A qualitative meta-summary using Sandelowski and Barroso's method for integrating qualitative research to explore barriers and facilitators to self-care in heart failure patients.

PubMed

Herber, Oliver Rudolf; Bücker, Bettina; Metzendorf, Maria-Inti; Barroso, Julie

2017-12-01

Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary. A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences. Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.

The Promise and Perils of Population Research on Same-Sex Families.

PubMed

Reczek, Corinne; Spiker, Russell; Liu, Hui; Crosnoe, Robert

2017-12-01

As a follow-up to our 2016 study, this article presents new findings examining the relationship between same-sex family structure and child health using the 2008-2015 National Health Interview Survey (NHIS). After discussing NIHS data problems, we examine the relationship between family structure and a broad range of child well-being outcomes, including school days lost, behavior, parent-rated health, emotional difficulties, and activity limitations. We find both similarities (school days lost, behavior, parent-rated health) and differences (emotional difficulties and activity limitations) across our two studies using different survey years, but our overall conclusions are robust. We further discuss the implications of our findings for future research on this topic, including how to account for biological relatedness in a study on child health in same-sex families.

Large-Scale functional network overlap is a general property of brain functional organization: Reconciling inconsistent fMRI findings from general-linear-model-based analyses

PubMed Central

Xu, Jiansong; Potenza, Marc N.; Calhoun, Vince D.; Zhang, Rubin; Yip, Sarah W.; Wall, John T.; Pearlson, Godfrey D.; Worhunsky, Patrick D.; Garrison, Kathleen A.; Moran, Joseph M.

2016-01-01

Functional magnetic resonance imaging (fMRI) studies regularly use univariate general-linear-model-based analyses (GLM). Their findings are often inconsistent across different studies, perhaps because of several fundamental brain properties including functional heterogeneity, balanced excitation and inhibition (E/I), and sparseness of neuronal activities. These properties stipulate heterogeneous neuronal activities in the same voxels and likely limit the sensitivity and specificity of GLM. This paper selectively reviews findings of histological and electrophysiological studies and fMRI spatial independent component analysis (sICA) and reports new findings by applying sICA to two existing datasets. The extant and new findings consistently demonstrate several novel features of brain functional organization not revealed by GLM. They include overlap of large-scale functional networks (FNs) and their concurrent opposite modulations, and no significant modulations in activity of most FNs across the whole brain during any task conditions. These novel features of brain functional organization are highly consistent with the brain’s properties of functional heterogeneity, balanced E/I, and sparseness of neuronal activity, and may help reconcile inconsistent GLM findings. PMID:27592153

Postsecondary study and mental ill-health: a meta-synthesis of qualitative research exploring students' lived experiences.

PubMed

Ennals, Priscilla; Fossey, Ellie; Howie, Linsey

2015-04-01

The postsecondary educational experiences of students living with mental health issues are not well understood. Existing studies are generally qualitative, small and context-specific in nature, and individually have limited influence on policy and practice. To identify and synthesise the findings of qualitative studies exploring student views of studying while living with mental ill-health. A systematic search of six electronic databases including CINAHL, ERIC, PsycINFO and Medline up to March 2013 was conducted. Findings were extracted from included studies and combined using qualitative meta-synthesis to identify core processes. The search identified 16 studies from five countries, with a total of 231 participants. Meta-synthesis of the findings revealed three common core processes: (1) knowing oneself and managing one's mental illness, (2) negotiating the social space, and (3) doing the academic work required for successful postsecondary participation. Beyond the learning processes that underpin studying, these findings suggest knowing oneself and negotiating social spaces of educational settings are key processes for students living with mental ill-health seeking to survive and thrive in postsecondary education. With increased awareness of these processes, students and policy makers may conceive new ways to optimise student experiences of postsecondary study.

Academic Bargaining: Origins and Growth.

ERIC Educational Resources Information Center

Begin, James P.; And Others

The determinants of faculty bargaining, including the impact of the organizational context of faculty behavior toward bargaining, are discussed in relation to findings from existing studies and findings from a longitudinal study of the New Jersey system of higher education. The introduction of this book provides the general context for studying…

Recovery High Schools: Students and Responsive Academic and Therapeutic Services

ERIC Educational Resources Information Center

Moberg, D. Paul; Finch, Andrew J.; Lindsley, Stephanie M.

2014-01-01

This article reviews findings from the authors' studies of recovery high schools (RHS), including a 1995 program evaluation of a school in New Mexico (Moberg & Thaler, 1995), a 2006-09 descriptive study of 17 recovery high schools (Moberg & Finch, 2008), and presents early findings from a current study of the effectiveness of recovery high…

Research activities to improve the utilization of antibiotics in Africa.

PubMed

Massele, Amos; Tiroyakgosi, Celda; Matome, Matshediso; Desta, Abayneh; Muller, Arno; Paramadhas, Bene D Anand; Malone, Brighid; Kurusa, Gobuiwang; Didimalang, Thatayaone; Moyo, Mosana; Godman, Brian

2017-02-01

There is a need to improve the rational use of antibiotics across continents including Africa. This has resulted in initiatives in Botswana including treatment guidelines and the instigation of Antibiotic Stewardship Programs (ASPs). The next steps involve a greater understanding of current antibiotic utilization and resistance patterns (AMR). This resulted in a 2-day meeting involving key stakeholders principally from Botswana to discuss key issues including AMR rates as well as ASPs in both the public and private sectors. Following this, the findings will be used to plan future studies across Africa including point prevalence studies. The findings will be presented in July 2016 at the next Medicines Utilization Research in Africa meeting will ideally serve as a basis for planning future pertinent interventional studies to enhance the rational use of antibiotics in Botswana and wider.

Correlation between Clinical Features and Magnetic Resonance Imaging Findings in Lumbar Disc Prolapse.

PubMed

Thapa, S S; Lakhey, R B; Sharma, P; Pokhrel, R K

2016-05-01

Magnetic resonance imaging is routinely done for diagnosis of lumbar disc prolapse. Many abnormalities of disc are observed even in asymptomatic patient.This study was conducted tocorrelate these abnormalities observed on Magnetic resonance imaging and clinical features of lumbar disc prolapse. A This prospective analytical study includes 57 cases of lumbar disc prolapse presenting to Department of Orthopedics, Tribhuvan University Teaching Hospital from March 2011 to August 2012. All patientshad Magnetic resonance imaging of lumbar spine and the findings regarding type, level and position of lumbar disc prolapse, any neural canal or foraminal compromise was recorded. These imaging findings were then correlated with clinical signs and symptoms. Chi-square test was used to find out p-value for correlation between clinical features and Magnetic resonance imaging findings using SPSS 17.0. This study included 57 patients, with mean age 36.8 years. Of them 41(71.9%) patients had radicular leg pain along specific dermatome. Magnetic resonance imaging showed 104 lumbar disc prolapselevel. Disc prolapse at L4-L5 and L5-S1 level constituted 85.5%.Magnetic resonance imaging findings of neural foramina compromise and nerve root compression were fairly correlated withclinical findings of radicular pain and neurological deficit. Clinical features and Magnetic resonance imaging findings of lumbar discprolasehad faircorrelation, but all imaging abnormalities do not have a clinical significance.

The views of young children in the UK about obesity, body size, shape and weight: a systematic review

PubMed Central

2011-01-01

Background There are high levels of concern about childhood obesity, with obese children being at higher risk of poorer health both in the short and longer terms. Children's attitudes to, and beliefs about, their bodies have also raised concern. Children themselves have a stake in this debate; their perspectives on this issue can inform the ways in which interventions aim to work. This systematic review of qualitative and quantitative research aimed to explore the views of UK children about the meanings of obesity and body size, shape or weight and their own experiences of these issues. Methods We conducted sensitive searches of electronic databases and specialist websites, and contacted experts. We included studies published from the start of 1997 which reported the perspectives of UK children aged 4-11 about obesity or body size, shape or weight, and which described key aspects of their methods. Included studies were coded and quality-assessed by two reviewers independently. Findings were synthesised in two analyses: i) an interpretive synthesis of findings from open-ended questions; and ii) an aggregative synthesis of findings from closed questions. We juxtaposed the findings from the two syntheses. The effect of excluding the lowest quality studies was explored. We also consulted young people to explore the credibility of a subset of findings. Results We included 28 studies. Instead of a focus on health, children emphasised the social impact of body size, describing experiences and awareness of abuse and isolation for children with a greater weight. Body size was seen as under the individual's control and children attributed negative characteristics to overweight people. Children actively assessed their own size; many wished their bodies were different and some were anxious about their shape. Reviewers judged that children's engagement and participation in discussion had only rarely been supported in the included studies, and few study findings had depth or breadth. Conclusions Initiatives need to consider the social aspects of obesity, in particular unhelpful beliefs, attitudes and discriminatory behaviours around body size. Researchers and policy-makers should involve children actively and seek their views on appropriate forms of support around this issue. PMID:21439062

How healthcare organizations use the Internet to market quality achievements.

PubMed

Revere, Lee; Robinson, Leroy

2010-01-01

The increasingly competitive environment is having a strong bearing on the strategic marketing practices of hospitals. The Internet is a fairly new marketing tool, and it has the potential to dramatically influence healthcare consumers. This exploratory study investigates how hospitals use the Internet as a tool to market the quality of their services. Significant evidence exists that customers use the Internet to find information about potential healthcare providers, including information concerning quality. Data were collected from a random sample of 45 U.S. hospitals from the American Hospital Association database. The data included hospital affiliation, number of staffed beds, accreditation status, Joint Commission quality awards, and number of competing hospitals. The study's findings show that system-affiliated hospitals do not provide more, or less, quality information on their websites than do non-system-affiliated hospitals. The findings suggest that the amount of quality information provided on a hospital website is not dependent on hospital size. Research provides evidence that hospitals with more Joint Commission awards promote their quality accomplishments more so than their counterparts that earned fewer Joint Commission awards. The findings also suggest that the more competitors in a marketplace the more likely a hospital is to promote its quality as a potential differential advantage. The study's findings indicate that a necessary element of any hospital's competitive strategy should be to include the marketing of its quality on the organization's website.

Detecting Regional Myocardial Abnormalities in Patients With Wolff-Parkinson-White Syndrome With the Use of ECG-Gated Cardiac MDCT.

PubMed

Lee, Hye-Jeong; Uhm, Jae-Sun; Joung, Boyoung; Hong, Yoo Jin; Hur, Jin; Choi, Byoung Wook; Kim, Young Jin

2016-04-01

Myocardial dyskinesia caused by the accessory pathway and related reversible heart failure have been well documented in echocardiographic studies of pediatric patients with Wolff-Parkinson-White (WPW) syndrome. However, the long-term effects of dyskinesia on the myocardium of adult patients have not been studied in depth. The goal of the present study was to evaluate regional myocardial abnormalities on cardiac CT examinations of adult patients with WPW syndrome. Of 74 patients with WPW syndrome who underwent cardiac CT from January 2006 through December 2013, 58 patients (mean [± SD] age, 52.2 ± 12.7 years), 36 (62.1%) of whom were men, were included in the study after the presence of combined cardiac disease was excluded. Two observers blindly evaluated myocardial thickness and attenuation on cardiac CT scans. On the basis of CT findings, patients were classified as having either normal or abnormal findings. We compared the two groups for other clinical findings, including observations from ECG, echocardiography, and electrophysiologic study. Of the 58 patients studied, 16 patients (27.6%) were found to have myocardial abnormalities (i.e., abnormal wall thinning with or without low attenuation). All abnormal findings corresponded with the location of the accessory pathway. Patients with abnormal findings had statistically significantly decreased left ventricular function, compared with patients with normal findings (p < 0.001). The frequency of regional wall motion abnormality was statistically significantly higher in patients with abnormal findings (p = 0.043). However, echocardiography documented structurally normal hearts in all patients. A relatively high frequency (27.6%) of regional myocardial abnormalities was observed on the cardiac CT examinations of adult patients with WPW syndrome. These abnormal findings might reflect the long-term effects of dyskinesia, suggesting irreversible myocardial injury that ultimately causes left ventricular dysfunction.

Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information.

PubMed

Champlin, Sara; Mackert, Michael; Glowacki, Elizabeth M; Donovan, Erin E

2017-07-01

While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low ( n = 13) and adequate ( n = 14) health literacy patients, and health professionals ( n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.

Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

PubMed

Sposato, Niklas S; Bjerså, Kristofer

2017-01-01

Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Unexpected findings after surgery for suspected appendicitis rarely change treatment in pediatric patients; Results from a cohort study.

PubMed

Gorter, Ramon R; van Amstel, Paul; van der Lee, Johanna H; van der Voorn, Patick; Bakx, Roel; Heij, Hugo A

2017-08-01

To determine if non-operative treatment is safe in children with acute appendicitis, we evaluated the incidence of unexpected findings after an appendectomy in children, and the influence they have on subsequent treatment. A historical cohort study (January 2004-December 2014) was performed including children, aged 0-17 years, who underwent an appendectomy for the suspicion of acute appendicitis. Patients were divided based upon histopathological examination. Unexpected findings were reviewed, as well as the subsequent treatment plan. In total 484 patients were included in this study. In the overall group, unexpected findings were noted in 10 (2.1%) patients of which two patients intra-operatively with a non-inflamed appendix (Ileitis terminalis N=1 and ovarian torsion N=1) and in 8 patients on histopathological examination. The latter group consisted of 4 patients with concomitant simple appendicitis (parasitic infection N=3 and Walthard cell rest N=1), two with concomitant complex appendicitis (carcinoid N=1 and parasitic infection N=1) and two patients with a non-inflamed appendix (endometriosis N=1 and parasitic infection N=1). Treatment was changed in 4 patients (<1%). Results from this study corroborate the safety of non-operative strategy for acute simple appendicitis, as the occurrence of unexpected findings was low, with extremely few necessary changes of the treatment plan because of serious findings. Prognosis study. Level 2 (retrospective cohort study). Copyright © 2017 Elsevier Inc. All rights reserved.

Experiences of mental health professionals and patients in the use of pro re nata medication in acute adult mental healthcare settings: a systematic review.

PubMed

Morkunas, Bernadette; Porritt, Kylie; Stephenson, Matthew

2016-10-01

The use of pro re nata (PRN) medication, a medication that is given when needed, as opposed to medication that is given at a regular time, is surrounded by claims of misuse and poor accountability within the mental health setting. Gaining insight into and understanding of the experiences of health professionals' and patients' use of PRN medication will assist in contributing to improving education and safety around this common intervention. To analyze and synthesize the best available evidence on the perspectives of patients and mental health professionals (MHPs) with their experiences of PRN medication in mental health settings. Participants considered for inclusion in this review include MHPs working in, and adult patients admitted to, an acute adult mental healthcare setting. This review will consider studies that investigated the experience of MHPs' and patients' use of PRN medication in acute adult mental healthcare settings. The current review will consider studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. The context of the review is acute adult mental healthcare settings with no restriction on geographical location. The search strategy aims to find both published and unpublished studies. The databases searched include CINAHL, PubMed, Scopus, PsycINFO and Embase. A gray literature search included ProQuest Dissertations and Theses, Mednar and Google Scholar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The standardized data extraction tool from the JBI-QARI was used to extract data from the papers. Qualitative research findings were pooled using the JBI-QARI. This involved the aggregation of findings to generate a set of statements that represented that aggregation, through assembling the findings rated according to their quality and categorizing these findings by similarity in meaning. These categories were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Four studies were included in the systematic review. Two studies each from both groups' perspective. These experiences were combined in one synthesis to look at the issues from mutual perspectives. A total of 40 findings were extracted from these four studies. The findings were grouped into 10 categories and five synthesized findings were developed. Pro re nata medication use among MHPs and service users is subject to many variables from individual decision making to organizational policies. There are many factors that contribute to MHPs prescribing and administering PRN medications and patients had views and opinions on their use of PRN medication in the acute mental health setting.

Do Disadvantaged Students Get Less Effective Teaching? Key Findings from Recent Institute of Education Sciences Studies. NCEE Evaluation Brief. Technical Appendix. NCEE 2014-4010

ERIC Educational Resources Information Center

Max, Jeffrey; Glazerman, Steven

2014-01-01

This document represents the technical appendix intended to accompany "Do Disadvantaged Students Get Less Effective Teaching? Key Findings from Recent Institute of Education Sciences Studies. NCEE Evaluation Brief. NCEE 2014-4010." Contents include: (1) Summary of Related, Non-Peer-Reviewed Studies; (2) Methods for Comparing Findings…

The Development of Young Children's Memory Strategies: First Findings from the Wurzburg Longitudinal Memory Study

ERIC Educational Resources Information Center

Schneider, Wolfgang; Kron, Veronika; Hunnerkopf, Michael; Krajewski, Kristin

2004-01-01

This article reports the first findings of the Wurzburg Longitudinal Memory Study, which focuses on children's verbal memory development, particularly the acquisition of memory strategies. At the beginning of the study, 100 kindergarten children (mean age 6-and-1/2 years) were tested on various memory measures, including sort--recall, text recall,…

MRI Features of Hepatocellular Carcinoma Related to Biologic Behavior

PubMed Central

Cho, Eun-Suk

2015-01-01

Imaging studies including magnetic resonance imaging (MRI) play a crucial role in the diagnosis and staging of hepatocellular carcinoma (HCC). Several recent studies reveal a large number of MRI features related to the prognosis of HCC. In this review, we discuss various MRI features of HCC and their implications for the diagnosis and prognosis as imaging biomarkers. As a whole, the favorable MRI findings of HCC are small size, encapsulation, intralesional fat, high apparent diffusion coefficient (ADC) value, and smooth margins or hyperintensity on the hepatobiliary phase of gadoxetic acid-enhanced MRI. Unfavorable findings include large size, multifocality, low ADC value, non-smooth margins or hypointensity on hepatobiliary phase images. MRI findings are potential imaging biomarkers in patients with HCC. PMID:25995679

Interventions to assist health consumers to find reliable online health information: a comprehensive review.

PubMed

Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery D; Emmerton, Lynne M

2014-01-01

Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus 'gray literature' search engines; and manual review of reference lists of selected publications. Publications were selected by firstly screening title, abstract, and then full text. Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design) Model. Two eligible gray literature papers were also reported. Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn. The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for assisting health consumers to find reliable online health information, and to assess outcomes via objective measures.

CLINICAL APPROACH TO THE DIAGNOSTIC EVALUATION OF HERDITARY AND ACQUIRED NEUROMUSCULAR DISEASES

PubMed Central

McDonald, Craig M.

2012-01-01

SYNOPSIS In the context of a neuromuscular disease diagnostic evaluation, the clinician still must be able to obtain a relevant patient and family history and perform focused general, musculoskeletal, neurologic and functional physical examinations to direct further diagnostic evaluations. Laboratory studies for hereditary neuromuscular diseases include relevant molecular genetic studies. The EMG and nerve conduction studies remain an extension of the physical examination and help to guide further diagnostic studies such as molecular genetic studies, and muscle and nerve biopsies. All diagnostic information needs to be interpreted not in isolation, but within the context of relevant historical information, family history, physical examination findings, and laboratory data, electrophysiologic findings, pathologic findings, and molecular genetic findings if obtained. PMID:22938875

Preoperative thoracic radiographic findings in dogs presenting for gastric dilatation-volvulus (2000-2010): 101 cases.

PubMed

Green, Jaime L; Cimino Brown, Dorothy; Agnello, Kimberly A

2012-10-01

To identify the incidence of clinically significant findings on preoperative thoracic radiographs in dogs with gastric dilatation-volvulus (GDV) and to determine if those findings are associated with survival. Retrospective study from 2000 to 2010. Urban university small animal teaching hospital. One hundred and one dogs diagnosed with GDV that had thoracic radiographs obtained preoperatively, and medical records available with the following information available: signalment, time of presentation, respiratory status, plasma lactate, presence of cardiac arrhythmias, reason for thoracic radiographs, radiographic findings, and outcome. None. Findings on preoperative thoracic radiographs included small vena cava (40%), esophageal dilation (39%), microcardia (34%), aspiration pneumonia (14%), cardiomegaly (5%), pulmonary nodule (4%), pulmonary edema (2%), sternal lymphadenopathy (1%), and pulmonary bullae (1%). Eighty-four percent of dogs (85 out of 101) survived to discharge. Dogs without cardiomegaly on presenting thoracic radiographs had a 10.2 greater odds of surviving to discharge. The most common findings on preoperative thoracic radiographs include esophageal dilation, microcardia, and a small vena cava while the incidence of pulmonary nodules was low. A negative association between survival and presence of cardiomegaly on preoperative thoracic radiographs in dogs with GDV supports the need to obtain these images for prognostic information in spite of the emergency surgical nature of the GDV. The main limitations of this study include the possibilities of type I and type II errors, the retrospective nature of the study, and the lack of well-defined criteria for obtaining thoracic radiographs. © Veterinary Emergency and Critical Care Society 2012.

Leininger's Ethnonursing Research Methodology and Studies of Cancer Survivors: A Review.

PubMed

Farren, Arlene T

2015-09-01

The purpose of this article is to present the findings of a literature review regarding the use of Leininger's ethnonursing research methodology (ENRM) in studies addressing adult cancer survivors. It is important to learn about differences and similarities among cancer survivors' experiences so that patient-centered, culturally congruent care can be provided. A review of the literature was conducted using databases such as CINAHL and MEDLINE. Search terms included variations on ENRM and cancer survivors. The results were a small number of published studies that used the ENRM examining breast cancer survivors' perceptions and experiences. A review instrument was developed to estimate study quality based on established criteria. The studies are critiqued in relation to the theory-based methodology, evaluation criteria for qualitative research, and study findings are summarized. The author concludes that although there is a paucity of research using ENRM with adult cancer survivors, the preliminary findings of the included studies contribute to what is known about breast cancer survivors. Implications for research include recommendations to increase the use of ENRM to discover the universal and diverse experiences of care practices in adult cancer survivors and use the evidence to develop patient-centered, culturally congruent, quality care for cancer survivors. © The Author(s) 2014.

The Effects of a BDNF Val66Met Polymorphism on Posttraumatic Stress Disorder: A Meta-Analysis.

PubMed

Bountress, Kaitlin E; Bacanu, Silviu-Alin; Tomko, Rachel L; Korte, Kristina J; Hicks, Terrell; Sheerin, Christina; Lind, Mackenzie J; Marraccini, Marisa; Nugent, Nicole; Amstadter, Ananda B

2018-06-06

Given evidence that posttraumatic stress disorder (PTSD) is moderately heritable, a number of studies utilizing candidate gene approaches have attempted to examine the potential contributions of theoretically relevant genetic variation. Some of these studies have found sup port for a brain-derived neurotrophic factor (BDNF) variant, Val66Met, in the risk of developing PTSD, while others have failed to find this link. This study sought to reconcile these conflicting findings using a meta-analysis framework. Analyses were also used to determine whether there is significant heterogeneity in the link between this variant and PTSD. We conducted a systematic review of the literature on BDNF and PTSD from the PsycINFO and PubMed databases. A total of 11 studies were included in the analysis. Findings indicate a marginally significant effect of the BDNF Val66Met variant on PTSD (p < 0.1). However, of the 11 studies included, only 2 suggested an effect with a non-zero confidence interval, one of which showed a z score of 3.31. We did not find any evidence for heterogeneity. Findings from this meta-analytic investigation of the published literature provide little support for the Val66Met variant of BDNF as a predictor of PTSD. Future well-powered agnostic genome-wide association studies with more refined phenotyping are needed to clarify genetic influences on PTSD. © 2018 S. Karger AG, Basel.

Pharmacogenetics of Antipsychotics

PubMed Central

Brandl, Eva J; Kennedy, James L; Müller, Daniel J

2014-01-01

Objective: During the past decades, increasing efforts have been invested in studies to unravel the influence of genetic factors on antipsychotic (AP) dosage, treatment response, and occurrence of adverse effects. These studies aimed to improve clinical care by predicting outcome of treatment with APs and thus allowing for individualized treatment strategies. We highlight most important findings obtained through both candidate gene and genome-wide association studies, including pharmacokinetic and pharmacodynamic factors. Methods: We reviewed studies on pharmacogenetics of AP response and adverse effects published on PubMed until early 2012. Owing to the high number of published studies, we focused our review on findings that have been replicated in independent studies or are supported by meta-analyses. Results: Most robust findings were reported for associations between polymorphisms of the cytochrome P450 system, the dopamine and the serotonin transmitter systems, and dosage, treatment response, and adverse effects, such as AP-induced weight gain or tardive dyskinesia. These associations were either detected for specific medications or for classes of APs. Conclusion: First promising and robust results show that pharmacogenetics bear promise for a widespread use in future clinical practice. This will likely be achieved by developing algorithms that will include many genetic variants. However, further investigation is warranted to replicate and validate previous findings, as well as to identify new genetic variants involved in AP response and for replication of existing findings. PMID:24881126

The experiences of midwives and nurses collaborating to provide birthing care: a systematic review.

PubMed

Macdonald, Danielle; Snelgrove-Clarke, Erna; Campbell-Yeo, Marsha; Aston, Megan; Helwig, Melissa; Baker, Kathy A

2015-11-01

Collaboration has been associated with improved health outcomes in maternity care. Collaborative relationships between midwives and physicians have been a focus of literature regarding collaboration in maternity care. However despite the front line role of nurses in the provision of maternity care, there has not yet been a systematic review conducted about the experiences of midwives and nurses collaborating to provide birthing care. The objective of this review was to identify, appraise and synthesize qualitative evidence on the experiences of midwives and nurses collaborating to provide birthing care.Specifically, the review question was: what are the experiences of midwives and nurses collaborating to provide birthing care? This review considered studies that included educated and licensed midwives and nurses with any length of practice. Nurses who work in labor and delivery, postpartum care, prenatal care, public health and community health were included in this systematic review.This review considered studies that investigated the experiences of midwives and nurses collaborating during the provision of birthing care. Experiences, of any duration, included any interactions between midwives and nurses working in collaboration to provide birthing care.Birthing care referred to: (a) supportive care throughout the pregnancy, labor, delivery and postpartum, (b) administrative tasks throughout the pregnancy, labor, delivery and postpartum, and (c) clinical skills throughout the pregnancy, labor, delivery and postpartum. The postpartum period included the six weeks after delivery.The review considered English language studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.This review considered qualitative studies that explored the experiences of collaboration in areas where midwives and nurses work together. Examples of these areas included: hospitals, birth centers, client homes, health clinics and other public or community health settings. These settings were located in any country, cultural context, or geographical location. A three-step search strategy was used to identify relevant published and unpublished studies. English papers from 1981 onwards were considered. The following databases were searched: Anthrosource, CENTRAL (The Cochrane Library), CINAHL, EMBASE, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. In addition to the databases, several grey literature sources were searched. Papers that were selected for retrieval were independently assessed for inclusion in the review by two JBI-trained reviewers. The two reviewers used a standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Once qualitative studies were assessed using the the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical appraisal tool, findings of the included studies were extracted. These findings were aggregated into categories according to their similarity in meaning. These categories were then subjected to a meta-synthesis to produce a comprehensive set of synthesized findings. Five studies were included in the review. Thirty-eight findings were extracted from the included studies and were aggregated into five categories. The five categories were synthesized into two synthesized findings. The two synthesized findings were:Synthesized finding1: Negative experiences of collaboration between nurses and midwives may be influenced by distrust, lack of clear roles, or unprofessional or inconsiderate behavior.Synthesized finding 2: If midwives and nurses have positive experiences collaborating thenthere is hope that the challenges of collaboration can be overcome. Qualitative evidence about the experiences of midwives and nurses collaborating to provide birthing care was identified, appraised and synthesized. Two synthesized findings were created from the findings of the five included studies. Midwives and nurses had negative experiences of collaboration which may be influenced by: distrust, unclear roles, or a lack of professionalism or consideration. Midwives and nurses had positive experiences of teamwork which can be a source of hope for overcoming the challenges of sharing care.There is clearly a gap in the literature about the collaborative experiences of midwives and nurses, given that only five studies were located for inclusion in the systematic review. More qualitative research exploring collaboration as a process and the interactional dynamics of midwives and nurses in a variety of practice and professional contexts is required.Distrust, unclear roles, and lack of professionalism and consideration must all be addressed. Strategies that address and minimize the occurrences of these three elements need to be developed and implemented in an effort to reduce negative collaborative experiences for midwives and nurses. Postive experiences of teamwork must be acknowleged and celebrated, and the challenges that sharing care present must be understood as a part of the collaborative process.More qualitative research is required to explore the collaborative process between midwives and nurses. Further exploration of their interactional dynamics, their relationship between power and collaboration, and the experiences of collaboration in a variety of professional and practice contexts is recommended.

Welfare to What: Early Findings on Family Hardship and Well-Being.

ERIC Educational Resources Information Center

Sherman, Arloc; Amey, Cheryl; Duffield, Barbara; Ebb, Nancy; Weinstein, Deborah

This report takes an in-depth look at the evidence of family well-being since the 1996 federal welfare legislation drawing on new national survey data, a review of studies by states and research institutions, and a compilation of findings from informal community-based monitoring projects. Disturbing findings include: Only a small fraction of…

The TIMSS Videotape Classroom Study: Methods and Findings from an Exploratory Research Project on Eighth-Grade Mathematics Instruction in Germany, Japan, and the United States. A Research and Development Report.

ERIC Educational Resources Information Center

Stigler, James W.; Gonzales, Patrick; Kwanaka, Takako; Knoll, Steffen; Serrano, Ana

This report presents the methods and preliminary findings of the Videotape Classroom Study, a video study of eighth-grade mathematics lessons in Germany, Japan, and the United States. This exploratory research project is part of the Third International Mathematics and Science Study (TIMSS). The study included 231 eighth-grade mathematics…

The intergenerational transfer of psychosocial risk: mediators of vulnerability and resilience.

PubMed

Serbin, Lisa A; Karp, Jennifer

2004-01-01

The recurrence of social, behavioral, and health problems in successive generations of families is a prevalent theme in both the scientific and popular literatures. This review discusses recent conceptual models and findings from longitudinal studies concerning the intergenerational transfer of psychosocial risk, including intergenerational continuity, and the processes whereby a generation of parents may place their offspring at elevated risk for social, behavioral, and health problems. Key findings include the mediational effects of parenting and environmental factors in the transfer of risk. In both girls and boys, childhood aggression and antisocial behavior appear to predict long-term trajectories that place offspring at risk. Sequelae of childhood aggression that may threaten the well-being of offspring include school failure, adolescent risk-taking behavior, early and single parenthood, and family poverty. These childhood and adolescent behavioral styles also predict harsh, aggressive, neglectful, and unstimulating parenting behavior toward offspring. Buffering factors within at-risk families include maternal educational attainment and constructive parenting practices (e.g., emotional warmth, consistent disciplinary practices, and cognitive scaffolding). These findings highlight the potential application and relevance of intergenerational studies for social, educational, and health policy.

How International Field Experiences Promote Cross-Cultural Awareness in Preservice Teachers through Experiential Learning: Findings from a Six-Year Collective Case Study

ERIC Educational Resources Information Center

Malewski, Erik; Sharma, Suniti; Phillion, JoAnn

2012-01-01

Background/Context: The article examines how international field experiences promote cross-cultural awareness in U.S. American preservice teachers through experiential learning. The findings presented here are based on a 6-year study of a short-term study abroad program in Honduras that included an international field experience component and took…

A Nonword Repetition Task for Speakers with Misarticulations: The Syllable Repetition Task (SRT)

PubMed Central

Shriberg, Lawrence D.; Lohmeier, Heather L.; Campbell, Thomas F.; Dollaghan, Christine A.; Green, Jordan R.; Moore, Christopher A.

2010-01-01

Purpose Conceptual and methodological confounds occur when non(sense) repetition tasks are administered to speakers who do not have the target speech sounds in their phonetic inventories or who habitually misarticulate targeted speech sounds. We describe a nonword repetition task, the Syllable Repetiton Task (SRT) that eliminates this confound and report findings from three validity studies. Method Ninety-five preschool children with Speech Delay and 63 with Typical Speech, completed an assessment battery that included the Nonword Repetition Task (NRT: Dollaghan & Campbell, 1998) and the SRT. SRT stimuli include only four of the earliest occurring consonants and one early occurring vowel. Results Study 1 findings indicated that the SRT eliminated the speech confound in nonword testing with speakers who misarticulate. Study 2 findings indicated that the accuracy of the SRT to identify expressive language impairment was comparable to findings for the NRT. Study 3 findings illustrated the SRT’s potential to interrogate speech processing constraints underlying poor nonword repetition accuracy. Results supported both memorial and auditory-perceptual encoding constraints underlying nonword repetition errors in children with speech-language impairment. Conclusion The SRT appears to be a psychometrically stable and substantively informative nonword repetition task for emerging genetic and other research with speakers who misarticulate. PMID:19635944

Characteristics of Qualitative Descriptive Studies: A Systematic Review

PubMed Central

Kim, Hyejin; Sefcik, Justine S.; Bradway, Christine

2016-01-01

Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, despite inconsistencies, most articles included characteristics consistent with limited, available QD definitions and descriptions. Next, flexibility or variability of methods was common and desirable for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD study so that readers can determine whether the methods used were reasonable and effective in producing useful findings. PMID:27686751

"Oos Sensei! Oos Sempai!": A Karate School and Lessons on Inclusion

ERIC Educational Resources Information Center

Rao, Shridevi

2008-01-01

Based on the findings of a qualitative case study, this paper describes how a karate school within a community came naturally to include students with disabilities. Data for this study were collected through in-depth interviews with the Sensei or head instructor of the school and participant observations. Findings indicate that the Sensei's…

Mind-body Therapies for Menopausal Symptoms: A Systematic Review

PubMed Central

Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

2010-01-01

Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

Fluid-electrolyte responses during prolonged space flight: A review and interpretation of significant findings

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1985-01-01

The most important results of the Skylab studies related to fluid-electrolyte regulation are summarized. These data are the starting point of a systems analysis to study adaptation to the weightlessness environment. A summary of the systems analysis study, including an interpretation of Skylab results, is included.

Histopathologic Findings in Autopsies with Emphasis on Interesting and Incidental Findings-A Pathologist’s Perspective

PubMed Central

Rajalakshmi, B.R.; Manjunath, G.V.

2016-01-01

Introduction Autopsy aids to the knowledge of pathology by unveiling the rare lesions which are a source of learning from a pathologist’s perspective Some of them are only diagnosed at autopsy as they do not cause any functional derangement. This study emphasizes the various incidental lesions which otherwise would have been unnoticed during a person’s life. Aim The aim of this study was to determine the spectrum of histopathological findings including neoplastic lesions related or unrelated to the cause of death. It was also aimed to highlight various incidental and interesting lesions in autopsies. Materials and Methods A retrospective study of medicolegal autopsies for six years was undertaken in a tertiary care centre to determine the spectrum of histopathological findings including neoplastic lesions related or unrelated to the cause of death and to highlight various incidental and interesting lesions in autopsies. Statistical Analysis: Individual lesions were described in numbers and incidence in percentage. Results The study consisted of a series of 269 autopsy cases and histopathological findings were studied only in 202 cases. The commonest cause of death was pulmonary oedema. The most common incidental histopathological finding noted was atherosclerosis in 55 (27.2%) cases followed by fatty liver in 40 (19.8%) cases. Neoplastic lesions accounted for 2.47% of cases. Conclusion This study has contributed a handful of findings to the pool of rare lesions in pathology. Some of these lesions encountered which served as feast to a pathologist are tumour to tumour metastasis, a case with coexistent triple lesions, Dubin Johnson syndrome, von Meyenburg complex, Multilocular Cystic Renal Cell Carcinoma (MCRCC), Autosomal Dominant Polycystic Kidney Disease (ADPKD), liver carcinod and an undiagnosed vaso-occlusive sickle cell crisis. Autopsy studies help in the detection of unexpected findings significant enough to have changed patient management had they been recognized before death. PMID:28050373

Clinical, laboratory, and hemostatic findings in cats with naturally occurring sepsis.

PubMed

Klainbart, Sigal; Agi, Limor; Bdolah-Abram, Tali; Kelmer, Efrat; Aroch, Itamar

2017-11-01

OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.

Awakening to the other: reflections on developing intercultural competence through an undergraduate study tour.

PubMed

Stone, Teresa E; Francis, Lyn; van der Riet, Pamela; Dedkhard, Saowapa; Junlapeeya, Piyatida; Orwat, Edith

2014-12-01

For the past 4 years, undergraduate students from the Faculty of Health, University of Newcastle, Newcastle, Australia, have undertaken a two week cultural study tour in Thailand, being exposed to a broad range of cultural interactions, health settings in rural and remote areas, and health-treatment approaches, including traditional and complementary therapies. Student evaluations and reflections were collected after the 2010 and 2011 study tours. This paper reports on findings following thematic analysis of the data, which identified central themes, including connectivity to others, "awakenings", "embodiment", and looking to the future. Findings included a recognition by students of a growth in awareness and change in perspective, which they felt would impact on their future approach in caring for patients from culturally- and linguistically-diverse backgrounds. We conclude that the study tour provided an effective way of sensitizing students to cultural differences and promoting cross-cultural awareness. © 2014 Wiley Publishing Asia Pty Ltd.

Assessment of Patient Empowerment - A Systematic Review of Measures

PubMed Central

Barr, Paul J.; Scholl, Isabelle; Bravo, Paulina; Faber, Marjan J.; Elwyn, Glyn; McAllister, Marion

2015-01-01

Background Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric properties of questionnaires purporting to capture patient empowerment, evaluate the methodological quality of these studies and assess the psychometric properties of measures identified. Methods Electronic searches in five databases were combined with reference tracking of included articles. Peer-reviewed articles reporting psychometric testing of empowerment measures for adult patients in French, German, English, Portuguese and Spanish were included. Study characteristics, constructs operationalised and psychometric properties were extracted. The quality of study design, methods and reporting was assessed using the COSMIN checklist. The quality of psychometric properties was assessed using Terwee’s 2007 criteria. Findings 30 studies on 19 measures were included. Six measures are generic, while 13 were developed for a specific condition (N=4) or specialty (N=9). Most studies tested measures in English (N=17) or Swedish (N=6). Sample sizes of included studies varied from N=35 to N=8261. A range of patient empowerment constructs was operationalised in included measures. These were classified into four domains: patient states, experiences and capacities; patient actions and behaviours; patient self-determination within the healthcare relationship and patient skills development. Quality assessment revealed several flaws in methodological study quality with COSMIN scores mainly fair or poor. The overall quality of psychometric properties of included measures was intermediate to positive. Certain psychometric properties were not tested for most measures. Discussion Findings provide a basis from which to develop consensus on a core set of patient empowerment constructs and for further work to develop a (set of) appropriately validated measure(s) to capture this. The methodological quality of psychometric studies could be improved by adhering to published quality criteria. PMID:25970618

Characteristic Magnetic Resonance Imaging Findings in Rheumatoid Arthritis of the Temporomandibular Joint: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle, Pannus, and Lymph Node Swelling in the Parotid Glands.

PubMed

Hirahara, Naohisa; Kaneda, Takashi; Muraoka, Hirotaka; Fukuda, Taiga; Ito, Kotaro; Kawashima, Yusuke

2017-04-01

The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings indicating bone and soft tissue involvement in patients with rheumatoid arthritis (RA) of the temporomandibular joints (TMJs). Twenty-one patients with RA and TMJ pain who underwent MRI examination of the TMJs at the authors' hospital from August 2006 to December 2014 were included in this study. Twenty-two patients with normal TMJs who underwent MRI examination at the authors' hospital from November to December 2014 were included as controls. MRI findings were compared between the 2 groups. MRI findings of RA in the TMJ included 1) abnormal disc position (95.2%), 2) abnormal disc morphology (83.3%), 3) joint effusion (30.9%), 4) osseous changes in the mandibular condyle (83.3%), 5) synovial proliferation (pannus; 85.7%), 6) erosion of the articular eminence and glenoid fossa (9.52%), 7) deformity of the articular eminence and glenoid fossa (16.6%), 8) abnormal bone marrow signal in the mandibular condyle (83.3%), and 9) swelling of lymph nodes in the parotid glands (78.5%). The abnormal bone marrow signal and pannus in the mandibular condyle and lymph node swelling in the parotid glands were markedly more common in patients with RA than in controls. MRI findings of RA of the TMJs were characterized by bone and soft tissue involvement, including abnormal bone marrow signal of the mandibular condyle, pannus, and swelling of lymph nodes in the parotid glands. These characteristic MRI findings could be useful in detecting RA in the TMJ in a clinical situation. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study.

PubMed

Cho, Iksung; Al'Aref, Subhi J; Berger, Adam; Ó Hartaigh, Bríain; Gransar, Heidi; Valenti, Valentina; Lin, Fay Y; Achenbach, Stephan; Berman, Daniel S; Budoff, Matthew J; Callister, Tracy Q; Al-Mallah, Mouaz H; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Villines, Todd C; Hadamitzky, Martin; Hausleiter, Joerg; Leipsic, Jonathon; Shaw, Leslee J; Kaufmann, Philipp A; Feuchtner, Gudrun; Kim, Yong-Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Marques, Hugo; Rubinshtein, Ronen; Chang, Hyuk-Jae; Min, James K

2018-03-14

The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental χ2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.

A systematic review of grounded theory studies in physiotherapy.

PubMed

Ali, Nancy; May, Stephen; Grafton, Kate

2018-05-23

This systematic review aimed at appraising the methodological rigor of grounded theory research published in the field of physiotherapy to assess how the methodology is understood and applied. A secondary aim was to provide research implications drawn from the findings to guide future grounded theory methodology (GTM) research. A systematic search was conducted in MEDLINE, CINHAL, SPORT Discus, Science Direct, PubMed, Scopus, and Web of Science to identify studies in the field of physiotherapy that reported using GTM and/or methods in the study title and/or abstract. The descriptive characteristics and methodological quality of eligible studies were examined using grounded theory methodology assessment guidelines. The review included 68 studies conducted between 1998 and 2017. The findings showed that GTM is becoming increasingly used by physiotherapy researchers. Thirty-six studies (53%) demonstrated a good understanding and appropriate application of GTM. Thirty-two studies (47%) presented descriptive findings and were considered to be of poor methodological quality. There are several key tenets of GTM that are integral to the iterative process of qualitative theorizing and need to be applied throughout all research practices including sampling, data collection, and analysis.

Fatal heat stroke in children found in parked cars: autopsy findings.

PubMed

Adato, Berliz; Dubnov-Raz, Gal; Gips, Hadas; Heled, Yuval; Epstein, Yoram

2016-09-01

A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The aim of this study was to analyze the pathological consequences of such grave events. Autopsy reports of all children that were brought to a national forensic medicine center after being found dead in closed vehicles over a 21-year period (1995-2015) were reviewed. Data extracted were the circumstances of the events, child age, sex, height and weight, time, date and duration of entrapment, and environmental temperatures at the time of entrapment and the autopsy findings. Eight deceased children were brought to the forensic medicine center for autopsy, and seven families consented to the procedure. Autopsy findings included diffuse petechiae and hemorrhages of serosal membranes (n = 7/7) and lung congestion (n = 3/7). Typical autopsy findings following classical heat stroke in children include diffuse petechiae and hemorrhages and lung involvement. These findings are similar to those reported in adults that had died following exertional heat stroke-a very different mechanism of heat accumulation. Prevention of future events can possibly be obtained by public education on the rapid heating of closed vehicles, the vulnerability of children to heat, and the caregiver role in child entrapment. • A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The pathological consequences of such grave events have not been previously reported. What is New: • This study is the first to describe autopsy findings from children who were found dead in parked cars. • Autopsy findings included diffuse petechiae hemorrhages of serosal membranes and lung congestion. • These findings are identical to those seen in adults following exertional heat stroke.

National survey of distracted and drowsy driving attitudes and behaviors : 2002. Volume 1, Findings

DOT National Transportation Integrated Search

2003-04-01

This report represents the findings on distracted driving (including cell phone use) and drowsy driving. The data come from a pair of studies undertaken by the National Highway Traffic Safety Administration (NHTSA) to better understand drivers' behav...

Analysis of change in timber volume on non-Federal timberlands in Washington.

Treesearch

Daniel D. Oswald

1986-01-01

This report presents the findings of a study conducted to determine change in per acre timber volume on non-Federal timberlands in Washington from the mid-1960’s to 1978-80. The basis for the-study was the measurement of 1,576 permanent plots at two occasions. The study findings include estimates of change in volume and of the components of change-growth, mortality,...

Examining the Needs of Paediatric Nurses Caring for Children and Young People Presenting with Self-Harm/Suicidal Behaviour on General Paediatric Wards: Findings from a Small-Scale Study

ERIC Educational Resources Information Center

Fisher, Gemma; Foster, Celeste

2016-01-01

This article reports on the process and findings from a small-scale qualitative research study. The study intended to develop an evidence-based care plan/pathway for children and young people in paediatric inpatient settings presenting with self-harm/suicidal behaviour. The article includes a critical review of unanticipated challenges of…

Consulting communities on feedback of genetic findings in international health research: sharing sickle cell disease and carrier information in coastal Kenya

PubMed Central

2013-01-01

Background International health research in malaria-endemic settings may include screening for sickle cell disease, given the relationship between this important genetic condition and resistance to malaria, generating questions about whether and how findings should be disclosed. The literature on disclosing genetic findings in the context of research highlights the role of community consultation in understanding and balancing ethically important issues from participants’ perspectives, including social forms of benefit and harm, and the influence of access to care. To inform research practice locally, and contribute to policy more widely, this study aimed to explore the views of local residents in Kilifi County in coastal Kenya on how researchers should manage study-generated information on sickle cell disease and carrier status. Methods Between June 2010 and July 2011, we consulted 62 purposively selected Kilifi residents on how researchers should manage study-generated sickle cell disease findings. Methods drew on a series of deliberative informed small group discussions. Data were analysed thematically, using charts, to describe participants’ perceptions of the importance of disclosing findings, including reasoning, difference and underlying values. Themes were derived from the underlying research questions and from issues emerging from discussions. Data interpretation drew on relevant areas of social science and bioethics literature. Results Perceived health and social benefits generated strong support for disclosing findings on sickle cell disease, but the balance of social benefits and harms was less clear for sickle cell trait. Many forms of health and social benefits and harms of information-sharing were identified, with important underlying values related to family interests and the importance of openness. The influence of micro and macro level contextual features and prioritization of values led to marked diversity of opinion. Conclusions The approach demonstrates a high ethical importance in many malaria endemic low-to-middle income country settings of disclosing sickle cell disease findings generated during research, alongside provision of effective care and locally-informed counselling. Since these services are central to the benefits of disclosure, health researchers whose studies include screening for sickle cell disease should actively promote the development of health policy and services for this condition in situations of unmet need, including through the prior development of collaborative partnerships with government health managers and providers. Community consultation can importantly enrich ethical debate on research practice where in-depth exploration of informed views and the potential for difference are taken into account. PMID:24125465

Consulting communities on feedback of genetic findings in international health research: sharing sickle cell disease and carrier information in coastal Kenya.

PubMed

Marsh, Vicki; Kombe, Francis; Fitzpatrick, Raymond; Williams, Thomas N; Parker, Michael; Molyneux, Sassy

2013-10-14

International health research in malaria-endemic settings may include screening for sickle cell disease, given the relationship between this important genetic condition and resistance to malaria, generating questions about whether and how findings should be disclosed. The literature on disclosing genetic findings in the context of research highlights the role of community consultation in understanding and balancing ethically important issues from participants' perspectives, including social forms of benefit and harm, and the influence of access to care. To inform research practice locally, and contribute to policy more widely, this study aimed to explore the views of local residents in Kilifi County in coastal Kenya on how researchers should manage study-generated information on sickle cell disease and carrier status. Between June 2010 and July 2011, we consulted 62 purposively selected Kilifi residents on how researchers should manage study-generated sickle cell disease findings. Methods drew on a series of deliberative informed small group discussions. Data were analysed thematically, using charts, to describe participants' perceptions of the importance of disclosing findings, including reasoning, difference and underlying values. Themes were derived from the underlying research questions and from issues emerging from discussions. Data interpretation drew on relevant areas of social science and bioethics literature. Perceived health and social benefits generated strong support for disclosing findings on sickle cell disease, but the balance of social benefits and harms was less clear for sickle cell trait. Many forms of health and social benefits and harms of information-sharing were identified, with important underlying values related to family interests and the importance of openness. The influence of micro and macro level contextual features and prioritization of values led to marked diversity of opinion. The approach demonstrates a high ethical importance in many malaria endemic low-to-middle income country settings of disclosing sickle cell disease findings generated during research, alongside provision of effective care and locally-informed counselling. Since these services are central to the benefits of disclosure, health researchers whose studies include screening for sickle cell disease should actively promote the development of health policy and services for this condition in situations of unmet need, including through the prior development of collaborative partnerships with government health managers and providers. Community consultation can importantly enrich ethical debate on research practice where in-depth exploration of informed views and the potential for difference are taken into account.

Some Thoughts on Mexican Poverty Viewed from the Perspective of the World Population Plan of Action.

ERIC Educational Resources Information Center

Serron, Luis A.

The paper summarizes findings of a study of Mexican poverty (SO 010 522), and relates these findings to guidelines of the World Population Plan of Action. The study indicated that poverty in Mexico is based upon national and international economic, political, and social factors. Included among these factors are exploitation of labor, rapid…

Bullying Victimisation and Social Support of Adolescent Male Dance Students: An Analysis of Findings

ERIC Educational Resources Information Center

Risner, Doug

2014-01-01

This analysis (n?=?33), drawn from the findings of the author's larger mixed method research study, investigated bullying and harassment of adolescent male students (ages 13-18) pursuing dance study at the pre-professional level in the United States. Procedures for this analysis included review of primary and secondary sources from the…

Spontaneous Findings in the Eyes of Cynomolgus Monkeys ( Macaca fascicularis) of Mauritian Origin.

PubMed

Woicke, Jochen; Haile, Solomon; Mysore, Jagannatha; Peden, W Michael; Lejeune, Typhaine; Sanderson, Thomas; Brodie, Thomas

2018-04-01

Spontaneous findings noted in the eyes of Mauritian cynomolgus monkeys are described and descriptions are supplemented with illustrations. Findings observed after extensive histopathologic examinations (20 to 44 sections per eye) from 20 control, 17 treatment-naive stock monkeys, and 2 findings noted in drug-treated monkeys that were considered to be spontaneous are included. Also included are findings from 361 control monkeys of routine toxicity studies performed at our laboratories, for most of which a standard histopathological examination of 1 section per eye was conducted. Common observations in monkeys examined extensively and in historical controls were limited to lymphocytic or mononuclear cell infiltrations of the uvea and/or conjunctiva/sclera and, less commonly observed, melanocytoma of the ciliary body or iris. Findings noted only in monkeys examined extensively consisted of inflammation of the conjunctiva, ora serrata cysts, glial nodules, focal degeneration of the retina, cystoid degeneration of the central retina, ballooning degeneration of the ciliary epithelium, cyst of the ciliary body, and decreased pigmentation of the retinal pigment epithelium. Changes recorded only in historical controls included retinal atrophy and nuclear displacement in the retina. Lesions are discussed and compared with pertinent literature.

What is knowledge and when should it be implemented?

PubMed

O'Grady, Laura

2012-10-01

A primary purpose of research is to generate new knowledge. Scientific advances have progressively identified optimal ways to achieve this purpose. Included in this evolution are the notions of evidence-based medicine, decision aids, shared decision making, measurement and evaluation as well as implementation. The importance of including qualitative and quantitative methods in our research is now understood. We have debated the meaning of evidence and how to implement it. However, we have yet to consider how to include in our study findings other types of information such as tacit and experiential knowledge. This key consideration needs to take place before we translate new findings or 'knowledge' into clinical practice. This article critiques assumptions regarding the nature of knowledge and suggests a framework for implementing research findings into practice. © 2012 Blackwell Publishing Ltd.

Finding the Optimal Scaffoldings for Learners' Epistemological Beliefs during Ill-Structured Problem Solving

ERIC Educational Resources Information Center

Shin, Suhkyung; Song, Hae-Deok

2016-01-01

This study investigates how scaffolding type and learners' epistemological beliefs influence ill-structured problem solving. The independent variables in this study include the type of scaffolding (task-supported, self-monitoring) and the student's epistemological belief level (more advanced, less advanced). The dependent variables include three…

Physics students' approaches to learning and cognitive processes in solving physics problems

NASA Astrophysics Data System (ADS)

Bouchard, Josee

This study examined traditional instruction and problem-based learning (PBL) approaches to teaching and the extent to which they foster the development of desirable cognitive processes, including metacognition, critical thinking, physical intuition, and problem solving among undergraduate physics students. The study also examined students' approaches to learning and their perceived role as physics students. The research took place in the context of advanced courses of electromagnetism at a Canadian research university. The cognitive science, expertise, physics and science education, instructional psychology, and discourse processes literature provided the framework and background to conceptualize and structure this study. A within-stage mixed-model design was used and a number of instruments, including a survey, observation grids, and problem sets were developed specifically for this study. A special one-week long problem-based learning (PBL) intervention was also designed. Interviews with the instructors participating in the study provided complementary data. Findings include evidence that students in general engage in metacognitive processes in the organization of their personal study time. However, this potential, including the development of other cognitive processes, might not be stimulated as much as it could in the traditional lecture instructional context. The PBL approach was deemed as more empowering for the students. An unexpected finding came from the realisation that a simple exposure to a structured exercise of problem-solving (pre-test) was sufficient to produce superior planning and solving strategies on a second exposure (post-test) even for the students who had not been exposed to any special treatment. Maturation was ruled out as a potential threat to the validity of this finding. Another promising finding appears to be that the problem-based learning (PBL) intervention tends to foster the development of cognitive competencies, particularly physical intuition, even if it was only implemented for a short period of time. Other findings relate to the nature of the cognitive actions and activities that the students engage in when learning to solve electromagnetism problems in a PBL environment for the first time and the tutoring actions that guide students in this context.

EAR AND TAIL LESIONS ON CAPTIVE WHITE-TAILED DEER FAWNS (ODOCOILEUS VIRGINIANUS): A CASE STUDY.

PubMed

Ferguson, Treena L; Demarais, Stephen; Cooley, Jim; Fleming, Sherrill; Michel, Eric S; Flinn, Emily

2016-06-01

During the 2008-2011 time period, undiagnosed lesions were observed in 21 of 150 white-tailed deer fawns (Odocoileus virginianus) that were part of a captive deer herd at Mississippi State University. Clinical findings in healthy and diseased fawns from 0 to 90 days of age included bite and scratch marks followed by moderate to severe ear and tail necrosis. Gross necropsy findings of necrotizing ulcerative dermatitis correlated with histopathologic findings that included focally severe multifocal vasculitis, vascular necrosis, and thrombosis. This article is a clinical description of these previously unreported lesions associated with tissue necrosis in young captive white-tailed deer.

Electrodiagnostic findings in a patient with Waardenburg syndrome.

PubMed

Ahmed, Aiesha; Simmons, Zachary

2009-09-01

Waardenburg syndrome is associated with a variety of clinical features, which may include polyneuropathy. We describe a patient with Waardenburg syndrome type 2 and provide detailed electrodiagnostic findings, thus complementing the biopsy data and brief descriptions of nerve conduction studies found in the literature.

Air pollution and allergic diseases

PubMed Central

Brandt, Eric B.; Biagini Myers, Jocelyn M.; Ryan, Patrick H.; Khurana Hershey, Gurjit K.

2015-01-01

Purpose of review Exposure to traffic-related air pollutants (TRAP) has been implicated in asthma development, persistence, and exacerbation. This exposure is highly significant because increasingly large segments of the population worldwide reside in zones that have high levels of TRAP (1), including children since schools are often located in high traffic pollution exposure areas. Recent findings Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of traffic pollution on allergic diseases and the biology underlying this impact. In addition, new innovative methods to assess and quantify traffic pollution have been developed to assess exposure and identify vulnerable populations and individuals. Summary This review will summarize the most recent findings in each of these areas. These findings will have substantial impact on clinical practice and research by development of novel methods to quantify exposure and identify at-risk individuals, as well as mechanistic studies that identify new targets for intervention for individuals most adversely affected by TRAP exposure. PMID:26474340

Plain radiologic findings and chronological changes of incipient phase osteosarcoma overlooked by primary physicians.

PubMed

Song, Won Seok; Jeon, Dae-Geun; Cho, Wan Hyeong; Kong, Chang-Bae; Cho, Sang Hyun; Lee, Jung Wook; Lee, Soo-Yong

2014-06-01

We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.

The 2010 California Research at the Nexus of Air Quality and Climate Change (CalNex) field study

NASA Astrophysics Data System (ADS)

Ryerson, T. B.; Andrews, A. E.; Angevine, W. M.; Bates, T. S.; Brock, C. A.; Cairns, B.; Cohen, R. C.; Cooper, O. R.; de Gouw, J. A.; Fehsenfeld, F. C.; Ferrare, R. A.; Fischer, M. L.; Flagan, R. C.; Goldstein, A. H.; Hair, J. W.; Hardesty, R. M.; Hostetler, C. A.; Jimenez, J. L.; Langford, A. O.; McCauley, E.; McKeen, S. A.; Molina, L. T.; Nenes, A.; Oltmans, S. J.; Parrish, D. D.; Pederson, J. R.; Pierce, R. B.; Prather, K.; Quinn, P. K.; Seinfeld, J. H.; Senff, C. J.; Sorooshian, A.; Stutz, J.; Surratt, J. D.; Trainer, M.; Volkamer, R.; Williams, E. J.; Wofsy, S. C.

2013-06-01

The California Research at the Nexus of Air Quality and Climate Change (CalNex) field study was conducted throughout California in May, June, and July of 2010. The study was organized to address issues simultaneously relevant to atmospheric pollution and climate change, including (1) emission inventory assessment, (2) atmospheric transport and dispersion, (3) atmospheric chemical processing, and (4) cloud-aerosol interactions and aerosol radiative effects. Measurements from networks of ground sites, a research ship, tall towers, balloon-borne ozonesondes, multiple aircraft, and satellites provided in situ and remotely sensed data on trace pollutant and greenhouse gas concentrations, aerosol chemical composition and microphysical properties, cloud microphysics, and meteorological parameters. This overview report provides operational information for the variety of sites, platforms, and measurements, their joint deployment strategy, and summarizes findings that have resulted from the collaborative analyses of the CalNex field study. Climate-relevant findings from CalNex include that leakage from natural gas infrastructure may account for the excess of observed methane over emission estimates in Los Angeles. Air-quality relevant findings include the following: mobile fleet VOC significantly declines, and NOx emissions continue to have an impact on ozone in the Los Angeles basin; the relative contributions of diesel and gasoline emission to secondary organic aerosol are not fully understood; and nighttime NO3 chemistry contributes significantly to secondary organic aerosol mass in the San Joaquin Valley. Findings simultaneously relevant to climate and air quality include the following: marine vessel emissions changes due to fuel sulfur and speed controls result in a net warming effect but have substantial positive impacts on local air quality.

Dietary Inflammatory Potential Score and Risk of Breast Cancer: Systematic Review and Meta-analysis.

PubMed

Zahedi, Hoda; Djalalinia, Shirin; Sadeghi, Omid; Asayesh, Hamid; Noroozi, Mehdi; Gorabi, Armita Mahdavi; Mohammadi, Rasool; Qorbani, Mostafa

2018-02-07

Several studies have been conducted on the relationship between dietary inflammatory potential (DIP) and breast cancer. However, the findings are conflicting. This systematic review and meta-analysis summarizes the findings on the association between DIP and the risk of breast cancer. We used relevant keywords and searched online international electronic databases, including PubMed and NLM Gateway (for Medline), Institute for Scientific Information (ISI), and Scopus for articles published through February 2017. All cross-sectional, case-control, and cohort studies were included in this meta-analysis. Meta-analysis was performed using the random effects meta-analysis method to address heterogeneity among studies. Findings were analyzed statistically. Nine studies were included in the present systematic review and meta-analysis. The total sample size of these studies was 296,102, and the number of participants varied from 1453 to 122,788. The random effects meta-analysis showed a positive and significant association between DIP and the risk of breast cancer (pooled odds ratio, 1.14; 95% confidence interval, 1.01-1.27). The pooled effect size was not statistically significant because of the type of studies, including cohort (pooled relative risk, 1.04; 95% confidence interval, 0.98-1.10) and case-control (pooled odds ratio, 1.63; 95% confidence interval, 0.89-2.37) studies. We found a significant and positive association between higher DIP score and risk of breast cancer. Modifying inflammatory characteristics of diet can substantially reduce the risk of breast cancer. Copyright © 2018 Elsevier Inc. All rights reserved.

Does the use of efficacy or effectiveness evidence in cost-effectiveness analysis matter?

PubMed

Dilokthornsakul, Piyameth; Chaiyakunapruk, Nathorn; Campbell, Jonathan D

2017-01-02

To test the association of clinical evidence type, efficacy-based or effectiveness-based ("E"), versus whether or not asthma interventions' cost-effectiveness findings are favorable. We conducted a systematic review of PubMed, EMBASE, Tufts CEA registry, Cochrane CENTRAL, and the UK National Health Services Economic Evaluation Database from 2009 to 2014. All cost-effectiveness studies evaluating asthma medication(s) were included. Clinical evidence type, "E," was classified as efficacy-based if the evidence was from an explanatory randomized controlled trial(s) or meta-analysis, while evidence from pragmatic trial(s) or observational study(s) was classified as effectiveness-based. We defined three times the World Health Organization cost-effectiveness willingness-to-pay (WTP) threshold or less as a favorable cost-effectiveness finding. Logistic regression tested the likelihood of favorable versus unfavorable cost-effectiveness findings against the type of "E." 25 cost-effectiveness studies were included. Ten (40.0%) studies were effectiveness-based, yet 15 (60.0%) studies were efficacy-based. Of 17 studies using endpoints that could be compared to WTP threshold, 7 out of 8 (87.5%) effectiveness-based studies yielded favorable cost-effectiveness results, whereas 4 out of 9 (44.4%) efficacy-based studies yielded favorable cost-effectiveness results. The adjusted odds ratio was 15.12 (95% confidence interval; 0.59 to 388.75) for effectiveness-based versus efficacy-based achieving favorable cost-effectiveness findings. More asthma cost-effectiveness studies used efficacy-based evidence. Studies using effectiveness-based evidence trended toward being more likely to disseminate favorable cost-effective findings than those using efficacy. Health policy decision makers should pay attention to the type of clinical evidence used in cost-effectiveness studies for accurate interpretation and application.

Predictors for delayed encephalopathy following acute carbon monoxide poisoning.

PubMed

Kudo, Kaoru; Otsuka, Kotaro; Yagi, Junko; Sanjo, Katsumi; Koizumi, Noritaka; Koeda, Atsuhiko; Umetsu, Miki Yokota; Yoshioka, Yasuhito; Mizugai, Ayumi; Mita, Toshinari; Shiga, Yu; Koizumi, Fumito; Nakamura, Hikaru; Sakai, Akio

2014-01-31

In Japan, many carbon monoxide (CO) poisoning cases are transported to emergency settings, making treatment and prognostic assessment an urgent task. However, there is currently no reliable means to predict whether "delayed neuropsychiatric sequelae (DNS)" will develop after acute CO poisoning. This study is intended to find out risk factors for the development of DNS and to characterize the clinical course following the development of DNS in acute CO poisoning cases. This is a retrospective cohort study of 79 consecutive patients treated at a single institution for CO poisoning. This study included 79 cases of acute CO poisoning admitted to our emergency department after attempted suicide, who were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not. The two groups were compared and analyzed in terms of clinical symptoms, laboratory findings, etc. Predictors for the development of DNS following acute CO poisoning included: serious consciousness disturbance at emergency admission; head CT findings indicating hypoxic encephalopathy; hematology findings including high creatine kinase, creatine kinase-MB and lactate dehydrogenase levels; and low Global Assessment Scale scores. The clinical course of the DNS-developing cases was characterized by prolonged hospital stay and a larger number of hyperbaric oxygen (HBO) therapy sessions. In patients with the characteristics identified in this study, administration of HBO therapy should be proactively considered after informing their family, at initial stage, of the risk of developing DNS, and at least 5 weeks' follow-up to watch for the development of DNS is considered necessary.

Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial

PubMed Central

Schregel, Katharina; Karch, André; Weber-Krueger, Mark; Stahrenberg, Raoul; Gröschel, Klaus; Knauth, Michael; Psychogios, Marios-Nikos; Wachter, Rolf; Liman, Jan

2017-01-01

Background. Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. Methods. Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained. Embolic stroke patterns in CT- or MR-imaging were correlated with the diagnosis of ESUS as well as the short- (on baseline ECG and during 7-day Holter) and long-term (12-month follow-up) diagnosis of AF. Results. From 281 patients included in the Find-AF study, 127 (45.2%) patients with ischemic lesions detected in CT or MRI were included. 26 (20.5%) of these patients had ESUS. At least one embolic stroke pattern was detected in 67 (52.7%) patients. Embolic stroke patterns were not associated with ESUS (OR 1.57, 0.65–3.79, p = 0.317), the short-term (OR 0.64, 0.26–1.58, p = 0.327) or long-term diagnosis of AF (OR 0.72, 0.31–1.68, p = 0.448). Conclusions. This secondary data analysis of the Find-AF study could not provide evidence for an association between embolic stroke patterns, ESUS, and the new diagnosis of AF. PMID:28536667

Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial.

PubMed

Maier, Ilko L; Schregel, Katharina; Karch, André; Weber-Krueger, Mark; Mikolajczyk, Rafael T; Stahrenberg, Raoul; Gröschel, Klaus; Bähr, Mathias; Knauth, Michael; Psychogios, Marios-Nikos; Wachter, Rolf; Liman, Jan

2017-01-01

Background . Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. Methods . Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained. Embolic stroke patterns in CT- or MR-imaging were correlated with the diagnosis of ESUS as well as the short- (on baseline ECG and during 7-day Holter) and long-term (12-month follow-up) diagnosis of AF. Results . From 281 patients included in the Find-AF study, 127 (45.2%) patients with ischemic lesions detected in CT or MRI were included. 26 (20.5%) of these patients had ESUS. At least one embolic stroke pattern was detected in 67 (52.7%) patients. Embolic stroke patterns were not associated with ESUS (OR 1.57, 0.65-3.79, p = 0.317), the short-term (OR 0.64, 0.26-1.58, p = 0.327) or long-term diagnosis of AF (OR 0.72, 0.31-1.68, p = 0.448). Conclusions . This secondary data analysis of the Find-AF study could not provide evidence for an association between embolic stroke patterns, ESUS, and the new diagnosis of AF.

The travesty of choosing after positive prenatal diagnosis.

PubMed

Sandelowski, Margarete; Barroso, Julie

2005-01-01

To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis. Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies. Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion. Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings. The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance. Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.

The influence of occupation on wellbeing, as experienced by the elderly: a systematic review.

PubMed

Jessen-Winge, Christina; Petersen, Mille Nyboe; Morville, Anne-Le

2018-05-01

The objective of this review was to synthesize knowledge regarding which types of occupations the elderly perceive as important to and supporting their overall wellbeing. Being active is an important part of managing the daily challenges of advanced old age. Occupational therapy and occupational science are based on the premise that a person's occupations are intertwined with their health and are thus needed for them to experience a meaningful life and improve their wellbeing. This review, which included independently living elderly people aged 65 and over living in Europe, the USA, Canada and Australia, sought to uncover if the elderly see any specific types of occupations as enhancing their wellbeing. This review included qualitative studies with designs including, but not limited to, phenomenology, grounded theory, ethnography and action research. A three-step search strategy using Joanna Briggs Institute methodology was utilized. Both published and unpublished studies were searched. The following databases were searched for studies up to 2017: CINAHL, Nursing and Allied Health Source, Web of Science, PubMed and OpenGrey. Using the JBI Critical Appraisal Checklist for Qualitative Research, two independent reviewers assessed whether each study had the methodological quality required to be included in the review. Any disagreements were resolved through discussion with a third reviewer. The standardized JBI data extraction tool for interpretive and critical research was used to extract data from the included studies. JBI tools were used to pool the qualitative research findings. The findings were then aggregated through a process of rating according to quality, and categorized according to similarity in meaning, which generated a set of statements for each category. These categories were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings useful as a basis for evidence-based practice. All three of the included studies utilized qualitative interviews and followed a phenomenological approach. The studies included only participants aged 85 and over. Thirty-five findings were extracted and grouped into four categories, which were synthesized into two meta-syntheses: 1) The importance of "doing" alone - to feel good, I have to be the master of my own life; and 2) Old habits never die - a structured day is a good day. Based on the dependability and credibility of the three studies, the ranking was high (see Summary of Findings). The present review shows that two factors enhance elderly people's wellbeing: first, variation and independence in undertaking activities; second, having a choice between the occupations and a structure of activities that make up daily life. The two factors are influenced by a balance between having activities alone and with others. This review is not intended to identify specific occupations that enhance elderly people's wellbeing, but rather to indicate which types of occupations enhance the wellbeing of the elderly, and provide value and meaning to their daily lives.Both the dependability and the credibility of the studies have been rated as moderate.

An Overview of Findings from Wave 2 of the National Longitudinal Transition Study-2 (NLTS2). NCSER 2006-3004

ERIC Educational Resources Information Center

Wagner, Mary; Newman, Lynn; Cameto, Renee; Levine, Phyllis; Garza, Nicolle

2006-01-01

This report is an executive summary of two previously-released reports presenting findings from Wave 2: The Academic Achievement and Functional Performance of Youth with Disabilities and After High School: A First Look at the Postschool Experiences of Youth with Disabilities. Some key findings presented in the Overview include the following: (1) A…

Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery.

PubMed

Jacobsen, Paul B; DeRosa, Antonio P; Henderson, Tara O; Mayer, Deborah K; Moskowitz, Chaya S; Paskett, Electra D; Rowland, Julia H

2018-05-18

Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers' concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence.

PubMed

MacKinnon, Karen; Marcellus, Lenora; Rivers, Julie; Gordon, Carol; Ryan, Maureen; Butcher, Diane

2017-11-01

Although maternal-child care is a pillar of primary health care, there is a global shortage of maternal-child health care providers. Nurse educators experience difficulties providing undergraduate students with maternal-child learning experiences for a number of reasons. Simulation has the potential to complement learning in clinical and classroom settings. Although systematic reviews of simulation are available, no systematic reviews of qualitative evidence related to maternal-child simulation-based learning (SBL) for undergraduate nursing students and/or educators have been located. The aim of this systematic review was to identify the appropriateness and meaningfulness of maternal-child simulation-based learning for undergraduate nursing students and nursing educators in educational settings to inform curriculum decision-making. The review questions are: INCLUSION CRITERIA TYPES OF PARTICIPANTS: Pre-registration or pre-licensure or undergraduate nursing or health professional students and educators. Experiences of simulation in an educational setting with a focus relevant to maternal child nursing. Qualitative research and educational evaluation using qualitative methods. North America, Europe, Australia and New Zealand. A three-step search strategy identified published studies in the English language from 2000 until April 2016. Identified studies that met the inclusion criteria were retrieved and critically appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) by at least two independent reviewers. Overall the methodological quality of the included studies was low. Qualitative findings were extracted by two independent reviewers using JBI-QARI data extraction tools. Findings were aggregated and categorized on the basis of similarity in meaning. Categories were subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. Twenty-two articles from 19 studies were included in the review. A total of 112 findings were extracted from the included articles. Findings were grouped into 15 categories created on the basis of similarity of meaning. Meta-synthesis of these categories generated three synthesized findings.Synthesized finding 1 Students experienced simulated learning experiences (SLE) as preparation that enhanced their confidence in practice. When simulation was being used for evaluation purposes many students experienced anxiety about the SLE.Synthesized finding 2 Pedagogical practices thought to be appropriate and meaningful included: realistic, relevant and engaging scenarios, a safe non-threatening learning environment, supportive guidance throughout the process, and integration with curriculum.Synthesized finding 3 Barriers and enablers to incorporating SLEs into maternal child education were identified including adequate resources, technological support and faculty development. Students and educators recognized that some things, such as relationship building, could not be simulated. Students felt that simulation prepared them for practice through building their self-confidence related to frequently and infrequently seen maternal-child scenarios. Specific pedagogical elements support the meaningfulness of the simulation for student learning. The presence or absence of resources impacts the capacity of educators to integrate simulation activities throughout curricula.

Lifespan changes in attention revisited: Everyday visual search.

PubMed

Brennan, Allison A; Bruderer, Alison J; Liu-Ambrose, Teresa; Handy, Todd C; Enns, James T

2017-06-01

This study compared visual search under everyday conditions among participants across the life span (healthy participants in 4 groups, with average age of 6 years, 8 years, 22 years, and 75 years, and 1 group averaging 73 years with a history of falling). The task involved opening a door and stepping into a room find 1 of 4 everyday objects (apple, golf ball, coffee can, toy penguin) visible on shelves. The background for this study included 2 well-cited laboratory studies that pointed to different cognitive mechanisms underlying each end of the U-shaped pattern of visual search over the life span (Hommel et al., 2004; Trick & Enns, 1998). The results recapitulated some of the main findings of the laboratory study (e.g., a U-shaped function, dissociable factors for maturation and aging), but there were several unique findings. These included large differences in the baseline salience of common objects at different ages, visual eccentricity effects that were unique to aging, and visual field effects that interacted strongly with age. These findings highlight the importance of studying cognitive processes in more natural settings, where factors such as personal relevance, life history, and bodily contributions to cognition (e.g., limb, head, and body movements) are more readily revealed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature.

PubMed

Oyesanya, Tolu

2017-01-01

Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyse and synthesize studies' findings separately for the patient and family experience. The initial search provided 2871 records. Ultimately, 11 studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient's injury, a desire to be involved in the patient's care, mixed feelings about staff support and a high perceived need for information. Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centred and directions for future research.

Responding to the Ideals of Lassallian Education in the 21st Century: A Case Study of St. Paul's Secondary School in Marsabit, Kenya

ERIC Educational Resources Information Center

Marius, Boya Francois; Teklemariam, Amanuel Abraha; Akala, Winston Jumba

2011-01-01

De La Salle Brothers are Christian educators operating in more than 80 countries, including Kenya. The purpose of this study was to find if the ideals of Lasallian education are being realized in the 21st century in Kenya and to establish whether the findings concur with the Lasallian philosophy of education. The study was conducted at St. Paul's…

Characteristics of Qualitative Descriptive Studies: A Systematic Review.

PubMed

Kim, Hyejin; Sefcik, Justine S; Bradway, Christine

2017-02-01

Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, although there were some inconsistencies, most articles included characteristics consistent with the limited available QD definitions and descriptions. Next, flexibility or variability of methods was common and effective for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD studies so that readers can determine whether the methods used were reasonable and effective in producing useful findings. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Renal incidental findings on computed tomography

PubMed Central

Meyer, Hans Jonas; Pfeil, Alina; Schramm, Dominik; Bach, Andreas Gunter; Surov, Alexey

2017-01-01

Abstract Renal incidental findings (IFs) are common. However, previous reports investigated renal IFs were limited to patient selection. The purpose of this study was to estimate the prevalence and distribution of all renal IFs on computed tomography (CT) in a large patient collective. All patients, who underwent CT investigations of the abdominal region at our institution in the time period between January 2006 and February 2014 were included in this study. Inclusion criteria were as follows: no previous history of renal diseases and well image quality. Patients with known kidney disorders were excluded from the study. Overall, 7365 patients meet the inclusion criteria were identified. There were 2924 (39.7%) women and 4441 men (60.3%) with a mean age of 59.8 ± 16.7 years. All CTs were retrospectively analyzed in consensus by 2 radiologists. Collected data were evaluated by means of descriptive statistics. Overall, 2756 patients (37.42% of all included patients) showed 3425 different renal IFs (1.24 findings per patient). Of all renal IFs, 123 (3.6%) findings were clinically relevant, 259 (7.6%) were categorized as possibly clinically relevant, and 3043 (88.8%) were clinically non relevant. Different renal IFs can be detected on CT. The present study provides a real prevalence and proportion of them in daily clinical routine. Kidneys should be thoroughly evaluated because of the fact that incidental renal findings occur frequently. PMID:28658098

Correlation between morphological MRI findings and specific diagnostic categories in fetal alcohol spectrum disorders.

PubMed

Boronat, S; Sánchez-Montañez, A; Gómez-Barros, N; Jacas, C; Martínez-Ribot, L; Vázquez, E; Del Campo, M

2017-01-01

Fetal alcohol spectrum disorders (FASD) include physical and neurodevelopmental abnormalities related to prenatal alcohol exposure. Some neuroimaging findings have been clearly related to FASD, including corpus callosum and cerebellar anomalies. However, detailed studies correlating with specific FASD categories, that is, the fetal alcohol syndrome (FAS), partial FAS (pFAS) and alcohol related neurodevelopmental disorders (ARND), are lacking. We prospectively performed clinical assessment and brain MR imaging to 72 patients with suspected FASD, and diagnosis was confirmed in 62. The most frequent findings were hypoplasia of the corpus callosum and/or of the cerebellar vermis. Additional findings were vascular anomalies, gliosis, prominent perivascular spaces, occipito-cervical junction and cervical vertebral anomalies, pituitary hypoplasia, arachnoid cysts, and cavum septum pellucidum. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

45 CFR 74.36 - Intangible property.

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2014-10-01

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45 CFR 2543.36 - Intangible property.

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2013-10-01

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45 CFR 2543.36 - Intangible property.

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45 CFR 74.36 - Intangible property.

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45 CFR 74.36 - Intangible property.

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45 CFR 74.36 - Intangible property.

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45 CFR 74.36 - Intangible property.

Code of Federal Regulations, 2013 CFR

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45 CFR 2543.36 - Intangible property.

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45 CFR 2543.36 - Intangible property.

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Parental Involvement in Norwegian Schools

ERIC Educational Resources Information Center

Paulsen, Jan Merok

2012-01-01

This article examines findings on key challenges of school-parent relations in Norway. The review is based on recent large-scale studies on several issues, including formalized school-parent cooperation, parental involvement in the pedagogical discourse, and teacher perspectives on the parents' role in the school community. Findings suggest a…

Parent–Child Aggression Risk in Expectant Mothers and Fathers: A Multimethod Theoretical Approach

PubMed Central

Smith, Tamika L.; Silvia, Paul J.

2016-01-01

The current investigation evaluated whether cognitive processes characteristic of the Social Information Processing model predicted parent-child aggression (PCA) risk independent of personal vulnerabilities and resiliencies. This study utilized a multimethod approach, including analog tasks, with a diverse sample of 203 primiparous expectant mothers and 151 of their partners. Factors considered in this study included PCA approval attitudes, empathy, reactivity, negative child attributions, compliance expectations, and knowledge of non-physical discipline alternatives; additionally, vulnerabilities included psychopathology symptoms, domestic violence victimization, and substance use, whereas resiliencies included perceived social support, partner relationship satisfaction, and coping efficacy. For both mothers and fathers, findings supported the role of greater approval of PCA attitudes, lower empathy, more overreactivity, more negative attributions, and higher compliance expectations in relation to elevated risk of PCA. Moreover, personal vulnerabilities and resiliencies related to PCA risk for mothers; however, fathers and mothers differed on the nature of these relationships with respect to vulnerabilities as well as aspects of empathy and PCA approval attitudes. Findings provide evidence for commonalities in many of the factors investigated between mothers and fathers with some notable distinctions. Results are discussed in terms of how findings could inform prevention programs. PMID:28082826

"Who Stays and Who Leaves?" Findings from a Three-Part Study of Teacher Turnover in NYC Middle Schools. Technical Appendices

ERIC Educational Resources Information Center

Marinell, William H.; Coca, Vanessa M.; Arum, Richard; Goldstein, Jennifer; Kemple, James; Pallas, Aaron; Bristol, Travis; Buckley, Clare; Scallon, Amy; Tanner, Barbara

2013-01-01

The technical appendices presented in this document correspond to the synthesis report, "'Who Stays and Who Leaves?' Findings from a Three-Part Study of Teacher Turnover in NYC Middle Schools." The appendices include: (1) Description of Data Source and Samples; (2) Methods; and (3) Who Are the Middle School Teachers in NYC? [The…

Perceptions and Expectations of Youth with Disabilities. A Special Topic Report of Findings from the National Longitudinal Transition Study-2 (NLTS2). NCSER 2007-3006

ERIC Educational Resources Information Center

Wagner, Mary; Newman, Lynn; Cameto, Renee; Levine, Phyllis; Marder, Camille

2007-01-01

The National Longitudinal Transition Study-2 (NLTS2) was initiated to provide a national picture of the characteristics and experiences of youth with disabilities, including their self-representations, their schooling, their personal relationships, and their hopes for the future. This report presents findings drawn from the first time (2003) data…

Understanding the role of the volunteer in specialist palliative care: a systematic review and thematic synthesis of qualitative studies

PubMed Central

2014-01-01

Background Volunteers make a major contribution to palliative patient care, and qualitative studies have been undertaken to explore their involvement. With the aim of making connections between existing studies to derive enhanced meanings, we undertook a systematic review of these qualitative studies including synthesising the findings. We sought to uncover how the role of volunteers with direct contact with patients in specialist palliative care is understood by volunteers, patients, their families, and staff. Methods We searched for relevant literature that explored the role of the volunteer including electronic citation databases and reference lists of included studies, and also undertook handsearches of selected journals to find studies which met inclusion criteria. We quality appraised included studies, and synthesised study findings using a novel synthesis method, thematic synthesis. Results We found 12 relevant studies undertaken in both inpatient and home-care settings, with volunteers, volunteer coordinators, patients and families. Studies explored the role of general volunteers as opposed to those offering any professional skills. Three theme clusters were found: the distinctness of the volunteer role, the characteristics of the role, and the volunteer experience of the role. The first answers the question, is there a separate volunteer role? We found that to some extent the role was distinctive. The volunteer may act as a mediator between the patient and the staff. However, we also found some contradictions. Volunteers may take on temporary surrogate family-type relationship roles. They may also take on some of the characteristics of a paid professional. The second cluster helps to describe the essence of the role. Here, we found that the dominant feature was that the role is social in nature. The third helps to explain aspects of the role from the point of view of volunteers themselves. It highlighted that the role is seen by volunteers as flexible, informal and sometimes peripheral. These characteristics some volunteers find stressful. Conclusions This paper demonstrates how qualitative research can be sythnesised systematically, extending methodological techniques to help answer difficult research questions. It provides information that may help managers and service planners to support volunteers appropriately. PMID:24506971

Implementing Tuberculosis Close-contact Investigation in a Tertiary Hospital in Iran.

PubMed

Shamaei, Masoud; Esmaeili, Shahrbanoo; Marjani, Majid; Tabarsi, Payam

2018-01-01

Close contact investigation is the essential key in tuberculosis (TB) case finding and an effective strategy for TB control program within any society. In this prospective study, 1186 close family contacts of hospitalized TB patients (index) in a referral TB hospital in Tehran-Iran were passively studied. These people were studied to rollout TB infection and disease. Demographic characteristics, clinical and laboratory data of these individuals were reviewed and summarized for analysis. A total of 886 (74.4%) close-family contacts completed their investigation. The index TB patients of these individuals were sputum smear negative for acid-fast bacilli in 137 cases (11.6%) and the rest were smear positive. A total of 610 (68.8%) close-family contact ruled out for TB infection or disease (Group I). A total of 244 cases (27.5%) had latent TB infection (Group II) and active TB (Group III) was confirmed in 32 cases (3.6%). A significant difference was shown for female gender, signs and symptoms, family size, and positive radiological finding between Group I and Group II. The study of index parameter including positive sputum smear/culture did not reveal any significant difference, but positive cavitary lesion significantly more has seen in active TB group ( P = 0.004). This study emphasizes on sign and symptoms and radiological finding in TB contact investigation, where index parameters including positive smear/culture, does not implicate any priority. Although cavitary lesions in index patient have more accompanied by active TB, close contact study should include all of TB indexes. This investigation should include chest radiography for these individuals.

The Relation of Empathy and Defending in Bullying: A Meta-Analytic Investigation

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Aloe, Ariel M.; Werth, Jilynn M.

2015-01-01

This meta-analysis synthesized results about the association between empathy and defending in bullying. A total of 20 studies were included, with 22 effect sizes from 6 studies that separated findings by the defender's gender, and 31 effect sizes from 18 studies that provided effects for the total sample were included in the analysis. The weighted…

Can Funding for University Partnerships between Africa and the US Contribute to Social Development and Poverty Reduction?

ERIC Educational Resources Information Center

Collins, Christopher S.

2014-01-01

This study explores US funding for university partnerships between the US and Africa. The primary objective was to study how funds are facilitated through partnerships to promote social development and poverty reduction. Findings include the innovative and resilient nature of the 11 projects included in the study as well as pitfalls in the…

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study

PubMed Central

2014-01-01

Background In previous studies, many indicator factors have been proposed to select patients who need an MRI screening of the spinal canal. In current study, the clinical and radiologic factors including coronal parameters of the curve were evaluated to find out which indicator is more important. Methods A prospective study included 143 consecutive patients with the diagnosis of adolescent idiopathic scoliosis who were treated between 2010 and 2013 at our spinal clinics. Only patients with normal or subtle neurologic findings were included. All patients were evaluated by a total spine MRI protocol for examination of neuroaxial abnormalities. Known indicators and also coronal shift were analysed in all patients with or without abnormal MRI. Results The incidence of neuroaxial abnormalities was 11.9% (17 of 143); only 5 patients (3.5%) were operated to treat their neuroaxial problem. The significant indicators of the abnormalities in our patients were: younger age at onset, asymmetric superficial abdominal reflex and, coronal shift more than 15 mm (P = 0.03). Some previously known indicators like atypical curves, male gender, double curves and absence of thoracic lordosis were not different between two groups of the patients. Conclusions A total spine MRI is recommended at presentation in patients with younger age, abnormal neurologic findings and severe coronal shift. PMID:25071863

Elucidating the evolutionary relationships of the Aiptasiidae, a widespread cnidarian-dinoflagellate model system (Cnidaria: Anthozoa: Actiniaria: Metridioidea).

PubMed

Grajales, Alejandro; Rodríguez, Estefanía

2016-01-01

Sea anemones of the family Aiptasiidae sensu Grajales and Rodríguez (2014) are conspicuous members of shallow-water environments, including several species widely used as model systems for the study of cnidarian-dinoflagellate symbiosis and coral bleaching. Although previously published phylogenetic studies of sea anemones recovered Aiptasiidae as polyphyletic, they only included a sparse sample in terms of its taxonomic diversity and membership of the family had not been yet revised. This study explores the phylogenetic relationships of this family using five molecular markers and including newly collected material from the geographical distribution of most of the currently described genera and species. We find a monophyletic family Aiptasiidae. All the currently proposed genera were recovered as monophyletic units, a finding also supported by diagnostic morphological characters. Our results confirm Bellactis and Laviactis as members of Aiptasiidae, also in agreement with previous morphological studies. The monophyly of the group is congruent with the morphological homogeneity of the members of this family. The obtained results also allow discussing the evolution of morphological characters within the family. Furthermore, we find evidence for and describe a new cryptic species, Exaiptasia brasiliensis sp. nov., based on molecular data, geographical distribution, and the identity of its endosymbiotic dinoflagellate. Copyright © 2015 Elsevier Inc. All rights reserved.

Parenting Stress in Families of Children with ADHD: A Meta-Analysis

ERIC Educational Resources Information Center

Theule, Jennifer; Wiener, Judith; Tannock, Rosemary; Jenkins, Jennifer M.

2013-01-01

Meta-analyses were conducted to examine findings on the association between parenting stress and ADHD. Predictors comprising child, parent, and contextual factors, and methodological and demographic moderators of the relationship between parenting stress and ADHD, were examined. Findings from 22 published and 22 unpublished studies were included.…

The Female Voice: Applications to Bowen's Family Systems Theory.

ERIC Educational Resources Information Center

Knudson-Martin, Carmen

1994-01-01

Responds to calls from feminist scholars to address potential biases against women in theories of family therapy. Summarizes findings from studies of female development and integrates findings into expanded model of Bowen's family systems theory. Includes case example comparing expanded model with traditional application of Bowen's theory.…

24 CFR 84.36 - Intangible property.

Code of Federal Regulations, 2012 CFR

2012-04-01

...” material excludes physical objects (e.g., laboratory samples). Research data also do not include: (A) Trade... study. (ii) Published is defined as either when: (A) Research findings are published in a peer-reviewed...) request for research data relating to published research findings produced under an award that were used...

24 CFR 84.36 - Intangible property.

Code of Federal Regulations, 2013 CFR

2013-04-01

...” material excludes physical objects (e.g., laboratory samples). Research data also do not include: (A) Trade... study. (ii) Published is defined as either when: (A) Research findings are published in a peer-reviewed...) request for research data relating to published research findings produced under an award that were used...

24 CFR 84.36 - Intangible property.

Code of Federal Regulations, 2014 CFR

2014-04-01

...” material excludes physical objects (e.g., laboratory samples). Research data also do not include: (A) Trade... study. (ii) Published is defined as either when: (A) Research findings are published in a peer-reviewed...) request for research data relating to published research findings produced under an award that were used...

24 CFR 84.36 - Intangible property.

Code of Federal Regulations, 2010 CFR

2010-04-01

...” material excludes physical objects (e.g., laboratory samples). Research data also do not include: (A) Trade... study. (ii) Published is defined as either when: (A) Research findings are published in a peer-reviewed...) request for research data relating to published research findings produced under an award that were used...

24 CFR 84.36 - Intangible property.

Code of Federal Regulations, 2011 CFR

2011-04-01

...” material excludes physical objects (e.g., laboratory samples). Research data also do not include: (A) Trade... study. (ii) Published is defined as either when: (A) Research findings are published in a peer-reviewed...) request for research data relating to published research findings produced under an award that were used...

Nonvisualization of the ovaries on pelvic ultrasound: does MRI add anything?

PubMed

Lisanti, Christopher J; Wood, Jonathan R; Schwope, Ryan B

2014-02-01

The purpose of our study is to assess the utility of pelvic magnetic resonance imaging (MRI) in the event that either one or both ovaries are not visualized by pelvic ultrasound. This HIPAA-compliant retrospective study was approved by our local institutional review board and informed consent waived. 1926 pelvic MRI examinations between March 2007 and December 2011 were reviewed and included if a combined transabdominal and endovaginal pelvic ultrasound had been performed in the preceding 6 months with at least one ovary nonvisualized. Ovaries not visualized on pelvic ultrasound were assumed to be normal and compared with the pelvic MRI findings. MRI findings were categorized as concordant or discordant. Discordant findings were divided into malignant, non-malignant physiologic or non-malignant non-physiologic. The modified Wald, the "rule of thirds", and the binomial distribution probability tests were performed. 255 pelvic ultrasounds met inclusion criteria with 364 ovaries not visualized. 0 malignancies were detected on MRI. 6.9% (25/364) of nonvisualized ovaries had non-malignant discordant findings on MRI: 5.2% (19/364) physiologic, 1.6% (6/364) non-physiologic. Physiologic findings included: 16 functional cysts and 3 hemorrhagic cysts. Non-physiologic findings included: 3 cysts in post-menopausal women, 1 hydrosalpinx, and 2 broad ligament fibroids. The theoretical risk of detecting an ovarian carcinoma on pelvic MRI when an ovary is not visualized on ultrasound ranges from 0 to 1.3%. If an ovary is not visualized on pelvic ultrasound, it can be assumed to be without carcinoma and MRI rarely adds additional information.

[Comorbid psychiatric symptoms in pathological gamblers: anxiety, depression and substance abuse].

PubMed

Dannon, Pinhas; Sason, Marina; Shalgi, Bosmat; Tusan, Lali; Sapir, Yafa; Kotler, Moshe

2004-09-01

Over the centuries, gambling behaviour has been well known and characterized by the combination of pleasure, luck and competition. Our study explored the relationship between pathological gambling, depression and anxiety. We also explored demographic findings and behavioural patterns of the pathological gamblers. Fourty-seven patients were included in this study and they anonymously completed questionnaires which included demographic findings, the Hamilton depression rating scale and the Hamilton anxiety rating scale. The study results demonstrated a strong correlation between depression, anxiety, substance abuse, and pathological gambling. It also presented lower income and higher anxiety levels associated with a higher tendency for gambling. The subjects suffering from depression and anxiety also showed higher levels of suicidality and other abuse dependencies. In order to confirm these preliminary results larger studies are needed in this field.

A study of coherence of soft gluons in hadron jets

NASA Astrophysics Data System (ADS)

Akrawy, M. Z.; Alexander, G.; Allison, J.; Allport, P. P.; Anderson, K. J.; Armitage, J. C.; Arnison, G. T. J.; Ashton, P.; Azuelos, G.; Baines, J. T. M.; Ball, A. H.; Banks, J.; Barker, G. J.; Barlow, R. J.; Batley, J. R.; Becker, J.; Behnke, T.; Bell, K. W.; Bella, G.; Bethke, S.; Biebel, O.; Binder, U.; Bloodworth, I. J.; Bock, P.; Breuker, H.; Brown, R. M.; Brun, R.; Buijs, A.; Burckhart, H. J.; Capiluppi, P.; Carnegie, R. K.; Carter, A. A.; Carter, J. R.; Chang, C. Y.; Charlton, D. G.; Chrin, J. T. M.; Clarke, P. E. L.; Cohen, I.; Collins, W. J.; Conboy, J. E.; Couch, M.; Coupland, M.; Cuffiani, M.; Dado, S.; Dallavalle, G. M.; Debu, P.; Deninno, M. M.; Dieckmann, A.; Dittmar, M.; Dixit, M. S.; Duchovni, E.; Duerdoth, I. P.; Dumas, D. J. P.; El Mamouni, H.; Elcombe, P. A.; Estabrooks, P. G.; Etzion, E.; Fabbri, F.; Farthouat, P.; Fischer, H. M.; Fong, D. G.; French, M. T.; Fukunaga, C.; Gaidot, A.; Ganel, O.; Gary, J. W.; Gascon, J.; Geddes, N. I.; Gee, C. N. P.; Geich-Gimbel, C.; Gensler, S. W.; Gentit, F. X.; Giacomelli, G.; Gibson, V.; Gibson, W. R.; Gillies, J. D.; Goldberg, J.; Goodrick, M. J.; Gorn, W.; Granite, D.; Gross, E.; Grunhaus, J.; Hagedorn, H.; Hagemann, J.; Hansroul, M.; Hargrove, C. K.; Harrus, I.; Hart, J.; Hattersley, P. M.; Hauschild, M.; Hawkes, C. M.; Heflin, E.; Hemingway, R. J.; Heuer, R. D.; Hill, J. C.; Hillier, S. J.; Ho, C.; Hobbs, J. D.; Hobson, P. R.; Hochman, D.; Holl, B.; Homer, R. J.; Hou, S. R.; Howarth, C. P.; Hughes-Jones, R. E.; Humbert, R.; Igo-Kemenes, P.; Ihssen, H.; Imrie, D. C.; Jawahery, A.; Jeffreys, P. W.; Jeremie, H.; Jimack, M.; Jobes, M.; Jones, R. W. L.; Jovanovic, P.; Karlen, D.; Kawagoe, K.; Kawamoto, T.; Kellogg, R. G.; Kennedy, B. W.; Kleinwort, C.; Klem, D. E.; Knop, G.; Kobayashi, T.; Kokott, T. P.; Köpke, L.; Kowalewski, R.; Kreutzmann, H.; Kroll, J.; Kuwano, M.; Kyberd, P.; Lafferty, G. D.; Lamarche, F.; Larson, W. J.; Layter, J. G.; Le Du, P.; Leblanc, P.; Lee, A. M.; Lehto, M. H.; Lellouch, D.; Lennert, P.; Lessard, L.; Levinson, L.; Lloyd, S. L.; Loebinger, F. K.; Lorah, J. M.; Lorazo, B.; Losty, M. J.; Ludwig, J.; Ma, J.; Macbeth, A. A.; Mannelli, M.; Marcellini, S.; Maringer, G.; Martin, A. J.; Martin, J. P.; Mashimo, T.; Mättig, P.; Maur, U.; McMahon, T. J.; McNutt, J. R.; McPherson, A. C.; Meijers, F.; Menszner, D.; Merritt, F. S.; Mes, H.; Michelini, A.; Middleton, R. P.; Mikenberg, G.; Miller, D. J.; Milstene, C.; Minowa, M.; Mohr, W.; Montanari, A.; Mori, T.; Moss, M. W.; Murphy, P. G.; Murray, W. J.; Nellen, B.; Nguyen, H. H.; Nozaki, M.; O'Dowd, A. J. P.; O'Neale, S. W.; O'Neill, B. P.; Oakham, F. G.; Odorici, F.; Ogg, M.; Oh, H.; Oreglia, M. J.; Orito, S.; Pansart, J. P.; Patrick, G. N.; Pawley, S. J.; Pfister, P.; Pilcher, J. E.; Pinfold, J. L.; Plane, D. E.; Poli, B.; Pouladdej, A.; Pritchard, T. W.; Quast, G.; Raab, J.; Redmond, M. W.; Rees, D. L.; Regimbald, M.; Riles, K.; Roach, C. M.; Robins, S. A.; Rollnik, A.; Roney, J. M.; Rossberg, S.; Rossi, A. M.; Routenburg, P.; Runge, K.; Runolfsson, O.; Sanghera, S.; Sansum, R. A.; Sasaki, M.; Saunders, B. J.; Schaile, A. D.; Schaile, O.; Schappert, W.; Scharff-Hansen, P.; Schreiber, S.; Schwarz, J.; Shapira, A.; Shen, B. C.; Sherwood, P.; Simon, A.; Singh, P.; Siroli, G. P.; Skuia, A.; Smith, A. M.; Smith, T. J.; Snow, G. A.; Springer, R. W.; Sproston, M.; Stephens, K.; Stier, H. E.; Ströhmer, R.; Strom, D.; Takeda, H.; Takeshita, T.; Tsukamoto, T.; Turner, M. F.; Tysarczyk-Niemeyer, G.; Van den plas, D.; VanDalen, G. J.; Vasseur, G.; Virtue, C. J.; von der Schmitt, H.; von Krogh, J.; Wagner, A.; Wahl, C.; Ward, C. P.; Ward, D. R.; Waterhouse, J.; Watkins, P. M.; Watson, A. T.; Watson, N. K.; Weber, M.; Weisz, S.; Wells, P. S.; Wermes, N.; Weymann, M.; Wilson, G. W.; Wilson, J. A.; Wingerter, I.; Winterer, V.-H.; Wood, N. C.; Wotton, S.; Wuensch, B.; Wyatt, T. R.; Yaari, R.; Yang, Y.; Yekutieli, G.; Yoshida, T.; Zeuner, W.; Zorn, G. T.; OPAL Collaboration

1990-09-01

We study the inclusive momentum distribution of charged particles in multihadronic events produced in e +e - annihilations at ECM∼ M(Z 0). We find agreement with the analytical formulae for gluon production that include the phenomena of soft gluon interference. Using data from CM energies between 14 and 91 GeV, we study the dependence of the inclusive momentum distribution on the centre of momentum energy. We find that the analytical formulae describe the data over the entire energy range. Both the momentum distribution at a fixed energy and the change with energy are described by QCD shower Monte Carlo's which include either coherent gluon branchings or string fragmentation. Simple incoherent models with independent fragmentation fail to reproduce the energy dependence and momentum spectra.

Athletic pubalgia and the "sports hernia": MR imaging findings.

PubMed

Zoga, Adam C; Kavanagh, Eoin C; Omar, Imran M; Morrison, William B; Koulouris, George; Lopez, Hector; Chaabra, Avneesh; Domesek, John; Meyers, William C

2008-06-01

To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a chi(2) analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis). (c) RSNA, 2008.

The impact of science teachers' epistemological beliefs on authentic inquiry: A multiple-case study

NASA Astrophysics Data System (ADS)

Jackson, Dionne Bennett

The purpose of this study was to examine how science teachers' epistemological beliefs impacted their use of authentic inquiry in science instruction. Participants in this multiple-case study included a total of four teachers who represented the middle, secondary and post-secondary levels. Based on the results of the pilot study conducted with a secondary science teacher, adjustments were made to the interview questions and observation protocol. Data collection for the study included semi-structured interviews, direct observations of instructional techniques, and the collection of artifacts. The cross case analysis revealed that the cases epistemological beliefs were mostly Transitional and the method of instruction used most was Discussion. Two of the cases exhibited consistent beliefs and instructional practices, whereas the other two exhibited beliefs beyond their instruction. The findings of this study support the literature on the influence of contextual factors and professional development on teacher beliefs and practice. The findings support and contradict literature relevant to the consistency of teacher beliefs with instruction. This study's findings revealed that the use of reform-based instruction, or Authentic Inquiry, does not occur when science teachers do not have the beliefs and experiences necessary to implement this form of instruction.

Human interactions in space: ISS vs. Shuttle/Mir

NASA Astrophysics Data System (ADS)

Kanas, N. A.; Salnitskiy, V. P.; Ritsher, J. B.; Gushin, V. I.; Weiss, D. S.; Saylor, S. A.; Kozerenko, O. P.; Marmar, C. R.

2006-07-01

This paper compares findings from two NASA-funded studies of international long-duration missions to the Mir space station (Shuttle/Mir) and to the International Space Station (ISS). American and Russian crewmembers and mission control personnel participated. Issues examined included changes in mood and group social climate over time, displacement of group tension to outside monitoring personnel, cultural differences, and leadership roles. Findings were based on the completion of a weekly questionnaire that included items from the Profile of Mood States, the Group Environment Scale, and the Work Environment Scale. An examination of issues investigated in both studies revealed much similarity in findings. There was little support for the presence of changes in levels of mood and group climate over time, and no evidence for a "3rd quarter phenomenon". Both studies also provided evidence for the displacement of negative emotions to outside personnel in both crewmembers and mission control personnel. There were similar patterns of differences between Americans and Russians and between crewmembers and mission control personnel. Finally, in both studies, the support role of the leader was related to group cohesion among crewmembers, and both the task and support roles of the leader were related to cohesion among mission control personnel. Thus, in these four areas, the ISS study substantially replicated the findings from the earlier Shuttle/Mir study, suggesting that common psychosocial issues affect people engaged in on-orbit space missions.

Lung ultrasound has limited diagnostic value in rare cystic lung diseases: a cross-sectional study.

PubMed

Davidsen, Jesper Rømhild; Bendstrup, Elisabeth; Henriksen, Daniel P; Graumann, Ole; Laursen, Christian B

2017-01-01

Background : Lung ultrasound (LUS) used to identify interstitial syndrome (IS) and pleural thickening related to diffuse parenchymal lung disease (DPLD) has shown significant correlations with ground glass opacity (GGO) on high-resolution computed tomography (HRCT). However, the applicability of LUS in patients with DPLD subtypes as rare cystic lung diseases has not previously been investigated. This study aimed to observe if distinctive LUS findings could be found in patients with lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), and Birt-Hogg-Dubé syndrome (BHDS). Methods : This single centre case-based cross-sectional study of patients diagnosed with LAM, PCLH and BHDS was conducted at a Danish DPLD specialist centre. Patients underwent clinical examination including LUS. LUS findings were compared to findings scored according to a modified Belmaati score on HRCT and reviewed in consensus between two pulmonologists and one radiologist. Results : Twelve patients with HRCT proven cystic lung disease were included, six with LAM, three with PLCH, two with BHDS, and one with uncharacteristic cystic lung disease. The mean age was 48.7 years (SD ± 15.8). In general all had normal LUS findings. IS could not be found in any patients despite GGO presentation on HRCT among 75% of the patients with a Belmaati in the highest category of 0.76-1.00. Pleural thickening on LUS was present in three patients, but with inconsistent findings. Conclusion : This study indicates that LUS has limited value as a diagnostic tool in patients with LAM, PLCH, and BHDS as normal LUS findings did not rule out severe cystic lung disease.

Office design and health: a systematic review.

PubMed

Richardson, Ann; Potter, John; Paterson, Margaret; Harding, Thomas; Tyler-Merrick, Gaye; Kirk, Ray; Reid, Kate; McChesney, Jane

2017-12-15

To carry out a systematic review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. The research question was "Does workplace design (specifically individual offices compared with shared workspaces) affect the health of workers?" A literature search limited to articles published between 2000 and 2017 was undertaken. A systematic review was carried out, and the findings of the reviewed studies grouped into themes according to the primary outcomes measured in the studies. The literature search identified 15 relevant studies addressing health effects of shared or open-plan offices compared with individual offices. Our systematic review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees' health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. Our findings are also consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.

Chest CT findings in patients with dysphagia and aspiration: a systematic review

PubMed Central

Scheeren, Betina; Gomes, Erissandra; Alves, Giordano; Marchiori, Edson; Hochhegger, Bruno

2017-01-01

ABSTRACT The objective of this systematic review was to characterize chest CT findings in patients with dysphagia and pulmonary aspiration, identifying the characteristics and the methods used. The studies were selected from among those indexed in the Brazilian Virtual Library of Health, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Cochrane Library, SciELO, and PubMed databases. The search was carried out between June and July of 2016. Five articles were included and reviewed, all of them carried out in the last five years, published in English, and coming from different countries. The sample size in the selected studies ranged from 43 to 56 patients, with a predominance of adult and elderly subjects. The tomographic findings in patients with dysphagia-related aspiration were varied, including bronchiectasis, bronchial wall thickening, pulmonary nodules, consolidations, pleural effusion, ground-glass attenuation, atelectasis, septal thickening, fibrosis, and air trapping. Evidence suggests that chest CT findings in patients with aspiration are diverse. In this review, it was not possible to establish a consensus that could characterize a pattern of pulmonary aspiration in patients with dysphagia, further studies of the topic being needed. PMID:28767772

Chest CT findings in patients with dysphagia and aspiration: a systematic review.

PubMed

Scheeren, Betina; Gomes, Erissandra; Alves, Giordano; Marchiori, Edson; Hochhegger, Bruno

2017-01-01

The objective of this systematic review was to characterize chest CT findings in patients with dysphagia and pulmonary aspiration, identifying the characteristics and the methods used. The studies were selected from among those indexed in the Brazilian Virtual Library of Health, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Cochrane Library, SciELO, and PubMed databases. The search was carried out between June and July of 2016. Five articles were included and reviewed, all of them carried out in the last five years, published in English, and coming from different countries. The sample size in the selected studies ranged from 43 to 56 patients, with a predominance of adult and elderly subjects. The tomographic findings in patients with dysphagia-related aspiration were varied, including bronchiectasis, bronchial wall thickening, pulmonary nodules, consolidations, pleural effusion, ground-glass attenuation, atelectasis, septal thickening, fibrosis, and air trapping. Evidence suggests that chest CT findings in patients with aspiration are diverse. In this review, it was not possible to establish a consensus that could characterize a pattern of pulmonary aspiration in patients with dysphagia, further studies of the topic being needed.

Neuroimaging features in subacute encephalopathy with seizures in alcoholics (SESA syndrome)

PubMed Central

Drake-Pérez, Marta; de Lucas, Enrique Marco; Lyo, John; Fernández-Torre, José L.

2017-01-01

Purpose To describe the neuroimaging findings in subacute encephalopathy with seizures in alcoholics (SESA syndrome). Methods We reviewed all cases reported previously, as well as 4 patients diagnosed in our center. We included a total of 8 patients. All subjects had clinical and EEG findings compatible with SESA syndrome and at least one MRI study that did not show other underlying condition that could be responsible for the clinical presentation. Results Initial MRI studies revealed the following features: cortical-subcortical areas of increased T2/FLAIR signal and restricted diffusion (6 patients), hyperperfusion (3 patients), atrophy (5 patients), chronic microvascular ischemic changes (4 patients). Follow-up MRI was performed in half of the patients, all showing a resolution of the hyperintense lesions, but developing focal atrophic changes in 75%. Conclusions SESA syndrome should be included among the alcohol-related encephalopathies. Its radiological features include transient cortical-subcortical T2-hyperintense areas with restricted diffusion (overlapping the typical findings in status epilepticus) observed in a patient with atrophy and chronic multifocal vascular lesions. PMID:27391464

Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

PubMed Central

Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie

2014-01-01

Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly, reduced social interaction may ultimately exacerbate language symptoms over time. PMID:24890186

The experience of international doctoral education in nursing: an exploratory survey of staff and international nursing students in a British university.

PubMed

Evans, Catrin

2007-07-01

As part of the internationalization of higher education, increasing numbers of international doctoral students are coming to study in British nursing schools. This paper reports on a small-scale exploratory survey that sought to investigate the educational experiences of these students and their supervisors in one British School of Nursing. Both staff and students saw great value in international education. However both groups identified the need for greater support to facilitate adjustment in a number of areas, including: understanding the PhD process, studying in a second language, working within a different academic culture, managing the supervision relationship, and finding a sense of community. This was a small study, but the findings confirm key issues identified in the limited available literature. Recommendations include staff training and the development of additional in-puts for students. Future research should include qualitative, longitudinal and multi-site studies to more thoroughly assess the process and outcomes of international doctoral education in nursing.

Brain magnetic resonance imaging findings in young patients with hepatosplenic schistosomiasis mansoni without overt symptoms.

PubMed

Manzella, Adonis; Borba-Filho, Paulo; Brandt, Carlos T; Oliveira, Keyla

2012-06-01

The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9-25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.5-T system that included multiplanar pre-contrast and post-contrast sequences, and reports were completed by two radiologists after a consensus review. Twenty (58.8%) patients had MRI signal changes that were believed to be related to schistosomiasis mansoni. Twelve of the 20 patients had small focal hyperintensities on T2WI in the cerebral white matter, and eight patients had symmetric hyperintense basal ganglia on T1WI. There was a high frequency of brain MRI signal abnormalities in this series. Although not specific, these findings may be related to schistosomiasis.

Defining Happiness for Young Adults with Schizophrenia: A Building Block for Recovery

PubMed Central

Buckland, Helen T.; Schepp, Karen G.; Crusoe, Kristen

2013-01-01

Purpose Findings from this mixed methods descriptive study include a definition of happiness for young adults with schizophrenia (SCZ). Methods Thirteen men and women, ages 23 to 35, completed a series of three individual one-hour interviews over six weeks. Results This definition included themes of material happiness, relational happiness, and health happiness. Although these themes correspond to those for young adults without SCZ, four barriers to happiness were identified for this vulnerable population: 1) fear, 2) isolation, 3) medication, 4) not being considered “normal.” Conclusion Implications of these findings include designing interventions to support recovery by overcoming barriers to happiness. PMID:24070992

The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature

PubMed Central

Oyesanya, Tolu

2017-01-01

Background Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. Methods A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyze and synthesize studies’ findings separately for the patient and family experience. Results The initial search provided 2,871 records. Ultimately, eleven studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient’s injury, desire to be involved in the patient’s care, mixed feelings about staff support, and high perceived need for information. Conclusions Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centered, and directions for future research. PMID:28055226

78 FR 65338 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

..., other clinical studies, or in vitro testing. Reports from animal testing are not included. \\3\\ Includes... serious risks from clinical trials within 15 calendar days for findings from in vitro testing that suggest...

Metabolomic signatures of aggressive prostate cancer.

PubMed

McDunn, Jonathan E; Li, Zhen; Adam, Klaus-Peter; Neri, Bruce P; Wolfert, Robert L; Milburn, Michael V; Lotan, Yair; Wheeler, Thomas M

2013-10-01

Current diagnostic techniques have increased the detection of prostate cancer; however, these tools inadequately stratify patients to minimize mortality. Recent studies have identified a biochemical signature of prostate cancer metastasis, including increased sarcosine abundance. This study examined the association of tissue metabolites with other clinically significant findings. A state of the art metabolomics platform analyzed prostatectomy tissues (331 prostate tumor, 178 cancer-free prostate tissues) from two independent sites. Biochemicals were analyzed by gas chromatography-mass spectrometry and ultrahigh performance liquid chromatography-tandem mass spectrometry. Statistical analyses identified metabolites associated with cancer aggressiveness: Gleason score, extracapsular extension, and seminal vesicle and lymph node involvement. Prostate tumors had significantly altered metabolite profiles compared to cancer-free prostate tissues, including biochemicals associated with cell growth, energetics, stress, and loss of prostate-specific biochemistry. Many metabolites were further associated with clinical findings of aggressive disease. Aggressiveness-associated metabolites stratified prostate tumor tissues with high abundances of compounds associated with normal prostate function (e.g., citrate and polyamines) from more clinically advanced prostate tumors. These aggressive prostate tumors were further subdivided by abundance profiles of metabolites including NAD+ and kynurenine. When added to multiparametric nomograms, metabolites improved prediction of organ confinement (AUROC from 0.53 to 0.62) and 5-year recurrence (AUROC from 0.53 to 0.64). These findings support and extend earlier metabolomic studies in prostate cancer and studies where metabolic enzymes have been associated with carcinogenesis and/or outcome. Furthermore, these data suggest that panels of analytes may be valuable to translate metabolomic findings to clinically useful diagnostic tests. Copyright © 2013 Wiley Periodicals, Inc.

Predictors for delayed encephalopathy following acute carbon monoxide poisoning

PubMed Central

2014-01-01

Background In Japan, many carbon monoxide (CO) poisoning cases are transported to emergency settings, making treatment and prognostic assessment an urgent task. However, there is currently no reliable means to predict whether “delayed neuropsychiatric sequelae (DNS)” will develop after acute CO poisoning. This study is intended to find out risk factors for the development of DNS and to characterize the clinical course following the development of DNS in acute CO poisoning cases. Methods This is a retrospective cohort study of 79 consecutive patients treated at a single institution for CO poisoning. This study included 79 cases of acute CO poisoning admitted to our emergency department after attempted suicide, who were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not. The two groups were compared and analyzed in terms of clinical symptoms, laboratory findings, etc. Results Predictors for the development of DNS following acute CO poisoning included: serious consciousness disturbance at emergency admission; head CT findings indicating hypoxic encephalopathy; hematology findings including high creatine kinase, creatine kinase-MB and lactate dehydrogenase levels; and low Global Assessment Scale scores. The clinical course of the DNS-developing cases was characterized by prolonged hospital stay and a larger number of hyperbaric oxygen (HBO) therapy sessions. Conclusion In patients with the characteristics identified in this study, administration of HBO therapy should be proactively considered after informing their family, at initial stage, of the risk of developing DNS, and at least 5 weeks’ follow-up to watch for the development of DNS is considered necessary. PMID:24484081

Research on Animal-Assisted Intervention and Autism Spectrum Disorder, 2012-2015

ERIC Educational Resources Information Center

O'Haire, Marguerite E.

2017-01-01

Including animals in autism intervention is growing in both research and practice. A systematic literature review was conducted to collate and synthesize all empirical research on animal-assisted intervention (AAI) for autism published from 2012 to 2015. Findings from 28 included studies revealed that AAI programs generally include one animal per…

Fall 1989-Spring 1990 Retention Analysis. Enrollment Analysis EA91-3.

ERIC Educational Resources Information Center

Clagett, Craig A.

Fall-to-spring retention rates were calculated at Prince George's Community College (PGCC) for several demographic groups and for first-time students attending the college in fall 1989. Data from longitudinal studies were included to provide a more complete picture of student persistence at PGCC. Study findings included the following: (1) 60% of…

Family physicians' perspectives on interprofessional teamwork: Findings from a qualitative study.

PubMed

Szafran, Olga; Torti, Jacqueline M I; Kennett, Sandra L; Bell, Neil R

2018-03-01

The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes. The study findings revealed that family physicians consistently perceived themselves as having the leadership role on in the primary care team. Facilitators of teamwork included: communication; trust and respect; defined roles/responsibilities of team members; co-location; task shifting to other health professionals; and appropriate payment mechanisms. Barriers to teamwork included: undefined roles/responsibilities; lack of space; frequent staff turnover; network boundaries; and a culture of power and control. The findings suggest that moving family physicians toward more integrative and interdependent functioning within the primary care team will require overcoming the culture of traditional professional roles, addressing facilitators and barriers to teamwork, and providing training in teamwork.

Early studies reported extreme findings with large variability: a meta-epidemiologic study in the field of endocrinology.

PubMed

Wang, Zhen; Alahdab, Fares; Almasri, Jehad; Haydour, Qusay; Mohammed, Khaled; Abu Dabrh, Abd Moain; Prokop, Larry J; Alfarkh, Wedad; Lakis, Sumaya; Montori, Victor M; Murad, Mohammad Hassan

2016-04-01

To evaluate the presence of extreme findings and fluctuation in effect size in endocrinology. We systematically identified all meta-analyses published in 2014 in the field of endocrinology. Within each meta-analysis, the effect size of the primary binary outcome was compared across studies according to their order of publication. We pooled studies using the DerSimonian and Laird random-effects method. Heterogeneity was evaluated using the I(2) and tau(2). Twelve percent of the included 100 meta-analyses reported the largest effect size in the very first published study. The largest effect size occurred in the first 2 earliest studies in 31% of meta-analyses. When the effect size was the largest in the first published study, it was three times larger than the final pooled effect (ratio of rates, 3.26; 95% confidence interval: 1.80, 5.90). The largest heterogeneity measured by I(2) was observed in 18% of the included meta-analyses when combining the first 2 studies or 17% when combing the first 3 studies. In endocrinology, early studies reported extreme findings with large variability. This behavior of the evidence needs to be taken into account when used to formulate clinical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Psychosocial functioning and risk factors among siblings of children with cancer: An updated systematic review.

PubMed

Long, Kristin A; Lehmann, Vicky; Gerhardt, Cynthia A; Carpenter, Aubrey L; Marsland, Anna L; Alderfer, Melissa A

2018-06-01

Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides clinical recommendations, and offers future research directions. MEDLINE/Pubmed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized. In total, 102 studies were included (63 quantitative, 35 qualitative, 4 mixed-methods). Methodological limitations are common. Mean levels of anxiety, depression, and general adjustment are similar across siblings and comparisons, but symptoms of cancer-related posttraumatic stress are prevalent. School-aged siblings display poorer academic functioning and more absenteeism but similar peer relationships as peers. Quality of life findings are mixed. Adult siblings engage in higher levels of risky health behaviors and may have poorer health outcomes than comparisons. Risk factors for poor sibling adjustment include lower social support, poorer family functioning, lower income, non-White race, and shorter time since diagnosis, but findings are inconsistent. Qualitative themes include siblings' maturity, compassion, and autonomy, but also strong negative emotions, uncertainty, family disruptions, limited parental support, school problems, altered friendships, and unmet needs. Despite methodological limitations, research indicates a strong need for sibling support. Clinical recommendations include identifying at-risk siblings and developing interventions to facilitate family communication and increase siblings' social support, cancer-related knowledge, and treatment involvement. Future longitudinal studies focusing on mechanisms and moderators of siblings' adjustment would inform timing and targets of psychosocial care. Copyright © 2018 John Wiley & Sons, Ltd.

Speech-language pathology findings in patients with mouth breathing: multidisciplinary diagnosis according to etiology.

PubMed

Junqueira, Patrícia; Marchesan, Irene Queiroz; de Oliveira, Luciana Regina; Ciccone, Emílio; Haddad, Leonardo; Rizzo, Maria Cândida

2010-11-01

The purpose of this study was to identify and compare the results of the findings from speech-language pathology evaluations for orofacial function including tongue and lip rest postures, tonus, articulation and speech, voice and language, chewing, and deglutition in children who had a history of mouth breathing. The diagnoses for mouth breathing included: allergic rhinitis, adenoidal hypertrophy, allergic rhinitis with adenoidal hypertrophy; and/or functional mouth breathing. This study was conducted with on 414 subjects of both genders, from 2 to 16-years old. A team consisting of 3 speech-language pathologists, 1 pediatrician, 1 allergist, and 1 otolaryngologist, evaluated the patients. Multidisciplinary clinical examinations were carried out (complete blood counting, X-rays, nasofibroscopy, audiometry). The two most commonly found etiologies were allergic rhinitis, followed by functional mouth breathing. Of the 414 patients in the study, 346 received a speech-language pathology evaluation. The most prevalent finding in this group of 346 subjects was the presence of orofacial myofunctional disorders. The most frequently orofacial myofunctional disorder identified in these subjects who also presented mouth breathing included: habitual open lips rest posture, low and forward tongue rest posture and lack of adequate muscle tone. There were also no statistically significant relationships identified between etiology and speech-language diagnosis. Therefore, the specific type of etiology of mouth breathing does not appear to contribute to the presence, type, or number of speech-language findings which may result from mouth breathing behavior.

Parent and child distress after war exposure.

PubMed

Lai, Betty S; Hadi, Fawzyiah; Llabre, Maria M

2014-09-01

The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined. Parents and children were assessed at one time point. Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female). Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety. Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed. Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures. © 2014 The British Psychological Society.

Diagnostic yield of cystoscopy in the evaluation of recurrent urinary tract infection in women.

PubMed

Pagano, Matthew J; Barbalat, Yanina; Theofanides, Marissa C; Edokpolo, Leonard; James, Maxwell B; Cooper, Kimberly L

2017-03-01

Due to a paucity of evidence-based guidelines, anecdotal practice patterns often dictate clinical management of recurrent urinary tract infection (UTI) in women. Our aim was to identify pathologic findings of the urinary tract through cystoscopy and imaging in women with recurrent UTI, and to determine if specific risk factors are associated with a higher rate of abnormal findings. In a single-institutional cohort, cystoscopy was performed for women with recurrent UTI between 1/2010 and 7/2014. All eligible patients were included in a maintained database and those with gross or microscopic hematuria were excluded. Abdominopelvic imaging was recommended and included in study data when completed. Associations between clinical risk factors (history of renal transplant, urogynecologic surgery, or urolithiasis) and abnormal findings were analyzed by Fisher's exact test. A total of 163 women (mean age 60.6 years) were included in final analysis. Abdominopelvic imaging was available in 133 (82%) cases. Cystoscopy identified 9 (5.5%) cases of significant clinical findings. Of these only 5 (3.8%) cases were uniquely identified on cystoscopy and missed on imaging modalities. When imaging was normal, cystoscopy was also normal in 94% of cases. The examined clinical risk factors were not associated with higher risk of abnormal cystoscopy (P = 0.49) or imaging (P = 0.42). Cystoscopy performed solely for recurrent UTI is low yield in patients with normal imaging studies, but a small number of abnormal findings may be missed by foregoing this element of the patient workup. No studied risk factor was predictive of an abnormal workup. Neurourol. Urodynam. 36:692-696, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Active Music Therapy and Physical Improvements From Rehabilitation for Neurological Conditions.

PubMed

Kogutek, Demian Leandro; Holmes, Jeffrey David; Grahn, Jessica Adrienne; Lutz, Sara G; Ready, Emily

2016-01-01

Context • A variety of rehabilitation-based interventions are currently available for individuals with physical impairments resulting from neurological conditions, including physiotherapy, occupational therapy, and speech language pathology. Many individuals find participation in those therapies to be challenging. Alternative therapies have emerged as beneficial adjunctive treatments for individuals undergoing neurological rehabilitation, including music therapy (MT). Objective • The study intended to identify and collate systematically the evidence on MT interventions that address physical improvements in a rehabilitative setting. Design • The research team performed a literature review, searching electronic databases from their inception to April 2014, including Embase, CINAHL, PubMed, Scopus, and ProQuest. The review included original studies that examined the use of active MT as an intervention that promotes physical improvements for adults >18 y of age. Articles were excluded if the studies focused primarily on psychosocial, emotional, or spiritual therapeutic goals. The review identified the studies' outcome measures for different populations and the MT approaches and interventions and obtained a general description of the clinical sessions, such as the frequency and duration of the therapy, interventions performed, sessions designs, populations, equipment used, and credentials of the therapists. Results • Eleven studies identified 2 major categories for the delivery of MT sessions: individual and group. One study included group sessions, and 10 studies included individual sessions. The studies included a total of 290 participants, 32 in the group MT, and 258 in the individual MT. The one study that used group therapy was based on active MT improvisation. For the individual therapy, 2 studies had investigated therapeutic instrument music performance and 8 used music-supported therapy. Conclusions • The findings of the review suggested that active MT can improve motor skills and should be considered as a potential adjunctive treatment.

Psychiatric service users' experiences of emergency departments: a CERQual review of qualitative studies.

PubMed

Carstensen, Kathrine; Lou, Stina; Groth Jensen, Lotte; Konstantin Nissen, Nina; Ortenblad, Lisbeth; Pfau, Margarete; Vedel Ankersen, Pia

2017-05-01

There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title/abstract identified 57 studies and, after full text assessment, nine studies were included. The included studies were critically appraised using CASP. Thematic synthesis was applied for data extraction and identification of findings. The CERQual approach was utilized to assess the confidence of the findings. The results of the review showed moderate confidence in the findings that service users experience meeting caring and judgmental ED staff, and that waiting times and a stressful environment are integral to their ED experiences. In contrast, low-to-very low confidence was seen in the findings that service users experience having their symptoms ignored and that EDs are used due to a lack of alternatives. A companion may improve service users experience and outcome of ED visits. Service users experience stress and discomfort in the ED. Service users highly appreciate knowing staff who can ease the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users' needs are more likely to be recognized and accommodated.

Florida's Opinion on K-12 Public Education Spending

ERIC Educational Resources Information Center

Forster, Greg

2006-01-01

This scientifically representative poll of 1,200 Floridians finds that public opinion about K-12 public education spending is seriously misinformed. Floridians think public schools need more money, but the main reason is that they are badly mistaken about how much money the public schools actually get. Key findings of the study include: (1) Half…

The Effects of Ability Grouping: A Meta-Analysis of Research Findings.

ERIC Educational Resources Information Center

Noland, Theresa Koontz; Taylor, Bob L.

The study reported in this paper quantitatively integrated the recent research findings on ability grouping in order to generalize about these effects on student achievement and student self-concept. Meta-analysis was used to statistically integrate the empirical data. The relationships among various experimental variables including grade level,…

Visionary Democratic Leaders of Very Small Districts: Getting the Job Done Right.

ERIC Educational Resources Information Center

McGuire, Jerry

1994-01-01

Findings from a survey of rural school administrators in Oregon include profiles of three superintendent-principals that practice democratic leadership. Findings contrast with a national study that painted a discouraging picture of rural schooling in which few superintendents had a vision of working with people in collaborative ways. (LP)

ALPBP Project Research Component: Summary of Research Findings and Final Reports.

ERIC Educational Resources Information Center

Rivera, Charlene

This report summarizes the Assessment of Language Proficiency of Bilingual Persons (ALPBP) project research component and provides a summary of the findings of the other six components of the study. The summary of the research component includes an outline of the goals, activities, and requests for proposals. After the introduction, the following…

77 FR 52043 - Privacy Act of 1974; Proposed Exempt New System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... study. 6. After NIH makes a finding of research misconduct and has informed ORI of the finding... Internet traffic to and from federal computer networks to prevent malicious computer code from reaching the... portable/ mobile devices including, but not limited to: Laptops, PDAs, USB drives, portable hard drives...

The Effects of Cooperative Learning on Student Achievement in Algebra I

ERIC Educational Resources Information Center

Brandy, Travis D.

2013-01-01

It is a well-documented finding that high school students in schools across the nation, including California, fail to achieve at the proficient level in mathematics, based on standardized test scores. The purpose of this research study was to compare the findings of students taught using traditional instructional methodologies versus cooperative…

The Impact of Computerization on Archival Finding Aids: A RAMP Study.

ERIC Educational Resources Information Center

Kitching, Christopher

This report is based on a questionnaire sent to 32 selected National Archives and on interviews with archivists from eight countries. Geared to the needs of developing countries, the report covers: (1) the impact of computerization on finding aids; (2) advantages and problems of computerization, including enhanced archival control, integration of…

An Ongoing Investigation of Science Literacy: Results of a 22-Year Study Probing Students' Knowledge and Attitude Towards Science

NASA Astrophysics Data System (ADS)

Impey, C.; Buxner, S.; Antonellis, J.; CATS

2013-04-01

This talk presents findings related to our ongoing work investigating students' knowledge and attitudes towards science and technology. We present an overview of research studies and findings including a comparison of the science literacy measures of University of Arizona students compared to national studies, conceptions related to astrology, views of radiation, and students' pseudoscience and religious beliefs. We discuss implications for instructors and researchers interested in improving students' science literacy scores and diagnosing alternative beliefs.

Ophthalmologic Findings in Patients with Neuro-metabolic Disorders.

PubMed

Jafari, Narjes; Golnik, Karl; Shahriari, Mansoor; Karimzadeh, Parvaneh; Jabbehdari, Sayena

2018-01-01

We aimed to present the ophthalmic manifestations of neuro-metabolic disorders. Patients who were diagnosed with neuro-metabolic disorders in the Neurology Department of Mofid Pediatric Hospital in Tehran, Iran, between 2004 and 2014 were included in this study. Disorders were confirmed using clinical findings, neuroimaging, laboratory data, and genomic analyses. All enrolled patients were assessed for ophthalmological abnormalities. A total of 213 patients with 34 different neuro-metabolic disorders were included. Ophthalmological abnormalities were observed in 33.5% of patients. Abnormal findings in the anterior segment included Kayser-Fleischer rings, congenital or secondary cataracts, and lens dislocation into the anterior chamber. Posterior segment (i.e., retina, vitreous body, and optic nerve) evaluation revealed retinitis pigmentosa, cherry-red spots, and optic atrophy. In addition, strabismus, nystagmus, and lack of fixation were noted during external examination. Ophthalmological examination and assessment is essential in patients that may exhibit neuro-metabolic disorders.

Systemic mastocytosis: CT and US features of abdominal manifestations.

PubMed

Avila, N A; Ling, A; Worobec, A S; Mican, J M; Metcalfe, D D

1997-02-01

To study the imaging findings in patients with systemic mastocytosis and to correlate the findings with the severity of disease on the basis of an established classification system. Pathologic findings, when available, were correlated with imaging findings. Computed tomographic (CT) and ultrasound (US) scans and corresponding pathologic findings, when available, were retrospectively reviewed in 27 patients with systemic mastocytosis. Only five (19%) of the patients in our series had normal abdominal CT and/or US examination results. Common abdominal imaging findings associated with systemic mastocytosis were hepatosplenomegaly, retroperitoneal adenopathy, periportal adenopathy, mesenteric adenopathy, thickening of the omentum and the mesentery, and ascites. Less common findings included hepatofugal portal venous flow, Budd-Chiari syndrome, cavernous transformation of the portal vein, ovarian mass, and complications such as chloroma. The findings were more common in patients with category II and those with category III disease. Abdominal findings at CT and US are common in patients with systemic mastocytosis. Although the findings in patients with systemic mastocytosis are not specific to the disease, they are useful in directing further studies for diagnostic confirmation and in estimating the extent of systemic involvement.

Influences of social power and normative support on condom use decisions: a research synthesis

PubMed Central

Albarracín, D.; Kumkale, G. T.; Johnson, B. T.

2016-01-01

A meta-analysis of 58 studies involving 30,270 participants examined how study population and methodological characteristics influence the associations among norms, control perceptions, attitudes, intentions and behaviour in the area of condom use. Findings indicated that control perceptions generally correlated more strongly among members of societal groups that lack power, including female, younger individuals, ethnic-minorities and people with lower educational levels. Furthermore, norms generally had stronger influences among younger individuals and among people who have greater access to informational social support, including males, ethnic majorities and people with higher levels of education. These findings are discussed in the context of HIV prevention efforts. PMID:15370059

Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence.

PubMed

Cowley, Alison; Evans, Catrin; Bath-Hextall, Fiona; Cooper, Joanne

2016-10-01

Esophagogastric cancer is the fifth most common malignancy and its incidence is increasing. The disease progresses quickly and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence on the most effective service models to support esophagogastric cancer patients. The overall objective of this systematic review was to synthesize the best available evidence on the experiences and perceptions of patients and health professionals with regard to the care of people diagnosed with palliative esophagogastric cancer. The review considered studies that included patients diagnosed with palliative esophagogastric cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting. The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people. Studies that were carried out in any setting, including in-patient and outpatient areas, specialist cancer and non-specialist palliative care services and those were any patient were in receipt or had experiences of palliative care services were considered. All types of health practitioners delivering palliative care to esophagogastric cancer patients were considered. Studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and narrative approaches were considered. Mixed methods studies were considered in the review only if qualitative findings were reported separately. A three-step search strategy was utilized. A total 11 databases were searched for studies from 2000 onward, followed by hand searching of reference lists. Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical appraisal tool (JBI-QARI). Qualitative findings were extracted using the JBI-QARI data extraction Instrument. Qualitative research findings were pooled using a pragmatic meta-aggregative approach. The review included two publications. There were 46 findings which were aggregated into four categories and one overall synthesized finding: "In addition to support for physical needs, patients need support that takes into account changing life situations to achieve the best quality of life." The review shows that patients value services and support that addresses their complex, fluctuating and highly individual needs. No evidence was uncovered regarding how these services should be designed and delivered.

Theoretical rationale for music selection in oncology intervention research: an integrative review.

PubMed

Burns, Debra S

2012-01-01

Music-based interventions have helped patients with cancer improve their quality of life, decrease treatment related distress, and manage pain. However, quantitative findings from music intervention studies are inconsistent. The purpose of this review was to explore the theoretical underpinnings for the selection of the music stimuli used to influence targeted outcomes. It was hypothesized that disparate findings were due in part to the atheoretical nature of music selection and the resulting diversity in music stimuli between and within studies. A systematic research synthesis including a comprehensive database and reference list search resulted in 22 studies. Included studies were compiled into two tables cataloging intervention theory, intervention content, and outcomes. A majority of studies did not provide a rationale or intervention theory for the delivery of music or choice of outcomes. Recorded music was the most common delivery method, but the specific music was rarely included within the report. Only two studies that included a theoretical framework reported null results on at least some of the outcomes. Null results are partially explained by an incomplete or mismatch in intervention theory and music selection and delivery. While the inclusion of an intervention theory does not guarantee positive results, including a theoretical rationale for the use of music, particular therapeutic processes or mechanisms, and the specifics of how music is selected and delivered increases scientific rigor and the probability of clinical translation.

An Analysis of Popular Ninth Grade Literature Anthologies with Respect to Selected Objectives for the Study of Literature in the Ninth Grade.

ERIC Educational Resources Information Center

Jakiel, Stanley James

The problem approached in this study was to ascertain what objectives should be included in the study of literature in the ninth grade and to analyze some popular anthologies to find if appropriate goals and materials to meet these goals are included. Research on the subject of objectives for literature study was examined as were the writings of…

The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography.

PubMed

Kaewlai, Rathachai; Greene, Reginald E; Asrani, Ashwin V; Abujudeh, Hani H

2010-09-01

The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P < .001). Staggered radiologist work shifts that include an early-morning shift can improve the timeliness of reporting urgent findings on overnight portable chest radiography of hospitalized patients. Published by Elsevier Inc.

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

Eun-Young Kang; Patz, E.F. Jr.; Mueller, N.L.

Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). Nine of 10 patients had parenchymal abnormalities apparent at CT and I had normal CT scans. The findings in the nine patients includedmore » small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation. 13 refs., 4 figs., 1 tab.« less

Enhancing Higher Education Student Attendance through Classroom Management

ERIC Educational Resources Information Center

Al-Shammari, Zaid N.

2016-01-01

The findings of three consecutive studies about effective classroom management techniques designed to enhance higher education student attendance and the resulting correlation between student attendance and student achievement are reported here. The consecutive studies included a pilot study, culminating study, and replication study. The…

The Northern Norway mother-and-child contaminant cohort study: implementation, population characteristics and summary of dietary findings

PubMed Central

Veyhe, Anna Sofía; Hansen, Solrunn; Sandanger, Torkjel M.; Nieboer, Evert; Odland, Jon Øyvind

2012-01-01

Objectives To describe the essential features of a new Northern Norway mother-and-child contaminant cohort study called MISA, including its rationale, content, implementation and selected findings (mostly dietary). Study design Cross-sectional with longitudinal aspects. Methods Five hundred and fifteen eligible women were enrolled in early pregnancy, with 391 completing the study protocol that included a self-administrated food frequency questionnaire (FFQ) and donation of biological samples for contaminant analysis in the 2nd trimester, just after delivery, and 6 weeks postpartum. Macronutrient consumption was converted to energy intake, and the amounts of both macro- and micronutrients ingested were estimated. Some of the MISA findings were compared to data available in the Medical Birth Registry of Norway (MBRN). Results Compared to all 2004–2006 mothers in Northern Norway, the study cohort women were about 2 years older and smoked less; on average, they had close to 16 years of education. Parity, gestational age and birth weight of the newborn were comparable as well. The estimated average dietary intake of 8.1 MJ per day was less than that recommended by the Nordic Nutritional Recommendations (NNR), but the intake of micronutrients per MJ complied. Conclusions Although the final cohort sample size was less than targeted, the generally good comparisons observed between MBRN-registered information for the study cohort and dropouts suggest that this occurrence introduced minimal bias. The agreement of the observed demographic and clinical characteristics of the cohort women and newborns with all births in Northern Norway implied acceptable external validity. Also, the dietary findings aligned well with Norwegian national data and guidelines and other studies, as did the high prevalence of breastfeeding. The MISA database is considered suitable for exploring associations between contaminant exposure and diet, enhancing our knowledge of the interplay of the physiological changes that occur in mothers with contaminant pharmacokinetics (including transfer to the infant before and after birth), and conducting prospective health studies of the children. PMID:22957315

International comparisons in critical care: a necessity and challenge.

PubMed

Wunsch, Hannah; Rowan, Kathryn M; Angus, Derek C

2007-12-01

Understanding variation in critical care resources, and delivery of care between countries will allow for improved disaster planning, evaluation of research findings, and assessment of the utility of critical care itself. This review describes the available data for international comparisons and the many factors that need to be addressed for an appropriate interpretation of results. Recent studies on subgroups of critical care patients include data from many different countries. These new studies provide important information on the overall incidence of these disease states, but most of these international studies do not take into account the critical care resources of the countries being discussed. For an appropriate interpretation of findings the relevant baseline critical care resources, prevalence of diseases, and cultural practices, need to be quantified. The existence of these other factors prevents the use of a severity of illness scoring system alone to account for differences between countries. Many recent critical care studies include data from multiple countries. With continued movement towards international studies, and improvements in data collection systems, comparisons between countries are becoming easier. These findings need to be interpreted in the context of all the relevant country information.

An Interpretative Study on Nurses' Perspectives of Working in an Overcrowded Emergency Department in Taiwan.

PubMed

Chen, Li-Chin; Lin, Chun-Chih; Han, Chin-Yen; Hsieh, Chun-Lan; Wu, Chiung-Jung Jo; Liang, Hwey-Fang

2018-03-01

This study aims to gain in-depth understanding of nurses' perspectives of working in an overcrowded emergency. Symbolic interactionism and Charmaz's construction of grounded theory were used. Purposive sampling at the start of the study and a further theoretical sampling by snowball technique were used to recruit 40 registered nurses (RN) to participate in in-depth, semi-structured interviews between May and November, 2014. Data analysis included analytic techniques of initial, focused and theoretical coding. Study findings showed searching for work role is derived by the themes of Finding the role of positioning in Emergency Department (ED), Recognizing causes of ED overcrowding, and Confined working environment. Nurses' work experience which represents the RNs not gained control over their work, as care actions influenced by the problematic overcrowded circumstance of the ED environment. The findings fill a gap in knowledge about how RNs experience their work role in the context of an overcrowded Emergency Department in Taiwan. Arising from the study result include taking account of nurses' perspectives when planning staff/patient ratios, strategies to reduce waiting time and ensure that clients receive appropriate care. Copyright © 2018. Published by Elsevier B.V.

Cancer awareness among community pharmacist: a systematic review.

PubMed

Mensah, Kofi Boamah; Oosthuizen, Frasia; Bonsu, Adwoa Bemah

2018-03-16

The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. EMBASE (ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion.

Tobacco packaging design for reducing tobacco use.

PubMed

McNeill, Ann; Gravely, Shannon; Hitchman, Sara C; Bauld, Linda; Hammond, David; Hartmann-Boyce, Jamie

2017-04-27

Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging. To assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction. We searched MEDLINE, Embase, PsycINFO and six other databases from 1980 to January 2016. We checked bibliographies and contacted study authors to identify additional peer-reviewed studies. Primary outcomes included changes in tobacco use prevalence incorporating tobacco use uptake, cessation, consumption and relapse prevention. Secondary outcomes covered intermediate outcomes that can be measured and are relevant to tobacco use uptake, cessation or reduction. We considered multiple study designs: randomised controlled trials, quasi-experimental and experimental studies, observational cross-sectional and cohort studies. The review focused on all populations and people of any age; to be included, studies had to be published in peer-reviewed journals. We examined studies that assessed the impact of changes in tobacco packaging such as colour, design, size and type of health warnings on the packs in relation to branded packaging. In experiments, the control condition was branded tobacco packaging but could include variations of standardised packaging. Screening and data extraction followed standard Cochrane methods. We used different 'Risk of bias' domains for different study types. We have summarised findings narratively. Fifty-one studies met our inclusion criteria, involving approximately 800,000 participants. The studies included were diverse, including observational studies, between- and within-participant experimental studies, cohort and cross-sectional studies, and time-series analyses. Few studies assessed behavioural outcomes in youth and non-smokers. Five studies assessed the primary outcomes: one observational study assessed smoking prevalence among 700,000 participants until one year after standardised packaging in Australia; four studies assessed consumption in 9394 participants, including a series of Australian national cross-sectional surveys of 8811 current smokers, in addition to three smaller studies. No studies assessed uptake, cessation, or relapse prevention. Two studies assessed quit attempts. Twenty studies examined other behavioural outcomes and 45 studies examined non-behavioural outcomes (e.g. appeal, perceptions of harm). In line with the challenges inherent in evaluating standardised tobacco packaging, a number of methodological imitations were apparent in the included studies and overall we judged most studies to be at high or unclear risk of bias in at least one domain. The one included study assessing the impact of standardised tobacco packaging on smoking prevalence in Australia found a 3.7% reduction in odds when comparing before to after the packaging change, or a 0.5 percentage point drop in smoking prevalence, when adjusting for confounders. Confidence in this finding is limited, due to the nature of the evidence available, and is therefore rated low by GRADE standards. Findings were mixed amongst the four studies assessing consumption, with some studies finding no difference and some studies finding evidence of a decrease; certainty in this outcome was rated very low by GRADE standards due to the limitations in study design. One national study of Australian adult smoker cohorts (5441 participants) found that quit attempts increased from 20.2% prior to the introduction of standardised packaging to 26.6% one year post-implementation. A second study of calls to quitlines provides indirect support for this finding, with a 78% increase observed in the number of calls after the implementation of standardised packaging. Here again, certainty is low. Studies of other behavioural outcomes found evidence of increased avoidance behaviours when using standardised packs, reduced demand for standardised packs and reduced craving. Evidence from studies measuring eye-tracking showed increased visual attention to health warnings on standardised compared to branded packs. Corroborative evidence for the latter finding came from studies assessing non-behavioural outcomes, which in general found greater warning salience when viewing standardised, than branded packs. There was mixed evidence for quitting cognitions, whereas findings with youth generally pointed towards standardised packs being less likely to motivate smoking initiation than branded packs. We found the most consistent evidence for appeal, with standardised packs rating lower than branded packs. Tobacco in standardised packs was also generally perceived as worse-tasting and lower quality than tobacco in branded packs. Standardised packaging also appeared to reduce misperceptions that some cigarettes are less harmful than others, but only when dark colours were used for the uniform colour of the pack. The available evidence suggests that standardised packaging may reduce smoking prevalence. Only one country had implemented standardised packaging at the time of this review, so evidence comes from one large observational study that provides evidence for this effect. A reduction in smoking behaviour is supported by routinely collected data by the Australian government. Data on the effects of standardised packaging on non-behavioural outcomes (e.g. appeal) are clearer and provide plausible mechanisms of effect consistent with the observed decline in prevalence. As standardised packaging is implemented in different countries, research programmes should be initiated to capture long term effects on tobacco use prevalence, behaviour, and uptake. We did not find any evidence suggesting standardised packaging may increase tobacco use.

Lung ultrasound has limited diagnostic value in rare cystic lung diseases: a cross-sectional study

PubMed Central

Davidsen, Jesper Rømhild; Bendstrup, Elisabeth; Henriksen, Daniel P.; Graumann, Ole; Laursen, Christian B.

2017-01-01

ABSTRACT Background: Lung ultrasound (LUS) used to identify interstitial syndrome (IS) and pleural thickening related to diffuse parenchymal lung disease (DPLD) has shown significant correlations with ground glass opacity (GGO) on high-resolution computed tomography (HRCT). However, the applicability of LUS in patients with DPLD subtypes as rare cystic lung diseases has not previously been investigated. This study aimed to observe if distinctive LUS findings could be found in patients with lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), and Birt-Hogg-Dubé syndrome (BHDS). Methods: This single centre case-based cross-sectional study of patients diagnosed with LAM, PCLH and BHDS was conducted at a Danish DPLD specialist centre. Patients underwent clinical examination including LUS. LUS findings were compared to findings scored according to a modified Belmaati score on HRCT and reviewed in consensus between two pulmonologists and one radiologist. Results: Twelve patients with HRCT proven cystic lung disease were included, six with LAM, three with PLCH, two with BHDS, and one with uncharacteristic cystic lung disease. The mean age was 48.7 years (SD ± 15.8). In general all had normal LUS findings. IS could not be found in any patients despite GGO presentation on HRCT among 75% of the patients with a Belmaati in the highest category of 0.76–1.00. Pleural thickening on LUS was present in three patients, but with inconsistent findings. Conclusion: This study indicates that LUS has limited value as a diagnostic tool in patients with LAM, PLCH, and BHDS as normal LUS findings did not rule out severe cystic lung disease. PMID:28649310

Alzheimer's Disease Sequencing Project discovery and replication criteria for cases and controls: Data from a community-based prospective cohort study with autopsy follow-up.

PubMed

Crane, Paul K; Foroud, Tatiana; Montine, Thomas J; Larson, Eric B

2017-12-01

The Alzheimer's Disease Sequencing Project (ADSP) used different criteria for assigning case and control status from the discovery and replication phases of the project. We considered data from a community-based prospective cohort study with autopsy follow-up where participants could be categorized as case, control, or neither by both definitions and compared the two sets of criteria. We used data from the Adult Changes in Thought (ACT) study including Diagnostic and Statistical Manual-IV criteria for dementia status, McKhann et al. criteria for clinical Alzheimer's disease, and Braak and Consortium to Establish a Registry for AD findings on neurofibrillary tangles and neuritic plaques to categorize the 621 ACT participants of European ancestry who died and came to autopsy. We applied ADSP discovery and replication definitions to identify controls, cases, and people who were neither controls nor cases. There was some agreement between the discovery and replication definitions. Major areas of discrepancy included the finding that only 40% of the discovery sample controls had sufficiently low levels of neurofibrillary tangles and neuritic plaques to be considered controls by the replication criteria and the finding that 16% of the replication phase cases were diagnosed with non-AD dementia during life and thus were excluded as cases for the discovery phase. These findings should inform interpretation of genetic association findings from the ADSP. Differences in genetic association findings between the two phases of the study may reflect these different phenotype definitions from the discovery and replication phase of the ADSP. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Formulating autism systemically: Part 1 - A review of the published literature and case assessments.

PubMed

Crittenden, Patricia M

2017-07-01

Autism is a psychiatric disorder of unknown aetiology. In this article, the literature on genetic, neurological, psychological, relational and cultural causes of autism is reviewed, beginning with the 2014 review of Crittenden, Dallos, Landini et al. (pp. 64-70) up to and including recent publications in 2017. Some of the findings were unexpected; others led to new questions. The unexpected findings were the minimal contribution of genes to autism, the extremely evident neurological differences, the interpersonal quality of the psychological findings (that lacked evidence of parents' behaviour), the relational evidence that mothers' childhood trauma, perinatal stress and marital stress increased the risk of autism, and the reciprocal relation between funding for treatment of autism and diagnoses of autism. Notably, there was an abundance of genetic studies, numerous neurological studies and only scattered psychological, relational and cultural studies, thus rendering those findings speculative. The new questions included whether mothers used postural/gestural signs to signal their children to maintain distance and whether mothers experienced wariness of males as a result of childhood trauma, with their sons possibly experiencing gender confusion. Following the literature review, a small archival set of video-recorded and transcribed assessments of attachment of cases of autism were examined for evidence to corroborate or refute the psychological and relational findings of the literature review. The findings were striking in their support of mothers' use of postural/gestural communication regarding distance, children's close attention to mothers' bodily signals, without looking at mothers' face, mothers' greater comfort when they approached their sons than when their sons approached them, one boy's lack of verbal self-representation and mothers' childhood triangulation. These became hypotheses regarding what to look for in Part 2 of this article, a prospective, 12-year case study.

Mobility in Higher Education: Cross-Cultural Communication Issues.

ERIC Educational Resources Information Center

Baumgratz, Gisela

1993-01-01

A study of the role of foreign languages in European higher education focused on the influence of institutional culture, including that of the discipline, on quality of professional communication. Findings are discussed, and related issues are examined, including student/professional mobility, interinstitutional cooperation, standards for…

Increasing High School Student Interest in Science: An Action Research Study

NASA Astrophysics Data System (ADS)

Vartuli, Cindy A.

An action research study was conducted to determine how to increase student interest in learning science and pursuing a STEM career. The study began by exploring 10th-grade student and teacher perceptions of student interest in science in order to design an instructional strategy for stimulating student interest in learning and pursuing science. Data for this study included responses from 270 students to an on-line science survey and interviews with 11 students and eight science teachers. The action research intervention included two iterations of the STEM Career Project. The first iteration introduced four chemistry classes to the intervention. The researcher used student reflections and a post-project survey to determine if the intervention had influence on the students' interest in pursuing science. The second iteration was completed by three science teachers who had implemented the intervention with their chemistry classes, using student reflections and post-project surveys, as a way to make further procedural refinements and improvements to the intervention and measures. Findings from the exploratory phase of the study suggested students generally had interest in learning science but increasing that interest required including personally relevant applications and laboratory experiences. The intervention included a student-directed learning module in which students investigated three STEM careers and presented information on one of their chosen careers. The STEM Career Project enabled students to explore career possibilities in order to increase their awareness of STEM careers. Findings from the first iteration of the intervention suggested a positive influence on student interest in learning and pursuing science. The second iteration included modifications to the intervention resulting in support for the findings of the first iteration. Results of the second iteration provided modifications that would allow the project to be used for different academic levels. Insights from conducting the action research study provided the researcher with effective ways to make positive changes in her own teaching praxis and the tools used to improve student awareness of STEM career options.

Imaging characteristics of hemophagocytic lymphohistiocytosis.

PubMed

Fitzgerald, Nancy E; MacClain, Kenneth L

2003-06-01

Hemophagocytic lymphohistiocytosis (HLH) is a nonmalignant disorder of immune regulation, with overproduction of cytokines and diminished immune surveillance. Symptoms are nonspecific and may affect multiple organs, including the central nervous system. Neuroimaging findings have been described in case reports and small series; body imaging findings have not been described extensively. OBJECTIVE. To summarize findings of the most frequently performed imaging studies of the brain, chest and abdomen in patients with HLH. Retrospective review of chest radiographs and CT, abdominal ultrasound and CT, brain CT and MRI, skeletal surveys, and autopsy data. Twenty-five patients were diagnosed and treated for HLH at our institution over an 11-year period; 15 patients (60%) died. Common chest radiograph findings included alveolar-interstitial opacities with pleural effusions, often with rapid evolution and resolution. Hepatosplenomegaly, gallbladder wall thickening, hyperechoic kidneys and ascites were common abdominal findings, which resolved after therapy in some cases. Brain-imaging studies revealed nonspecific periventricular white-matter abnormalities, brain-volume loss and enlargement of extra-axial fluid spaces. Three infant cases, one with intracranial hemorrhage, one with multiple pathologic rib fractures and one with diaphyseal periosteal reaction involving multiple long bones on skeletal survey, raised suspicion of child abuse at presentation. Abuse was not substantiated in any case. Clinicians and radiologists should be aware of the radiographic manifestations of HLH, which are nonspecific and overlap with infectious, inflammatory and neoplastic disorders. Findings in the chest (similar to acute respiratory distress syndrome) and abdomen may progress rapidly and then regress with institution of appropriate anti-HLH therapy. CNS findings may be progressive. In some infants, initial imaging findings may mimic nonaccidental trauma.

Knowledge, attitudes and practices on adolescent vaccination among parents, teachers and adolescents in Africa: a systematic review protocol

PubMed Central

2014-01-01

Background Vaccines are the most successful and cost-effective public health interventions available to avert vaccine-preventable diseases and deaths. Despite progress in the field of adolescent health, many young people in Africa still get sick and die from vaccine-preventable diseases due to lack of vaccination. Parents, adolescents and teachers are key players with regard to implementation of adolescent vaccination policies. Therefore, understanding their knowledge, attitudes and practices towards adolescent vaccination may provide clues on what can be done to improve vaccine uptake among adolescents. The aim of this study is to conduct a qualitative and quantitative systematic review on knowledge, attitudes and practices on adolescent vaccination among parents, teachers and adolescents in Africa. Methods We will include both quantitative and qualitative primary studies. Eligible quantitative studies include both intervention and observational studies. Qualitative studies to be included are focus group discussions, direct observations, in-depth interviews and case ethnographic studies. We will search PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, WHOLIS, Africa Wide and CINAHL for eligible studies with no time and language limits. We will also check reference lists of included studies for other eligible reports. Two authors will independently screen the search output, select studies and extract data, resolving discrepancies by consensus and discussion. We will analyse qualitative data using thematic analysis where applicable, and quantitative studies findings will be presented in a narrative synthesis form based on the outcomes. Discussion The findings from this systematic review will guide the identification of gaps on knowledge, attitudes and practices among the key role players on adolescent vaccination. We anticipate that our findings will guide the development of adolescent-focused vaccination policy in Africa, which is virtually non-existent at present. Systematic review registration This review is registered with PROSPERO, registration number CRD42014010395. PMID:25200458

ASSOCIATIONS BETWEEN ULTRASOUND AND CLINICAL FINDINGS IN 87 CATS WITH URETHRAL OBSTRUCTION.

PubMed

Nevins, Jonathan R; Mai, Wilfried; Thomas, Emily

2015-01-01

Urethral obstruction is a life-threatening form of feline lower urinary tract disease. Ultrasonographic risk factors for reobstruction have not been previously reported. Purposes of this retrospective cross-sectional study were to describe urinary tract ultrasound findings in cats following acute urethral obstruction and determine whether ultrasound findings were associated with reobstruction. Inclusion criteria were a physical examination and history consistent with urethral obstruction, an abdominal ultrasound including a full evaluation of the urinary system within 24 h of hospitalization, and no cystocentesis prior to ultrasound examination. Medical records for included cats were reviewed and presence of azotemia, hyperkalemia, positive urine culture, and duration of hospitalization were recorded. For medically treated cats with available outcome data, presence of reobstruction was also recorded. Ultrasound images were reviewed and urinary tract characteristics were recorded. A total of 87 cats met inclusion criteria. Common ultrasound findings for the bladder included echogenic urine sediment, bladder wall thickening, pericystic effusion, hyperechoic pericystic fat, and increased urinary echoes; and for the kidneys/ureters included pyelectasia, renomegaly, perirenal effusion, hyperechoic perirenal fat, and ureteral dilation. Six-month postdischarge outcomes were available for 61 medically treated cats and 21 of these cats had reobstruction. No findings were associated with an increased risk of reobstruction. Ultrasonographic perirenal effusion was associated with severe hyperkalemia (P = 0.009, relative risk 5.75, 95% confidence interval [1.54-21.51]). Findings supported the use of ultrasound as an adjunct for treatment planning in cats presented with urethral obstruction but not as a method for predicting risk of reobstruction. © 2015 American College of Veterinary Radiology.

Maintaining an outward image: a Korean immigrant's life with type 2 diabetes mellitus and hypertension.

PubMed

Pistulka, Gina M; Winch, Peter J; Park, Hyunjeong; Han, Hae-Ra; Kim, Miyong T

2012-06-01

Type 2 diabetes mellitus (DM) and hypertension (HTN) disproportionately affect minority populations in the United States, including Korean American immigrants (KAI). We conducted qualitative interviews with middle-aged KAI in Maryland living with DM and HTN to examine the illness experience to inform future intervention strategies. Study results show that participants utilized strategies to maintain respect and Korean identity, including an image of being healthy and in control of their behavior in the public arena. These strategies included the lack of disclosure of their illness, even to family members, and avoiding outside assistance when engaging in problem solving. Maintaining an outward image of health was a common goal that affected the self-care of KAI in this study, a finding that might prove significant in the management of other chronic illnesses affecting this population. The study findings demonstrate the importance of in-depth understanding of specific populations when treating chronic illness, and caretakers' sensitivity to each population's unique cultural issues regarding identity, image, and disclosure.

Antithyroid Drug Use in Pregnancy and Birth Defects: Why Some Studies Find Clear Associations, and Some Studies Report None.

PubMed

Laurberg, Peter; Andersen, Stine Linding

2015-11-01

Rare cases of birth defects after the use of methimazole (MMI) or carbimazole to treat hyperthyroidism in early pregnancy have been reported since 1972, whereas propylthiouracil (PTU) has not been considered teratogenic. Recently, two studies reported birth defects after the use of MMI in early pregnancy to affect 2-4% of exposed children, and one study also found birth defects after the use of PTU. On the other hand, some published studies did not find associations between the use of thionamides and birth defects. The methods used in the two positive and the four negative reports are reviewed. The two positive studies included a sufficient number of children exposed to MMI (n = 1231 and 1097) to evaluate the studied outcomes, whereas the four negative studies included a much lower number of exposed children (n = 73, 108, 30, and 124). Considering PTU, the birth defects observed in one study were in general milder and tended to be diagnosed and registered only when they resulted in complications and led to surgery after one year of age. None of the negative studies has investigated outcomes after one year of age. Studies finding no associations between early pregnancy exposure to antithyroid drugs and birth defects were either not sufficiently powered or did not study outcomes at optimal ages.

"Where I'm From": Utilizing Place-Based Pedagogy and Multimodal Literacy in a Graduate Children's Literature Class

ERIC Educational Resources Information Center

Bemmett, Stephanie M.

2016-01-01

In this study, I examined integrating place-based education pedagogy and multimodal literacies into a graduate level children's literature class. The findings suggest including place-based education pedagogy allows middle level graduate students to connect to geographically-based children's literature. The findings also propose that incorporating…

Home Literacy Environments of Young Children with Down Syndrome: Findings from a Web-Based Survey

ERIC Educational Resources Information Center

Al Otaiba, Stephanie; Lewis, Sandra; Whalon, Kelly; Dyrlund, Allison; McKenzie, Amy R.

2009-01-01

Early home literacy experiences, including parent--child book reading, account for a significant amount of children's later reading achievement. Yet there is a very limited research base about the home literacy environments and experiences of children with cognitive disabilities. The purpose of this study is to describe findings from a Web-based…

Enhance Academic Study in Vocational Education in China

ERIC Educational Resources Information Center

Sun, Ling

2010-01-01

The increase in international trade and the information technology boom led us to begin to face the previously unthinkable of academic shortage towards vocational education. The main objective of this paper is to present the problem and find ways to solve it. The main finding included lack of investment from society and high degree involvement of…

Projected Employment Scenarios Show Possible Shortages in Some Engineering and Computer Specialties. Science Resources Studies Highlights.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. Div. of Science Resources Studies.

This report presents findings of a National Science Foundation (NSF) assessment of the adequacy of the supply of science, engineering, and technician (SET) personnel for meeting defense and non-defense requirements between 1982 and 1987. Selected findings included in the report follow. Based on four scenarios representing combinations of low and…

Taiwanese Mothers' Beliefs about Reading Aloud with Preschoolers: Findings from the Parent Reading Belief Inventory

ERIC Educational Resources Information Center

Wu, Chu-Chu; Honig, Alice Sterling

2010-01-01

In this study we adapted DeBaryshe and Binder's Parent Reading Belief Inventory (PRBI) with middle-class, well-educated (M = 14-15 years of education) Taiwanese mothers to find what their beliefs were about reading aloud to young children. Parental reports of home literacy practices including children's emergent literacy behaviours were also…

Exploring scientific creativity of eleventh-grade students in Taiwan

NASA Astrophysics Data System (ADS)

Liang, Jia-Chi

2002-04-01

Although most researchers focus on scientists' creativity, students' scientific creativity should be considered, especially for high school and college students. It is generally assumed that most professional creators in science emerge from amateur creators. Therefore, the purpose of this study is to investigate the relationship between students' scientific creativity and selected variables including creativity, problem finding, formulating hypotheses, science achievement, the nature of science, and attitudes toward science for finding significant predictors of eleventh grade students' scientific creativity. A total of 130 male eleventh-grade students in three biology classes participated in this study. The main instruments included the Test of Divergent Thinking (TDT) for creativity measurement, the Creativity Rating Scale (CRS) and the Creative Activities and Accomplishments Check Lists (CAACL ) for measurement of scientific creativity, the Nature of Scientific Knowledge Scale (NSKS) for measurement of the nature of science, and the Science Attitude Inventory II (SAI II) for measurement of attitudes toward science. In addition, two instruments on measuring students' abilities of problem finding and abilities of formulating hypotheses were developed by the researcher in this study. Data analysis involved descriptive statistics, Pearson product-moment correlations, and stepwise multiple regressions. The major findings suggested the following: (1) students' scientific creativity significantly correlated with some of selected variables such as attitudes toward science, problem finding, formulating hypotheses, the nature of science, resistance to closure, originality, and elaboration; (2) four significant predictors including attitudes toward science, problem finding, resistance to closure, and originality accounted for 48% of the variance of students' scientific creativity; (3) there were big differences between students with a higher and a lower degree of scientific creativity on the variables of family support, career images, and readings about science; and (4) many students were confused about the creative and moral levels on NSKS and the concept of "almighty of science" and purposes of science on SAI II. The results of this study may provide a more holistic and integrative interpretation of students' scientific creativity and propose better ways of evaluating students' scientific creativity. In addition, the research results may encourage teachers to view scientific creativity as an ability that can be enhanced through various means in classroom science teaching.

The Northern Norway mother-and-child contaminant cohort study: implementation, population characteristics and summary of dietary findings.

PubMed

Veyhe, Anna Sofía; Hansen, Solrunn; Sandanger, Torkjel M; Nieboer, Evert; Odland, Jon Øyvind

2012-01-01

To describe the essential features of a new Northern Norway mother-and-child contaminant cohort study called MISA, including its rationale, content, implementation and selected findings (mostly dietary). Cross-sectional with longitudinal aspects. Five hundred and fifteen eligible women were enrolled in early pregnancy, with 391 completing the study protocol that included a self-administrated food frequency questionnaire (FFQ) and donation of biological samples for contaminant analysis in the 2nd trimester, just after delivery, and 6 weeks postpartum. Macronutrient consumption was converted to energy intake, and the amounts of both macro- and micronutrients ingested were estimated. Some of the MISA findings were compared to data available in the Medical Birth Registry of Norway (MBRN). Compared to all 2004-2006 mothers in Northern Norway, the study cohort women were about 2 years older and smoked less; on average, they had close to 16 years of education. Parity, gestational age and birth weight of the newborn were comparable as well. The estimated average dietary intake of 8.1 MJ per day was less than that recommended by the Nordic Nutritional Recommendations (NNR), but the intake of micronutrients per MJ complied. Although the final cohort sample size was less than targeted, the generally good comparisons observed between MBRN-registered information for the study cohort and dropouts suggest that this occurrence introduced minimal bias. The agreement of the observed demographic and clinical characteristics of the cohort women and newborns with all births in Northern Norway implied acceptable external validity. Also, the dietary findings aligned well with Norwegian national data and guidelines and other studies, as did the high prevalence of breastfeeding. The MISA database is considered suitable for exploring associations between contaminant exposure and diet, enhancing our knowledge of the interplay of the physiological changes that occur in mothers with contaminant pharmacokinetics (including transfer to the infant before and after birth), and conducting prospective health studies of the children.

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens.

PubMed

Otani, Hideji; Tanaka, Tomonori; Murata, Kiyoshi; Fukuoka, Junya; Nitta, Norihisa; Nagatani, Yukihiro; Sonoda, Akinaga; Takahashi, Masashi

2016-01-01

To evaluate the incidence and pathologic correlation of thin-section computed tomography (TSCT) findings in smoking-related interstitial fibrosis (SRIF) with pulmonary emphysema. Our study included 172 consecutive patients who underwent TSCT and subsequent lobectomy. TSCT findings including clustered cysts with visible walls (CCVW) and ground-glass attenuation with/without reticulation (GGAR) were evaluated and compared in nonsmokers and smokers and among lung locations. TSCT findings, especially CCVW, were also compared with histological findings using lobectomy specimens. The incidence of CCVW and GGAR was significantly higher in smokers than in nonsmokers (34.1% and 40.7%, respectively, vs 2.0% and 12.2%). CCVW and GGAR were frequently found in the lower and peripheral zones. Histologically, CCVW corresponded more often with SRIF with emphysema than usual interstitial pneumonia (UIP, 63.3% vs 30%). CCVW of irregular size and shape were seen in 19 of 20 SRIF with emphysema and in seven of nine UIP-manifested areas with similar round cysts. A less-involved subpleural parenchyma was observed more frequently in SRIF with emphysema. SRIF with emphysema is a more frequent pathological finding than UIP in patients with CCVW on TSCT. The irregular size and shape of CCVW and a less-involved subpleural parenchyma may be a clue suggesting the presence of SRIF with emphysema.

Pathological findings of uterine tumors preoperatively diagnosed as red degeneration of leiomyoma by MRI.

PubMed

Nakai, Go; Yamada, Takashi; Hamada, Takamitsu; Atsukawa, Natsuko; Tanaka, Yoshikazu; Yamamoto, Kiyohito; Higashiyama, Akira; Juri, Hiroshi; Nakamoto, Atsushi; Yamamoto, Kazuhiro; Hirose, Yoshinobu; Ohmichi, Masahide; Narumi, Yoshifumi

2017-07-01

Venous infarction of a leiomyoma is known as red degeneration of leiomyoma (RDL) and can be a cause of acute abdomen. Although magnetic resonance imaging (MRI) is the only modality that can depict the inner condition of a leiomyoma, the typical MR findings of RDL are sometimes identified incidentally even in asymptomatic patients. The purpose of this study is to clarify common pathological findings of uterine tumors preoperatively diagnosed as RDL by MRI. We diagnosed 28 cases of RDL by MRI from March 2007 to April 2015. The ten lesions subjected to pathological analysis after resection were included in the study and reviewed by a gynecological pathologist. The average time from MRI to operation was 4.7 months. The typical beefy-red color was not observed on the cut surface of the tumor except in one tumor resected during the acute phase. All lesions diagnosed as RDL by MRI had common pathological findings consistent with red degeneration of leiomyoma, including coagulative necrosis. Other common pathological features of RDL besides extensive coagulative necrosis appear to be a lack of inflammatory cell infiltrate or hemorrhage in the entire lesion. Although RDL is known to cause acute abdomen, its typical MR findings can be observed even in asymptomatic patients in a condition that manifests long after red degeneration. The characteristic pathological findings in both the acute phase and the chronic phase that we found in this study, along with radiology reports, will be helpful references for gynecologists and pathologists in suspecting a history of red degeneration and confirming the diagnosis.

Delineation and Diagnostic Criteria of Oral-Facial-Digital Syndrome Type VI

PubMed Central

2012-01-01

Oral-Facial-Digital Syndrome type VI (OFD VI) represents a rare phenotypic subtype of Joubert syndrome and related disorders (JSRD). In the original report polydactyly, oral findings, intellectual disability, and absence of the cerebellar vermis at post-mortem characterized the syndrome. Subsequently, the molar tooth sign (MTS) has been found in patients with OFD VI, prompting the inclusion of OFD VI in JSRD. We studied the clinical, neurodevelopmental, neuroimaging, and genetic findings in a cohort of 16 patients with OFD VI. We derived the following inclusion criteria from the literature: 1) MTS and one oral finding and polydactyly, or 2) MTS and more than one typical oral finding. The OFD VI neuroimaging pattern was found to be more severe than in other JSRD subgroups and includes severe hypoplasia of the cerebellar vermis, hypoplastic and dysplastic cerebellar hemispheres, marked enlargement of the posterior fossa, increased retrocerebellar collection of cerebrospinal fluid, abnormal brainstem, and frequently supratentorial abnormalities that occasionally include characteristic hypothalamic hamartomas. Additionally, two new JSRD neuroimaging findings (ascending superior cerebellar peduncles and fused thalami) have been identified. Tongue hamartomas, additional frenula, upper lip notch, and mesoaxial polydactyly are specific findings in OFD VI, while cleft lip/palate and other types of polydactyly of hands and feet are not specific. Involvement of other organs may include ocular findings, particularly colobomas. The majority of the patients have absent motor development and profound cognitive impairment. In OFD VI, normal cognitive functions are possible, but exceptional. Sequencing of known JSRD genes in most patients failed to detect pathogenetic mutations, therefore the genetic basis of OFD VI remains unknown. Compared with other JSRD subgroups, the neurological findings and impairment of motor development and cognitive functions in OFD VI are significantly worse, suggesting a correlation with the more severe neuroimaging findings. Based on the literature and this study we suggest as diagnostic criteria for OFD VI: MTS and one or more of the following: 1) tongue hamartoma(s) and/or additional frenula and/or upper lip notch; 2) mesoaxial polydactyly of one or more hands or feet; 3) hypothalamic hamartoma. PMID:22236771

Teaching childbirth with high-fidelity simulation. Is it better observing the scenario during the briefing session?

PubMed

Cuerva, Marcos J; Piñel, Carlos S; Martin, Lourdes; Espinosa, Jose A; Corral, Octavio J; Mendoza, Nicolás

2018-02-12

The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth. The first briefing session included the observations of a properly performed scenario according to Spanish clinical practice guidelines on care in normal childbirth by the teachers whereas the second group did not include the observations of a properly performed scenario, and the students observed it only after the simulation process. The group that observed a properly performed scenario after the simulation obtained worse grades during the simulation, but better grades during the debriefing and evaluation. Simulator use in childbirth may be more fruitful when the medical students observe correct performance at the completion of the scenario compared to that at the start of the scenario. Impact statement What is already known on this subject? There is a scarcity of literature about the design of optimal high-fidelity simulation training in childbirth. It is known that preparing simulator-based learning activities is a complex process. Simulator-based learning includes the following steps: briefing, simulation, debriefing and evaluation. The most important part of high-fidelity simulations is the debriefing. A good briefing and simulation are of high relevance in order to have a fruitful debriefing session. What do the results of this study add? Our study describes a full simulator-based learning activity on childbirth that can be reproduced in similar facilities. The findings of this study add that high-fidelity simulation training in childbirth is favoured by a short briefing session and an abrupt start to the scenario, rather than a long briefing session that includes direct instruction in the scenario. What are the implications of these findings for clinical practice and/or further research? The findings of this study reveal what to include in the briefing of simulator-based learning activities on childbirth. These findings have implications in medical teaching and in medical practice.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 7: understanding the potential impacts of dissemination bias.

PubMed

Booth, Andrew; Lewin, Simon; Glenton, Claire; Munthe-Kaas, Heather; Toews, Ingrid; Noyes, Jane; Rashidian, Arash; Berg, Rigmor C; Nyakang'o, Brenda; Meerpohl, Joerg J

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on a probable fifth component, dissemination bias. Given its exploratory nature, we are not yet able to provide guidance on applying this potential component of the CERQual approach. Instead, we focus on how dissemination bias might be conceptualised in the context of qualitative research and the potential impact dissemination bias might have on an overall assessment of confidence in a review finding. We also set out a proposed research agenda in this area. We developed this paper by gathering feedback from relevant research communities, searching MEDLINE and Web of Science to identify and characterise the existing literature discussing or assessing dissemination bias in qualitative research and its wider implications, developing consensus through project group meetings, and conducting an online survey of the extent, awareness and perceptions of dissemination bias in qualitative research. We have defined dissemination bias in qualitative research as a systematic distortion of the phenomenon of interest due to selective dissemination of studies or individual study findings. Dissemination bias is important for qualitative evidence syntheses as the selective dissemination of qualitative studies and/or study findings may distort our understanding of the phenomena that these syntheses aim to explore and thereby undermine our confidence in these findings. Dissemination bias has been extensively examined in the context of randomised controlled trials and systematic reviews of such studies. The effects of potential dissemination bias are formally considered, as publication bias, within the GRADE approach. However, the issue has received almost no attention in the context of qualitative research. Because of very limited understanding of dissemination bias and its potential impact on review findings in the context of qualitative evidence syntheses, this component is currently not included in the GRADE-CERQual approach. Further research is needed to establish the extent and impacts of dissemination bias in qualitative research and the extent to which dissemination bias needs to be taken into account when we assess how much confidence we have in findings from qualitative evidence syntheses.

Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?

PubMed

Lovrenski, Jovan; Petrović, Slobodanka; Balj-Barbir, Svetlana; Jokić, Radoica; Vilotijević-Dautović, Gordana

2016-05-01

To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient's clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial). For LUS examinations a combined transthoracic - transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC) diameter was measured, and 95% confidence intervals (CI) of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar's test. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar's test showed a statistically significant difference between LUS and auscultation. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern”

PubMed Central

Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

2015-01-01

Background and Study Aims Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. Patients and Methods This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, “pinstripe pattern (PSP)” was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. Results The prevalence rates of the above-mentioned findings (1–5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861) and PSP (k = 0.6098), and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively. Conclusion “Pinstripe pattern” could be a reliable indicator for early discrimination of primary esophageal achalasia. PMID:25664812

Metasynthesis: Experiences of Women with Severe Maternal Morbidity and Their Perception of the Quality of Health Care

PubMed Central

Norhayati, Mohd Noor

2015-01-01

Aim To explore the experiences of women with severe maternal morbidity and their perception of the quality of health care. Background The exploration of factors associated with severe maternal morbidity has emerged as an alternative strategy in reducing maternal mortality. This approach is useful for the evaluation and improvement of maternal health services. Design Included a comprehensive search, appraisal of reports of qualitative studies, the classification of studies and the synthesis of findings. Data Sources A literature search was conducted through nine databases for articles published between January 1980 and August 2013. Review Methods The quality of included studies was assessed with a modified Critical Appraisal Skills Program tool. The synthesis applied a meta-ethnographic approach. It involved (1) identifying and comparing the findings; (2) creating a parsimonious thematic structure and (3) searching for disconfirming data. Results Nine studies published between 2005 and 2012, involving 292 women with severe maternal morbidity, were included. Three key themes were identified: 'provision of care', 'severe maternal morbidity' and 'health care seeking behavior'. Barriers to the access and utilization of heath care services were identified. Conclusion The findings appear to suggest that mental and physical health outcomes of women who experienced severe maternal morbidity were poor. There is a need to identify the persistence and severity of these outcomes over a longer period of time. More realistic and less biased information may be obtained in community-based interviews. The impact of potential negative fetal outcomes would be a strong influencing factor for the women. These findings may help to increase awareness of the non-physical components of severe maternal morbidity and provide guidance for professionals regarding preventive measures. PMID:26132107

Metasynthesis: Experiences of Women with Severe Maternal Morbidity and Their Perception of the Quality of Health Care.

PubMed

Norhayati, Mohd Noor; Surianti, Sukeri; Nik Hazlina, Nik Hussain

2015-01-01

To explore the experiences of women with severe maternal morbidity and their perception of the quality of health care. The exploration of factors associated with severe maternal morbidity has emerged as an alternative strategy in reducing maternal mortality. This approach is useful for the evaluation and improvement of maternal health services. Included a comprehensive search, appraisal of reports of qualitative studies, the classification of studies and the synthesis of findings. A literature search was conducted through nine databases for articles published between January 1980 and August 2013. The quality of included studies was assessed with a modified Critical Appraisal Skills Program tool. The synthesis applied a meta-ethnographic approach. It involved (1) identifying and comparing the findings; (2) creating a parsimonious thematic structure and (3) searching for disconfirming data. Nine studies published between 2005 and 2012, involving 292 women with severe maternal morbidity, were included. Three key themes were identified: 'provision of care', 'severe maternal morbidity' and 'health care seeking behavior'. Barriers to the access and utilization of heath care services were identified. The findings appear to suggest that mental and physical health outcomes of women who experienced severe maternal morbidity were poor. There is a need to identify the persistence and severity of these outcomes over a longer period of time. More realistic and less biased information may be obtained in community-based interviews. The impact of potential negative fetal outcomes would be a strong influencing factor for the women. These findings may help to increase awareness of the non-physical components of severe maternal morbidity and provide guidance for professionals regarding preventive measures.

Noninvasive Assessment of Left Ventricular Assist Devices with Cardiovascular Computed Tomography and Impact on Management

PubMed Central

Raman, Subha V.; Sahu, Anurag; Merchant, Ali Z.; Louis, Louis B.; Firstenberg, Michael S.; Sun, Benjamin

2009-01-01

Background Left ventricular assist devices (LVADs) provide a bridge to recovery or heart transplantation, but require serial assessment. Echocardiographic approaches may be limited by device artifact and acoustic window. Cardiovascular computed tomography (CCT) provides noninvasive imaging of LVADs, yet no study has evaluated CCT’s impact on clinical care. We evaluated the diagnostic findings and clinical impact of CCT for noninvasive assessment of patients with LVADs. Methods CCT examinations performed between 2005 and 2008 in patients with LVADs were identified. Acquisitions were completed on the identical 64 detector-row scanner with intravenous contrast administration; electrocardiographic gating was used in patients with pulsatile devices, while peripheral pulse gating was used in patients with continuous-flow devices. Comparison was made between CCT results and 30-day outcomes, including echocardiographic and intraoperative findings. Results Thirty-two CCT examinations from 28 patients were reviewed. Indications included evaluation of low cardiac output symptoms, assessment of cannula position, low flow reading on the LVAD, and surgical planning. CCT identified critical findings in 6 patients including thrombosis and inlet cannula malposition, all confirmed intraoperatively; one case of intra-LVAD thrombus was missed by CCT. Using intraoperative findings as the gold standard, CCT’s sensitivity was 85% and specificity was 100%. Echocardiographic LVAD evaluation did not correlate with findings on CCT (kappa = −0.29, 95% CI −0.73−0.13). Conclusions This preliminary observational cohort study indicates that noninvasive imaging using CCT of LVADs is feasible and accurate. CCT warrants consideration in the initial evaluation of symptomatic patients with LVADs. PMID:19782594

Effects of Erotic Films of Sexual Behavior of Married Couples. Sex-guilt and Reactions to Pornographic Films. Exposure to Pornography, Character, and Sexual Deviance: A Retrospective Survey.

ERIC Educational Resources Information Center

Mann, Jay; And Others

This paper reviews some of the findings from two studies of the reactions of single college students and married couples who viewed one of two pornographic films. Findings from the first study included: (1) women were aroused as much as men upon viewing the film showing intercourse; they were less aroused and the men were more aroused after the…

The “Gray Zone” of Police Work During Mental Health Encounters: Findings from an Observational Study in Chicago

PubMed Central

Wood, Jennifer D; Watson, Amy C; Fulambarker, Anjali J

2016-01-01

Although improving police responses to mental health crises has received significant policy attention, most encounters between police and persons with mental illnesses do not involve major crimes or violence, nor do they rise to the level of requiring emergency apprehension. Here, we report on field observations of police officers handling mental health-related encounters in Chicago. Findings confirm that these encounters often occur in the “gray zone”, where the problems at hand do not call for formal or legalistic interventions including arrest and emergency apprehension. In examining how police resolved such situations, we observed three core features of police work: (1) accepting temporary solutions to chronic vulnerability; (2) using local knowledge to guide decision-making; and (3) negotiating peace with complainants and call subjects. Study findings imply the need to advance field-based studies using systematic social observations of gray zone decision-making within and across distinct geographic and place-based contexts. Policy implications for supporting police interventions, including place-based enhancements of gray zone resources, are also discussed. PMID:28286406

Incidental genetic findings in randomized clinical trials: recommendations from the Genomics and Randomized Trials Network (GARNET)

PubMed Central

2013-01-01

Recommendations and guidance on how to handle the return of genetic results to patients have offered limited insight into how to approach incidental genetic findings in the context of clinical trials. This paper provides the Genomics and Randomized Trials Network (GARNET) recommendations on incidental genetic findings in the context of clinical trials, and discusses the ethical and practical issues considered in formulating our recommendations. There are arguments in support of as well as against returning incidental genetic findings in clinical trials. For instance, reporting incidental findings in clinical trials may improve the investigator-participant relationship and the satisfaction of participation, but it may also blur the line between clinical care and research. The issues of whether and how to return incidental genetic findings, including the costs of doing so, should be considered when developing clinical trial protocols. Once decided, plans related to sharing individual results from the aim(s) of the trial, as well as incidental findings, should be discussed explicitly in the consent form. Institutional Review Boards (IRBs) and other study-specific governing bodies should be part of the decision as to if, when, and how to return incidental findings, including when plans in this regard are being reconsidered. PMID:23363732

Goal importance within planned behaviour theory as 'the' predictor of study behaviour in college.

PubMed

Sideridis, G D; Kaissidis-Rodafinos, A

2001-12-01

The theory of planned behaviour has been rarely used for the explanation of student study behaviour and achievement. Although successful, the theory has been criticised for not including important cognitions, so goal importance was added in the present study. Goal importance refers to the weight-importance an individual assigns towards achieving a specific goal (Hollenbeck & Williams, 1987). The purpose of Study 1 was to explain the study behaviour habits of first year college students, using a) Ajzen and Madden's (1986) theory of planned behaviour, and b) planned behaviour with the addition of goal importance. The purpose of Study 2 was to replicate the findings of Study 1. The sample of Study 1 included 149 first year students of an American College located in northern Greece. Study 2 included 85 first year students of the same institution. The students in Study 1 were given a questionnaire four weeks prior to the end of the spring 1998 semester, and those in Study 2 in the autumn of 1998, including all elements of the theory of planned behaviour and goal importance. The data were modelled using Covariance Structural Modelling (CSM) and EQS 5.7b (Bentler, 1998). The planned behaviour model was not well supported in Study 1 providing a Comparative Fit Index (CFI) of.83. However, when goal importance was included in the equation, the resulting structural model produced a CFI of.94. The final structural model of Study 1 was re-tested with the sample of Study 2 and produced a CFI =.95. Findings suggest that goal importance is the causal agent in directing all elements necessary to achieve high levels of study behaviour. Future studies should examine the role of goal importance with other behaviours as well.

New endoscopic indicator of esophageal achalasia: "pinstripe pattern".

PubMed

Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

2015-01-01

Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, "pinstripe pattern (PSP)" was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. The prevalence rates of the above-mentioned findings (1-5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861) and PSP (k = 0.6098), and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively. "Pinstripe pattern" could be a reliable indicator for early discrimination of primary esophageal achalasia.

Exploring the Best Practices of Nursing Research Councils in Magnet® Organizations: Findings From a Qualitative Research Study.

PubMed

Day, Jennifer; Lindauer, Cathleen; Parks, Joyce; Scala, Elizabeth

2017-05-01

The objective of this descriptive qualitative study was to identify best practices of nursing research councils (NRCs) at Magnet®-designated hospitals. Nursing research (NR) is essential, adding to the body of nursing knowledge. Applying NR to the bedside improves care, enhances patient safety, and is an imperative for nursing leaders. We interviewed NR designees at 26 Magnet-recognized hospitals about the structure and function of their NRCs and used structural coding to identify best practices. Most organizations link NR and evidence-based practice. Council membership includes leadership and clinical nurses. Councils conduct scientific reviews for nursing studies, supporting nurse principal investigators. Tracking and reporting of NR vary widely and are challenging. Councils provide education, sponsor research days, and collaborate interprofessionally, including with academic partners. Findings from this study demonstrate the need to create formal processes to track and report NR and to develop outcome-focused NR education.

Lights, Camera: Learning! Findings from studies of video in formal and informal science education

NASA Astrophysics Data System (ADS)

Borland, J.

2013-12-01

As part of the panel, media researcher, Jennifer Borland, will highlight findings from a variety of studies of videos across the spectrum of formal to informal learning, including schools, museums, and in viewers homes. In her presentation, Borland will assert that the viewing context matters a great deal, but there are some general take-aways that can be extrapolated to the use of educational video in a variety of settings. Borland has served as an evaluator on several video-related projects funded by NASA and the the National Science Foundation including: Data Visualization videos and Space Shows developed by the American Museum of Natural History, DragonflyTV, Earth the Operators Manual, The Music Instinct and Time Team America.

The needs of siblings of children with cancer: a nursing perspective.

PubMed

O'Shea, Eileen R; Shea, Joyce; Robert, Tracey; Cavanaugh, Cathleen

2012-01-01

Findings from research studies on the needs of siblings of children with cancer have highlighted the imperative that these siblings be supported and involved in the plan of care when a diagnosis of cancer is made. However, few studies have included the perspective of the nurse when evaluating sibling needs or identifying interventions used to meet the needs. This qualitative descriptive study used a combination of individual interviews and a focus group to capture perspectives from 13 pediatric oncology nurses employed at a leading Children's Hospital located in the northeast. Transcripts were analyzed for content and theme in relation to the 2 research questions. Needs identified included getting attention, wanting to know, having fears/worries, feeling at fault, wanting to help, and wanting a normal routine, whereas interventions identified included recognizing their needs, getting siblings involved, sharing appropriate information, being a resource, giving support, and bending the rules. Findings support previous studies that document the variety of needs experienced by siblings of children with cancer and offer examples of nursing interventions to meet these needs.

Auditory Hallucinations in Schizophrenia and Nonschizophrenia Populations: A Review and Integrated Model of Cognitive Mechanisms

PubMed Central

Waters, Flavie; Allen, Paul; Aleman, André; Fernyhough, Charles; Woodward, Todd S.; Badcock, Johanna C.; Barkus, Emma; Johns, Louise; Varese, Filippo; Menon, Mahesh; Vercammen, Ans; Larøi, Frank

2012-01-01

While the majority of cognitive studies on auditory hallucinations (AHs) have been conducted in schizophrenia (SZ), an increasing number of researchers are turning their attention to different clinical and nonclinical populations, often using SZ findings as a model for research. Recent advances derived from SZ studies can therefore be utilized to make substantial progress on AH research in other groups. The objectives of this article were to (1) present an up-to-date review regarding the cognitive mechanisms of AHs in SZ, (2) review findings from cognitive research conducted in other clinical and nonclinical groups, and (3) integrate these recent findings into a cohesive framework. First, SZ studies show that the cognitive underpinnings of AHs include self-source-monitoring deficits and executive and inhibitory control dysfunctions as well as distortions in top-down mechanisms, perceptual and linguistic processes, and emotional factors. Second, consistent with SZ studies, findings in other population groups point to the role of top-down processing, abnormalities in executive inhibition, and negative emotions. Finally, we put forward an integrated model of AHs that incorporates the above findings. We suggest that AHs arise from an interaction between abnormal neural activation patterns that produce salient auditory signals and top-down mechanisms that include signal detection errors, executive and inhibition deficits, a tapestry of expectations and memories, and state characteristics that influence how these experiences are interpreted. Emotional factors play a particular prominent role at all levels of this hierarchy. Our model is distinctively powerful in explaining a range of phenomenological characteristics of AH across a spectrum of disorders. PMID:22446568

Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

PubMed

Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

2017-09-01

Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

[Work-related COPD].

PubMed

Fell, Anne Kristin Møller; Aasen, Tor Olav Brøvig; Kongerud, Johny

2014-11-01

Work-related COPD occurs as a result of exposure to harmful particles and gases/fumes in the workplace, including among non-smokers. The objective of this article is to present more recent findings on the correlation between occupational exposure and COPD. In addition, we review diagnostic and prognostic considerations and the potential for prevention. We have undertaken literature searches in Medline and EMBASE for the period May 2009 - July 2014. Studies without any measurements of pulmonary function or references to occupational exposure were excluded. We have also included three prospective studies on pulmonary function and occupational exposure that were not indexed with the search terms used for obstructive pulmonary disease. Three population studies and eight studies that described a specific industry or sector were included. Recent studies detect an association between exposure and an increased risk of COPD in the construction industry, metallurgical smelting, cement production and the textile industry. In other respects, the findings from previous review studies are confirmed. Exposure to a number of organic and inorganic particles and fumes in the workplace may cause COPD even at prevailing levels of exposure. Doctors should inquire about such exposure in cases of suspected and established COPD and should have a low threshold for referral to occupational health assessment.

Perspectives about family meals from single-headed and dual-headed households: a qualitative analysis.

PubMed

Berge, Jerica M; Hoppmann, Caroline; Hanson, Carrie; Neumark-Sztainer, Dianne

2013-12-01

Cross-sectional and longitudinal research has shown that family meals are protective for adolescent healthful eating behaviors. However, little is known about what parents think of these findings and whether parents from single- vs dual-headed households have differing perspectives about the findings. In addition, parents' perspectives regarding barriers to applying the findings on family meals in their own homes and suggestions for more widespread adoption of the findings are unknown. The current study aimed to identify single- and dual-headed household parents' perspectives regarding the research findings on family meals, barriers to applying the findings in their own homes, and suggestions for helping families have more family meals. The current qualitative study included 59 parents who participated in substudy of two linked multilevel studies-EAT 2010 (Eating and Activity in Teens) and Families and Eating and Activity in Teens (F-EAT). Parents (91.5% female) were racially/ethnically and socioeconomically diverse. Data were analyzed using a grounded theory approach. Results from the current study suggest that parents from both single- and dual-headed households have similar perspectives regarding why family meals are protective for healthful eating habits for adolescents (eg, provides structure/routine, opportunities for communication, connection), but provide similar and different reasons for barriers to family meals (eg, single-headed=cost vs dual-headed=lack of creativity) and ideas and suggestions for how to increase the frequency of family meals (eg, single-headed=give fewer options vs dual-headed=include children in the meal preparation). Findings can help inform public health intervention researchers and providers who work with adolescents and their families to understand how to approach discussions regarding reasons for having family meals, barriers to carrying out family meals, and ways to increase family meals depending on family structure. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Perspectives about Family Meals from Single-Headed and Dual-Headed Households: A Qualitative Analysis

PubMed Central

Berge, Jerica M.; Hoppmann, Caroline; Hanson, Carrie; Neumark-Sztainer, Dianne

2013-01-01

Cross-sectional and longitudinal research has shown that family meals are protective for adolescent healthful eating behaviors. However, little is known about what parents think of these findings and whether parents from single- versus dual-headed households have differing perspectives about the findings. Additionally, parents’ perspectives regarding barriers to applying the findings on family meals in their own homes and suggestions for more wide-spread adoption of the findings are unknown. The current study aimed to identify single- and dual-headed household parents’ perspectives regarding the research findings on family meals, barriers to applying the findings in their own homes and suggestions for helping families have more family meals. The current qualitative study included 59 parents who participated in sub-study of two linked multi-level studies—EAT 2010 (Eating and Activity in Teens) and Families and Eating and Activity in Teens (F-EAT). Parents (91.5% female) were racially/ethnically and socio-economically diverse. Data were analyzed using a grounded theory approach. Results from the current study suggest that parents from both single- and dual-headed households have similar perspectives regarding why family meals are protective for healthful eating habits for adolescents (e.g., provides structure/routine, opportunities for communication, connection), but provide similar and different reasons for barriers to family meals (e.g., single-headed=cost vs. dual-headed=lack of creativity) and ideas and suggestions for how to increase the frequency of family meals (e.g., single-headed=give fewer options vs. dual-headed=include children in the meal preparation). Findings may help inform public health intervention researchers and providers who work with adolescents and their families to understand how to approach discussions regarding reasons for having family meals, barriers to carrying out family meals and ways to increase family meals depending on family structure. PMID:24238144

A Study of Learning Strategies in Foreign Language Instruction: Findings of the Longitudinal Study.

ERIC Educational Resources Information Center

Chamot, Anna Uhl; And Others

Part of a larger research project, this longitudinal study analyzed differences between effective and ineffective high school and college language learners and changes in strategy uses over time. Related studies include a descriptive study, which identified learning strategies used in studying foreign languages, and a course development study, in…

Observational descriptive study of cutaneous manifestations in patients from Mato Grosso with viral chronic hepatitis*

PubMed Central

Rostey, Renato Roberto Liberato; Souto, Francisco José Dutra

2015-01-01

BACKGROUND Extrahepatic manifestations are seen in association with chronic infection by hepatitis B or C virus including cutaneous disorders. The frequency of these findings seems to vary among different places and reports. There is a lack of information about this issue in Brazil. OBJECTIVES To estimate the prevalence of cutaneous findings affecting HBV or HCV carriers from a reference outpatient unit in Mato Grosso. METHODS A cross-sectional observational study. RESULTS 108 patients were studied. 88.9% presented some cutaneous findings but must of them were nonrelated to chronic viral infection. Four patients had cutaneous or autoimmune syndromes that may be HBV or HCV related. CONCLUSION In our study we found no statistical association between viral hepatitis and skin diseases. PMID:26734863

Incidental findings in children with blunt head trauma evaluated with cranial CT scans.

PubMed

Rogers, Alexander J; Maher, Cormac O; Schunk, Jeff E; Quayle, Kimberly; Jacobs, Elizabeth; Lichenstein, Richard; Powell, Elizabeth; Miskin, Michelle; Dayan, Peter; Holmes, James F; Kuppermann, Nathan

2013-08-01

Cranial computed tomography (CT) scans are frequently obtained in the evaluation of blunt head trauma in children. These scans may detect unexpected incidental findings. The objectives of this study were to determine the prevalence and significance of incidental findings on cranial CT scans in children evaluated for blunt head trauma. This was a secondary analysis of a multicenter study of pediatric blunt head trauma. Patients <18 years of age with blunt head trauma were eligible, with those undergoing cranial CT scan included in this substudy. Patients with coagulopathies, ventricular shunts, known previous brain surgery or abnormalities were excluded. We abstracted radiology reports for nontraumatic findings. We reviewed and categorized findings by their clinical urgency. Of the 43,904 head-injured children enrolled in the parent study, 15,831 underwent CT scans, and these latter patients serve as the study cohort. On 670 of these scans, nontraumatic findings were identified, with 16 excluded due to previously known abnormalities or surgeries. The remaining 654 represent a 4% prevalence of incidental findings. Of these, 195 (30%), representing 1% of the overall sample, warranted immediate intervention or outpatient follow-up. A small but important number of children evaluated with CT scans after blunt head trauma had incidental findings. Physicians who order cranial CTs must be prepared to interpret incidental findings, communicate with families, and ensure appropriate follow-up. There are ethical implications and potential health impacts of informing patients about incidental findings.

An Integrative Review of Technology to Support Communication With Parents of Infants in the NICU

PubMed Central

Epstein, Elizabeth G.; Arechiga, Jaqueline; Dancy, Margaret; Simon, Jordan; Wilson, Daniel; Alhusen, Jeanne L.

2017-01-01

Objective To synthesize findings from the published literature on the use of technology in the NICU to improve communications and interactions among health care providers, parents, and infants. Data Sources Electronic databases including Ovid MEDLINE, CINAHL, Web of Science, and Google Scholar were searched for related research published through May 2016. The reference lists of all studies were reviewed, and a hand search of key journals was also conducted to locate eligible studies. Study Selection Eleven studies (five quantitative, two qualitative, and four mixed methods) were identified that met the inclusion criteria. Only studies published in English were included. Data Extraction Whittemore and Knafl’s methodology for conducting integrative reviews was used to guide data extraction, analysis, and synthesis. Data were extracted and organized according to the following headings: author, year, and location; study purpose and design; sample size and demographics; technology used; study findings; and limitations. Data Synthesis Various technologies were used, including videoconferencing, videophone, and commercially available modalities such as Skype, FaceTime, AngelEye, and NICView Webcams. In the 11 studies, three main outcomes were evaluated: parents’ perception of technology use, health care providers’ perceptions of technology use, and objective outcomes, such as parental anxiety or stress or infant length of stay. Overall, parents and health care providers perceived the varied interventions quite favorably, although a few significant differences were found for the objective measures. Conclusion Several interventions have been tested to improve communications and promote interactions among NICU health care team members, parents, and infants. Although initial findings are positive, research in this area is quite limited, and the reviewed studies had several limitations. There is a significant need for further rigorous research to be conducted with diverse samples. PMID:28263727

Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence.

PubMed

Vaiserman, Alexander M

2017-03-05

Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies ('natural experiments'). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed.

Ethical responsibilities in nursing: research findings and issues.

PubMed

Cassidy, V R

1991-01-01

Discussions in the literature assert that nurses are becoming increasingly cognizant of their ethical responsibilities, but that they are often ill prepared to participate in ethical decision making. A review of selected research literature from 1970 to 1987 was undertaken to validate these assertions. A total of 12 studies related to ethical responsibilities was identified in the review; all studies were published between 1980 and 1987. The majority of studies were at the descriptive and exploratory levels and employed Kohlberg's cognitive theory of moral development as their conceptual framework. Significant findings related to educational level and ethical responsibilities were consistent across studies. Findings related to age and clinical experience were mixed; the effects of economic level, religion-religiosity, ethnicity, and other variables on ethical responsibilities were not significant. Issues raised in the light of the existing research include the use of Kohlberg's theory as a conceptual orientation in nursing groups and limited data on the reliability and validity of instruments used in measuring ethical constructs. Recommendations for future research on ethical responsibilities include the validation of Kohlberg's theory for nursing investigations, exploration of other frameworks for developing a multidimensional view of ethical responsibilities, and the use of qualitative research designs.

Promoting patient participation in healthcare interactions through communication skills training: A systematic review.

PubMed

D'Agostino, Thomas A; Atkinson, Thomas M; Latella, Lauren E; Rogers, Madeline; Morrissey, Dana; DeRosa, Antonio P; Parker, Patricia A

2017-07-01

To present literature on training patients in the use of effective communication skills. Systematic searches were conducted in six databases. References were screened for inclusion through several phases. Extracted data included intervention study design, sample characteristics, content and structure of training programs, outcomes assessed, and findings reported. A total of 32 unique intervention studies were included. Most targeted primary care or cancer patients and used a randomized controlled study design. Interventions used a variety of training formats and modes of delivering educational material. Reported findings suggest that communication training is an effective approach to increase patients' total level of active participation in healthcare interactions and that some communication behaviors may be more amenable to training (e.g., expressing concerns). Trained patients do not have longer visits and tend to receive more information from their providers. Most studies have found no relationship between communication training and improved health, psychosocial wellbeing, or treatment-related outcomes. Findings reinforce the importance and potential benefits of patient communication training. Additional research is warranted to determine the most efficacious training programs with the strongest potential for dissemination. Copyright © 2017 Elsevier B.V. All rights reserved.

A descriptive study of Bruneian student nurses' perceptions of stress.

PubMed

Burnard, Philip; Haji Abd Rahim, Hajah Thaibah Binti P D P D D P; Hayes, Derek; Edwards, Deborah

2007-10-01

While much has been written about stress in nursing in the 'West', less research has been done on this issue in many 'Eastern' countries. This paper offers the findings of the first study of stress in student nurses in Brunei. The paper describes a study of 20 Brunei nursing students and their views about stress in nursing. A modified grounded theory approach was used in collecting and analysing data (and the 'modifications' are described). Findings were organised around the themes: stressors, moderators and outcomes [Carson, J., and Kuipers, E., 1998. Stress management interventions. In: Hardy, S., Carson, J., Thomas, B. (Eds.), Occupational Stress: Personal and Professional Approaches. Stanley Thornes, Cheltenham. pp. 157-174.]. Students often found their status as students caused them stress in the clinical setting: with other nurses, with doctors and even with patients. Academic related stressors included having to complete assignments and having to study in English. Various ways of moderating stress were reported including talking to 'trusted friends', engaging in sports or simply being quiet. Positive and negative outcomes of stress were identified: stress could lead to mental illness but, also, it could be motivating. This report concludes with a Weberian 'ideal type': a composite word-picture of the findings.

Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence

PubMed Central

Vaiserman, Alexander M.

2017-01-01

Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies (‘natural experiments’). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed. PMID:28273874

Self-healing juvenile cutaneous mucinosis: cases highlighting subcutaneous/fascial involvement.

PubMed

Nagaraj, Lavanya V; Fangman, William; White, Wain L; Woosley, John T; Prose, Neil; Selim, M Angelica; Morrell, Dean S

2006-12-01

Self-healing juvenile cutaneous mucinosis is a rare disease affecting young people characterized by transient cutaneous lesions and sometimes mild inflammatory symptoms. The deep dermal and subcutaneous features of this disorder have not yet been well described. The purpose of our study was to present 3 cases of self-healing juvenile cutaneous mucinosis in which the histopathologic features caused diagnostic confusion between this disorder and proliferative fasciitis. The study includes clinical and histologic findings of 3 patients, complemented by a literature review. The histologic descriptions of nodular lesions in self-healing juvenile cutaneous mucinosis reveal features of proliferative fasciitis, including a myxoid stroma and gangliocyte-like giant cells. Self-healing juvenile cutaneous mucinosis is a rare condition and has not been frequently reported in medical literature. Our findings are based on the pathologic features of 3 patients. Our findings further elucidate the histologic features of self-healing juvenile cutaneous mucinosis and expand the differential diagnosis for entities in which gangliocyte-like giant cells are noted.

What Value Can Qualitative Research Add to Quantitative Research Design? An Example From an Adolescent Idiopathic Scoliosis Trial Feasibility Study.

PubMed

Toye, Francine; Williamson, Esther; Williams, Mark A; Fairbank, Jeremy; Lamb, Sarah E

2016-08-09

Using an example of qualitative research embedded in a non-surgical feasibility trial, we explore the benefits of including qualitative research in trial design and reflect on epistemological challenges. We interviewed 18 trial participants and used methods of Interpretive Phenomenological Analysis. Our findings demonstrate that qualitative research can make a valuable contribution by allowing trial stakeholders to see things from alternative perspectives. Specifically, it can help to make specific recommendations for improved trial design, generate questions which contextualize findings, and also explore disease experience beyond the trial. To make the most out of qualitative research embedded in quantitative design it would be useful to (a) agree specific qualitative study aims that underpin research design, (b) understand the impact of differences in epistemological truth claims, (c) provide clear thematic interpretations for trial researchers to utilize, and (d) include qualitative findings that explore experience beyond the trial setting within the impact plan. © The Author(s) 2016.

Volumetric and Voxel-Based Morphometry Findings in Autism Subjects With and Without Macrocephaly

PubMed Central

Bigler, Erin D.; Abildskov, Tracy J.; Petrie, Jo Ann; Johnson, Michael; Lange, Nicholas; Chipman, Jonathan; Lu, Jeffrey; McMahon, William; Lainhart, Janet E.

2015-01-01

This study sought to replicate Herbert et al. (2003a), which found increased overall white matter (WM) volume in subjects with autism, even after controlling for head size differences. To avoid the possibility that greater WM volume in autism is merely an epiphenomena of macrocephaly over-representation associated with the disorder, the current study included control subjects with benign macrocephaly. The control group also included subjects with a reading disability to insure cognitive heterogeneity. WM volume in autism was significantly larger, even when controlling for brain volume, rate of macrocephaly, and other demographic variables. Autism and controls differed little on whole-brain WM voxel-based morphometry (VBM) analyses suggesting that the overall increase in WM volume was non-localized. Autism subjects exhibited a differential pattern of IQ relationships with brain volumetry findings from controls. Current theories of brain overgrowth and their importance in the development of autism are discussed in the context of these findings. PMID:20446133

A review of studies of parent-child communication about sexuality and HIV/AIDS in sub-Saharan Africa

PubMed Central

2011-01-01

Parent-child sexuality communication has been identified as a protective factor for adolescent sexual and reproductive health, including HIV infection. The available literature on this topic in sub-Saharan Africa is increasing; however a systematic review of studies has not been conducted. This article reviews the literature in the area of parental or caregiver and child communication about sexuality and HIV/AIDS in sub-Saharan Africa. A review of peer reviewed literature published between 1980 and April 2011 was conducted. Communication process studies investigating the frequency, content, style, tone of discussions, preferences, as well as associations with and barriers to sexuality communication are reviewed. In addition, studies which examine behavioral associations with parent-child sexuality communication, and intervention studies to improve parent-child sexuality communication are examined. The findings from process studies suggest wide variation in terms of frequency of discussions, with a range of socio-demographic and other factors associated with sexuality communication. Overall, findings demonstrate that discussions tend to be authoritarian and uni-directional, characterized by vague warnings rather than direct, open discussion. Moreover, parents and young people report a number of barriers to open dialogue, including lack of knowledge and skills, as well as cultural norms and taboos. Findings are less clear when it comes to associations between parental communication and adolescent sexual activity and contraception use. However, nascent indications from intervention research suggest positive findings with increases in frequency and comfort of discussions, among other outcomes. Gaps in the research are identified and discussed with implications for future studies. PMID:21943095

A review of studies of parent-child communication about sexuality and HIV/AIDS in sub-Saharan Africa.

PubMed

Bastien, S; Kajula, L J; Muhwezi, W W

2011-09-24

Parent-child sexuality communication has been identified as a protective factor for adolescent sexual and reproductive health, including HIV infection. The available literature on this topic in sub-Saharan Africa is increasing; however a systematic review of studies has not been conducted. This article reviews the literature in the area of parental or caregiver and child communication about sexuality and HIV/AIDS in sub-Saharan Africa. A review of peer reviewed literature published between 1980 and April 2011 was conducted. Communication process studies investigating the frequency, content, style, tone of discussions, preferences, as well as associations with and barriers to sexuality communication are reviewed. In addition, studies which examine behavioral associations with parent-child sexuality communication, and intervention studies to improve parent-child sexuality communication are examined. The findings from process studies suggest wide variation in terms of frequency of discussions, with a range of socio-demographic and other factors associated with sexuality communication. Overall, findings demonstrate that discussions tend to be authoritarian and uni-directional, characterized by vague warnings rather than direct, open discussion. Moreover, parents and young people report a number of barriers to open dialogue, including lack of knowledge and skills, as well as cultural norms and taboos. Findings are less clear when it comes to associations between parental communication and adolescent sexual activity and contraception use. However, nascent indications from intervention research suggest positive findings with increases in frequency and comfort of discussions, among other outcomes. Gaps in the research are identified and discussed with implications for future studies.

Solar Pond Potential as A New Renewable Energy in South Sulawesi

NASA Astrophysics Data System (ADS)

Fadliah Baso, Nur; Chaerah Gunadin, Indar; Yusran

2018-03-01

Renewable energy sources need to be developed to maintain the electric energy availability by utilizing oceanic energy, namely solar pond energy. This energy is highly influenced by several factors including salinity, air temperature and solar radiation. This study was focused on finding the potential of solar pond in South Sulawesi, a region with fairly high solar radiation and abundant salt water raw materials availability. The method used in this study was analyzing the values from the mathematic models of daily horizontal solar radiation, air temperature, wind speed, relative humidity and atmospheric pressure for the last 22 years which were finalized using MATLAB. The findings of this study will show the areas with good potentials to apply solar pond in South Sulawesi that can be utilized in various fields including power generator, industrial heating process, desalination and heating for biomass conversion.

Elucidating the Construct Validity of the Psychopathic Personality Inventory Triarchic Scales.

PubMed

Sellbom, Martin; Wygant, Dustin B; Drislane, Laura E

2015-01-01

This study sought to replicate and extend Hall and colleagues' (2014) work on developing and validating scales from the Psychopathic Personality Inventory (PPI) to index the triarchic psychopathy constructs of boldness, meanness, and disinhibition. This study also extended Hall et al.'s initial findings by including the PPI Revised (PPI-R). A community sample (n = 240) weighted toward subclinical psychopathy traits and a male prison sample (n = 160) were used for this study. Results indicated that PPI-Boldness, PPI-Meanness, and PPI-Disinhibition converged with other psychopathy, personality, and behavioral criteria in ways conceptually expected from the perspective of the triarchic psychopathy model, including showing very strong convergent and discriminant validity with their Triarchic Psychopathy Measure counterparts. These findings further enhance the utility of the PPI and PPI-R in measuring these constructs.

The patient experience of high technology medical imaging: a systematic review of the qualitative evidence.

PubMed

Munn, Zachary; Jordan, Zoe

When presenting to an imaging department, the person who is to be imaged is often in a vulnerable state, and out of their comfort zone. It is the role of the medical imaging technician to produce a high quality image and facilitate patient care throughout the imaging process. Qualitative research is necessary to better inform the medical imaging technician and to help them to understand the experience of the person being imaged. Some issues that have been identified in the literature include fear, claustrophobia, dehumanisation, and an uncomfortable or unusual experience. There is now a small but worthwhile qualitative literature base focusing on the patient experience in high technology imaging. There is no current qualitative synthesis of the literature on the patient experience in high technology imaging. It is therefore timely and worthwhile to produce a systematic review to identify and summarise the existent literature exploring the patient experience of high technology imaging. To identify the patient experience of high technology medical imaging. Studies that were of a qualitative design that explored the phenomenon of interest, the patient experience of high technology medical imaging. Participants included anyone who had undergone one of these procedures. The search strategy aimed to find both published and unpublished studies, and was conducted over a period from June - September 2010. No time limits were imposed on this search strategy. A three-step search strategy was utilised in this review. All studies that met the criteria were selected for retrieval. They were then assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data was extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Research findings were pooled using the Qualitative Assessment and Review Instrument. Following the search and critical appraisal processes, 15 studies were identified that were deemed of suitable quality to be included in the review. From these 15 studies, 127 findings were extracted, forming 33 categories and 11 synthesised findings. These synthesised findings related to the patient experience, the emotions they felt (whether negative or positive), the need for support and information, and highlighted the importance of imaging to the patient. The synthesised findings in this review highlight the diverse, unique and challenging ways in which people experience imaging with MRI and CT scanners. All health professionals involved in imaging need to be aware of the different ways each patient may experience imaging, and provide them with ongoing support and information. The implications for practice are derived directly from the results of the meta-synthesis, and each of the 11 synthesised findings. There is still scope for further high methodological qualitative studies to be conducted in this field, particularly in the field of nuclear medicine imaging and Positron Emission Tomography. Further studies may be conducted in certain patient groups, and in certain age ranges. No studies were found assessing the experience of children undergoing high technology imaging.

Integrating the Constructs of Anosognosia and Metacognition: A Review of Recent Findings in Dementia

PubMed Central

Sunderaraman, Preeti; Cosentino, Stephanie

2017-01-01

The current review integrates recent findings regarding the construct of self-awareness in dementia from both clinical and cognitive perspectives. We present the predominant theoretical models of awareness, and summarize both traditional and emerging approaches to assessing awareness from clinical and metacognitive perspectives. In this review, we focus primarily on findings from recent studies in anosognosia and metacognition in the context of neurodegenerative disease with special emphasis on Alzheimer's disease and Frontotemporal dementia. Emerging trends in the study of awareness, including examination of the longitudinal course of anosognosia, and investigation of the neural substrates underlying metacognitive abilities are addressed. Finally, the practical importance of studying and assessing awareness from both theoretical and clinical angles is emphasized. PMID:28283961

Integrating the Constructs of Anosognosia and Metacognition: a Review of Recent Findings in Dementia.

PubMed

Sunderaraman, Preeti; Cosentino, Stephanie

2017-03-01

The current review integrates recent findings regarding the construct of self-awareness in dementia from both clinical and cognitive perspectives. We present the predominant theoretical models of awareness and summarize both traditional and emerging approaches to assessing awareness from clinical and meta-cognitive perspectives. In this review, we focus primarily on findings from recent studies in anosognosia and meta-cognition in the context of neurodegenerative disease with special emphasis on Alzheimer's disease and frontotemporal dementia. Emerging trends in the study of awareness, including examination of the longitudinal course of anosognosia, and investigation of the neural substrates underlying meta-cognitive abilities are addressed. Finally, the practical importance of studying and assessing awareness from both theoretical and clinical angles is emphasized.

SABIS International Charter School: Management Issues and Recommendations.

ERIC Educational Resources Information Center

Massachusetts State Office of the Inspector General, Boston.

SABIS International Charter School was among 24 Commonwealth charter schools included in a study undertaken by the Office of the Inspector General in March 1998. The Office identified weaknesses in the contracting practices, procurement procedures, and financial management. Findings include: (1) the Board of Trustees did not employ sound business…

Space flight-associated neuro-ocular syndrome (SANS).

PubMed

Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Brunstetter, Tyson J; Tarver, William J

2018-03-12

Interesting novel and somewhat perplexing physiologic and pathologic neuro-ocular findings have been documented in astronauts during and after long duration space flight (LDSF). These findings collectively have been termed the "space flight-associated neuro-ocular syndrome" (SANS). The National Aeronautics and Space Administration (NASA) in the United States has meticulously and prospectively documented the clinical, ultrasound, optical coherence tomography imaging, and radiographic findings of SANS including unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts (i.e., cotton wool spots). NASA and collaborating researchers continue to study SANS in preparation for future manned missions to space, including continued trips to the ISS, a return to the moon, or perhaps new voyages to the asteroid belt, or the planet, Mars.

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review.

PubMed

Ryan, Richella; Booth, Sara; Spathis, Anna; Mollart, Sarah; Clow, Angela

2016-04-01

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with diverse adverse health outcomes, making it an important therapeutic target. Measurement of the diurnal rhythm of cortisol secretion provides a window into this system. At present, no guidelines exist for the optimal use of this biomarker within randomised controlled trials (RCTs). The aim of this study is to describe the ways in which salivary diurnal cortisol has been measured within RCTs of health or behavioural interventions in adults. Six electronic databases (up to May 21, 2015) were systematically searched for RCTs which used salivary diurnal cortisol as an outcome measure to evaluate health or behavioural interventions in adults. A narrative synthesis was undertaken of the findings in relation to salivary cortisol methodology and outcomes. From 78 studies that fulfilled the inclusion criteria, 30 included healthy participants (38.5 %), 27 included patients with physical disease (34.6 %) and 21 included patients with psychiatric disease (26.9 %). Psychological therapies were most commonly evaluated (n = 33, 42.3 %). There was substantial heterogeneity across studies in relation to saliva collection protocols and reported cortisol parameters. Only 39 studies (50 %) calculated a rhythm parameter such as the diurnal slope or the cortisol awakening response (CAR). Patterns of change in cortisol parameters were inconsistent both within and across studies and there was low agreement with clinical findings. Salivary diurnal cortisol is measured inconsistently across RCTs, which is limiting the interpretation of findings within and across studies. This indicates a need for more validation work, along with consensus guidelines.

Empathy-related Responding: Associations with Prosocial Behavior, Aggression, and Intergroup Relations

PubMed Central

Eisenberg, Nancy; Eggum, Natalie D.; Di Giunta, Laura

2010-01-01

Empathy-related responding, including empathy, sympathy, and personal distress, has been implicated in conceptual models and theories about prosocial behavior and altruism, aggression and antisocial behavior, and intergroup relationships. Conceptual arguments and empirical findings related to each of these topics are reviewed. In general, there is evidence that empathy and/or sympathy are important correlates of, and likely contributors to, other-oriented prosocial behavior, the inhibition of aggression and antisocial behavior, and the quality of intergroup relationships. Applied implications of these findings, including preventative studies, are discussed, as are possible future directions. PMID:21221410

Demand-side financing measures to increase maternal health service utilisation and improve health outcomes: a systematic review of evidence from low- and middle-income countries.

PubMed

Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

2012-01-01

In many countries financing for health services has traditionally been disbursed directly from governmental and non-governmental funding agencies to providers of services: the 'supply-side' of healthcare markets. Demand-side financing offers a supplementary model in which some funds are instead channelled through, or to, prospective users. In this review we considered evidence on five forms of demand-side financing that have been used to promote maternal health in developing countries: OBJECTIVES: The overall review objective was to assess the effects of demand-side financing interventions on maternal health service utilisation and on maternal health outcomes in low- and middle-income countries. Broader effects on perinatal and infant health, the situation of underprivileged women and the health care system were also assessed. This review considered poor, rural or socially excluded women of all ages who were either pregnant or within 42 days of the conclusion of pregnancy, the limit for postnatal care as defined by the World Health Organization. The review also considered the providers of services.The intervention of interest was any programme that incorporated demand-side financing as a mechanism to increase the consumption of goods and services that could impact on maternal health outcomes. This included the direct consumption of maternal health care goods and services as well as related 'merit goods' such as improved nutrition. We included systems in which potential users of maternal health services are financially empowered to make restricted decisions on buying maternal health-related goods or services - sometimes known as consumer-led demand-side financing. We also included programmes that provided unconditional cash benefits to pregnant women (for example in the form of maternity allowances), or to families with children under five years of age where there was evidence concerning maternal health outcomes.We aimed to include quantitative studies (experimental, observational and descriptive), qualitative studies (including designs based on phenomenology, grounded theory, ethnography, action research and feminist research), and economic studies (cost-effectiveness, cost-utility and costs studies). The Joanna Briggs Institute methodology for mixed-method systematic reviews was adopted. A three-step systematic search strategy was used to: 1) identify key terms, 2) search bibliographic databases and 3) retrieve additional publications from reference lists and sources of grey literature. Data were extracted from papers included in the review using the standardised data extraction tools for quantitative, qualitative and economic data from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. The quantitative and economic findings are presented in narrative form. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. This involved the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings (Level 1 findings), and categorising these findings on the basis of similarity in meaning (Level 2 findings). These categories were then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesised findings (Level 3 findings) that can be used as a basis for evidence-based practice or policy. Seventy-two studies were included in the review. Drawing on work from several continents, many of the included studies were reports and evaluations for relevant government or funding agencies and represented important lesson-learning about implementation issues. However, fewer than half were published in peer reviewed journals and few were of high research quality.For three modes of demand-side financing (conditional cash transfers, payments to offset costs of access to maternal healthcare, and vouchers for maternity services) we found evidence relevant to review questions on the utilisation of maternal health services, barriers to the provision of demand-side financing and supply-side preconditions to implementing demand-side financing schemes. There was insufficient evidence to provide comprehensive answers for review questions on the effect of demand-side financing interventions on maternal, perinatal and infant health outcomes and on the social and financial situation of underprivileged women. There was also insufficient evidence on the cost-effectiveness of demand-side financing interventions and preconditions for sustainability and scale-up of demand-side financing schemes.Salient recommendations for policymakers regarding demand-side financing for maternal health derived from the current evidence are:There is a pressing need for large, robust studies on the short- and longer-term impact of demand-side financing on maternal and infant mortality and morbidity, which should also reflect 'good practice' indicators such as the uptake and duration of exclusive breastfeeding and compliance with infant immunisation programmes. It is also important that the impact on outcomes of subsequent pregnancies is evaluated. Moderate and large-sized demand-side financing programmes that have recently or will soon be scaled up, such as those in Kenya, Uganda and Bangladesh, represent the most obvious sites for such evaluations, and lessons may be learnt from Mexico's PROGRESA/ Oportunidades about how to establish a well-embedded monitoring and rigorous evaluation structure.Other important areas that require further study include.

Health Care Aides' Struggle to Build and Maintain Relationships with Families in Complex Continuing Care Settings

ERIC Educational Resources Information Center

McGilton, Katherine S.; Guruge, Sepali; Librado, Ruby; Bloch, Lois; Boscart, Veronique

2008-01-01

Research on the relationships between health care aides (HCAs) and families of clients has been situated mainly in long-term care settings and includes scant findings about the perceptions of HCAs. Based on the findings of a larger qualitative study using a grounded theory approach, this paper addresses the topic of HCA-family relationships in…

A Priority for California's Future: Science for Students. Summary Report. Strengthening Science Education in California

ERIC Educational Resources Information Center

Center for the Future of Teaching and Learning, 2010

2010-01-01

This paper presents findings of a study that examined Californians' views on science education. The findings are based on telephone interviews with 1,004 adults conducted April 7-22, 2010. Cell phone and Spanish language interviews were included to provide more complete coverage of California's population. In order to enhance understanding of the…

Learning Curve: How College Graduates Solve Information Problems Once They Join the Workplace. Project Information Literacy Research Report

ERIC Educational Resources Information Center

Head, Allison J.

2012-01-01

Qualitative findings about the information-seeking behavior of today's college graduates as they transition from the campus to the workplace. Included are findings from interviews with 23 US employers and focus groups with 33 recent graduates from four US colleges and universities, conducted as an exploratory study for Project Information…

The Internet and Education: Findings of the Pew Internet & American Life Project.

ERIC Educational Resources Information Center

Lenhart, Amanda; Simon, Maya; Graziano, Mike

Research by the Pew Internet & American Life Project shows that teenagers use the Internet as an essential study aid outside the classroom and that the Internet increasingly has a place inside the classroom. Findings from a survey of 754 youths ages 12-17 conducted November and December 2000 include: 94% who have Internet access say they use the…

Graph theory findings in the pathophysiology of temporal lobe epilepsy

PubMed Central

Chiang, Sharon; Haneef, Zulfi

2014-01-01

Temporal lobe epilepsy (TLE) is the most common form of adult epilepsy. Accumulating evidence has shown that TLE is a disorder of abnormal epileptogenic networks, rather than focal sources. Graph theory allows for a network-based representation of TLE brain networks, and has potential to illuminate characteristics of brain topology conducive to TLE pathophysiology, including seizure initiation and spread. We review basic concepts which we believe will prove helpful in interpreting results rapidly emerging from graph theory research in TLE. In addition, we summarize the current state of graph theory findings in TLE as they pertain its pathophysiology. Several common findings have emerged from the many modalities which have been used to study TLE using graph theory, including structural MRI, diffusion tensor imaging, surface EEG, intracranial EEG, magnetoencephalography, functional MRI, cell cultures, simulated models, and mouse models, involving increased regularity of the interictal network configuration, altered local segregation and global integration of the TLE network, and network reorganization of temporal lobe and limbic structures. As different modalities provide different views of the same phenomenon, future studies integrating data from multiple modalities are needed to clarify findings and contribute to the formation of a coherent theory on the pathophysiology of TLE. PMID:24831083

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

PubMed

Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan

2017-08-01

The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.

University Students' Study Orientations, Learning Experiences and Study Success in Innovative Courses

ERIC Educational Resources Information Center

Honkimaki, Sanna; Tynjala, Paivi; Valkonen, Sakari

2004-01-01

The aim of this study was to find out whether university students' study orientations on four innovative courses differed from their usual orientations to their studies. Furthermore, students' study success and learning experiences were examined. The pedagogical innovations carried out on the courses included different kinds of activating…

Sexual Violence Among Male Inmates.

PubMed

Hilinski-Rosick, Carly M; Freiburger, Tina L

2018-04-01

Inmate misconduct has been a widely studied topic for many decades. General studies of misconduct have found that there are certain factors that contribute to misconduct, including age, gender, sentence length, and facility type. Few studies, however, have examined the factors predicting sexual offenses in a prison conduct. Although many studies of victims of sexual offenses in prison have been conducted, there is a lack of studies examining the perpetrators of prison sexual violence. The current study attempted to expand this body of literature by examining the correlates of sexual misconduct among a sample of male inmates incarcerated in the state of North Carolina during 2010. Deprivation and importation theories of inmate behavior were used to guide the analysis, and measures of deprivation and importation factors were both included in the analytical models. Findings indicate that Black, nonmarried, younger inmates, who had more previous incarcerations and had been incarcerated longer, had greater odds of having a sexual infraction. Additional findings, as well as policy implications, are discussed.

"Selling It as a Holistic Health Provision and Not Just about Condoms..." Sexual Health Services in School Settings: Current Models and Their Relationship with Sex and Relationships Education Policy and Provision

ERIC Educational Resources Information Center

Formby, Eleanor; Hirst, Julia; Owen, Jenny; Hayter, Mark; Stapleton, Helen

2010-01-01

In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in--or closely linked with--schools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this…

Truancy Interventions: A Review of the Research Literature

ERIC Educational Resources Information Center

Sutphen, Richard D.; Ford, Janet P.; Flaherty, Chris

2010-01-01

Objectives: This article presents a systematic review of the literature on evaluative studies of truancy interventions. Method: Included studies evaluating truancy interventions appearing in peer-reviewed academic journals from 1990 to 2007. Findings: In total, 16 studies were assessed. Eight studies used group comparison designs and eight studies…

Outcome-Reporting Bias in Education Research

ERIC Educational Resources Information Center

Pigott, Therese D.; Valentine, Jeffrey C.; Polanin, Joshua R.; Williams, Ryan T.; Canada, Dericka D.

2013-01-01

Outcome-reporting bias occurs when primary studies do not include information about all outcomes measured in a study. When studies omit findings on important measures, efforts to synthesize the research using systematic review techniques will be biased and interpretations of individual studies will be incomplete. Outcome-reporting bias has been…

Electric System Flexibility and Storage | Energy Analysis | NREL

Science.gov Websites

. Featured Studies India Renewable Integration Study Grid Flexibility and Storage Required To Achieve Very demand-in Texas. Key findings from this study include: A highly flexible system with must-run baseload . Publications Renewable Electricity Futures Study. Volume 2: Renewable Electricity Generation and Storage

Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review.

PubMed

Butenko, Samantha; Lockwood, Craig; McArthur, Alexa

2017-06-01

Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them. Partnering within the context of healthcare, and between the patient and healthcare professional, can be considered as a general concept that involves the empowerment of patients to participate in their care. Terms used to describe patient partnering within healthcare vary and include patient participation, patient-centeredness, patient empowerment and patient engagement. Although patients appear generally to have positive attitudes and intentions about engaging in their safety and partnering in the healthcare setting, their intentions and actual behaviors vary considerably. Patients appear less likely to engage in behaviors that require questioning of the perceived or real authority of healthcare professionals. A patient's intention and subsequent act of partnering with healthcare professionals for hand hygiene compliance by the healthcare professional are influenced by complex internal, external and social factors as well as cultural, behavioral and systematic factors. To determine the best available evidence in relation to the experiences of the patient partnering with healthcare professionals for hand hygiene compliance. The current review considered qualitative (critical or interpretive) papers that included adult in-patients and healthcare professionals (medical and nursing staff), in the acute hospital-care setting. Adult was considered to be any person aged 18 years or over. It should be noted that consumers in this context were patients and vice versa; the term patient is therefore used throughout this report for consistency. The current review considered studies that investigated the experience of partnership between patients and healthcare professionals in relation to hand hygiene compliance. This review investigated the phenomena of partnering from both the perspectives of the patient and the healthcare professional. The current review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. As qualitative studies were identified and on appraisal found to be of sufficient quality for inclusion, this review did not seek alternate forms of evidence such as text and opinion. The search strategy aimed to find both published and unpublished studies from 1990 to May 2015. Studies published in English were considered for inclusion in this review. Qualitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Qualitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-QARI. Qualitative research findings were pooled using JBI-QARI. Following the systematic search and critical appraisal process, three studies were included in the review for data extraction and synthesis of findings. The review process resulted in 29 study findings that were aggregated into seven categories. The categories generated two meta-synthesized findings. The two final synthesized findings were as follows. Synthesized finding 1: Organizational structures enable partnering between healthcare professionals and patients for hand hygiene compliance; however, the culture, beliefs and behaviors of healthcare professionals and patients do not fully support this partnership. Synthesized finding 2: Patients have differing levels of knowledge and balance partnering in hand hygiene against possible detrimental impacts on the caring relationship provided by healthcare professionals, out of concern for their own wellbeing, health outcomes, treatment and/or recovery. The current review highlights the complexity of the patient's experience of partnering with healthcare professionals for hand hygiene compliance. The experiences reported indicated that there is a possible disparity between the healthcare facility and healthcare professionals' promotion and intention of partnering for hand hygiene compliance, and the actual patient's acceptance, participation, partnership, experience and implementation of this initiative. This disconnect between intent and action appears to be influenced by a number of factors including organizational structures as well as drivers such as cultural beliefs and behavior.

Do nurses provide a safe sleep environment for infants in the hospital setting? An integrative review.

PubMed

Patton, Carla; Stiltner, Denise; Wright, Kelly Barnhardt; Kautz, Donald D

2015-02-01

Sudden infant death syndrome (SIDS) may be the most preventable cause of death for infants 0 to 6 months of age. The American Academy of Pediatrics (AAP) first published safe sleep recommendations for parents and healthcare professionals in 1992. In 1994, new guidelines were published and they became known as the "Back to Sleep" campaign. After this, a noticeable decline occurred in infant deaths from SIDS. However, this number seems to have plateaued with no continuing significant improvements in infant deaths. The objective of this review was to determine whether nurses provide a safe sleep environment for infants in the hospital setting. Research studies that dealt with nursing behaviors and nursing knowledge in the hospital setting were included in the review. A search was conducted of Google Scholar, CINAHL, PubMed, and Cochrane, using the key words "NICU," "newborn," "SIDS," "safe sleep environment," "nurse," "education," "supine sleep," "prone sleep," "safe sleep," "special care nursery," "hospital policy for safe sleep," "research," "premature," "knowledge," "practice," "health care professionals," and "parents." The review included research reports on nursing knowledge and behaviors as well as parental knowledge obtained through education and role modeling of nursing staff. Only research studies were included to ensure that our analysis was based on rigorous research-based findings. Several international studies were included because they mirrored findings noted in the United States. All studies were published between 1999 and 2012. Healthcare professionals and parents were included in the studies. They were primarily self-report surveys, designed to determine what nurses, other healthcare professionals, and parents knew or had been taught about SIDS. Integrative review. Thirteen of the 16 studies included in the review found that some nurses and some mothers continued to use nonsupine positioning. Four of the 16 studies discussed nursing knowledge and noncompliance with AAP safe sleep recommendations. Eleven of the 16 studies found that some nurses were recommending incorrect sleep positions to mothers. Five of the 16 studies noted that some nurses and mothers gave fear of aspiration as the reason they chose to use a nonsupine sleep position. In the majority of the studies, the information was self-reported, which could impact the validity of the findings. Also, the studies used convenience sampling, which makes study findings difficult to generalize. The research indicates that there has been a plateau in safe sleeping practices in the hospital setting. Some infants continue to be placed in positions that increase the risk for SIDS. The research also shows that some nurses are not following the 2011 AAP recommendations for a safe sleep environment. Clearly, nurses need additional education on SIDS prevention and the safe sleep environment, and additional measures need to be adopted to ensure that all nurses and all families understand the research supporting the AAP recommendation that supine sleep is best. Further work is needed to promote evidence-based practice among healthcare professionals and families.

Identifying people with type 2 diabetes and those at risk: lessons from the measure your waist (MY-WAIST) mixed-methods study in UK primary care.

PubMed

Aujla, Navneet; Stone, Margaret A; Taub, Nicholas; Davies, Melanie J; Khunti, Kamlesh

2013-12-01

This paper focuses mainly on explanations and lessons from a research-based programme for identifying undiagnosed type 2 diabetes and high risk. In addition to outlining key quantitative findings, we specifically aim to explore reasons for low uptake from the perspective of primary care staff involved. The MY-WAIST study was conducted in UK primary care and included the use of oral glucose tolerance tests (OGTTs) and waist measurement. Qualitative data from interviews with healthcare providers and records of meetings were analysed thematically. The key quantitative finding was low uptake of the assessments offered (8.6% overall, 2.6% in inner-city locations with high South Asian residency). In addition to confirming patient-reported barriers including those associated with OGTTs, qualitative findings highlighted a number of primary care provider barriers, including limited staff capacity. Interviewees suggested that those who attended were typically the 'worried well' rather than those from hard-to-reach groups. Implications discussed include the impact of low uptake on the usefulness of the quantitative data obtained, and lessons relevant to research design. Relevance to current guidance regarding early identification strategies is discussed and the importance of addressing the needs of less accessible groups is highlighted. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

A multi-institutional study using simulation to teach cardiopulmonary physical examination and diagnosis skills to physician assistant students.

PubMed

Multak, Nina; Newell, Karen; Spear, Sherrie; Scalese, Ross J; Issenberg, S Barry

2015-06-01

Research demonstrates limitations in the ability of health care trainees/practitioners, including physician assistants (PAs), to identify important cardiopulmonary examination findings and diagnose corresponding conditions. Studies also show that simulation-based training leads to improved performance and that these skills can transfer to real patients. This study evaluated the effectiveness of a newly developed curriculum incorporating simulation with deliberate practice for teaching cardiopulmonary physical examination/bedside diagnosis skills in the PA population. This multi-institutional study used a pretest/posttest design. Participants, PA students from 4 different programs, received a standardized curriculum including instructor-led activities interspersed among small-group/independent self-study time. Didactic sessions and independent study featured practice with the "Harvey" simulator and use of specially developed computer-based multimedia tutorials. Preintervention: participants completed demographic questionnaires, rated self-confidence, and underwent baseline evaluation of knowledge and cardiopulmonary physical examination skills. Students logged self-study time using various learning resources. Postintervention: students again rated self-confidence and underwent repeat cognitive/performance testing using equivalent written/simulator-based assessments. Physician assistant students (N = 56) demonstrated significant gains in knowledge, cardiac examination technique, recognition of total cardiac findings, identification of key auscultatory findings (extra heart sounds, systolic/diastolic murmurs), and the ability to make correct diagnoses. Learner self-confidence also improved significantly. This study demonstrated the effectiveness of a simulation-based curriculum for teaching essential physical examination/bedside diagnosis skills to PA students. Its results reinforce those of similar/previous research, which suggest that simulation-based training is most effective under certain educational conditions. Future research will include subgroup analyses/correlation of other variables to explore best features/uses of simulation technology for training PAs.

42 CFR 93.215 - Investigation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH... or to a recommendation for a finding of research misconduct which may include a recommendation for...

42 CFR 93.215 - Investigation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH... or to a recommendation for a finding of research misconduct which may include a recommendation for...

Bias in dissemination of clinical research findings: structured OPEN framework of what, who and why, based on literature review and expert consensus.

PubMed

Bassler, Dirk; Mueller, Katharina F; Briel, Matthias; Kleijnen, Jos; Marusic, Ana; Wager, Elizabeth; Antes, Gerd; von Elm, Erik; Altman, Douglas G; Meerpohl, Joerg J

2016-01-21

The aim of this study is to review highly cited articles that focus on non-publication of studies, and to develop a consistent and comprehensive approach to defining (non-) dissemination of research findings. We performed a scoping review of definitions of the term 'publication bias' in highly cited publications. Ideas and experiences of a core group of authors were collected in a draft document, which was complemented by the findings from our literature search. The draft document including findings from the literature search was circulated to an international group of experts and revised until no additional ideas emerged and consensus was reached. We propose a new approach to the comprehensive conceptualisation of (non-) dissemination of research. Our 'What, Who and Why?' approach includes issues that need to be considered when disseminating research findings (What?), the different players who should assume responsibility during the various stages of conducting a clinical trial and disseminating clinical trial documents (Who?), and motivations that might lead the various players to disseminate findings selectively, thereby introducing bias in the dissemination process (Why?). Our comprehensive framework of (non-) dissemination of research findings, based on the results of a scoping literature search and expert consensus will facilitate the development of future policies and guidelines regarding the multifaceted issue of selective publication, historically referred to as 'publication bias'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations.

PubMed

Abraham, Alon; Alabdali, Majed; Alsulaiman, Abdulla; Albulaihe, Hana; Breiner, Ari; Katzberg, Hans D; Aljaafari, Danah; Lovblom, Leif E; Bril, Vera

2017-01-01

Polyneuropathy is one of the most prevalent neurologic disorders. Although several studies explored the role of the neurological examination in polyneuropathy, they were mostly restricted to specific subgroups of patients and have not correlated examination findings with symptoms and electrophysiological results. To explore the sensitivity and specificity of different neurological examination components in patients with diverse etiologies for polyneuropathy, find the most sensitive combination of examination components for polyneuropathy detection, and correlate examination findings with symptoms and electrophysiological results. Patients with polyneuropathy attending the neuromuscular clinic from 01/2013 to 09/2015 were evaluated. Inclusion criteria included symptomatic polyneuropathy, which was confirmed by electrophysiological studies. 47 subjects with no symptoms or electrophysiological findings suggestive for polyneuropathy, served as controls. The total cohort included 312 polyneuropathy patients, with a mean age of 60±14 years. Abnormal examination was found in 95%, most commonly sensory findings (86%). The most common abnormal examination components were impaired ankle reflexes (74%), vibration (73%), and pinprick (72%) sensation. Combining ankle reflex examination with vibration or pinprick perception had the highest sensitivity, of 88%. The specificities of individual examination component were generally high, excluding ankle reflexes (62%), and vibration perception (77%). Abnormal examination findings were correlated with symptomatic weakness and worse electrophysiological parameters. The neurological examination is a valid, sensitive and specific tool for diagnosing polyneuropathy, and findings correlate with polyneuropathy severity. Ankle reflex examination combined with either vibration or pinprick sensory testing is the most sensitive combination for diagnosing polyneuropathy, and should be considered minimal essential components of the physical examination in patients with suspected polyneuropathy.

A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting.

PubMed

Addissie, Adamu; Davey, Gail; Newport, Melanie J; Addissie, Thomas; MacGregor, Hayley; Feleke, Yeweyenhareg; Farsides, Bobbie

2014-05-02

Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended.

A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting

PubMed Central

2014-01-01

Background Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Methods Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. Results In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. Conclusion The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended. PMID:24885049

Benefit Finding in Maternal Caregivers of Pediatric Cancer Survivors: A Mixed Methods Approach.

PubMed

Willard, Victoria W; Hostetter, Sarah A; Hutchinson, Katherine C; Bonner, Melanie J; Hardy, Kristina K

2016-09-01

Benefit finding has been described as the identification of positive effects resulting from otherwise stressful experiences. In this mixed methods study, we examined the relations between qualitative themes related to benefit finding and quantitative measures of psychosocial adjustment and coping as reported by maternal caregivers of survivors of pediatric cancer. Female caregivers of survivors of pediatric cancer (n = 40) completed a qualitative questionnaire about their experiences caring for their child, along with several quantitative measures. Qualitative questionnaires were coded for salient themes, including social support and personal growth. Correlation matrices evaluated associations between qualitative themes and quantitative measures of stress and coping. Identified benefits included social support and personal growth, as well as child-specific benefits. Total benefits reported were significantly positively correlated with availability of emotional resources. Coping methods were also associated, with accepting responsibility associated with fewer identified benefits. Despite the stress of their child's illness, many female caregivers of survivors of pediatric cancer reported finding benefits associated with their experience. Benefit finding in this sample was associated with better adjustment. © 2016 by Association of Pediatric Hematology/Oncology Nurses.

Early and simple detection of diastolic dysfunction during weaning from mechanical ventilation

PubMed Central

2012-01-01

Weaning from mechanical ventilation imposes additional work on the cardiovascular system and can provoke or unmask left ventricular diastolic dysfunction with consecutive pulmonary edema or systolic dysfunction with inadequate increase of cardiac output and unsuccessful weaning. Echocardiography, which is increasingly used for hemodynamic assessment of critically ill patients, allows differentiation between systolic and diastolic failure. For various reasons, transthoracic echocardiographic assessment was limited to patients with good echo visibility and to those with sinus rhythm without excessive tachycardia. In these patients, often selected after unsuccessful weaning, echocardiographic findings were predictive for weaning failure of cardiac origin. In some studies, patients with various degrees of systolic dysfunction were included, making evaluation of the diastolic dysfunction to the weaning failure even more difficult. The recent study by Moschietto and coworkers included unselected patients and used very simple diastolic variables for assessment of diastolic function. They also included patients with atrial fibrillation and repeated echocardiographic examination only 10 minutes after starting a spontaneous breathing trial. The main finding was that weaning failure was not associated with systolic dysfunction but with diastolic dysfunction. By measuring simple and robust parameters for detection of diastolic dysfunction, the study was able to predict weaning failure in patients with sinus rhythm and atrial fibrillation as early as 10 minutes after beginning a spontaneous breathing trial. Further studies are necessary to determine whether appropriate treatment tailored according to the echocardiographic findings will result in successful weaning. PMID:22770365

Early and simple detection of diastolic dysfunction during weaning from mechanical ventilation.

PubMed

Voga, Gorazd

2012-07-06

Weaning from mechanical ventilation imposes additional work on the cardiovascular system and can provoke or unmask left ventricular diastolic dysfunction with consecutive pulmonary edema or systolic dysfunction with inadequate increase of cardiac output and unsuccessful weaning. Echocardiography, which is increasingly used for hemodynamic assessment of critically ill patients, allows differentiation between systolic and diastolic failure. For various reasons, transthoracic echocardiographic assessment was limited to patients with good echo visibility and to those with sinus rhythm without excessive tachycardia. In these patients, often selected after unsuccessful weaning, echocardiographic findings were predictive for weaning failure of cardiac origin. In some studies, patients with various degrees of systolic dysfunction were included, making evaluation of the diastolic dysfunction to the weaning failure even more difficult. The recent study by Moschietto and coworkers included unselected patients and used very simple diastolic variables for assessment of diastolic function. They also included patients with atrial fibrillation and repeated echocardiographic examination only 10 minutes after starting a spontaneous breathing trial. The main finding was that weaning failure was not associated with systolic dysfunction but with diastolic dysfunction. By measuring simple and robust parameters for detection of diastolic dysfunction, the study was able to predict weaning failure in patients with sinus rhythm and atrial fibrillation as early as 10 minutes after beginning a spontaneous breathing trial. Further studies are necessary to determine whether appropriate treatment tailored according to the echocardiographic findings will result in successful weaning.

Pulmonary manifestations of Q fever: analysis of 38 patients.

PubMed

Kelm, Diana J; White, Darin B; Fadel, Hind J; Ryu, Jay H; Maldonado, Fabien; Baqir, Misbah

2017-10-01

Lung involvement in both acute and chronic Q fever is not well described with only a few reported cases of pseudotumor or pulmonary fibrosis in chronic Q fever. The aim of this study was to better understand the pulmonary manifestations of Q fever. We conducted a retrospective cohort study of patients with diagnosis of Q fever at Mayo Clinic Rochester. A total of 69 patients were initially identified between 2001 and 2014. Thirty-eight patients were included in this study as 3 were pediatric patients, 20 did not meet serologic criteria for Q fever, and 8 did not have imaging available at time of initial diagnosis. Descriptive analysis was conducted using JMP software. The median age was 57 years [interquartile range (IQR) 43, 62], 84% from the Midwest, and 13% worked in an occupation involving animals. The most common presentation was fevers (61%). Respiratory symptoms, such as cough, were noted in only 4 patients (11%). Twelve patients (29%) had abnormal imaging studies attributed to Q fever. Three patients (25%) with acute Q fever had findings of consolidation, lymphadenopathy, pleural effusions, and nonspecific pulmonary nodules. Radiographic findings of chronic Q fever were seen in 9 patients (75%) and included consolidation, ground-glass opacities, pleural effusions, lymphadenopathy, pulmonary edema, and lung pseudotumor. Our results demonstrate that pulmonary manifestations are uncommon in Q fever but include cough and consolidation for acute Q fever and radiographic findings of pulmonary edema with pleural effusions, consolidation, and pseudotumor in those with chronic Q fever.

Clinical germline diagnostic exome sequencing for hereditary cancer: Findings within novel candidate genes are prevalent.

PubMed

Powis, Zöe; Espenschied, Carin R; LaDuca, Holly; Hagman, Kelly D; Paudyal, Tripti; Li, Shuwei; Inaba, Hiroto; Mauer, Ann; Nathanson, Katherine L; Knost, James; Chao, Elizabeth C; Tang, Sha

2018-08-01

Clinical diagnostic exome sequencing (DES) has been effective in diagnosing individuals with suspected genetic conditions; nevertheless little has been described regarding its clinical utility in individuals with a personal and family history of cancer. This study aimed to assess diagnostic yield and clinical characteristics of pediatric and adult patients undergoing germline DES for hereditary cancer. We retrospectively reviewed 2171 patients referred for DES; cases with a personal and/or family history of cancer were further studied. Of 39 cancer patients, relevant alterations were found in eight individuals (21%), including one (3%) positive pathogenic alteration within a characterized gene, two (5%) uncertain findings in characterized genes, and five (13%) alterations in novel candidate genes. Two of the 5 pediatric patients, undergoing testing, (40%) had findings in novel candidate genes, with the remainder being negative. We include brief case studies to illustrate the variety of challenging issues related to these patients. Our observations demonstrate utility of family-based exome sequencing in patients for suspected hereditary cancer, including familial co-segregation analysis, and comprehensive medical review. DES may be particularly useful when traditional approaches do not result in a diagnosis or in families with unique phenotypes. This work also highlights the importance and complexity of analysis of uncharacterized genes in exome sequencing for hereditary cancer. Copyright © 2018 Elsevier Inc. All rights reserved.

What Influences Patient-Therapist Interactions in Musculoskeletal Physical Therapy? Qualitative Systematic Review and Meta-Synthesis.

PubMed

O'Keeffe, Mary; Cullinane, Paul; Hurley, John; Leahy, Irene; Bunzli, Samantha; O'Sullivan, Peter B; O'Sullivan, Kieran

2016-05-01

Musculoskeletal physical therapy involves both specific and nonspecific effects. Nonspecific variables associated with the patient, therapist, and setting may influence clinical outcomes. Recent quantitative research has shown that nonspecific factors, including patient-therapist interactions, can influence treatment outcomes. It remains unclear, however, what factors influence patient-therapist interaction. This qualitative systematic review and meta-synthesis investigated patients' and physical therapists' perceptions of factors that influence patient-therapist interactions. Eleven databases were searched independently. Qualitative studies examining physical therapists' and patients' perceptions of factors that influence patient-therapist interactions in musculoskeletal settings were included. Two reviewers independently selected articles, assessed methodological quality using the Critical Appraisal Skills Programme (CASP), and performed the 3 stages of analysis: extraction of findings, grouping of findings (codes), and abstraction of findings. Thirteen studies were included. Four themes were perceived to influence patient-therapist interactions: (1) physical therapist interpersonal and communication skills (ie, presence of skills such as listening, encouragement, confidence, being empathetic and friendly, and nonverbal communication), (2) physical therapist practical skills (ie, physical therapist expertise and level of training, although the ability to provide good education was considered as important only by patients), (3) individualized patient-centered care (ie, individualizing the treatment to the patient and taking patient's opinions into account), and (4) organizational and environmental factors (ie, time and flexibility with care and appointments). Only studies published in English were included. A mix of interpersonal, clinical, and organizational factors are perceived to influence patient-therapist interactions, although research is needed to identify which of these factors actually influence patient-therapist interactions. Physical therapists' awareness of these factors could enhance patient interactions and treatment outcomes. Mechanisms to best enhance these factors in clinical practice warrant further study. © 2016 American Physical Therapy Association.

A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview

PubMed Central

Cohen, Jeffrey; Stuve, Olaf; Trojano, Maria; Sørensen, Per Soelberg; Reingold, Stephen; Cutter, Gary; Reider, Nadia

2015-01-01

Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population. PMID:25623244

Hospital Acquisitions Before Healthcare Reform.

PubMed

McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun

2015-01-01

The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.

What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings.

PubMed

Jellema, Sandra; van Hees, Suzanne; Zajec, Jana; van der Sande, Rob; Nijhuis-van der Sanden, Maria Wg; Steultjens, Esther Mj

2017-07-01

Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.

Associations between thoracic radiographic changes and severity of pulmonary arterial hypertension diagnosed in 60 dogs via Doppler echocardiography: A retrospective study.

PubMed

Adams, Dustin S; Marolf, Angela J; Valdés-Martínez, Alejandro; Randall, Elissa K; Bachand, Annette M

2017-07-01

Doppler echocardiography is a noninvasive method for estimating and grading pulmonary arterial hypertension. No current literature associates significance of radiographic findings with severity of pulmonary arterial hypertension. We hypothesized that the number and conspicuity of radiographic findings suggestive of pulmonary arterial hypertension would be greater based on the severity of pulmonary arterial hypertension. Dogs with pulmonary arterial hypertension and normal control dogs were included in this retrospective, case control study. Three radiologists blinded to echocardiographic results scored thoracic radiographs for right ventricular and main pulmonary artery enlargement and pulmonary lobar artery enlargement, tortuosity, and blunting by multiple methods. Presence or absence of each finding was scored in an additive fashion and averaged for each grade of pulmonary arterial hypertension severity. Seventy-one dogs (60 dogs with pulmonary arterial hypertension and 11 control dogs) of which some had multiple studies were included: 20 mild, 21 moderate, 25 severe, and 11 absent pulmonary arterial hypertension. The following radiographic findings were significantly associated with increasing pulmonary arterial hypertension severity: right ventricular enlargement by "reverse D" and "3/5-2/5 cardiac ratio" methods, main pulmonary artery enlargement, and caudal lobar artery enlargement by the "3rd rib" method. Mean scores for severe pulmonary arterial hypertension and normal dogs were significantly different (P-value < 0.0001). Mean scores between different pulmonary arterial hypertension grades increased with severity but were not statistically significant. Individually and in combination, radiographic findings performed poorly in differentiating severity of pulmonary arterial hypertension. Findings indicated that thoracic radiographs should be utilized in conjunction with Doppler echocardiography in a complete diagnostic work-up for dogs with suspected pulmonary arterial hypertension. © 2017 American College of Veterinary Radiology.

High Frequency of Neuroimaging Abnormalities Among Pediatric Patients With Sepsis Who Undergo Neuroimaging.

PubMed

Sandquist, Mary K; Clee, Mark S; Patel, Smruti K; Howard, Kelli A; Yunger, Toni; Nagaraj, Usha D; Jones, Blaise V; Fei, Lin; Vadivelu, Sudhakar; Wong, Hector R

2017-07-01

This study was intended to describe and correlate the neuroimaging findings in pediatric patients after sepsis. Retrospective chart review. Single tertiary care PICU. Patients admitted to Cincinnati Children's Hospital Medical Center with a discharge diagnosis of sepsis or septic shock between 2004 and 2013 were crossmatched with patients who underwent neuroimaging during the same time period. All neuroimaging studies that occurred during or subsequent to a septic event were reviewed, and all new imaging findings were recorded and classified. As many patients experienced multiple septic events and/or had multiple neuroimaging studies after sepsis, our statistical analysis utilized the most recent or "final" imaging study available for each patient so that only brain imaging findings that persisted were included. A total of 389 children with sepsis and 1,705 concurrent or subsequent neuroimaging studies were included in the study. Median age at first septic event was 3.4 years (interquartile range, 0.7-11.5). Median time from first sepsis event to final neuroimaging was 157 days (interquartile range, 10-1,054). The most common indications for final imaging were follow-up (21%), altered mental status (18%), and fever/concern for infection (15%). Sixty-three percentage (n = 243) of final imaging studies demonstrated abnormal findings, the most common of which were volume loss (39%) and MRI signal and/or CT attenuation abnormalities (21%). On multivariable logistic regression, highest Pediatric Risk of Mortality score and presence of oncologic diagnosis/organ transplantation were independently associated with any abnormal final neuroimaging study findings (odds ratio, 1.032; p = 0.048 and odds ratio, 1.632; p = 0.041), although early timing of neuroimaging demonstrated a negative association (odds ratio, 0.606; p = 0.039). The most common abnormal finding of volume loss was independently associated with highest Pediatric Risk of Mortality score (odds ratio, 1.037; p = 0.016) and oncologic diagnosis/organ transplantation (odds ratio, 2.207; p = 0.001) and was negatively associated with early timing of neuroimaging (odds ratio, 0.575; p = 0.037). The majority of pediatric patients with sepsis and concurrent or subsequent neuroimaging have abnormal neuroimaging findings. The implications of this high incidence for long-term neurologic outcomes and follow-up require further exploration.

Work zone traffic legislation in Texas

DOT National Transportation Integrated Search

1999-03-01

This report presents the findings from speed studies before and after implementation of the double-fine law in Texas, as well as citation and fine data from those study sites. Also included in the report is an assessment of other legislation that cou...

Advanced batteries for electric vehicles : an assessment of performance, cost, and availability [Draft

DOT National Transportation Integrated Search

2000-06-22

This report documents the findings of a study undertaken to investigate batteries for use in electric vehicles. Batteries studied include lead-acid batteries, nickel-metal hydride batteries, lithium-ion electric vehicle batteries, and lithium-metal p...

Where to find weather and climatic data for forest research studies and management planning.

Treesearch

Donald A. Haines

1977-01-01

Forest-range research or operational study designs should include the possible effects of weather and climate. This document describes the meteorological observational networks, the data available from them, and where the information is stored.

Turkish Primary Students' Perceptions of Geography

ERIC Educational Resources Information Center

Senyurt, Secil

2014-01-01

This study provides an in-depth investigation of Turkish primary school students' perceptions of geography. Gender differences in students' perceptions of geography were investigated, including definitions of geography and its field of study. The findings showed that "landforms," "our geographical regions/Turkey,"…

Hypertrophic lichen sclerosus sine sclerosis: clues to histopathologic diagnosis when presenting as psoriasiform lichenoid dermatitis.

PubMed

Weyers, Wolfgang

2015-02-01

The histopathologic diagnosis of lichen sclerosus (LS) is usually facilitated by a subepidermal zone of sclerosis. In the absence of sclerosis, LS mostly presents itself as a psoriasiform lichenoid dermatitis that may be difficult to distinguish from other diseases. We sought to assess histopathologic findings that allow recognition of LS in the absence of sclerosis. We studied 28 criteria in 100 biopsy specimens of LS from genital or perianal skin, including 55 cases with marked sclerosis, 16 cases with mild sclerosis confined to foci of the papillary dermis and 29 cases without sclerosis. Fifteen cases each of the early plaque stage of mycosis fungoides, lichen planus and lichen simplex chronicus were studied for comparison. Some histopathologic hallmarks of LS were seen chiefly in sclerotic lesions and, therefore, did not contribute to the diagnosis of difficult cases, such as dissolution of elastic fibers. Others were seen rarely in non-sclerotic lesions but might be helpful in individual cases, including follicular hyperkeratosis and thickening of the basement membrane. Findings that were more common and may be utilized as clues to the histopathologic diagnosis of non-sclerotic LS include tiny foci of homogenized tissue in dermal papillae, marked fibrosis with thickening of the papillary dermis, marked thickening of individual collagen fibers, lymphocytes aligned in rows between those fibers, necrotic keratinocytes, often with preserved pyknotic nuclei, in all reaches of the epidermis, including the cornified layer, clustering of necrotic keratinocytes above elongated dermal papillae and vertical columns of parakeratosis with distinct dyskeratotic parakeratotic cells. In the absence of sclerosis, histopathologic diagnosis of LS depends on findings that are less distinctive. Nonetheless, a constellation of those findings allows a specific diagnosis to be made. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Benefits of sensory garden and horticultural activities in dementia care: a modified scoping review.

PubMed

Gonzalez, Marianne T; Kirkevold, Marit

2014-10-01

To provide a review on the benefits associated with the use of sensory gardens and horticultural activities in dementia care. Maintaining quality of life is important in dementia care. Sensory gardens and horticultural activities are increasingly used in dementia care, yet their benefits are uncertain. A modified scoping review with descriptive analysis of selected empirical studies. Systematic searches in Amed, CINAHL, MEDLINE, ISI Web of Science, Embase and Scopus were used. Search terms were the free-text concepts 'healing garden', 'horticultural therapy', 'restorative garden' and 'wander garden' which were combined with dementia and Alzheimer. Sixteen studies were included with included participants ranging from eight to 129 participants. Research designs were case studies (n = 2), survey (n = 1), intervention studies with pretest/post-test design (n = 11) and randomised controlled studies (n = 2). Of these 16 studies, eight examined the benefits of sensory gardens, seven examined horticultural therapy or therapeutic horticulture and one examined the use of plants indoors. This study offers a review of the research addressing benefits of sensory gardens, therapeutic horticulture, horticultural therapy and other purposeful use of plants in dementia care. The reported findings are mainly on issues related to behaviour, affect and well-being. The findings are in general mutually supportive, however, with some contradictory findings. In addition, sleep pattern, well-being and functional level seem to improve. These types of nonpharmacological interventions may improve well-being and affect and reduce the occurrence of disruptive behaviour. Additionally, the use of psychotropic drugs, incidents of serious falls, sleep and sleep pattern also seem to improve. To further improve the use of the existing or planned gardens, an educational programme for staff that also includes skill training is recommended. © 2013 John Wiley & Sons Ltd.

A qualitative study of primary care professionals’ views of case finding for depression in patients with diabetes or coronary heart disease in the UK

PubMed Central

2013-01-01

Background Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Methods Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. Results We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. Conclusion The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case finding/screening. PMID:23557512

Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia.

PubMed

Ebrahimzadeh, Azadeh; Mohammadifard, Mahyar; Naseh, Godratallah; Mirgholami, Alireza

2015-01-01

Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. This study was performed to derive practical criteria for performing chest radiographs for the evaluation of community-acquired pneumonia (CAP). A total of 420 patients with acute respiratory symptoms and positive findings on chest radiograph were evaluated from December 2008 to December 2009. The subjects were referred to outpatient clinics or emergency departments of Birjand's medical university hospitals, Iran, and were enrolled as positive cases. A checklist was completed for each patient including their demographic information, clinical signs and symptoms (cough, sputum production, dyspnea, chest pain, fever, tachycardia, and tachypnea), abnormal findings in pulmonary auscultation and laboratory findings (erythrocyte sedimentation rate, C-reactive protein levels, and white blood cell count). An equal number of age-matched individuals with acute respiratory symptoms, but insignificant findings on chest radiography, were included as the control group. Finally, the diagnostic values of different findings were compared. The data showed that vital signs and physical examination findings are useful screening parameters for predicting chest radiograph findings in outpatient settings. Therefore, by implementing a prediction rule, we would be able to determine which patients would benefit from a chest X-Ray (sensitivity, 94% and specificity, 57%). This study's findings suggest that requesting chest radiographs might not be necessary in patients with acute respiratory symptoms unless the vital signs and/or physical examination findings are abnormal. Considering the 94% sensitivity of this rule for predicting CAP, a chest radiograph is required for patients with unreliable follow-ups or moderate to high likelihood of morbidity if CAP is not initially detected.

A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK.

PubMed

Maxwell, Margaret; Harris, Fiona; Hibberd, Carina; Donaghy, Eddie; Pratt, Rebekah; Williams, Chris; Morrison, Jill; Gibb, Jennifer; Watson, Philip; Burton, Chris

2013-04-04

Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case finding/screening.

Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview.

PubMed

Alotaibi, Abdulellah; Perry, Lin; Gholizadeh, Leila; Al-Ganmi, Ali

2017-12-01

This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990-2015). A descriptive review. A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia. Copyright © 2017. Published by Elsevier Ltd.

Factors affecting recruitment into depression trials: Systematic review, meta-synthesis and conceptual framework.

PubMed

Hughes-Morley, Adwoa; Young, Bridget; Waheed, Waquas; Small, Nicola; Bower, Peter

2015-02-01

Depression is common and clinical trials are crucial for evaluating treatments. Difficulties in recruiting participants into depression trials are well-documented, yet no study has examined the factors affecting recruitment. This review aims to identify the factors affecting recruitment into depression trials and to develop a conceptual framework through systematic assessment of published qualitative research. Systematic review and meta-synthesis of published qualitative studies. Meta-synthesis involves a synthesis of themes across a number of qualitative studies to produce findings that are "greater than the sum of the parts". ASSIA, CINAHL, Embase, Medline and PsychInfo were searched up to April 2013. Reference lists of included studies, key publications and relevant reviews were also searched. Quality appraisal adopted the "prompts for appraising qualitative research". 7977 citations were identified, and 15 studies were included. Findings indicate that the decision to enter a depression trial is made by patients and gatekeepers based on the patient׳s health state at the time of being approached to participate; on their attitude towards the research and trial interventions; and on the extent to which patients become engaged with the trial. Our conceptual framework highlights that the decision to participate by both the patient and the gatekeeper involves a judgement between risk and reward. Only English language publications were included in this review. Findings from this review have implications for the design of interventions to improve recruitment into depression trials. Such interventions may aim to diminish the perceived risks and increase the perceived rewards of participation. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Parents, Peers, and Social Withdrawal in Childhood: A Relationship Perspective

PubMed Central

Rubin, Kenneth H.; Root, Amy Kennedy; Bowker, Julie

2013-01-01

In this chapter, the authors review the history of the Waterloo Longitudinal Project (WLP), the first longitudinal study (1980–1992) dedicated to the study of social withdrawal, its correlates, and consequences. Theories underlying the WLP are described, as are its empirical findings. Recent research from other labs that has extended the findings of the original WLP is briefly described. The authors’ research that draws on the findings of WLP are noted as well. An underlying theme in this work is that relationships (and interactions) with parents and friends can serve as protective or exacerbating factors in the developmental course of social withdrawal and its concomitants (including social anxiety). PMID:20205181

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

PubMed Central

Otani, Hideji; Tanaka, Tomonori; Murata, Kiyoshi; Fukuoka, Junya; Nitta, Norihisa; Nagatani, Yukihiro; Sonoda, Akinaga; Takahashi, Masashi

2016-01-01

Purpose To evaluate the incidence and pathologic correlation of thin-section computed tomography (TSCT) findings in smoking-related interstitial fibrosis (SRIF) with pulmonary emphysema. Patients and methods Our study included 172 consecutive patients who underwent TSCT and subsequent lobectomy. TSCT findings including clustered cysts with visible walls (CCVW) and ground-glass attenuation with/without reticulation (GGAR) were evaluated and compared in nonsmokers and smokers and among lung locations. TSCT findings, especially CCVW, were also compared with histological findings using lobectomy specimens. Results The incidence of CCVW and GGAR was significantly higher in smokers than in nonsmokers (34.1% and 40.7%, respectively, vs 2.0% and 12.2%). CCVW and GGAR were frequently found in the lower and peripheral zones. Histologically, CCVW corresponded more often with SRIF with emphysema than usual interstitial pneumonia (UIP, 63.3% vs 30%). CCVW of irregular size and shape were seen in 19 of 20 SRIF with emphysema and in seven of nine UIP-manifested areas with similar round cysts. A less-involved subpleural parenchyma was observed more frequently in SRIF with emphysema. Conclusion SRIF with emphysema is a more frequent pathological finding than UIP in patients with CCVW on TSCT. The irregular size and shape of CCVW and a less-involved subpleural parenchyma may be a clue suggesting the presence of SRIF with emphysema. PMID:27445472

Simulation of multiple personalities: a review of research comparing diagnosed and simulated dissociative identity disorder.

PubMed

Boysen, Guy A; VanBergen, Alexandra

2014-02-01

Dissociative Identity Disorder (DID) has long been surrounded by controversy due to disagreement about its etiology and the validity of its associated phenomena. Researchers have conducted studies comparing people diagnosed with DID and people simulating DID in order to better understand the disorder. The current research presents a systematic review of this DID simulation research. The literature consists of 20 studies and contains several replicated findings. Replicated differences between the groups include symptom presentation, identity presentation, and cognitive processing deficits. Replicated similarities between the groups include interidentity transfer of information as shown by measures of recall, recognition, and priming. Despite some consistent findings, this research literature is hindered by methodological flaws that reduce experimental validity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Balance across contexts: importance of balanced need satisfaction across various life domains.

PubMed

Milyavskaya, Marina; Gingras, Isabelle; Mageau, Geneviève A; Koestner, Richard; Gagnon, Hugo; Fang, Jianqun; Boiché, Julie

2009-08-01

Self-determination theory posits that satisfaction of three basic psychological needs-autonomy, competence, and relatedness-are required for psychological well-being, and a recent study showed that the balance in the satisfaction of these three needs independently affects well-being. The present investigation builds on these findings by examining the balance of adolescents' need satisfaction across distinct life contexts. The results of three studies show that adolescents who experience a balance of need satisfaction across important life contexts, including at school, at home, with friends, and in part-time jobs, reported higher well-being and better school adjustment. This finding emerged consistently across four countries and across multiple measures of school adjustment, including teacher reports. Together, these results support previous research that highlights the importance of consistency for psychological functioning.

Mathematical modeling of fluid-electrolyte alterations during weightlessness

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1984-01-01

Fluid electrolyte metabolism and renal endocrine control as it pertains to adaptation to weightlessness were studied. The mathematical models that have been particularly useful are discussed. However, the focus of the report is on the physiological meaning of the computer studies. A discussion of the major ground based analogs of weightlessness are included; for example, head down tilt, water immersion, and bed rest, and a comparison of findings. Several important zero g phenomena are described, including acute fluid volume regulation, blood volume regulation, circulatory changes, longer term fluid electrolyte adaptations, hormonal regulation, and body composition changes. Hypotheses are offered to explain the major findings in each area and these are integrated into a larger hypothesis of space flight adaptation. A conceptual foundation for fluid electrolyte metabolism, blood volume regulation, and cardiovascular regulation is reported.

Atmospheric numerical modeling resource enhancement and model convective parameterization/scale interaction studies

NASA Technical Reports Server (NTRS)

Cushman, Paula P.

1993-01-01

Research will be undertaken in this contract in the area of Modeling Resource and Facilities Enhancement to include computer, technical and educational support to NASA investigators to facilitate model implementation, execution and analysis of output; to provide facilities linking USRA and the NASA/EADS Computer System as well as resident work stations in ESAD; and to provide a centralized location for documentation, archival and dissemination of modeling information pertaining to NASA's program. Additional research will be undertaken in the area of Numerical Model Scale Interaction/Convective Parameterization Studies to include implementation of the comparison of cloud and rain systems and convective-scale processes between the model simulations and what was observed; and to incorporate the findings of these and related research findings in at least two refereed journal articles.

Topical Review: Integrating Findings on Direct Observation of Family Communication in Studies Comparing Pediatric Chronic Illness and Typically Developing Samples.

PubMed

Murphy, Lexa K; Murray, Caitlin B; Compas, Bruce E

2017-01-01

To review research on observed family communication in families with children with chronic illnesses compared with families with healthy, typically developing children, and to integrate findings utilizing a unifying family communication framework. Topical review of studies that have directly observed family communication in pediatric populations and included a typically developing comparison group. Initial findings from 14 studies with diverse approaches to quantifying observed family communication suggest that families with children with chronic illnesses may demonstrate lower levels of warm and structured communication and higher levels of hostile/intrusive and withdrawn communication compared with families with healthy, typically developing children. An integrative framework of family communication may be used in future studies that examine the occurrence, correlates, and mechanisms of family communication in pediatric populations.

Experimental Evidence for Diagramming Benefits in Science Writing

ERIC Educational Resources Information Center

Barstow, Brendan; Fazio, Lisa; Schunn, Christian; Ashley, Kevin

2017-01-01

Arguing for the need for a scientific research study (i.e. writing an introduction to a research paper) poses significant challenges for students. When faced with these challenges, students often generate overly safe replications (i.e. fail to find and include opposition to their hypothesis) or in contrast include no strong support for their…

Applying Minimal Manual Principles for Documentation of Graphical User Interfaces.

ERIC Educational Resources Information Center

Nowaczyk, Ronald H.; James, E. Christopher

1993-01-01

Investigates the need to include computer screens in documentation for software using a graphical user interface. Describes the uses and purposes of "minimal manuals" and their principles. Studies student reaction to their use of one of three on-screen manuals: screens, icon, and button. Finds some benefit for including icon and button…

Social Outcomes Associated with Media Viewing Habits of Low-Income Preschool Children

ERIC Educational Resources Information Center

Conners-Burrow, Nicola A.; McKelvey, Lorraine M.; Fussell, Jill J.

2011-01-01

Research Findings: The purpose of this study was to examine the relationship between preschool children's social outcomes in the classroom (including hyperactivity, aggression, and social skills) and their media viewing habits (including the amount of television they watch and whether they watch videos/movies that are rated as inappropriate for…

Child Care Teachers' Perspectives on Including Children with Challenging Behavior in Child Care Settings

ERIC Educational Resources Information Center

Quesenberry, Amanda C.; Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Hamann, Kira

2014-01-01

In this study, 9 teachers from 5 child care centers were interviewed to examine their perceptions on including children with challenging behavior in their classrooms. The findings provide a firsthand view into how child care teachers support children's social and emotional development and address challenging behavior. Results confirm previous…

A Collection of NIDA NOTES. Articles That Address Research on Heroin.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

Included in this document are selections of topic-specific articles on heroin research reprinted from the National Institute on Drug Abuses (NIDA) research newsletter, NIDA Notes. Titles include: Buprenorphine Taken Three Times Per Week Is as Effective as Daily Doses in Treating Heroin Addiction; 33-Year Study Finds Lifelong, Lethal Consequences…

Transmitting Success: Comprehensive Peer Mentoring for At-Risk Students in Developmental Math

ERIC Educational Resources Information Center

Morales, Erik E.; Ambrose-Roman, Sarah; Perez-Maldonado, Rosa

2016-01-01

This study presents and assesses a developmental math focused peer mentoring program at a public urban university. Over three semesters 45 mentees participated in the program. Results include substantive increases in developmental pass rates as well as increases in self-efficacy and social integration. Other noteworthy findings include the…

The Adoption and Rejection of Innovations by Strawberry Growers in the Lower Fraser Valley.

ERIC Educational Resources Information Center

Alleyne, E. Patrick; Verner, Coolie

The study investigated the adoption behavior of 100 strawberry growers (including 32 Mennonites and 23 Japanese) in the lower Fraser Valley of British Columbia. Adoption of six selected practices was examined in relation to socioeconomic characteristics and ethnicity. Findings included the following: (1) ethnic groups differed significantly on…

Why Teachers Find It Difficult to Include Students with EBD in Mainstream Classes

ERIC Educational Resources Information Center

Gidlund, Ulrika

2018-01-01

In Sweden, teachers in mainstream schools show frustration and insecurity about how to organise education for inclusion and diversity. This article contributes to the understanding of how they articulate their view of the advantages and disadvantages of including students with EBD in mainstream classes. To study teachers' understanding, an…

Internal Consistency of the easyCBM© CCSS Reading Measures: Grades 3-8. Technical Report #1407

ERIC Educational Resources Information Center

Guerreiro, Meg; Alonzo, Julie; Tindal, Gerald

2014-01-01

This technical report documents findings from a study of the internal consistency and split-half reliability of the easyCBM© CCSS Reading measures, grades 3-8. Data, drawn from an extant data set gathered in school year 2013-2014, include scores from over 150,000 students' fall and winter benchmark assessments. Findings suggest that the easyCBM©…

Contruction worker profile. community report--Center, North Dakota

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

Chalmers, J.A.; Glazner, J.

Center, North Dakota is one of the currently affected communities included in the study to help us learn something of the effects which large-scale construction projects have on small communities. The findings of the Project Survey, which was conducted at the Milton R. Young and Leland Olds Power plants, along with the findings of the Household Survey and the Community Survey, are presented.

Endoscopy of the upper gastrointestinal tract as a diagnostic tool for children with human immunodeficiency virus infection.

PubMed

Miller, T L; McQuinn, L B; Orav, E J

1997-05-01

The purpose of this study was to determine the prevalence of upper gastrointestinal tract lesions in children with human immunodeficiency virus (HIV) infection who undergo endoscopy of the upper gastrointestinal tract and to identify important clinical predictors of abnormal endoscopic results. All HIV-infected children who underwent endoscopy and were followed at Children's Hospital, Boston, from January 1985 to August 1994 were studied. The main outcome measure was endoscopic results, which were categorized into observational, histologic, and microbiologic findings. Potential predictors included height, weight, nutritional interventions, HIV disease stage, CD4 T-lymphocyte count, medications, active infections, and indications for endoscopy. Forty-three endoscopies in unique patients are reported. Most children had advanced HIV infection (67% acquired immunodeficiency syndrome, mean CD4 T-lymphocyte count z score = -2.71, weight z score = -2.04). An abnormal endoscopic finding was discovered in 93% of children and confirmed by histologic, microbiologic, or a combination of these studies in 72% of children. Thirty-five percent of children had an opportunistic pathogen identified endoscopically; 65% of these pathogens were previously undiagnosed. Observational findings often were poor indicators of histologic and microbiologic abnormalities. Independent predictors of abnormal histologic findings include younger age at endoscopy (odds ratio (OR) = 1.16 per year, 95% confidence interval (CI) (1.02, 1.33)) and guaiac-negative stools (OR = 16.7, 95% CI (1.92, 142.9)). Independent predictors of finding a pathogen at the time of endoscopy include a greater number of indications for endoscopy (OR = 2.6 per indication, 95% CI (1.3, 5.3)) and diagnosis of acquired immunodeficiency syndrome (OR = 16.4, 95% CI (1.3, 213)). No other gastrointestinal, nutritional, or immunologic parameters were significantly predictive of endoscopic outcomes. Medical management was changed in 70% of children because of the endoscopic findings. Endoscopy is a useful tool to direct therapy against peptic and infectious disorders of the upper gastrointestinal tract in children with HIV infection. Specific gastrointestinal symptoms are not useful predictors of abnormal results.

Psychological adaptation and salutogenesis in space: Lessons from a series of studies

NASA Astrophysics Data System (ADS)

Ritsher, J. B.; Kanas, N. A.; Ihle, E. C.; Saylor, S. A.

2007-02-01

Individuals who adapt positively to an inhospitable or extreme environment can derive benefit from their experiences. This positive effect may include an initial improvement in mental health as someone adjusts to the environment (adaptation) as well as more sustained personal growth during the mission (salutogenesis). We review relevant findings from our prior work, including two post-mission surveys of astronauts and cosmonauts, and three studies of crewmembers during missions in a space station simulator, the Mir space station, and the International Space Station (ISS). We also present new analyses showing evidence for adaptation to ISS missions. This finding replicates our previous results from the simulation study, but this effect was not found on the Mir. A better understanding of psychological adaptation and salutogenesis during space flight should help us develop strategies to enhance crewmembers' in-flight stress tolerance and post-flight adjustment.

Uses and Misuses of Ted Kaczynski's MMPI.

PubMed

Ben-Porath, Yossef S

2018-05-22

Although case studies can be a helpful didactic aid when teaching personality assessment and illustrating use of a test, they can, of course, not be used as "evidence" that a test "works" or does not work. This article, however, reviews and discusses the far more problematic uses instantiated in a case study of Ted Kaczynski's Minnesota Multiphasic Personality Inventory (MMPI). A series of errors of omission and commission are identified in Butcher, Hass, Greene, and Nelson's ( 2015 ) effort to criticize the MMPI-2-RF. These include not disclosing that Butcher's interpretive Minnesota Report for Forensic Settings indicates that the protocol is invalid, not including most of the MMPI-2 and MMPI-2-RF scores that contradict the authors' assertions, and mischaracterizing the MMPI-2-RF findings. Proper use of a case study is then illustrated by a discussion of diagnostic considerations indicated by the MMPI-2-RF findings.

Incidence of Propionibacterium acnes in initially culture-negative thioglycollate broths-a prospective cohort study at a Danish University Hospital.

PubMed

Kvich, L; Jensen, P Ø; Justesen, U S; Bjarnsholt, T

2016-11-01

The aim of this study was to prospectively investigate the incidence of Propionibacterium acnes in thioglycollate broths reported as culture-negative at the Department of Clinical Microbiology, Rigshospitalet, to evaluate whether 5 days of incubation was enough to find all relevant cases. Five hundred thioglycollate broths reported as culture-negative after 5 days were consecutively collected and incubated for at least a further 9 days (at least 14 days of incubation in total). Only tissue samples from sterile sites of the body (n = 298), bone tissue (n = 197) and foreign material (n = 5) were included in this study. Samples were divided into two groups: infected group and control group. This made it possible to compare findings between groups, thereby making it possible to estimate the level of true-positive findings and contamination. Samples from 296 participants were included in this study. After exclusion criteria were met, P. acnes was cultured from ten out of 151 patients (6.6%) in the infected group and from one out of 138 participants (0.7%) in the control group. This resulted in more findings of P. acnes in the infected group on day 14 than on day 5 (p 0.002). Furthermore, P. acnes was cultured more often from bone tissue and tissue surrounding foreign materials on day 14 than on day 5 (p 0.04). Clinical microbiology laboratories should consider incubating thioglycollate broths for at least 14 days to find all relevant cases of P. acnes, especially when it comes to bone tissue and tissue surrounding foreign materials. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Smoking and Body Weight: Evidence using Genetic Instruments

PubMed Central

Wehby, George; Murray, Jeffrey C.; Wilcox, Allen; Lie, Rolv T.

2011-01-01

Several studies have evaluated whether the high and rising obesity rates over the past three decades may be due to the declining smoking rates. There is mixed evidence across studies – some find negative smoking effects and positive cigarette cost effects on body weight, while others find opposite effects. This study applies a unique approach to identify the smoking effects on body weight and to evaluate the heterogeneity in these effects across the body mass index (BMI) distribution by utilizing genetic instruments for smoking. Using a data sample of 1,057 mothers from Norway, the study finds heterogeneous effects of cigarette smoking on BMI – smoking increases BMI at low/moderate BMI levels and decreases BMI at high BMI levels. The study highlights the potential advantages and challenges of employing genetic instrumental variables to identify behavior effects including the importance of qualifying the instruments and the need for large samples. PMID:22024417

Neuroimaging and Other Biomarkers for Alzheimer's Disease: The Changing Landscape of Early Detection

PubMed Central

Risacher, Shannon L.; Saykin, Andrew J.

2014-01-01

The goal of this review is to provide an overview of biomarkers for Alzheimer's disease (AD), with emphasis on neuroimaging and cerebrospinal fluid (CSF) biomarkers. We first review biomarker changes in patients with late-onset AD, including findings from studies using structural and functional magnetic resonance imaging (MRI), advanced MRI techniques (diffusion tensor imaging, magnetic resonance spectroscopy, perfusion), positron emission tomography with fluorodeoxyglucose, amyloid tracers, and other neurochemical tracers, and CSF protein levels. Next, we evaluate findings from these biomarkers in preclinical and prodromal stages of AD including mild cognitive impairment (MCI) and pre-MCI conditions conferring elevated risk. We then discuss related findings in patients with dominantly inherited AD. We conclude with a discussion of the current theoretical framework for the role of biomarkers in AD and emergent directions for AD biomarker research. PMID:23297785

Do aftercare services reduce inpatient psychiatric readmissions?

PubMed Central

Foster, E M

1999-01-01

OBJECTIVE: To determine whether aftercare services reduce the likelihood that children and adolescents will be readmitted to inpatient psychiatric facilities. DATA SOURCES/STUDY SETTING: Analyses of data from the Fort Bragg Demonstration. Data were based on 204 sample individuals (children and adolescents), all of whom were discharged from inpatient facilities during the study period. STUDY DESIGN: These analyses use hazard modeling to examine the impact of aftercare services on the likelihood of readmission. Comparisons of individuals for whom the timing of aftercare services differ are adjusted for a wide range of individual characteristics, including client demographics, diagnosis, symptomatology, and psychosocial functioning. DATA COLLECTION/EXTRACTION METHODS: Detailed data on psychopathology, symptomatology, and psychosocial functioning were collected on individuals included in these analyses. This information was taken from structured diagnostic interviews and behavior checklists, including the Child Behavior Checklist and Diagnostic Interview Schedule for Children, completed by the child and his or her caretaker. Information on the use of mental health services was taken from insurance claims and a management information system, and was used to identify the period from discharge to readmission and to describe the client's use of outpatient therapy, case management, intermediate (or stepdown) services, and residential treatment centers during this period. PRINCIPAL FINDINGS/CONCLUSIONS: Using Cox models that allow for censoring and that include the use of aftercare services as time-varying covariates, we find that aftercare services generally do not influence the likelihood of inpatient readmission. For the lower middle class families included in this study, the estimated effect of aftercare is not statistically significant and has limited practical significance. When we look at specific forms of aftercare, we find that outpatient therapy has the largest effect and that stepdown services in intermediate settings have the smallest. We also identify family and individual characteristics that influence the likelihood of readmission. PMID:10445899

Effect of Reflexology to Depressive Symptoms in Women With Overactive Bladder.

PubMed

Aydin, Yasemin; Aslan, Ergul; Yalcin, Onay

2016-01-01

This study is to determine the effect of foot reflexology on the level of depression in women with OAB. Study findings included in the study showed foot reflexology as a part of OAB treatment relieved urinary and depressive symptoms and had a positive effect on quality of life.

25 CFR 225.22 - Approval of minerals agreements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... agreement. (1) The written findings shall include an environmental study which meets the requirements of..., studies, data or other information (other than the environmental study required by § 225.24) possessed by... interest of the Indian mineral owner; (2) The minerals agreement does not have adverse cultural, social, or...

25 CFR 225.22 - Approval of minerals agreements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... agreement. (1) The written findings shall include an environmental study which meets the requirements of..., studies, data or other information (other than the environmental study required by § 225.24) possessed by... interest of the Indian mineral owner; (2) The minerals agreement does not have adverse cultural, social, or...

A Critical Analysis of Research on the Overjustification Effect.

ERIC Educational Resources Information Center

Berkay, Paul James

This document examined studies of the overjustification effect. Many studies examining the phenomenon were conducted during the 1970s; findings appeared to be accepted without qualification. It is unclear whether researchers conducted the studies with the proper methodologies and interpreted results correctly. Such factors included the type of…

Designing Assessment into a Study Abroad Course

ERIC Educational Resources Information Center

Santanello, Cathy; Wolff, Laura

2008-01-01

One faces several challenges when designing an education abroad program. These include engaging non-traditional majors in study abroad experiences; facilitating learning activities that directly align with the learning goals of the courses; assessing specific learning outcomes; and finding ways to close the circle after the study abroad programs…

Political Science, The Judicial Process, and A Legal Education

ERIC Educational Resources Information Center

Funston, Richard

1975-01-01

Application of the behavioral approach to the study of the judicial process is examined including methodological approaches used, typical findings, and "behavioralists'" rejection of the case method of studying law. The author concludes that the behavioral approach to the study of judicial politics has not been substantially productive. (JT)

What Works Clearinghouse[TM] Reporting Guide for Study Authors

ERIC Educational Resources Information Center

What Works Clearinghouse, 2012

2012-01-01

This document provides guidance about how to describe studies and report their findings in a way that is clear, complete, and transparent. This document does not include information about how studies are judged against What Works Clearinghouse evidence standards. For information about What Works Clearinghouse evidence standards, please refer to…

NASA astronomical findings highlighted on This Week @NASA – January 8, 2016

NASA Image and Video Library

2016-01-08

New NASA astrophysics findings were highlighted at the 227th American Astronomical Society meeting, Jan. 4-8 in Kissimmee, Florida. The findings, which ranged from runaway stars to a burping galaxy, were made with the help of several NASA observation instruments, including the Spitzer Space Telescope, the Wide-field Infrared Survey Explorer, the Chandra X-ray Observatory, the Nuclear Spectroscopic Telescope Array and others. Also, Next space station crew preparing for mission, Economical new era of aviation, A new level of coral reef studies and more!

78 FR 48674 - Announcement of the IRIS Public Meeting Schedule for Calendar Years 2013 and 2014; Announcement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

...; methodological considerations that could affect the interpretation of or confidence in study results; and... summarizing key characteristics and findings from critical studies that EPA proposes to consider in..., screening studies for consideration, and selecting studies to include in evidence tables, are responsive to...

A Preliminary Investigation of the Empirical Validity of Study Quality Appraisal

ERIC Educational Resources Information Center

Cook, Bryan G.; Dupuis, Danielle N.; Jitendra, Asha K.

2017-01-01

When classifying the evidence base of practices, special education scholars typically appraise study quality to identify and exclude from consideration in their reviews unacceptable-quality studies that are likely biased and might bias review findings if included. However, study quality appraisals used in the process of identifying evidence-based…

An Investigation of Higher-Order Thinking Skills in Smaller Learning Community Social Studies Classrooms

ERIC Educational Resources Information Center

Fischer, Christopher; Bol, Linda; Pribesh, Shana

2011-01-01

This study investigated the extent to which higher-order thinking skills are promoted in social studies classes in high schools that are implementing smaller learning communities (SLCs). Data collection in this mixed-methods study included classroom observations and in-depth interviews. Findings indicated that higher-order thinking was rarely…

Cirrus and Polar Stratospheric Cloud Studies using CLAES Data

NASA Technical Reports Server (NTRS)

Mergenthaler, John L.; Douglass, A. (Technical Monitor)

2001-01-01

We've concluded a 3 year (Period of Performance- January 21, 1998 to February 28, 2001) study of cirrus and polar stratospheric clouds using CLAES (Cryogenic Limb Array Etalon Spectrometer) data. We have described the progress of this study in monthly reports, UARS (Upper Atmosphere Research Satellite) science team meetings, American Geophysical Society Meetings, refereed publications and collaborative publications. Work undertaken includes the establishment of CLAES cloud detection criteria, the refinement of CLAES temperature retrieval techniques, compare the findings of CLAES with those of other instruments, and present findings to the larger community. This report describes the progress made in these areas.

The increased risk of globus pharyngeus in patients with chronic thyroiditis: a case control study.

PubMed

Karahatay, S; Ayan, A; Aydin, U; Ince, S; Emer, O; Alagoz, E

2015-12-01

A correlation between globus pharyngeus and thyroid gland inflammation has been mentioned in previous studies. However, the potential risk of globus pharyngeus in chronic thyroiditis patients has not been shown so far. The aim of this study is to investigate a possible association between chronic thyroiditis and globus pharyngeus. The study was performed in an ultrasound (US) center of a tertiary health care institution. Ninety-two patients who were under examination for suspected thyroid pathologies or undergoing follow-up for a previously diagnosed thyroid disease were enrolled in the study. The patients were divided into two groups according to the existence of globus symptoms. Subsequently, all patients underwent high-resolution thyroid ultrasounds. The patients whose ultrasound findings were suggestive of chronic thyroiditis constituted the second subgroup. The demographic data of the patients and other ultrasound findings including the volume of the thyroid glands and nodules, if any, were noted as well. Sixty-seven female (73%) and 25 male (27%) patients were enrolled in the study. Thirty-two (35%) of the 92 patients constituted the globus pharyngeus group according to their responses to the questionnaire and the US findings were concordant with chronic thyroiditis in 36 (39%) patients. The correlation between chronic thyroiditis and globus sensation was significant (p = 0.004), and the odds ratio was calculated as 3.7 (95% CI = 1.5-9.11). Other parameters including age, sex, thyroid volume and nodule status were not significantly related to globus pharyngeus in this particular patient series. In the presented study, the risk of globus pharyngeus occurrence was calculated as 3.7-fold higher in patients with chronic thyroiditis. Being a preliminary report, it is necessary to confirm this finding and understand the pathophysiological mechanism via further investigations with a larger patient series.

Communication Strategy of Transboundary Air Pollution Findings in a US-Mexico Border XXI Program Project

NASA Astrophysics Data System (ADS)

Mukerjee, Shaibal

2002-01-01

From 1996 to 1997, the US Environmental Protection Agency (EPA) and the Texas Natural Resource Conservation Commission (TNRCC) conducted an air quality study known as the Lower Rio Grande Valley Transboundary Air Pollution Project (TAPP). The study was a US-Mexico Border XXI program project and was developed in response to local community requests on a need for more air quality measurements and concerns about the health impact of local air pollutants; this included concerns about emissions from border-dependent industries in Mexico, known as maquiladoras. The TAPP was a follow-up study to environmental monitoring done by EPA in this area in 1993 and incorporated scientific and community participation in development, review of results, and public presentation of findings. In spite of this, critical remarks were leveled by community activists against the study's preliminary "good news" findings regarding local air quality and the influence of transboundary air pollution. To resolve these criticisms and to refine the findings to address these concerns, analyses included comparisons of daily and near real-time measurements to TNRCC effects screening levels and data from other studies along with wind sector analyses. Reassessment of the data suggested that although regional source emissions occurred and outliers of elevated pollutant levels were found, movement of air pollution across the border did not appear to cause noticeable deterioration of air quality. In spite of limitations stated to the community, the TAPP was presented as establishing a benchmark to assess current and future transboundary air quality in the Valley. The study has application in Border XXI Program or other air quality studies where transboundary transport is a concern since it involved interagency coordination, public involvement, and communication of scientifically sound results for local environmental protection efforts.

Communication strategy of transboundary air pollution findings in a US-Mexico Border XXI program project.

PubMed

Mukerjee, Shaibal

2002-01-01

From 1996 to 1997, the US Environmental Protection Agency (EPA) and the Texas Natural Resource Conservation Commission (TNRCC) conducted an air quality study known as the Lower Rio Grande Valley Transboundary Air Pollution Project (TAPP). The study was a US-Mexico Border XXI program project and was developed in response to local community requests on a need for more air quality measurements and concerns about the health impact of local air pollutants; this included concerns about emissions from border-dependent industries in Mexico, known as maquiladoras. The TAPP was a follow-up study to environmental monitoring done by EPA in this area in 1993 and incorporated scientific and community participation in development, review of results, and public presentation of findings. In spite of this, critical remarks were leveled by community activists against the study's preliminary "good news" findings regarding local air quality and the influence of transboundary air pollution. To resolve these criticisms and to refine the findings to address these concerns, analyses included comparisons of daily and near real-time measurements to TNRCC effects screening levels and data from other studies along with wind sector analyses. Reassessment of the data suggested that although regional source emissions occurred and outliers of elevated pollutant levels were found, movement of air pollution across the border did not appear to cause noticeable deterioration of air quality. In spite of limitations stated to the community, the TAPP was presented as establishing a benchmark to assess current and future transboundary air quality in the Valley. The study has application in Border XXI Program or other air quality studies where transboundary transport is a concern since it involved interagency coordination, public involvement, and communication of scientifically sound results for local environmental protection efforts.

Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review.

PubMed

Shah, Sonal N; Bachur, Richard G; Simel, David L; Neuman, Mark I

2017-08-01

Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria. Two authors independently abstracted raw data and assessed methodological quality. A third author resolved disputes. Likelihood ratios (LRs), sensitivity, and specificity were calculated for individual symptoms and physical examination findings for the diagnosis of pneumonia. An infiltrate on chest radiograph was considered the reference standard for the diagnosis of pneumonia. Twenty-three prospective cohort studies of children (N = 13 833) with possible pneumonia were included (8 from North America), with a range of 78 to 2829 patients per study. The prevalence of radiographic pneumonia in North American studies was 19% (95% CI, 11%-31%) and 37% (95% CI, 26%-50%) outside of North America. No single symptom was strongly associated with pneumonia; however, the presence of chest pain in 2 studies that included adolescents was associated with pneumonia (LR, 1.5-5.5; sensitivity, 8%-14%; specificity, 94%-97%). Vital sign abnormalities such as fever (temperature >37.5°C [LR range, 1.7-1.8]; sensitivity, 80%-92%; specificity, 47%-54%) and tachypnea (respiratory rate >40 breaths/min; LR, 1.5 [95% CI, 1.3-1.7]; sensitivity, 79%; specificity, 51%) were not strongly associated with pneumonia diagnosis. Similarly, auscultatory findings were not associated with pneumonia diagnosis. The presence of moderate hypoxemia (oxygen saturation ≤96%; LR, 2.8 [95% CI, 2.1-3.6]; sensitivity, 64%; specificity, 77%) and increased work of breathing (grunting, flaring, and retractions; positive LR, 2.1 [95% CI, 1.6-2.7]) were signs most associated with pneumonia. The presence of normal oxygenation (oxygen saturation >96%) decreased the likelihood of pneumonia (LR, 0.47 [95% CI, 0.32-0.67]). Although no single finding reliably differentiates pneumonia from other causes of childhood respiratory illness, hypoxia and increased work of breathing are more important than tachypnea and auscultatory findings.

Thoughts on Expertise.

ERIC Educational Resources Information Center

Glaser, Robert

This paper briefly reviews research on tasks in knowledge-rich domains including developmental studies, work in artificial intelligence, studies of expert/novice problem solving, and information processing analysis of aptitude test tasks that have provided increased understanding of the nature of expertise. Particularly evident is the finding that…

Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening

MedlinePlus

... decrease the risk of dying from cancer. Scientists study screening tests to find those with the fewest risks and ... of cancer, including ovarian cancer, or other conditions. Studies have also shown that ... Screening tests have risks. The risks of ovarian, fallopian tube, ...

Multimodal Retinal Imaging in Incontinentia Pigmenti Including Optical Coherence Tomography Angiography: Findings From an Older Cohort With Mild Phenotype.

PubMed

Liu, Tin Yan Alvin; Han, Ian C; Goldberg, Morton F; Linz, Marguerite O; Chen, Connie J; Scott, Adrienne W

2018-05-01

Incontinentia pigmenti (IP) is a rare, X-linked dominant disease with potentially severe ocular complications that predominantly affect the peripheral retina. However, little is known about its effects on the macula. To describe the structural and vascular abnormalities observed in the maculas of patients with IP and to correlate these findings with peripheral pathologies. Prospective, cross-sectional study at Wilmer Eye Institute, Johns Hopkins University. Five participants with a clinical diagnosis of IP were included and underwent multimodal imaging with ultra-wide-field fluorescein angiography (FA), spectral-domain optical coherence tomography (OCT), and OCT angiography. The structural and vascular abnormalities observed on spectral-domain OCT and OCT angiography and their correlation with peripheral pathologies seen on ultra-wide-field FA. A total of 9 eyes from 5 patients (median age, 20.5 years; range, 8.4-54.2 years) were included. Median Snellen visual acuity was 20/32 (range, 20/16 to 20/63). ultra-wide-field FA-identified retinal vascular abnormalities in all 7 eyes in which FA was obtained. These abnormalities included microaneurysms, areas of nonperfusion, and vascular anastomoses, most of which were peripheral to the standard view of 30° FA with peripheral sweeps. Structural abnormalities were observed in 6 eyes on spectral-domain OCT, including inner retinal thinning and irregularities in the outer plexiform layer. Optical coherence tomography angiography abnormalities were noted in all 9 eyes, including decreased vascular density, abnormal vascular loops, and flow loss in the superficial and deep plexuses, which corresponded to areas of retinal thinning on spectral-domain OCT. Although our study is limited by the small sample size, the findings suggest that multimodal imaging is useful for detecting structural and vascular abnormalities that may not be apparent on ophthalmoscopy in patients with IP. Macular pathologies, especially a decrease in vascular density on OCT angiography, are common. Further studies are needed to characterize further the association between macular and peripheral abnormalities in patients with IP.

Sexual Dynamics of Married Women with Interpersonal Dependency: A Qualitative Study on Iranian Women.

PubMed

Sharifi, Marziye; Fatehizade, Maryam; Bahrami, Fatemeh; Jazayeri, Rezvan Alsadat; Etemadi, Ozra

2017-01-01

Considering the lack of documented research on the sexuality of dependent persons, this qualitative study examined sexual dynamics among Iranian married women with excessive interpersonal dependency. Interviews with 18 married women with high interpersonal dependency were coded using thematic analysis. Three major areas emerged from the data under which the themes clustered. These were (1) intrapersonal level which included confused sexual cognitions, intrusive thoughts during sex, preoccupation by sexual thoughts, low tolerance for reduction or interruption of sexual activity, and emotional distress during sex, (2) interactional dynamics including imposing pressure on the husband to have sex and assuming a submissive and receptive role during sex, and (3) contextual processes including social stigma and the effects of social phenomena. These findings presented a relatively clear understanding of the impacts of interpersonal dependency on the sexuality of Iranian women. The majority of the women reported maladaptive sexual strategies, attitudes, and emotions. Moreover, there were several similarities between the sexual dynamics of the women and those of individuals with anxious attachment style. These findings suffer from some limitations in terms of generalization due to the small size of the sample and clinical and cultural considerations. The implications of these findings for practitioners are also considered. © 2017 S. Karger AG, Basel.

Chronic gastritis in China: a national multi-center survey

PubMed Central

2014-01-01

Background Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. Methods A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Results Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. Conclusions The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy. PMID:24502423

Chronic gastritis in China: a national multi-center survey.

PubMed

Du, Yiqi; Bai, Yu; Xie, Pei; Fang, Jingyuan; Wang, Xiaozhong; Hou, Xiaohua; Tian, Dean; Wang, Chengdang; Liu, Yandi; Sha, Weihong; Wang, Bangmao; Li, Yanqing; Zhang, Guoliang; Li, Yan; Shi, Ruihua; Xu, Jianming; Li, Youming; Huang, Minghe; Han, Shengxi; Liu, Jie; Ren, Xu; Xie, Pengyan; Wang, Zhangliu; Cui, Lihong; Sheng, Jianqiu; Luo, Hesheng; Wang, Zhaohui; Zhao, Xiaoyan; Dai, Ning; Nie, Yuqiang; Zou, Yiyou; Xia, Bing; Fan, Zhining; Chen, Zhitan; Lin, Sanren; Li, Zhao-Shen

2014-02-07

Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.

Behavioral risk factors associated with listeriosis in the home: a review of consumer food safety studies.

PubMed

Evans, Ellen W; Redmond, Elizabeth C

2014-03-01

Listeria monocytogenes causes human listeriosis, which is associated with the highest hospitalization and mortality rates of all foodborne illnesses. In recent years, the incidence of listeriosis has doubled in Europe, almost exclusively among older adults (≥ 60 years of age). Food safety factors associated with increased risk of listeriosis include lack of adherence to "use by" dates and ineffective refrigerated storage of foods. Consequently, older adult consumers' implementation of safe food practices should be evaluated. This article is a review of consumer food safety cognitive and behavioral data relating to risk factors associated with listeriosis in the home as reported in 165 consumer food safety studies. Overall, only 41% of studies included assessment of consumer cognitive or behavioral data associated with listeriosis; of these studies 59% included data on safe refrigeration, 54% included data on storage time for opened ready-to-eat foods, and 49% included data on adherence to use-by dates. In most (83%) of the studies, survey-based data collection methods (questionnaires/interviews) were used; thus, the majority of findings were based on self-report (74%) and knowledge (44%). Observation (31%) and focus groups (12%) were less commonly used, resulting in a lack of actual behaviors and attitudinal data relating to listeriosis risk factors. Only 7% of studies included food safety data for older adults. Although older adults may fail to implement recommended practices, this review reveals a need for in-depth research to determine food safety attitudes and actual behaviors of older adults in conjunction with knowledge and selfreport of practices linked to increased risks of listeriosis. Such data combined with review findings would inform targeted food safety education to reduce risks associated with listeriosis in the home.

Management options for echogenic intracardiac focus and choroid plexus cysts: a review including Australian Association of Obstetrical and Gynaecological Ultrasonologists consensus statement.

PubMed

Bethune, M

2007-08-01

Echogenic intracardiac focus and choroid plexus cysts are common findings at the midtrimester ultrasound. These findings have been linked with an increased risk of Down syndrome and trisomy 18. Most fetuses with these findings will, however, not have chromosomal abnormalities, especially when these findings are isolated. Patients experience considerable anxiety when informed of these findings and require extensive counselling in order to minimize anxiety not only about aneuploidy but also about the structure and development of the heart and brain. Although early studies showed an association with aneuploidies, several recent studies have cast doubt on this association. Many of the early studies were carried out in high-risk populations or in populations that had not had the benefit of other screening tests. Many Australian and New Zealand patients will access screening tests designed to detect these aneuploidies before presenting for a midtrimester ultrasound. Patients who have been screened by nuchal translucency, maternal serum screening or some combination of the two will already have had most cases of Down syndrome and trisomy 18 detected, and any soft marker found will almost certainly be a false positive. It is time to rethink the management of these markers. Recent evidence indicates that if these markers are found in isolation in an otherwise low-risk pregnancy, then there is minimal or no increase in the risk of Down syndrome or trisomy 18: these markers should be considered normal variants. The Australian Association of Obstetrical and Gynaecological Ultrasonologists consensus statement on these markers is included.

Political violence and mental health: a multi-disciplinary review of the literature on Nepal.

PubMed

Tol, Wietse A; Kohrt, Brandon A; Jordans, Mark J D; Thapa, Suraj B; Pettigrew, Judith; Upadhaya, Nawaraj; de Jong, Joop T V M

2010-01-01

Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psychosocial wellbeing in Nepal. A systematic search of six databases resulted in the identification of 572 studies, of which 44 were included in the review. These studies investigated the influence of political violence on contextual variables that shape mental health and psychosocial wellbeing, and examined psychological distress and mental disorders in the context of political violence. The majority of studies addressed the mental health of Bhutanese refugees in Nepal and the impact of the Maoist People's War. Based upon these results from Nepal, we discuss a number of issues of concern to international researchers and practitioners and present policy and research recommendations. Specifically, we consider (a) the need for longitudinal multi-disciplinary research into protective and risk factors, including agency, of psychological distress and mental disorders in situations of political violence, (b) the continuing controversy regarding the PTSD construct, and (c) the lack of robust findings regarding the effectiveness of mental health and psychosocial support.

Testing the accuracy of redshift-space group-finding algorithms

NASA Astrophysics Data System (ADS)

Frederic, James J.

1995-04-01

Using simulated redshift surveys generated from a high-resolution N-body cosmological structure simulation, we study algorithms used to identify groups of galaxies in redshift space. Two algorithms are investigated; both are friends-of-friends schemes with variable linking lengths in the radial and transverse dimenisons. The chief difference between the algorithms is in the redshift linking length. The algorithm proposed by Huchra & Geller (1982) uses a generous linking length designed to find 'fingers of god,' while that of Nolthenius & White (1987) uses a smaller linking length to minimize contamination by projection. We find that neither of the algorithms studied is intrinsically superior to the other; rather, the ideal algorithm as well as the ideal algorithm parameters depends on the purpose for which groups are to be studied. The Huchra & Geller algorithm misses few real groups, at the cost of including some spurious groups and members, while the Nolthenius & White algorithm misses high velocity dispersion groups and members but is less likely to include interlopers in its group assignments. Adjusting the parameters of either algorithm results in a trade-off between group accuracy and completeness. In a companion paper we investigate the accuracy of virial mass estimates and clustering properties of groups identified using these algorithms.

Effects of Epilepsy on Language Functions: Scoping Review and Data Mining Findings.

PubMed

Dutta, Manaswita; Murray, Laura; Miller, Wendy; Groves, Doyle

2018-03-01

This study involved a scoping review to identify possible gaps in the empirical description of language functioning in epilepsy in adults. With access to social network data, data mining was used to determine if individuals with epilepsy are expressing language-related concerns. For the scoping review, scientific databases were explored to identify pertinent articles. Findings regarding the nature of epilepsy etiologies, patient characteristics, tested language modalities, and language measures were compiled. Data mining focused on social network databases to obtain a set of relevant language-related posts. The search yielded 66 articles. Epilepsy etiologies except temporal lobe epilepsy and older adults were underrepresented. Most studies utilized aphasia tests and primarily assessed single-word productions; few studies included healthy control groups. Data mining revealed several posts regarding epilepsy-related language problems, including word retrieval, reading, writing, verbal memory difficulties, and negative effects of epilepsy treatment on language. Our findings underscore the need for future specification of the integrity of language in epilepsy, particularly with respect to discourse and high-level language abilities. Increased awareness of epilepsy-related language issues and understanding the patients' perspectives about their language concerns will allow researchers and speech-language pathologists to utilize appropriate assessments and improve quality of care.

Pediatric bipolar disorder: validity, phenomenology, and recommendations for diagnosis

PubMed Central

Youngstrom, Eric A; Birmaher, Boris; Findling, Robert L

2013-01-01

Objective To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis. Methods The present qualitative review summarizes and synthesizes available evidence about the phenomenology of bipolar disorder (BD) in youths, including description of the diagnostic sensitivity and specificity of symptoms, clarification about rates of cycling and mixed states, and discussion about chronic versus episodic presentations of mood dysregulation. The validity of the diagnosis of BD in youths is also evaluated based on traditional criteria including associated demographic characteristics, family environmental features, genetic bases, longitudinal studies of youths at risk of developing BD as well as youths already manifesting symptoms on the bipolar spectrum, treatment studies and pharmacologic dissection, neurobiological findings (including morphological and functional data), and other related laboratory findings. Additional sections review impairment and quality of life, personality and temperamental correlates, the clinical utility of a bipolar diagnosis in youths, and the dimensional versus categorical distinction as it applies to mood disorder in youths. Results A schema for diagnosis of BD in youths is developed, including a review of different operational definitions of `bipolar not otherwise specified.' Principal areas of disagreement appear to include the relative role of elated versus irritable mood in assessment, and also the limits of the extent of the bipolar spectrum – when do definitions become so broad that they are no longer describing `bipolar' cases? Conclusions In spite of these areas of disagreement, considerable evidence has amassed supporting the validity of the bipolar diagnosis in children and adolescents. PMID:18199237

Exploring gender and culture with Khmer refugee women: reflections on participatory feminist research.

PubMed

Thompson, J L

1991-03-01

This article discusses the process and findings from a study based on the paradigm of feminist participatory research. The research is first discussed in relation to contemporary feminist scholarship. The project combined elements of community health nursing practice and feminist research in a support group with Khmer refugee women. The research explored psychosocial adjustment and the construction of gender among Khmer women. Methods of data collection included life history and trauma history interviews, discussion of dream narratives and Cambodian myths, and participant observation. Findings included four recurring themes identified in the women's stories. The research process is discussed in terms of its implications for nursing praxis.

Neuroimaging of Reading Intervention: A Systematic Review and Activation Likelihood Estimate Meta-Analysis

PubMed Central

Barquero, Laura A.; Davis, Nicole; Cutting, Laurie E.

2014-01-01

A growing number of studies examine instructional training and brain activity. The purpose of this paper is to review the literature regarding neuroimaging of reading intervention, with a particular focus on reading difficulties (RD). To locate relevant studies, searches of peer-reviewed literature were conducted using electronic databases to search for studies from the imaging modalities of fMRI and MEG (including MSI) that explored reading intervention. Of the 96 identified studies, 22 met the inclusion criteria for descriptive analysis. A subset of these (8 fMRI experiments with post-intervention data) was subjected to activation likelihood estimate (ALE) meta-analysis to investigate differences in functional activation following reading intervention. Findings from the literature review suggest differences in functional activation of numerous brain regions associated with reading intervention, including bilateral inferior frontal, superior temporal, middle temporal, middle frontal, superior frontal, and postcentral gyri, as well as bilateral occipital cortex, inferior parietal lobules, thalami, and insulae. Findings from the meta-analysis indicate change in functional activation following reading intervention in the left thalamus, right insula/inferior frontal, left inferior frontal, right posterior cingulate, and left middle occipital gyri. Though these findings should be interpreted with caution due to the small number of studies and the disparate methodologies used, this paper is an effort to synthesize across studies and to guide future exploration of neuroimaging and reading intervention. PMID:24427278

Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?

PubMed

Maglione, Jeanne E; Thomas, Scot E; Jeste, Dilip V

2014-05-01

To review recent literature about late-onset schizophrenia (LOS): schizophrenia with onset between ages 40 and 60 years. New findings are presented in the context of the previous literature. Newer studies continue to suggest that early-onset schizophrenia (EOS) and LOS share fundamental clinical features (i.e., positive symptoms, negative symptoms, functional deficits). One larger recent study confirmed earlier findings that LOS differs from EOS in several important ways, including predominance of women, lower severity of positive symptoms, and lower average antipsychotic dose requirement. However, this study did not find LOS patients were more likely to have the paranoid subtype or to have less severe negative symptoms compared with EOS patients. New neuroimaging and molecular studies are identifying possible differences in the underlying pathophysiology of EOS and schizophrenia developing in mid-life to late-life; however, more research is needed to confirm these findings and determine their significance. No studies evaluated treatment strategies specifically in LOS. LOS continues to be an understudied area. Recent studies add support to the idea that LOS may be a distinct subtype of schizophrenia. Studies designed to elucidate the pathophysiology of LOS in comparison with EOS and to assess treatment strategies in this population are needed.

A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries

PubMed Central

2013-01-01

Background This systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6–18 years) in school and community-based settings. Methods Searching a range of electronic databases, 22 studies employing RCTs (N = 11) and quasi-experimental designs conducted in LMICs since 2000 were identified. Fourteen studies of school-based interventions implemented in eight LMICs were reviewed; seven of which included interventions for children living in areas of armed conflict and six interventions of multicomponent lifeskills and resilience training. Eight studies evaluating out-of-school community interventions for adolescents were identified in five countries. Using the Effective Public Health Practice Project (EPHPP) criteria, two reviewers independently assessed the quality of the evidence. Results The findings from the majority of the school-based interventions are strong. Structured universal interventions for children living in conflict areas indicate generally significant positive effects on students’ emotional and behavioural wellbeing, including improved self-esteem and coping skills. However, mixed results were also reported, including differential effects for gender and age groups, and two studies reported nonsignficant findings. The majority of the school-based lifeskills and resilience programmes received a moderate quality rating, with findings indicating positive effects on students’ self-esteem, motivation and self-efficacy. The quality of evidence from the community-based interventions for adolescents was moderate to strong with promising findings concerning the potential of multicomponent interventions to impact on youth mental health and social wellbeing. Conclusions The review findings indicate that interventions promoting the mental health of young people can be implemented effectively in LMIC school and community settings with moderate to strong evidence of their impact on both positive and negative mental health outcomes. There is a paucity of evidence relating to interventions for younger children in LMIC primary schools. Evidence for the scaling up and sustainability of mental health promotion interventions in LMICs needs to be strengthened. PMID:24025155

Interrelationships of Hormones, Diet, Body Size and Breast Cancer Among Hispanic Women

DTIC Science & Technology

2006-09-01

faculty, and 2) to design and conduct a clinic-based case-control study to include completion of a questionnaire, anthropometry and a blood draw...clinic-based case- control study to include completion of a questionnaire, anthropometry and a blood draw, 3) to disseminate findings to the Texas...Psychosocial stress, coping and prostate cancer. Ethnicity Dis (In Press). Sanderson M, Coker AL, Perez A, Du XL , Peltz G, Fadden MK. A

Sex Work and Mental Health: A Study of Women in the Netherlands.

PubMed

Krumrei-Mancuso, Elizabeth J

2017-08-01

This study examined how characteristics of prostitution and quality-of-life factors related to symptoms of depression and post-traumatic stress among 88 women engaged in prostitution in the Netherlands. Numerous factors were associated with elevated mental health concerns, including the experience of violence in prostitution, engaging in street prostitution, being motivated to engage in prostitution for financial reasons, having less confidence in one's ability to find alternative work, desiring to leave prostitution, and sense of self-transcendence. In contrast, focusing on achievement, having a sense of fair treatment from others and society, and self-acceptance were associated with better mental health outcomes. Finally, mediation analyses indicated that post-traumatic stress associated with engaging in prostitution against one's deeper desire to exit prostitution was, in part, the result of a lack of self-acceptance. The analyses controlled for relevant demographic factors, including age and level of education. The effect sizes for each of the findings ranged from medium to large. Implications for mental health care and public policy are included.

Adaptive and Maladaptive Means of Using Facebook: A Qualitative Pilot Study to Inform Suggestions for Development of a Future Intervention for Depression.

PubMed

Tran, Tanya B; Uebelacker, Lisa; Wenze, Susan J; Collins, Caitlin; Broughton, Monica K

2015-11-01

Existing literature examining the relation between social networking sites and mental health is primarily based on correlational methods and presents mixed findings. Many researchers neglect to examine the cognitive and behavioral processes used while online. This study's qualitative approach strives to understand how individuals with elevated depressive symptoms may use Facebook following an interpersonal stressor. Participants' narration of their Facebook use was coded. Common adaptive uses included using Facebook to seek social support, actively communicate, distract, recall positive memories, and reappraise negative thoughts. Maladaptive uses included engaging in social comparison, ruminating, and recalling negative memories. Feedback regarding development of a future intervention was also elicited. Suggestions included using Facebook to view positive, interesting, or meaningful information, distract, garner social support, and engage in social activities. Findings indicate that how one engages with Facebook after an interpersonal stressor may affect adjustment and may help to inform the development of a novel, Facebook-based intervention.

Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis

PubMed Central

Garcia-Larsen, Vanessa; Jarrold, Katharine; Chivinge, Jennifer; Robinson, Zoe; Geoghegan, Natalie; Ruparelia, Alisha; Devani, Pooja; Leonardi-Bee, Jo

2018-01-01

Background There is uncertainty about the influence of diet during pregnancy and infancy on a child’s immune development. We assessed whether variations in maternal or infant diet can influence risk of allergic or autoimmune disease. Methods and findings Two authors selected studies, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings. We searched Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) between January 1946 and July 2013 for observational studies and until December 2017 for intervention studies that evaluated the relationship between diet during pregnancy, lactation, or the first year of life and future risk of allergic or autoimmune disease. We identified 260 original studies (964,143 participants) of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies (542,672 participants) of other maternal or infant dietary exposures, including 80 trials of maternal (n = 26), infant (n = 32), or combined (n = 22) interventions. Risk of bias was high in 125 (48%) milk feeding studies and 44 (25%) studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with nonpathogenic micro-organisms (probiotics) during late pregnancy and lactation may reduce risk of eczema (Risk Ratio [RR] 0.78; 95% CI 0.68–0.90; I2 = 61%; Absolute Risk Reduction 44 cases per 1,000; 95% CI 20–64), and 6 trials suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitisation to egg (RR 0.69, 95% CI 0.53–0.90; I2 = 15%; Absolute Risk Reduction 31 cases per 1,000; 95% CI 10–47). GRADE certainty of these findings was moderate. We found weaker support for the hypotheses that breastfeeding promotion reduces risk of eczema during infancy (1 intervention trial), that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus (28 observational studies), and that probiotics reduce risk of allergic sensitisation to cow’s milk (9 intervention trials), where GRADE certainty of findings was low. We did not find that other dietary exposures—including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake—influence risk of allergic or autoimmune disease. For many dietary exposures, data were inconclusive or inconsistent, such that we were unable to exclude the possibility of important beneficial or harmful effects. In this comprehensive systematic review, we were not able to include more recent observational studies or verify data via direct contact with authors, and we did not evaluate measures of food diversity during infancy. Conclusions Our findings support a relationship between maternal diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively. PMID:29489823

What works in family planning interventions: A systematic review of the evidence

PubMed Central

Mwaikambo, Lisa; Speizer, Ilene S.; Schurmann, Anna; Morgan, Gwen; Fikree, Fariyal

2013-01-01

This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions. PMID:21834409

You and Your Endocrinologist

MedlinePlus

... Find an Endocrinologist Search You and Your Endocrinologist Endocrinology is the study of medicine that relates to ... an endocrinologist include: Thyroid imaging and analysis Clinical endocrinology Endocrinology and genetics Molecular endocrinology concepts Endocrine tumors ...

Imaging genetics paradigms in depression research: Systematic review and meta-analysis.

PubMed

Pereira, Lícia P; Köhler, Cristiano A; Stubbs, Brendon; Miskowiak, Kamilla W; Morris, Gerwyn; de Freitas, Bárbara P; Thompson, Trevor; Fernandes, Brisa S; Brunoni, André R; Maes, Michael; Pizzagalli, Diego A; Carvalho, André F

2018-05-17

Imaging genetics studies involving participants with major depressive disorder (MDD) have expanded. Nevertheless, findings have been inconsistent. Thus, we conducted a systematic review and meta-analysis of imaging genetics studies that enrolled MDD participants across major databases through June 30th, 2017. Sixty-five studies met eligibility criteria (N = 4034 MDD participants and 3293 controls), and there was substantial between-study variability in the methodological quality of included studies. However, few replicated findings emerged from this literature with only 22 studies providing data for meta-analyses (882 participants with MDD and 616 controls). Total hippocampal volumes did not significantly vary in MDD participants or controls carrying either the BDNF Val66Met 'Met' (386 participants with MDD and 376 controls) or the 5-HTTLPR short 'S' (310 participants with MDD and 230 controls) risk alleles compared to non-carriers. Heterogeneity across studies was explored through meta-regression and subgroup analyses. Gender distribution, the use of medications, segmentation methods used to measure the hippocampus, and age emerged as potential sources of heterogeneity across studies that assessed the association of 5-HTTLPR short 'S' alleles and hippocampal volumes. Our data also suggest that the methodological quality of included studies, publication year, and the inclusion of brain volume as a covariate contributed to the heterogeneity of studies that assessed the association of the BDNF Val66Met 'Met' risk allele and hippocampal volumes. In exploratory voxel-wise meta-analyses, MDD participants carrying the 5-HTTLPR short 'S' allele had white matter microstructural abnormalities predominantly in the corpus callosum, while carriers of the BDNF Val66Met 'Met' allele had larger gray matter volumes and hyperactivation of the right middle frontal gyrus compared to non-carriers. In conclusion, few replicated findings emerged from imaging genetics studies that included participants with MDD. Nevertheless, we explored and identified specific sources of heterogeneity across studies, which could provide insights to enhance the reproducibility of this emerging field. Copyright © 2018 Elsevier Inc. All rights reserved.

Risk factors of overweight and obesity in childhood and adolescence in South Asian countries: a systematic review of the evidence.

PubMed

Mistry, S K; Puthussery, S

2015-03-01

To assess and synthesize the published evidence on risk factors of overweight and obesity in childhood and adolescence in South Asia. A systematically conducted narrative review. A systematic review was conducted of all primary studies published between January 1990 and June 2013 from India, Pakistan, Nepal, Bangladesh, Sri Lanka, Bhutan, and Maldives located through the following data bases: PubMed, PubMed central, EMBASE, MEDLINE, BioMed central, Directory of Open Access Journals (DOAJ) and electronic libraries of the authors' institutions. Data extraction and quality appraisal of included studies was done independently by two authors and findings were synthesized in a narrative manner as meta-analysis was found to be inappropriate due to heterogeneity of the included studies. Eleven primary studies were included in the final review, all of which were conducted in school settings in India, Pakistan and Bangladesh. Prevalence of overweight and obesity showed wide variations in the included studies. The key individual risk factors with statistically significant associations to overweight and obesity included: lack of physical activities reported in six studies; prolonged TV watching/playing computer games reported in four studies; frequent consumption of fast food/junk food reported in four studies; and frequent consumption of calorie dense food items reported in two studies. Family level risk factors included higher socioeconomic status reported in four studies and family history of obesity reported in three studies. This review provides evidence of key contributors to the increasing burden of obesity and overweight among children and adolescents in South Asia, and demonstrates the nutritional transition that characterizes other developing countries and regions around the world. The findings have implications for policy, practice and the development of interventions at various levels to promote healthy eating and physical activity among children and adolescents in the region as well as more globally. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

An investigation of content and media images in gay men's magazines.

PubMed

Saucier, Jason A; Caron, Sandra L

2008-01-01

This study provides an analysis of gay men's magazines, examining both the content and advertisements. Four magazine titles were selected, including The Advocate, Genre, Instinct, and Out, each targeting gay men as its target audience. These magazines were coded for both article content and advertisement content. In the advertisement analysis, both the type of advertisement and characteristics of the men depicted within the advertisement when present. The results mirror previous research findings relating to the portrayal of women, including the objectification of specific body parts and the high community standards set by the images depicted. These findings were reinforced by both the advertisements and content analyzed to include a high degree of importance being placed on having the right body type. Implications for further research are discussed.

Effect of Addiction to Computer Games on Physical and Mental Health of Female and Male Students of Guidance School in City of Isfahan

PubMed Central

Zamani, Eshrat; Chashmi, Maliheh; Hedayati, Nasim

2009-01-01

Background: This study aimed to investigate the effects of addiction to computer games on physical and mental health of students. Methods: The study population includes all students in the second year of public guidance schools in the city of Isfahan in the educational year of 2009-2010. The sample size includes 564 students selected by multiple steps stratified sampling. Dependent variables include general health in dimensions of physical health, anxiety and sleeplessness and impaired social functioning. Data were collected using General Health Questionnaire (GHQ-28) scale and a questionnaire on addiction to computer games. Pearson's correlation coefficient and structural model were used for data analysis. Findings: There was a significant positive correlation between students' computer games addiction and their physical and mental health in dimensions of physical health, anxiety and sleeplessness There was a significant negative relationship between addictions to computer games and impaired social functioning. Conclusion: The results of this study are in agreement with the findings of other studies around the world. As the results show, addiction to computer games affects various dimensions of health and increases physical problems, anxiety and depression, while decreases social functioning disorder. PMID:24494091

The Psychological Effects of Unemployment and Unsatisfactory Employment on Young Adults: Findings from a 10-Year Longitudinal Study.

PubMed

Winefield, Anthony H; Delfabbro, Paul H; Winefield, Helen R; Duong, David; Malvaso, Catia

2017-01-01

The purpose of the present study was to extend the external validity of an earlier longitudinal study of school leavers by including participants from a representative sample of secondary schools. Questionnaires were administered annually to a sample of South Australian school leavers over a 10-year period. At Time 1 participants were in the last compulsory year of high school aged around 15 years and at Time 10 they were aged around 25 years. Results confirmed those from an earlier longitudinal study showing that the transition from school to satisfactory employment was associated with significant improvements in psychological well-being, whereas transition from school to unemployment or unsatisfactory employment showed no change in psychological well-being. The current findings extended the external validity of the earlier study because whereas participants in the earlier study were sampled from co-educational metropolitan public high schools, the current study included participants from every kind of high school: single sex as well as co-educational, rural as well as metropolitan, and private as well as public.

The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations

PubMed Central

Alabdali, Majed; Alsulaiman, Abdulla; Albulaihe, Hana; Breiner, Ari; Katzberg, Hans D.; Aljaafari, Danah; Lovblom, Leif E.; Bril, Vera

2017-01-01

Introduction Polyneuropathy is one of the most prevalent neurologic disorders. Although several studies explored the role of the neurological examination in polyneuropathy, they were mostly restricted to specific subgroups of patients and have not correlated examination findings with symptoms and electrophysiological results. Objectives To explore the sensitivity and specificity of different neurological examination components in patients with diverse etiologies for polyneuropathy, find the most sensitive combination of examination components for polyneuropathy detection, and correlate examination findings with symptoms and electrophysiological results. Methods Patients with polyneuropathy attending the neuromuscular clinic from 01/2013 to 09/2015 were evaluated. Inclusion criteria included symptomatic polyneuropathy, which was confirmed by electrophysiological studies. 47 subjects with no symptoms or electrophysiological findings suggestive for polyneuropathy, served as controls. Results The total cohort included 312 polyneuropathy patients, with a mean age of 60±14 years. Abnormal examination was found in 95%, most commonly sensory findings (86%). The most common abnormal examination components were impaired ankle reflexes (74%), vibration (73%), and pinprick (72%) sensation. Combining ankle reflex examination with vibration or pinprick perception had the highest sensitivity, of 88%. The specificities of individual examination component were generally high, excluding ankle reflexes (62%), and vibration perception (77%). Abnormal examination findings were correlated with symptomatic weakness and worse electrophysiological parameters. Conclusion The neurological examination is a valid, sensitive and specific tool for diagnosing polyneuropathy, and findings correlate with polyneuropathy severity. Ankle reflex examination combined with either vibration or pinprick sensory testing is the most sensitive combination for diagnosing polyneuropathy, and should be considered minimal essential components of the physical examination in patients with suspected polyneuropathy. PMID:28249029

Rate of abnormal osteoarticular radiographic findings in pediatric patients.

PubMed

Petit, P; Sapin, C; Henry, G; Dahan, M; Panuel, M; Bourlière-Najean, B; Chaumoitre, K; Devred, P

2001-04-01

The objective of our study was to assess the rate of abnormal radiographic findings in the most frequent osteoarticular locations of traumatic injury in a pediatric population. During two periods of 12 weeks each, all patients admitted to the pediatric emergency department for osteoarticular trauma who underwent radiography were prospectively included in this study. A connection was drawn between the rate of abnormal radiographic findings for the seven most frequently radiographed locations and the clinical findings. Of 3128 locations of trauma in 2470 children, only 22% of the radiographic examinations were considered to reveal abnormal findings. In decreasing order, the hand and fingers, the ankle, the wrist, the knee, the elbow, the foot and toes, and the forearm were the most frequently examined locations. The rate of abnormal findings was 25.7% for the hand and fingers, 9.0% for the ankle, 42.5% for the wrist, 9.5% for the knee, 33.3% for the elbow, 18.3% for the foot, and 43.2% for the forearm. When only the direct sign of fracture was taken into account, these rates decreased for the ankle and knee to 2.6% and 1.9%, respectively. There was always a significant link between the degree of clinical suspicion and the rate of abnormal radiographic findings. However, fewer than 50% of the cases with high clinical suspicion of fracture were radiographically confirmed. It appears necessary, especially in cases of lower limb trauma, to evaluate clinical tests, including the implementation of the Ottawa ankle rules, to reduce the number of unnecessary radiographic examinations. This reduction will improve some parameters of children's quality of life and will significantly decrease the cost of emergency care.

More experiences with the Tzanck smear test: cytologic findings in cutaneous granulomatous disorders.

PubMed

Durdu, Murat; Baba, Mete; Seçkin, Deniz

2009-09-01

Granulomatous dermatitis is a distinctive histopathologic cutaneous reaction pattern against various infectious and noninfectious agents. Cytologically, granulomatous dermatitis shows granulomas and multinucleated giant cells. Various etiologic agents of granulomatous diseases can also be identified. We aimed to investigate Tzanck smear findings in granulomatous skin diseases. Patients who had granulomas and/or multinucleated giant cells of Langhans, foreign body- and/or Touton type in Tzanck smear tests were included in the study. In these patients, Tzanck preparations were then further evaluated for additional cytologic findings. Samples stained with May-Grünwald-Giemsa stain were evaluated by the same dermatologist throughout the study. In some patients, methylene blue, Gram and/or Erlich-Ziehl-Nielsen stains were also performed. In all of the study cases, the final diagnosis was established after the evaluation of clinical and laboratory findings (including, when appropriate, potassium hydroxide examination; bacterial, leishmanial, and fungal cultures; histopathology; tuberculosis and leishmania polymerase chain reaction). We also calculated the sensitivity and specificity of the Leishman-Donovan body for cutaneous leishmaniasis. Over a 2-year period, 94 of 950 patients (9.9%) in whom Tzanck smear tests were performed had cytologic findings consistent with a granulomatous reaction. In 74 (78.7%) and 20 (21.3%) patients, the granulomatous reaction was due to infectious and noninfectious causes, respectively. Infectious causes included cutaneous leishmaniasis in 65 patients (87.8%), candidal granuloma in two patients, botyromycosis in two patients, and aspergillosis, blastomycosis, mucormycosis, leprosy, and cutaneous tuberculosis in one patient each. In 58 of 74 patients (78.4%) with infectious granulomatous dermatitis, the causes of the granulomas were identified. Noninfectious granulomatous reactions were due to granuloma annulare in 7 patients, sarcoidosis in 5 patients, a foreign body in 4 patients, necrobiosis lipoidica in 2 patients, and juvenile xanthogranuloma in 2 patients. In 17 of 20 patients (85%) with noninfectious granulomatous reactions, the cytologic findings were characteristic of the final diagnoses. The sensitivity and specificity of Leishman-Donovan bodies for cutaneous leishmaniasis were 76.9% and 100%, respectively. All of the samples were evaluated by the same dermatologist throughout the study; therefore no comment could be made regarding the reliability of the Tzanck smear test. In addition, the sensitivity and specificity of Tzanck smear test findings for diseases other than cutaneous leishmaniasis could not be calculated because of an insufficient number of patients. The Tzanck smear test may be a useful diagnostic tool for certain granulomatous skin diseases.

Living with a child with attention deficit hyperactivity disorder: a systematic review.

PubMed

Laugesen, Britt; Lauritsen, Marlene Briciet; Jørgensen, Rikke; Sørensen, Erik Elgaard; Rasmussen, Philippa; Grønkjær, Mette

2016-12-01

This systematic review is aimed to identify and synthesize the best available evidence on parenting experiences of living with a child with attention-deficit hyperactivity disorder, including their experiences of healthcare and other services. A meta-synthesis was conducted following the Joanna Briggs Institute (JBI) guidelines. Qualitative research articles were considered for inclusion in the review and the meta-aggregative approach to synthesizing qualitative evidence from JBI was followed. An extensive search for relevant literature was undertaken in scientific databases. Data were extracted from the included research articles, and qualitative research findings were pooled using the Qualitative Assessment and Review Instrument. This involved categorization of findings on the basis of similarity of meaning and aggregation of these categories to produce a comprehensive set of synthesized findings. A total of 21 research articles met the inclusion criteria and were included in the review. The review process resulted in 129 study findings that were aggregated into 15 categories. The categories generated six synthesized findings: an emotional roller coaster between hope and hopelessness; mothers as advocates in a battlefield within the system and family; parental experiences in a crossfire of blame, self-blame, and stigmatization; shuttling between supportive and nonsupportive services and professionals; routines, structures and strategies within everyday life; and despite multiple challenges, it is not all bad. The findings illustrate the complexity of parental experiences that are influenced by guilt, hope, blame, stigmatization, exhaustion, reconciliation, and professional collaboration. The findings address the impact that attention-deficit hyperactivity disorder has on everyday family life, and how parents seem to adapt to their life situation in the process of accepting their child's disorder.

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

PubMed Central

de Abreu, Tiago Tribolet; Mateus, Sonia; Carreteiro, Cecilia; Correia, Jose

2008-01-01

Background The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) findings. Methods We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE findings that might indicate anticoagulation as beneficial were identified. Results A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as beneficial were found in 32.1%: spontaneous echo contrast (1.2%), complex aortic atheroma (27.4%), thrombus (8.3%), and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%). Conclusions The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation. PMID:18629351

New Jersey's Medicaid waiver for acquired immunodeficiency syndrome

PubMed Central

Merzel, Cheryl; Crystal, Stephen; Sambamoorthi, Usha; Karus, Daniel; Kurland, Carol

1992-01-01

This article contains data from a study of New Jersey's home and community-based Medicaid waiver program for persons with symptomatic human immunodeficiency virus illness. Major findings include lower hospital costs and utilization for waiver participants compared with general Medicaid acquired immunodeficiency syndrome admissions in New Jersey. Average program expenditures were $2,400 per person per month. Based on study findings, it is evident that the waiver program is an important means of providing financial benefits and access to services and that comprehensive case management is a critical factor in assuring program quality. PMID:10120180

Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion

NASA Astrophysics Data System (ADS)

Lee, Scott

2015-02-01

In our first article1 on scaling in theropod dinosaurs, the longitudinal stress in the leg bones due to supporting the weight of the animal was studied and found not to control the dimensions of the femur. As a continuation of our study of elasticity in dinosaur bones, we now examine the transverse stress in the femur due to locomotion and find that this effect is important for the geometry of the bone. We find that larger theropods (including Tyrannosaurus rex) were less athletic than smaller theropods.

Integrative Learning: A Grounded Theory

ERIC Educational Resources Information Center

Leonard, Jeannie Brown

2012-01-01

This article reports the findings from a study of undergraduate students in an academic program focused on integrative learning rather than interdisciplinarity. One aspect of this study included how students defined integrative learning. This participant-shaped understanding of integrative learning was broad and reflected a continuum of…

Risks of Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening

MedlinePlus

... decrease the risk of dying from cancer. Scientists study screening tests to find those with the fewest risks and ... of cancer, including ovarian cancer, or other conditions. Studies have also shown that ... Screening tests have risks. The risks of ovarian, fallopian tube, ...

76 FR 19362 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... contaminants that can cause health effects, including acute gastrointestinal and respiratory illness... risk for acute gastrointestinal or respiratory illness. This study would be, to our knowledge, the... gastrointestinal and respiratory illnesses. Study findings will inform the Environmental Protection Agency (EPA...

The Poisons Project.

ERIC Educational Resources Information Center

Crawford, Barbara A.

1998-01-01

Details a project in which students explore and study the poisons in their environment by asking and finding answers to their own research questions. Includes some suggestions for involving students successfully in inquiry-based learning. (DDR)

Characteristics of Venture Capital Network and Its Correlation with Regional Economy: Evidence from China.

PubMed

Jin, Yonghong; Zhang, Qi; Shan, Lifei; Li, Sai-Ping

2015-01-01

Financial networks have been extensively studied as examples of real world complex networks. In this paper, we establish and study the network of venture capital (VC) firms in China. We compute and analyze the statistical properties of the network, including parameters such as degrees, mean lengths of the shortest paths, clustering coefficient and robustness. We further study the topology of the network and find that it has small-world behavior. A multiple linear regression model is introduced to study the relation between network parameters and major regional economic indices in China. From the result of regression, we find that, economic aggregate (including the total GDP, investment, consumption and net export), upgrade of industrial structure, employment and remuneration of a region are all positively correlated with the degree and the clustering coefficient of the VC sub-network of the region, which suggests that the development of the VC industry has substantial effects on regional economy in China.

Characteristics of Venture Capital Network and Its Correlation with Regional Economy: Evidence from China

PubMed Central

Jin, Yonghong; Zhang, Qi; Shan, Lifei; Li, Sai-Ping

2015-01-01

Financial networks have been extensively studied as examples of real world complex networks. In this paper, we establish and study the network of venture capital (VC) firms in China. We compute and analyze the statistical properties of the network, including parameters such as degrees, mean lengths of the shortest paths, clustering coefficient and robustness. We further study the topology of the network and find that it has small-world behavior. A multiple linear regression model is introduced to study the relation between network parameters and major regional economic indices in China. From the result of regression, we find that, economic aggregate (including the total GDP, investment, consumption and net export), upgrade of industrial structure, employment and remuneration of a region are all positively correlated with the degree and the clustering coefficient of the VC sub-network of the region, which suggests that the development of the VC industry has substantial effects on regional economy in China. PMID:26340555

Cognitive Effects of Air Pollution Exposures and Potential Mechanistic Underpinnings

PubMed Central

Allen, J.L.; Klocke, C.; Morris-Schaffer, K.; Conrad, K.; Sobolewski, M.; Cory-Slechta, D.A.

2017-01-01

Purpose of review This review sought to address the potential for air pollutants to impair cognition and mechanisms by which that might occur. Recent findings Air pollution has been associated with deficits in cognitive functions across a wide range of epidemiological studies, both with developmental and adult exposures. Studies in animal models are significantly more limited in number, with somewhat inconsistent findings to date for measures of learning, but show more consistent impairments for short term memory. Potential contributory mechanisms include oxidative stress/inflammation, altered levels of dopamine and/or glutamate and changes in synaptic plasticity/structure. Summary Epidemiological studies are consistent with adverse effects of air pollutants on cognition, but additional studies and better phenotypic characterization are needed for animal models, including more precise delineation of specific components of cognition that are affected, as well as definitions of critical exposure periods for such effects and the components of air pollution responsible. This would permit development of more circumscribed hypotheses as to potential behavioral and neurobiological mechanisms. PMID:28435996

Barriers and facilitators of access to maternal services for women with disabilities: scoping review protocol.

PubMed

Mheta, Doreen; Mashamba-Thompson, Tivani P

2017-05-16

The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.

Family studies to find rare high risk variants in migraine.

PubMed

Hansen, Rikke Dyhr; Christensen, Anne Francke; Olesen, Jes

2017-12-01

Migraine has long been known as a common complex disease caused by genetic and environmental factors. The pathophysiology and the specific genetic susceptibility are poorly understood. Common variants only explain a small part of the heritability of migraine. It is thought that rare genetic variants with bigger effect size may be involved in the disease. Since migraine has a tendency to cluster in families, a family approach might be the way to find these variants. This is also indicated by identification of migraine-associated loci in classical linkage-analyses in migraine families. A single migraine study using a candidate-gene approach was performed in 2010 identifying a rare mutation in the TRESK potassium channel segregating in a large family with migraine with aura, but this finding has later become questioned. The technologies of next-generation sequencing (NGS) now provides an affordable tool to investigate the genetic variation in the entire exome or genome. The family-based study design using NGS is described in this paper. We also review family studies using NGS that have been successful in finding rare variants in other common complex diseases in order to argue the promising application of a family approach to migraine. PubMed was searched to find studies that looked for rare genetic variants in common complex diseases through a family-based design using NGS, excluding studies looking for de-novo mutations, or using a candidate-gene approach and studies on cancer. All issues from Nature Genetics and PLOS genetics 2014, 2015 and 2016 (UTAI June) were screened for relevant papers. Reference lists from included and other relevant papers were also searched. For the description of the family-based study design using NGS an in-house protocol was used. Thirty-two successful studies, which covered 16 different common complex diseases, were included in this paper. We also found a single migraine study. Twenty-three studies found one or a few family specific variants (less than five), while other studies found several possible variants. Not all of them were genome wide significant. Four studies performed follow-up analyses in unrelated cases and controls and calculated odds ratios that supported an association between detected variants and risk of disease. Studies of 11 diseases identified rare variants that segregated fully or to a large degree with the disease in the pedigrees. It is possible to find rare high risk variants for common complex diseases through a family-based approach. One study using a family approach and NGS to find rare variants in migraine has already been published but with strong limitations. More studies are under way.

Poststroke Seizures and Epilepsy: Clinical Studies and Animal Models

PubMed Central

Kelly, Kevin M.

2002-01-01

Poststroke seizures and epilepsy have been described in numerous clinical studies for many years. Most studies are retrospective in design, include relatively small numbers of patients, have limited periods of follow-up, and report a diversity of findings. Well-designed clinical trials and population studies in the recent past addressed several critical clinical issues and generated important findings regarding the occurrence of poststroke seizures and epilepsy. In contrast, the pathophysiologic events of injured brain that establish poststroke epileptogenesis are not well understood, and animal modeling has had limited development. Reviews of several important clinical studies and animal models that hold promise for a better understanding of poststroke epileptogenesis are presented. PMID:15309107

Work-family enrichment and job performance: a constructive replication of affective events theory.

PubMed

Carlson, Dawn; Kacmar, K Michele; Zivnuska, Suzanne; Ferguson, Merideth; Whitten, Dwayne

2011-07-01

Based on affective events theory (AET), we hypothesize a four-step model of the mediating mechanisms of positive mood and job satisfaction in the relationship between work-family enrichment and job performance. We test this model for both directions of enrichment (work-to-family and family-to-work). We used two samples to test the model using structural equation modeling. Results from Study 1, which included 240 full-time employees, were replicated in Study 2, which included 189 matched subordinate-supervisor dyads. For the work-to-family direction, results from both samples support our conceptual model and indicate mediation of the enrichment-performance relationship for the work-to-family direction of enrichment. For the family-to-work direction, results from the first sample support our conceptual model but results from the second sample do not. Our findings help elucidate mixed findings in the enrichment and job performance literatures and contribute to an understanding of the mechanisms linking these concepts. We conclude with a discussion of the practical and theoretical implications of our findings.

Breast care screening for underserved African American women: Community-based participatory approach.

PubMed

Davis, Cindy; Darby, Kathleen; Moore, Matthew; Cadet, Tamara; Brown, Gwendolynn

2017-01-01

Traditional health promotion models often do not take into account the importance of shared cultural backgrounds, beliefs, and experiences unique to underserved African American women when designing community-based cancer screening and prevention programs. Thus, the purpose of this study was the development, implementation, and evaluation of a community-based participatory research (CBPR) program designed to increase breast cancer screening awareness in an underserved African American population by providing culturally appropriate social support and information. The study includes 357 African American women who participated in the program and completed the 6-month follow-up questionnaire. The program consisted of a 45-minute play, using community members and storytelling to honor and incorporate five different cultural experiences (skits) with breast care and cancer. Overall, findings indicate that the educational intervention was effective. In addition, these findings are consistent with the literature that suggests that educational interventions that include knowledge to alleviate concerns, dispel myths, and create awareness can increase breast cancer screening participation rates. Furthermore, these findings confirm the importance of CBPR in health promotion activities in reducing health and cancer disparities.

Does money matter in inflation forecasting?

NASA Astrophysics Data System (ADS)

Binner, J. M.; Tino, P.; Tepper, J.; Anderson, R.; Jones, B.; Kendall, G.

2010-11-01

This paper provides the most fully comprehensive evidence to date on whether or not monetary aggregates are valuable for forecasting US inflation in the early to mid 2000s. We explore a wide range of different definitions of money, including different methods of aggregation and different collections of included monetary assets. In our forecasting experiment we use two nonlinear techniques, namely, recurrent neural networks and kernel recursive least squares regression-techniques that are new to macroeconomics. Recurrent neural networks operate with potentially unbounded input memory, while the kernel regression technique is a finite memory predictor. The two methodologies compete to find the best fitting US inflation forecasting models and are then compared to forecasts from a naïve random walk model. The best models were nonlinear autoregressive models based on kernel methods. Our findings do not provide much support for the usefulness of monetary aggregates in forecasting inflation. Beyond its economic findings, our study is in the tradition of physicists’ long-standing interest in the interconnections among statistical mechanics, neural networks, and related nonparametric statistical methods, and suggests potential avenues of extension for such studies.

Correlation between blink reflex abnormalities and magnetic resonance imaging findings in patients with multiple sclerosis.

PubMed

Degirmenci, Eylem; Erdogan, Cagdas; Bir, Levent Sinan

2013-09-01

This study investigates the correlation between brain magnetic resonance imaging findings and blink reflex abnormalities in patients with relapsing remitting multiple sclerosis. Twenty-six patients and 17 healthy subjects were included in this study. Blink reflex test (BRT) results were obtained using right and left stimulations; thus, 52 BRT results were recorded for the patient group, and 34 BRT results were recorded for the control group. The magnetic resonance imaging (MRI) findings were classified based on the existence of brainstem lesions (hyperintense lesion on T2 weighted (W) and fast fluid-attenuated inversion recovery MRI or contrast-enhancing lesion on T1W MRI). Correlation analysis was performed for the BRT and MRI findings. The percentage of individuals with abnormal BRT results (including R1 latency, ipsilateral R2 latency, and contralateral R2 latency) was significantly higher in the patient group as compared to the control group (p values: 0.015, 0.001, and 0.002, respectively). Correlation analysis revealed significant correlations between contralateral R2 latency abnormalities and brainstem lesions (p value: 0.011). Our results showed significant correlation correlations between contralateral R2 latency abnormalities and brainstem lesions and these results may be explained the effects of multiple demyelinating lesions of the brain stem of patients with relapsing remitting multiple sclerosis.

Graph theory findings in the pathophysiology of temporal lobe epilepsy.

PubMed

Chiang, Sharon; Haneef, Zulfi

2014-07-01

Temporal lobe epilepsy (TLE) is the most common form of adult epilepsy. Accumulating evidence has shown that TLE is a disorder of abnormal epileptogenic networks, rather than focal sources. Graph theory allows for a network-based representation of TLE brain networks, and has potential to illuminate characteristics of brain topology conducive to TLE pathophysiology, including seizure initiation and spread. We review basic concepts which we believe will prove helpful in interpreting results rapidly emerging from graph theory research in TLE. In addition, we summarize the current state of graph theory findings in TLE as they pertain its pathophysiology. Several common findings have emerged from the many modalities which have been used to study TLE using graph theory, including structural MRI, diffusion tensor imaging, surface EEG, intracranial EEG, magnetoencephalography, functional MRI, cell cultures, simulated models, and mouse models, involving increased regularity of the interictal network configuration, altered local segregation and global integration of the TLE network, and network reorganization of temporal lobe and limbic structures. As different modalities provide different views of the same phenomenon, future studies integrating data from multiple modalities are needed to clarify findings and contribute to the formation of a coherent theory on the pathophysiology of TLE. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

MR imaging of the hippocampus in normal pressure hydrocephalus: correlations with cortical Alzheimer's disease confirmed by pathologic analysis.

PubMed

Savolainen, S; Laakso, M P; Paljärvi, L; Alafuzoff, I; Hurskainen, H; Partanen, K; Soininen, H; Vapalahti, M

2000-02-01

MR studies have shown hippocampal atrophy to be a sensitive diagnostic feature of Alzheimer's disease (AD). In this study, we measured the hippocampal volumes of patients with a clinical diagnosis of normal pressure hydrocephalus (NPH), a potentially reversible cause of dementia when shunted. Further, we examined the relationship between the hippocampal volumes and cortical AD pathologic findings, intracranial pressure, and clinical outcomes in cases of NPH. We measured hippocampal volumes from 37 patients with a clinical diagnosis of NPH (27 control volunteers and 24 patients with AD). The patients with NPH underwent biopsy, and their clinical outcomes were followed for a year. Compared with those for control volunteers, the findings for patients with NPH included a minor left-side decrease in the hippocampal volumes (P < .05). Compared with those for patients with AD, the findings for patients with NPH included significantly larger hippocampi on both sides. Although not statistically significant, trends toward larger volumes were observed in patients with NPH who had elevated intracranial pressure, who benefited from shunting, and who did not display cortical AD pathologic findings. Measurements of hippocampal volumes among patients with a clinical diagnosis of NPH have clear clinical implications, providing diagnostic discrimination from AD and possibly prediction of clinical outcome after shunting.

Methodological issues in studies of air pollution and reproductive health.

PubMed

Woodruff, Tracey J; Parker, Jennifer D; Darrow, Lyndsey A; Slama, Rémy; Bell, Michelle L; Choi, Hyunok; Glinianaia, Svetlana; Hoggatt, Katherine J; Karr, Catherine J; Lobdell, Danelle T; Wilhelm, Michelle

2009-04-01

In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O(3)), particulate matter (PM), sulfur dioxide (SO(2)), carbon monoxide (CO), and nitrogen dioxide (NO(2)), and various indices of perinatal health, including fetal growth, pregnancy duration, and infant mortality. While most published studies have found some marker of air pollution related to some types of perinatal outcomes, variability exists in the nature of the pollutants and outcomes associated. Synthesis of the findings has been difficult for various reasons, including differences in study design and analysis. A workshop was held in September 2007 to discuss methodological differences in the published studies as a basis for understanding differences in study findings and to identify priorities for future research, including novel approaches for existing data. Four broad topic areas were considered: confounding and effect modification, spatial and temporal exposure variations, vulnerable windows of exposure, and multiple pollutants. Here we present a synopsis of the methodological issues and challenges in each area and make recommendations for future study. Two key recommendations include: (1) parallel analyses of existing data sets using a standardized methodological approach to disentangle true differences in associations from methodological differences among studies; and (2) identification of animal studies to inform important mechanistic research gaps. This work is of critical public health importance because of widespread exposure and because perinatal outcomes are important markers of future child and adult health.

Pulmonary and cardiac pathology in sudden unexpected death in epilepsy (SUDEP).

PubMed

Nascimento, Fábio A; Tseng, Zian H; Palmiere, Cristian; Maleszewski, Joseph J; Shiomi, Takayuki; McCrillis, Aileen; Devinsky, Orrin

2017-08-01

To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period. Fourteen postmortem studies reported pulmonary findings in SUDEP cases. Two focused mainly on assessing lung weights in SUDEP cases versus controls; no group difference was found. The other 12 reported descriptive autopsy findings. Among all SUDEP cases with available descriptive postmortem pulmonary examination, 72% had pulmonary changes, most often pulmonary edema/congestion, and, less frequently, intraalveolar hemorrhage. Eleven studies reported on cardiac pathology in SUDEP. Cardiac abnormalities were found in approximately one-fourth of cases. The most common findings were myocyte hypertrophy and myocardial fibrosis of various degrees. Among living epilepsy patients, postictal pulmonary pathology was the most commonly reported pulmonary abnormality and the most common postictal cardiac abnormality was transient left ventricular dysfunction - Takotsubo or neurogenic stunned myocardium. Cardiac and pulmonary pathological abnormalities are frequent among SUDEP cases, most commonly pulmonary edema/congestion and focal interstitial myocardial fibrosis. Most findings are not quantified, with subjective elements and undefined interobserver reliability, and lack of controls such as matched epilepsy patients who died from other causes. Further, studies have not systematically evaluated potential confounding factors, including postmortem interval to autopsy, paramedic resuscitation and IV fluids administration, underlying heart/lung disease, and risk factors for cardiac or pulmonary disease. Prospective studies with controls are needed to define the heart and lung changes in SUDEP and understand their potential relationship to mechanisms of death in SUDEP. Copyright © 2017 Elsevier Inc. All rights reserved.

"I Wanted To See If We Could Make It Work": Perspectives on Inclusive Childcare.

ERIC Educational Resources Information Center

Devore, Simone; Hanley-Maxwell, Cheryl

2000-01-01

A study explored how six childcare providers who have included children with special needs are able to provide care on a daily basis. Factors included the providers' commitment, finding the balance between resources and needs, problem-solving with parents, access to emotional support and technical assistance, and access to other supports.…

Leveraging Terminologies for Retrieval of Radiology Reports with Critical Imaging Findings

PubMed Central

Warden, Graham I.; Lacson, Ronilda; Khorasani, Ramin

2011-01-01

Introduction: Communication of critical imaging findings is an important component of medical quality and safety. A fundamental challenge includes retrieval of radiology reports that contain these findings. This study describes the expressiveness and coverage of existing medical terminologies for critical imaging findings and evaluates radiology report retrieval using each terminology. Methods: Four terminologies were evaluated: National Cancer Institute Thesaurus (NCIT), Radiology Lexicon (RadLex), Systemized Nomenclature of Medicine (SNOMED-CT), and International Classification of Diseases (ICD-9-CM). Concepts in each terminology were identified for 10 critical imaging findings. Three findings were subsequently selected to evaluate document retrieval. Results: SNOMED-CT consistently demonstrated the highest number of overall terms (mean=22) for each of ten critical findings. However, retrieval rate and precision varied between terminologies for the three findings evaluated. Conclusion: No single terminology is optimal for retrieving radiology reports with critical findings. The expressiveness of a terminology does not consistently correlate with radiology report retrieval. PMID:22195212

Predictors for work participation in individuals with an Autism spectrum disorder: a systematic review.

PubMed

Holwerda, Anja; van der Klink, Jac J L; Groothoff, Johan W; Brouwer, Sandra

2012-09-01

Research shows that only about 25% of people with autism are employed. We conducted a systematic review on factors facilitating or hindering work participation of people with autism in longitudinal studies. An extensive search in biomedical and psychological databases yielded 204 articles and 18 satisfied all inclusion criteria. We assessed the methodological quality of included studies using an established criteria list. Seventeen factors were identified and categorized as disease-related factors, personal factors or external factors. Limited cognitive ability was the only significant predictor consistently found for work outcome. Functional independence and institutionalization were both reported by one study to be significantly related to work outcome. Inconsistent findings or non significant findings were reported for the other fourteen factors. These findings emphasize the need for more high quality cohort studies focussing on work participation as the main outcome among people with Autism.

Sanctions as a tactic used in partner conflicts: theoretical, operational, and preliminary findings.

PubMed

Winstok, Zeev; Smadar-Dror, Ronit

2015-07-01

Partner sanction in this study is a form/tactic of violence, much like verbal and physical violence, which partners use toward each other during their conflicts. The partner sanction embodies a temporary deprivation of a mutually agreed-on right. The purpose of this study is to develop a theoretical and operational framework of sanctions partners use. The study sampled 74 heterosexual couples from the general population (148 male and female participants). The findings support the validity and reliability of the sanction measurement. Furthermore, findings indicate that the use of sanctions between partners is highly prevalent among men and women in the general population; that the more one partner uses sanctions, the more the other partner uses it; and that sanctions are strongly associated with other violent tactics partners use in their conflict (i.e., verbal and physical). Theoretical and empirical implications of the theoretical framework and the findings are discussed, including the role of sanctions in partner conflicts that escalate to severe forms of violence. © The Author(s) 2014.

Opto-acoustic image fusion technology for diagnostic breast imaging in a feasibility study

NASA Astrophysics Data System (ADS)

Zalev, Jason; Clingman, Bryan; Herzog, Don; Miller, Tom; Ulissey, Michael; Stavros, A. T.; Oraevsky, Alexander; Lavin, Philip; Kist, Kenneth; Dornbluth, N. C.; Otto, Pamela

2015-03-01

Functional opto-acoustic (OA) imaging was fused with gray-scale ultrasound acquired using a specialized duplex handheld probe. Feasibility Study findings indicated the potential to more accurately characterize breast masses for cancer than conventional diagnostic ultrasound (CDU). The Feasibility Study included OA imagery of 74 breast masses that were collected using the investigational Imagio® breast imaging system. Superior specificity and equal sensitivity to CDU was demonstrated, suggesting that OA fusion imaging may potentially obviate the need for negative biopsies without missing cancers in a certain percentage of breast masses. Preliminary results from a 100 subject Pilot Study are also discussed. A larger Pivotal Study (n=2,097 subjects) is underway to confirm the Feasibility Study and Pilot Study findings.

Effectiveness and experience of arts-based pedagogy among undergraduate nursing students: a mixed methods systematic review.

PubMed

Rieger, Kendra L; Chernomas, Wanda M; McMillan, Diana E; Morin, Francine L; Demczuk, Lisa

2016-11-01

To develop well rounded professional nurses, educators need diverse pedagogical approaches. There is growing interest in arts-based pedagogy (ABP) as the arts can facilitate reflection, create meaning and engage healthcare students. However, the emerging body of research about ABP needs to be systematically examined. To synthesize the best available evidence on the effectiveness of ABP in enhancing competencies and learning behaviors in undergraduate nursing education and to explore nursing students' experiences with art-based pedagogy. The review considered studies that included participants who are undergraduate nursing students. The qualitative (QL) component considered studies investigating nursing students' experiences of ABP, and the quantitative (QN) component considered studies evaluating the effectiveness of ABP in undergraduate nursing education. The QL component considered QL studies including designs such as phenomenology, grounded theory, ethnography, action research and feminist research. The QN component considered studies that examined the effectiveness of ABP including designs such as randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case-control studies, analytical cross-sectional studies, case series, individual case reports and descriptive cross-sectional studies. The following QN outcomes of ABP were assessed: knowledge acquisition, level of empathy, attitudes toward others, emotional states, reflective practice, self-transcendence, cognitive/ethical maturity, learning behaviors and students' perspectives of ABP. An extensive three-step search strategy was conducted for primary research studies published between January 1, 1994 and April 7, 2015. The strategy included searching CINAHL, MEDLINE, ERIC, PsycINFO, Academic Search Complete, Arts and Humanities Citation Index, Art Full Text, Scopus, ProQuest Dissertations and Theses, A&I, and gray literature. Only studies published in English were included. Two reviewers assessed all studies for methodological quality using appropriate critical appraisal checklists from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) or the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data were extracted from included articles using the standardized data extraction tool from JBI-QARI or JBI-MAStARI. Qualitative studies were pooled through a meta-synthesis. Data from the QN studies were combined using a narrative synthesis as a meta-analysis was not possible. The researchers used a segregated mixed methods approach to integrate the QL and QN components. Twenty-one QL studies of high methodological quality were included. The two synthesized findings revealed that art forms could create meaning and inspire learning in undergraduate nursing education and that ABP can develop important learner outcomes/competencies for professional nursing. These synthesized findings received a moderate ConQual rating. Fifteen experimental/quasi-experimental studies of moderate methodological quality were included. The narrative synthesis suggested that ABP improved nursing students' knowledge acquisition, level of empathy, attitude toward others, emotional states, level of reflective practice, learning behaviors and aspects of cognitive/ethical maturity. In five cross-sectional studies, the majority of students had a positive perspective of ABP. When the QL and QN findings were interpreted as a whole, ABP appeared to facilitate learning in the cognitive and affective domains and may be especially useful in addressing the affective domain. Nurse educators should consider using ABP as students found that this approach offered a meaningful way of learning and resulted in the development of important competencies for professional nursing. The QN studies provide a very low level of evidence that ABP improved students' knowledge acquisition, level of empathy, attitude toward others, emotional states, level of reflective practice, learning behaviors and aspects of cognitive/ethical maturity. Although the QN findings can inform future research, the evidence is not robust enough to demonstrate improved outcomes.

Environmental sanitary interventions for preventing active trachoma.

PubMed

Rabiu, Mansur; Alhassan, Mahmoud B; Ejere, Henry O D; Evans, Jennifer R

2012-02-15

Trachoma is a major cause of avoidable blindness. It is responsible for about six million blind people worldwide, mostly in the poor communities of developing countries. One of the major strategies advocated for the control of the disease is the application of various environmental sanitary measures to such communities. To assess the evidence for the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 9), MEDLINE (January 1950 to September 2011), EMBASE (January 1980 to September 2011), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to September 2011), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) and ClinicalTrials.gov (www.clinicaltrials.gov). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 23 September 2011. We checked the reference list of included trials and the Science Citation Index. We also contacted agencies, experts and researchers in trachoma control. We included randomised and quasi-randomised controlled trials comparing any form of environmental hygiene measures with no measure. These hygiene measures included fly control, provision of water and health education. Participants in the trials were people normally resident in the trachoma endemic areas. Two authors independently extracted data and assessed the quality of the included trials. Study authors were contacted for additional information. Six trials met the inclusion criteria but we did not conduct meta-analysis due to heterogeneity of the studies. We included six studies with a total of 12,294 participants from 79 communities. Two studies that assessed insecticide spray as a fly control measure found that trachoma is reduced by at least 55% to 61% with this measure compared to no intervention. However, another study did not find insecticide spray to be effective in reducing trachoma. One study found that another fly control measure, latrine provision, reduced trachoma by 29.5% compared to no intervention; this was, however, not statistically significantly different and findings have not been confirmed by a more recent study. Another study revealed that health education reduced the incidence of trachoma. These findings were not confirmed by a second study, however, which found that a modest health education programme with modest water supply did not reduce trachoma. However, all the studies have some methodological concerns. There is some evidence from two trials that insecticides are effective in reducing trachoma, however, this effect was not demonstrated in another trial that used insecticides. Two trials on latrine provision as a fly control measure have not demonstrated significant trachoma reduction. Health education had shown significant reduction of trachoma in one study but another study did not demonstrate similar findings. Generally there is a dearth of data to determine the effectiveness of all aspects of environmental sanitation in the control of trachoma.

A systematic review of the experiences of undergraduate nursing students choosing to study at an English speaking university outside their homeland.

PubMed

Terwijn, Ruth; Pearce, Susanne; Rogers-Clark, Catherine

Increasingly overseas students are attending university nursing programs in English-speaking countries to gain additional tertiary qualifications that may not be available in their homeland and also to fill the international nursing shortfall. For these students, some common issues identified and affirmed in qualitative research papers include loneliness, discriminatory experiences, developing communication, and academic skills. This systematic review will help identify and synthesise current issues through exploring the existing literature, giving an insight into the lives of international nursing students. Given the large and increasing number of these students, it is important to acknowledge and improve learning and other outcomes for them. The objective of this systematic review was to determine the best available evidence in relation to the experiences of undergraduate nursing students choosing to study at an English speaking university outside their homeland. This review sought high quality studies aimed at exploring the experience of undergraduate nursing students studying outside their homeland at an English speaking university. Both qualitative research studies and opinion-based text were considered for this review. An extensive search of the literature was conducted to identify research studies published between January 1990 and April 2011 in English and indexed in 37 major databases. All included articles were assessed independently by two reviewers (RT and SP), using the appropriate critical appraisal tool from the Joanna Briggs Institute. Data were extracted from included papers using appropriate standardised data extraction tools developed by the Joanna Briggs Institute. Data from qualitative studies and textual and opinion papers were meta-synthesised separately using standardised instruments. Data synthesis of all included studies involved the pooling of findings and then grouping into categories on a basis of similarity of meaning. The categories were further aggregated into a set of statements representing synthesised findings as a coherent whole. A total of 19 studies were identified as of high quality and meeting the inclusion criteria. From these studies, 254 findings were extracted which were grouped into 13 categories and further aggregated into four synthesised findings. The four major areas identified in this review in relation to the experiences of undergraduate nursing students studying outside their homeland at an English-speaking university include the need for support and encouragement, valuing and respecting difference, and the desire to succeed despite challenges and inclusion. Recognising the unique needs of international nursing students, in the clinical, academic and social context, is critical to improve the experiences of this student cohort. Educational and support strategies and programs are needed to respond to these needs. The implications for research are substantial. Given the outcomes of this review, action and evaluative research is needed to explore, implement and evaluate support strategies for students from non-English speaking backgrounds studying nursing. Research in the areas of curriculum development, supporting students' clinical experiences, and university social and academic support programs is recommended.

77 FR 51044 - Laguna Cartagena National Wildlife Refuge, PR; Final Comprehensive Conservation Plan and Finding...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... plants, haying, research studies, wildlife surveying and monitoring, scientific collections, and camping... interest, including West Indian whistling ducks and kestrels. Under this alternative, specific activities...

Publishing a Simulation Game.

ERIC Educational Resources Information Center

Gohring, Ralph J.

1979-01-01

A case study describing the process involved in publishing a personally developed simulation game including finding a publisher, obtaining a copyright, negotiating the contract, controlling front-end costs, marketing the product, and receiving feedback from users. (CMV)

Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction: a systematic review.

PubMed

Mariscalco, Michael W; Magnussen, Robert A; Mehta, Divyesh; Hewett, Timothy E; Flanigan, David C; Kaeding, Christopher C

2014-02-01

An autograft has traditionally been the gold standard for anterior cruciate ligament reconstruction (ACLR), but the use of allograft tissue has increased in recent years. While numerous studies have demonstrated that irradiated allografts are associated with increased failure rates, some report excellent results after ACLR with nonirradiated allografts. The purpose of this systematic review was to determine whether the use of nonirradiated allograft tissue is associated with poorer outcomes when compared with autografts. Patients undergoing ACLR with autografts versus nonirradiated allografts will demonstrate no significant differences in graft failure risk, laxity on postoperative physical examination, or differences in patient-oriented outcome scores. Systematic review. A systematic review was performed to identify prospective or retrospective comparative studies (evidence level 1, 2, or 3) of autografts versus nonirradiated allografts for ACLR. Outcome data included graft failure based on clinical findings and instrumented laxity, postoperative laxity on physical examination, and patient-reported outcome scores. Studies were excluded if they did not specify whether the allograft had been irradiated. Quality assessment and data extraction were performed by 2 examiners. Nine studies comparing autografts and nonirradiated allografts were included. Six of the 9 studies compared bone-patellar tendon-bone (BPTB) autografts with BPTB allografts. Two studies compared hamstring tendon autografts to hamstring tendon allografts, and 1 study compared hamstring tendon autografts to tibialis anterior allografts. The mean patient age in 7 of 9 studies ranged from 24.5 to 32 years, with 1 study including only patients older than 40 years and another not reporting patient age. The mean follow-up duration was 24 to 94 months. Six of 9 studies reported clinical graft failure rates, 8 of 9 reported postoperative instrumented laxity measurements, 7 of 9 reported postoperative physical examination findings, and all studies reported patient-reported outcome scores. This review demonstrated no statistically significant difference between autografts and nonirradiated allografts in any outcome measure. No significant differences were found in graft failure rate, postoperative laxity, or patient-reported outcome scores when comparing ACLR with autografts to nonirradiated allografts in this systematic review. These findings apply to patients in their late 20s and early 30s. Caution is advised when considering extrapolation of these findings to younger, more active cohorts.

Does neighbourhood social capital aid in levelling the social gradient in the health and well-being of children and adolescents? A literature review

PubMed Central

2013-01-01

Background Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers. Methods This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included. Results Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear. Conclusions Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed. PMID:23339776

Does neighbourhood social capital aid in levelling the social gradient in the health and well-being of children and adolescents? A literature review.

PubMed

Vyncke, Veerle; De Clercq, Bart; Stevens, Veerle; Costongs, Caroline; Barbareschi, Giorgio; Jónsson, Stefán Hrafn; Curvo, Sara Darias; Kebza, Vladimir; Currie, Candace; Maes, Lea

2013-01-23

Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers. This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included. Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear. Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed.

The effectiveness of mindfulness-based interventions for supporting people with intellectual disabilities: a narrative review.

PubMed

Harper, Sarah K; Webb, Thomas L; Rayner, Kelly

2013-05-01

A number of studies have used mindfulness-based interventions to influence the behavior of people with intellectual disabilities, to improve their quality of life, and to reduce challenging behavior. The present review critically evaluates 18 studies and assesses the clinical and academic impact of their findings. Strengths identified included replicable methodological approaches, use of multiple baseline designs, strong construct and criterion validity, and consideration of the mechanisms by which mindfulness influences behavior change. Limitations included a lack of randomized controlled trials, inclusion of qualitative data without structured analysis, limited use of statistical analyses, and problems with sampling leading to difficulties generalizing findings. There was also a paucity of research investigating the impact of "Dialectical Behavior Therapy" and "Acceptance and Commitment Therapy" and the role of mindfulness within these approaches. Further research is warranted in this regard.

Functional abdominal pain in childhood: background studies and recent research trends.

PubMed

Levy, Rona L; van Tilburg, Miranda A L

2012-01-01

The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors' research program. Specific areas discussed based on work within the authors' group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research.

Profile of students’ generated representations and creative thinking skill in problem solving in vocational school

NASA Astrophysics Data System (ADS)

Fikri, P. M.; Sinaga, P.; Hasanah, L.; Solehat, D.

2018-05-01

This study aims to determine profile of students’ generated representations and creative thinking skill on problem solving in vocational school. This research is a descriptive research to get an idea of comprehend students’ generated representations and creative thinking skill on problem solving of vocational school in Bandung. Technique of collecting data is done by test method, observation, and interview. Representation is something that represents, describes or symbolizes an object or process. To evaluate the multi-representation skill used essay test with rubric of scoring was used to assess multi-depressant student skills. While creative thinking skill on problem solving used essay test which contains the components of skills in finding facts, problem finding skills, idea finding skills and solution finding skills. The results showed generated representations is still relatively low, this is proven by average student answers explanation is mathematically correct but there is no explanation verbally or graphically. While creative thinking skill on problem solving is still relatively low, this is proven by average score for skill indicator in finding the student problem is 1.52 including the non-creative category, average score for the skill indicator in finding the student idea is 1.23 including the non-creative category, and the average score of the students skill in finding this solution is 0.72 belongs to a very uncreative category.

An Overview of Recent Studies in Junior College Electrical-Electronics Curriculum.

ERIC Educational Resources Information Center

Williams, Harry E.

This brief paper discusses in some detail several recent studies of electrical-electronics curricula at the junior college level and presents a 22-item bibliography of studies in this area. Comments based on the findings of the studies include: (1) A method of instruction, particulary applicable to the field of electronics education, seems to be…

Measuring value for money: a scoping review on economic evaluation of health information systems.

PubMed

Bassi, Jesdeep; Lau, Francis

2013-01-01

To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Forty-two papers were selected and 33 were deemed high quality (scores ≥ 8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.

Task Force on Teacher Education in Physics: Findings and Recommendations

NASA Astrophysics Data System (ADS)

Otero, Valerie

2010-03-01

In response to the national crisis in science education, including low performance in high school physical science and a critical shortage of highly qualified physics teachers, a National Task Force was convened to investigate the state of physics education in the United States. The Task Force spent one year collecting data from over 900 universities and conducting site visits at 13 universities that were identified as ``high producers'' of physics teachers. The final report of the Task Force will be published early in 2010 and will highlight the findings and recommendations that resulted from the study. In this presentation, the main findings and recommendations will be presented along with selected case studies that illustrate exemplary practices in physics and education departments.

The Battle over Studies of Faculty Bias

ERIC Educational Resources Information Center

Gravois, John

2007-01-01

The American Federation of Teachers (AFT) recently commissioned a study to review the research that finds liberal bias run amok in academe. Believing that the AFT is not a dispassionate observer of this debate, this article provides "The Chronicle of Higher Education's" survey of the genre. The studies reviewed include: (1) "Political Bias in the…

Increasing Parent Involvement in Youth HIV Prevention: A Randomized Caribbean Study

ERIC Educational Resources Information Center

Baptiste, Donna R.; Kapungu, Chisina; Miller, Steve; Crown, Laurel; Henry, David; Da Costa Martinez, Dona; Jo-Bennett, Karen

2009-01-01

This article presents preliminary findings of a randomized HIV prevention study in Trinidad and Tobago in the Caribbean. The study centers on a family HIV workshop aimed at strengthening parenting skills that are empirically linked to reducing adolescent HIV exposure and other sexual risks. These skills include parental monitoring; educating youth…

Guide for Calculating and Interpreting Effect Sizes and Confidence Intervals in Intellectual and Developmental Disability Research Studies

ERIC Educational Resources Information Center

Dunst, Carl J.; Hamby, Deborah W.

2012-01-01

This paper includes a nontechnical description of methods for calculating effect sizes in intellectual and developmental disability studies. Different hypothetical studies are used to illustrate how null hypothesis significance testing (NHST) and effect size findings can result in quite different outcomes and therefore conflicting results. Whereas…

Comparative Analysis of Institutional Policy Definitions of Plagiarism: A Pan-Canadian University Study

ERIC Educational Resources Information Center

Eaton, Sarah Elaine

2017-01-01

This article shares the findings of a study investigating institutional policy definitions of plagiarism at twenty English-speaking Canadian universities. The types of primary sources consulted for this study included: (1) university academic calendars for 2016-2017, (2) institutional policies on academic misconduct, and (3) student academic codes…

Teachers' Perceptions Regarding School Principals' Coaching Skills

ERIC Educational Resources Information Center

Yirci, Ramazan; Özdemir, Tuncay Yavuz; Kartal, Seçil Eda; Kocabas, Ibrahim

2014-01-01

The purpose of this study was to find out teachers' perceptions about school principals' coaching skills. The study was carried out within qualitative research methods. The study group included 76 teachers in Elazig and 73 teachers in Kahramanmaras provinces of Turkey. All the data were processed using Nvivo 9 software. The results indicate that…

The Student Affair Organizational Dissertation: A Bounded Qualitative Meta-Study

ERIC Educational Resources Information Center

Banning, James H.; Kuk, Linda

2009-01-01

The purpose of this study was to examine dissertations over the past five years that focused on student affairs organizational issues. A bounded qualitative meta-study was used and the methods, theories, and findings of the dissertations were examined. A variety of research methods were used including quantitative, qualitative and mixed designs.…

An Exploration of Conflict and Conflict Management.

ERIC Educational Resources Information Center

Trusty, Francis M.

The study reported on was conducted to study aspects of conflict and conflict management that might have implications for the fields of education and educational administration. The five phases of the study include a review of the literature, a series of interviews, a synthesis of ideas, the dissemination of findings, and a concluding research…

Language Interdependence between American Sign Language and English: A Review of Empirical Studies

ERIC Educational Resources Information Center

Rusher, Melissa Ausbrooks

2012-01-01

This study provides a contemporary definition of American Sign Language/English bilingual education (AEBE) and outlines an essential theoretical framework. Included is a history and evolution of the methodology. The author also summarizes the general findings of twenty-six (26) empirical studies conducted in the United States that directly or…

Teaching Kindergartners Racial Diversity through Multicultural Literature: A Case Study in a Kindergarten Classroom in Korea

ERIC Educational Resources Information Center

Kim, So Jung; Wee, Su-Jeong; Lee, Young Mi

2016-01-01

Research Findings: This qualitative case study examines Korean kindergartners' literary discussions about racial/cultural diversity during a whole-group read-aloud. Using multiple sources of data, including observations, open-ended interviews, and written materials and children's artifacts, this study found that (a) the children exhibited a biased…

Motivating Study Groups across the Disciplines in Secondary Schools

ERIC Educational Resources Information Center

Styslinger, Mary E.; Clary, Deidre M.; Oglan, Victoria A.

2015-01-01

This article introduces Project RAISSE: Reading Assistance Initiative for Secondary School Educators and shares the findings of a study into those factors found to motivate study group participants at two rural high schools in the southern USA. The research team collected qualitative data over a two-year period, including interviews, artifacts,…

Pressurized Wideband Absorbance Findings in Healthy Neonates: A Preliminary Study

ERIC Educational Resources Information Center

Wali, Hamzah A.; Mazlan, Rafidah; Kei, Joseph

2017-01-01

Purpose: The present study aimed to establish normative data for wideband absorbance (WBA) measured at tympanometric peak pressure (TPP) and 0 daPa and to assess the test-retest reliability of both measurements in healthy neonates. Method: Participants of this cross-sectional study included 99 full-term neonates (165 ears) with mean chronological…

Effects of a Developmental Adventure on the Self-Esteem of College Students

ERIC Educational Resources Information Center

Paquette, Linda; Brassard, Audrey; Guérin, Audrey; Fortin-Chevalier, Justine; Tanguay-Beaudoin, Laurence

2014-01-01

This study examines the effects of outdoor developmental adventure programming (ODA) on college students' self-esteem. Although some previous studies have shown that outdoor adventure programming has positive effects on self-esteem, others did not find any effect. A quasi-experimental study was conducted over 5 months, which included two pretests…

Education Policy Studies in South Africa, 1995-2006

ERIC Educational Resources Information Center

Deacon, Roger; Osman, Ruksana; Buchler, Michelle

2010-01-01

This article reports on findings pertaining to scholarship in education policy drawn from a wider study on all education research in South Africa from 1995 to 2006. This study, which defined education research as broadly pertaining to teaching and/or learning, obtained extensive data from a wide range of sources, including universities, public…

Investigating Students' Attitudes towards Private Sector Work during Study in Saudi Arabia

ERIC Educational Resources Information Center

Al-asqah, Amnah

2018-01-01

Purpose: The purpose of this paper is to identify the students' attitudes towards private sector work during study. Design/methodology/approach: This study used a comprehensive social survey (including questionnaire and interviewing) distributed to experts in departments and colleges in King Saud University and Princess Nora University. Findings:…

Waiting list randomized controlled trial within a case-finding design: methodological considerations.

PubMed

Ronaldson, Sarah; Adamson, Joy; Dyson, Lisa; Torgerson, David

2014-10-01

Randomized controlled trials (RCTs) are widely used in health care research to provide high-quality evidence of effectiveness of an intervention. However, sometimes a study does not require an RCT in order to answer its primary objective; a case-finding design may be more appropriate. The aim of this paper was to introduce a new study design that nests a waiting list RCT within a case-finding study. An example of the new study design is the DOC Study, which primarily aims to determine the diagnostic accuracy of lung function tests for chronic obstructive pulmonary disease. It also investigates the impact of lung function tests on smoking behaviour through use of a waiting list design. The first step of the study design is to obtain participants' consent. Individuals are then randomized to one of two groups; either the 'intervention now' group or the 'intervention later' group, that is, participants are placed on a waiting list. All participants receive the same intervention; the only difference between the groups is the timing of the intervention. The design addresses patient preference issues and recruitment issues that can arise in other trial designs. Potential limitations include differential attrition between study groups and potential demoralization for the 'intervention later' group. The 'waiting list case-finding trial' design is a valuable method that could be applied to case-finding studies; the design enables the case-finding component of a study to be maintained while simultaneously exploring additional hypotheses through conducting a trial. © 2014 John Wiley & Sons, Ltd.

Pesticides, chemical and industrial exposures in relation to systemic lupus erythematosus

PubMed Central

Parks, Christine G.; De Roos, Anneclaire J.

2013-01-01

Growing evidence suggests exposure to chemicals and industrial pollutants may increase risk of SLE. Here we review research on SLE associations with occupational and industrial exposures, primarily drawing on studies in human populations and summarizing epidemiologic research published in the past decade. The association of occupational silica exposure with SLE is well established, but key questions remain, including the required dose and susceptibility factors, and SLE risk due to other silicate exposures. Research on SLE and other exposures is less well developed, though several potential associations merit further consideration due to the consistency of preliminary human findings, experimental animal research, and biologic plausibility. These include pesticides and solvents, for which experimental findings also support investigation of specific agents, including organochlorines and trichloroethylene. Experimental findings and biologic plausibility suggest research on SLE and occupational exposure to hydrocarbons (i.e., mineral oils) is warranted, especially given the widespread exposures in the population. Experimental and limited human findings support further investigation of SLE related to mercury exposure, especially in dental occupations. Research on environmental risk factors in risk-enriched cohorts (family based) is recommended, as is further investigation of exposures in relation to intermediate markers of effect (e.g., antinuclear antibodies), clinical features (e.g., nephritis) and outcomes. PMID:24763537

Meta-ethnography to understand healthcare professionals’ experience of treating adults with chronic non-malignant pain

PubMed Central

Seers, Kate; Barker, Karen L

2017-01-01

Objectives We aimed to explore healthcare professionals’ experience of treating chronic non-malignant pain by conducting a qualitative evidence synthesis. Understanding this experience from the perspective of healthcare professionals will contribute to improvements in the provision of care. Design Qualitative evidence synthesis using meta-ethnography. We searched five electronic bibliographic databases from inception to November 2016. We included studies that explore healthcare professionals’ experience of treating adults with chronic non-malignant pain. We used the GRADE-CERQual framework to rate confidence in review findings. Results We screened the 954 abstracts and 184 full texts and included 77 published studies reporting the experiences of over 1551 international healthcare professionals including doctors, nurses and other health professionals. We abstracted six themes: (1) a sceptical cultural lens, (2) navigating juxtaposed models of medicine, (3) navigating the geography between patient and clinician, (4) challenge of dual advocacy, (5) personal costs and (6) the craft of pain management. We rated confidence in review findings as moderate to high. Conclusions This is the first qualitative evidence synthesis of healthcare professionals’ experiences of treating people with chronic non-malignant pain. We have presented a model that we developed to help healthcare professionals to understand, think about and modify their experiences of treating patients with chronic pain. Our findings highlight scepticism about chronic pain that might explain why patients feel they are not believed. Findings also indicate a dualism in the biopsychosocial model and the complexity of navigating therapeutic relationships. Our model may be transferable to other patient groups or situations. PMID:29273663

A Thematic Inquiry into the Burnout Experience of Australian Solo-Practicing Clinical Psychologists.

PubMed

Hammond, Trent E; Crowther, Andrew; Drummond, Sally

2017-01-01

Objective: Burnout is conceptualized as a syndrome that consists of emotional exhaustion, depersonalization, and decreased personal accomplishment. Despite the increased frequency and severity of burnout in the Western world, there is limited published research regarding the experiences of clinical psychologists who have had burnout. The present study examines clinical psychologists' different experiences of burnout in Australia. Design and Methods: In the year 2015, six privately practicing and solo-employed clinical psychologists provided rich qualitative data by participating in semi-structured interviews. Thematic analysis was the method used to analyze clinical psychologists' natural accounts of their burnout experiences. Using NVivo, emerging themes were identified through coding 'first order constructs' and then axial code 'second order constructs.' Findings: Clinical psychologists indicated that their roles are demanding and a diverse range of symptoms, including the enduring effects of burnout, mental stress, fatigue, decreased personal accomplishment, negative affect, depersonalization, reduced productivity and motivation, and insomnia. They identified precursors of burnout, including excessive workload and hours of work, life stresses, mismanaged workload, and transference. Clinical psychologists suggested that protective factors of burnout include knowledge and years worked in direct care, and trusting and long-term relationships. They indicated that the barriers to overcoming burnout include the fallacy that their clients' expectations and needs are more important than their own, the financial cost of working in private practice, contemporary knowledge and inadequate education regarding self-care, and time constraints. Discussion and Conclusion: The findings presented in this study provide psychologists and other health professionals with an insight about the burnout experience and inform professionals of the mental shortcomings of working as a solo-practicing clinical psychologist. Findings from this study should lead to an increased understanding of the complexities of burnout, and ultimately reduced cases of burnout, absenteeism, and staff disengagement.

Does Breastfeeding Protect Against Childhood Obesity? Moving Beyond Observational Evidence.

PubMed

Woo, Jessica G; Martin, Lisa J

2015-06-01

Human milk is the optimal feeding choice for infants, as it dynamically provides the nutrients, immunity support, and other bioactive factors needed for infants at specific stages during development. Observational studies and several meta-analyses have suggested that breastfeeding is protective against development of obesity in childhood and beyond. However, these findings are not without significant controversy. This review includes an overview of observational findings to date, then focuses on three specific pathways that connect human milk and infant physiology: maternal obesity, microbiome development in the infant, and the development of taste preference and diet quality. Each of these pathways involves complex interactions between mother and infant, includes both biologic and non-biologic factors, and may have both direct and indirect effects on obesity risk in the offspring. This type of integrated approach to examining breastfeeding and childhood obesity is necessary to advance research in this area beyond observational findings.

Parent's perceptions of interactions with health professionals in the pathway to gaining a diagnosis of tuberous sclerosis (TS) and beyond.

PubMed

Whitehead, Lisa C; Gosling, Vashti

2003-01-01

This paper presents selected findings from a qualitative study on the lived experience of young people with tuberous sclerosis (TS) and their families. In-depth interviews with 109 participants from 40 families were undertaken. This paper presents the findings in relation to parents' interactions with health professionals before, during and after a diagnosis of TS was given. The majority of parents recalled examples of both positive and negative experiences with health professionals. Negative experiences included having to 'fight' for the recognition of symptoms and the reluctance of doctors to move on beyond a diagnosis of epilepsy. Attributes valued by parents pre-diagnosis included health professionals showing understanding at diagnosis, flexibility, support, accessibility, time and attention, honesty, reliability, sensitivity and post-diagnosis a willingness to find out and share information and to consult colleagues and other professionals. The interviews indicated that these were not always demonstrated by professionals.

Real-time Raman spectroscopy for automatic in vivo skin cancer detection: an independent validation.

PubMed

Zhao, Jianhua; Lui, Harvey; Kalia, Sunil; Zeng, Haishan

2015-11-01

In a recent study, we have demonstrated that real-time Raman spectroscopy could be used for skin cancer diagnosis. As a translational study, the objective of this study is to validate previous findings through a completely independent clinical test. In total, 645 confirmed cases were included in the analysis, including a cohort of 518 cases from a previous study, and an independent cohort of 127 new cases. Multi-variant statistical data analyses including principal component with general discriminant analysis (PC-GDA) and partial least squares (PLS) were used separately for lesion classification, which generated similar results. When the previous cohort (n = 518) was used as training and the new cohort (n = 127) was used as testing, the area under the receiver operating characteristic curve (ROC AUC) was found to be 0.889 (95 % CI 0.834-0.944; PLS); when the two cohorts were combined, the ROC AUC was 0.894 (95 % CI 0.870-0.918; PLS) with the narrowest confidence intervals. Both analyses were comparable to the previous findings, where the ROC AUC was 0.896 (95 % CI 0.846-0.946; PLS). The independent study validates that real-time Raman spectroscopy could be used for automatic in vivo skin cancer diagnosis with good accuracy.

Translational Approaches for Studying Neurodevelopmental Disorders Utilizing in Vivo Proton (+H) Magnetic Resonance Spectroscopic Imaging in Rats

NASA Technical Reports Server (NTRS)

Ronca, April E.

2014-01-01

Intrauterine complications have been implicated in the etiology of neuripsychiatric disorders including schizophrenia, autism and ADHD. This presentation will describe new translational studies derived from in vivo magnetic resonance imaging of developing and adult brain following perinatal asphyxia (PA). Our findings reveal significant effects of PA on neurometabolic profiles at one week of age, and significant relationships between early metabolites and later life phenotypes including behavior and brain morphometry

QCD sum-rules analysis of vector (1-) heavy quarkonium meson-hybrid mixing

NASA Astrophysics Data System (ADS)

Palameta, A.; Ho, J.; Harnett, D.; Steele, T. G.

2018-02-01

We use QCD Laplace sum rules to study meson-hybrid mixing in vector (1-) heavy quarkonium. We compute the QCD cross-correlator between a heavy meson current and a heavy hybrid current within the operator product expansion. In addition to leading-order perturbation theory, we include four- and six-dimensional gluon condensate contributions as well as a six-dimensional quark condensate contribution. We construct several single and multiresonance models that take known hadron masses as inputs. We investigate which resonances couple to both currents and so exhibit meson-hybrid mixing. Compared to single resonance models that include only the ground state, we find that models that also include excited states lead to significantly improved agreement between QCD and experiment. In the charmonium sector, we find that meson-hybrid mixing is consistent with a two-resonance model consisting of the J /ψ and a 4.3 GeV resonance. In the bottomonium sector, we find evidence for meson-hybrid mixing in the ϒ (1 S ) , ϒ (2 S ), ϒ (3 S ), and ϒ (4 S ).

Association between BDNF levels and suicidal behaviour: a systematic review and meta-analysis.

PubMed

Eisen, Rebecca B; Perera, Stefan; Banfield, Laura; Anglin, Rebecca; Minuzzi, Luciano; Samaan, Zainab

2015-12-30

Suicidal behaviour is a complex phenomenon with a multitude of risk factors. Brain-derived neurotrophic factor (BDNF), a protein crucial to nervous system function, may be involved in suicide risk. The objective of this systematic review is to evaluate and summarize the literature examining the relationship between BDNF levels and suicidal behaviour. A predefined search strategy was used to search MEDLINE, EMBASE, PsychINFO, and CINAHL from inception to December 2015. Studies were included if they investigated the association between BDNF levels and suicidal behaviours (including completed suicide, attempted suicide, or suicidal ideation) by comparing BDNF levels in groups with and without suicidal behaviour. Only the following observational studies were included: case-control and cohort studies. Both clinical- and community-based samples were included. Screening, data extraction, and risk of bias assessment were conducted in duplicate. Six-hundred thirty-one articles were screened, and 14 were included in the review. Three studies that assessed serum BDNF levels in individuals with suicide attempts and controls were combined in a meta-analysis that showed no significant association between serum BDNF and suicide attempts. The remaining 11 studies were not eligible for the meta-analysis and provided inconsistent findings regarding associations between BDNF and suicidal behaviour. The findings of the meta-analysis indicate that there is no significant association between serum BDNF and attempted suicide. The qualitative review of the literature did not provide consistent support for an association between BDNF levels and suicidal behaviour. The evidence has significant methodological limitations. PROSPERO CRD42015015871.

CHIP: Facilitating Interprofessional and Culturally Competent Patient Care Through Experiential Learning in China.

PubMed

Mu, Keli; Peck, Kirk; Jensen, Lou; Bracciano, Al; Carrico, Cathy; Feldhacker, Diana

2016-12-01

Health care professionals have advocated for educating culturally competent practitioners. Immersion in international experiences has an impact on student cultural competency and interprofessional development. The China Honors Interprofessional Program (CHIP) at a university in the Midwest is designed to increase students' cultural competency and interprofessional development. From 2009 to 2013, a total of 25 professional students including twelve occupational therapy students, ten physical therapy students and three nursing students were enrolled in the programme. Using a one group pre and posttest research design, this study evaluated the impact of CHIP on the participating students. Both quantitative and qualitative data were collected in the study. Findings of the study revealed that CHIP has impact on students' cultural competency and professional development including gaining appreciation and understanding of the contributions of other healthcare professionals and knowledge and skills in team work. The findings of the study suggested that international immersion experience such as CHIP is an important way to increase students' cultural competency and interprofessional knowledge and skills. Limitations of the study included the small sample in the study, indirect outcome measures and the possible celling effect of the instruments of the study. Future research studies should include a larger and more representative sample, direct outcome measures such as behaviour observation and more rigorous design such as prospective experimental comparison group design. Future research should also examine the long-term effects of international experience on the professional development of occupational therapy students. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Associations between dietary and lifestyle risk factors and colorectal cancer in the Scottish population.

PubMed

Theodoratou, Evropi; Farrington, Susan M; Tenesa, Albert; McNeill, Geraldine; Cetnarskyj, Roseanne; Korakakis, Emmanouil; Din, Farhat V N; Porteous, Mary E; Dunlop, Malcolm G; Campbell, Harry

2014-01-01

Colorectal cancer (CRC) accounts for 9.7% of all cancer cases and for 8% of all cancer-related deaths. Established risk factors include personal or family history of CRC as well as lifestyle and dietary factors. We investigated the relationship between CRC and demographic, lifestyle, food and nutrient risk factors through a case-control study that included 2062 patients and 2776 controls from Scotland. Forward and backward stepwise regression was applied and the stability of the models was assessed in 1000 bootstrap samples. The variables that were automatically selected to be included by the forward or backward stepwise regression and whose selection was verified by bootstrap sampling in the current study were family history, dietary energy, 'high-energy snack foods', eggs, juice, sugar-sweetened beverages and white fish (associated with an increased CRC risk) and NSAIDs, coffee and magnesium (associated with a decreased CRC risk). Application of forward and backward stepwise regression in this CRC study identified some already established as well as some novel potential risk factors. Bootstrap findings suggest that examination of the stability of regression models by bootstrap sampling is useful in the interpretation of study findings. 'High-energy snack foods' and high-energy drinks (including sugar-sweetened beverages and fruit juices) as risk factors for CRC have not been reported previously and merit further investigation as such snacks and beverages are important contributors in European and North American diets.

Geographic access to mammography and its relationship to breast cancer screening and stage at diagnosis: a systematic review

PubMed Central

Khan-Gates, Jenna A.; Ersek, Jennifer L.; Eberth, Jan M.; Adams, Swann A.; Pruitt, Sandi

2016-01-01

Introduction A review was conducted to summarize the current evidence and gaps in the literature on geographic access to mammography and its relationship to breast cancer-related outcomes. Methods Ovid Medline and PubMed were searched for articles published between January 1, 2000 and April 1, 2013 using Medical Subject Headings and key terms representing geographic accessibility and breast cancer-related outcomes. Due to a paucity of breast cancer treatment and mortality outcomes meeting the criteria (N=6), outcomes were restricted to breast cancer screening and stage at diagnosis. Studies included one or more of the following types of geographic accessibility measures: capacity, density, distance and travel time. Study findings were grouped by outcome and type of geographic measure. Results Twenty-one articles met inclusion criteria. Fourteen articles included stage at diagnosis as an outcome, five included mammography utilization, and two included both. Geographic measures of mammography accessibility varied widely across studies. Findings also varied, but most articles found either increased geographic access to mammography associated with increased utilization and decreased late-stage at diagnosis or no statistically significant association. Conclusion The gaps and methodologic heterogeneity in the literature to date limit definitive conclusions about an underlying association between geographic mammography access and breast cancer-related outcomes. Future studies should focus on the development and application of more precise and consistent measures of geographic access to mammography. PMID:26219677

Foundations of Job Satisfaction in the Media Industries.

ERIC Educational Resources Information Center

DeFleur, Margaret H.

1992-01-01

Examines classic sources on job satisfaction, including Adam Smith, Karl Marx, and the Hawthorne studies. Studies the job satisfaction of 1,526 mass communication graduates and compares satisfaction levels across the 9 different media fields. Finds a clear hierarchy of satisfaction within the nine fields. (SR)

NCI study finds extreme obesity may shorten life expectancy up to 14 years

Cancer.gov

Extremely obese people have increased risks of dying from cancer and many other causes including heart disease, stroke, diabetes, and kidney and liver diseases, according to results of an analysis of data pooled from 20 large studies of people from three

A Quantitative Analysis of Countries' Research Strengths

ERIC Educational Resources Information Center

Saxena, Anurag; Brazer, S. David; Gupta, B. M.

2009-01-01

This study employed a multidimensional analysis to evaluate transnational patterns of scientific research to determine relative research strengths among widely varying nations. Findings from this study may inform national policy with regard to the most efficient use of scarce national research resources, including government and private funding.…

RESEARCH REPORT, 1966-1967.

ERIC Educational Resources Information Center

Connecticut Vocational Education Research and Planning Unit, Hartford.

ABSTRACTS OF 31 COMPLETED AND IN-PROCESS PROJECTS ARE PRESENTED IN THIS ANNUAL REVIEW OF VOCATIONAL RESEARCH IN CONNECTICUT. EACH ABSTRACT INCLUDES THE PROJECT NUMBER, PRINCIPAL INVESTIGATOR, PURPOSE OF THE STUDY, SOURCE OF DATA, FINDINGS AND CONCLUSIONS, AND IMPLEMENTATION, WHERE POSSIBLE. REPRESENTATIVE PROJECT TITLES ARE--(1) "A STUDY OF THE…

Bakersfield College Transfer Study Data.

ERIC Educational Resources Information Center

Scott, David C.

Data provided by the University of California (UC) and California State University and Colleges (CSUC) were analyzed to identify enrollment trends and assess academic performance among transfer students from Bakersfield College. Study findings included the following: (1) first-time transfers from Bakersfield College to CSUC decreased from 391 in…

Counselor Trainees' Experiences Counseling Disability: A Phenomenological Study

ERIC Educational Resources Information Center

Rivas, Michele; Hill, Nicole R.

2018-01-01

Transcendental phenomenology was used in this study to examine the lived experiences of counseling interns (N = 10) receiving multicultural training to assist clients with disabilities. Five essential themes were identified. Drawing on their findings, the authors recommend programmatic and curricular changes, including the infusion of personal…

29 CFR Section 1607.16 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... action are open to users. T. Skill. A present, observable competence to perform a learned psychomoter act... criterion-related validity studies. These conditions include: (1) An adequate sample of persons available for the study to achieve findings of statistical significance; (2) having or being able to obtain a...

Early visual language exposure and emergent literacy in preschool deaf children: findings from a national longitudinal study.

PubMed

Allen, Thomas E; Letteri, Amy; Choi, Song Hoa; Dang, Daqian

2014-01-01

Brief review is provided of recent research on the impact of early visual language exposure on a variety of developmental outcomes, including literacy, cognition, and social adjustment. This body of work points to the great importance of giving young deaf children early exposure to a visual language as a critical precursor to the acquisition of literacy. Four analyses of data from the Visual Language and Visual Learning (VL2) Early Education Longitudinal Study are summarized. Each confirms findings from previously published laboratory findings and points to the positive effects of early sign language on, respectively, letter knowledge, social adaptability, sustained visual attention, and cognitive-behavioral milestones necessary for academic success. The article concludes with a consideration of the qualitative similarity hypothesis and a finding that the hypothesis is valid, but only if it can be presented as being modality independent.

The association of suicide and bullying in childhood to young adulthood: a review of cross-sectional and longitudinal research findings.

PubMed

Brunstein Klomek, Anat; Sourander, Andre; Gould, Madelyn

2010-05-01

To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings. Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles. Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead to suicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies' participants and methods. Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.

Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis.

PubMed

Garcia-Larsen, Vanessa; Ierodiakonou, Despo; Jarrold, Katharine; Cunha, Sergio; Chivinge, Jennifer; Robinson, Zoe; Geoghegan, Natalie; Ruparelia, Alisha; Devani, Pooja; Trivella, Marialena; Leonardi-Bee, Jo; Boyle, Robert J

2018-02-01

There is uncertainty about the influence of diet during pregnancy and infancy on a child's immune development. We assessed whether variations in maternal or infant diet can influence risk of allergic or autoimmune disease. Two authors selected studies, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings. We searched Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) between January 1946 and July 2013 for observational studies and until December 2017 for intervention studies that evaluated the relationship between diet during pregnancy, lactation, or the first year of life and future risk of allergic or autoimmune disease. We identified 260 original studies (964,143 participants) of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies (542,672 participants) of other maternal or infant dietary exposures, including 80 trials of maternal (n = 26), infant (n = 32), or combined (n = 22) interventions. Risk of bias was high in 125 (48%) milk feeding studies and 44 (25%) studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with nonpathogenic micro-organisms (probiotics) during late pregnancy and lactation may reduce risk of eczema (Risk Ratio [RR] 0.78; 95% CI 0.68-0.90; I2 = 61%; Absolute Risk Reduction 44 cases per 1,000; 95% CI 20-64), and 6 trials suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitisation to egg (RR 0.69, 95% CI 0.53-0.90; I2 = 15%; Absolute Risk Reduction 31 cases per 1,000; 95% CI 10-47). GRADE certainty of these findings was moderate. We found weaker support for the hypotheses that breastfeeding promotion reduces risk of eczema during infancy (1 intervention trial), that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus (28 observational studies), and that probiotics reduce risk of allergic sensitisation to cow's milk (9 intervention trials), where GRADE certainty of findings was low. We did not find that other dietary exposures-including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake-influence risk of allergic or autoimmune disease. For many dietary exposures, data were inconclusive or inconsistent, such that we were unable to exclude the possibility of important beneficial or harmful effects. In this comprehensive systematic review, we were not able to include more recent observational studies or verify data via direct contact with authors, and we did not evaluate measures of food diversity during infancy. Our findings support a relationship between maternal diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively.

Brain Structural Effects of Psychopharmacological Treatment in Bipolar Disorder

PubMed Central

McDonald, Colm

2015-01-01

Bipolar disorder is associated with subtle neuroanatomical deficits including lateral ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging studies to date and differential psychotropic medication use is potentially a substantial contributor to this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are associated with neuroanatomical variation. Most studies are negative and suffer from methodological weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic structures. These findings are further supported by the more methodologically robust studies which include large numbers of patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by preclinical studies. PMID:26412064

How new graduate nurses experience patient death: A systematic review and qualitative meta-synthesis.

PubMed

Zheng, Ruishuang; Lee, Susan Fiona; Bloomer, Melissa Jane

2016-01-01

Patient death is an emotional and demanding experience for nurses, especially for new graduate nurses who are unprepared to deliver end-of-life care. Understanding new graduate nurses' experience of death and dying will inform the design of training programs and interventions for improvements in the quality of care and support of new graduates. To summarize new graduate nurses' experience with patient death by examining the findings of existing qualitative studies. Systematic review methods incorporating meta-synthesis were used. A comprehensive search was conducted in 12 databases from January 1990 to December 2014. All qualitative and mixed-method studies in English and Chinese that explored new graduate nurses' experience of patient death were included. Two independent reviewers selected the studies for inclusion and assessed each study quality. Meta-aggregation was performed to synthesize the findings of the included studies. Five primary qualitative studies and one mix-method study met inclusion and quality criteria. Six key themes were identified from the original findings: emotional experiences, facilitating a good death, support for family, inadequacy on end-of-life care issues, personal and professional growth and coping strategies. New graduate nurses expressed a variety of feelings when faced with patient death, but still they tried to facilitate a good death for dying patients and provide support for their families. The nurses benefited from this challenging encounter though they lacked of coping strategies. Copyright © 2015. Published by Elsevier Ltd.

Brain Structural Effects of Psychopharmacological Treatment in Bipolar Disorder.

PubMed

McDonald, Colm

2015-01-01

Bipolar disorder is associated with subtle neuroanatomical deficits including lateral ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging studies to date and differential psychotropic medication use is potentially a substantial contributor to this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are associated with neuroanatomical variation. Most studies are negative and suffer from methodological weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic structures. These findings are further supported by the more methodologically robust studies which include large numbers of patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by preclinical studies.

Creative conceptual expansion: A combined fMRI replication and extension study to examine individual differences in creativity.

PubMed

Abraham, Anna; Rutter, Barbara; Bantin, Trisha; Hermann, Christiane

2018-05-05

The aims of this fMRI study were two-fold. The first objective of the study was to verify whether the findings associated with a previous fMRI study could be replicated in which a novel event-related experimental design was developed which rendered it possible to investigate the brain basis of creative conceptual expansion. The ability to widen the boundaries of conceptual structures is integral to creative idea generation, which makes conceptual expansion a core component of creative cognition. Creative conceptual expansion led to the engagement of brain regions that are known to be involved in the access, storage and relational integration of conceptual knowledge in the original study. These included the anterior inferior frontal gyrus, the temporal poles and the lateral frontal pole. These findings in relation to the brain basis of creative conceptual expansion were replicated in the current study. The second objective of this study was to evaluate the brain basis of individual differences in creative conceptual expansion. The high creative group relative to the low creative group was shown to exhibit greater activity in regions of the semantic cognition network as well as the salience network during creative conceptual expansion. The findings are discussed from the point of view of classical hypotheses about information processing biases that explain individual differences in creativity including flat associative hierarchies, defocused attention and cognitive disinhibition. Copyright © 2018 Elsevier Ltd. All rights reserved.

Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies.

PubMed

Sandelowski, Margarete; Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L

2013-06-01

Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. The data extraction challenges described here were encountered, and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011-2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. © 2012 Blackwell Publishing Ltd.

Electric utility pole yard training facility: Designing an effective learning environment

NASA Astrophysics Data System (ADS)

Topping, Robert P.

The primary responsibility of electric utilities is to supply consistent, dependable, and affordable energy to private customers, businesses, and industries. As with many businesses, electric utilities are experiencing the effects of an aging workforce and expending considerable resources to train their current and replacement workers. Community colleges can partner with electric utilities to provide effective learning environments for these workers, and gain access to new sources of revenue and community support for the colleges. The purpose of this study was to describe the functions, features, and major design issues of an effective learning environment for training electric utility industry workers, the electric utility line-worker pole yard. Case studies of three "state of the art" line-worker pole yard training environments provide the basis for the study's findings and implications. The study was guided by the following research questions: (1) What is the function of a line-worker pole yard in supporting effective training? (2) What are the features of present day ("state of the art") line-worker pole yard learning environments? and (3) What are the major issues that need to be addressed in designing a line-worker pole yard learning environment for the future? The study participants included industry representatives, training coordinators, instructors, and students from the three selected "state of the art" line-worker pole yard sites. The overall findings from the study resulted in composites of the desired features of learning outcomes, learning process, and learning environment for a line-worker pole yard training program and major issues that are affecting the future design of these training programs. Composite findings of a pole-yard training environment included unique features associated with: (a) outdoor, (b) indoor, (c) underground, (d) classroom, (e) gathering places, and (f) work-based learning components. Composite findings with regard to major issues that need to be considered in future designs of pole-yard training environments included: (a) available unrestricted land for expansion, (b) resource commitment level, (c) workforce demographics, (d) aging industrial infrastructure, (e) electronic information and communication capability, (f) quality and quantity of available instructors, and (g) environmental and economic impact.

Experiences of chronic low back pain: a meta-ethnography of qualitative research.

PubMed

MacNeela, Padraig; Doyle, Catherine; O'Gorman, David; Ruane, Nancy; McGuire, Brian E

2015-01-01

Chronic low back pain (CLBP) is associated with a number of costly disability-related outcomes. It has received increasing attention from qualitative researchers studying its consequences for personal, social, and health care experiences. As research questions and methods diversify, there is a growing need to integrate findings emerging from these studies. A meta-ethnography was carried out to synthesise the findings of 38 separate qualitative articles published on the subjective experience of CLBP between 1994 and 2011. Studies were identified following a literature search and quality appraisal. Four themes were proposed after a process of translating the meaning of text extracts from the findings sections across all the articles. The themes referred to the undermining influence of pain, its disempowering impact on all levels, unsatisfying relationships with health care professionals, and learning to live with the pain. The findings are dominated by wide-ranging distress and loss but also acknowledge self-determination and resilience. Implications of the meta-ethnography for clinicians and future qualitative research are outlined, including the need to study relatively unexamined facets of subjective experience such as illness trajectory and social identity.

Clinical predictors of high risk histopathology in retinoblastoma.

PubMed

Kashyap, Seema; Meel, Rachna; Pushker, Neelam; Sen, Seema; Bakhshi, Sameer; Sreenivas, Vishnubhatla; Sethi, Sumita; Chawla, Bhavna; Ghose, Supriyo

2012-03-01

Previous studies show that clinical features at presentation, in retinoblastoma patients, like glaucoma and neovascularization of iris are associated with a higher incidence of high risk histopathology findings (HRF) in enucleated eyes. Herein, we analyze association between clinical features at time of enucleation and occurrence of HRF including invasion of anterior chamber, iris, ciliary body, choroid (massive), sclera, extrascleral tissue, optic nerve beyond lamina cribrosa, and optic nerve cut end, in a large series of eyes enucleated for retinoblastoma. We retrospectively studied demographic, clinical, and histopathology findings in all retinoblastoma patients who underwent primary enucleation at our center, over a 5 years duration. Statistical analysis was done to find any association between clinical features at presentation and the presence of HRF. Three hundred twenty-six eyes were studied. Median age of presentation was 2 years. Glaucoma was the most common clinical finding at presentation apart from leucocoria. Out of 326 enucleated eyes, 28 (8.6%) had extrascleral and/or optic nerve transection invasion. Among remaining 298 eyes, with completely resected tumor, 115 (38.6%) had massive choroidal invasion, 54 (17%) had retrolaminar optic nerve invasion, and 24 (7%), 29 (9%), and 23(7%) had anterior chamber, iris, and ciliary body invasion, respectively. Age more than 2 years, lag period more than 3 months, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were associated with occurrence of three or more HRF on univariate analysis. Clinical variables including older age, longer lag period, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were strongly associated with occurrence of HRF in this study. Copyright © 2011 Wiley Periodicals, Inc.

Older Age and Leg Pain Are Good Predictors of Pain and Disability Outcomes in 2710 Patients Who Receive Lumbar Fusion.

PubMed

Cook, Chad E; Frempong-Boadu, Anthony K; Radcliff, Kristen; Karikari, Isaac; Isaacs, Robert

2015-10-01

Identifying appropriate candidates for lumbar spine fusion is a challenging and controversial topic. The purpose of this study was to identify baseline characteristics related to poor/favorable outcomes at 1 year for a patient who received lumbar spine fusion. The aims of this study were to describe baseline characteristics of those who received lumbar surgery and to identify baseline characteristics from a spine repository that were related to poor and favorable pain and disability outcomes for patient who received lumbar fusion (with or without decompression), who were followed up for 1 full year and discriminate predictor variables that were either or in contrast to prognostic variables reported in the literature. This study analyzed data from 2710 patients who underwent lumbar spine fusion. All patient data was part of a multicenter, multi-national spine repository. Ten relatively commonly captured data variables were used as predictors for the study. Univariate/multivariate logistic regression analyses were run against outcome variables of pain/disability. Multiple univariate findings were associated with pain/disability outcomes at 1 year including age, previous surgical history, baseline disability, baseline pain, baseline quality of life scores, and leg pain greater than back pain. Notably significant multivariate findings for both pain and disability include older age, previous surgical history, and baseline mental summary scores, disability, and pain. Leg pain greater than back pain and older age may yield promising value when predicting positive outcomes. Other significant findings may yield less value since these findings are similar to those that are considered to be prognostic regardless of intervention type.

42 CFR 93.500 - General policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General... findings of research misconduct and HHS administrative actions, including debarment or suspension, arising... to contest ORI research misconduct findings and HHS administrative actions under this part, including...

42 CFR 93.500 - General policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General... findings of research misconduct and HHS administrative actions, including debarment or suspension, arising... to contest ORI research misconduct findings and HHS administrative actions under this part, including...

Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

PubMed

Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S

2017-09-01

The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

Family adjustment across cultural groups in autistic spectrum disorders.

PubMed

Lobar, Sandra L

2014-01-01

This pilot ethnomethodological study examined perceptions of parents/caregivers of children diagnosed with autistic spectrum disorders concerning actions, norms, understandings, and assumptions related to adjustment to this chronic illness. The sample included 14 caregivers (75% Hispanic of various ethnic groups). Maximum variation sampling was used to compare participants on variables that were inductively derived via constant comparative methods of analysis. The following action categories emerged: "Seeking Diagnosis," "Engaging in Routines to Control behavior," "Finding Therapies (Types of Therapies)," "Finding School Accommodations," "Educating Others," "Rising to Challenges," and "Finding the Role of Spiritual and Religious Belief."

Paradox of Modern Pregnancy: A Phenomenological Study of Women's Lived Experiences from Assisted Pregnancy

PubMed Central

Ranjbar, Fahimeh; Akhondi, Mohammad-Mehdi; Borimnejad, Leili; Ghaffari, Saeed-Reza; Behboodi-Moghadam, Zahra

2015-01-01

The purpose of our study was describing the meaning of pregnancy through Assisted Reproductive Technologies (ARTs). A qualitative design with hermeneutic phenomenology approach was selected to carry out the research. Semistructured in-depth interviews were conducted with 12 women who experienced assisted pregnancy. Three themes emerged from women's experience including finding peace in life, paradoxical feelings, and struggling to realize a dream. We concluded that pregnancy is the beginning of a new and hard struggle for women with fertility problems. The findings of our study resulted in helpful implications for the health care professionals managing assisted pregnancies. PMID:26064687

Drivers willingness to pay progressive rate for street parking.

DOT National Transportation Integrated Search

2015-01-01

This study finds willingness to pay and price elasticity for on-street parking demand using stated : preference data obtained from 238 respondents. Descriptive, statistical and economic analyses including : regression, generalized linear model, and f...

Proceedings of the ASPE/MSFC Symposium on Engineering and Productivity Gains from Space Technology

NASA Technical Reports Server (NTRS)

1977-01-01

Aerospace technology findings were examined in regard to nonaerospace applications. Studies of energy generation, materials and processes, earth observation as well as advances and benefits of electronics are included.

System-Level Process Change Improves Communication and Follow-Up for Emergency Department Patients With Incidental Radiology Findings.

PubMed

Baccei, Steven J; Chinai, Sneha A; Reznek, Martin; Henderson, Scott; Reynolds, Kevin; Brush, D Eric

2018-04-01

The appropriate communication and management of incidental findings on emergency department (ED) radiology studies is an important component of patient safety. Guidelines have been issued by the ACR and other medical associations that best define incidental findings across various modalities and imaging studies. However, there are few examples of health care facilities designing ways to manage incidental findings. Our institution aimed to improve communication and follow-up of incidental radiology findings in ED patients through the collaborative development and implementation of system-level process changes including a standardized loop-closure method. We assembled a multidisciplinary team to address the nature of these incidental findings and designed new workflows and operational pathways for both radiology and ED staff to properly communicate incidental findings. Our results are based on all incidental findings received and acknowledged between November 1, 2016, and May 30, 2017. The total number of incidental findings discovered was 1,409. Our systematic compliance fluctuated between 45% and 95% initially after implementation. However, after overcoming various challenges through optimization, our system reached a compliance rate of 93% to 95%. Through the implementation of our new, standardized communication system, a high degree of compliance with loop closure for ED incidental radiology findings was achieved at our institution. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Staying On-Track Despite the Odds: Factors That Assist Young People Facing Adversity to Continue with Their Education

ERIC Educational Resources Information Center

Sanders, Jackie; Munford, Robyn; Thimasarn-Anwar, Tewaporn

2016-01-01

This article draws on the findings from a mixed-methods New Zealand study of the experience of service use of 605 vulnerable young people (aged 13-17 years). Drawing on the survey data, it focuses on the factors that assisted young people to stay on-track with their education. Key findings include: being able to stay at mainstream school was the…

"Hoping to see the future I prefer": an element of life-world for older women living alone.

PubMed

Porter, Eileen J; Oyesanya, Tolu O; Johnson, Kathy A

2013-01-01

We interact with Dorcy's earlier work in Advances in Nursing Science on hope, noting that scholars have emphasized hope in suffering rather than exploring hoping in everyday life. We did a secondary analysis of 4 descriptive phenomenological studies with older women (N = 81, aged 75-98). Findings included a 4-level taxonomy of life-world. Four future-related subelements (such as, having a future I cannot see, down the road) intersected with the element hoping to see the future I prefer. Five of its subelements were common across the sample, including hoping that I do not get to that point. Findings have implications for expanding scholarship pertaining to hoping.

Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease.

PubMed

Garrett, Kevin M; Levitt, Marc A; Peña, Alberto; Kraus, Steven J

2012-09-01

The radiologic evaluation of Hirschsprung disease is well described in the literature. However, there is a paucity of literature describing the appearance of the neo-rectum and colon after repair, specifically describing findings in patients with poor functional outcome, which would suggest the need for reoperation. We describe findings on contrast enema and correlate them with surgical findings at reoperation in children with poor functional outcome after primary repair for Hirschsprung disease who suffer from bowel dysfunction that can manifest with either soiling or obstructive symptoms such as enterocolitis. Children were identified from our colorectal surgery database. At the time of abstract submission, 35 children had contrast enemas prior to reoperation. Additional children continue to present for evaluation. The majority of children included in the study had their primary repair performed elsewhere. The initial procedures included: Duhamel (n = 11), Soave (n = 20) or Swenson (n = 3). One child had undergone a primary Soave repair and subsequently had a Swenson-type reoperation but continued to have a poor outcome. One child's initial surgical repair could not be determined. Images were reviewed by a staff pediatric radiologist and a pediatric radiology fellow. Findings encountered on contrast enema in these children include a distal narrowed segment due to stricture or aganglionic/transitional zone segment (8), dilated/hypomotile distal segment (7), thickened presacral space due to compressing Soave cuff (11), dilated Duhamel pouch (8), active enterocolitis (3) and partially obstructing twist of the pull-through segment (1). Multiple anatomical and pathological complications exist that can lead to bowel dysfunction in children after repair of Hirschsprung disease. Little recent literature exists regarding the radiographic findings in children. We had the opportunity to review a substantial series of these children, describe the contrast enema findings in these difficult cases and correlate them with operative findings. Radiologic evaluation is key to assessing such patients; it defines the potential anatomical problem with the pull-through and facilitates surgical planning.

Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review.

PubMed

Alhowimel, Ahmed; AlOtaibi, Mazyad; Radford, Kathryn; Coulson, Neil

2018-01-01

Almost 80% of people have low back pain at least once in their life. Clinical guidelines emphasize the use of conservative physiotherapy and the importance of staying active. While the psychological factors predicting poor recovery following surgical intervention are understood, the psychosocial factors associated with poor outcomes following physiotherapy have yet to be identified. Electronic searches of PubMed, Medline, CINAHL, PsycINFO and EBSCO were conducted using terms relating to psychosocial factors, chronic low back pain, disability and physiotherapy. Papers examining the relationship between psychosocial factors and pain and disability outcomes following physiotherapy were included. Two reviewers selected, appraised and extracted studies independently. In total, 10 observational studies were identified that suggested an association between fear of movement, depression, self-efficacy and catastrophizing in modifying pain and disability outcomes following physiotherapy. Although limited by methodological shortcomings of included studies, and heterogeneity of physiotherapy interventions and measures of disability and psychosocial outcomes, the findings are consistent with other research in the context of back pain and physiotherapy, which suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist. However, a direct relationship cannot be concluded from this study. Findings suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist, which warrants further study.

Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review.

PubMed

Memon, Muzammil; Kay, Jeffrey; Quick, Emily; Simunovic, Nicole; Duong, Andrew; Henry, Patrick; Ayeni, Olufemi R

2018-06-01

Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors' knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies. The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%. Systematic review; Level of evidence, 4. The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist. In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure. Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.

The Canon and Cultural Studies: Culture and Anarchy in Gotham City.

ERIC Educational Resources Information Center

DeBona, Guerric

1997-01-01

Finds that including media studies at the end of a traditional literature course is an effective pedagogical instrument for instigating discussion regarding the literary canon, since students recognize and address the important contribution of popular culture when it is in dialogue with more traditional material. Selects the film…

Models of Mentoring in Communication

ERIC Educational Resources Information Center

Buell, Cindy

2004-01-01

This study examined faculty and student conceptualizations and distinctively communicative practices of mentoring in the academy. The study included three phases: (1) open-ended surveys conducted with faculty and students via e-mail, (2) focus groups conducted with faculty and students to elaborate on findings from the e-mail interviews, and (3)…

Service Learning and the Development of Social Responsibility.

ERIC Educational Resources Information Center

Johnson, Scott D.; Bozeman, Marci

This essay presents the findings of a study employing a developmental approach to student acquisition of social responsibility. Professors at seven collegiate institutions of differing types who teach service-learning courses were asked if they would be willing to include their students in a study of social responsibility development through…

Creating a Shared Formulary in 7 Critical Access Hospitals

ERIC Educational Resources Information Center

Wakefield, Douglas S.; Ward, Marcia M.; Loes, Jean L.; O'Brien, John; Abbas, Nancy

2010-01-01

Purpose: This paper reports a case study of 7 Critical Access Hospitals' (CAH) and 1 rural referral hospital's successful collaboration to develop a shared formulary. Methods: Study methods included document reviews, interviews with key informants, and use of descriptive statistics. Findings: Through a systematic review and decision process, CAH…

Taking "O" Level GCE Examinations: The Strategies Employed by Candidates and Their Teachers.

ERIC Educational Resources Information Center

Francis, J.C.

1981-01-01

Examines the relationship of study techniques and test-taking strategies to success on the "O" level of the British General Certificate of Education (GCE) examination. Findings showed that teachers and students felt that course reviews, including study of past examinations, was the best preparation. (AM)

Data Collection Management. A Supporting Report of the Instructional Dimensions Study, 1976-1977.

ERIC Educational Resources Information Center

Peterson, Morris

This report is one of 8 volumes which describe the findings and procedures of the Instructional Dimensions Study, an in-depth assessment of the relationships between selected instructional constructs and students' achievement. These constructs include individualization, opportunity to learn, motivational factors, instructional events, and teacher…

The Effectiveness of Psychotherapeutic Interventions for Bereaved Persons: A Comprehensive Quantitative Review

ERIC Educational Resources Information Center

Currier, Joseph M.; Neimeyer, Robert A.; Berman, Jeffrey S.

2008-01-01

Previous quantitative reviews of research on psychotherapeutic interventions for bereaved persons have yielded divergent findings and have not included many of the available controlled outcome studies. This meta-analysis summarizes results from 61 controlled studies to offer a more comprehensive integration of this literature. This review examined…

Family Adjustment to Childhood Cancer: A Systematic Review

ERIC Educational Resources Information Center

Long, Kristin A.; Marsland, Anna L.

2011-01-01

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer,…

Single-Sex Education in Public School Settings

ERIC Educational Resources Information Center

Crawford-Ferre, Heather Glynn; Wiest, Lynda R.

2013-01-01

Although researchers have studied the effectiveness of single-sex education (SSE), the findings have been mixed. This exploratory study reports the perceived goals and effectiveness of single-sex education based on interviews with a small group of educators involved with SSE in various ways. Research participants included a school principal and…

Brief Treatments for Cannabis Dependence: Findings From a Randomized Multisite Trial

ERIC Educational Resources Information Center

Babor, Thomas F.

2004-01-01

This study evaluated the efficacy of 2 brief interventions for cannabis-dependent adults. A multisite randomized controlled trial compared cannabis use outcomes across 3 study conditions: (a) 2 sessions of motivational enhancement therapy (MET); (b) 9 sessions of multicomponent therapy that included MET, cognitive-behavioral therapy, and case…

Studying the Impacts of Globalization on Iranian Education System

ERIC Educational Resources Information Center

Chahardahcheriki, Mitra Abdolahi; Shahi, Sakine

2012-01-01

The purpose of this study is to analyze the degree of globalization of important indicators of education system in Iran including teaching approaches, educational tools and facilities, curriculums and contents, and education management. Findings suggest that the situation of Iranian education system has some distance with the globalized level and…

Child Development and the Language Arts.

ERIC Educational Resources Information Center

Russell, David H., Ed.; And Others

This monograph presents research findings on child development and points out implications for the language arts program, examining both the learner and the learning process. Chapters include "Introduction: The Child Study Movement and the Language Arts Curriculum," which traces the development of child study research and lists five influences on…

NCAA Study of Substance Use of College Student-Athletes

ERIC Educational Resources Information Center

DeHass, Denise M.

2006-01-01

This report details findings from the 2006 National Collegiate Athletic Association (NCAA) study of college student athletes, tracking their use of ergogenic drugs (steroids, ephedrine, amphetamine) and social drugs (alcohol, marijuana, cocaine, and tobacco). It also includes data on where student athletes obtain drugs, their perceptions of drug…

KINETIC STUDIES RELATED TO THE LIMB (LIMESTONE INJECTION MULTISTAGE BURNER) BURNER

EPA Science Inventory

The report gives results of theoretical and experimental studies of subjects related to the limestone injection multistage burner (LIMB). The main findings include data on the rate of evolution of H2S from different coals and on the dependence of the rate of evolution on the dist...

Planning for Quality: Perils and Possibilities.

ERIC Educational Resources Information Center

Schmidtlein, Frank A.

This paper reports selected findings from a study of formal, institution-wide planning in the United States undertaken by the National Center for Postsecondary Governance and Finance, located at the University of Maryland. The study included a review of higher education planning literature, a survey of administrators at 256 institutions, and…

Instructional Leadership: Four Ethnographic Studies on Junior High School Principals.

ERIC Educational Resources Information Center

Newberg, Norman A.; Glatthorn, Allan A.

This study explores the principal's role as instructional leader in four urban schools showing improvement in test scores. Data gathering procedures included ethnographic observations and interviews of principals; principals' logs of time use; interviews with teachers, school administrators, and students; and faculty surveys. The findings were…

Attention Deficit Hyperactivity Disorder among Asian American Families: Challenges in Assessment and Treatment

ERIC Educational Resources Information Center

Pham, Andy V.

2013-01-01

Studies addressing assessment and treatment of attention deficit hyperactivity disorder (ADHD) have primarily been focused on Caucasian populations, although a growing number of studies have included ethnic minority populations, particularly Hispanic and African American children. Findings regarding the relationship between ADHD diagnosis and race…

School Leaders' Perceptions about Incompetent Teachers: Implications for Supervision and Evaluation

ERIC Educational Resources Information Center

Range, Bret G.; Duncan, Heather E.; Scherz, Susan Day; Haines, Courtney A.

2012-01-01

This study explored Wyoming school leaders' perceptions about the traits of incompetent teachers, strategies used to work with incompetent teachers, and the barriers to their dismissal. Most importantly, this study differentiated how principals and superintendents viewed incompetency issues. Some major findings include school leaders' beliefs that…

Engaging Employers in Public Workforce Efforts in Texas.

ERIC Educational Resources Information Center

McPherson, Robert E.; Long, Donald W.; Sim, Shao Chee

To determine how best to connect public work force services in Texas with employers' needs, a study reviewed literature on employer involvement in government-sponsored training programs. Study activities included the following: review of findings from two recent national surveys on employer training, identification of states most strongly…

Likelihood of Timber Management on Nonindustrial Private Forests: Evidence From Research Studies

Treesearch

Ralph J. Alig; Karen J. Lee; Robert J. Moulton

1990-01-01

Research on timber management tendencies by nonindustrial private forest owners, while sometimes conflicting, provides useful information to support policy analyses of timber supply and investment behavior. Numerous research studies regarding tree planting, intermediate stand treatments, and timber harvesting are reviewed. Conclusive research findings include that: (1...

The Internet as a Source of Academic Research Information: Findings of Two Pilot Studies.

ERIC Educational Resources Information Center

Kibirige, Harry M.; DePalo, Lisa

2000-01-01

Discussion of information available on the Internet focuses on two pilot studies that investigated how academic users perceive search engines and subject-oriented databases as sources of topical information. Highlights include information seeking behavior of academic users; undergraduate users; graduate users; faculty; and implications for…

Seven Special Kids: Employment Problems of Handicapped Youth.

ERIC Educational Resources Information Center

Smith, R. C.

A study of the employment problems facing physically and mentally handicapped youth is reported. To illustrate the main points, results of extensive interviews with seven handicapped youth are juxtaposed with statistics and findings. The study looks at tne continuum of services offered to handicapped individuals, including understanding the…

Minor Anomalies and Behavior in Different Home Environments.

ERIC Educational Resources Information Center

LaVeck, Beverly; And Others

This study presents research findings of a four year study intended to identify infant and family characteristics which, singly or in combination, predict developmental problems during preschool and school years. Predictors included a variety of measures of parental and neonatal biological conditions as well as measures of the quality of the…

Clinical Course of Ophthalmic Findings and Potential Influence Factors of Herpesvirus Infections: 18 Month Follow-Up of a Closed Herd of Lipizzaners

PubMed Central

Rushton, James O.; Kolodziejek, Jolanta; Tichy, Alexander; Nowotny, Norbert; Nell, Barbara

2013-01-01

Background To date the influence of herpesviruses on the development of equine ocular diseases has not been clearly determined. Objective The purpose of this study was to illustrate the course of equine ocular findings over a period of 18 months at 6 month intervals, in correlation with the results of herpesvirus detection. Methods 266 Lipizzaners in 3 federal states of Austria underwent complete ophthalmologic examination 4 times. Blood samples, nasal- and conjunctival swabs were obtained at the same time and used for the detection of the equid gammaherpesviruses EHV-2 and EHV-5 using consensus herpesvirus PCR and type-specific qPCRs. Ophthalmic findings and results of herpesvirus PCRs were recorded and statistically analysed using one-way ANOVA, and multiple logistic regression analysis to determine the influence of herpesvirus infections and other contributing factors on the presence of ophthalmic findings. Results In the first, second, third and fourth examination period 266, 261, 249 and 230 horses were included, respectively. Ophthalmic findings consistent with herpesvirus infections included conjunctival- and corneal pathologies. Statistical analysis revealed that the probability of positive herpesvirus PCR results decreased with progressing age; however the presence of corneal findings increased over time. At the time of each examination 45.1%, 41.8%, 43.0%, and 57.0% of horses with conjunctival or corneal findings, respectively, were positive for EHV-2 and/or EHV-5. However, 31.6%, 17.6%, 20.1%, and 13.0% of clinically sound horses were positive for these herpesviruses at each examination period, too. Conclusion Based on the results of our study there is a significant influence of young age on EHV-2 and/or EHV-5 infection. Corneal pathologies increased over time and with progressing age. Whether the identified findings were caused by herpesviruses could not be unequivocally determined. PMID:24278206

The influence of workplace culture on nurses' learning experiences: a systematic review of qualitative evidence.

PubMed

Davis, Kate; White, Sarahlouise; Stephenson, Matthew

2016-06-01

A healthy workplace culture enables nurses to experience valuable learning in the workplace. Learning in the workplace enables the provision of evidence-based and continuously improving safe patient care, which is central to achieving good patient outcomes. Therefore, nurses need to learn within a workplace that supports the implementation of evidence-based, professional practice and enables the best patient outcomes; the influence of workplace culture may play a role in this. The purpose of this review was to critically appraise and synthesize the best available qualitative evidence to understand both the nurses' learning experiences within the workplace and the factors within the workplace culture that influence those learning experiences. Registered and enrolled nurses regulated by a nursing and midwifery board and/or recognized health practitioner regulation agency (or their international equivalent). This review considered studies that described two phenomena of interest: the nurses' learning experience, either within an acute healthcare workplace or a workplace-related learning environment and the influence of workplace culture on the nurses' learning experience (within the workplace or workplace-related learning environment). This review considered studies that included nurses working in an acute healthcare organization within a Western culture. This review considered studies that focused on qualitative evidence and included the following research designs: phenomenological, grounded theory and critical theory. Published and unpublished studies in English from 1980 to 2013 were identified using a three-step search strategy, searching various databases, and included hand searching of the reference lists within articles selected for appraisal. For studies meeting the inclusion criteria, methodological quality was assessed using a standardized checklist from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Qualitative data were extracted from articles included in the review using the standardized data extraction tool from the JBI-QARI. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Appraisal and Review Instrument (JBI-QARI). This involved the aggregation and synthesis of findings to generate a set of categories, which were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings that could be used as a basis for evidence-based practice. Fourteen articles were identified following appraisal and a total of 105 findings (85 unequivocal and 20 credible) were extracted from included studies and grouped into eight categories based on similarity of meaning. Subsequently, categories were grouped into two synthesized findings. The two synthesized findings were as follows: ORGANIZATIONAL INFLUENCES: Enabling nurses to demonstrate accountability for their own learning, along with clear organizational systems that provide resources, time, adequate staffing and support, demonstrates encouragement for and the value of nurses' learning and education. Nurses value their peers, expert nurses, preceptors, mentors and educators facilitating and encouraging their learning and professional development. An optimal workplace culture is central for nurses to experience valuable and relevant learning in the workplace. To emphasize the importance of nurses' learning in the workplace, working and learning is understood as an integrated experience. Consequently, a dual system that enables nurses to demonstrate accountability for their own learning, along with clear organizational and educational systems, is required to demonstrate the value in nurses' learning and education.

A systematic review of risk and protective factors associated with family related violence in refugee families.

PubMed

Timshel, Isabelle; Montgomery, Edith; Dalgaard, Nina Thorup

2017-08-01

The current systematic review summarizes the evidence from studies examining the risk and protective factors associated with family related violence in refugee families. Data included 15 peer-reviewed qualitative and quantitative studies. In order to gain an overview of the identified risk and protective factors an ecological model was used to structure the findings. At the individual level, parental trauma experiences/mental illness, substance abuse and history of child abuse were found to be risk factors. Family level risk factors included parent-child interaction, family structure and family acculturation stress. At the societal level low socioeconomic status was identified as a risk factor. Cultural level risk factors included patriarchal beliefs. Positive parental coping strategies were a protective factor. An ecological analysis of the results suggests that family related violence in refugee families is a result of accumulating, multiple risk factors on the individual, familial, societal and cultural level. The findings suggest that individual trauma and exile related stress do not only affect the individual but have consequences at a family level. Thus, interventions targeting family related violence should not only include the individual, but the family. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors affecting social workers' inclusion of animals in practice.

PubMed

Risley-Curtiss, Christina; Rogge, Mary E; Kawam, Elisa

2013-04-01

Experts suggest that social work practitioners can improve their client service with a more thorough understanding of the impact of other animals on individuals and families. Studies indicate that some social work practitioners are including animals in their practices through assessment and interventions. Little is known about what factors contribute to this inclusion, especially because there is a lack of attention in social work education and research to animal-human relationships. This study used logistical regression to examine the impact of certain demographic, knowledge, and practice variables on the inclusion of animals in social work practice. Findings include that knowing other social workers who include animals in practice and primary client population served were significant for inclusion of animals in assessment, animal-assisted intervention, and treating clients for animal abuse or loss of an animal. Although practitioners' having a companion animal was positively related to including animals in interventions and treating clients for loss of an animal, contributing to animal welfare through volunteering at shelters or financially contributing to animal groups did not have an effect on inclusion of animals in practice. Implications for these and other findings are discussed, and recommendations for social work research, education, and practice are offered.

Patient adherence to tuberculosis treatment: a systematic review of qualitative research.

PubMed

Munro, Salla A; Lewin, Simon A; Smith, Helen J; Engel, Mark E; Fretheim, Atle; Volmink, Jimmy

2007-07-24

Tuberculosis (TB) is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence. We searched 19 electronic databases (1966-February 2005) for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms "Tuberculosis AND (adherence OR compliance OR concordance)". We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the themes across all studies produced a line-of-argument synthesis describing how four major factors interact to affect adherence to TB treatment: structural factors, including poverty and gender discrimination; the social context; health service factors; and personal factors. The findings of this study are limited by the quality and foci of the included studies. Adherence to the long course of TB treatment is a complex, dynamic phenomenon with a wide range of factors impacting on treatment-taking behaviour. Patients' adherence to their medication regimens was influenced by the interaction of a number of these factors. The findings of our review could help inform the development of patient-centred interventions and of interventions to address structural barriers to treatment adherence.

[Asperger syndrome with highly exceptional calendar memory: a case report].

PubMed

Sevik, Ali Emre; Cengel Kültür, Ebru; Demirel, Hilal; Karlı Oğuz, Kader; Akça, Onur; Lay Ergün, Eser; Demir, Başaran

2010-01-01

Some patients with pervasive developmental disorders develop unusual talents, which are characterized as savant syndrome. Herein we present neuropsychological examination and brain imaging (fMRI and brain SPECT) findings of an 18-year-old male with Asperger syndrome and highly unusual calendar memory. Neuropsychological evaluation of the case indicated mild attention, memory, and problem solving deficits, and severe executive function deficits that included conceptualization, category formation, and abstraction. Functional MRI findings showed activation above the baseline level (P<0.05) in the bilateral inferior parietal lobule, precuneus, superior and middle frontal gyri, and medial frontal cortex. Brain SPECT findings, in comparison to rest-SPECT findings, showed that there was hypoperfusion in some brain regions, including the right frontal cortex and right parietal cortex. Baseline blood perfusion in the left frontal cortex was also observed, as well as hypoperfusion in the right parietal-occipital cortex and in the right basal ganglion (compared to the left side). The results of the present study and further research will contribute to our understanding of calendar memory and savant syndrome.

Passing the baton: Community-based ethnography to design a randomized clinical trial on the effectiveness of oral pre-exposure prophylaxis for HIV prevention among Black men who have sex with men.

PubMed

Garcia, Jonathan; Colson, Paul W; Parker, Caroline; Hirsch, Jennifer S

2015-11-01

Although HIV interventions and clinical trials increasingly report the use of mixed methods, studies have not reported on the process through which ethnographic or qualitative findings are incorporated into RCT designs. We conducted a community-based ethnography on social and structural factors that may affect the acceptance of and adherence to oral pre-exposure prophylaxis (PrEP) among Black men who have sex with men (BMSM). We then devised the treatment arm of an adherence clinical trial drawing on findings from the community-based ethnography. This article describes how ethnographic findings informed the RCT and identifies distilled themes and findings that could be included as part of an RCT. The enhanced intervention includes in-person support groups, online support groups, peer navigation, and text message reminders. By describing key process-related facilitators and barriers to conducting meaningful mixed methods research, we provide important insights for the practice of designing clinical trials for 'real-world' community settings. Copyright © 2015 Elsevier Inc. All rights reserved.

Passing the Baton: Community-based ethnography to design a randomized clinical trial on the effectiveness of oral pre-exposure prophylaxis for HIV prevention among Black men who have sex with men

PubMed Central

Garcia, Jonathan; Colson, Paul W.; Parker, Caroline; Hirsch, Jennifer S.

2015-01-01

Although HIV interventions and clinical trials increasingly report the use of mixed methods, studies have not reported on the process through which ethnographic or qualitative findings are incorporated into RCT designs. We conducted a community-based ethnography on social and structural factors that may affect the acceptance of and adherence to oral pre-exposure prophylaxis (PrEP) among Black men who have sex with men (BMSM). We then devised the treatment arm of an adherence clinical trial drawing on findings from the community-based ethnography. This article describes how ethnographic findings informed the RCT and identifies distilled themes and findings that could be included as part of an RCT. The enhanced intervention includes in-person support groups, online support groups, peer navigation, and text message reminders. By describing key process-related facilitators and barriers to conducting meaningful mixed methods research, we provide important insights for the practice of designing clinical trials for ‘real-world’ community settings. PMID:26476286

Ocular abnormalities in congenital Zika syndrome: are the ophthalmoscopic findings "the top of the iceberg"?

PubMed

de Oliveira Dias, João Rafael; Ventura, Camila V; de Paula Freitas, Bruno; Prazeres, Juliana; Ventura, Liana O; Bravo-Filho, Vasco; Aleman, Tomas; Ko, Albert Icksang; Zin, Andréa; Belfort, Rubens; Maia, Mauricio

2018-04-23

Zika virus (ZIKV) is an arbovirus mainly transmitted to humans by mosquitoes from Aedes genus. Other ways of transmission include the perinatal and sexual routes, blood transfusion, and laboratory exposure. Although the first human cases were registered in 1952 in African countries, outbreaks were only reported since 2007, when entire Pacific islands were affected. In March 2015, the first cases of ZIKV acute infection were notified in Brazil and, to date, 48 countries and territories in the Americas have confirmed local mosquito-borne transmission of ZIKV. Until 2015, ZIKV infection was thought to only cause asymptomatic or mild exanthematous febrile infections. However, after explosive ZIKV outbreaks in Polynesia and Latin American countries, it was confirmed that ZIKV could also lead to Guillain-Barré syndrome and congenital birth abnormalities. These abnormalities, which can include neurologic, ophthalmologic, audiologic, and skeletal findings, are now considered congenital Zika syndrome (CZS). Brain abnormalities in CZS include cerebral calcifications, malformations of cortical development, ventriculomegaly, lissencephaly, hypoplasia of the cerebellum and brainstem. The ocular findings, which are present in up to 70% of infants with CZS, include iris coloboma, lens subluxation, cataract, congenital glaucoma, and especially posterior segment findings. Loss of retinal pigment epithelium, the presence of a thin choroid, a perivascular choroidal inflammatory infiltrate, and atrophic changes within the optic nerve were seen in histologic analyses of eyes from deceased fetuses. To date, there is no ZIKV licensed vaccines or antiviral therapies are available for treatment. Preventive measures include individual protection from mosquito bites, control of mosquito populations and the use of barriers measures such as condoms during sexual intercourse or sexual abstinence for couples either at risk or after confirmed infection. A literature review based on studies that analyzed ocular findings in mothers and infants with CZS, with or without microcephaly, was conducted and a theoretical pathophysiologic explanation for ZIKV-ocular abnormalities was formulated. Copyright © 2018. Published by Elsevier Ltd.

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

PubMed Central

2013-01-01

Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words) PMID:23331384

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

PubMed

Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

2013-01-19

Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).

Trends in hypothesis testing and related variables in nursing research: a retrospective exploratory study.

PubMed

Lash, Ayhan Aytekin; Plonczynski, Donna J; Sehdev, Amikar

2011-01-01

To compare the inclusion and the influences of selected variables on hypothesis testing during the 1980s and 1990s. In spite of the emphasis on conducting inquiry consistent with the tenets of logical positivism, there have been no studies investigating the frequency and patterns of hypothesis testing in nursing research The sample was obtained from the journal Nursing Research which was the research journal with the highest circulation during the study period under study. All quantitative studies published during the two decades including briefs and historical studies were included in the analyses A retrospective design was used to select the sample. Five years from the 1980s and 1990s each were randomly selected from the journal, Nursing Research. Of the 582 studies, 517 met inclusion criteria. Findings suggest that there has been a decline in the use of hypothesis testing in the last decades of the 20th century. Further research is needed to identify the factors that influence the conduction of research with hypothesis testing. Hypothesis testing in nursing research showed a steady decline from the 1980s to 1990s. Research purposes of explanation, and prediction/ control increased the likelihood of hypothesis testing. Hypothesis testing strengthens the quality of the quantitative studies, increases the generality of findings and provides dependable knowledge. This is particularly true for quantitative studies that aim to explore, explain and predict/control phenomena and/or test theories. The findings also have implications for doctoral programmes, research preparation of nurse-investigators, and theory testing.

Ultrasonographic evaluation of abdominal distension in 52 camels (Camelus dromedarius).

PubMed

Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

2012-08-01

The purpose of this study was to assess the diagnostic value of ultrasonography in the evaluation of abdominal distension in 52 camels (Camelus dromedarius). The conditions included trypanosomiasis (n=35), intestinal obstruction (n=12) and ruptured urinary bladder (n=5). Fifteen clinically normal camels were included as controls. Transabdominal and transrectal ultrasonography was carried out on all camels. In animals with trypanosomiasis, ultrasonographic findings included accumulation of massive amounts of hypoechoic abdominal fluids where liver, intestine, kidney, spleen and urinary bladder were imaged floating. Except in two cases of bile duct calcification and one of hepatic abscessation, no detectable abnormal sonographic lesions were detected while imaging the hepatic and renal parenchyma, and the heart and its valves and major blood vessels. In camels with intestinal obstruction, ultrasonographic findings included distended intestinal loops with markedly reduced or absent motility. In one camel, the intestinal lumen contained localised hyperechoic material that was consistent with a foreign body. Hypoechoic fluid with or without fibrin was seen between intestinal loops. In camels with ruptured urinary bladder, ultrasonographic findings included collapsed and perforated bladder, echogenic blood clots within the urinary bladder and peritoneal cavity, increased thickness of the bladder wall, floating intestines in hypoechogenic fluid and echogenic calculi within the urethra. Ultrasonography was considered a useful tool for the evaluation of dromedary camels with abdominal distension. Copyright © 2011 Elsevier Ltd. All rights reserved.

Validity of Cognitive Load Measures in Simulation-Based Training: A Systematic Review.

PubMed

Naismith, Laura M; Cavalcanti, Rodrigo B

2015-11-01

Cognitive load theory (CLT) provides a rich framework to inform instructional design. Despite the applicability of CLT to simulation-based medical training, findings from multimedia learning have not been consistently replicated in this context. This lack of transferability may be related to issues in measuring cognitive load (CL) during simulation. The authors conducted a review of CLT studies across simulation training contexts to assess the validity evidence for different CL measures. PRISMA standards were followed. For 48 studies selected from a search of MEDLINE, EMBASE, PsycInfo, CINAHL, and ERIC databases, information was extracted about study aims, methods, validity evidence of measures, and findings. Studies were categorized on the basis of findings and prevalence of validity evidence collected, and statistical comparisons between measurement types and research domains were pursued. CL during simulation training has been measured in diverse populations including medical trainees, pilots, and university students. Most studies (71%; 34) used self-report measures; others included secondary task performance, physiological indices, and observer ratings. Correlations between CL and learning varied from positive to negative. Overall validity evidence for CL measures was low (mean score 1.55/5). Studies reporting greater validity evidence were more likely to report that high CL impaired learning. The authors found evidence that inconsistent correlations between CL and learning may be related to issues of validity in CL measures. Further research would benefit from rigorous documentation of validity and from triangulating measures of CL. This can better inform CLT instructional design for simulation-based medical training.

Representation and treatment allocation of racial groups in dermatologic therapy trials: A 2-year review of the literature.

PubMed

Park, Christina K; Alhusayen, Raed

2018-02-15

Although most investigators would agree that including minority races in clinical trials is important, recruitment and retention may differ among these populations. The objective of this review was to perform an audit of phase III dermatologic therapy trials to determine representation for minority groups and to explore the possibility of racial allocation bias. In this review of 11 dermatology or general medicine journals in 2015-16, we did not find evidence of systemic racial allocation bias. We did however note variation in the proportion of minority races included in studies; whereas some trials had high success in recruiting minorities, many did not. Furthermore, most studies did not provide information on individual racial groups and rather presented an 'other' category. This supports findings from previous reviews of dermatologic therapy trials that suggest that most participants are white, race data are not included for many studies, and there is underrepresentation of some racial groups. We conclude that although there is no evidence of racial allocation bias in the previous two years, there remains a need for standardization in the reporting of racial groups and for increased participant diversity in dermatologic therapy trials.

The association between school-based physical activity, including physical education, and academic performance: a systematic review of the literature.

PubMed

Rasberry, Catherine N; Lee, Sarah M; Robin, Leah; Laris, B A; Russell, Lisa A; Coyle, Karin K; Nihiser, Allison J

2011-06-01

The purpose of this review is to synthesize the scientific literature that has examined the association between school-based physical activity (including physical education) and academic performance (including indicators of cognitive skills and attitudes, academic behaviors, and academic achievement). Relevant research was identified through a search of nine electronic databases using both physical activity and academic-related search terms. Forty-three articles (reporting a total of 50 unique studies) met the inclusion criteria and were read, abstracted, and coded for this synthesis. Findings of the 50 studies were then summarized. Across all the studies, there were a total of 251 associations between physical activity and academic performance, representing measures of academic achievement, academic behavior, and cognitive skills and attitudes. Slightly more than half (50.5%) of all associations examined were positive, 48% were not significant, and 1.5% were negative. Examination of the findings by each physical activity context provides insights regarding specific relationships. Results suggest physical activity is either positively related to academic performance or that there is not a demonstrated relationship between physical activity and academic performance. Results have important implications for both policy and schools. Copyright © 2010 Elsevier Inc. All rights reserved.

Osteonic organization of limb bones in mammals, including humans, and birds: a preliminary study.

PubMed

Castrogiovanni, Paola; Imbesi, Rosa; Fisichella, Marco; Mazzone, Venera

2011-01-01

As it is well known, bone tissue is characterized by a calcified extracellular matrix which makes this tissue suitable to support the body and protect the inner organs. Lamellar bone tissue is organized in lamellae, 3-7 microm in thickness, and arranged concentrically around vascular channels: the basic structure in this type of organization is called Haversian system or osteon and the diameter of osteons depends on the number of lamellae. Shape and regional density of osteons are related to the bone segment and the specific functional requirements to meet. Aim of this study is to correlate the compact bone tissue microstructure in various classes of mammals, including humans, and birds in order to find an adequate identification key. The results of our study show that in bone tissue samples from various classes of mammals, including humans, and birds the osteonic structure shows peculiar features, often depending on the rate of bone remodelling, different in different animal species. We conclude that a careful microscopic analysis of bone tissue and the characterization of distinctive osteonic features could give a major contribution to forensic medicine to obtain a more reliable recognition of bone findings.

Psychophysiological correlates of aggression and violence: an integrative review.

PubMed

Patrick, Christopher J

2008-08-12

This paper reviews existing psychophysiological studies of aggression and violent behaviour including research employing autonomic, electrocortical and neuroimaging measures. Robust physiological correlates of persistent aggressive behaviour evident in this literature include low baseline heart rate, enhanced autonomic reactivity to stressful or aversive stimuli, enhanced EEG slow wave activity, reduced P300 brain potential response and indications from structural and functional neuroimaging studies of dysfunction in frontocortical and limbic brain regions that mediate emotional processing and regulation. The findings are interpreted within a conceptual framework that draws on two integrative models in the literature. The first is a recently developed hierarchical model of impulse control (externalizing) problems, in which various disinhibitory syndromes including aggressive and addictive behaviours of different kinds are seen as arising from common as well as distinctive aetiologic factors. This model represents an approach to organizing these various interrelated phenotypes and investigating their common and distinctive aetiologic substrates. The other is a neurobiological model that posits impairments in affective regulatory circuits in the brain as a key mechanism for impulsive aggressive behaviour. This model provides a perspective for integrating findings from studies employing different measures that have implicated varying brain structures and physiological systems in violent and aggressive behaviour.

Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

PubMed

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2009-03-01

Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

Applicability, limitations and downstream impact of echocardiography utilization based on the Appropriateness Use Criteria for transthoracic and transesophageal echocardiography.

PubMed

Alqarqaz, Mohammad; Koneru, Jayanth; Mahan, Meredith; Ananthasubramaniam, Karthik

2012-12-01

To evaluate impact of echocardiography on patient management based on published transthoracic echocardiography (TTE) Appropriate Use Criteria (AUC). A prospective analysis of 170 consecutive outpatients who underwent TTE over a period of 2 months. Echo studies were classified into appropriate (A), inappropriate (I), or uncertain (U) based on the 2007/2011 AUC. A fourth group of studies which were not addressed by the 2007 AUC and therefore have unclassifiable category (UC) were also included in the analysis. The impact of AUC categorized echo results on patient management were evaluated by review of patient records in the ensuing 2 months. Based on 2007 AUC, 77% (131/170) were A, 9% were I, and 14% were UC category. Echo studies classified as A were more likely to be associated with new and major findings, (P = 0.034) and (P = 0.028) respectively when compared to all other studies. Furthermore, patient care intervention as defined in the study protocol was significantly associated with A studies as opposed to I and UC studies (P = 0.004). A studies were also more likely to have an impact on patient management when compared to other studies (P = 0.022). When studies were re-evaluated based on the 2011 AUC, all prior UC studies were now included in the U group in the new AUC of 2011, and there was no change in A or I study classification. This study demonstrates that the 2007/2011 AUC are helpful in evaluating practice patterns in a majority of outpatients undergoing TTE. Implementing AUC have a direct clinical impact as A studies are significantly more likely to reveal new and major findings, and more likely to result in a patient care intervention based on the echo findings.

A Study of English Language Training for Refugees. Public Report.

ERIC Educational Resources Information Center

Reder, Stephen; And Others

The final report of a study on the impact of English language training on adult Southeast Asian refugees in the United States summarizes the findings of the study's three phases, which include (1) a mail survey of local, regional, and state program administrators; (2) 22 program site visits and four community surveys; and (3) a six-month…

Attitudes towards Teachers' Motivation, and Classroom Strategy, in English Language Classrooms

ERIC Educational Resources Information Center

Pahlavanpoorfard, Samira; Soori, Afshin

2014-01-01

This study aimed at investigating the attitudes of Iranian EFL students towards teachers' motivation and classroom strategy in English classroom. The subjects of the study included a sample of 235 students in their classes. The findings of this study revealed that teachers' motivation and classroom strategy used by teachers have effects on the…

Summer Literacy Intervention for Homeless Children Living in Transitional Housing

ERIC Educational Resources Information Center

Willard, Adrienne Lisa; Kulinna, Pamela Hodges

2012-01-01

This study reports the findings of a six-week summer literacy program conducted at a transitional housing facility for homeless families in the Southwestern region of the U.S. This study is grounded on the body of knowledge on students' literacy and homelessness. The intervention included one-on-one instruction by tutors. This study examined…

Finding Ways to Teach to Students with FASD: A Research Study

ERIC Educational Resources Information Center

Edmonds, Kelly; Crichton, Susan

2008-01-01

This study examines a unique educational program designed for youth with Fetal Alcohol Spectrum Disorder [FASD] in Alberta, Canada. Care was taken to include the participants' voice in this case study resulting in key insights and strategies for working with youth and/or students struggling with FASD. Using observation notes, survey and interview…

The Role of Behavioral Self-Regulation in Learning to Read: A 2-Year Longitudinal Study of Icelandic Preschool Children

ERIC Educational Resources Information Center

Birgisdóttir, Freyja; Gestsdóttir, Steinunn; Thorsdóttir, Fanney

2015-01-01

Research Findings: Research suggests that behavioral self-regulation skills are critical for early school success, including success in literacy, but few studies have explored the relations that behavioral self-regulation may have with different components of early literacy development. The present study investigated the longitudinal contribution…

A Longitudinal Study of Factors Producing High School Dropout among Handicapped and Non-Handicapped Students. Final Report.

ERIC Educational Resources Information Center

Brennan, Tim; Anderson, Frank

This report presents findings from a multi-year project on handicapped and non-handicapped high school dropouts, including a longitudinal study of high school students in five Colorado school districts and a social ecological study to identify community characteristics which predispose a school district to high dropout rates. The longitudinal…

College Student Employment: Patterns and Profiles. Maryland Longitudinal Study Research Highlights. Research Report 7.

ERIC Educational Resources Information Center

Maryland Univ., College Park. Maryland Longitudinal Study Steering Committee.

As part of the Maryland Longitudinal Study of 772 students entering the University of Maryland, College Park (UMCP) in the fall of 1980, a study was conducted to determine patterns of college student employment and profiles of students in different employment categories. Findings included the following: (1) approximately 40% of students were…