taken to address the phenomenon internationally.

  9. Development and psychometric evaluation of the Personal Growth Initiative Scale-II.

    PubMed

    Robitschek, Christine; Ashton, Matthew W; Spering, Cynthia C; Geiger, Nathaniel; Byers, Danielle; Schotts, G Christian; Thoen, Megan A

    2012-04-01

    The original Personal Growth Initiative Scale (PGIS; Robitschek, 1998) was unidimensional, despite theory identifying multiple components (e.g., cognition and behavior) of personal growth initiative (PGI). The present research developed a multidimensional measure of the complex process of PGI, while retaining the brief and psychometrically sound properties of the original scale. Study 1 focused on scale development, including theoretical derivation of items, assessing factor structure, reducing number of items, and refining the scale length using samples of college students. Study 2 consisted of confirmatory factor analysis with 3 independent samples of college students and community members. Lastly, Study 3 assessed test-retest reliability over 1-, 2-, 4-, and 6-week periods and tests of concurrent and discriminant validity using samples of college students. The final measure, the Personal Growth Initiative Scale-II (PGIS-II), includes 4 subscales: Readiness for Change, Planfulness, Using Resources, and Intentional Behavior. These studies provide exploratory and confirmatory evidence for the 4-factor structure, strong internal consistency for the subscales and overall score across samples, acceptable temporal stability at all assessed intervals, and concurrent and discriminant validity of the PGIS-II. Future directions for research and clinical practice are discussed.

  10. Optimizing surveillance for livestock disease spreading through animal movements

    PubMed Central

    Bajardi, Paolo; Barrat, Alain; Savini, Lara; Colizza, Vittoria

    2012-01-01

    The spatial propagation of many livestock infectious diseases critically depends on the animal movements among premises; so the knowledge of movement data may help us to detect, manage and control an outbreak. The identification of robust spreading features of the system is however hampered by the temporal dimension characterizing population interactions through movements. Traditional centrality measures do not provide relevant information as results strongly fluctuate in time and outbreak properties heavily depend on geotemporal initial conditions. By focusing on the case study of cattle displacements in Italy, we aim at characterizing livestock epidemics in terms of robust features useful for planning and control, to deal with temporal fluctuations, sensitivity to initial conditions and missing information during an outbreak. Through spatial disease simulations, we detect spreading paths that are stable across different initial conditions, allowing the clustering of the seeds and reducing the epidemic variability. Paths also allow us to identify premises, called sentinels, having a large probability of being infected and providing critical information on the outbreak origin, as encoded in the clusters. This novel procedure provides a general framework that can be applied to specific diseases, for aiding risk assessment analysis and informing the design of optimal surveillance systems. PMID:22728387

  11. Review of proton pump inhibitors for the initial treatment of heartburn: is there a dose ceiling effect?

    PubMed

    Kushner, Pamela R; Peura, David A

    2011-05-01

    Proton pump inhibitors (PPIs) are widely used in clinical practice. However, concerns have been expressed about their long-term use, particularly with regard to bone health, Clostridium difficile infections, and drug interactions with platelet aggregation inhibitors. There has been limited guidance for clinicians concerning appropriate dose selection of PPIs for the initial treatment of heartburn. This review explored whether published clinical trials provide evidence of a ceiling above which higher PPI doses do not provide additional clinical benefit over the lowest approved dose. All articles of randomized, controlled clinical trials in nonerosive gastroesophageal reflux disease (GERD) in which the effects of two or more doses of the same PPI on symptomatic relief of heartburn were quantified as a study endpoint were identified and analyzed through PubMed searches up to the end of September 2010. The majority of trials evaluated provided no evidence that higher PPI doses were superior to the lowest approved dose for the initial treatment of heartburn. There were no clinically relevant findings with respect to dose dependence and safety outcomes in these studies. Efficacy outcomes from the trials suggest there may be a dose ceiling effect and highlight the need for further research on the use of the lowest effective PPI doses as an appropriate strategy in the initial treatment of uncomplicated heartburn. Observational studies and some meta-analyses have suggested that long-term PPI pharmacotherapy might be associated with safety concerns, which necessitate the periodic evaluation of therapeutic benefit in terms of symptom resolution and regimen tolerability. However, evidence to date suggests that use of the lowest effective dose for the indication is not associated with significant adverse events, particularly in the short term. Clinical practice suggests that patients requiring long-term treatment should be maintained on the lowest dose necessary to control symptoms, and monitored for potentially confounding factors that may lead to safety concerns.

  12. 24 CFR 125.301 - Education and Outreach Initiative.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Education and Outreach Initiative... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.301 Education and Outreach Initiative. (a) The Education and Outreach Initiative provides funding for the purpose of developing, implementing, carrying out...

  13. 24 CFR 125.401 - Private Enforcement Initiative.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Private Enforcement Initiative. 125... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.401 Private Enforcement Initiative. (a) The Private Enforcement Initiative provides funding on a single-year or multi-year basis, to investigate violations and...

  14. 24 CFR 125.501 - Fair Housing Organizations Initiative.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Initiative. 125.501 Section 125.501 Housing and Urban Development Regulations Relating to Housing and Urban... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.501 Fair Housing Organizations Initiative. (a) The Fair Housing Organizations Initiative of the FHIP provides funding to develop or expand the ability of...

  15. 24 CFR 125.301 - Education and Outreach Initiative.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Education and Outreach Initiative... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.301 Education and Outreach Initiative. (a) The Education and Outreach Initiative provides funding for the purpose of developing, implementing, carrying out...

  16. 24 CFR 125.301 - Education and Outreach Initiative.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Education and Outreach Initiative... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.301 Education and Outreach Initiative. (a) The Education and Outreach Initiative provides funding for the purpose of developing, implementing, carrying out...

  17. 24 CFR 125.301 - Education and Outreach Initiative.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Education and Outreach Initiative... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.301 Education and Outreach Initiative. (a) The Education and Outreach Initiative provides funding for the purpose of developing, implementing, carrying out...

  18. 24 CFR 125.301 - Education and Outreach Initiative.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Education and Outreach Initiative... FAIR HOUSING FAIR HOUSING INITIATIVES PROGRAM § 125.301 Education and Outreach Initiative. (a) The Education and Outreach Initiative provides funding for the purpose of developing, implementing, carrying out...

  19. Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection.

    PubMed

    Jensen, Joanne; Nusstein, John; Drum, Melissa; Reader, Al; Beck, Mike

    2008-02-01

    The purpose of this prospective, randomized, single-blinded study was to determine the anesthetic efficacy of a repeated intraosseous injection given 30 minutes after a primary intraosseous injection. Using a crossover design, 55 subjects randomly received a primary X-tip intraosseous injection (Dentsply Inc, York, PA) of 1.4 mL of 2% lidocaine with epinephrine (using the Wand; Milestone Scientific, Deerfield, IL) and a repeated intraosseous or mock injection at 30 minutes in two appointments. The first molar and adjacent teeth were pulp tested every 2 minutes for a total of 120 minutes. Success was defined as obtaining two consecutive 80 readings with the electric pulp tester. Success of the initial intraosseous injection was 100% for the first molar. The repeated intraosseous injection mimicked the initial intraosseous injection in terms of pulpal anesthesia and statistically provided another 15 minutes of pulpal anesthesia. In conclusion, using the methodology presented, repeating the intraosseous injection 30 minutes after an initial intraosseous injection will provide an additional 15 minutes of pulpal anesthesia.

  20. Skylab

    NASA Image and Video Library

    1973-01-01

    Judith S. Miles of Lexington High School, Lexington, Massachusetts, proposed skylab student experiment ED-52, Web Formation. This experiment was a study of a spider's behavior in a weightless environment. The geometrical structure of the web of the orb-weaving spider provides a good measure of the condition of its central nervous system. Since the spider senses its own weight to determine the required thickness of web material and uses both the wind and gravity to initiate construction of its web, the lack of gravitational force in Skylab provided a new and different stimulus to the spider's behavioral response. Two common cross spiders, Arabella and Anita, were used for the experiment aboard the Skylab-3 mission. After initial disoriented attempts, both spiders produced almost Earth-like webs once they had adapted to weightlessness. This photograph is of Arabella, a cross spider, in her initial attempt at spirning a web. This picture was taken by the crew of the Skylab 3 mission before Arabella adapted to her new environment.

  1. Web Formation - Skylab Student Experiment ED-52

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Judith S. Miles of Lexington High School, Lexington, Massachusetts, proposed skylab student experiment ED-52, Web Formation. This experiment was a study of a spider's behavior in a weightless environment. The geometrical structure of the web of the orb-weaving spider provides a good measure of the condition of its central nervous system. Since the spider senses its own weight to determine the required thickness of web material and uses both the wind and gravity to initiate construction of its web, the lack of gravitational force in Skylab provided a new and different stimulus to the spider's behavioral response. Two common cross spiders, Arabella and Anita, were used for the experiment aboard the Skylab-3 mission. After initial disoriented attempts, both spiders produced almost Earth-like webs once they had adapted to weightlessness. This photograph is of Arabella, a cross spider, in her initial attempt at spirning a web. This picture was taken by the crew of the Skylab 3 mission before Arabella adapted to her new environment.

  2. Rhythm Perception and Its Role in Perception and Learning of Dysrhythmic Speech.

    PubMed

    Borrie, Stephanie A; Lansford, Kaitlin L; Barrett, Tyson S

    2017-03-01

    The perception of rhythm cues plays an important role in recognizing spoken language, especially in adverse listening conditions. Indeed, this has been shown to hold true even when the rhythm cues themselves are dysrhythmic. This study investigates whether expertise in rhythm perception provides a processing advantage for perception (initial intelligibility) and learning (intelligibility improvement) of naturally dysrhythmic speech, dysarthria. Fifty young adults with typical hearing participated in 3 key tests, including a rhythm perception test, a receptive vocabulary test, and a speech perception and learning test, with standard pretest, familiarization, and posttest phases. Initial intelligibility scores were calculated as the proportion of correct pretest words, while intelligibility improvement scores were calculated by subtracting this proportion from the proportion of correct posttest words. Rhythm perception scores predicted intelligibility improvement scores but not initial intelligibility. On the other hand, receptive vocabulary scores predicted initial intelligibility scores but not intelligibility improvement. Expertise in rhythm perception appears to provide an advantage for processing dysrhythmic speech, but a familiarization experience is required for the advantage to be realized. Findings are discussed in relation to the role of rhythm in speech processing and shed light on processing models that consider the consequence of rhythm abnormalities in dysarthria.

  3. Venture Class Launch Services

    NASA Technical Reports Server (NTRS)

    Wiese, Mark

    2016-01-01

    Provide an introduction to the Launch Services Program, and specifically the strategic initiative that drove the Venture Class Launch Services contracts. Provide information from the VCLS request for proposals, as well as the Agency's CubeSat Launch Initiative.

  4. Precision closed bomb calorimeter for testing flame and gas producing initiators

    NASA Technical Reports Server (NTRS)

    Carpenter, D. R., Jr.; Taylor, A. C., Jr.

    1972-01-01

    A calorimeter has been developed under this study to help meet the needs of accurate performance monitoring of electrically or mechanically actuated flame and gas producing devices, such as squib-type initiators. A ten cubic centimeter closed bomb (closed volume) calorimeter was designed to provide a standard pressure trace and to measure a nominal 50 calorie output, using the basic components of a Parr Model 1411 calorimeter. Two prototype bombs were fabricated, pressure tested to 2600 psi, and extensively evaluated.

  5. Local Gov`t assistance in commercial waste reduction & recycling

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

    Hannah, C.W.

    This paper outlines programs and strategies for reducing the waste stream by targeting the commercial, industrial and institutional sectors. The programs described are implemented by the Wake County Solid Waste Management Division, North Carolina. Findings and recommendations of a task force focusing on the role of the private sector in meeting state waste reduction mandates are summarized. Commercial initiatives, educational initiatives, and a grant program are described. Several case studies are provided which overview the variety of businesses and waste materials addressed.

  6. Observables for longitudinal flow correlations in heavy-ion collisions

    DOE PAGES

    Jia, Jiangyong; Huo, Peng; Ma, Guoliang; ...

    2017-06-06

    In this paper, we propose several new observables/correlators, based on correlations between two or more subevents separated in pseudorapidity η, to study the longitudinal flow fluctuations. We show that these observables are sensitive to the event-by-event fluctuations, as a function of η, of the initial condition as well as the nonlinear mode-mixing effects. Finally, experimental measurement of these observables shall provide important new constraints on the boost-variant event-by-event initial conditions required by all 3+1-dimensional viscous hydrodynamics models.

  7. Numerical simulation of film-cooled ablative rocket nozzles

    NASA Technical Reports Server (NTRS)

    Landrum, D. B.; Beard, R. M.

    1996-01-01

    The objective of this research effort was to evaluate the impact of incorporating an additional cooling port downstream between the injector and nozzle throat in the NASA Fast Track chamber. A numerical model of the chamber was developed for the analysis. The analysis did not model ablation but instead correlated the initial ablation rate with the initial nozzle wall temperature distribution. The results of this study provide guidance in the development of a potentially lighter, second generation ablative rocket nozzle which maintains desired performance levels.

  8. Early Amyloidogenic Oligomerization Studied through Fluorescence Lifetime Correlation Spectroscopy

    PubMed Central

    Paredes, Jose M.; Casares, Salvador; Ruedas-Rama, Maria J.; Fernandez, Elena; Castello, Fabio; Varela, Lorena; Orte, Angel

    2012-01-01

    Amyloidogenic protein aggregation is a persistent biomedical problem. Despite active research in disease-related aggregation, the need for multidisciplinary approaches to the problem is evident. Recent advances in single-molecule fluorescence spectroscopy are valuable for examining heterogenic biomolecular systems. In this work, we have explored the initial stages of amyloidogenic aggregation by employing fluorescence lifetime correlation spectroscopy (FLCS), an advanced modification of conventional fluorescence correlation spectroscopy (FCS) that utilizes time-resolved information. FLCS provides size distributions and kinetics for the oligomer growth of the SH3 domain of α-spectrin, whose N47A mutant forms amyloid fibrils at pH 3.2 and 37 °C in the presence of salt. The combination of FCS with additional fluorescence lifetime information provides an exciting approach to focus on the initial aggregation stages, allowing a better understanding of the fibrillization process, by providing multidimensional information, valuable in combination with other conventional methodologies. PMID:22949804

  9. Assessing the community clinic replacement effect on private Medicaid practices in oral health care within rural environments.

    PubMed

    Squillace, Joe

    2013-01-01

    Children in Medicaid/CHIP public coverage programs who reside in rural counties have limited access to dental care services. Shortages of dental professionals in rural areas impede utilization of dental care. Public and private initiatives are attempting to address this crisis. Missourians instituted deregulatory policies and invested in community-based initiatives. Using a Medicaid/CHIP claims administrative dataset from 2004 to 2007, this research explored patterns of utilization to assess the impact of these efforts. The number of participating private dental office providers declined over the study period, and the number of children utilizing clinics increased. Trends are being observed within the public health dental care market demonstrating clinics are replacing private dentists as providers of Medicaid/CHIP dental services. Allowing greater market entry through deregulation could provide states with greater improvements to their public dental health infrastructure. © 2012 American Association of Public Health Dentistry.

  10. Watershed management contributions to land stewardship: Case studies in the Southeast

    Treesearch

    Wayne T. Swank; David R. Tilley

    2000-01-01

    We describe three examples of watershed management studies, at different spatial scales, that provide approaches and information useful in enhancing natural resource stewardship in the southern Appalachians. A multiple use “pilot” study, initiated 35 years ago at the Coweeta Hydrologic Laboratory, demonstrates that southern Appalachian forests can be successfully...

  11. PEM-West trajectory climatology and photochemical model sensitivity study prepared using retrospective meteorological data

    NASA Technical Reports Server (NTRS)

    Merrill, John T.; Rodriguez, Jose M.

    1991-01-01

    Trajectory and photochemical model calculations based on retrospective meteorological data for the operations areas of the NASA Pacific Exploratory Mission (PEM)-West mission are summarized. The trajectory climatology discussed here is intended to provide guidance for flight planning and initial data interpretation during the field phase of the expedition by indicating the most probable path air parcels are likely to take to reach various points in the area. The photochemical model calculations which are discussed indicate the sensitivity of the chemical environment to various initial chemical concentrations and to conditions along the trajectory. In the post-expedition analysis these calculations will be used to provide a climatological context for the meteorological conditions which are encountered in the field.

  12. Automated imaging system for single molecules

    DOEpatents

    Schwartz, David Charles; Runnheim, Rodney; Forrest, Daniel

    2012-09-18

    There is provided a high throughput automated single molecule image collection and processing system that requires minimal initial user input. The unique features embodied in the present disclosure allow automated collection and initial processing of optical images of single molecules and their assemblies. Correct focus may be automatically maintained while images are collected. Uneven illumination in fluorescence microscopy is accounted for, and an overall robust imaging operation is provided yielding individual images prepared for further processing in external systems. Embodiments described herein are useful in studies of any macromolecules such as DNA, RNA, peptides and proteins. The automated image collection and processing system and method of same may be implemented and deployed over a computer network, and may be ergonomically optimized to facilitate user interaction.

  13. Effect of protein on biohydrogen production from starch of food waste.

    PubMed

    Ding, H B; Liu, X Y; Stabnikova, O; Wang, J-Y

    2008-01-01

    This study demonstrated the influence of protein on biohydrogen production from carbohydrates, especially starch, by using different combinations of two model food wastes, rice as starch-rich and soybean residue as protein-rich food waste. It was found the maximum specific hydrogen production potential, 0.99 mol H2/mol initial starch as glucose, and the maximum specific hydrogen production rate, 530 ml H2/h g-VS, occurred at a starch/protein ratio of 1.7. The protein content in the initial food waste not only provided buffering capacity to neutralize the volatile fatty acids as concurrent products but also enhanced the hydrogen production by providing readily available organic nitrogen such as soluble proteins and amino acids to microorganisms. Copyright IWA Publishing 2008.

  14. Mechanism and Regulation of Protein Synthesis in Saccharomyces cerevisiae

    PubMed Central

    Dever, Thomas E.; Kinzy, Terri Goss; Pavitt, Graham D.

    2016-01-01

    In this review, we provide an overview of protein synthesis in the yeast Saccharomyces cerevisiae. The mechanism of protein synthesis is well conserved between yeast and other eukaryotes, and molecular genetic studies in budding yeast have provided critical insights into the fundamental process of translation as well as its regulation. The review focuses on the initiation and elongation phases of protein synthesis with descriptions of the roles of translation initiation and elongation factors that assist the ribosome in binding the messenger RNA (mRNA), selecting the start codon, and synthesizing the polypeptide. We also examine mechanisms of translational control highlighting the mRNA cap-binding proteins and the regulation of GCN4 and CPA1 mRNAs. PMID:27183566

  15. Investigation of Cracks Found in Helicopter Longerons

    NASA Technical Reports Server (NTRS)

    Newman, John A.; Baughman, James M.; Wallace, Terryl A.

    2009-01-01

    Four cracked longerons, containing a total of eight cracks, were provided for study. Cracked regions were cut from the longerons. Load was applied to open the cracks, enabling crack surface examination. Examination revealed that crack propagation was driven by fatigue loading in all eight cases. Fatigue crack initiation appears to have occurred on the top edge of the longerons near geometric changes that affect component bending stiffness. Additionally, metallurigical analysis has revealed a local depletion in alloying elements in the crack initiation regions that may be a contributing factor. Fatigue crack propagation appeared to be initially driven by opening-mode loading, but at a crack length of approximately 0.5 inches (12.7 mm), there is evidence of mixed-mode crack loading. For the longest cracks studied, shear-mode displacements destroyed crack-surface features of interest over significant portions of the crack surfaces.

  16. Investigation of Helicopter Longeron Cracks

    NASA Technical Reports Server (NTRS)

    Newman, John A.; Baughman, James; Wallace, Terryl A.

    2009-01-01

    Four cracked longerons, containing a total of eight cracks, were provided for study. Cracked regions were cut from the longerons. Load was applied to open the cracks, enabling crack surface examination. Examination revealed that crack propagation was driven by fatigue loading in all eight cases. Fatigue crack initiation appears to have occurred on the top edge of the longerons near geometric changes that affect component bending stiffness. Additionally, metallurgical analysis has revealed a local depletion in alloying elements in the crack initiation regions that may be a contributing factor. Fatigue crack propagation appeared to be initially driven by opening-mode loading, but at a crack length of approximately 0.5 inches (12.7 mm), there is evidence of mixed-mode crack loading. For the longest cracks studied, shear-mode displacements destroyed crack-surface features of interest over significant portions of the crack surfaces.

  17. Statins in Acute Ischemic Stroke: A Systematic Review

    PubMed Central

    Hong, Keun-Sik; Lee, Ji Sung

    2015-01-01

    Background and Purpose Statins have pleiotropic effects of potential neuroprotection. However, because of lack of large randomized clinical trials, current guidelines do not provide specific recommendations on statin initiation in acute ischemic stroke (AIS). The current study aims to systematically review the statin effect in AIS. Methods From literature review, we identified articles exploring prestroke and immediate post-stroke statin effect on imaging surrogate markers, initial stroke severity, functional outcome, and short-term mortality in human AIS. We summarized descriptive overview. In addition, for subjects with available data from publications, we conducted meta-analysis to provide pooled estimates. Results In total, we identified 70 relevant articles including 6 meta-analyses. Surrogate imaging marker studies suggested that statin might enhance collaterals and reperfusion. Our updated meta-analysis indicated that prestroke statin use was associated with milder initial stroke severity (odds ratio [OR] [95% confidence interval], 1.24 [1.05-1.48]; P=0.013), good functional outcome (1.50 [1.29-1.75]; P<0.001), and lower mortality (0.42 [0.21-0.82]; P=0.0108). In-hospital statin use was associated with good functional outcome (1.31 [1.12-1.53]; P=0.001), and lower mortality (0.41 [0.29-0.58]; P<0.001). In contrast, statin withdrawal was associated with poor functional outcome (1.83 [1.01-3.30]; P=0.045). In patients treated with thrombolysis, statin was associated with good functional outcome (1.44 [1.10-1.89]; P=0.001), despite an increased risk of symptomatic hemorrhagic transformation (1.63 [1.04-2.56]; P=0.035). Conclusions The current study findings support the use of statin in AIS. However, the findings were mostly driven by observational studies at risk of bias, and thereby large randomized clinical trials would provide confirmatory evidence. PMID:26437994

  18. Recruitment, selection and retention of nursing and midwifery students in Scottish Universities.

    PubMed

    Rodgers, Sheila; Stenhouse, Rosie; McCreaddie, May; Small, Pauline

    2013-11-01

    High attrition rates from pre-registration nursing and midwifery programmes have been reported in both the UK and in other countries. A study was conducted to identify best practice in recruitment, selection and retention across Scottish Universities providing pre-registration programmes. A survey of all universities providing pre-registration programmes in Scotland was conducted. Semi-structured interviews were conducted with key personnel in each university. Documentary evidence was collected to supplement interview data and evidence recruitment, selection and retention practices. All universities in Scotland providing pre-registration nursing and/or midwifery programmes. All 10 identified universities agreed to take part and a total of 18 interviews were conducted. Semi-structured face to face and telephone interviews were conducted. Relevant documentary evidence was collected. All data were subject to thematic analysis. Universities are predominantly concerned with recruiting to the institution and not to the professions. Interviews are widely used, and are a requirement in the United Kingdom. However, there is no evidence base within the literature that they have predictive validity despite creating scales and scoring systems which are largely unvalidated. The study identified initiatives aimed at addressing attrition/retention, however most had not been evaluated often due to the multi-factorial nature of attrition/retention and difficulties with measurement. Recruitment selection and retention initiatives were rarely evaluated, and if so, adopted a relatively superficial approach. Evidence from existing studies to support practices was mostly weakly supportive or absent. The study highlights the need for a coordinated approach, supporting the development of a robust evidence base through the evaluation of local initiatives, and evaluation of new strategies. Evaluation strategies must take account of the local context to facilitate transferability of findings across different settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Status of the assessment phase of the ESA M3 mission candidate LOFT

    NASA Astrophysics Data System (ADS)

    Corral van Damme, Carlos; Ayre, Mark; Lumb, David; Short, Alexander D.; Rando, Nicola

    2012-09-01

    LOFT (Large Observatory For x-ray Timing) is one of four candidates for the M3 slot (launch in 2024, with the option of a launch in 2022) of ESAs Cosmic Vision 2015 - 2025 Plan, and as such it is currently undergoing an initial assessment phase lasting one year. The objective of the assessment phase is to provide the information required to enable the down selection process, in particular: the space segment definition for meeting the assigned science objectives; consideration of and initial definition of the implementation schedule; an estimate of the mission Cost at Completion (CaC); an evaluation of the technology readiness evaluation and risk assessment. The assessment phase is divided into two interleaved components: (i) A payload assessment study, performed by teams funded by member states, which is primarily intended for design, definition and programmatic/cost evaluation of the payload, and (ii) A system industrial study, which has essentially the same objectives for the space segment of the mission. This paper provides an overview of the status of the LOFT assessment phase, both for payload and platform. The initial focus is on the payload design status, providing the reader with an understanding of the main features of the design. Then the space segment assessment study status is presented, with an overview of the principal challenges presented by the LOFT payload and mission requirements, and a presentation of the expected solutions. Overall the mission is expected to enable cutting-edge science, is technically feasible, and should remain within the required CaC for an M3 candidate.

  20. Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

    PubMed

    Waltz, Thomas J; Powell, Byron J; Matthieu, Monica M; Damschroder, Laura J; Chinman, Matthew J; Smith, Jeffrey L; Proctor, Enola K; Kirchner, JoAnn E

    2015-08-07

    Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy's relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.

  1. Neurobiological signatures associated with alcohol and drug use in the human adolescent brain

    PubMed Central

    Silveri, Marisa M.; Dager, Alecia D.; Cohen-Gilbert, Julia E.; Sneider, Jennifer T.

    2017-01-01

    Magnetic resonance (MR) techniques provide opportunities to non-invasively characterize neurobiological milestones of adolescent brain development. Juxtaposed to the critical finalization of brain development is initiation of alcohol and substance use, and increased frequency and quantity of use, patterns that can lead to abuse and addiction. This review provides a comprehensive overview of existing MR studies of adolescent alcohol and drug users. The most common alteration reported across substance used and MR modalities is in the frontal lobe (63% of published studies). This is not surprising, given that this is the last region to reach neurobiological adulthood. Comparatively, evidence is less consistent regarding alterations in regions that mature earlier (e.g., amygdala, hippocampus), however newer techniques now permit investigations beyond regional approaches that are uncovering network-level vulnerabilities. Regardless of whether neurobiological signatures exist prior to the initiation of use, this body of work provides important direction for ongoing prospective investigations of adolescent brain development, and the significant impact of alcohol and substance use on the brain during the second decade of life. PMID:27377691

  2. Neurobiological signatures associated with alcohol and drug use in the human adolescent brain.

    PubMed

    Silveri, Marisa M; Dager, Alecia D; Cohen-Gilbert, Julia E; Sneider, Jennifer T

    2016-11-01

    Magnetic resonance (MR) techniques provide opportunities to non-invasively characterize neurobiological milestones of adolescent brain development. Juxtaposed to the critical finalization of brain development is initiation of alcohol and substance use, and increased frequency and quantity of use, patterns that can lead to abuse and addiction. This review provides a comprehensive overview of existing MR studies of adolescent alcohol and drug users. The most common alterations reported across substance used and MR modalities are in the frontal lobe (63% of published studies). This is not surprising, given that this is the last region to reach neurobiological adulthood. Comparatively, evidence is less consistent regarding alterations in regions that mature earlier (e.g., amygdala, hippocampus), however newer techniques now permit investigations beyond regional approaches that are uncovering network-level vulnerabilities. Regardless of whether neurobiological signatures exist prior to the initiation of use, this body of work provides important direction for ongoing prospective investigations of adolescent brain development, and the significant impact of alcohol and substance use on the brain during the second decade of life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Health provider responsiveness to social accountability initiatives in low- and middle-income countries: a realist review.

    PubMed

    Lodenstein, Elsbet; Dieleman, Marjolein; Gerretsen, Barend; Broerse, Jacqueline E W

    2017-02-01

    Social accountability in the health sector has been promoted as a strategy to improve the quality and performance of health providers in low- and middle-income countries. Whether improvements occur, however, depends on the willingness and ability of health providers to respond to societal pressure for better care. This article uses a realist approach to review cases of collective citizen action and advocacy with the aim to identify key mechanisms of provider responsiveness. Purposeful searches for cases were combined with a systematic search in four databases. To be included in the review, the initiatives needed to describe at least one outcome at the level of frontline service provision. Some 37 social accountability initiatives in 15 countries met these criteria. Using a realist approach, retroductive analysis and triangulation of methods and sources were performed to construct Context-Mechanism-Outcome configurations that explain potential pathways to provider responsiveness. The findings suggest that health provider receptivity to citizens' demands for better health care is mediated by health providers' perceptions of the legitimacy of citizen groups and by the extent to which citizen groups provide personal and professional support to health providers. Some citizen groups activated political or formal bureaucratic accountability channels but the effect on provider responsiveness of such strategies was more mixed. Favourable contexts for health provider responsiveness comprise socio-political contexts in which providers self-identify as activists, health system contexts in which health providers depend on citizens' expertise and capacities, and health system contexts where providers have the self-perceived ability to change the system in which they operate. Rather than providing recipes for successful social accountability initiatives, the synthesis proposes a programme theory that can support reflections on the theories of change underpinning social accountability initiatives and interventions to improve the quality of primary health care in different settings. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  4. Technical Operating Procedures for Providing Funding to Natural Resource Trustees to Conduct an Initiation of Assessment of Natural Resource Damages Under the Oil Pollution Act of 1990

    DOT National Transportation Integrated Search

    1996-06-01

    Technical Operating Procedures (TOPS) for Providing Funding to Natural Resources : Trustees To Conduct An Initiation of Assessment of Natural Resource Damages : under the Oil Pollution Act of 1990 have been developed to provide guidance on : funding ...

  5. 15 CFR 1160.22 - Goal of the Strategic Partnership initiative.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... initiative. 1160.22 Section 1160.22 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign... INNOVATION Strategic Partnership Initiative § 1160.22 Goal of the Strategic Partnership initiative. (a) This new initiative is designed to provide the private sector with the opportunity to discuss the possible...

  6. Recommendations for Establishing the Texas Roadway Research Implementation Center

    DOT National Transportation Integrated Search

    1998-07-01

    The overall objective of the Roadway Research Initiative study was to describe an advanced testing capability, on that would speed implementation of the results from traditional computer and laboratory-based research efforts by providing a reusable t...

  7. Safety and health concerns for KYTC and the contractor personnel.

    DOT National Transportation Integrated Search

    2004-09-01

    This study was initiated to provide a review of safety and health issues related to Kentucky Transportation Cabinet (KYTC) construction activities including both KYTC and contractor personnel. Work included a literature search, interviews with KYTC r...

  8. Developmental Neurotoxicology: History and Outline of Developmental Neurotoxicity Study Guidelines.

    EPA Science Inventory

    The present work provides a brief review of basic concepts in developmental neurotoxicology, as well as current representative testing guidelines for evaluating developmental neurotoxicity (DNT) of xenobiotics. Historically, DNT was initially recognized as a “functional” teratoge...

  9. Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study.

    PubMed

    Tang, Zhenzhu; Pan, Stephen W; Ruan, Yuhua; Liu, Xuanhua; Su, Jinming; Zhu, Qiuying; Shen, Zhiyong; Zhang, Heng; Chen, Yi; Lan, Guanghua; Xing, Hui; Liao, Lingjie; Feng, Yi; Shao, Yiming

    2017-06-09

    Current WHO guidelines recommend initiating ART regardless of CD4+ cell count. In response, we conducted an observational cohort study to assess the effects of pre-ART CD4+ cell count levels on death, attrition, and death or attrition in HIV treated patients. This large HIV treatment cohort study (n = 49,155) from 2010 to 2015 was conducted in Guangxi, China. We used a Cox regression model to analyze associations between pre-ART CD4+ cell counts and death, attrition, and death or attrition. The average mortality and ART attrition rates among all treated patients were 2.63 deaths and 5.32 attritions per 100 person-years, respectively. Compared to HIV patients with <350 CD4+ cells/mm 3 at ART initiation, HIV patients with >500 CD4+ cells/mm 3 at ART initiation had a significantly lower mortality rate (Adjusted hazard ratio: 0.56, 95% CI: 0.40-0.79), but significantly higher ART attrition rate (AHR: 1.17, 95% CI: 1.03-1.33). Results from this study suggest that HIV patients with high CD4+ cell counts at the time of ART initiation may be at greater risk of treatment attrition. To further reduce ART attrition, it is imperative that patient education and healthcare provider training on ART adherence be enhanced and account for CD4 levels at ART initiation.

  10. Timing of spring wild turkey hunting in relation to nest incubation

    USGS Publications Warehouse

    Casalena, Mary Jo; Everett, Rex; Vreeland, Wendy C.; Gregg, Ian D.; Diefenbach, Duane R.

    2016-01-01

    State wildlife agencies are often requested to open spring wild turkey (Meleagris gallopavo; hereafter, turkey) hunting seasons earlier to increase hunter satisfaction by hunters hearing more gobbling male turkeys. Timing of spring turkey hunting season in several states, including Pennsylvania, has been established to open, on average, near median date of incubation initiation of turkey nests. This is believed to reduce illegal and undesired hen harvest and possibly nest abandonment, while maintaining hunter satisfaction of hearing male turkeys when most hens are incubating eggs. However, Pennsylvania’s spring season structure was established in 1968. Given earlier spring phenology, and potentially more variation in spring weather due to climate change, there is concern that timing of nest incubation for turkeys in Pennsylvania could be changing. Therefore, our objective was to determine if nest incubation and opening of spring turkey hunting in Pennsylvania have continued to coincide. We attached satellite transmitters to 254 female turkeys during 2010–2014 and estimated median incubation initiation date to be 2 May, which was 2 days earlier than median date during a statewide study during 1953–1963 and 9 days earlier than during a smaller scale study in south–central Pennsylvania during 2000–2001. However, incubation initiation varied greatly among years and individual hens during all 3 studies. During 4 of 5 years of our study, Pennsylvania’s spring season opened 3 to 8 days prior to median date of incubation initiation. Over the 5 years, estimated initiation of incubation for first nesting attempts, measured from earliest date of incubation initiation to latest, was >2 months and maximum proportion of hens beginning incubation at any one time differed by several days to >1 week. Consequently, in years of late incubation, a constant season opening date set near the long-term median date of incubation initiation exposes few additional hens to risk and hunter satisfaction is likely maintained at greater levels than would be seen with a more conservative approach of opening the season later. Long-term and large scale studies using GPS transmitters that provide precise determination of incubation initiation will be useful to study environmental influences on initiation of incubation.

  11. Using Communication Technology to Facilitate Scientific Literacy: A Framework for Engaged Learning

    NASA Astrophysics Data System (ADS)

    VanBuskirk, Shireen Adele

    The purpose of this research project is to describe how existing communication technologies are used to foster scientific literacy for secondary students. This study develops a new framework as an analytic tool to categorize the activities of teachers and students involved in scientific literacy to describe what elements of scientific literacy are facilitated by such technologies. Four case studies are analyzed using the framework to describe the scientific literacy initiatives. Data collection at each site included interviews with the teacher, student focus groups, student surveys, and classroom observations. Qualitative analysis of the data provided insight into the learning activities and student experiences in the four cases. This study intentionally provides a platform for student voice. Very few previous empirical studies in the area of scientific literacy include the student experience. This represents a significant gap in the current literature on scientific literacy. An interpretation of scientific literacy that promotes student engagement, interaction, and initiative corresponds to a need to listen to students' perspectives on these experiences. Findings of the study indicated that the classroom activities depended on the teacher's philosophy regarding scientific literacy. Communication technology was ubiquitous; where the teacher did not initiate the use of social media in the classroom, the students did. The goal of supporting scientific literacy in students is an objective that extends beyond the boundaries of classroom walls, and it can be facilitated by technologies that seem both abundant and underutilized. Technology-enhanced pedagogy altered the classroom practices and resulted in more student participation and engagement.

  12. Models of initial training and pathways to registration: a selective review of policy in professional regulation.

    PubMed

    Fealy, Gerard M; Carney, Marie; Drennan, Jonathan; Treacy, Margaret; Burke, Jacqueline; O'Connell, Dympna; Howley, Breeda; Clancy, Alison; McHugh, Aine; Patton, Declan; Sheerin, Fintan

    2009-09-01

    To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models.

  13. Selection of the initial design for the two-stage continual reassessment method.

    PubMed

    Jia, Xiaoyu; Ivanova, Anastasia; Lee, Shing M

    2017-01-01

    In the two-stage continual reassessment method (CRM), model-based dose escalation is preceded by a pre-specified escalating sequence starting from the lowest dose level. This is appealing to clinicians because it allows a sufficient number of patients to be assigned to each of the lower dose levels before escalating to higher dose levels. While a theoretical framework to build the two-stage CRM has been proposed, the selection of the initial dose-escalating sequence, generally referred to as the initial design, remains arbitrary, either by specifying cohorts of three patients or by trial and error through extensive simulations. Motivated by a currently ongoing oncology dose-finding study for which clinicians explicitly stated their desire to assign at least one patient to each of the lower dose levels, we proposed a systematic approach for selecting the initial design for the two-stage CRM. The initial design obtained using the proposed algorithm yields better operating characteristics compared to using a cohort of three initial design with a calibrated CRM. The proposed algorithm simplifies the selection of initial design for the two-stage CRM. Moreover, initial designs to be used as reference for planning a two-stage CRM are provided.

  14. Unraveling the proteomic profile of mice testis during the initiation of meiosis.

    PubMed

    Shao, Binbin; Guo, Yueshuai; Wang, Lei; Zhou, Quan; Gao, Tingting; Zheng, Bo; Zheng, Haoyu; Zhou, Tao; Zhou, Zuomin; Guo, Xuejiang; Huang, Xiaoyan; Sha, Jiahao

    2015-04-29

    In mice, once primordial germ cells (PGCs) are generated, they continue to proliferate and migrate to eventually reach the future gonads. They initiate sexual differentiation after their colonization of the gonads. During this process, retinoic acid (RA) induces meiosis in the female germ cells, which proceeds to the diplotene stage of meiotic prophase I, whereas the male germ cells initiate growth arrest. After birth, meiosis is initiated in mice spermatogonia by their conversion to preleptotene spermatocytes. There are evidences showing the roles of RA in the regulation of spermatogonial differentiation and meiosis initiation. However, it is still not well known on what responds to RA and how RA signaling engages meiosis. Thus, we constructed a proteomic profile of proteins associated with meiosis onset during testis development in mouse and identified 104 differentially expressed proteins (≥1.5 folds). Bioinformatic analysis showed proteins functioning in specific cell processes. The expression patterns of five selected proteins were verified via Western blot, of which we found that Tfrc gene was RA responsive, with a RA responsive element, and could be up regulated by RA in spermatogonial stem cell (SSC) line. Taken together, the results provide an important reference profile for further functional study of meiosis initiation. Spermatogenesis involves mitosis of spermatogonia, meiosis of spermatocytes and spermiogenesis, in which meiosis is a unique event to germ cells, and not in the somatic cells. Till now, the detailed molecular mechanisms of the transition from mitosis to meiosis are still not elucidated. With high-throughput proteomic technology, it is now possible to systemically identify proteins possibly involved. With TMT-6plex based quantification, we identified 104 proteins differentially between testes without meiosis (day 8.5) and those that were meiosis initiated (day 10.5). And a well-known protein essential for meiosis initiation, stra8, was identified to be differentially expressed in the study. And bioinformatic analysis and functional studies revealed several proteins regulated by retinoic acid, a chemical known to regulate the meiosis initiation. Thus, this quantitative proteomic approach can identify meiosis initiation regulating proteins, and further functional studies of these proteins will help elucidate the mechanisms of meiosis initiation. Copyright © 2015. Published by Elsevier B.V.

  15. Decomposition of fluctuating initial conditions and flow harmonics

    NASA Astrophysics Data System (ADS)

    Qian, Wei-Liang; Mota, Philipe; Andrade, Rone; Gardim, Fernando; Grassi, Frédérique; Hama, Yogiro; Kodama, Takeshi

    2014-01-01

    Collective flow observed in heavy-ion collisions is largely attributed to initial geometrical fluctuations, and it is the hydrodynamic evolution of the system that transforms those initial spatial irregularities into final state momentum anisotropies. Cumulant analysis provides a mathematical tool to decompose those initial fluctuations in terms of radial and azimuthal components. It is usually thought that a specified order of azimuthal cumulant, for the most part, linearly produces flow harmonics of the same order. In this work, by considering the most central collisions (0%-5%), we carry out a systematic study on the connection between cumulants and flow harmonics using a hydrodynamic code called NeXSPheRIO. We conduct three types of calculation, by explicitly decomposing the initial conditions into components corresponding to a given eccentricity and studying the out-coming flow through hydrodynamic evolution. It is found that for initial conditions deviating significantly from Gaussian, such as those from NeXuS, the linearity between eccentricities and flow harmonics partially breaks down. Combined with the effect of coupling between cumulants of different orders, it causes the production of extra flow harmonics of higher orders. We argue that these results can be seen as a natural consequence of the non-linear nature of hydrodynamics, and they can be understood intuitively in terms of the peripheral-tube model.

  16. Incidence and predictors of onset of injection drug use in a San Francisco cohort of homeless youth.

    PubMed

    Parriott, Andrea M; Auerswald, Colette L

    2009-01-01

    Few studies document incidence of injection drug use among homeless youth. We followed a cohort of 70 street-recruited homeless youth in San Francisco, California who had never injected drugs for six months in 2004-5. We examined initiation of injection drug use and its predictors, informed by prior ethnographic findings. Data were analyzed using exact logistic regression. 11.4% of youth initiated injection drug use. Having no high school education, being over 21 years old, and being in disequilibrium predicted initiation. Limitations, implications and suggestions for future research are noted. Funding was provided by the National Institute for Child Health and Development.

  17. Computer-Facilitated Substance Use Screening and Brief Advice for Teens in Primary Care: An International Trial

    PubMed Central

    Csémy, Ladislav; Sherritt, Lon; Starostova, Olga; Van Hook, Shari; Johnson, Julie; Boulter, Suzanne; Brooks, Traci; Carey, Peggy; Kossack, Robert; Kulig, John W.; Van Vranken, Nancy; Knight, John R.

    2012-01-01

    OBJECTIVE: Primary care providers need effective strategies for substance use screening and brief counseling of adolescents. We examined the effects of a new computer-facilitated screening and provider brief advice (cSBA) system. METHODS: We used a quasi-experimental, asynchronous study design in which each site served as its own control. From 2005 to 2008, 12- to 18-year-olds arriving for routine care at 9 medical offices in New England (n = 2096, 58% females) and 10 in Prague, Czech Republic (n = 589, 47% females) were recruited. Patients completed measurements only during the initial treatment-as-usual study phase. We then conducted 1-hour provider training, and initiated the cSBA phase. Before seeing the provider, all cSBA participants completed a computerized screen, and then viewed screening results, scientific information, and true-life stories illustrating substance use harms. Providers received screening results and “talking points” designed to prompt 2 to 3 minutes of brief advice. We examined alcohol and cannabis use, initiation, and cessation rates over the past 90 days at 3-month follow-up, and over the past 12 months at 12-month follow-up. RESULTS: Compared with treatment as usual, cSBA patients reported less alcohol use at follow-up in New England (3-month rates 15.5% vs 22.9%, adjusted relative risk ratio [aRRR] = 0.54, 95% confidence interval 0.38–0.77; 12-month rates 29.3% vs 37.5%, aRRR = 0.73, 0.57–0.92), and less cannabis use in Prague (3-month rates 5.5% vs 9.8%, aRRR = 0.37, 0.17–0.77; 12-month rates 17.0% vs 28.7%, aRRR = 0.47, 0.32–0.71). CONCLUSIONS: Computer-facilitated screening and provider brief advice appears promising for reducing substance use among adolescent primary care patients. PMID:22566420

  18. Creating the Exceptional Patient Experience in One Academic Health System

    PubMed Central

    Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A. Lorris

    2016-01-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient’s perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system’s ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams. PMID:26606723

  19. Creating the Exceptional Patient Experience in One Academic Health System.

    PubMed

    Lee, Vivian S; Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A Lorris

    2016-03-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient's perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system's ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams.

  20. The Impact of a History of Adverse Childhood Experiences on Breastfeeding Initiation and Exclusivity: Findings from a National Population Health Survey.

    PubMed

    Ukah, Ugochinyere Vivian; Adu, Prince A; De Silva, Dane A; von Dadelszen, Peter

    2016-12-01

    Exclusive breastfeeding is strongly recommended by the World Health Organization. Given the low rate of exclusive breastfeeding in Canada and the increasing reports of a history of adverse childhood experiences, this study sought to investigate the association between a history of adverse childhood experiences and breastfeeding initiation and breastfeeding. Data used for this study were based on the 2011-2012 Canadian Community Health Survey, collected using a cross-sectional survey. The outcome measures were breastfeeding initiation and exclusive breastfeeding for 6 months or more. History of adverse childhood experiences was the main explanatory variable. Multivariable logistic regression models were developed to investigate the effect on breastfeeding initiation and on exclusive breastfeeding in women who gave birth within 5 years before when the surveys were conducted. The study sample included 697 and 633 women for analyses on breastfeeding initiation and breastfeeding, respectively. The proportion of women with breastfeeding initiation and exclusive breastfeeding for up to 6 months in this study were 96.8% and 42.8%, respectively. After controlling for age and highest level of education, having a history of adverse childhood experiences was not significantly associated with breastfeeding initiation (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.10-1.87), but mothers with such history were less likely to exclusively breastfeed for up to 6 months compared with those without (OR 0.53, 95% CI 0.31-0.90). These findings suggest the need for more breastfeeding monitoring programs beyond the hospital environment to provide more support to Canadian mothers, especially those who have experienced adverse childhood experiences or trauma in the past.

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